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Despite the enigmatic title, this book presents an interesting, useful and detailed account of the changing aims that psychoanalysts have pursued in their work both in theory and practice. The authors wisely pursue a historical approach, having failed to find any coherent contemporary formulation of aims and, dividing the history of psychoanalysis into decades, they describe the way that analysts in different periods were preoccupied with different themes. This provides a convenient structure for the book, and most analysts will value the detailed and thoughtful descriptions, not only of aims but of the trends in psychoanalytic theory and technique that each chapter provides.
Chapter 1 deals with Freud's views and although many will be familiar with the main themes this is one of the most fascinating in the book and shows Freud's impressive stature in relation to those who followed him. He is always interested in first principles and the authors show how his formulation of amis changed as his theory of the nature and structure of the mind developed. Making the unconscious conscious appears as early as The Interpretation of Dreams (1900) and soon the overcoming of resistance (1905) is added as a necessary task for the analyst. It is the confronting of resistance, including the resistance against insight, which has remained both a frustration and a challenge for later generations and this obstacle to development has had a variety of formulations over the years.
Sandler & Dreher point out how often Freud uses metaphors based on a military model when he speaks of resistance, conflict, defences, and fight against recovery, and are concerned with the dangers of adopting a moralistic stand if the analyst sees himself as helping the patient in a kind of war of good against evil. Freud himself avoided such a posture, but he did continue to see intrapsychic conflict as central, ultimately relating this to the operation of the death instinct in its endless struggle with the life