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In the present state of the practice of psychotherapy,
it is a brave man who dares write a book on technique. One cannot help but remember Freud's metaphor about psycho-analysis:
Anyone who hopes to learn the noble game of chess from books will soon discover that only the opening and end-games admit of an exhaustive systematic presentation and that the infinite variety of moves which develop after the opening defy any such description. This gap in instruction can only be filled by a diligent study of games fought out by masters.
Tarachow's book shows that while style and flare are, as in chess, crucial elements in good treatment, an attempt to understand the long middle stretches of dynamic psychotherapy is not hopeless.
There are a number of vehicles upon which the healing effects of psychotherapy are carried: interpretation, confrontation, empathy, transference, adherence to a theory, insight ('true' or intellectual, conscious or unconscious), sympathy, environmental manipulation, advice, and so on, each carrying its greater or lesser burden for the treatment at any particular moment. This excellent book takes these into account by the convincing use of clinical data, viewed from within a psycho-analytic framework.
An early chapter, 'The Theory of the Therapeutic Relationship', is a stimulating exposition, illustrating the powers the clinically experienced analyst can bring to dynamic psychotherapy. In this chapter, Tarachow is concerned with the issue, still so inflammatory to many analysts, of the differences between psycho-analysis and psychotherapy. Without resolving this issue (though the position taken in this book is that there is a clear theoretical and clinical difference between psychotherapy and psycho-analysis), he points out:
The very basis for an analysis involves really disappointing the patient. In psychotherapy we do not so globally disappoint the patient. This makes the therapist's role more bearable in psychotherapy than in analysis.
In ess