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In these days of managed care, with the emphasis on short-term therapy, it is refreshing to find works dealing with the theory and techniques of psychoanalytical psychotherapy. This book focuses on the treatment of families that present with problems with an adolescent. The theoretical background is based on the work of Melanie Klein and Wilfred Bion, and there are many rich case presentations to give color and significance to the text. Though the chapters are authored by several therapists, there is a remarkable consistency of tone and of content, which makes for easy reading. This is probably due to the skillful editing of Sally Box, and to the fact that all of the authors had worked together at the Tavistock Clinic in London.
Familiarity with the Object Relations School is helpful, but not a necessity in understanding the therapeutic approach, for the authors to provide sufficient basic foundation material. The clinical case presentations, for the most part, deal with the therapeutic application of such concepts as splitting, the paranoid-schizoid position, and the depressive position, which have come out of the writings of Melanie Klein. W. R. Bion's contributions, particularly the concept of the container-contained, also serves to clarify the struggle of the adolescent to individuate himself/herself within the family context.
Most of the therapeutic interventions are couched in terms of the therapists' understanding of projective identification. The therapists are sensitive to what is being placed in them by the family group (Bion's concept of the working group). I have questions about the notion of the passivity of the recipient of these “projections.” The case presentations do reveal how the therapist can use his or her sense of what the family can expect, and how this then clarifies the issues within the family. Again, it is Bion's view of the group being represented by a spokesperson. This gives the family a one-dimensional view, in contrast to the multidimen