Inner Torment - by Salman Akhtar (Hardcover)

About the Book

Can hope be pathological? What is love? How are envy and arrogance related to hatred? What is the optimal distance between the self and others? Why are some individuals excessively vulnerable to nostalgia? What are the distinctions between a need and a wish? Integrating divers...

Book Synopsis

Can hope be pathological? What is love? How are envy and arrogance related to hatred? What is the optimal distance between the self and others? Why are some individuals excessively vulnerable to nostalgia? What are the distinctions between a need and a wish?

Such questions frequently arise as one encounters individuals whose difficulties originate from an area between psychotic and neurotic organizations and yet who are not overtly borderline. These patients seem to be living between conflict and fragmentation. Working with them. poses many technical challenges. How does one meet their ego needs without gratifying their regressive wishes? Do affirmative interventions work better than interpretive ones when the patient is in deep emotional turmoil? What is the role of the patient's nonverbal communications? What are developmental interventions? How does one manage the countertransference risks inherent in treating such patients?

Integrating diverse psychoanalytic traditions with his own theoretical and, clinical insights, Salman Akhtar provides answers to these and other important questions in this realm. He weaves the existing conceptual schisms and technical diversity into an integrated theory and technique. In a truly original contribution, he delineates certain ubiquitous human fantasies (e.g., "someday" and "if only" fantasies of optimism and nostalgia, and fantasies of powerful psychic tethers that bind us to others) and shows how their pathological variants underlie the suffering of these patients. Akhtar's book is full of poignant clinical vignettes that clearly illustrate his technical interventions.

Review Quotes

"At a scientific level, Akhtar explains the complexities underlying the human emotions of love, hate, hope, nostalgia, envy, and arrogance. At a poetic level, he relates these emotions to our day-to-day life in a clear and stimulating manner." --Henk-Jan Dalewijk, Amsterdam

"Salman Akhtar is not only a scholarly scientist but also a poet who listens with a fresh ear and talks with a fresh tongue. In the Winnicott tradition, he avoids jargon and finds a new use for a familiar word. The poet analyst comes close to his patients. The scientist analyst asks vital questions and searches for their answers. Inner Torment is a good book by a good man!" --Saide Gillespie, London

"Akhtar integrates controversial psychoanalytic conceptualizations with his own scholarly thinking and expert outlook on technique. Moving between old and new, Freud and post-Freudians, separation-individuation experiences and oedipal conflicts, an intrapsychic and interpersonal dimensions, his powerful book becomes a landmark in the understanding and treatment of difficult patients." --Jacquline Amati-Mehler, Rome

About the Author

Salman Akhtar, M.D., is Professor of Psychiatry at Jefferson Medical College, Lecturer on Psychiatry at Harvard Medical School, and Training and Supervising Analyst at the Philadelphia Psychoanalytic Institute. He is the Book Review Editor of the Journal of Applied Psychoanalytic Studies, an associate edi-tor of the Journal of Psychotherapy Practice and Research, member of the editorial board of the Journal of the American Psychoanalytic Association, past member of the editorial board of the International Journal of Psycho-Analysis, and an editorial reader for Psychoanalytic Quarterly. He is the author of Broken Structures: Severe Personality Disorders and Their Treatment (1992) and Quest for Answers: A Primer for Understanding and Treating Severe Personality Disorders (1995). His more than 130 scientific publications also include thirteen edited or co-edited books. Dr. Akhtar is the recipient of the Journal of the American Psychoanalytic Association's Award (1995) and the Margaret Mahler Literature Prize (1996), and was named the 1998 Clinician of the Year by IPTAR, New York. He has also published five volumes of poetry.