Between Unknown Change and Familiar Retreat

Psychotherapy Technique for Our Most Challenging Patients


The theme of Dr. Robert Waska’s new book involves how all patients, whether neurotic, borderline, or psychotic, want their problems to ease and their stress to stop but unconsciously they avoid any real psychological change. They strive to maintain their psychic equilibrium regardless of how destructive it may be, in an effort to avoid the loss of what is known and to avoid the unknown pain or punishment that change might bring.
Each chapter provides the reader with a contemporary Kleinian focus on central theoretical and clinical concepts such as projective identification, enactment, transference, pathological organizations, and depressive or paranoid acting out. The reader then is shown the careful and thoughtful interpretive work necessary in these complex clinical situations.
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EUR €100.00USD $115.00

Biographical Note

Robert Waska MFT, LPCC, PhD is in private practice in San Francisco and a full analytic member of the San Francisco Center for Psychoanalysis. He has authored thirteen text books, numerous book chapters, and over one hundred journal articles on the Modern Kleinian approach to individuals and couples.

Table of contents

Part I. Contemporary Kleinian Therapy
1 Translating the Turmoil in the First Five Sessions: Real Time Response in Psychoanalytic Treatment Using the Modern Kleinian Therapy Approach
 Case Material
 Case #1
 Case #2
 Case #3
2 The Territory of the Transference and the Value of Phantasy Interpretation: A Kleinian Expansion
 Case Material
 Case #2
 Case Material
3 Working Within, the Compromised Formation, and Analytic Contact: Three Aspects of Modern Kleinian Clinical Work
 Working With/Within
 Compromised Formation
 Analytic Contact
 Case Material
 Recent Progress
Part II. The Darkness of the Depressive Position
4 For My Benefit: A Case Study of One Patient's Fear of Self-Definition and His Depressive Phantasies of Disappointment and Rejection
 Case Study
 Clinical Issues within the Transference and Counter-Transference
 Session #14
5 The Depths of Depressive Despair: When Saying Goodbye is Too Dangerous to Bear
 The Patient
 The Treatment
 Case Material
 Theoretical Issues
6 Depressive Anxiety and the Motives for Manic Control
 Case Material
 Case Material
7 Unbearable Separation, Guilt, and the Dread of Loss
 Case Material
Part III. Paranoid Schizoid Inertia and Countertransference Conflict
8 Psychotic Process, Counter-Transference, and the Psychic Shelter
 The Psychic Shelter
 Case Material
9 Projective Identification in Restricted and Uncontained States of Mind
 Case Material
 Ben's Shelter
 The Countertransference


Beginning clinicians as well as advanced practitioners will be interested.


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