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Stanley Greenspan is an eminent psychiatrist, professor and psychoanalyst based in Washington who has written prolifically, this being his twenty-eighth book. He writes in the introduction that he is aiming to present a ‘new developmental theory that unifies and extends the practice of psychotherapy’ (p. 1). His own psychoanalytic base seems to be contemporary Freudian, and his psychoanalytic theories are framed within this tradition and its language. However, he sees the aim of this book as partly to challenge the hegemony of any particular theoretical framework and to attempt an integration of psychotherapeutic techniques as diverse as self-psychology, object relations, supportive therapies, short-term therapies and even behavioural techniques. Indeed questions of technique and ‘tactics' are at the heart of the book, and specifically the myriad possible interventions from which we are called upon to choose in each moment of a therapeutic encounter. Greenspan is particularly keen to warn against the ways in which we may defensively use overly well-worn interventions at inappropriate junctures. In numerous detailed case examples he focuses particularly on therapies that fail or reach an impasse because the therapist has been insufficiently aware of the specific developmental stage a patient is at. Indeed, the notion of developmental levels is Greenspan's organizing principle, around which his theories are based.
In the first chapter he outlines his ‘principles of developmentally based psychotherapy’. He states his aim of harnessing a number of what he terms core developmental processes. These have to do with the capacities for self-regulation, forming intimate relationships, engaging in boundary-defining gestures, representing internal experience such as wishes and affects, and being able to differentiate between these internal representations and to build bridges between them. Other clinicians better known to this journal, such as Alvarez (1992), have argued that we