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This book is a pleasure to read. Any discussion of theoretical perspectives is given meaning and life by vivid case vignettes. We work best, the author writes, if we do not think in terms of diagnostic conditions or symptoms, but try to help by restoring the patient's own mental and physical regulatory and restorative capacities. So much of our sophisticated literature is predominantly about the analyst's conceptions and reactions and less about the patient's goals and participation. The book is about the mutuality of the analytic endeavor.
Bach writes with an expressive clarity, without jargon, which never leaves you hovering in a fog of abstractions. I enjoyed his description of our various therapeutic frameworks, usually referred to as ideologies. The basic metaphors with which each views the analytic situation differ. An emphasis on trauma and repression of secrets suggests a crime scene and an image of the analyst as detective and archeologist. A focus on resistance leads to a military metaphor of struggle against character armor. The object relations theorist brings to mind facilitation of growth, an unfolding, and a nourishing. Our most recent emphasis is on mutuality and interdependence. All of these metaphors highlight and by selecting also obscure. The military metaphor stresses structure and separateness; the nursing metaphor emphasizes process and continuity, like attachments. We need to encompass as many perspectives as possible, so we can be well attuned to all aspects of our patient's existence. Our most important therapeutic goal is to have the ability to enter the patients' world, get a sense of their raw experience, the phenomenology of their existence. This is far more than empathy. It means also having a sense of their self and their object awareness, their thought and memory organizations, and much else.
Not least, Bach believes that Freud was correct in his conclusion that the psychoanalytic cure is a cure effected by love. Bach devotes his last