Between Unknown Change and Familiar Retreat

Book excerpt: The theme of Dr. Robert Waska’s new book involves how all patients, whether neurotic, borderline, or psychotic, want their problems to ease and their stress to stop but unconsciously they avoid any real psychological change. They strive to maintain their psychic equilibrium regardless of how destructive it may be, in an effort to avoid the loss of what is known and to avoid the unknown pain or punishment that change might bring. Each chapter provides the reader with a contemporary Kleinian focus on central theoretical and clinical concepts such as projective identification, enactment, transference, pathological organizations, and depressive or paranoid acting out. The reader then is shown the careful and thoughtful interpretive work necessary in these complex clinical situations.