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This engaging collection of papers begins with a 30-page introduction, by the senior editor that serves as an orientation to the theoretical perspectives and techniques addressing internalized object relations as well as an overview of the historical development of working psychoanalytically with regressed patients. Emphasis is placed on the distinction between a “corrective emotional experience” through manipulation and internal structural change achieved through the understanding of the patient's dynamics.
I shall attempt to present some aspects of the various papers which took my attention. Peter Giovacchini, in “Interpretation, Fusion and Psychic Synthesis,” expresses the view that is essentially shared by all the contributors: “The aim of treatment is to attain some character change…. This goal seems to be markedly different from that of resolving intrapsychic conflict and could easily be thought of as requiring more than interpretations alone” (p. 36). He describes “a type of structural defect that is characterized by discontinuity between primitive and higher integrated levels of the personality.” Because of the absence of “connecting bridges” between such levels, specific symptoms develop, requiring an alteration in the classical psychoanalytic technique. Giovacchini gives examples of interventions he has used, including what he calls countertransference; that is, he was drawn into feeling and acting like the patient's father and felt unable to do otherwise (until he became conscious of this action). This action is on the order of the therapist's being “transformed” by the patient's projections, rather than acting within the frame of his own past dynamics.
With few clinical vignettes, Thomas H. Ogden cogently demonstrates the functioning of the interplay—“dialectic”—of the