This collection investigates the fundamental mechanisms of psychic equilibrium and the conditions necessary for genuine psychic change within the framework of Kleinian psychoanalysis. The authors, including prominent analysts such as Elizabeth Bott Spillius and Michael Feldman, curate a selection of Betty Joseph’s most influential papers to demonstrate her clinical focus on the 'here-and-now' of the analytic session. By examining the patient’s unconscious communication and the analyst’s countertransference, the text argues that structural change occurs through the rigorous analysis of the patient's defensive organizations and their resistance to growth.

Experts in the field of psychoanalysis regard this volume as a foundational text for understanding the evolution of post-Kleinian clinical technique. Readers frequently note the high level of technical density, making it a primary resource for advanced practitioners and students of clinical psychology.