On Bearing Unbearable States of Mind: 1st Edition (Paperback) book cover

On Bearing Unbearable States of Mind

1st Edition

By Ruth Riesenberg-Malcolm

Edited by Priscilla Roth


216 pages

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This is a problem almost all practising psychoanalysts will face at some time in their career, yet there is very little in the existing literature which offers guidance in this important area.

On Bearing Unbearable States of Mind provides clear guidance on how the analyst can encourage the patient to communicate the quality of their often intolerably painful states of mind, and how he/she can interpret these states, using them as a basis for insight and psychic change in the patient. Employing extensive and detailed clinical examples, and addressing important areas of Kleinian theory, the author examines the problems that underlie severe pathology, and shows how meaningful analytic work can take place, even with very disturbed patients.

On Bearing Unbearable States of Mind will be a useful and practical guide for psychoanalysts and psychotherapists, and all those working in psychological settings with severely disturbed patients.


I was most struck by the details of her clinical work with the array of patients that constitutes an analyst's practice. Firmly based in Kleinian theory and technique, Riesenberg-Malcolm shows sensitivity in working closely with the clinical material of patients who represent the severe psychopathologies. Her elaborate descriptions of clinical material, startin in the first paper in the collection, on "The Mirror", allow readers to immerse themselves within the deeply disturbing world of perversion and borderline-psychotic states. Even from a differing clinical vantage point one can follow her clinical logic through the evolution of her interpretations. Excellent case descriptions permit us to form our own ideas about etiology and clinical intervention, a possibility not always afforded readers when briefer vignettes are provided. - Abbot A.Bronstein, IJPA 83 (1), 2002

'…a remarkable series of papers, noteworthy for their clarity on what many analysts are concerned with today: the complex issue of the positions of mutual influence in the consulting-room - the ways in which the patient through projective identification exerts a subtle pressure on the analyst to recreate early object relations and the manner in which the analyst as a recipient of these projections is inevitably drawn into this in some way, and under these pressures is 'recruited' to enact something of the patient's disturbing primitive object relations. …Therapists will be richly rewarded by the thoughtful and detailed descriptions of analytic work with patients who often seem unreachable. I believe they will find their clinical thinking deepened and challenged by this book.' - Erika Bard, Member of the British Psychoanalytical Society.

Table of Contents

Roth, General Introduction. Part I: The Internal World in the Transference. Roth, Introduction. The Mirror: A Perverse Sexual Phantasy Seen in a Woman as a Defence Against Psychotic Breakdown. Interpretation: The Past in the Present. The Constitution and Operation of the Superego. Construction as Reliving History. Part II: Defences Against Anxieties of the Depressive Position. Roth, Introduction. Self-punishment as Defence. Technical Problems in the Analysis of a Pseudo-compliant Patient. As-if: The Phenomenon of Not Learning. Hyperbole in Hysteria: 'How Can We Know the Dancer from the Dance.' Pain, Sorrow and Resolution. Part III: Theoretical Refinements. Roth, Introduction. The Three W's: What, Where and When: The Rationale of Interpretation. Conceptualisation of Clinical Facts in the Analytic Process.

About the Series

The New Library of Psychoanalysis

The New Library of Psychoanalysis is published by Routledge Mental Health in association with the Institute of Psychoanalysis, London.

Its purpose is to facilitate a greater and more widespread appreciation of psychoanalysis and to provide a forum for increasing mutual understanding between psychoanalysts and those in other disciplines. The series also aims to make some of the work of continental and other non-English speaking analysts more readily available to English-speaking readers, and to increase the interchange of ideas between British and American analysts.

The New Library of Psychoanalysis published its first book in 1987 under the editorship of David Tuckett, later followed by Elizabeth Bott Spillius, Susan Budd and Dana Birksted-Breen. A considerable number of Associate Editors and readers have assisted the editors.

Under the guidance of Foreign Rights Editors, a considerable number of the New Library books have been published abroad, particularly in Brazil, Germany, France, Italy, Peru, Spain and Japan.

The aim of the New Library of Psychoanalysis is to maintain the high level of scholarship of the previous series, to provide a forum for increasing understanding between psychoanalysis and other disciplines and to increase the interest of the general book-reading public in psychoanalysis.

The New Library of Psychoanalysis also aims to help the various schools of psychoanalysis to better understand each other. It has published books representing all three schools of thought in British psychoanalysis, including a particularly important work edited by Pearl King and Riccardo Steiner, expounding the intellectual and organisational controversies that developed in the British psychoanalytical Society between Kleinian, Viennese and 'middle group' analysts during the Second World War.

The New Library of Psychoanalysis has also translated and published several books by Continental psychoanalysts, and it plans in the future to continue the policy of publishing books that express as clearly as possible a variety of psychoanalytic points of view.

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Subject Categories

BISAC Subject Codes/Headings:
PSYCHOLOGY / Mental Health