A framework for the imaginary

Judith Mitrani's collection of eleven essays follows a psychoanalyst as she tries to take in the intense impressions her patients bring from their rawest, least-processed experiences, which surface through the feelings passing between analyst and patient. She works to sense and endure these states, to transform them in her own mind, and then to put into words, together with the patient, what they might mean. Those early experiences return inside the therapy room as lived re-enactments. Her clinical reflections add to British and American object relations theory and to the theory of analytic technique.

Four of the essays appear in print for the first time. Mitrani draws on Melanie Klein, Donald Winnicott, Wilfred Bion and Frances Tustin, bringing their ideas into conversation as she explores primitive emotional terrain. A central concern is why patients adopt certain pathological strategies when faced with anxieties they cannot think about, and how those strategies serve to protect them.

Through detailed accounts of many clinical cases, the book shows practical methods for converting unmentalized experience into thought within the therapeutic relationship. Mitrani also points out the hazards a clinician may meet along the way.