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Perhaps there was a time when psychoanalytic treatment was largely an option for the intelligentsia and the working well. Some, in America, may indeed have considered those years psychoanalysis' heyday. A number of recent thinkers, however, have reminded us of the origins of our work (e.g., Wurmser, 2000). Analysis was not created for the treatment of the working well and it was not designed to necessarily work independently of other treatment techniques (other than interpretation, that is). There are those of us who regularly treat those suffering from the severer disturbances while recognizing the need to refer certain such patients for adjunctive behavioral, pharmacotherapeutic, or hospital treatments, while the analysis of defense, transference, and resistance continues (e.g., Wurmser, 2000). Psychoanalysis, indeed, began with the treatment of Anna O. , a woman whose dissociative states threatened her life and discontinued her everyday functioning. Most of us cut our theoretical teeth on the treatment of young Dora, whose borderline-like vengefulness carried over into a life of misery and complaint (, F. Deutsch 1957), just as we studied the work of The Master in the analysis of a young Russian who was sufficiently ill so that he couldn't travel alone to Vienna to see Dr. Freud—requiring, as he did, the services of a traveling psychiatrist and an attendant to dress him. These were our origins. The early analysts treated those for whom other treatments had already failed. Ira Brenner's Psychic Trauma follows in this tradition with recommendations for the treatment of patients suffering from multiple personality disorder (MPD) or, in the language of today's taxonomies, dissociative identity disorder (DID).
Early on (pp. 7-8), Brenner outlines an ambitious goal for this volume:
In contrast to the classic views regarding the organization and structure of the mind—(1) the structural theory of id, ego and superego, and the central role of the defense of repression; and