Narcissistic States and the Therapeutic Process

Sheldon Bach's beautifully written Narcissistic States and the Therapeutic Process presents new understanding and challenges to our hard-won perceptions of the clinical dilemmas entailed in the nearly three decades of Kohut-Kernberg controversies on narcissism. By focusing his primary attention (and ours) on the suffering of narcissistic patients and their special qualities of self-assertion, autonomy, and love, and speaking only secondarily of their more obvious qualities of envy, exploitiveness, rage, and cold indifference, Dr. Bach has found a way to compose these two diverse clinical experiences into a coherent portrait of the narcissistic patient. Thus, Bach is neither Kohutian nor Kernbergian, but something quite his own—an original explorer into the possibilities of psychoanalytic work with narcissistic patients.