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Book Forum: PSYCHOANALYSIS   |    
Listening to Patients: Relearning the Art of Healing in Psychotherapy
RUSSELL EISENMAN, PH.D.
Am J Psychiatry 2002;159:511-511. doi:10.1176/appi.ajp.159.3.511
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Edinburg, Tex.

By Richard G. Druss, M.D. New York, Oxford University Press, 2000, 133 pp., $19.95.

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In this very small volume, Druss does an excellent job of showing how he works with patients. His insights are useful for other therapists, or for those who want to understand how insights from psychoanalysis can be applied. Even one not psychoanalytically oriented would have to admit that Druss has good insights that seem useful and on target. He does not go into great detail in any chapter but gives a brief understanding of the important issues. The chapters deal with such topics as the initial session, transference, supervision, and termination of psychotherapy.

Druss is not rigidly psychoanalytic. In seeing himself as a collaborator with his patients, he is much like behavior therapists and somewhat unlike the stereotyped, seemingly detached psychoanalyst, who says little but knows all. In one instance, Druss pays much attention to the patient’s lifestyle, and the patient consults with a nutritionist and joins a group to help him stop smoking. It is hard to imagine Freud, or his traditional followers, doing something like that. Like psychoanalysts, however, Druss conceptualizes the cases in such terms as transference and repression. Thus, the reader gets a sense of how a case can be handled psychoanalytically but with more flexibility than in traditional psychoanalysis. Druss has great insights into the cases he presents, so the book is useful to all, not just psychoanalysts, who try to understand what is occurring.

One of his most interesting cases is that of Ms. E, a high school sophomore who came to New York City from Puerto Rico. A devout Catholic, Ms. E suffers from conversion hysteria; she has become deaf and totally paralyzed from the waist down. The cause is found to be her conflicts between emerging sexuality and her strict Catholic upbringing. Specifically, in the girls’ locker room at school, she overhears two popular girls talking about going to the school dance and seeing which one will be the first to cause an erection in their boyfriend by dancing close. Of interest, during the therapy session Dr. Druss gives Ms. E three 15-mg phenobarbital tablets, one each at different times, to ease her anxiety and foster her speaking about her problems. Part of his technique is to discuss boring school topics initially in the session, such as Latin and other courses she was taking. This, along with the phenobarbital, puts her enough at ease that she eventually discusses the sexually charged locker room incident.

Ms. E was cured via abreaction, the bringing to consciousness of repressed material. Druss defines abreaction as occurring when the repressed material is quickly brought to consciousness. Thus, all of the treatment occurred in one 5-hour session, when he saw Ms. E in the emergency room of a hospital on a Sunday morning. This goes against the notion of psychoanalysts or other therapists only seeing patients in their office, at scheduled times. Finally, it was not only getting her to unmask the repressed material that seemed to cure Ms. E but also the discussion that she could go to the dance but adhere to her own values and not have to be like those popular girls whom she overheard.

There are several other interesting cases in this small book. It should be useful to many, both those who believe in psychoanalysis and those who do not. Druss has good insights into people, and he writes well about them.

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