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The essays in this book honour the psychoanalyst Robert Wallerstein, whose work as a teacher and researcher in psychotherapy has been very influential in the American clinical culture. As some writing by European and South American psychoanalysts is included, the book offers a useful opportunity to compare diverse theoretical views illustrated with clinical material on the crucial topic of psychic change.
The editors suggest that the current concern is with how and why change occurs psychologically, and what is specific to psychoanalytical work. They suggest there is more interest in studying therapeutic effect than in debating the classification of psychopathology. Unless there is structural change, they say, defined as ‘systems of enduring and slowly changing meanings’, it is questionable whether resources will be made available for the work. As we are well placed to know, there is intense resistance within the individual, fuelled by the compulsion to repeat, which works against change. Presumably a similar opposition is reflected in political arguments over the provision of psychotherapy to deal with such potent yet invisible forces. If simple support or the passage of time effect change, what can justify our long, often-slow psychoanalytic work? How much could be left to these and other non-analytic factors to modify distress? What is specific to psychoanalytic work? Wallerstein's studies have tried to deal with these issues; so it follows that this book offers a variety of approaches to them, and could be helpful in allowing us articulately to join the debate. On reading this book, however, I was left with a concern that such a range