by Herbert J. Schlesinger. Hillsdale, NJ, Analytic Press, 2008, 232 pp., $49.95.
Herbert Schlesinger has long been a psychoanalytic clinician and theoretician whose wisdom has been valued by psychoanalysts everywhere. In recent years he has begun to record the clinical wisdom accumulated over a lifetime as a psychoanalyst in a series of books. In 2003 he issued a treatise on technique (1). Two years later he published a superb text on the topic of termination (2).
With this third contribution, he approaches a topic about which little has been written in the psychoanalytic literature—namely, the psychology of promising. Among the topics covered are empirical studies of moral development, the philosophical and historical background of promise making, the link of promising with the theory of mind, the clinical problems associated with promises, and even digressions into applied psychoanalytic topics, such as promising in Greek tragedy and Shakespearean drama.
The sections on the clinical meanings and implications of promises are particularly useful for psychoanalysts and psychotherapists who read this book. For example, Schlesinger makes the point that the very act of making a promise reflects that a patient has a conflict about the subject of the promise, and this deserves clinical exploration. Promising can be viewed as additional reinforcement to overcome a wish to undermine the promise. Schlesinger also stresses that implicit promises appear more commonly than explicit promises in the context of psychotherapy. For example, the way the patient behaves towards the therapist may be some version of an unconscious contract—namely, that “if I please the therapist/parent, I will be rewarded.” The patient unconsciously believes that if he or she upholds his or her end of the bargain, the longed-for but disappointing parent will surface in the figure of the analyst or therapist.
In Schlesinger’s perceptive dissection of the clinical situation, it is not only patients who make implicit promises. Analysts make them as well. The practice of long-term psychoanalytic treatment implicitly promises that the patient will not have to part from the analyst until his goals have been reached. In this context, he notes the legions of disappointed patients who are treated in training clinics, where rotating out of the clinic or graduating from the residency is not routinely brought up at the beginning of the treatment. Emotions may also coerce a promise out of patients when they make contracts for suicide or other aspects of maintaining the “rules” of treatment for the therapist’s benefit.
The clinical discussion of promises inevitably leads to explorations of patients characterized by chronic disappointment. In one of the most compelling passages in the book, Schlesinger takes on this group of patients, who feel that life has promised them something that was never delivered. These patients will soon feel that the analyst is not delivering on an implicit promise as well. The analyst may be viewed as holding the patient back. Many of these patients have a narcissistic need for some kind of affirmation or blessing from the analyst that never arrives. The situation is often complicated by the fact that the analysand in question is a psychoanalytic candidate as well and feels that a seal of approval from his analyst is necessary to go forth in the world of psychoanalytic work.
Schlesinger also illustrates how promising and oath making are at the center of much of Shakespearean drama and ancient Greek tragedy. He ingeniously notes that the histrionics of the theatrical situation frequently transfer to real life, where those who promise may make a point of doing so with a theatrical intensity designed to convince others of their righteousness. Taking an oath may exalt one’s status in the eyes of others.
As in all of Schlesinger’s books, clinical pearls abound. The psychotherapist or psychoanalyst who spends an afternoon or evening with this slim volume will be richly rewarded. The clinical wisdom imparted in the pages will pay off in the reader’s own practice. I promise.
1.Schlesinger HJ: The Texture of Treatment: On the Matter of Psychoanalytic Technique. Hillsdale, NJ, Analytic Press, 2003
2.Schlesinger HJ: Endings and Beginnings: On Terminating Psychotherapy and Psychoanalysis. Hillsdale, NJ, Analytic Press, 2005
Book review accepted for publication April 2008 (doi:10.1176/appi.ajp.2008.08040535).
Reprints are not available; however, Book Forum reviews can be downloaded at http://ajp.psychiatryonline.org.