Understanding and Treating Patients in Clinical Psychoanalysis: Lessons from Literature, 1st Edition (Paperback) book cover

Understanding and Treating Patients in Clinical Psychoanalysis

Lessons from Literature, 1st Edition

By Sandra Buechler


140 pages

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Understanding and Treating Patients in Clinical Psychoanalysis: Lessons from Literature describes the problematic ways people learn to cope with life’s fundamental challenges, such as maintaining self-esteem, bearing loss, and growing old. People tend to deal with the challenges of being human in characteristic, repetitive ways. Descriptions of these patterns in diagnostic terms can be at best dry, and at worst confusing, especially for those starting training in any of the clinical disciplines. To try to appeal to a wider audience, this book illustrates each coping pattern using vivid, compelling fiction whose characters express their dilemmas in easily accessible, evocative language. Sandra Buechler uses these examples to show some of the ways we complicate our lives and, through reimagining different scenarios for these characters, she illustrates how clients can achieve greater emotional health and live their lives more productively.

Drawing on the work of Dostoevsky, Tolstoy, Munro, Mann, James, O’Connor, Chopin, McCullers, Carver, and the many other authors represented here, Buechler shows how their keen observational short fiction portrays self-hurtful styles of living. Sheexplores how human beings cope using schizoid, paranoid, grandiose, hysteric, obsessive, and other defensive styles. Each is costly, in many senses, and each limits the possibility for happiness and fulfillment.

Understanding and Treating Patients in Clinical Psychoanalysis offers insights into what living with and working with problematic behaviors really means through a series of examples of the major personality disorders as portrayed in literature. Through these fictitious examples, clinicians and trainees, and undergraduate and graduate students can gain a greater understanding of how someone becomes paranoid, schizoid, narcissistic, obsessive, or depressive, and how that affects them, and those around them, including the mental health professionals who work with them.


"In her latest book, Understanding and Treating Patients in Clinical Psychoanalysis: Lessons from Literature, Sandra Buechler summarizes and quotes from a myriad of the best works of fiction that depict the ways people address the challenge of being a person. The book stands out for its originality and vivid, creative style. It really is a double pleasure to read, firstly for the author's deft summaries of the stories, followed by her marvelously insightful comments and interpretations. Her choice of fictional works is every book lover's dream and she uses each one to narrate and share some important psychoanalytic concepts in a fresh and engaging way. To me, it is almost as though each illustrative story were a musical note added to the score of a symphony, with, of course, Sandra Buechler as its composer. What a masterpiece she has created. I enjoyed this book immensely and cannot recommend it highly enough."—Antonino Ferro, President of the Italian Psychoanalytic Society

"Sandra Buechler continues in the spirit that Freud initiated over one hundred years ago. She uses vivid, compelling short fiction to udnerstand the repetitive ways human beings engage in self-defeating patterns. She, too, believes that good literature can offer a clinician considerable insight into the problems of his or her patients. […] [Short] stories can be read within a week, making them ideal for teaching. […] [She] aims at getting at the heart of what it means to suffer. […] This effort is about patients in their full, complex humanity rather than as simple diagnostic codes. […] We learn from her that good fiction can organize our understanding, perhaps not unlike what a good therapist does. Without reducing her argument to analyzable abstractions, Buechler expands the outer limits of our knowing and our imagining." --Spyros D. Orfanos, PsyCRITIQUES, October 2015

Table of Contents

Introduction: Characters in Fiction as Templates for Clinical Assessment and Treatment, 1. Schizoid Relating, 2. Paranoid Processing, 3. Humiliated Suffering, 4. Grandiose Posturing, 5. Hysterical Bargaining, 6. Obsessive, Controlling, 7. Anguished Grieving, 8. Depressive Self-Harming, 9. Generative Aging.

About the Author

Sandra Buechler is a training and supervising analyst at the William Alanson White Institute. She is also a supervisor at Columbia Presbyterian Hospital’s internship and postdoctoral programs, and a supervisor at the Institute for Contemporary Psychotherapy. Her publications include Clinical Values: Emotions that Guide Psychoanalytic Treatment (Routledge, 2004), Making a Difference in Patients’ Lives: Emotional Experience in the Therapeutic Setting (Routledge, 2008), and Still Practicing: The Heartaches and Joys of a Clinical Career (Routledge, 2012).

About the Series

Psychoanalysis in a New Key Book Series

When music is played in a new key, the melody does not change, but the notes that make up the composition do: change in the context of continuity, continuity that perseveres through change. Psychoanalysis in a New Key publishes books that share the aims psychoanalysts have always had, but that approach them differently. The books in the series are not expected to advance any particular theoretical agenda, although to this date most have been written by analysts from the Interpersonal and Relational orientations.

The most important contribution of a psychoanalytic book is the communication of something that nudges the reader’s grasp of clinical theory and practice in an unexpected direction. Psychoanalysis in a New Key creates a deliberate focus on innovative and unsettling clinical thinking. Because that kind of thinking is encouraged by exploration of the sometimes surprising contributions to psychoanalysis of ideas and findings from other fields, Psychoanalysis in a New Key particularly encourages interdisciplinary studies. Books in the series have married psychoanalysis with dissociation, trauma theory, sociology, and criminology. The series is open to the consideration of studies examining the relationship between psychoanalysis and any other field – for instance, biology, literary and art criticism, philosophy, systems theory, anthropology, and political theory.

But innovation also takes place within the boundaries of psychoanalysis, and Psychoanalysis in a New Key therefore also presents work that reformulates thought and practice without leaving the precincts of the field. Books in the series focus, for example, on the significance of personal values in psychoanalytic practice, on the complex interrelationship between the analyst’s clinical work and personal life, on the consequences for the clinical situation when patient and analyst are from different cultures, and on the need for psychoanalysts to accept the degree to which they knowingly satisfy their own wishes during treatment hours, often to the patient’s detriment.

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Subject Categories

BISAC Subject Codes/Headings:
PSYCHOLOGY / Movements / Psychoanalysis