Errant Selves

A major addition to the psychoanalytic casebook literature, Errant Selves: A Casebook of Misbehavior is a collection of case studies dedicated to the psychoanalytic understanding and treatment of behavior disorders. The contributors to this volume explore cases of perversion, delinquency, and addiction in which the misbehavior at issue served primarily to ward off painful affects or states of dysphoria in order to achieve a basic integrity of the self. For these patients, the pathway to self-cohesion entailed the florid acting out typical of narcissistic behavior disorders. Clinical readers of all persuasions will be intrigued by treatment narratives that chronicle the special challenges of working with patients who, in Goldberg's words, "were neither unitary selves nor persons with an easy ability to bolster or reconstitute themselves in socially acceptable ways." Of special interest is the contributors' sensitivity to what they missed with these troubled and troubling patients; they recount examples of skewed focus, of strained rationalization, even of glaring clinical omission, all of which suggest that the patients' psychic splits activated parallel splits on the part of their therapists. What emerges from the contributors' efforts, then, is very much a casebook of our time. It extends the purview of psychoanalysis to the developmental history and psychodynamics of disavowal; explores the analytic management of delinquent, perverse, and addicted patients; and examines the analyst's subjective presence in these treatments, including his or her potential for self-deception and collusion. And it does so in the context of probing a theoretical issue of continuing practical import: whether or not psychoanalytic therapy is best served by viewing the patient as a unitary individual with a coherent sense of agency and an integrated set of values and goals.