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This collection of eight elegant chapters theorizes on the possible underpinnings of madness in the dynamic unconscious and amply supports these ideas in masterful accounts of treatments. While representing work in the United States, Germany and Finland, conveying the field's diverse views and advances, the collection has a cohesiveness rarely found in edited books. The editors emphasize the importance of the 1994 triennial International Symposium for the Psychotherapy of Schizophrenia, at which some of the papers included here were presented. The book gels around a shared dedication to insight-oriented work with severely ill patients. One senses that each contributor knows from personal experience the effectiveness of this treatment approach. Their chapters document both the sophistication of understanding of schizophrenia, and the awesome mystery still enveloping the disorder.
Volkan, here as elsewhere (1995), hypothesizes that the infant begins life in an undifferentiated state. Her mind “hatches” in the “incubator” of the mother-infant experience that channels development toward madness or health. He holds that both nature and nurture contribute to schizophrenia. For people who become mad, their treatment involves “reconstructing” those early experiences. Volkan postulates two cycles of self and object relationships, the first, fusion-defusion, the second, the introjective-projective cycle. These cycles inevitably reoccur as individuals attempt mastery and renewed development. He discusses the importance of naming of affects and of reliving and mastering infantile depression in the course of later treatment.
Johannes Lehtonen, from Finland, delineates a theory of the development of the body ego. Drawing support from the Isakower