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Occasionally, a book is published that carries implication for the reader far beyond its stated purpose. This is one of those books. As far as its formal purpose is concerned, Dr. Steinman has quite successfully dealt a major blow to the myth that mental maladies involving delusion and thought disorder are beyond treatment with psychodynamic tools. In doing so he has done a great service.
The book is primarily a collection of psychotherapies carried out by Dr. Steinman with patients previously diagnosed with schizophrenia or similar conditions, as well as dissociative disorders manifested by multiple personality. Success of varying degree, involving remission of symptoms and increase in level of life function is reported with these cases, together with some sense of the time, energy and difficulties involved. The case reports are accompanied by brief discussion of therapeutic approaches as well as a general but also brief formulation of the dynamics of symptom formation. There is a somewhat sketchy and incomplete but pertinent discussion of personality integration and growth following therapy There are modest references to previous work in the area of the psychotherapy of psychotic states.
This book suffers somewhat from incomplete supportive and theoretical material behind the clinical cases discussed. However, such should not be construed to detract from the importance of the book, both clinically and beyond its immediate reference. I am informed that Dr. Steinman is aware of these shortcomings, and plans to address them in one or two subsequent books.
As I have already stated, this is a book of seminal importance for the psychotherapeutic and psychodynamic treatment of mental disorder—probably not only for the psychoses, but applicable to other diagnostic categories as well.
The tendency of modern psychiatry to deal with psychotic conditions exclusively through environmental support and psychotropic medication is continua