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Modell has now assembled the most comprehensive view yet of his way of conceptualizing psychopathology, psychoanalytic technique, and the goals of psychoanalysis from an object relations perspective. His writings over the past thirty years have ranged from the theoretical examination of metapsychological concepts to the clinical theory derived from the practice of psychoanalysis. Well known for his conceptualization of "the holding environment" of the psychoanalytic situation and his description of "pseudo self-sufficiency" as a narcissistic defense against affects, he has tended in his works to focus more on the primitive end of the spectrum of patients seeking analysis than on the more "classically neurotic" end.
Modell has attempted to differentiate his views from those of other theorists and clinicians. He has made it clear, in previous works as well as in this one, that he is not in the camp of "classical" theory (and its primary emphasis on internalized structural conflict to the neglect of object relationships and the two-person nature of the psychoanalytic situation). He has also made it clear that he is not in the camp of self psychology with its primary emphasis on developmental "deficit" and the need for corrective emotional experience in the two-person psychoanalytic situation (to the neglect of internalized conflict and the role of transference interpretation). Rather, Modell wishes to encompass the strengths and to avoid the deficiencies of both of these competing theories by focusing on internalized object relations and their conflicts as re-experienced in the psychoanalytic situation, where both the relationship to the analyst and the use of transference interpretations regarding conflict have complementary and/or synergistic roles.
Modell begins this work with a historical review of Freud's limited consideration of the theory of treatment and of the role of the analyst as object in the psychoanalytic situation. He cites Freud's overemphasis on t