Psychic Retreats: Pathological Organizations in Psychotic, Neurotic and Borderline Patients

by John Steiner, Roy Schafer (Foreword)

Essentially clinical in its approach, Psychic Retreats discusses the problem of patients who are 'stuck' and with whom it is difficult to make meaningful contact. John Steiner, an experienced psychoanalyst, uses new developments in Kleinian theory to explain how this happens. He examines the way object relationships and defences can be organized into complex structures which lead to a personality and an analysis becoming rigid and stuck, with little opportunity for development or change. These systems of defences are pathological organisations of the John Steiner describes them as 'psychic retreats', into which the patient can withdraw to avoid contact both with the analyst and with reality. To provide a background to these original and controversial concepts, the author builds on more established ideas such as Klein's distinction between the paranoid-schizoid and depressive positions, and briefly reviews previous work on pathological organizations of the personality. He illustrates his discussion with detailed clinical material, with examples of the way psychic retreats operate to provide a respite from both paranoid-schizoid and depressive anxieties. He looks at the way such organizations function as a defence against unbearable guilt and describes the mechanism by which fragmentation of the personality can be reversed so the lost parts of the self can be regained and reintegrated in to the personality. Psychic Retreats is written with the practising psychoanalysts and psychoanalytic psychotherapists in mind. The emphasis is therefore clinical throughout the book, which concludes with a chapter on the technical problems which arise in the treatment of such severely ill patients.

Genres: Psychoanalysis, Psychology, Nonfiction

162 pages, Paperback

First published February 12, 1993

About the author

Librarian Note: There is more than one author in the GoodReads database with this name.

John Steiner is a psychoanalyst. He is considered one of the most interesting theorists for understanding pathological personality structures.

Reviews

[Mohsen · Rating 5 out of 5]

In the beginning pages, I felt so close to what the author's idea of this new position is. It felt like me, in a sense. For long I've known myself to be hiding behind many walls and defences. Not hiding in waiting, no. Hiding for keeping myself safe. The only place which has ever felt safe. So i can say that it's really hard sometimes to come out of this protective shell. And there were times which I've wanted to know what its like to go out, and it was hurtful. And so I retreated more, with wounds to heal. So this book talked to that part of me. That hidden scared child waiting to be known and understood. I really liked it.

[Paul Johnston · Rating 5 out of 5]

This is an excellent book. It contains some theory but has a strong clinical focus. John Steiner writes from a Kleinian perspective, so it is probably helpful to know a bit about Klein before reading it. The book shows how flexible the Kleinian framework is and it is thought-provoking to see it being applied so subtly and sensitively.

[Joanna · Rating 5 out of 5]

I found this book immensely helpful in understanding patients and psychological processes. It is also not too difficult to understand so you don't have to be very advanced in order to read it.

The author further develops Melanie Klein's theory of the two stages of development, adding substages and explaining how we can help patients move from one stage to the next and what that change may look like.

He compares the inner world of severe patients with that of a maffia organisation that controls and grips the patient through seduction and threats of pain and violence, making it more obvious why some patients struggle so much with change.

Towards the end he uses the story of Oedipus to describe two different ways in which patients can deny reality and then reserves a final chapter to explain how different types of relational interpretation can help contain a patients anxiety or help them gain understanding on themselves, and when to best use each of these techniques.

[Sergey Kochergan · Rating 5 out of 5]

Interesting clinical examples with kleinian approach of psychoanalysis.

[Deborah · Rating 5 out of 5]

John Steiner really has an excellent grip on this subject and he has been immensely helpful to me in my work.I met him at a conference on his book in Cambridge a few years ago and thought he was a nice bloke as well. looking forward to the new book seeing and being seen...waiting for it to come through the post.