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THIS IS A WONDERFUL, revolutionary, somewhat fragmented, difficult, and very important book for all psychotherapists and psychoanalysts. The issue of boundary violations by ourselves and our colleagues is problematic. It was never resolved by Freud, Jung, Ferenczi, or their contemporaries. Where is the “proper” analytic, boundary — how close and how far? How do we enact our ultimate seperateness or express our unenmeshed attachment? Boundaries and boundary differentiation are at the core of all analytic work. We are indebted to Gabbard and Lester for this scholarly, clinical entrée into such difficult terrain.
The book begins with a review of theories of boundaries and boundary differentiation. To my mind, this is the book's weakest point. It frequently gets bogged down in theoretical abstractions. The most cogent (i.e., clinically useful) concept that they discuss is that of “thin/thick” and “inner/outer” boundaries. The essential idea, I believe, is an attempt to consider whether therapists may require “thick” inner boundaries (e.g., professional identity, sense of self) to define who they are, while simultaneously presenting “thin” outer boundaries to make themselves empathically available to take in, understand, and identify with patients' inner worlds. Alternatively, if one has “thin” inner boundaries, does that reflect an insecure identity and sense of self, or perhaps a helpful capacity to explore one's regressive inner life? Likewise, “thick” outer boundaries may express one's difficulty in either understanding or empathizing with another's experience, or they may express the necessary interpersonal bulwark that is required to engage with patients while warding off the extreme pressure and seduction to become merged. In a style characteristic of their approach throughout the entire book, the authors discuss the possible implications of the various configurations, without answers and without judgment. They thoughtfully raise questions for the reader to conside