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In spite of this book presenting, in my view, some rather questionable theorizing on creativity, phallicity as just a defensive structure and more topics to be mentioned, I find it a valuable contribution in many respects, especially because of the author's deep involvement and understanding of this often tabooed topic. It is a book of about 250 pages divided into five parts. The first part is about the typical process of the dying patient put in relation to loss, looked upon from an “ego-psychological” point of view and studied during psychotherapy with five dying patients, and through an analysis of the poetry and biography of a Swedish-speaking, Finnish poetess. This chapter is co-authored with the Finnish psychoanalyst, Mikael Enckell. The second part is a psychoanalytic study of narcissism, phallic defence and creativity in connection with mourning. The third part is a study of psychotherapy, bordering on psychoanalysis of three dying patients. The fourth and fifth parts include a summary and general discussion, and some viewpoints on the psychoanalytic study of dying.
I find parts one and three the most valuable ones, because they add some important knowledge gained from actual work with dying patients, whereas the other parts put forward speculations, without much substantiation, which I think almost overthrow some basic psychoanalytic knowledge.
To begin with the valuable contributions, I would like to give a condensed presentation of Part One. The author believes that the dying patient goes through a typical development which can stop at any level, depending on the personality structure of the patient, the circumstances around his dying, among which are the diagnosis, his knowledge of it and how he is taken care of, not least by a therapist, if there is any. This typical development is best illustrated by the author's own figure.