Psychotherapy and psychoanalysis don't always work. Inevitably, a therapy or analysis may fail to alleviate the suffering of the patient. The reasons why this occurs are as manifold as the patients and analysts themselves, and oftentimes are a source of frustration and vexation to clinicians, who aren't always eager to discuss them. Taking the challenge head-on, Arnold Goldberg proposes to demystify failure in an effort to determine its essential meaning before determining its causes. Utilizing multiple vignettes of failed cases, he offers a deconstruction and a subsequent taxonomy of failure, delineating cases that go bad after six months from cases that never get off the ground, mismatches from impasses, failures of empathy from failures of inattention. Commonalities in the experience of failure – conceived as less a misapplication of technique than consequences of a co-constructed yet fraught therapeutic relationship – begin to emerge for scrutiny.
Table of Contents
Introducing Failure. The Failure Project. Facing Failure. Dismissing Failure. Deconstructing Failure. A Taxonomy of Failure. Failure to Launch. Interruptions, Interferences, and Bad Endings. On Losing One's Patients. Analyzability and Failure. How Does Analysis Fail? Me and Max: A Misalliance of Goals. Empathy and Failure. Rethinking Empathy. Self Psychology and Failure. The Future for Failure.
Arnold Goldberg, M.D., is a Training and Supervising Analyst at the Chicago Institute for Psychoanalysis, where he was the Director from 1989-1992, and the Cynthia Oudejans Harris Professor of Psychiatry at Rush Medical College. The author of numerous articles and reviews, he was the editor of The Annual of Psychoanalysis from 1988-1991 and Progress in Self Psychology from 1985-2002, and has written or edited 30 books. He was the recipient of the Sigourney Award in 2006 for distinguished contributions in the field of psychoanalysis.
"Arnold Goldberg has succeeded in writing an illuminating account of a study of a very difficult subject: failure. Its organizing principle is that everything matters. It is beautifully written, philosophically sophisticated, and clinically wise. He confronts the unpleasant and the uncomfortable head-on and demands honesty of himself and all the participants in the study. This book is essential reading for every psychotherapist and psychoanalyst. It deserves a place chairside of the novitiate as well as the most experienced practitioner." - Arnold Richards, M.D., Training and Supervising Analyst, New York Psychoanalytic Institute
"Arnold Goldberg concludes this absorbing new volume on analytic and therapeutic failures by declaring that the book itself is a failure. After all, there is no agreed upon definition of failure or success, so how can one judge which treatments are disappointing? I came to a different conclusion than Goldberg's—I found this exploration of treatment failures to be an impressive success. By entering this heart of darkness, the graveyard of analytic casualties where no clinician really wants to go, the author guides us through the major controversies within psychoanalysis today: the challenge of comparing one approach to another, the disparity between therapist and patient goals, the privileging of theory over outcome, and the impossibility of reaching consensus on what constitutes a success. I found this a riveting discourse on the state of contemporary psychoanalysis, and I recommend it equally to neophytes in the field and to experienced psychoanalysts." - Glen O. Gabbard, M.D., author, Love and Hate in the Analytic Setting (2000)
"A pioneer can extend a clearing in a forest only by working at the edge of darkness. Beware this book for it will make you think, and think about the dark edges of clinical experience, those places not lit by the flickering light of overgrown theories and those times when analytic inquiry fails. In this essential and liberating work, Goldberg, with his characteristic incisiveness and clarity, demonstrates how relentless inquiry into its clinical dark side can rekindle analytic enlightenment. As analytic work can help an individual overcome the constriction of hidden fears, Goldberg provides a model, one replete with many clinical examples, of how uncompromising examination of failures can help the field of analysis itself grow. Goldberg shows how analysis can restore its progress beyond parochial polemics, how through exploration of its own disappointing experiences it can know its limits and thus better know its strengths. Here be not dragons; here promise lies." - Warren S. Poland, M.D., author, Melting the Darkness (1996)
"The book does offer a valuable addition to the currently available literature on analytic failure, and it has the considerable virtue of attempting to normalize failure and to situate it as a proper and necessary focus of analytic inquiry. It clarifies the nature of analytic goals, and usefully deconstructs those that are unrealistic and grandiose...The book is a welcome addition to the literature on analytic failure, and it will undoubtedly spur further thinking and discussion among its readers." - Steven H. Goldberg, Journal of the American Psychoanalytic Association (2013)
"What I found... was a tremendous effort for balance, openness, and dialogue about the very polariy of success/failure, and the multiplicity of angles on how such judgments can be framed... [He] is in a position to be extremely empathic with failures of clinicians of all stripes, and one of the clearest take-home messages that pervades this book is a call for clinicians of varying treatment models--from psychopharmacologists to cognitive behaviorists to psychoanalysts from the growing number of theoretical schools--to engage in dialogue about what kinds of cases we succeed with and what we know about where we fail... [The] book succeeds in this complex task." - Sarah Ackerman, Psychoanalytic Quarterly (2013)