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This is a book about an extremely important question: the risk that the practice of psychoanalysis will disappear within a limited time span in the Scandinavian countries, because of rapidly changing State regulations for financing mental health services.
Reeder's book offers an alarming picture of the present situation, based on his own research, followed by an illuminating description of the gradual changes in governmental policy and jurisdiction in this field. Further, Reeder undertakes a thorough reflection about the nature of the psychoanalytic treatment, fundamentally different from the standard medical treatment model. He emphasizes the confidentiality as a sine qua non for the psychoanalytic treatment, and discusses how governmental regulations, prevailing and predicted, for public health insurance imbursement jeopardize this necessary precondition. The last part of the book contains a detailed suggestion for a 5-year pilot project for the preservation of the possibility for psychoanalytic treatment in the future. The key point is that the costs for psychoanalytic treatment, paid fully by the patient, are tax deductible both for analyst and analysand.
This book is based on Swedish conditions, but the challenges and risks facing psychoanalysis are similar for any country where psychoanalytic treatment has been partly paid for by health insurance. The author's description of the current situation is very convincing, and so are his reflections and arguments. His suggested remedy (for the acute situation) deserves a very serious discussion, and is maybe the best solution for psychoanalysis and its future patients. However, this solution is not for psychoanalytic societies to choose; an agreement with the government, nationally and regionally, is necessary.
As emphasized by the author, the dangers facing psychoanalysis are also directed towards all kinds of long-term, psychodynamic psychotherapy, not only in private practice, but also within the public mental health