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One of therapy's greatest challenges is the moment of transference, when a patient unconsciously transfers emotion or desire to a new and present object—in some cases the therapist. During the course of treatment, a patient's projections and the analyst's struggle to divert them can stress, distort, or contaminate the therapeutic relationship. It may lead to various forms of enactment, in which the therapist unconsciously colludes with the client in interpretation and treatment, or it can lead to projective identification, in which the client imposes negative feelings and behaviors onto the therapist, further interfering with analysis and intervention. Drawing on decades of clinical case experience, this book leads practitioners through the steps of phantasy and transference mechanisms and their ability to increase, oppose, embrace, or neutralize analytic contact. Operating from a psychoanalytic perspective, it explains how to cope professionally with moments of transference and maintain an objective interpretive stance within the ongoing matrix of projective identification, countertransference, and enactment. The book discusses a wide spectrum of cases and clinical situations, describing in detail the processes that invite a playing out of the patient's phantasies and the work required to reestablish balance. It recognizes the imperfections of analysis yet reaffirms its potential for greater psychological integration and stability for the patient. It also acknowledges the limits and frequent roadblocks of working with difficult patients, such as those who suffer from psychic retreat, paranoid phantasies, and depressive anxieties, yet indicates an effective path for resetting the clinical moment and redirecting the course for treatment.

The multimodal treatment of acute psychiatric illness involves a set of integrated, systematic interventions that stabilize individuals with severe mental illness and help them avoid unnecessary psychiatric hospitalization. This volume focuses on those suffering from schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, severe anxiety, and substance dependence, and provides individual practitioners and professional teams with the tools for responding to crisis and delivering acute care. The text includes real-world case examples, diagrams, and printable worksheets.

The unexpected loss of a client can be a lonely and isolating experience for therapists. While family and friends can ritually mourn the deceased, the nature of the therapeutic relationship prohibits therapists from engaging in such activities. Practitioners can only share memories of a client in circumscribed ways, while respecting the patient's confidentiality. Therefore, they may find it difficult to discuss the things that made the therapeutic relationship meaningful. Similarly, when a therapist loses someone in their private lives, they are expected to isolate themselves from grief, since allowing one's personal life to enter the working relationship can interfere with a client's self-discovery and healing. For therapists caught between their grief and the empathy they provide for their clients, this collection explores the complexity of bereavement within the practice setting. It also examines the professional and personal ramifications of death and loss for the practicing clinician. Featuring original essays from longstanding practitioners, the collection demonstrates the universal experience of bereavement while outlining a theoretical framework for the position of the bereft therapist. Chapters cover the unexpected death of clients and patient suicide, personal loss in a therapist's life, the grief of clients who lose a therapist, disastrous loss within a community, and the grief resulting from professional losses and disruptions.