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This original, timely, and clearly written book will be of interest to all those who do psychodynamic psychotherapy and may well prove stimulating also to those who do behavior therapy. It represents Dr. Wachtel's attempt to initiate an exploration of possible areas of integration of psychoanalysis and behavior therapy, in both theoretical and practical terms, including description of his own current style of “active intervention” into patients’ troubling life patterns. He was trained in psychoanalysis and states that he became interested in behavior therapy in the process of preparing a criticism: he experienced the methods as promising and thus began the work that his book describes.
Poised as it is between two “schools” that are often in conflict, the book attempts synthesis chiefly by studying the roles of understanding and action in psychotherapy. Dr. Wachtel sums up his attitude in the sentence: “As with the patient, the therapist, too, must not only understand but at some point must act on the basis of that understanding.” The action he suggests here is a deliberate, structured influence on the part of the therapist, and he views this as better than disavowed, less conscious influence. In describing his own work, he reports that he generally begins with more traditional “understanding” techniques and later incorporates more “active” and directive modes, although there is clearly overlap throughout.
The empirical crux of the book appears to be the widely known issue that significant insights often follow or accompany changes of action or life circumstance rather than preceding them: thus, in Dr. Wachtel's opinion, a