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A wonderful blast from the past! What a pleasure to read a book rich in clinical vignettes that explores in great depth adolescent development,
normal and pathological, with the insights gained from over four decades of working with adolescents and young adults!
Bloch is a masterful clinician—a child psychiatrist and psychoanalyst who has great familiarity with current neurobiological research. His purpose in writing this book is clear. “Evidence-based” research is important to continued growth in medicine including psychiatry but “those [research] findings should raise a cautionary note before throwing single case study out with the proverbial bath water!!…Seeking insight from both perspectives is reasonable” (p. xv).
Bloch is concerned about the fact that epidemiology and psychopharmacology have displaced psychodynamics and he believes that many clinicians have felt the need to medicate adolescents, no matter what their diagnoses. Even adolescents treated for serious psychiatric illnesses like schizophrenia and bipolar disorder do not always respond to medication: hence the book title “Treating the Other Third.”
The book is comprised of five distinct sections involving severe psychopathology, vicissitudes in development, homosexuality, the relationship between suicide and homicide, and dilemmas at the interface of individual psychology and sociology.
Bloch is most convincing when he presents clinical case histories focusing on psychodynamic therapy in particular. Of special interest is the case of Will, a 20-year-old college junior who became depressed and preoccupied with existential suicidal thoughts following his father's sudden severe paralyzing stroke. He refused medication and was negative about beginning psychotherapy. Moreover, he used alcohol and marijuana for symptom relief. Bloch's sensitivity in convincing Will to engage in therapy is beautifully described. An additional traumatic event—the death of a friend from a car crash—thrust Will into a manic stat