Narcissistic States and the Therapeutic Process

Louise Kaplan

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.

Arlene Kramer Richards

Narcissistic States and the Therapeutic Process is a rare book. It is lively and interesting, lucid, and yet profound. It succeeds where many other recent attempts to provide new insight about narcissistically vulnerable patients have failed. It offers a framework for understanding the sicker patient without resorting to cumbersome theoretical constructs of simplistic formulas or contrived developmental narratives. The patients' words and the analyst's responses remain always in focus.

Fred Pine

This is a richly colored tapestry woven by a gifted clinician who offers us his unique contribution to description, understanding, and technical approaches to problems in the narcissistic domain. By steadfastly not getting caught up in ideological battles, instead building on the harmonies underlying them, Dr. Bach shows us in rich clinical detail the 'other worlds' that can be discerned as we truly listen to our patients in open-ended ways.