The Analyst’s Torment : Unbearable Mental States in Countertransference

A searingly honest book that shifts the emphasis of clinical practice from psychoanalytic theory towards the analyst’s subjectivity. By understanding their own therapeutic motivations, mishaps, and stumbles with patients, analysts can understand what impedes their capacity to face up to their feelings and the impact of this in the therapy room.

Dhwani Shah moves the focus from using psychoanalytic theory and technique to explore the patient’s mind from a safe distance. Instead, he concentrates on the analyst’s feelings, subjective experiences, and histories, and how these impact on the intersubjective space between analyst and patient. His eight chapters each highlight a particular emotional state or problematic feeling and explore their impact on the analytic work, which requires emotional honesty and open reflection. This authenticity is vital for every unique encounter within the shared space of both the analyst and patient. The analyst must strive to be responsive, yet disciplined, and this requires the work of mentalization. An ability to “go there” with patients offers the best chance at helping them. The analyst’s uncomfortable and disowned emotional states of mind are inevitably entangled with the therapeutic process and this has the potential to derail or facilitate progress. The chapters deal with uncomfortable themes for the analyst to face: arrogance, racism, dread and its close relation erotic dread, dissociation, shame, hopelessness, and jealousy. These bring up common ways in which analysts stop listening and struggle in the face of uncertainty and intensity; the difficulties in facing unbearable experiences with patients, such as suicidality; disruptions to being with patients in an affective and embodied way; and thwarted fantasies of being the “hero”. With all of these difficult topics, Shah describes painful and tormenting experiences in a clinically meaningful way that allow growth. In this exceptional debut work, Shah demonstrates that what analysts feel, in their affects, bodies, and reveries with patients, is vital in helping them to understand and metabolise the patients’ emotional experiences. This is a must-read for all practising clinicians.