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As a practitioner of both psychoanalysis and psychotherapy, I found Jerome Oremland's monograph admirably concise, challenging, and very relevant both to my clinical work and to my teaching. He delineates what he calls psychoanalytically oriented psychotherapy as a distinctive modality with interpretation of the transference aspects of interactions as its predominant intervention and with the aim, as in psychoanalysis, of increasing insight to widen choices.
Though his ideas resemble Merton Gill's (1982) advocacy of applying psychoanalytic technique, primarily analysis of transference, in therapy without the frequency of sessions or the recumbency inherent in traditional psychoanalysis, Oremland has apparently developed his conceptualization and procedure through his own practice and with his students and colleagues. In proposing that a person in twice weekly face-to-face psychotherapy can achieve objectives previously thought attainable only through psychoanalysis, he adds to the results of the Topeka study reported by Wallerstein that lasting structural changes were achieved not only in psychoanalysis but also across a range of exploratory and supportive psychotherapy. His proposal is particularly timely as economic constraints press analysts to work with less frequent visits.
In tracing the history of psychotherapy to humane treatment of the mentally ill and to Sullivan's interpersonal theories developed for a broader scope of psychopathology, Oremland emphasizes its primarily therapeutic or palliative aims. In contrast, he sees psychoanalysis as primarily an extension of scientism and rationalism to understand irrational phenomena, first dreams and then neurosis and psychosis. The primary aims, he contends, are insight and expanding knowledge, Freud's “after-education,” therapeutic effects being byproducts. He proposes a revision of the usual spectrum of