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This book evolved out of a conference celebrating the 50th anniversary of the New York University Psychoanalytic Institute at the New York University Medical Center. At the meeting Dr. Claudia Lament presented a case to four discussants: Kathleen Lyon, Shelley Orgel, Peter Neubauer and M. Nasir Ilahi. The first three come from a more or less ‘classical Freudian’ perspective according to the editors, and Ilahi represents the British object-relations point of view. What is unusual about this volume is that the editors decided after the conference to engage the participants in further written dialog. Thus, we have here two more cycles of interaction among the discussants.
While the title of the volume suggests the book will explain how and why analysts think the way they do, I would like to paraphrase that to ‘how some analysts think.’ The perspective of self-psychology and outlook of a relational analyst were missing, though self-psychological thinking had clearly influenced some of the participants.1 Nor did I come away with a very solid idea of the ‘why’ they think of the clinical material as necessitating the particular theoretical perspective that each has, rather than any other. That said, I enjoyed the dialog immensely. I read most of the book riding home from work on the bus and I found myself wishing that the trip were longer so I would not have to stop reading. What I liked about the book was the detailed clinical material and the chance to struggle personally with the ideas of the discussants.
Dr. Lament's patient, Mr. A, was a middle-aged entrepreneur and writer, despondent over the break-up of an affair with a married woman. He seemed engaged in the analysis, but reached a phase in which he was very critical of the analyst and spent long periods in silence. After much frustration, Dr. Lament found herself in a reverie, seeing a lonely little boy futilely trying to make contact with a depressed mother. She imagined the mother angrily yelling, ‘Get out,’ while