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Esman, A.H. (1998). The Symptom-Context Method: Symptoms as Opportunities in Psychotherapy. By Lester Luborsky. Washington, DC: American Psychological Association, 1996, xi + 422 pp., $39.95. J. Amer. Psychoanal. Assn., 46(3):966-970.
(1998). Journal of the American Psychoanalytic Association, 46(3):966-970
The Symptom-Context Method: Symptoms as Opportunities in Psychotherapy. By Lester Luborsky. Washington, DC: American Psychological Association, 1996, xi + 422 pp., $39.95
Review by: Aaron H. Esman
Lester Luborsky has for many years been one of that small group of dedicated investigators, drawn largely from the Menninger Alumni Association and the Sons of David Rapaport, who have conscientiously pursued their conviction that psychoanalytic principles can in fact be subjected to empirical testing and that, Adolf Grünbaum's opinion notwithstanding, clinical data can be used for this purpose. The present volume constitutes, I believe, a triumphant vindication of this conviction.
The book brings together an updated and revised selection of papers, written over the past three decades with a sizable group of collaborating investigators, that deal with what Luborsky has named the “symptom-context method” for studying the psychological conditions under which symptoms or symptom equivalents emerge during psychotherapy sessions. Beginning with a patient's episodes of momentary forgetting, Luborsky and his associates have studied, in individual cases, recurrent depressive episodes, descriptions of phobic states, recurrent peptic ulcer pains, migraine headaches, premature ventricular contractions, and petit mal or “absence” attacks—each described in great detail and with the support of an elaborate statistical apparatus which, to this naive reader, appears both impressive and persuasive.
The problem of controls has for obvious reasons long been a source of vexation to those interested in empirical study of clinical psychoanalytic data.
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