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Otto F. Kernberg is one of the best known and most highly respected psychoanalysts in the United States today. This book, a collection of his previously published papers, is nicely printed and never boring to read, but it is extremely difficult and not for beginners. It actually contains two books mixed together. One of these, which affords a welcome relief from the other, is a set of case vignettes that demonstrate Kernberg in action as a psychoanalytic psychotherapist. This is by far the most readable part of the book and reveals Kernberg to be an effective and insightful psychotherapist with a distinctive style of doing psychoanalysis that some will approve of and some will not. The other book is a highly metapsychological set of formulations, classifications, and distinctions in the tradition of the Medieval scholastics that only a therapist with the superior intelligence of Kernberg could keep in mind as he or she struggles in the day-to-day work with very disturbed patients. For example:
These rapid oscillations, as well as the sharp dissociation between loving and hating aspects of the relation to the same object, may be further complicated by defensive condensations of several object relations under the impact of the same primitive affect, so that combined father-mother images confusingly condense the aggressively perceived aspects of father and mother. Idealized or devalued aspects of the self similarly condense various levels of past experiences.
An object relations frame of reference permits the analyst to understand and organize what looks like complete chaos so that he [sic] can clarify the various condensed part-object relations in the transference, bringing about an integration of self and object representations, which leads to the more advanced neurotic type of transference. (p. 94)
This statement leads immediately to two questions: Are Kernberg's innumerable formulations and classifications valid, and are