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There has been a perhaps justifiable reaction against psychoanalytic theory in its most abstract form—that is, a theory separated from its clinical base. This work by Gedo and Goldberg uses theory not as a set of universal laws but as a means of organizing clinical experience. Their major thesis is that there is a broad spectrum of disorders to which the tripartite structural model does not apply. They are referring to patients who have not achieved a good resolution
of the Oedipus complex, patients with a structural arrest in the area of the sense of self, who are characterized by a tendency to use the mechanism of denial, with a resulting relative loss of the ego's synthetic functions. Further, these patients do not share the same capacity, as do 'classical neurotics', to develop a therapeutic alliance and a transference neurosis. The range of these disorders includes a variety of nosological designations but the authors pay special attention to Kohut's description of the narcissistic character disorder. The usefulness of theory here is apparent, for the alternative to a comprehensive psychoanalytic theory is a veritable Tower of Babel, with each clinician employing his own conceptual language.
Now, a model is an attempt to idealize the relationship of structure and function for heuristic purposes. A good model should be relatively simple and yet faithful to the data from which it is derived. Freud's tripartite model, the authors would claim, is useful only in a limited sense, since it applies only to those patients who have achieved the triadic stage: those who have achieved some resolution of the Oedipus complex and a relatively good differentiation of their psychic structure. However, Freud's model of the ego and the id was intended to be something more than the model for clinical syndromes; Freud was addressing himself not only to specific forms of neurosis, but was creating a universal system of classification for all mental phenomena, regardless o