For Love Or Money: A review of Psychoanalytic Technique and the Creation of Analytic Patients by Arnold Rothstein, M. D. New York: International Universities Press, 1995. 137 pp.

ARNOLD ROTHSTEIN HAS WRITTEN a unique, provocative, and clinically useful book. His topic is the creation of an analytic process with new patients who want their treatment to be conducted in some way other than what the analyst recommends. For Rothstein, this usually means that they want lower fees, less frequent sessions, or a chair instead of the couch. Readers, however, will find that his thinking about and handling of those particular disagreements are applicable to virtually any disparity between how clinician and patient want to proceed.

Rothstein aims to enhance our ability to open an analytic process in which there is an opportunity to understand patients’ motives for not wanting to follow the recommendation of the professional they consult and whose opinion about treatment they have requested. The catalysts for writing the book appear to be (1) several studies over the last two decades which indicate that most analysts spend much time doing clinical work that they do not consider to be psychoanalysis; (2) Rothstein’s success in keeping his own practice filled with analytic cases (ten, in fact); and (3) his belief that when prospective patients say they want once- or twice-weekly treatment, to sit up, and a reduced fee, too often we meet such confusion and ambivalence with our own; we fail to hold in our minds with conviction, and to convey to prospective analysands with confidence, the attitude that analysis is likely to be the optimal treatment for what ails them and that a trial of it should be undertaken.

The book’s basic premise is that more patients would be in analysis if