Picking Up the Pieces

"The doctor says, You have to keep cutting yourself. Go on cutting yourself; you have to remain in touch with your body, with yourself, in whatever way you can."-Grace Jackson When Grace Jackson began analytic therapy with Dr. Fayek Nakhla, she was struggling with the feeling that she did not exist. After many months of baffling silence in her therapy sessions, she experienced a psychotic regression characterized by violent behavior and self-mutilation. This engrossing and moving book is the story of the first few years of Grace's controversial analytic treatment, told in separate chapters by analyst and patient. This is the first time that a detailed account of the treatment process has been presented from both points of view. Although Grace Jackson had a job and functioned relatively well in the outside world, the one activity that made her feel real-aside from cutting herself-was writing in a diary; her narrative is interspersed with excerpts from this journal, giving us a privileged insight into her private world, into her suffering and terror. Dr. Nakhla's account tells us of his misgivings as he attempted to understand Grace's extreme mental pain and conflict and to devise an effective treatment. Dr. Nakhla's approach, which eventually proved successful, was based on his understanding of the work of the British psychoanalyst D.W. Winnicott, and it followed the dangerous course of permitting Grace to experience her regression fully-even its violent aspects-in order to achieve the rebirth of her self. Together the two narratives provide an intimate picture of mental illness and of the therapeutic relationship that can help the patient regain sanity.