Discussion

THE BOOK FOCAL PSYCHOTHERAPY IS a fascinating and carefully elaborated documentation of the treatment of a man in a paranoid state. The authors of the book investigated the feasibility and effectiveness of choosing and sticking to a major focus for therapy. Doctor Balint, in treating the patient, deliberately overlooked clinical material and responses of his patient that might have suggested another focus. The authors cogently present their reasons why this particular focus was selected. They indicate both the positive and negative effects that the therapist's interventions based on achieving his aim had upon the patient. In an unusually honest manner, Balint presents his own reactions and state of mind during and after the therapeutic sessions—the interpretations he considered giving but did not, his fears about treating so disturbed a person, and his confusion when he did not understand what was taking place. In chapters written after Dr. Balint's death, Dr. Ornstein thoughtfully discusses the patient's treatment experience as a process and the nature of the patient's personality and illness. He straightforwardly highlights the problems in treating someone with a major disturbance by a focal psychotherapy.

What can we learn when we read and think about what has been