Wisdom In The Practice Of Psychotherapy.: By T. Byram Karasu, M.D.. New York: Basic Books, 1992. 300 pp.

This book is organized through a series of axioms in which the author hopes to capture the essence of “wisdom” in the practice of psychotherapy. Karasu has designed these axioms to try to amplify and sharpen the therapeutic process for the reader. He is concerned with what psychotherapists do when they treat patients, and the axioms presented are an attempt to “locate the interface of theory and experience” (p. xvi). Karasu attempts to elucidate specific techniques as well as to present a philosophy of the interface between theory and strategy. He identifies basic principles of treatment which are grounded in the major theoretical concepts of the four major psychologies: drive theory, ego psychology, object relations theory, and self psychology. The emphasis is on helping the clinician synthesize these schools, on increasing the ability to think simultaneously in multiple frameworks, and on developing the skill to shift to different perspectives, within the basic context of dynamically oriented psychotherapy. To achieve these ends, the book is arranged in thematic sections, not in conventional chapters. Important questions are posed at the start of each section and answers searched for.

I think this format is remarkably successful, capturing the reader's interest and transcending the inherent difficulties of focusing on one particular topic at a time. Karasu's attempt to coordinate technique with theory and strategy is particularly useful. The book is engaging, interesting, and easy to read. Karasu states that this book is primarily directed toward the clinician already familiar with basic premises and practices of psychotherapy. I found myself repeatedly thinking that this would be a good basic teaching textbook for the beginner because of the focus on synthesis of theory, common sense, and technique. It seems equally useful for the more experienced psychotherapist and psychoanalyst, as we are reminded, in an interesting, clinically focused way, of basic precepts th