Twenty plus years ago, I had little difficulty finding a publisher who did a commendable job editing and marketing my first book, Adolescent Development, Psychopathology, and Treatment (International Universities Press, Inc. 1995 IUP). The marketing was certainly aided by splendid prepublication reviews written by prominent researcher-clinicians in the field of adolescence who generously agreed to do so for an unknown. Except for Cal Settlage, a mentor/colleague, I had never met the others—Morton and Estelle Shane, Aaron Esman, Joseph Lichtenberg and Daniel Offer. The impetus for that undertaking originated from being unable to find the kind of textbook I would have wanted as a student, when I taught the course on adolescence at the (then) San Francisco Psychoanalytic Institute.
All went well with that endeavor, Doody's rating of 97 and favorable reviews in many journals from all the mental health disciplines. Then, after the hardback copies sold out, the editor promised the paperback in three months. But seven years passed before it appeared, which put an end to whatever momentum the book had enjoyed. I have presumed that trajectory reflected IUP's quiet fading away.
I have belabored this to illustrate the remarkable difference I experienced 20 years later with this second book. Everyone knows during those intervening years the “scientific” revolution burgeoned, with overwhelming interest becoming focused on “evidence-based” psychopharmacologic, epidemiologic, genetic and randomized controlled studies. Psychotherapeutic offerings were all but cast aside, until maturation of that scientific revolution in our field revealed its limitations. This in turn led to renewed interest in psychotherapeutic approaches, albeit with emphasis on evidence-based studies. And initially, among the psychotherapies, psychodynamic treatment with roots in psychoanalysis seemed most in danger of being discarded. Fortunately this has not proven to be the case. But I was persuaded early on from my experience with individual adolescents that single case study retained a more important role for both understanding adolescent psychological development and treatment than it was being accorded by the current scientific paradigm. Giving this perspective an airing was one motive for writing this book, which was relevant to the broader mental health field.
My other motive originated in a sense I developed that our field had moved toward unquestioning acceptance of certain conditions more on the basis of social consciousness and so-called political correctness than one would expect and hope from practitioners of a discipline with strong roots in rigorous, unbiased analysis of observed and researched data. Considering the pendulum to have swung too far in the new direction, I hoped to encourage more balance.
That was the climate in which I began searching for a publisher of my completed manuscript. After five to six years of failed, relentless efforts, I submitted pared down versions of its five chapters to journals. One was published by The Psychoanalytic Study of the Child. The others were declined. The responses of journal editors and book publishers alike were either that their interest was in “research studies,” or this work did not conform sufficiently to certain shibboleths of psychoanalytic thinking, the old story of “what constitutes psychoanalysis.” Interestingly, brief, trenchant comments from two journal editors reinforced my persuasion that single case study retains an important place in advancing our understanding of psychological development and treatment, and to not hesitate to present views that go against the grain of both the currently popular trends on the one hand and the long-held truisms within the field on the other.
So I returned to submitting the manuscript as a book, still without success for by now seven years. Then most serendipitously, in early 2014, I sat next to Mali Mann at a small dinner gathering in memory of Cal Settlage. We had met once in 2005 when invited to discuss a case of hers, aspects of which she kindly allowed me to include in the book. Only because of the latter did I mention my difficulty finding a publisher, and she immediately shot back, “Rod Tweedy—Karnac,” who it turns out did not hesitate to publish a manuscript that went against the popular grain; and Karnac has done a fine job producing it. Its release in April 2015 ended this eight-year odyssey.
I am not sure whether the experience has served me as testimony to the adage, good things come to those who wait (at least sometimes), or one should never give up efforts to present their professional views, even against odds.
Treating the Other Third refers to that more than one-third of adolescent patients who do not respond to medication, leaving psychotherapeutic intervention as the only alternative. Elaborating upon ideas introduced in
H. Spencer Bloch, M.D., certified in psychoanalysis (1982) and child/adolescent psychoanalysis (1983) has practiced in San Rafael, CA, since 1970. Other than having taught psychoanalytic candidates (1979-1986), his extra-practice activities have been consulting with public agencies, special-ed schools, and therapists.
my earlier book, cases of severe psychopathology, namely, suicidal depression with bipolar complications (Chapter 1) and bulimia (Chapter 2) are detailed. The other half of the title, Vicissitudes of Adolescent Development and Therapy, considers two outlier end-points of psychological development with respect to the objects of one's love and sexual desire (Chapter 3) and of one's aggression (Chapter 4). Chapter 5 examines an aspect of the interface with sociology, positing a contribution from the developmental psychology of individuals as necessary for dramatic changes in normative adolescent behaviors (risk-taking), and in social institutions (day care and divorce) to occur within one to two generations.