This book provides as convincing a demonstration as any I have seen of the relevance of philosophy to clinical practice. With the increasing pluralism in psychoanalysis in recent years, there has developed, in some psychoanalytic quarters, a concern with elucidating the underlying philosophical assumptions in various psychoanalytic schools of thought and technique. Irwin Hoffman (1998) and Donnel Stern have been the trailblazers in this line of inquiry. Hoffman, in the process of developing his own position that he now calls “dialectical constructivism,” pointed out the mix of constructivist and positivist epistemological assumptions in the work of various psychoanalytic theorists. Positivist epistemology asserts that we can, if we study things with the proper objevity, know them as they are in themselves. From that point of view, objectivity allows the knower to transcend preconception and prejudice, that is, the influence of the observer's subjectivity. Constructivist epistemology,