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This is an outstanding collection of articles written by practitioners who have had extensive contact with Margaret Mahler, M.D., and Selma Kramer, M.D., and who have a long-standing interest in this area of development. Thirteen of the contributors are from Philadelphia. The others either trained there or in New York with Mahler or are those whose own interests led them toward the separation-individuation phase of development. The essays are divided into three groups: theoretical contrast, comparison, and update of separation-individuation theory; the contribution of theory to the understanding of psychopathology; and implications for treatment. References are conveniently placed at the end of each essay, and there is an extensive name and subject index. The editing was done well. The contributions read well, and for the most part there is a unity and integration binding the essays to one another, probably a reflection of the many years of discourse and study among the members of this tightly knit group.
The all too brief “Prelude” reviewing Dr. Kramer's odyssey to child analysis is a delightful way to introduce the volume and to help us understand why we, too, honor Dr. Kramer. It also serves to remind us how little we actually know about our esteemed colleagues and how much is gained by even a short biography. Too often we confuse analytic neutrality with personal anonymity.
The title most likely stems from Akhtar's chapter, “Three Fantasies,” wherein he suggests that his patient's fantasy of “being on a tether” is attributable to unresolved separation-individuation issues. The tether served to keep the patient within the symbiotic sphere of the mother. To approach the outer limit of this orbit caused the patient considerable anxiety, necessitating a retreat to a more central (symbiotic) core position. “Symbiotic orbit” was first used by Mahler in 1975 to refer to the