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After having read this book several times, I am still in the process of trying to digest Lear's many ideas; he is a deep thinker whose mind never rests. Emphasizing inquiry and openness rather than indoctrination, he takes us back to the past in order to help us better comprehend therapeutic action today. He helps us understand yesterday primarily by way of a rich, spirited conversation
about Loewald's classic essay, “On the Therapeutic Action of Psychoanalysis.” But his conversation does not stop there. He also joins Socrates, Kierkegaard, Loewald, and Freud in a conversation about irony (not to be misinterpreted as sarcasm) and therapeutic action. And then he brings Gray's ideas into the mix as he elaborates on Loewald's conversation with Freud. Tactfully and tastefully, Lear seasons his arguments with just a pinch of clinical material while he mines ideas that occur serendipitously to him, searching for their nuggets. His continuously shifting associations contain moments of stunning clarity, with insights that shake our assumptions about psychoanalysis and psychoanalytic theory.
Imagine how different the world would be today if government officials had heeded dire warnings years ago that the hurricane levees surrounding New Orleans could withstand an only relatively weak, “category-3” hurricane. Analogously, Lear issues a disturbing alert about “the disease of the current psychoanalytic profession” (p. 16). He argues that one of the symptoms of this disease is the institutional splitting expressed in analytic writing. Moreover, he argues that nowadays psychoanalysts do not know how to integrate theory into their clinical work; writing about analytic theory, among other things, is either altogether ignored or “has become so abstract and obscure that it becomes increasingly unclear what, if anything, this has to do with psychoanalysis as it is practiced in a clinical setting” (p. 16).
Throughout much of the book, the author contends that we psychoanalysts, for the