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This massive volume outlines an original hypothesis about psychological development and psychoanalytic treatment of its pathologies. The author is a senior figure of the Finnish psychoanalytic and psychiatric communities, but he has spent several years at the Austen Riggs Center in Stockbridge and has written this book in excellent English. The text does not always make for easy reading, but the difficulty comes from excessive use of the construct language of psychoanalysis and the relative scarcity of clinical reports: the entire book contains only eight case vignettes, taking up a mere six pages.
In a laudatory Foreword, Robert Wallerstein states that Tähkä actually presents us with two separate works, a 150-page monograph on the formation of the mind, and about 300 pages focused on psychoanalysis as treatment. I disagree with this, for Tähkä's theory of development, insofar as it relies on empirical evidence, is entirely dependent on clinical observation. One might question the author's methodology, as his rationale for various technical options is most often based on his conceptions about development, so that his arguments tend at times to be circular. This problem is aggravated by his exclusion of data from fields beyond psychoanalysis. His definition of psychoanalysis, however, is the broadest conceivable, including even the hospital treatment of schizophrenics, so that the practical experience he draws on is impressively wide.
Tähkä is truly an exemplar of “psychoanalytic psychiatry”; it is no coincidence that his book has earned endorsements from such American psychoanalyst-psychiatrists as Otto Kernberg and Vamik Volkan—nor that a disproportionate number of his references to