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This book will be valuable to all psychotherapists who work dynamically with regressed patients. Although the author focuses on the difficulties associated with working with severely disturbed patients, much of what he presents could also apply, perhaps to a lesser degree, to analytic work with neurotic patients.
Particularly useful is his explication of countertransference, in chapter 2, as a phenomenon that is almost always present.
Here he shows how Freud's original definition, suggesting that countertransference is always negative, disrupts the natural unfolding of the analytic process. He notes that such authors as Greenberg, Heiman, Little, Winnicott, and Racker have suggested the positive value of countertransference and that its analysis can help the analyst to understand the transference interaction more effectively and better analyze the patient. Perhaps one of the most important foci of this book is countertransference in the elucidation of the patient's dynamics.
The author describes a transference-countertransference axis as an important dimension through which to study the analytic process. What follows in the succeeding chapters are extended, and at times microscopic, descriptions of clinical process, with frequent descriptions of the long, detailed analysis of the countertransference with ultimate success of the analysis. He also describes unresolvable countertransferences that interrupted treatment. Not only is the author willing to present clinical situations where he was not able to effect an ideal outcome, but also he is able to derive additional theoretical perspectives from experiences that are, to say the least, disruptive to the therapeutic process. For example, he presents two instances of stormy treatments in which the patients suddenly and precipitously interrupted treatment. He describes how he was taken by surprise and tried, following the cessation of treatment, to analyze some of the countertransference responses that might have been r