Catch Them Before They Fall: The Psychoanalysis of Breakdown

Bollas has written a short and moving account of breakdown in this new book,with the major point of interest being that of a psychoanalytic technique for the treatment for the patient experiencing this breakdown. The technique (which I will not detail here)should not be read as a, "parameter", but rather as a specific and detailed set of procedures beyond the boundaries of the ongoing sessions. Bollas sees breakdown ( as occurring in any of the character types we visit in our analytic patients)as a special circumstance requiring extra special attention, which he explains in detail. He does clearly make the observation that, for the technique to be effective, the, "ordinary sessions", need to be technically focused on the free associative method- that it is not for the analyst who intensely focuses on the analysis of transference or the analyst who engages the patient in conversational responsive dialogue.While the technique, which I believe to be be groundbreaking for the outpatient treatment of breakdown, is of great and important interest, I find the book important in many additional ways. First, the description of breakdown and HOW TO RECOGNIZE this circumstance is essential, and I believe often missed by many finely trained analysts. Second, his explanation of psychoanalytic time is profound and is in need of greater understanding among those who are new to the discipline as well to to many seasoned therapists and analysts. Third,and to me most important,he explains the essential difference between affect and emotional experiencing; and in doing so highlights some of the shortcomings of attachment theory which places so much emphasis on the observable.In this sense, as Adam Phillips mentioned in remarks concerning Bollas's earlier book,CRACKING UP he (Bollas) makes the proposal of, "not a return to Freud exactly, but a return to something more paradoxical,something more radical: a return to the work of the unconscious." In concluding, I would like to state that there is a subtext in this volume that I read as a book on the ethics of the psychoanalyst. In explaining his technique to the reader one cannot miss his emphasis of a carefully constructed, but deep devotion we have to our patients and the care they should expect from the therapist/analyst. There is also an implicit understanding he conveys that an analyst over identified with one school will not be free to hear the meaning in the patients associations. Finally, Bollas makes it explicit, that at its best, psychoanalytic therapy offers not just self understanding,but a sustainable cure that goes far beyond the symptomatic improvements that are sometimes seen in the insurance driven therapies such as CBT and DBT.

A great read- opened up my mind to new ways of working and being with my patients.

The book is extremely instructive for every psychoanalyst, who have to deal with the first psychotic episode, as it encourages to see the breakdown as a attempt of the psyche (the athor prefers to call it 'self') at its re-restructuring, id est, appealing for an intense psychoanalytical cure, instead of even more pathological structuring, that the ill psyche risks to get within the traditional (and in all senses of the word -- cheap -- psychiatric institution).

If only I as a psychoanalytic psychotherapist were able financially to clear such time , therefore seeing no other patients/ clients. I believe , as c bolas that patients would benefit greatly. I don't think the American medical insurance system would support this. Neither could I or many therapists/analysts in the US be able to forge such teams.The potential for this, if I & or my patients could afford it seems life changing

Interesting - a read for psychoanalysts - if the author had suggested ways in which all of us can be catchers I would have given it 5

Uhm I don't know how I feel about this book, basically FSP services for 3years because he didn't catch her before she fell ?

Brilliant rebellious work. A must-read for the committed psychotherapist who is unafraid to do what it takes.

I am still reading this book which is excellent. It is a book one must read slowly, and then read it again.

I like this because Bollas centres on the meaning of what is happening for the person. He responds to what is needed, which I take to mean responsiveness, and in my view that could also mean a shorter term therapy, or the longer intensified response that he talks about.

Enlightening and interesting. Such a shame such work is not more widely done and accepted by the psychoanalytic community.

Brilliant