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Renik's book considers psychoanalysis as Freud thought of it, as others re-interpreted it, and as Renik's empirical data, collected over time from single-case studies, has shaped it. Not concerned with arguments, Renik speaks from his years of experience, saying what he
believes and illustrating it with cases. Renik is not advocating for an applied psychoanalysis here, but rather for the changes in analysis that he feels are needed due to its evolution. Take for instance Freud's original idea that the patient should come and talk rather than discharge in action. Having sex and making life changes were suspended for the relatively short time analysis lasted. According to Renik the trend toward longer analyses makes suspension of sex and life changes impractical these days.
Renik has long been looking at the changes in the work of analysis from the clinical perspective. Although his interest in the analyst's relationship with the patient places him in the relational school of thought, readers with a modern analytic background will agree with some of the modifications of technique he recommends, especially his idea that emotional experience rather than intellectual insight can promote cure.
Each chapter begins with a discussion of the theory or technique Renik is considering, and the remainder of the chapter is devoted to a case study. The chapters need not be read in order. Those familiar with Renik's writings may recognize some of the chapters from his papers of the 1990s (1995, 1996a, 1996b, 1997, 1998, 1999), following the relational surge prompted by Mitchell and Greenberg's (1983) book. Some cases, e.g., the boy with the bamboo phobia, come from work as far back as 1978.
Renik begins the book with a discussion of practical psychoanalysis, a phrase he feels is itself an oxymoron. He stresses that treatment should start with what the patient wants from treatment, for it is “the patient who must have the final word, because clinical analysis doesn't work when a patie