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Frankel introduces Intricate Engagements with clinical material illustrating his disconcerting experience with patients who persist in telling him that his traditional analytic approach is not meeting
their needs. Previously he had practiced psychoanalysis with a sense of certainty about what he knew; but more recently he became aware that, with certain patients, he had begun seriously to question his assumptions. He was familiar with the newer literature, but the thought of modifying his technique created anxiety and guilt. Those of us who completed our training prior to the mid-70s can identify with Frankel's visualizing his learned supervisors from 20 years ago peering over their glasses disapprovingly. He asked himself, “If I used a concept from self psychology or Winnicott, what happened to the drive and ego psychology I knew so well?” (p. xiv). His training in classical theory had shaped his professional identity and assumptions about reality. Besides, where were the guidelines by which one judged what works?
Faced with these dilemmas, Frankel set out on an expedition to find a clearer vision for his analytic work. The result is an engaging, well-organized excursion. Ultimately Frankel makes the transition from a traditional drive-conflict model to a two-person interactive approach that emphasizes the centrality of relationships in the development of the human psyche and the need for collaborative engagement of analyst and patient in the therapeutic process. En route he formulates an integrative and clinically useful model for conceptualizing clinical data. It utilizes concepts from object relations theory, interpersonal theory, self psychology and intersubjective theory, and weaves them together in a way that is surprisingly satisfying.
Frankel first reviews major research projects on the effectiveness of various psychoanalytic approaches (Wallerstein, Luborsky, Weiss and Sampson, and Kantrowitz) and concludes that currently there is no method for selecting am