Psychoanalytic Psychotherapy by Nancy McWilliams New York:  The Guilford Press, 2004;  353 pp.

Nancy McWilliams sets out a challenging agenda at the beginning of her book on psychoanalytic psychotherapy. Writing for the beginning psychotherapist, she seeks to provide the “essential features” of psychoanalytic therapy, taking into account the variety of patients seeking treatment, including those typically organized under the rubric of the so-called “widening scope” (Stone, 1954) of borderline, narcissistic, anti-social, PTSD, and other severe psychopathologies. Drawing from an extremely broad range of theoretical orientations to explicate her thinking, McWilliams walks a line between eschewing Procrustean technical precepts and asserting specific interventions in the service of letting the reader see her in action. In so doing, she provides a model for trial identifications with her and also potential for critique.

Approaching this review as a teacher and supervisor of beginning psychotherapists and psychoanalysts, the guiding question that formed in my mind was: How well does this book address what I think the neophyte psychoanalytic psychotherapist — for whom the book is written — should know and think about?

McWilliams astutely recognizes that her book occupies a particular historical and intellectual context. It is the age of psychoanalytic pluralism with the concomitant tension of what, if anything, constitutes “common ground” (Wallerstein, 1988, 1990) between different approaches, all of which call themselves “psychoanalytic.” She sharply and sweepingly puts herself forth as providing an integrative “embracing and less narrow” (p. 9) viewpoint in hopes of starting “a conversation about therapy that traverses theoretical orientations and professional disciplines” (p. 9). In her mind, this dialogue is proposed to counter a psychoanalytic discipline characterized by “arcane terminology and the trappings of a historically much too smug fraternity” (p. 9).