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In theory, every change in practice requires a change in theory. However, the analyst's personal proclivities, wishes for idiosyncratic satisfactions, and the many exigencies of everyday practice do not invite a steady integration of theory with practice. While we wait for innovations to find a place in theory, many are forced to use increasingly subjective indices, of immediacy, relevance, and efficiency, to guide our work. Some would say they are the calling cards of contemporary clinical work. Sandra Buechler, in Making a Difference in Patients' Lives: Emotional Experience in the Therapeutic Setting, describes how she works with emotions—her patients' and her own—to bring about change. In doing so, she attempts to lay the foundations of a general theory of emotions and to examine its relevance to the analyst's emotions in treatment.
Using interpersonal psychoanalysis, which is her stated training background, and a theory of emotions she ascribes mainly to Izard (1977),1 as well as the insights of a substantial clinical and scholarly career, she addresses several wide-ranging topics in this book. She begins with eight assumptions about emotions, many overlapping: emotions are separable into discrete and enumerated states, such as sadness and joy; each emotion alters every other emotion within an “emotion system”; cognition affects emotion, and vice versa; emotions are adaptive; each emotion has discrete motivational and species-specific importance (after Darwin); each person has an idiosyncratic history with each emotion due to personal and social experiences; and emotional life is frequently implicit, unformulated, and unverbalized.
Although none of the author's assumptions about emotions appear to be new, she sees them as providing a framework for clinical interventions she finds groundbreaking and curative. After describing the eight assumptions about emotions, Buechler leaves the dry shore of theory and wades into what seems like many oceans of experience all at