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Book Forum: Psychopathology   |    
Interpersonal Foundations of Psychopathology
Am J Psychiatry 2005;162:827-828. doi:10.1176/appi.ajp.162.4.827
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Seattle, Wash.

By Leonard M. Horowitz, Ph.D. Washington, D.C., American Psychological Association, 2004, 349 pp., $49.95.

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This is an excellent text. Dr. Horowitz displays impressive skills as a theoretician, a clinician, and an author. His language moves flawlessly from abstract, philosophical, and theoretical constructs, to complex statistical formulae, to concrete, substantive case examples. We read of the integrative forces of social, cognitive, motivational, and affective systems of human experience as they affect the development of personality and psychopathology.

Early chapters of the book outline an interpersonal approach to psychotherapy, with a focus on interpersonal motives in human experience. In particular, the concepts of "communal" and "agentic" motives are described as basic to interpersonal theory. Extended discussions of different disorders from an interpersonal perspective are then presented in later chapters.

A visual representation of interpersonal motives is provided throughout the book in the form of a graph whose characteristics evolve with the author’s developing discussion. This graph illustrates the relationship of different interpersonal motives to one another, to research findings, and to different mental disorders. As a pictorial image of interpersonal functioning, the graph provides the reader with a practical and unambiguous cognitive tool to grasp the main thesis of the text.

The author also uses literary and visual art to illustrate his themes. He describes a scene from Tennessee Williams’ A Streetcar Named Desire as reflective of frustrated goal achievement. He also portrays the life of the artist Edvard Munch as an example of schizoid personality disorder, noting the interpersonal terror of engulfment that emerges even in the artist’s paintings. These illustrations from the literary and visual art world only add to the readability and interest of the text.

Although informative and well-written, the text’s commentary on attributional style could be extended, particularly the discussion regarding the emotions of guilt and shame. Recent research on these emotions has noted important distinctions between them that the text does not consider. A fuller treatment of these issues would improve this section of the work and further highlight important interpersonal implications of attributional style.

The book could also benefit from greater clarification of the interpersonal motives in the experience of schizophrenia. The author does a nice job of describing research regarding communication deviance, expressed emotion, and affective style in the families of people with schizophrenia. Greater theoretical clarification as to the manner in which these might involve interpersonal motives, whether "communal" or "agentic," would continue to strengthen the theme of the book.

Overall, Dr. Horowitz has produced a fine text and has succeeded in the attempt to illustrate the power and significance of interpersonal motives in the development and maintenance of psychopathology. His book would be an excellent choice for the graduate student training to become a psychotherapist. It would also make a solid and important addition to the library of the seasoned clinician or the professional researcher.




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