The challenges and crises that kept resurfacing in Michael and Batya Shoshani’s work with extremely difficult patients hunted by anxieties of being, and in particular with perverse psychic organization, motivated them to write this book. It is an attempt to propose a clinical conceptualisation to enhance their understanding of these lost and confused patients, whose narcissistic struggle against human fate defies reality and truth, challenging the analyst and the analytic situation. Analysts, caught between their own perception of reality and truth and the wish to be empathetic to their patients’ experiences and views of reality, often feel torn and as if standing on quicksand.Here, the authors are joining a contemporary movement in the psychoanalytic tradition whilst turning to other disciplines in order to better understand and explain the suffering of their patients. The use of literature, in particular the fictional works of Jorge Luis Borges; film, with an in-depth look at Roman Polanski’s Bitter Moon (1992) and Denis Villeneuve’s Incendies (2010); and philosophy, the ideas of Heidegger and how they link to those of Freud, coupled together with a solid grasp of psychoanalytic theory, such as reflections on Neville Symington’s seminal theory of narcissism, interspersed with real-life case studies bring the chapters alive. Such interplay between the detailed clinical material and conceptual formulations to an interdisciplinary dialogue enables a different outlook that will enrich the ongoing professional discourse on these perplexing and illusive psychic phenomena.

The challenges and crises that kept resurfacing in Michael and Batya Shoshani’s work with extremely difficult patients hunted by anxieties of being, and in particular with perverse psychic organization, motivated them to write this book. It is an attempt to propose a clinical conceptualisation to enhance their understanding of these lost and confused patients, whose narcissistic struggle against human fate defies reality and truth, challenging the analyst and the analytic situation. Analysts, caught between their own perception of reality and truth and the wish to be empathetic to their patients’ experiences and views of reality, often feel torn and as if standing on quicksand.Here, the authors are joining a contemporary movement in the psychoanalytic tradition whilst turning to other disciplines in order to better understand and explain the suffering of their patients. The use of literature, in particular the fictional works of Jorge Luis Borges; film, with an in-depth look at Roman Polanski’s Bitter Moon (1992) and Denis Villeneuve’s Incendies (2010); and philosophy, the ideas of Heidegger and how they link to those of Freud, coupled together with a solid grasp of psychoanalytic theory, such as reflections on Neville Symington’s seminal theory of narcissism, interspersed with real-life case studies bring the chapters alive. Such interplay between the detailed clinical material and conceptual formulations to an interdisciplinary dialogue enables a different outlook that will enrich the ongoing professional discourse on these perplexing and illusive psychic phenomena.