Review of Sheldon Bach ' s Getting

Like a sculptor who can see the form hidden within the block of stone, Sheldon Bach— most recently in his third book on narcissism, Getting from Here to There: Analytic Love, Analytic Process—opens our eyes to the underlying structure and dynamics of narcissistic disorders. Bach’s observations and formulations are presented in an accessible, engaging and deceptively simple way, but they reflect precision of observation, clarity and sophistication of thought, deep empathy for patients, and genuine clinical wisdom. Indeed, Bach’s formulations are closely grounded in clinical observation. He is clearly gifted as a healer, scientist, and teacher. The book is, first, a distillation, synthesis and further development of Bach’s earlier discoveries about narcissistic disorders. As one makes one’s way through the book, reading Bach’s observations and formulations about one or another aspect of the functioning of people suffering from narcissistic disorders, the internal coherence of his overall framework becomes increasingly clear. Bach points us to the truly defining elements of narcissistic pathology and development—he focuses on the essentials without oversimplifying, giving us an elegantly described phenomenology of narcissistic disorders. And he brings in findings from studies in related areas such as attachment, mother-infant attunement, separation-individuation, and cognitive neurobiology that bolster the framework he has developed over the years. His gentle erudition permeates the book. But he also goes further in describing his clinical method than he has previously done. His method is faultlessly grounded in his understanding of the development and pathology of these disorders. Finally, Bach speaks to a truth about what clinical work can sometimes become— and may sometimes need to become—that is out of synch with our society’s prevailing objectivizing ethos and that we may seek to avoid. It is at this point that Bach’s clinical wisdom meets up with his courage to follow the truth as he sees it. What follows is a brief summary of Bach’s findings and ideas.