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Boyer and Giovacchini aim to demonstrate that the classical psychoanalytic method is therapeutically effective with a wide spectrum of severely disturbed patients, ranging from character disorders through the borderline states to the schizophrenic patients one encounters on the acute ward of a psychiatric hospital.
Boyer first appraises Freud's early theoretical formulations regarding the psychoses, particularly his statement that, because in narcissistic neurosis no transference reaction can be formed, psychoanalytic treatment is impossible. Clinical experience has not upheld Freud's dictum that total withdrawal of object cathexis is an integral part of psychosis. Boyer suggests that Freud, faced by Mr. X and the Wolf-man who were potentially psychotic patients, lost faith in the classical psychoanalytic method and responded with interventions motivated by countertransference. As a result his patients failed to improve. Boyer believes that had Freud not acted upon his fear of imminent psychotic decompensation in these patients, the therapeutic results would probably have been favorable and subsequent generations of psychoanalysts would be less timid in widening the scope of classical psychoanalysis.
In the light of the structural hypothesis and ego psychology, the authors view the neuroses and psychoses as a continuum of disorders to be differentiated chiefly by variable regressive alterations of ego functions. If such a continuum exists what better method of treatment than classical psychoanalysis?
In a chapter on Freud's followers, particular attention is given to Melanie Klein and Harry Stack Sullivan. Boyer's description of his own therapeutic work suggests that he was more strongly influenced by them than is apparent from his critical analysis of many of their basic concepts.
In the last chapter Boyer succeeds in giving the reader a feeling for his therapeutic style. Considerable emphasis is placed upon