Death Anxiety and Clinical Practice

Robert Langs, M.D., is well known as the author of many books on the subject of psychoanalytic psychotherapy, including 'The Technique of Psychoanalytic Psychotherapy' (2 volumes), 'Psychotherapy: A Basic Text' , 'A Primer of Psychotherapy ' and 'Decoding Your Dreams'. He is currently Executive Director at the Program for Psychoanalytic Psychotherapy at the Beth Israel Medical Center, New York; Clinical Professor with the Department of Psychiatry, Mt. Sinai Hospital and School of Medicine, New York; and Visiting Clinical Investigator at the Nathan S. Kline Institute for Psychiatric Research, New York.

'Dr. Robert Langs is well known to mental health professionals. He is a prolific writer, and his contributions have been highly significant. (He) introduces some intriguing ideas concerning psychic structures. He postulates that the deep unconscious has emotional intelligence and a wisdom system. It also has a perpetual system that is involved in subliminal perception, and, according to Dr. Langs, it is very sensitive to frame deviations, which, in turn, are linked to denial. Patients who want to change the conditions of the treatment setting want to be exceptions - a form of denial that death follows life. They are exceptions and not subject to this rule.'I believe that Dr. Langs has presented us with cogent ideas that have to be pursued further if we are to survive as psychoanalysts. There are also moral and philosophical issues as well as clinical ones, but in all instances the question of survival is involved.'- Peter L. Giovacchini, from his Foreword'In this courageous, provocative and important book, Dr. Langs deals in a scholarly and clinical manner with a subject that is in general shunned on our literature related to psychopathology and treatment. Dr. Langs is an esteemed maverick who holds fast to and continues to amplify his theoretical and technical hypothesis, some of which are considered over strict by many today, such as holding fast to the frame during treatment.'He infers that death anxiety is neglected in part because of treatment failures due to countertransference interferences during treatment, and brilliantly discusses the technical issues, whilst also introducing a concept which will be found highly controversial. He discusses immortality and mortality from historical and cultural frames and, additionally, from a neurobiological perspective, eventually hinting that mental activities are derived from immune system reactions. Like the immune system, the mind is more affected by trauma than by teaching; impingements lead to defenses and adaptations which are then stored, reminding us of antigen-antibody responses.'- L. Bryce Boyer M.D.

• Foreword , Death Issues: Basic Perspectives , A ubiquitous but elusive dread , Death themes, manifest and latent , Death anxiety and psychotherapy , Death issues in the clinical situation , Observing and formulating , The emotion-processing mind , Death and the two systems of the mind , Death Issues and the Patient , Death anxiety and the psychotherapy patient , How patients deal with death-related triggers , Selection principles and mental defences , Psychological defences , Communicative defences , The patient, the frame, and issues of death , Death issues and the therapist , Death anxiety and the psychotherapist , How therapists defend against death anxiety , Death anxiety and problems of technique