John Steiner uses current Kleinian theory to examine the way object relationships and defences can be organized into complex structures which can lead to a personality, and an analysis, becoming rigid and stuck, with no opportunity for development or change. In such cases, stablility is sought at the expense of adaptability and serious consequences result. He calls these systems of defences "pathological organizations of the personality", and discusses the situation which they give rise to spatially, as a refuge or psychic retreat into which the patient can withdraw to avoid contact with the analyst and reality. To provide a background to these new concepts, the author reviews established depressive positions, as well as previous work on pathological organizations of the personality. He illustrates his discussion with clinical examples of the way psychic retreats operate to provide a respite from both paranoid-schizoid and depressive anxieties. He discusses psychotic organizations as well as those which function as a defence against unbearable guilt.

Psychic Retreats discusses the problem of patients who have withdrawn to avoid anxiety and mental pain and with whom it is difficult to make meaningful contact. Using current Kleinian theory, Steiner examines how these retreats are constructed and how analysis can treat them. He examines the way object relationships and defenses can be organized into complex structures which lead to a personality and an analysis becoming rigid and stuck, with little opportunity for development or change--terming these structures ``psychic retreats.''

Psychic Retreats is written with practicing psychoanalysts and psychoanalytic psychotherapists in mind. The emphasis is therefore clinical throughout the book, which concludes with a chapter on the technical problems which arise in the treatment of such severely ill patients.