In three recent books, the American psychoanalyst Fred Busch puts forth a clear, rigorous, open-minded vision of contemporary psychoanalysis and makes a powerful case for its enduring relevance in 21st century life. Firmly grounded in the American Freudian tradition, Busch's work emphasizes the gradual working through of unconscious conflict and the bolstering of the mind's self-reflective capacities. In the introduction of A Fresh Look at Psychoanalytic Technique, an engaging and wide-ranging collection of clinically focused articles, originally published over a span of nearly 3 decades, Busch spells out his own dominant theoretical leaning: “The role of the ego as the arbiter of what is allowed in the patient's mind is the centerpiece of my thinking, along with its function in modulating anxiety” (2022, p. 3).

His approach is deeply indebted to the work of Paul Gray who developed a tightly focused method for analyzing the ego's unconscious defensive maneuvers. From Gray, Busch has learned to attend “to the process of associations” and to what Gray called “breaking points,” which are subtle or not-so-subtle shifts or interruptions in the patient's free associations, for it is here on the surface of speech that the analyst can observe defensive processes in action (, p. ). Once a resistance can be observed, it begins to become more conscious, and through analysis, the anxiety that mobilizes it can be lessened over time, and the unconscious wishes and fantasies underlying it can be brought to the surface of awareness. Busch warns about the dangers of the analyst seeking to bypass resistance in order to bring the unconscious fantasy to light and in so doing getting beyond what the patient is ready and able to hear: