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The Psychoanalytic Study of the Child, vol. 54
Reviewed by RICHARD D. CHESSICK, M.D., PH.D.
Am J Psychiatry 2000;157:1035-1036. doi:10.1176/appi.ajp.157.6.1035
View Author and Article Information
Evanston, Ill.

edited by Albert J. Solnit, M.D., Peter B. Neubauer, M.D., Samuel Abrams, M.D., and A. Scott Dowling, M.D. New Haven, Conn., Yale University Press, 1999, 366 pp., $60.00.

The Psychoanalytic Study of the Child is one of the most prestigious and outstanding annuals produced by the psychoanalytic community. The current volume carries on splendidly in that tradition and contains a whole series of sophisticated studies by an international array of psychoanalysts. Each study is preceded by a helpful summary in italics, a style that I wish would be adopted by all journals. The book opens with an article by Ethel Person dedicated to Gladys Topkis, who has retired from her full-time position as a senior editor at Yale University Press. Person discusses creativity, claiming that creative expression "often involves another person in either a fantasized or a real relationship that encourages or catalyzes creativity" (p. 2). Examples are given and a parallel is drawn with the findings of child researchers that development combines internal psychodynamics and interactions with significant others as well as cultural and social influences. Person contends that even when there is no significant partner available for the creative individual there may be an internalized "Other." This is consistent with Freud’s drawing of a parallel between the child at play, the adult daydreamer, and the creative artist, and my recent formulations (1). Person’s contribution is to focus on the importance of the social forces surrounding the emergence of creative insights.

All of the chapters in this volume are of outstanding technical quality, and there is something in it for every kind of psychiatric and psychoanalytic interest. The first major section of the volume is labeled Development and Technique. This 70-page section consists of three case reports from the Psychoanalytic Research and Development Fund’s 5-year study group on coordinating the psychoanalytic and developmental processes in children and adolescents. The authors point out that in the treatment of children one must deal directly with the vicissitudes of ongoing development along with the different aspects of the usual psychoanalytic process. The 5-year study group attempts "to sort out some of the encountered difficulties and begin to address ways to manage them" (p. 20) and "to consider additional techniques that might assist the needs of development without necessarily compromising fundamental analytic approaches" (p. 20). The case reports offer the details of three treatments. Wendy Olesker reports on the psychoanalytic therapy of an unusual 4-year-old boy in which she had to develop a variety of ways to facilitate his growth and ameliorate deviational aspects. Anita Schmukler presents the report of a 6-year psychoanalysis of a girl that began when she was 16, focusing on the technical demands of working in psychoanalysis during a period of the patient’s intense developmental change. Alan Zients presents the analysis of a 5-year-old boy with seriously compromised ego functions that might even be thought to have contraindicated psychoanalysis. Despite these problems, Zients contends that his traditional psychoanalytic position, which emphasized "dynamic interpretations" (p. 68), facilitated therapeutic changes.

The section on theory contains some important and stimulating essays. Leon Balter discusses three kinds of "unknowability" in psychoanalysis. These are "the patient’s inherently unobservable unconscious mental processes, practicably unobservable, extra-analytic influences on the analytic material, and the practically unanalyzable effects of the analyst’s activities" (p. 125). I found Balter’s chapter exceptionally thought provoking and reread it three times. Arthur Couch focuses on the therapeutic functions of the real relationship in psychoanalysis and includes an extensive review of the literature as well as his own formulations. This essay should not be missed. Linda Mayes presents clinical material from analyses with a child and an adult and other interview material with 4–5-year-old children "to explore individual fantasies of how development and change happens. The central role of internalization and object relations in regulating psychological development is emphasized" (p. 170). Ronnie Solan, an Israeli psychoanalyst, explores what he calls "healthy" narcissistic function, which includes "the narcissistic preservation of self-identities during interaction between self and others" (p. 193).

The clinical section begins with Judith Chused’s presentation of material from the analyses of three children who developed obsessional behavior during the course of their analyses. Her purpose is to try to understand the unconscious determinants that led to this as a way to deal with anxiety and psychic pain. Donald Coleman studies the nature of narrative and tries to explore why it has been so natural, important, and universal to people throughout the world over the centuries. He addresses the question of how this information will help the psychoanalyst in day-to-day work. Oscar Hills describes his psychoanalytic treatment of a patient "who experienced distortions in the perception of his body on the couch" (p. 259) and discusses how this relates to the well-known Isakower phenomenon involving certain hypnagogic phenomena (2). M.A. Tallandini studies the dread of integration in a chronically ill patient with borderline disorder who seemed to be terrified that integration might involve a loss of the self.

The final section is on adolescence. Debra Rosenblum et al. present a psychodynamic overview of the relationship between adolescents and certain elements of the popular culture: "Theoretical perspectives are integrated with case material to illustrate some of the roles of popular music and fashion in the lives of teenagers as a means of expression and in potential therapeutic alliance formation, dynamic understanding, and working through developmental conflicts in displacement" (pp. 319–320). Anita Schmukler reports and discusses the treatment of a preadolescent girl over a 7-year analysis, with a focus on the patient’s use of insight within the context of the transference.

As the reader can see even from this brief summary and book review, The Psychoanalytic Study of the Child contains high-quality chapters that will appeal to a great variety of interests among psychoanalytically oriented psychiatrists and other mental health professionals. It is a volume not to be missed by anyone engaged in psychodynamic psychotherapy or psychoanalysis.

Chessick RD: Emotional Illness and Creativity: A Psychoanalytic and Phenomenologic Study. Madison, Conn, International Universities Press, 1999
 
Isakower O: A contribution to the patho-psychology of phenomena associated with falling asleep. Int J Psychoanal  1938; 19:331–335
 
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References

Chessick RD: Emotional Illness and Creativity: A Psychoanalytic and Phenomenologic Study. Madison, Conn, International Universities Press, 1999
 
Isakower O: A contribution to the patho-psychology of phenomena associated with falling asleep. Int J Psychoanal  1938; 19:331–335
 
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