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The first three chapters of this excellent book provide a summary of familiar psychodynamic formulations, as well as a brief history of psychotherapeutic technique. The rest of the book is on a different level entirely and should prove valuable not only to the beginning psychotherapist, but to experienced clinicians as well. Chessick has written a guide to psychoanalytically oriented psychotherapy that should serve as a standard for other books in this field. He has accomplished this goal by writing a highly intelligent study of how psychoanalytic theory can be applied to understanding the progress of psychotherapy. The author demonstrates his awareness of countless practical considerations, e.g., the arrangement of office furniture, the atmosphere of the waiting room, and what to do if the patient calls the therapist at home, no less than his grasp of the subtleties of transference and countertransference. Chessick analyzes the therapeutic process phase by phase, indicating to the therapist how he can put the patient at ease initially, overcome resistance, deal with severe anxiety, determine if the patient is analyzable, assess the risk of suicide, involve relatives, etc. The author's advice, given systematically and within a strict framework of theory, reflects his solid experience with many types of patients in a wide variety of challenging circumstances.
The discussion of transference and countertransference is highly sophisticated and is consistent with the author's acceptance of classical Freudian thinking in regard to the stubbornness of the repetition-compulsion in interpersonal relations. Chessick warns repeatedly against giving in to infantile demands for emotional gratification by the patient and urges the therapist to consult with a colleague when persistent countertransference develops. There is an excellent chapter on acting out, particularly as a form of resistance. The author also calls attention to Zeligs' concept of “acting in,” i.e., behavior that