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This is a timely book which provides an overview of the historical origins of assessment in psychoanalytic theory and practice, the current state of debate and research, and several contributions from psychotherapists working in the Clinical Services of the British Association of Psychotherapists.
In her foreword Margaret Tonnesmann clarifies some confusion which can result from different approaches to assessment which have reflected a move from the symptomatic diagnostic approach of early psychoanalysis and psychiatry, together with estimation of intelligence, ego strength and motivation, towards the use of the concepts involved in early object relations which determine mental and psychic health. This requires the assessor to attempt some use of transference/ countertransference in the process in order that both parties can discover if ongoing psychotherapy could be helpful. She points out that ‘diagnosis of illness is only important at the borders’. That is where we need to be alert to overt psychosis, suicidal impulses or acute acting out.
In their introduction the editors stress the importance of assessment in a climate of a range of therapies being offered. And the necessity of establishing parameters in which it is made clear what can or cannot be offered by a psychoanalytic psychotherapist in private practice. It is an incredibly hard task. In one meeting between two strangers there is an expectation to differentiate between those for whom the psychoanalytic method is not appropriate and who may benefit from another form of treatment, and those who can make a serious commitment to intensive work.
In view of this undertaking which cannot escape the inherent dangers of deciding what is best for someone, it is perhaps understandable that I found some of the outlines for assessment and technique sounded rather imperative. There are a lot of ‘musts’ and for anyone embarking on this work it would be formidable to encompass a social and developmental history, whilst ‘g