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This book is an unusually detailed and instructive record of a psychotherapy. Treatment was carried out on the basis of one interview per week. It lasted for 6½ years, starting when the patient was just 16 years old. The first 6 years are given as a near-verbatim record of the individual sessions (216 sessions), whilst the last half-year is summarized. In addition, Dr Parker presents her comments on the sessions and her views on some major problems of psychopathology and of technique which are of general significance. The reader is thus enabled to follow closely her interchanges with the patient, whom she calls David, as well as her deliberations outside the therapeutic sessions.
As the sub-title shows, Parker is cautious in her diagnosis, choosing the milder term 'disturbed' as compared with Lidz, who regards the patient as schizophrenic or pre-schizophrenic. However, this milder diagnostic label does not mean that she was at any point unaware of the seriousness of her patient's illness. Discussing the problem of diagnostic designations, Parker suggests that it is a matter of semantics rather than of substance. As regards her patient she explains that she saw him nearer the normal end of the spectrum and therefore would call him a borderline patient. In fact, however, her diagnostic criterion, as she makes very clear, was based on her feeling that she could establish a significant therapeutic relationship with him. The patient's smile in response to a question settled, as it were, her diagnostic and prognostic qualms and made her decide to undertake his treatment, in spite of the highly unfavourable external circumstances in which it had to be carried out from the very beginning.
Although only a few facts about David's early history and his parents could be mentioned, it is clear that his illness was of long standing and that he grew up in a climate of severe conflict between his parents. He was born during a time of stress for them. His father was often