Bad Feelings (Book Review)

Author:  Schafer, Roy
Publisher:  New York: Other Press, 2003
Reviewed By:  Jane G. Tillman, Winter 2004, pp. 74-75

Roy Schafer has been publishing papers and books on psychology and psychoanalysis for the past 57 years. His most recent book, Bad Feelings, represents a highly successful synthesis and integration of Freudian, ego psychological, and neo-Kleinian theory, each of which Schafer has mastered as an expert in his long career. This slim volume provides the reader with the features experienced when in supervision with a master clinician: deep theoretical understanding, empathy, and clear technique. Schafer manages to distill a range of theoretical knowledge, and with ample clinical vignettes, provides a wise and sophisticated discussion of common states he plainly labels “bad feelings.” This is no small feat given the breadth of theory he is discussing, and his unwillingness to settle for being either a “Freudian” or a “Kleinian.” Instead, the reader is shown a model of integrative thinking, using the concepts of adaptation, defense mechanisms, transference, and countertransference, all located within the Kleinian concept of the paranoid-schizoid and the depressive positions.

Throughout the book Schafer attends to technique, particularly as influenced by countertransference feelings. In the clinical vignettes, he is open about his own countertransference pulls, often critiquing his work as an analyst upon further reflection about material from the session. Each chapter supplies clinical vignettes providing an analysis of the patient’s conflicts and defenses, and location within the paranoid-schizoid/depressive position continuum—as well as self-analysis by the analyst about the timing, content, and motivation for interpretations offered. The openness and scrutiny Dr. Schafer models for us about his work is quite refreshing. Often, clinical writing in our field emphasizes the mutative interpretation. In Bad Feelings there is a demonstration of analytic reflection about the choice of interpretation: “why this interpretation and not that one?” Consistently attending to the analyst’s process, Schafer is interested in what moves him away from the transference in the moment to another area of concern. Schafer’s close attention to clinical process is presented systematically throughout the chapters as he considers the predominant mood of the session, the genetic conflicts at work, the defenses in both the analysand and analyst in the moment, transference and countertransference, and the timing and content of interpretations, all of which provide rich instruction for the reader.

Defining “bad feelings” as painful affective states, Schafer cautions his reader that such feelings are not evidence of a moral flaw. Indeed, many bad feelings emanate from what Schafer calls “moralized mental health” where the sufferer inflicts guilt and shame for having painful reactions and feelings in the first place. The range of bad feelings includes the familiar experiences of shame, guilt, humiliation, envy, abandonment, rejection, mournful loss, sadomasochistic patterns, and disappointment. In the first four chapters, painful affects are examined, beginning with a chapter titled “A Joyless Life.” In this chapter Schafer takes up the role of defenses in managing painful affective states, noting that such defenses may become so rigid as to preclude the experience of positive affects as well. Patients in the predicament of “Ted” may constrict all affective experience believing that eventually even positive feelings will deteriorate into intolerably painful suffering.

Chapters two, three and four examine the affects of disappointment, extreme shame and mortification, and envy. In chapters two and three, a theoretical overview of these states and their developmental antecedents is presented, followed by several clinical illustrations. Chronic disappointedness may be adaptive, defensive, and/or moralistic. Analysands with this trouble often enter analysis committed to their certainty that analysis and the analyst will prove to be ultimately disappointing. The role of projective identification and defensive idealization of the past are taken up in relation to the creation and maintenance of disappointment. The following chapter considers the powerful and primitive mental contents contributing to the painful affects of shame, humiliation, and mortification. The role of envy and omnipotence in the transference and the interpretive understanding of these states provided me with a rich opportunity for considering my own practice as a therapist, working with patients who tend to inhabit this region for much of the early phase of the treatment. At the end of this chapter Schafer reassures the reader that feelings of humiliation and mortification and their attendant fantasies are built-in components of being in analysis. Humiliation and shame may contribute to negative therapeutic reactions, or be deployed as defenses against the corrosive experience of envy. The next chapter, specifically on envy, outlines both Freud’s and Klein’s contribution to the understanding of the origins and dynamics of envy as well as the clinical considerations and countertransference difficulties encountered when the analysand is working in the area of envy.

The most difficult chapter for me was “Defenses Against Goodness.” At the end of this chapter, in the discussion, Schafer gives his most compelling thinking about the term goodness and its problematic as well as useful aspects. I think his excellent, concise discussion would have been most helpful at the beginning of the chapter, but this is a minor organizational point. Noting that the term goodness is subject to ethical, cultural, and situational norms, Schafer cautions the practitioner about the potential countertransference construal of goodness as requiring submission or social conformity based on the analyst’s conception of goodness. As a clinical entity, defenses against goodness are related both to feeling envious as well as feeling envied by the other.

Finally, three chapters are devoted to specific clinical situations noted to evoke painful feelings. Chapters on the therapist’s absence, termination, and the negative therapeutic reaction all take up common conflicts, defenses, and transference/countertransference responses evoked by separation, ending, or entrenched bad feeling occurring in the grip of the negative therapeutic reaction. Shafer proposes one way of thinking about negative therapeutic reactions is as deferrals of conflicts that are dreaded or felt to be too dangerous to engage. Empathic in his approach to the patient who refuses to go deeper, Schafer notes “If, during the process, analysands draw back from fresh suffering, if they reverse direction and undo the presumed gains of the clinical work, what warrant has the analyst to consider them as behaving negatively?” The message here is familiar, that the term negative therapeutic reaction carries with it a pejorative stance toward the patient, and as such impedes ongoing empathic understanding.

Schafer has provided us with a model for thinking as well as pearls of clinical wisdom related to technique. Giving the reader an intimate view of the analyst at work, Schafer wrestles honestly with how hard the work can be at times. In the introduction he notes that his integrative efforts across psychoanalytic theorists represent an attempt to bring theoretical harmony to this project, not simply engage an “opportunistic eclecticism.” A minor difficulty, to my reading, is in the organization of the chapters. Several chapters were previously published as papers elsewhere, making the arrangement and order of the papers in this volume challenging at times. In the main, Schafer speaks in the voice of a teacher, an analyst, a supervisor, and a wise colleague. In each chapter, I found myself deepening my understanding of commonly encountered clinical experiences, and admiring Schafer’s clear thinking about the aims and discipline of analysis.

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