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In this contribution to his ongoing studies of the psychotherapeutic process, Langs has used minimally edited, transcribed tape recordings of a series of ten teaching conferences for beginning psychotherapists. The therapist who worked with the patient presents process notes to Langs and the group of colleagues. This format allows an accurate presentation of the clinical teaching process through spontaneous and unrehearsed reactions of an experienced therapist (Langs). It also presents the reactions of relatively less experienced therapists to the clinical material of a case other than their own. Langs is able to demonstrate the nature of his thinking and internal responses to the psychotherapeutic interaction between patient and therapist. And it allows him to make a variety of predictions in regard to the subsequent unfolding of the clinical material and interaction, which can then be tested by the further presentation of the original clinical data. From this, the reader has an experience of participation in this clinical exercise and a view into the working mind of a sophisticated therapist.
Langs's major thesis is that an extremely important element of the therapeutic process is the interaction that occurs between the two participants within a structured and firmly established psychotherapeutic situation. He demonstrates repeatedly the conscious and unconscious contributions of the therapist to this interaction, sometimes with positive therapeutic impact and sometimes in directions which disrupt the boundaries of the therapeutic situation. He emphasizes the invasion of the process by countertransference forces within the therapist, which have disruptive impact on the patients and their reactions. Langs's emphasis on the interactional elements of the therapeutic process represents a significant step beyond the usual focus on the purely intrapsychic elements within the patient.
This format, however, also has a number of disadvantages. Inevitably, there is