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This is a book of articles, all previously published in the last 10 years, about the application of object relations theory to psychotherapy. The editor, N. Gregory Hamilton, is a psychiatrist who wrote three of the contributions. Some professionals may feel uncomfortable with his reference to the therapist as “the psychiatrist.” He often alludes to how “psychiatrists” feel about various aspects of object relations theory and how various concepts do or do not fit into the biopsychosocial model.
The first section of the book focuses on using object relations theory for nonanalytic patients and for couples therapy. Mardi J. Horowitz's article discusses the importance of the therapist naming the patient's “states of mind.” The state of mind is a relatively coherent pattern of different forms of experience and expression, similar to what we might call an “ego state.” The therapist can describe the patient's state of mind in terms of expressive speech patterns, inflections, tone or pace of speech. Horowitz ties the states of mind to “person schemas.” Each state of mind is organized by a particular role-relationship composed of a self-representation and an object representation. Horowitz points out that naming a state of mind gives both the patient and the therapist a handle to observe and talk about the object relationship that is getting played out.
The second section emphasizes how the nature of the transference changes when projective identification, rather than displacement and projection, is the central dynamic between patient and therapist. The selections in the second section are a good indication of how broadly Hamilton defines “object relations theory.” One article in this section is by Stolorow, Brandchaft, and Atwood entitled: “Intersubjectivity in Psychoanalytic Treatment.” They argue that there is no such thing as a difficult patient. Rather, there is a difficulty between the therapist and the patient diat can lead to a so-called negative therapeutic reaction.