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For some years now, Gedo has been interested in constructing a “maximally inclusive and relevant clinical theory.” This book, the sixth in a series, completes his effort in this regard by contrasting his views and “their applications in the treatment setting” with
the views of others who have been engaged in innovative theory building.
Gedo's investigations, based on his reports here of 50 fully completed analyses over a period of 25 years, have led to certain technical innovations which extend “beyond interpretation.” His clinical experiences have revealed “the omnipresence of archaic transferences, that is, of deficit states that invariably underlie the more manifest intrapsychic conflicts … One must often go ‘beyond insight’ to account for the effects of interventions intended to be interpretive.” The technical need to make interpretations “presupposes a shared language between the participant, the achievement of which usually requires lengthy preparation involving noninterpretive measures.”
Modern analytic practitioners will be at home with this statement and with many of Gedo's statements which I have chosen to highlight for this review.
Gedo finds that the extensive work of a generation of ego psychologists points inexorably to the fact that “resistances generally derive from archaic fixations that antedate the oedipal stage of development … Most of the ego defenses which serve to ward off oedipal strivings consist of behaviors that constitute, at the same time, adaptive solutions to the psychological vicissitudes of still earlier phases of development.”
In treatment, such cases require a symbiotic partner to sustain the enactments of the archaic transferences (by which Gedo means the “entire field of preoedipal derivatives”). Such patients have missing psychological aptitudes and skills. “The task of identifying psychological deficits, of bringing them to the attention of the analysand, and of assisting the latter in learning to function in the area of deficit,