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As the subtitle promises, Rothstein undertakes in this book the worthy enterprise of reviewing psychoanalytic structural theory as an evolving organic theory, contributing along the way to its ongoing expansion in response to new experience and new data. He contrasts this with what he calls the revolutionary effort which view structural theory as a finite finished product, now outmoded, beyond repair, and needing to be discarded and replaced. He expands here what he has written previously to elucidate his view of structural theory as a conceptual framework adequate to encompass primitive, later preoedipal, and oedipal psychopathologies in a clinically meaningful and useful way.
Against a background of Thomas Kuhn's views of the paradigm in science, the author begins with a review of the effects of irrational narcissistic investments on our theories, on theory-building, and on the retention or discarding of particular theoretical frameworks. A narcissistic investment in a given paradigm, the traditional or the new, holds forth the promise, or conviction, of perfection. Internalized into the scientist's self-representation, it arms him against helplessness and uncertainty. Rothstein presents an interesting elaboration of certain special issues in psychoanalysis which he believes contribute to the pressures toward making paradigm changes. These include frustration over limits to the therapeutic effectiveness of psychoanalysis, which stimulates modifications in search of more favourable result with a broader spectrum of patients, and controversy over such issues as the primacy of oedipal vs pre-oedipal conflicts. He presents interesting discussions of the contributions of Mahler and Kohut, describing the efforts of the one to remain within the conceptual umbrella of traditional metapsychology, and of the other to emphasize, in latter years at least, the radical nature of his departures. These efforts to remain or depart are not necessarily proportional to the deg