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This book makes a companion volume to Mardi Horowitz's earlier Introduction to Psychodynamics: A New Synthesis, reviewed in the first issue of Psychoanalytic Books. Nuances of Technique is a compilation of nine of the author's papers ( to ), somewhat reduced in size but not basically altered in their conclusions. Part I, “The Therapeutic Process,” deals thoughtfully with such important issues as depth of interpretations, the therapeutic alliance and its vicissitudes, transference impediments, working through, impasses, and “difficult patients” (pp. 35-38). Part II, “Nuances of Interpretation,” describes, using the model of stress situations and responses, the markedly different ways in which patients perceive their dilemmas and organize their defenses. The author presents, in 24 innovative tables and figures throughout the book, the developmental levels and character structures from which these differences arise, the situational and interpersonal stresses that evoke them, and the choice of dynamic “nuances” that best address them.
In the last third of the book, Chapters 7 and 8 ingeniously present the characterological styles of three different personality types: obsessional, hysterical, and narcissistic, each in response to the identical severely traumatic situation; thus illustrating the differences in “perception, representation, translation of images to words, associations, and problem-solving” that distinguish each personality type and that call for differing and finely-tuned psychodynamic responses (pp. 144, 159, 190).
Chapter 9 presents a single analysis of a histrionic personality, its course in vivid brief over four years, and the observed processes of change. It ends with a discussion, first