may make for difficulty and perhaps the work could be improved by better integration of the chapters. This is not an adverse criticism of the book. It is merely a constructive criticism for the future, for there is no doubt that this work is the most useful book on operative obstetrics today in the English language. It is also the most beautifully produced and one of the most worth-while books on obstetrics in the whole of modern medical literature. E.E.P.

The Doctor, His Patient and the Illness

There is great promise in the title and the timing of this book, but great disappointment in the telling. It is rare for an author, in his introduction, to point out the major and pervasive flaw in his work, yet not repair it: "I am fond of meandering designs; this book proceeds more by associations than by orderly progression, and some motifs recur throughout...." Material from George Orwell's 1984 and quotes from Freud, Dickens, Chekhov, and Kipling are liberally used. However, these are interspersed in long, convoluted sentences about the author's case histories. Several readings are needed to establish some connections or even whether patient x or Orwell's Winston or a cannibalistic rat is being described. The author, apparently unaware of the contradictions, states: Soul murder is my dramatic designation for a certain category of traumatic experiences: instances of repetitive and chronic overstimulation alternating with emotional deprivation that are deliberately

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Soul Murder: The Effects of Childhood Abuse and Deprivation

do not play to the "sensual ear" and are in fact "of no tone." Filled with dualities—time and timelessness, silence and sound, the static and the eternal—the urn in the end is a riddle that has "teased" the speaker into believing that beauty is truth. In life, however, beauty is not necessarily truth, and the urn's message is one appropriate only in the rarefied, timeless world of art. Ode on a Grecian Urn: Text of the Poem Thou still unravish'd bride of quietness, Thou foster-child of silence and slow time, Sylvan historian, who canst thus express A flowery tale more sweetly than our rhyme: What leaf-fring'd legend haunts about thy shape Of deities or mortals, or of both, In Tempe or the dales of Arcady? What men or gods are these? What maidens loth? What mad pursuit? What struggle to escape? What pipes and timbrels? What wild ecstasy? Heard melodies are sweet, but those unheard Are sweeter; therefore, ye soft pipes, play on; Not to the sensual ear, but, more endear'd, Pipe to the spirit ditties of no tone: Fair youth, beneath the trees, thou canst not leave Thy song, nor ever can those trees be bare; Bold Lover, never, never canst thou kiss Though winning near the goal—yet, do not grieve; She cannot fade, though thou hast not thy bliss, For ever wilt thou love, and she be fair! Ah, happy, happy boughs! that cannot shed Your leaves, nor ever bid the Spring adieu; And, happy melodist, unwearied, For ever piping songs for ever new; More happy love! more happy, happy love! For ever warm and still to be enjoy'd, For ever panting, and forever young; All breathing human passion far above, That leaves a heart high-sorrowful and cloy'd, A burning forehead, and a parching tongue. Who are these coming to the sacrifice? To what green altar, O mysterious priest, Lead'st thou that heifer lowing at the skies, And all her silken flanks with garlands dressed? What little town by river or sea shore, Or mountain-built with peaceful citadel, Is emptied of this folk, this pious morn? And, little town, thy streets for evermore Will silent be; and not a soul to tell Why thou art desolate, can e'er return. O Attic shape! Fair attitude! with brede Of marble men and maidens overwrought With forest branches and the trodden weed; Thou, silent form, dost tease us out of thought As doth eternity: Cold Pastoral! When old age shall this generation waste, Thou shalt remain, in midst of other woe Ode on a Grecian Urn: Introduction 2 Than ours, a friend to man, to whom thou say'st, "Beauty is Truth, Truth Beauty,"—that is all Ye know on earth, and all ye need to know. Ode on a Grecian Urn: John Keats Biography Born in 1795, Keats, the son of a stablekeeper, was raised in Moorfields, London, and attended the Clarke School in Enfield. The death of his mother in 1810 left Keats and his three younger siblings in the care of a guardian, Richard Abbey. Although Keats was apprenticed to an apothecary, he soon realized that writing was his true talent, and he decided to become a poet. Forced to hide his ambition from Abbey, who would not have sanctioned it, Keats instead entered Guy's and St. Thomas's Hospitals in London, becoming an apothecary in 1816 and continuing his studies to become a surgeon. When he reached the age of twenty-one, Keats was free of Abbey's jurisdiction. Supported by his small inheritance, he devoted himself to writing. Keats also began associating with artists and writers, among them Leigh Hunt, who published Keats's first poems in his journal, the Examiner. But within a few years the poet experienced the first symptoms of tuberculosis, the disease that had killed his mother and brother. He continued writing and reading the great works of literature. He also fell in love with Fanny Brawne, a neighbor's daughter, though his poor health and financial difficulties made marriage impossible. He published a final work, Lamia, Isabella, The Eve of St. Agnes, and Other Poems, which included his famous odes and the unfinished narrative, Hyperion: A Fragment. Keats travelled to Italy in 1820 in an effort to improve his health but died in Rome the following year at the age of 26. Ode on a Grecian Urn: Summary Lines 1-4: The poem opens with three consecutive metaphors: the implied, rather than directly stated, comparisons between the urn the speaker is viewing and, respectively, a "bride of quietness," a "foster-child of silence and slow time," and a "Sylvan historian." Of these, the last is perhaps easiest for the reader to immediately comprehend. Ancient Grecian urns were commonly illustrated with scenes or subjects that varied depending on the era and style in which a given urn was created. While more ancient vessels featured paintings of war and heroic deeds, the one Keats had in mind probably came from the early free-style period. Urns of this era are characterized by scenes from religious and musical ceremonies similar to the ones described throughout "Ode on a Grecian Urn." Because of its subject matter, Keats's urn must date to before the fourth century B.C., yet the bucolic scenes it depicts have been preserved through the millennia. For this reason, the urn reveals to the viewer a "leaf-fring'd" bit of history: it is a "Sylvan historian." More puzzling to readers are the first two metaphors. Each involves the idea of "quietness" or "silence" because the urn relates its story in pictures rather than words. But why is it a "bride of quietness" and a "foster-child of silence and slow time"? The latter may be because while the urn's creation was the result of a fertile union between an ancient artist and some experience that informed his work, the same artist is now long-forgotten and the experience long-ended. Thus the urn, his "child," has fallen into the custody of the ages—"slow time." People who look at the urn can imagine but cannot actually hear the musical sounds and the story it depicts. Moreover, while in its own day the urn was used by people in their everyday lives, it has since become an artifact, perhaps in a museum, that viewers inspect reverentially—in "silence." The most cryptic meaning in these lines is of the word "still." Is it an adjective, suggesting the urn is "unmoving," or an adverb, meaning "not yet" deflowered or "ravished"? A dual intent seems to fit the poem best. While "unmoving" suggests the urn's static condition as an artifact, "not yet defiled" suggests that its Ode on a Grecian Urn: Text of the Poem 3 beauty, though still present after thousands of years, will one day be destroyed. This points directly to a major theme of the poem: the painful knowledge that all things must pass, including (and perhaps especially) beauty. Though the urn is ancient and might seem eternal, in fact it remains subject to decay and destruction—subject to time, even if, in the case of an antiquity, it seems to be "slow time." The urn's perishability is made apparent by a simple understanding: one of beauty's qualities is that it is rare. Though many urns were created, only few survive, and while this contributes to the speaker's conception that the urn is uncommon and therefore more striking, it is also evidence that even ancient relics are not immune to time. Lines 5-10: The poem's dualities are further expressed in the sestet. First, while the urn seems both unchanging and perishable, the questions its pictures raise suggest both the eternal and the mortal. Though the urn expresses "a flowery tale" (line 4), the tale itself is unclear in many ways. Observing the figures painted on the urn's surface, the speaker cannot tell whether they are "deities or mortals," whether they exist in Apollo's valley of Tempe or the heaven-like but mortally inhabited region of Arcady. The characters may be "men or gods"—they cannot be both—yet the speaker's repeated question demonstrates he is unsure in his interpretation. Further, though the urn is marked by its stillness and silence, the activities it depicts are filled with motion and sound: a "mad pursuit," "pipes and timbrels," "wild ecstasy." Though the speaker cannot hear the music, he can see the instruments; though he cannot see the motion, the still representations force him to imagine it. Thus the urn possesses a dual nature. On the one hand, it is itself a symbol of the static quality of art. On the other hand, however, its painted figures represent the dynamic process of life, which art distills in "slow time" and often in "silence." This is the puzzling nature of all art: its viewer responds to it both as a work, which seems eternal, and as an experience, which he knows to be fleeting. Though he pursues meaning the way the males in the painting pursue the females, the meaning is "loth" to yield itself. In such a way, the urn has a "teasing" nature that brings about more questions than answers, for if the answers were easily available then art itself would have little reason to exist. Lines 11-14: In the second stanza the speaker turns wholly to the sounds and activities depicted on the urn. Here he makes the distinction between ideal nature of art and the flawed, fleeting nature of life. Though he cannot physically hear the "melodies" the urn's characters play, "those unheard are sweeter" because they exist in the Platonic world of abstract forms. They are perfect precisely because they are unheard, because the "spirit" to which they appeal can grant them an imagined flawlessness impossible in songs perceived by the "sensual ear." If life forces imperfection on all things, art retains the ability to make—as Keats wrote in one of his letters—"all disagreeables evaporate." One such disagreeable is time. In life, where chronology is the rule, even the sweetest tunes must be brief. In art, however, the "soft pipes" can "play on" forever. Yet there is a paradox. What makes music both recognizable and beautiful is its tonal quality. The urn's musicians, however, play "ditties of no tone." While these songs may be ideal in their abstraction, they cannot possess the beauty of the 

'Ode on a Grecian Urn'における死と永遠

This qualitative research focused on the significance of subjective experience of mothers who gave birth in an emergency Caesarean section Ten first-time mothers experiencing emergency Caesarean section were interviewed, and their narrative accounts were analyzed using Giorgi's phenomenological method Mothers described alienation from the infant on encountering her/him; primal difficulties in holding; a 'mechanistic' pattern of childcare at home; over-apprehension and fear of a cradle-death A few of the women seemed to cope with these experiences by performing 'a symbolic adoption' of their infants In the context of object-relations theory, the findings, will potentially inform psychological care in obstetrics and gynaecology

On becoming a first-time mother after an emergency Caesarean section: a journey from alienation to symbolic adoption.

Objective: To explore the nature of professional wisdom, through learning from the experiences of a group of highly experienced senior therapists. Method: Twelve senior psychotherapists took part in qualitative in-depth interviews about their professional role and their views around a range of aspects of therapy theory and practice. Interview transcripts were subjected to thematic analysis. Results: The analysis yielded nine wisdom themes, clustered within three domains. Each domain represented efforts to resolve dilemmas arising from the experience of being a therapist, around the use of theory in psychotherapy practice, the type of therapeutic relationship that is most helpful for clients, and the experience of therapeutic failure. Conclusions: Therapist wisdom can be viewed as a form of contextualized knowledge, which functions as a source of emergent insights that arise as responses to the limitations of prevailing ways of thinking. Research into the nature of therapist wisdom draws attention ...

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Wisdom in professional knowledge: Why it can be valuable to listen to the voices of senior psychotherapists.

This paper introduces the subject of courage into the psychoanalytic discourse about masochism and also demonstrates that ordinary ethical and axiological concerns can and should be included in our psychoanalytic language and practice. At each stage of a psychoanalysis, it may be helpful to consider whether the patient's experience might be that taking a step deeper into the psychoanalytic relationship is both courageous and masochistic. This consideration can open the door to exploration of conscious beliefs and how they are related to unconscious fantasies and assumptions. Considering the possibility that even a sadomasochistic enactment may simultaneously represent a courageous attempt to rework conflict or trauma can enrich the way analysts listen to both manifest and latent material.

Catching the wrong leopard: courage and masochism in the psychoanalytic situation.

Psychoanalysts enjoy doing analysis above and beyond its usefulness to patients; one reason for this lies in the aesthetic pleasure the analyst may derive from the analytic process. The author discusses this aesthetic pleasure from the standpoint of meaning making, communication, love, and professional craft. Patients may themselves seek in analysis a certain kind of beauty that is normally a byproduct of good enough empathy and communication. Using Kleinian theory, the author examines the ways in which destructiveness and aggression may be understood in relationship to an aesthetic of psychoanalysis. It is further proposed that the aesthetic and ethical principles of psychoanalysis are indissolubly linked.

Beauty treatment: the aesthetics of the psychoanalytic process.

This paper reconsiders familiar concepts (such as internalization, object representation, and object constancy) in light of the notion of having, in order to facilitate creative thinking about how patients are or are not capable of experiencing analysts-and how analysts allow them to do so. The meaning of Other-having is examined from both a theoretical and a subjective point of view. The author suggests that the sense of having an Other results from positive real experiences, and that the ability to have an Other is the sine qua non, the building block, of all mental functions that require empathy.

Susan S. Levine

Papers

Catching the wrong leopard: courage and masochism in the psychoanalytic situation.

Beauty treatment: the aesthetics of the psychoanalytic process.

To have and to hold: on the experience of having an other.