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Classical psychoanalysis has long faced challenges on two fronts. On the one hand, severe psychopathology tests the conceptual and clinical range of the classical perspective prompting periodic revisions within its paradigm. On the other hand, severe pathologies inspire competing paradigms whose proponents advocate scientific revolution (Kuhn, 1962). In this volume, adherents of “modem structural theory” stake out contemporary theoretical positions and energetically confront both clinical and conceptual challenges.
The book features three theoretical and three clinical expositions, all by leading structural theorists, followed by both supporting and opposing discussions and rebuttals by five of the presenters. The presentations are compressed and pithy and require familiarity with recent structural theory, particularly the signal contributions of Charles Brenner (1982). Briefly, the modern structural paradigm posits that psychic conflict and compromise formations are ubiquitous features of mental life, that mental health and illness are determined by how well compromise formations succeed in promoting gratification and avoiding pain, and that all functional psychopathology can be explained by reference to conflict and compromise. Accordingly, modern structuralists hold that severe pathologies require no alternate theories of mental functioning and that psychoanalysis requires no scientific revolution.
In the opening paper Jacob Arlow explains that the concept of psychic conflict is “the essential feature” of all psychoanalytic theory and logically determines the interpretive method of psychoanalytic treatment. Experiences of trauma and deficit may help explain unsuccessful compromises (pathology), but such experiences are themselves only meaningful within the larger context of an individual's conflicting motives. Alternative “deficit theories” of pathogenesis suggest replacement therapies to provide “needed” emotional experiences. Such therapies may be emotionally app