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This book is essentially a compilation of papers published between 1961 and 1990. Some of the papers have been elaborated and extended. Unusually for such a collection, there is a sense of ‘connectedness’ between the papers, and the reader is presented with an opportunity to observe the development of the author's capacity to think about and understand his patients.
The first section is devoted to theoretical issues. Stewart describes his early experience in hypnotherapy and his recognition of its limitations. This has allowed him to formulate a theoretical view of the therapeutic relationship in hypnosis and other collusive relationships. I found the chapter on ‘Changes in the Experiencing of Dreams and their Relation to Transference’ particularly interesting with its attendant classification of ‘ego-distancing dreams’ and ‘ego-overwhelming dreams’.
The second section is devoted to matters of technique. Stewart provides rich clinical material from his analysis of very disturbed borderline and psychotic patients. There is a classification of the various kinds of transference interpretations and a further chapter on other agents for psychic change, including reconstruction and extra-transference interpretations. Most of this section is taken up with an overview of therapeutic regression. There is a helpful review of the literature including a succinct account of Balint's contribution. He describes his own experiences in managing regression in patients and a concern about the contributions of the analyst to ‘malignant regression’.
This is above all a thoughtful book combining extensive reviews of the literature with the author's own thoughts and theoretical constructs derived from long clinical experience. There is a sense of openness to differing theoretical viewpoints with an acknowledgement that others presented with the same clinical material might view it differently. It impresses as the work of a teacher who informs while allowing us to seek our own truths.