Separation-Individuation Struggles in Adult life: Leaving Home focuses on the developmental task of separating from parents and siblings for individuals and couples who have not been able to resolve these issues earlier in life. Sarah Fels Usher extends Mahler’s theory, and includes the writing of Loewald and Modell, among others, stressing the right of adult patients to a separate life. She describes the predicament of Oedipal victors (or victims), their introjected feelings of responsibility for their parents, and their resultant inability to be truly individuated adults. Difficulties separating from siblings are also given analytic attention. Usher’s experience treating couples adds a new and powerful dimension to her theory. She is optimistic throughout about the therapist’s ability to help adult patients resolve the rapprochement sub-phase in a satisfying manner. An additional, crucial question is raised when the author asks if the therapist can allow the patient to terminate treatment. Has the therapist achieved separation from their own parents—or, indeed, from their analyst? Exploring the plight of patients of the unseparated analyst, Usher describes how these generational factors rear their unfortunate heads when it is time to end therapy. Listening to patients from the perspective of separation-individuation is not new; what is new is Usher’s emphasis on how these particular issues are often masked by significant achievement in adult professional life. Separation-Individuation Struggles in Adult Life: Leaving Home will be of great importance for psychoanalysts and psychoanalytic psychotherapists working with adults, as well as for clinical postgraduate students.