Being There

In this collection of clinical essays, Jon Mills explores the complex interrelationship of developmental trauma on attachment, character structure, and extreme mental states. In a candid and uncensored portrayal of the raw intimate exposure of witnessing and working with extreme states in therapeutic struggle, Mills offers us a rare window into lived clinical experience: the mess, the enactments, the uncertainty of being there, and the actual demands this makes of the therapist. Spending his career treating severe psychopathology, Mills provides detailed case analyses in his work with attachment trauma, disorders of the self, schizoid and depressive phenomena, borderlineopathy, and severe mental illness including the psychotic spectrum. Featuring case studies that navigate the difficulty in working with extreme states with patients at all stages of life, the book offers a dialectical theory of intersubjectivity that conditions the structuralization process in the formation of personality and its impact on attachment capacities and psychological treatment. In outlining a typology of psychic structure based on early relational trauma, Mills argues that the formation of the self in relation to internalization, object relatedness, and interpersonal relationships lead to very different psychic organizations in the formation of the subject and personal identity. Being There shows what it’s actually like to sit with psychosis, suicidality, and severe trauma, including what it costs the therapist and requires of the therapeutic relationship. It will be of interest to mental health professionals including psychologists, psychiatrists, psychoanalysts, psychotherapists, counsellors, social workers, nurses, graduate students, and all practicing clinicians working with trauma, personality disorders, extreme mental states, and psychosis.