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Lou's book—most of his patients addressed him as Lou—is filled with his patients' reactions to their treatment. A distinguished psychoanalyst, he aims this book at people considering psychological treatment, and provides commentaries from many of the patients (in their own words) he has helped or not helped in their analytic work together. He cites only three other books in the past several decades with comparable detailed descriptions by patients of their analytic treatment.1
The tone and thesis are established in the first paragraph of the prologue, written by a former patient named Elizabeth. She comments “that Not Knowing” was okay” (p. ix). It is unlikely that Elizabeth is aware of Jonathan Lear's description of the affliction widespread among psychoanalysts that he termed “Knowingness,” i.e., knowing all one needs to know about psychoanalysis and psychoanalytic treatment. Lou either has a very strong constitution or had the benefit of an effective vaccination, because he seems immune to this common analytic ailment, and that is clear to his appreciative patients. Perhaps it is an expression of analysts' “Knowingness” that they fail to consider, as Lou does, that they may have a good deal to learn from their patients' views. His freedom from this affliction enables him to demonstrate how much can be learned from patients' views.
One important theme of the book is the patient's need to feel cared about, indeed, deeply cared about, by the therapist. Several patients cited their conviction that Lou really liked them, and the role that feeling played in their coming to like themselves. Lou wrote that it is “impossible to work at a deep emotional level with people over long periods without developing real affection for them” (p. 113). In one attuned expression of affection, he sent a patient a couple of CDs after learning she shared his enjoyment of the same music. As another patient, a young man who had reported having had too much to drink the previous night, left t