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John Gedo, who is one of our more prolific psychoanalytic authors, continues to elaborate in this work on his particular view of the psychoanalytic enterprise. A subtitle might have been: How many analysts does it take to change a paradigm? John Gedo approaches the current state of psychoanalysis with his usual wit and irreverence. It may even be pretentious to refer to paradigms in psychoanalysis; perhaps we have come too far to even pretend that we can share a common conceptual language. Other analogies regarding the current state of psychoanalysis are evoked by Gedo's book: contemporary psychoanalysis can be viewed as an assemblage of schools similar to those schools of painting clustered about the artist who demonstrates a new technique and with it asserts a new method of interpreting reality, whilst others, in opposition, retain a neoclassical vision. And there are those analysts, without followers, who have their own personal vision of psychoanalytic reality; they are in effect a one-man school. These divisions may be described politically as left, right, and center, or they may be, as Gedo suggests, divided in accordance with early religious controversies concerning original sin—whether or not one believes in the perfectability of man.
Despite the fundamental theoretical controversies within contemporary psychoanalysis, Gedo has chosen to write a book that for the most part skirts conceptual issues and has as its centerpiece two lengthy case histories of patients who can be described as on the very edge of analyzability. Of course there will be those who will question whether what Gedo has presented is psychoanalysis or a lengthy psychotherapy using a psychoanalytic setup. That type of question I find to be not particularly interesting as it hinges on a completely arbitrary definition. Be it psychoanalysis or not, Gedo has portrayed favorable outcomes in the treatment of very difficult patients, so that there is some need to account for the outcome