This book presents and elaborates on the rationale and implications of the transformational dimension of psychoanalysis. In so doing, it attempts to extend psychoanalytic theory and practice beyond neurosis and beyond what were formerly thought to be the limits of analytic understanding. Its theoretical vision sits at the crossroads of the thinking of Freud, Bion, Winnicott, Green and the Paris Psycho-Somatic School. Other sources include the contributions of contemporary French psychoanalysts such as Laplanche, Donnet, L. Kahn, P. Miller and the Botellas, along with the work of Alvarez, Scarfone, Ferro, Ogden, and more.

In re-examining the very epistemological foundations of psychoanalysis and their implications for a theory of psychic functioning, it follows upon and extends the radical implications of Freud's 1937 Constructions paper, the thoughts of Bion on intuition and Winnicott's understanding of the working through of the consequences of early pre-verbal environmental failure. In so doing, it makes a case for psychoanalysis as a powerful treatment for borderline, primitive narcissistic, post-traumatic and other character disorders and conditions – including perversions, addictions, psychosomatic, autistic and panic disorders.

By presenting a revised metapsychology that is Freudian, contemporary and clinically near, Affect, Representation and Language. Between the Silence and the Cry offers practitioners at all levels of analytic experience a way of understanding and treating the expanding range of patients and disorders that present for treatment in our modern era.