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This is a well organized and scholarly book, a credit to its author, a young man of obviously wide clinical and teaching experience, at the time of publication an advanced candidate at the Boston Psychoanalytic Institute. He is Director of Clinical Services and Co-Director of Psychiatric Residency Training at the Cambridge Hospital and Assistant Professor of Psychiatry at Harvard Medical School. He states that the book is aimed at the clinician relying on current psychoanalytic understanding and willing to revise it in the light of clinical observation—psychiatrists, and advanced degree clinical psychologists, psychiatric social workers, nurses, but also medical students etc. He may well be aiming accurately at such groups in the USA; in Britain he is likely to be shooting over their heads. But most psychoanalysts and psychotherapists, and their advanced students, would gain a lot from this book. Perhaps, like all heartfelt books, it was written for its author.
Paolino clearly states in Chapter 1 that while disavowing prejudice against other responsible treatments (e.g. group, family, behavioural or supportive) which may be more useful to some patients, he believes that psychoanalytic psychotherapy is the most potent instrument by which to 'elicit a fundamental and relatively permanent and stable alteration of personality structure and eradication or significant reduction of painful psychological processes'. He declares his bias that 'the hallmark of wellbeing is awareness of one's psychic and bodily self'. However, he warns that psychoanalytic psychotherapy will not be useful to the patient unless (1) the therapist has become a fully developed psychoanalytic