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Marshall L. Silverstein's Disorders of the Self attempts to add Heinz Kohut's conceptualizations to the understanding of personality disorders as defined by Axis II of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). In his summation, which he titles “Afterword,” Silverstein expresses his twofold purpose for including Kohut's conceptualizations. His first purpose is to identify aspects of personality disorders that are not well explained and where Kohut's contributions can be clarifying. Silverstein's attempt to infuse the DSM-IV with contributions that Kohut developed from his experience-near mode of observation is necessarily antagonistic to the descriptive, experience-distant mode of observation that is intrinsic to the DSM-IV classification system. Silverstein is aware of this difficulty: He states that his efforts are not intended to suggest that problems with self-cohesion, which he rightly concludes are paramount to understanding personality disorders, “be construed as potential dimensions for classification” (p. 4). He suggests further that while it is important to achieve a satisfactory framework for classifying personality disorders, an optimal conceptual approach is yet to be determined. His intent, then, is to demonstrate how self psychological views may potentially deepen an understanding of personality disorders.
The author's second purpose, though not so clearly stated, seems to be to bring Kohut's psychoanalytic contributions into the mainstream of psychiatric diagnostic nosology in an effort to support the legitimacy of psychoanalysis, which he considers to lack an acceptable standard for verifying its propositions. He identifies himself with those who are convinced of its validity because “they somehow benefited from its strangely unreliable method; they are discomfited by the