Arnold H. Modell.* Other Times, Other Realities. Toward a Theory of Psychoanalytic Treatment.  Harvard University Press, Cambridge (Mass.) - London, 1990,  175 pages, £21.95.

Compared with the author's previously published works,(1) the book under review is an attempt at a systematic explanation of the psychoanalytic process, and the elements responsible for therapeutic change. The result of Modell's efforts is the basis for a general theory of psychoanalytic treatment.

After beginning by noting that Freud paid little attention to this subject, the book devotes particular in depth consideration to the setting and the relationship, both of which are now seen as fundamental in therapy. The former was taken for granted by Freud, and the latter not included by him in technique.

Modell became convinced of the importance of these two elements as a result of observing patients who appear cut off from their emotional world. Both the setting and the relationship can supply the “holding environment” which is beneficial for them. A whole chapter (“Play, Illusion, and the Setting of Psychoanalysis”, p. 23) deals with the setting as a frame for the development of the analytical relationship. For many of the patients the author refers to, the setting itself becomes the crucial kernel which cannot be taken for granted.

The importance of the relationship with the analyst is a recurrent theme in the book, and is the result of the author's conviction, which he has already mentioned elsewhere, that analytic events are a “symbolic actualization”.

Here he joins those who see analysis as an opportunity for a ‘new experience’, though keeping their distances from the concept of regression.