Developmental, Cultural, and Clinical Realms

Paper: 978 1 78220 258 5 / $41.95
Published: December 2014  

Publisher: Karnac Books
256 pp., 6" x 9"
Hope is the most reliable sustainer of life. It offers the promise of something good in the future, contributes to resilience, and keeps one going. However, there are circumstances when hope dries up. This book maps out this dark terrain of hopelessness. While it allows for the fact that a modicum of hopelessness might help in reducing infantile omnipotence and curtailing fixation on unrealistic goals, its focus is upon severe and clinically significant shades of hopelessness. The book opens with a broad overview of the nature, developmental origins, and technical implications of hope and hopelessness, and closes with a thoughtful summary, synthesis, and critique of the intervening essays; this summary forges both theoretically and technically significant links between the experiences of helplessness and hopelessness. Sandwiched between these opening and closing commentaries are nine essays which address the ontogenetic trajectory, phenomenological variations, cultural and literary portrayals, and clinical ramifications of sustained hopelessness. Together, these essays provide an opportunity for the readers to enrich their knowledge base, deepen their empathy with patients struggling with despair, and sharpen their therapeutic skills in this painful realm of clinical practice.

Reviews & Endorsements:
"This book fills a lacuna in the psychoanalytic literature that has existed, presumably, because hopelessness is one of the most unbearable feelings human beings endure. Drs Akhtar and O’Neil, together with their outstanding contributors, have met that challenge courageously. With the help of numerous clinical examples, they offer the reader a theoretical, developmental, and technical approach to hopelessness. In addition, the book offers helpful perspectives from literature and cinema illustrating the universality of hopelessness. I found of particular value their insightful discussions about pathological optimism as a defense against hopelessness, the relationship between helplessness and hopelessness, and how frenetic desire can be an expression of hopelessness. Every clinician’s library will be enriched by this book."
- Axel Hoffer, MD, Training and Supervising Analyst , Boston Psychoanalytic Society and Institute
"Contending with hopelessness can, at times, lead to the creation of improbable and novel life alternatives that only the good fortunes of a depressive position can allow. More often, lasting despair results in psychic collapse or narcissistic retreat into a schizoid cloister of myth, magic, and distorted mentation. Such dark reaches of human experience form the topic of this book. Searching, informative, and moving essays by distinguished contributors shed light on the myriad phenomena associated with hopelessness that pose both clinical and existential challenges for all of us. Reading them greatly enhances therapeutic empathy for despondent and despairing individuals."
- M. Hossein Etezady, MD, Faculty member , The Psychoanalytic Center of Philadelphia