Description

Book Synopsis

In Suffering and Sacrifice in the Clinical Encounter, the authors identify the ways in which some patients seek to create what Freud termed a “private religion” and unconsciously substitute sacrificial enactments of scapegoat surrogates to protect them against the pain of separation, mourning, and loss of primary figures of attachment. They investigate the function of sacrifice and its relationship to the breakdown of psychic structure and the development of manic defenses and pathological narcissism. Such treatments are complex, the “reversed roles” of victim and perpetrator central to the sacrificial process when enacted in therapy can trigger feelings of shame, guilt and inadequacy in the therapist. Perverse, vengeful, and sadistic transference distortions are explored to enable the therapist to appreciate the true nature of the patient’s hidden traumatic experience, with the necessity for the working-through of genuine separation and grieving highlighted. Useful methods are detailed to counter the tendency to become overly active and inappropriately involved when working with patients who have deadened their desire to improve.

This book is unique in utilising the dynamic concepts of the effects of trauma and sacrifice, the role of the scapegoat, and the distinctions between the experience of pain and the accomplishment of suffering in order to develop a foundational understanding of such patients. It is a must-read for all practising and trainee therapists.



Trade Review

I have experienced this book as thought-provoking, offering a feast of psychoanalytic ideas and language, rich in Western classical and biblical allusions and paradoxes.

-- Alexandra Maeja Raicar, Attachment, November 2022

Suffering and Sacrifice in the Clinical Encounter makes a truly unique contribution to the clinical challenges of working with patients gripped by developmental loss and trauma. The authors sound a humanitarian plea for analytic therapists to learn ways to leverage their painful countertransference responses with such “difficult to reach” patients. Through many diverse theories and evocative clinical illustrations, these four highly dedicated and skilled therapists offer singular ways of thinking about, and working with, such patients whose early dependency longings went unheeded, tragically, from the beginning of life. The authors describe the transformative potential achievable if patients could bravely enter a therapeutic relationship where genuine psychic contact can be supported and contained; where suffering and sacrifice can be investigated and symbolized; and where mourning of traumatic loss can be facilitated and reworked. This collection belongs in the library of students and psychoanalytic practitioners who are committed to helping traumatized patients refind renewal, hope, and aliveness.’

-- Caroline Sehon, MD, FABP Director, International Psychotherapy Institute

The theory employed is rich and versatile, the clinical vignettes extremely vivid and instructive. The style of the book is happily communicative and allows a pleasant and rewarding read. I can only recommend reading this fascinating and brilliant book to all analysts, psychotherapists, and scholars of human sciences interested in using psychoanalysis to understand humanity and alleviate psychic suffering.

-- Giuseppe Civitarese, member of the American Psychoanalytic Association and Italian Psychoanalytic Society

This wide ranging and scholarly book goes a long way in answering what Leon Wurmser called “the riddle of masochism.” The authors remind readers of the deep philosophical and humanistic roots of psychoanalysis, while bringing their thinking squarely into the clinical situation and the complexities introduced in the therapeutic relationship by sadomasochistic dynamics.

-- Jack Novick and Kerry Kelly Novick, authors of ‘Fearful Symmetry: The Development and Treatment of Sadomasochism’ and ‘Freedom to Choose: Two Systems of Self-Regulation’

Table of Contents

Acknowledgements

About the authors

Introduction

CHAPTER ONE
Trauma, resistance, and sacrifice

CHAPTER TWO
The scapegoat sacrifice: repeat or reprieve?

CHAPTER THREE
Documenting parricide: Abraham, Isaac, and Hans

CHAPTER FOUR
Into the arms of the god-object: the seductive allure of timelessness

CHAPTER FIVE
Clinical factors in the treatment of the traumatised, resistant patient

References

Index

Suffering and Sacrifice in the Clinical Encounter

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Order before 4pm tomorrow for delivery by Thu 8 Jan 2026.

A Paperback / softback by Charles Ashbach, Karen Fraley, Paul Koehler

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    View other formats and editions of Suffering and Sacrifice in the Clinical Encounter by Charles Ashbach

    Publisher: Karnac Books
    Publication Date: 01/06/2020
    ISBN13: 9781912691579, 978-1912691579
    ISBN10: 1912691574

    Description

    Book Synopsis

    In Suffering and Sacrifice in the Clinical Encounter, the authors identify the ways in which some patients seek to create what Freud termed a “private religion” and unconsciously substitute sacrificial enactments of scapegoat surrogates to protect them against the pain of separation, mourning, and loss of primary figures of attachment. They investigate the function of sacrifice and its relationship to the breakdown of psychic structure and the development of manic defenses and pathological narcissism. Such treatments are complex, the “reversed roles” of victim and perpetrator central to the sacrificial process when enacted in therapy can trigger feelings of shame, guilt and inadequacy in the therapist. Perverse, vengeful, and sadistic transference distortions are explored to enable the therapist to appreciate the true nature of the patient’s hidden traumatic experience, with the necessity for the working-through of genuine separation and grieving highlighted. Useful methods are detailed to counter the tendency to become overly active and inappropriately involved when working with patients who have deadened their desire to improve.

    This book is unique in utilising the dynamic concepts of the effects of trauma and sacrifice, the role of the scapegoat, and the distinctions between the experience of pain and the accomplishment of suffering in order to develop a foundational understanding of such patients. It is a must-read for all practising and trainee therapists.



    Trade Review

    I have experienced this book as thought-provoking, offering a feast of psychoanalytic ideas and language, rich in Western classical and biblical allusions and paradoxes.

    -- Alexandra Maeja Raicar, Attachment, November 2022

    Suffering and Sacrifice in the Clinical Encounter makes a truly unique contribution to the clinical challenges of working with patients gripped by developmental loss and trauma. The authors sound a humanitarian plea for analytic therapists to learn ways to leverage their painful countertransference responses with such “difficult to reach” patients. Through many diverse theories and evocative clinical illustrations, these four highly dedicated and skilled therapists offer singular ways of thinking about, and working with, such patients whose early dependency longings went unheeded, tragically, from the beginning of life. The authors describe the transformative potential achievable if patients could bravely enter a therapeutic relationship where genuine psychic contact can be supported and contained; where suffering and sacrifice can be investigated and symbolized; and where mourning of traumatic loss can be facilitated and reworked. This collection belongs in the library of students and psychoanalytic practitioners who are committed to helping traumatized patients refind renewal, hope, and aliveness.’

    -- Caroline Sehon, MD, FABP Director, International Psychotherapy Institute

    The theory employed is rich and versatile, the clinical vignettes extremely vivid and instructive. The style of the book is happily communicative and allows a pleasant and rewarding read. I can only recommend reading this fascinating and brilliant book to all analysts, psychotherapists, and scholars of human sciences interested in using psychoanalysis to understand humanity and alleviate psychic suffering.

    -- Giuseppe Civitarese, member of the American Psychoanalytic Association and Italian Psychoanalytic Society

    This wide ranging and scholarly book goes a long way in answering what Leon Wurmser called “the riddle of masochism.” The authors remind readers of the deep philosophical and humanistic roots of psychoanalysis, while bringing their thinking squarely into the clinical situation and the complexities introduced in the therapeutic relationship by sadomasochistic dynamics.

    -- Jack Novick and Kerry Kelly Novick, authors of ‘Fearful Symmetry: The Development and Treatment of Sadomasochism’ and ‘Freedom to Choose: Two Systems of Self-Regulation’

    Table of Contents

    Acknowledgements

    About the authors

    Introduction

    CHAPTER ONE
    Trauma, resistance, and sacrifice

    CHAPTER TWO
    The scapegoat sacrifice: repeat or reprieve?

    CHAPTER THREE
    Documenting parricide: Abraham, Isaac, and Hans

    CHAPTER FOUR
    Into the arms of the god-object: the seductive allure of timelessness

    CHAPTER FIVE
    Clinical factors in the treatment of the traumatised, resistant patient

    References

    Index

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