After the biological turn of the Fliess years, the key word in psychoanalysis is no longer “trauma” but “drive.” The ultimate cause of neurotic disorders is no longer to be found in an external accident but in internal, hereditary instincts that repeat, in a compulsive and reflex way, the history of life and the species. As a result, everything that was previously described in terms of neuro-physio-psychological conflicts (desire/defense, will/counter-will, repression/return of the repressed, etc.) is henceforth interpreted as expressing conflicts between biological drives: sexual drive (reproductive instinct)/ego drive (self-preservation instinct); object (erotic) libido/ego (narcissistic) libido; and finally, life drive/death drive, Eros/Thanatos. Freud’s metapsychology is a speculative metabiology.

This chapter provides an overview of current thinking regarding the supporting theory of psychodynamic psychotherapy. Rather than going through theoretical constructs in historical order of when each theory was proposed, they are presented as a composite of past and present thinking that the authors have found to be clinically relevant. It commences by describing theories on the early development of the infant and the creation of the internal world and object relations. The chapter them moves on to the issue of accommodating to the world as it is experienced by the infant, outlining circumstances leading to adaptive and less adaptive development. The chapter then outlines ‘core theory’ which covers more traditional psychodynamic concepts such as conflict, resistance, and defence mechanisms with an emphasis on projective identification. The role of this latter defence mechanism is linked with the theoretical constructs of transference and countertransference. There is a section on the narcissistic constellation in order to help the reader negotiate later sections in the book. Finally the chapter concludes with an introduction to theories as to how change is effected in psychodynamic psychotherapy.

A mentalizing framework for understanding narcissism is outlined, and the resulting modifications of basic mentalization-based treatment (MBT) for narcissistic personality disorder are discussed. Treatment of patients with pathological narcissism requires an emphasis on empathic validation and support of the vulnerable “I-mode.” The dangers of not recognizing low mentalizing in narcissistic functioning are also discussed, as both patient and clinician can fail to recognize pretend mode, which may masquerade as “we-mode.” Together the patient and the therapist may then set up a pretend therapy that can be interminable and that functions only to fuel the mental narcissistic structure. A clinical example of a patient in treatment is used to illustrate the process of treatment.

While scholarship and cultural commentary following Wallace’s death was laudatory, straying at times into the hagiographic, at a distance of over ten years, different currents in his legacy are emerging. As might be expected with the developing field of research into any author of such high profile, a second wave of more critical work followed that first wave of scholarship, grappling with problems and failures in the Wallace oeuvre once the work of establishing the field was complete. This exciting period in the growth of Wallace Studies focused particularly around Wallace’s treatment of gender and positions of racial and gender privilege occupied by his writing. This turn, which has enriched and enlivened the scholarly dialogue, anticipated by some years the resurgence of a conversation regarding Wallace’s personal behavior in relationships with women, but Wallace’s public reputation has also been deeply affected by this conversation. Picking up some of the themes identified in earlier chapters relating specifically to the writing, this chapter traces the development of Wallace’s critical and cultural legacy with reference to this confluence of conversations, discussing the emerging public imagination of Wallace as well as the evolving critical dialogue around the strengths and weaknesses of his work.

The individual of our times is often characterized by a tendency toward narcissism and depression. What is the dynamic underlying these phenomena? How do these aspects correlate to the body image concept? Today we can also note that dynamics of counter-power inhabit the social system and trigger some processes: in the contemporary approach to the body, where frequently there is no “healthy distance,” there are difficulties in harmonizing sexual performance and tenderness, because people are often treated like things, or simply like soulless bodies (which is the point of view associated with pornography). The experience of falling in love also tends to assume the typical connotations of mercantile exchange in respect of particularly desirable personal and social characteristics, reflecting a more or less unconscious drive to obtain the best and most convenient things that concrete reality can offer. Contemporary psychological and anthropological perspectives on these topics are presented.

Chapter 6, ‘Absence of the Other’, points to moments in Schumann where the music is marked by the absence of another’s voice, be it through the Romantic evocation of distant voices in pieces such as the Novelletten’s ‘Stimme aus der Ferne’, or, more troublingly, the loss of voice in songs like ‘Des Sennen Abschied’ and ‘Die Sennin’ – a non-presence often explicitly denoting death, as is the case at the close of Frauenliebe or in the Kerner setting ‘Aus das Trinkglas eines verstorbenen Freundes’. As is found increasingly in Schumann’s later work, the music may pointedly not trace a successful ‘coming to lyricism’: the emergence of an expected lyrical voice is missing. This tendency is epitomised in the genre of melodrama, where music accompanies a declaimed speech that refuses to attain the subjective presence of lyricism, and in pieces such as Manfred.

This chapter examines military attitudes toward “emotional injuries” resulting from the end of romantic relationships. Evaluations of why some men “cracked” evolved substantially from World War I to the present. Often, however, psychiatrists attributed servicemen’s maladies to deficient female love: whether that of mothers or romantic partners. In Vietnam, psychiatrists construed romantic rejection as a “narcissistic injury”: a blow to the ego that led men to decompensate in various ways. Alcoholism, going AWOL, self-harm, and violence directed toward others were all associated with Dear John letters. The chapter considers how the military medical and legal establishments adjudicated unlawful acts perpetrated by servicemen whose intimate relationships had recently been severed by letter. It focuses on two court-martial cases: a Korean War POW who briefly rejected repatriation to the United States in 1953, citing a Dear John as his motive for defection, and a Marine Corps private court-martialled in 1969 for killing four Vietnamese peasants. In the latter case, military lawyers deemed the defendant to have been temporarily insane after his fiancée sent him a Dear John.

In Austen’s Pride and Prejudice and Persuasion, Elizabeth Bennet and Elizabeth Elliot, the preferred daughters of their fathers, are prey to blind spots in their judgments. Austen differentiates Elizabeth Elliot’s static character, certain of her “rights” to preference and pride of place in her father’s life, from Elizabeth Bennet’s character despite her prejudice as the favorite child of her father, in relishing quick judgments of others. Elizabeth realizes in time that she has been misled by her vanity in judging both Darcy and Wickham: “she had been blind, partial, prejudiced, absurd.” Elizabeth Elliot, favorite of her father and his consort, her mother having died when she was 16, suffers a harsher fate, in her oedipal victory. She remains an adolescent with self-centered misperceptions. Trapped in her narcissistic defenses, she misjudges the flattering Mr. Elliot and Mrs. Clay, suffers humiliation at their deceptions, but remains unchanged and alone with her father.

This chapter discusses why wisdom is so important to the world. In particular, it states:

1. 1. Most important problems cannot be solved by knowledge + intelligence (IQ) alone. This formula has failed.

2. 2. Analytical thinking untempered by wisdom can be risky and dangerous.

3. 3. Creativity untempered by wisdom can be risky or downright dangerous.

4. 4. Wisdom explicitly recognizes the role of positive human values.

5. 5. The world has become a more global place, so we need to take into account more diverse and often different viewpoints.

6. 6. The stakes for solving world problems are higher than they once were because of worldwide physical and virtual interconnection.

7. 7. Reward systems that condone or value foolish or even toxic behavior need to be replaced.

8. 8. Reward systems should not focus only on the short term.

9. 9. Reward systems should not focus on competition when resources are scarce, but rather on common gain.

10. 10. Increasing narcissism.

11. 11. The problem of political, socioeconomic, racial, cultural, and other forms of polarization.

    The chapter further discusses why wisdom is so little transmitted:

    1. 1. Wisdom is hard to teach.

    2. 2. Teachers were not trained to teach wisdom, and do not have time and resources for acquiring new skills.

    3. 3. Wisdom is not tested for.

    4. 4. Wisdom is not always valued and may be devalued by those in power.

    5. 5. Wisdom is sometimes seen as available only to the old or to authority figures.

    6. 6. Wisdom is often seen as the province of religious or political education.

    7. 7. Wisdom requires a certain amount of intelligence and creativity, so often is scorned by those without all so much of either.

    8. 8. People with high analytical, creative, and practical intelligence often use their intelligence to try to get others to bypass wisdom, including in the schools.

Wisdom is often at odds with our emotions, which are extremely important in our decision making.