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Leopold Bellak's latest volume provides a “how to” approach to handling the crises and special problems that occur in psychoanalysis and analytically oriented therapy. His common sense practical approach to treatment avoids the formulary and in its more free wheeling and spontaneous stance enlarges the scope of the analytic field of operation, giving the analyst license to step out of analytic garb into less formal attire. By so doing he means to loosen some of the strictures placed on traditional practice and bring it into better alignment with our humanistic times.
While contending that modification of the analytic process is highly desirable, Bellak worries that this stand could be considered akin to treason by some and taken by others as a green light for inappropriate intrusion into the therapeutic process. To forestall misunderstanding he cautiously sets forth in italicized sentences in the introduction the conceptual framework which underlies the book: “The most appropriate and useful attitude of the psychoanalytic therapist is to observe therapeutic neutrality …. [But] it is as important to abandon therapeutic neutrality under special circumstances as it is to observe it in all psychotherapeutic situations.”
The rationale for flexibility derives in part from the paucity of classical neurotics who, if not quite an endangered species, are far less numerous than in times past. The psychoanalyst perforce must see in addition to this shrinking population of neurotics a mix of patients with character disorders, borderline conditions, and psychoses, who have less well developed ego structures and fewer adaptive resources. These individuals, being more subject to crisis, require active and real interventions in therapy; crises in particular mandate temporary suspension of therapeutic neutrality with its “luxury of distance.” It is unfortunate, I think, that Bellak finds it necessary time and again to apologize for his “apostasy” since current ideology clearly has it t