Childhood Dialogues and the Lifting of Repression. Character Structure and Psychoanalytic Technique: By Paul Graves Myerson, M.D. New Haven/London: Yale University Press, 1991. 154 pp.

Myerson, identified on the jacket as Emeritus Professor of Psychiatry at Tufts Medical School, has written a wise and eminently readable book on the treatment of patients who are not able to tolerate a classical psychoanalytic approach, the aim of which he defines as the lifting of repressions. The subtitle of this book, Character Structure and Psychoanalytic Technique, is somewhat misleading. The word character does not appear in the index, although the book deals basically with the understanding and management of the attitudes of patients with narcissistic psychopathology who are not able to tolerate the frustrations of a "classical approach," either because they lack basic trust, do not believe emotionally that the therapist has their best interests in mind, or are unable to tolerate the unpleasant affects engendered by the process. No attempt is made to infer character pathology in terms of intrapsychic structures and no organizing framework, either dynamic or developmental, is offered. Be that as it may, the book is clearly written in a refreshing style, very close to the level of observation and with a total absence of jargon.

The first part of the title clarifies the author's theoretical orientation: Childhood Dialogues… The term "Dialogues" as used by Myerson refers to an interpersonal event in the past between the child and his or her parents. The basic assumption is "that only someone who has had helpful interactions and dialogues with a parent during his preoedipal and oedipal years is capable of lifting repressions" (p. 3). These dialogues, when successful, allow the