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It is a pleasure, albeit somewhat mixed, to welcome Fred Pine into the thin ranks of psychoanalytic ecumenicists—the stubborn few who refuse to join one of the competing schools that vie for our allegiance in this era of glasnost. Undaunted by the prevalent demands for theoretical and technical simplicity, Pine insists that unprejudiced attention to clinical material demonstrates that the four clusters of issues alluded to in the title of his book may have independent roles in pathogenesis, though in varying proportions in different instances. He rightly implies that excessive emphasis on one of these clusters (or perhaps a combination of two of them) characterizes the approach of many of the ideological factions within psychoanalysis. The latter may therefore be condemned as reductionistic, although Pine grants their proponents some credit for highlighting one or another of what he regards as the alternative "psychologies" at our disposal.
The argument for an ecumenical position stands or falls on the persuasiveness of its proponents' clinical accounts—at least, this will continue to be the case as long as unbiased follow-up studies of analyses conducted in accord with different premises remain unavailable. Pine is clearly aware that his narratives of clinical work form the core of his book; in addition to two cases culled from the literature, he provides a dozen fresh clinical illustrations, ranging from relatively brief vignettes to a couple of fuller accounts from completed analyses. Depending on the particular purpose of the illustrative material, it might be focused on reasonably detailed extracts from specific sessions (even some verbatim accounts), or it might organize narratives of analytic process in terms of the meaning of the data encoded in the construct language Pine favors.