The Danger of Change : The Kleinian Approach with Patients Who Experience Progress as Trauma book cover
1st Edition

The Danger of Change
The Kleinian Approach with Patients Who Experience Progress as Trauma

ISBN 9780415385855
Published April 19, 2006 by Routledge
272 Pages

SAVE ~ $10.59
was $52.95
USD $42.36

Prices & shipping based on shipping country


Book Description

Confusing clinical standoffs, loyalty to self-destruction and abrupt terminations are challenging and under-examined problems for the modern psychoanalytic practitioner. The Danger of Change is a timely book that addresses the so-called resistant patient so many clinicians are familiar with.

Robert Waska blends theory based on Melanie Klein’s classical stance with the more contemporary Freudian/Kleinian school, to demonstrate how to understand patients that are resistant to progress. Divided into four sections, this book covers:

  • reluctant patients and the fight against change: caught between the paranoid and depressive world
  • greed and the dangers of change
  • interruptions to the process of change: loss, envy, and the death instinct
  • working toward change in the face of overwhelming odds

Extensive and detailed clinical material is used to bring clarity to subjects including symbolism, conflict resolution, projective identification, the depressive and paranoid positions, change and trust.

The Danger of Change brings hope and clarity to cases involving patients who experience progress as a threat to their emotional wellbeing. It will be of great interest to all practising psychoanalysts, as well as those studying psychoanalytic theory and practice.

Table of Contents

Introduction. Acknowledgments. Part I: Reluctant Patients and the Fight Against Change: Caught Between the Paranoid and Depressive World. I Hear You Knocking But You Can't Come In. Mistrust of the Good Object. Fighting Off the Good Object. Problems in Receiving. Part II: Greed and the Dangers of Change. Melanie Klein's Theory of Greed. The Frightening Rumble of Psychic Hunger. The Impossible Dream. Greed, Idealization, and Insatiability. Setting the Bar Too High. Part III: Interruptions to the Process of Change: Loss, Envy, and the Death Instinct. The Clinical Advantage of the Death Instinct. Acting Out and the Death Instinct. Borderline and Psychotic Patients. Oral Deprivation, Envy, and Sadism. Part IV: Working Toward Change in the Face of Overwhelming Odds. A Case Study of Borderline Anxiety, Bargains, Treaties, and Delusions. Symbolization and the Good Object. Summary.

View More



Robert Waska is a Psychoanalyst and Psychoanalytic Psychotherapist in private practice in San Francisco and Marin County.  He is author of several books, including Projective Identification in the Clinical Setting and Real People, Real Problems, Real Solutions.


"...I have found this book to be immensely interesting and informative... It explains much of what we see in our consultation rooms and why a group of individuals leaves prematurely and angrily. The concepts Waska utilizes and explains can provide us insight into how to better work with this challenging group of individuals." - Charles Most, Psychologist-Psychoanalyst, APA Division 39 Newsletter, Winter Issue 2009