Ego Psychology: Theory and Practice: By gertrude and Rubin Blanck. New York and London: Columbia University Press, 1974. 394 pp.

In one of the outstanding laboratories of a leading medical school there is a sign that reads: 'In this lab we use the scientific method—try anything!'. In our attempts to deal with severely regressed or primitively organized patients, we all, at one time or another, have used this 'science'. A burgeoning literature is now helping us to think about what we are doing.

Gertrude and Rubin Blanck's Ego Psychology: Theory and Practice is an important addition to this literature. The book offers a compelling method of psychotherapy based on an ego-building technique rooted in the theoretical contributions of Hartmann, Mahler, and Spitz. By defining the neurotic patient as one who can be analyzed 'without the use of significant parameters', they are able to concentrate their effort on describing and explaining a variety of devices they have found useful in the treatment of individuals with more severe disturbances. The section on technique which makes up the second half of the book is particularly helpful; even the experienced therapist will find himself drawing on their sensitive advice. Their technical recommendations focus mainly on the nonneurotic patient, on borderlines and psychotics. In general, their position is: the better the patient's 'foothold in secondary process', the more the technique can allow and make use of regressive material. The estimation of the firmness of this foothold is a diagnostic process that continues throughout the therapy with the therapist assessing the dynamically important developments from