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Skolnikoff, A.Z. (1993). The Skin Ego: By Didier Anzieu. New Haven, CT: Yale Univ. Press, 1989, 246 pp., $30.00.. J. Amer. Psychoanal. Assn., 41:244-247.

(1993). Journal of the American Psychoanalytic Association, 41:244-247

The Skin Ego: By Didier Anzieu. New Haven, CT: Yale Univ. Press, 1989, 246 pp., $30.00.

Review by:
Alan Z. Skolnikoff, M.D.

This is a remarkable work from several perspectives. Metapsychologically, it returns to the concept of the body ego and the topographic model, showing how the concrete concept of skin can be imagined to separate, bind, and layer various parts of the mental apparatus: conscious, preconscious, and perception. These three regions of the mind apply to the layers of the skin. What it contains or separates can be designated as various levels of consciousness. The concept of envelope or container relates to the different layers of the skin or the body image. The author relates the actual layers of the skin to the body ego. Here, the skin's capacity to contain is related to the idea of the skin ego containing contents of the unconscious. Anzieu sees problems or defects in the skin ego relating to predominantly borderline and narcissistic conditions. But he also sees all analyses as encompassing both oedipal and narcissistic issues. He puts himself among those analysts who do not clearly differentiate between patients who present with predominantly preoedipal or oedipal issues. Here he is most imaginative as he develops the multiplicity of modes involved or connected with touching. Concepts such as the auditory, tactile, and olfactory envelope are all clinically based, but connected with metaphors of the function of the skin. In actual clinical treatment, he finds the use of his voice fulfilling touching or attachment functions. He often prefers vis-à-vis treatment instead of the couch, to ensure that the "visual envelope" contains the patient's anxiety.

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