This book describes in detail how to effectively treat severely ill but not psychotic patients, by careful psychotherapeutic work on the defenses and the superego. Diverging widely from Kernberg's and Kohut's work with the same broad spectrum of patients, Léon Wurmser demonstrates his flexible and individualized method with clinical material taken directly from actual patient-therapist interaction. The core of the therapeutic work focuses on trauma; forms of defense; conflicts within the superego; and the related affects of guilt, shame, depression, and resentment. Appreciating the complex and individual nature of each case, the author uses the familiar concepts of masochism, aggression, narcissism, and repetition compulsion as descriptions, not explanations, of clinical observations. There are no shortcuts; a genuine understanding that results in real change for the patient requires an in-depth exploration of the material in a nonjudgmental atmosphere. Observing that categories, while necessary, tend to be slowly transformed into words of devaluation, Dr. Wurmser addresses the implicit, and often quite explicit, judgmental spirit directed toward severely ill patients, and cautions clinicians to avoid falling into the role of a judging authority. This is an eloquent accounting of a master therapist's successes and failures, valuable especially for offering effective and decisive interventions in treating traditionally untreatable patients.
About the Author: Léon Wurmser, M.D., is clinical professor of psychiatry at the University of West Virginia and training and supervising analyst at the New York Freudian Society. Former professor of psychiatry and director of the Alcohol and Drug Abuse Program at the University of Maryland, he has also taught extensively throughout Europe. Dr. Wurmser trained as a psychiatrist in his native Switzerland and received his psychoanalytic training in this country. Author of 300 articles and coeditor of the six-volume textbook Psychiatric Foundations in Medicine, he has written several books such as The Hidden Dimension and The Mask of Shame. Dr. Wurmser is a recipient of the 1997 Margrit Egner Foundation Award in recognition of outstanding work in anthropologic psychology and philosophy. He maintains a private practice in psychotherapy in Towson, Maryland.