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The dramatic and provocative title of this book might lead the reader to expect a theoretical exposition on technique that falls under the rubric of wild analysis. Instead, Roy Mendelsohn presents a thoughtful exploration of therapy with difficult, often severely regressed patients who have suffered pre-verbal trauma. Their limited ability for symbolic communication makes these patients frequently unable to respond to verbal interpretation. To understand them the author integrates observations drawn from his own work with the ideas of Winnicott, Fairbairn, Bion, Tustin, and Wolf. Developmental deficits are seen as the primary cause of pathology in these hard-to-reach patients.
In 1953, Eissler proposed that psychoanalysts use parameters in the treatment of patients whose ego deficits did not allow interpretation to be the sole instrument of care. He cautioned that these modifications should only be thought of as temporary, would need to be interpreted eventually, and given up in later stages of treatment. Eissler warned that parameters could not always be undone, and if the conditions necessary for psychoanalytic treatment did not resume, there would be a limit on what could be accomplished.