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Psychoanalytic practitioners are eager for theory the way travelers are eager for directions and road-maps. It is one thing to have arrived somewhere, but it always seems more interesting to know where you have come from, and where you might go next. Clinicians are forever scanning theories for perspectives on the therapeutic odyssey they share with their patients. No clinician wants to be simply an aimless wanderer. And since the human spirit is a vast terrain, it has been charted abundantly.
Hence Althea Horner's Object Relations and the Emerging Ego in Treatment, the point of which is to “enable the clinician to better understand his patient and to formulate therapeutic goals based on a character diagnosis in developmental terms.” Horner's theory is constructed from the distinctive and ultimately disparate explorations of Margaret Mahler, Bowlby, Winnicott, Piaget, and others.
The author rightly emphasizes that an understanding of the human mind must begin with an understanding of human development. (Indeed, the genetic point of view has always been central to psychoanalytic thought). And the developmental paradigm she constructs, which derives largely from the work of Mahler, is easily followed, moving, as it does, from the earliest stage of normal autism through attachment to normal symbiosis, and through separation-individuation to the formation of object constancy, identity, and healthy self-esteem. Step by step, she summarizes the work of the theorists she has chosen and skillfully relates the unfolding of these ordinary developmental processes to possible pathological outcomes, particularly in the organizations of the borderline personality and the narcissistic character disorders. Often her suggestions for therapeutic interventions are useful and tactful.
However, in her attempted triangular synthesis (attachment theory, cognitive theory, object relations theory), she has had to cut corners, blunting the angles of each, and leaving us with a curiously shaped