Steiner utilises Kleinian theory to analyse those patients who have
organised object relationships and defences into complex, rigid internal struc-
tures. Using clinical examples he examines these psychotic organisations and
suggests a therapy.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 personality: 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.
