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Horner, Clinical Professor of Psychology at UCLA, uses the concept of structure to unite a series of her papers aimed at creating an integrated psychoanalytic approach to the treatment of character pathology. She uses the structural concept to refer to structure of
character, rather than in its more familiar form referring to Freud's second tripartite model of mind. Her particular blend of object relations, drive-, ego-, and self psychology is applied to several diagnostic entities while it directs treatment approaches toward underlying character formation.
Horner begins by placing herself in the psychoanalytic landscape. She values object relations over drive theory, focuses more on dyadic than on triadic relations, considers empathy and reparation more significant therapeutic agents than she does insight, and sees herself a humanist concerned with the use of the real relationship in treatment. A therapist is a model and therapy creates a new attachment; establishing trust and preserving the patient's self take priority over protecting autonomy and promoting initiative.
Dividing her papers into categories of Development of Character, Character Pathology, and Treatment, Horner explicates her general position with essays on development and associated pathologies, the roots of anxiety, and processes of identification. She then focuses on depression, bulimia, self-pathologies, and obsessive disorders. Her section on treatment deals with group psychotherapy, short-term treatment, and the concepts of alliance, resistance, will, and neutrality.
Throughout these papers, emphasizing a cautious approach to diagnosis and treatment, Horner notes therapy's potential for harm and the pitfalls of countertransference gratifications. She underscores the fact that development is a complex matter and that truly microscopic understanding is necessary for valid structural/developmental diagnosis and treatment.
In comparing and trying to integrate the viewpoints of four major analytic dime