The challenges and crises that kept resurfacing in Michael and Batya Shoshani's work with extremely difficult patients haunted by anxieties of being motivated them to write this book. It proposes a clinical conceptualization to enhance the understanding of these lost and confused patients, whose narcissistic struggle against human fate defies reality and truth, challenging the analyst and the analytic situation. Analysts, caught between their own perception of reality and truth and the wish to be empathetic to their patients' experiences and views of reality, often feel torn and as if standing on quicksand.

The authors journey beyond psychoanalysis to the worlds of literature, in particular the fictional works of Jorge Luis Borges; film, with an in-depth look at Roman Polanski's Bitter Moon and Denis Villeneuve's Incendies; and philosophy, examining the ideas of Heidegger and their links to Freud. These are coupled together with a solid grasp of psychoanalytic theory, such as reflections on Neville Symington's seminal theory of narcissism, interspersed with real-life case studies that bring the chapters alive. This interdisciplinary dialog enriches the ongoing professional discourse on these perplexing and illusive psychic phenomena.