Truly odd book, which I did not like at all. It struck me as poorly written, self-serving, and inappropriate. It's listed as fiction, but also supposedly true stories of people who the author worked with (as their therapist). I confess that I did not read much of it. . .when a therapist starts out by talking about how thinking about one of her clients makes her vagina tingle, I'm done. Well, okay, I read a bit beyond that. And even tried skipping to a different "story," but couldn't do it.

Spoiler alert: these stories are just so, fiction. While Orbach writes elegantly and intelligently the patients and their interactions with her projected self are merely products of her vast imagination.
It would be an interesting professional exercise to produce fictional clients and work through their concerns solely in ones mind, a working role play. Still, I can't help but feel a bit cheated.

I'm not in a position to evaluate the theory the author is working from, though some of it strikes me as baseless or heterosexist. The text reads well, especially at the start of the book.

Should this be shelved as fiction since all the case studies are made up? If so, it's only engaging fiction up to the last case study. The last, titular case study is the most theoretical, and it's followed by two chapters of discussion that seem part theoretical review, part author's extremely indulgent afterword.

Of the recent examples of psychoanalytic case studies I've read, this book is the most theoretical, and maybe tied for least readable. It also contains the most outlandish ideas, including the fictional therapist taking on the physical symptoms of her fictional clients and other explanations for the fictions clients' psychology that stem from the author's theoretical background but don't seem connected to the patients' lives. But I don't suppose I know enough about the field to really judge.