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In Treating the Other Third: Vicissitudes of Adolescent Development and Therapy, H. Spencer Bloch, a certified child, adolescent, and adult
psychoanalyst, has endeavored to write a clinically serviceable, easy-to-read book regarding adolescent development bolstered by relevant research in the field—in short, a clinical textbook. This primer and his previous book, Adolescent Development, Psychopathology, and Treatment, from 1995, were developed as resources for teaching analytic candidates and psychiatric residents.
The book is organized in three parts and contains five chapters. The organization allows easy navigation of the book's offerings. Part I, the first two chapters, focuses primarily on psychotherapeutic treatment of severe psychopathology as illustrated by two case studies. Bloch informs us of his discovery, in reviewing the literature before writing the book, that fully one-third of adolescents treated for serious psychiatric disorders do not respond to psychotropic medications: hence the book's title. Flat-out refusal to take medication, poor response, and/or unbearable side effects leave fully one-third of teenagers untreatable with psychopharmacological agents. The cases presented reflect this cohort of adolescent patients. Bloch explores internal conflicts related to the presenting problems and the challenges confronting the therapist in maintaining a workable therapeutic frame. Careful consideration of the normative developmental press for independence and emancipation is emphasized.
Parts II and III stand in marked contrast to Part I. These pages unfortunately deal with a controversial and by now recognizably dated approach to homosexuality, one the psychiatric/psychoanalytic field has repudiated. Bloch informs us in his introduction that he tried for eight years to get this book published. I can only wonder if these three chapters did not dissuade publishers from accepting the book. Many readers will be as upset as I was to read, with pain for Bloch