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The Therapeutic Process aims to impart insights to beginning students and clarity to experienced clinicians. Numerous clinical vignettes
strengthen this book, as do the excellent presentation and discussion of many dreams. In fact, almost an entire chapter (chapter 4, “Listening”—an idiosyncratic choice of title) is devoted to an introduction to dream theory and clinical work with dreams. There are good historical perspectives on the development of major theoretical concepts, and seminal psychoanalytic thinkers are referenced throughout the book, each with some comment about his/her theory or technique. A comprehensive bibliography complements every chapter; however, some cross-referencing between chapters would have been helpful to afford the reader with a sense of continuity and context of themes and topics.
Chapter 1 (“The Goals of Psychodynamic Psychotherapy”), chapter 2 (“Initial Evaluation of the Patient”), and chapter 3 (“Formulation”) instruct the student in how to begin a psychodynamic psychotherapy. They read like an encyclopedic overview of psychoanalytic theory and points of technique. The condensed information and tendency toward lists, here and elsewhere, might prove overwhelming for a beginning student of psychotherapy. In chapter 5, the characterization of defenses as primitive, middle level, or “neurotic”/mature (i.e., among other categorizations) may encourage a reliance upon descriptive rather than psychodynamic thinking, with a consequent stereotyping of patients. The explanation of resistance, in the same chapter, is rather brief, and the complexity and clinical application of the concept are not well conveyed.
The authors' approach is eclectic; they advise utilization of theory as a vehicle with which to understand the dynamics of an individual patient. Pine's (1988, 1989) important papers on what he described as the four psychologies of psychoanalysis—structural theory, ego psychology, object relations theory, and self psychology—are cited se