Borderline and Narcissistic Patients in Therapy edited by Nonna Slavinska-Holy. New York:  Int. Univ. Press.

This collection of papers, all in some way clinically oriented, although uneven in quality and depth, is often useful and interesting. The reader is given ample chance to explore contributions written from the self-psychology perspective and also from psychoanalytical humanism. I was interested by how often the self-psychology contributors, in particular, appear to recoil from trying to help patients face destructive aspects of their psychotic processes. However, much case material is offered, allowing the reader to understand something of why some of the authors considerably emphasise the positive in their approach to patients.

A range of psychotherapy methods is described and presented. Hence the book seems to be posing questions about what is curative or mutative in treatment: is it the method used or the kinds of understanding potentially available in the therapist? Although the contributors argue for their own favoured modes of practice, there was no discussion that I could find about the relationship between treatment methods (individual, group, combined, etc.) and possible models of understanding. Amongst the types of treatment included are individual and group therapy (sometimes combined), marital therapy, milieu therapy, drama therapy, and psychopharmacological therapy. Some chapters describe in-patient settings where several methods are offered to patients in combination. Readers working within institutions, particularly in-patient settings, may find some interesting points of contact with their own practice.

One of the best chapters in the collection is by Brandchaft & Stolorow, entitled “The Difficult Patient”. They write fervently from the standpoint of self-psychology and from their belief that ideas stemming from Heinz Kohut's work have brought to hand a new way of understanding clinical material. They include within their interesting and carefully-argued paper a vivid and concise clinical illustration. This I thought enabled the reader to test his or h