Introduction

This introduction presents an overview of key concepts discussed in the subsequent chapters of this book. The book addresses clinical situations in which awareness of emotions is not available and in which there is a significant lack of connection between emotion or sensation and idea, and in which necessary representation is unavailable. It focuses on femininity and proposes a duality at the heart of femininity. The book then considers sexuality as it manifests in the consulting room, making a distinction between 'noisy and silent sexuality'. Clinical psychoanalysis deals with those situations in which an individual has become stuck in repetitive patterns and cannot change over time due to being out of touch with aspects of him or herself. Continuity is the basis of a sense of identity. Identity is not in itself a psychoanalytic concept although disturbances of identity are described as central to the severe pathologies, and projective identification 'confuses the distinction between the self and the external object'.