It is clinical work with the most difficult patients - those with severe narcissistic, sadomasochistic, and borderline disorders - that poses the greatest challenge to the therapist's guiding assumptions about clinical process; indeed, such work often leads therapists to question beliefs and expectations that formerly seemed self-evident. In Getting From Here to There: Analytic Love, Analytic Process, Sheldon Bach elaborates the holistic vision that guides him in work with just such patients. He dwells especially on the "attentive presence" through which the analyst effects a "meeting" with patients that invites the latter's trust in the analyst and in the therapeutic process. And he writes of love - of patient for analyst and of analyst for patient - that grows out of this mutual trust and sustains therapeutic process. For Bach, analytic therapy aims at understanding the person as a mind-body unity that manifests particular states of consciousness. This holistic vision of treatment sustains a flexible clinical orientation that enables the analyst to "meet" states of consciousness in order to bring them into a system of which the analyst forms a part. Bach thoughtfully explores the clinical issues that enter into this taxing process, among them the establishment and maintenence of basic trust; the patient's or the therapist's presence in the other's mind; and the shifts in agency between patient and therapist. And he describes at length the frequently exhausting, even demoralizing, transference-countertransference struggles that enter into this type of analytic work. Throughout, Bach is guided by the conviction that work with extremely challenging patients promotes the psychological growth and increased self-knowledge of patient and analyst alike. And he is admirably clear that the "mutual living through" of such treatments nurtures a kind of love between patient and analyst. Getting From Here to There not only records the clinical lessons learned by an unusually gifted analyst; it also chronicles the movement of psychoanalysis itself from the dissection of love into component parts to a synthetic grasp of its vital role in psychoanalytically informed treatment.

This is a book that grew out of the many practical "how-to" questions that the author's psychotherapy students have asked him over the years. It is neither an evidence-based compendium nor an attempt to summarize general practice or the viewpoints of others, but rather a handbook of practical answers to many of the questions that may puzzle student

It is clinical work with the most difficult patients - those with severe narcissistic, sadomasochistic, and borderline disorders - that poses the greatest challenge to the therapist's guiding assumptions about clinical process; indeed, such work often leads therapists to question beliefs and expectations that formerly seemed self-evident. In Getting From Here to There: Analytic Love, Analytic Process, Sheldon Bach elaborates the holistic vision that guides him in work with just such patients. He dwells especially on the "attentive presence" through which the analyst effects a "meeting" with patients that invites the latter's trust in the analyst and in the therapeutic process. And he writes of love - of patient for analyst and of analyst for patient - that grows out of this mutual trust and sustains therapeutic process. For Bach, analytic therapy aims at understanding the person as a mind-body unity that manifests particular states of consciousness. This holistic vision of treatment sustains a flexible clinical orientation that enables the analyst to "meet" states of consciousness in order to bring them into a system of which the analyst forms a part. Bach thoughtfully explores the clinical issues that enter into this taxing process, among them the establishment and maintenence of basic trust; the patient's or the therapist's presence in the other's mind; and the shifts in agency between patient and therapist. And he describes at length the frequently exhausting, even demoralizing, transference-countertransference struggles that enter into this type of analytic work. Throughout, Bach is guided by the conviction that work with extremely challenging patients promotes the psychological growth and increased self-knowledge of patient and analyst alike. And he is admirably clear that the "mutual living through" of such treatments nurtures a kind of love between patient and analyst. Getting From Here to There not only records the clinical lessons learned by an unusually gifted analyst; it also chronicles the movement of psychoanalysis itself from the dissection of love into component parts to a synthetic grasp of its vital role in psychoanalytically informed treatment.

From long before the Trojan War to the ethnic cleansings of our own century, people have often used their potential to treat other human beings as things. It is this treatment of another person as a thing rather than as a human being that the eminent psychoanalyst, Dr. Sheldon Bach, sees as a perversion of object relationships and that forms the background of this powerful book. Perversion is a lack of capacity for whole object love, and while this includes the sexual perversions it also includes certain character perversions, character disorders and psychotic conditions. Dr. Bach's clinical work has led him to conclude that sexual perversions are generally inconsistent with whole object love. Therapeutic experience suggests that the pathways to object love may be strewn with outgrown and discarded sexual perversions. But whether a sexual perversion per se exists or not, the issue of how it happens that one person can degrade another to the status of a thing is an issue of importance not only for the psychoanalysis of character but for our larger understanding of human nature as well. Perversions are attempts to simplistically resolve or defend against some of the central paradoxes of human existence. How is it possible for us to be born of someone's flesh yet be separate from them, or to live in one's own experience yet observe oneself from the outside? How are we able to deal with feelings of being both male and female, child and adult, or to negotiate between the worlds of internal and external stimulation? People with perversions have special difficulty in dealing with the ambiguity of human relationships. They have not developed the transitional psychic space that would allow them to contain paradox, making it difficult for them to recognize the reality and legitimacy of multiple points of view. Thus they tend to think in either/or dichotomies, to search for dominant/submissive relationships and to perceive the world from idiosyncratically subjective or coldly objective perspectives. In this

This is a book that grew out of the many practical "how-to" questions that the author's psychotherapy students have asked him over the years. It is neither an evidence-based compendium nor an attempt to summarize general practice or the viewpoints of others, but rather a handbook of practical answers to many of the questions that may puzzle students of psychotherapy and psychoanalysis. Some of the short chapters include: How to choose a personal psychoanalyst. How to do an initial interview. How to listen to a patient. How to recognize and understand self-states, multiple identities, true and false selves, etc. How to tell what the transference is. How to deal with the sadomasochistic transference. How to understand the need for recognition. How to think about analytic processHow to practice holistic healing. How to refer a patient for medication. How to get paid for your work. How to manage vacations, weekends, illnesses, no-shows and other disturbances of continuity.

Dr. Bach composes diverse clinical experiences into a coherent portrait of the narcissitic patients.