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Leonard Horwitz's Listening with the Fourth Ear: Unconscious Dynamics in Analytic Group Psychotherapy is an amazingly comprehensive, supremely clinical book written for students and practitioners of group psychotherapy,
as well as for individual therapists whose work would be improved by learning more about group tensions. I might add that I hope those of us who teach in psychotherapy training institutes will also read it, because we need to learn about our involvement in the group dynamics of those institutes so we can free them to change and grow in relevance and resilience.
Horwitz describes the forty-year history of group psychotherapy in the United States and how it led to his own major contribution as a clinician and researcher at the Menninger Clinic and a leader of the American Group Psychotherapy Association. One of the fathers of psychoanalytic group psychotherapy, and a sustaining practitioner and teacher whose main interest is group therapy, Horwitz nevertheless makes it clear that the treatment of the individual is always his primary concern. He moves the concept of group psychotherapy beyond the notion of individual psychotherapy practiced in a group setting to a view of it as treatment of the individual by attending to the effect of the group process on the individual. He delves into projective identification in groups and into individual, peer-to-peer, and group-to-therapist transference, leading up to a chapter in which Horwitz introduces his own theory and practice. Clinical illustrations of his approach with specific types of pathology, mainly narcissistic and borderline personality disorders, follow. The book concludes with a section on experiential training groups for mental health professionals and for those training specifically in group psychotherapy programs or workshops.
Horwitz begins by reviewing the history of the development of the field of group relations in the United States, respectfully catalogues the diversity of approaches to anal