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Bauer, S.F. (1992). Impasse and Interpretation: Therapeutic and Anti-Therapeutic Factors in the Psychoanalytic Treatment of Psychotic, Borderline, and Neurotic Patients by Herbert Rosenfeld New Library of Psychoanalysis. London: Tavistock, 1987, vii + 324 pp., $35.00. Psa. Books, 3(1):64-71.

(1992). Psychoanalytic Books, 3(1):64-71

Impasse and Interpretation: Therapeutic and Anti-Therapeutic Factors in the Psychoanalytic Treatment of Psychotic, Borderline, and Neurotic Patients by Herbert Rosenfeld New Library of Psychoanalysis. London: Tavistock, 1987, vii + 324 pp., $35.00

Review by:
Stephen F. Bauer, M.D.

Herbert Rosenfeld devoted most of his professional career to the study and treatment of severely ill patients, especially patients with psychoses. This last book is his final statement about the subject.

In 1947 Rosenfeld presented a paper, applying Melanie Klein's ideas to the treatment of psychosis, in which the analysis of infantile object relations and mechanisms enacted in a transference psychosis took on central significance. Almost every year since that first publication has seen one or more papers extending those initial insights and emphasizing the importance of the analysis of psychotic transference phenomena in the psychoanalytic treatment of psychosis.

As might be expected, the clinical observations stemming from the treatment of psychoses were paralleled by contributions to the understanding of narcissism. The idea of “narcissistic omnipotent object relations” was introduced in 1963, and the related theory of “destructive narcissism” in 1971. Omnipotence as a defense is a core concept in much of Rosenfeld's writing. Also central to many of his discussions, theoretical and clinical, and pivotal in this book is the elucidation and explication of projective identification in the clinical encounter between patient and analyst and its role in applying understandings gleaned from the analyst's countertransference to his transference interpretations.

When a book sums up a life work, as this one does, it tends to call forth special interest and attention. This book does not disappoint.

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