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Chessick, R.D. (1998). The Clinical Exchange: Techniques Derived from Self and Motivational Systems. By Joseph D. Lichtenberg, Frank M. Lachmann, and James L. Fosshage. Hillsdale, NJ: The Analytic Press, 1996, 264 pp., $39.95. J. Amer. Psychoanal. Assn., 46(3):975-982.

(1998). Journal of the American Psychoanalytic Association, 46(3):975-982

THERAPEUTIC ACTION AND TECHNIQUE

The Clinical Exchange: Techniques Derived from Self and Motivational Systems. By Joseph D. Lichtenberg, Frank M. Lachmann, and James L. Fosshage. Hillsdale, NJ: The Analytic Press, 1996, 264 pp., $39.95

Review by:
Richard D. Chessick

In 1995 Fenichel's The Psychoanalytic Theory of Neurosis (1945) was reissued to commemorate the fiftieth anniversary of its original publication. In his comments to accompany that republication, the eminent psychoanalyst Leo Rangell maintained that he found the basic principles presented there still fundamental to the approach he uses today. He expressed the hope that Fenichel's textbook might serve as a unifying point on which the various schools of psychoanalysis might agree, occasioning thereby “a definite return to basic enduring theory.”

With the publication of The Clinical Exchange, three sophisticated and experienced psychoanalysts with impressive titles and credentials have demolished that hope. In their work they have thrown out just about everything of major significance in classical Freudian theory and technique as outlined in Fenichel's classic. They present instead a carefully thought out amalgam of Kohut's self psychology and their own theory of five motivational systems (Lichtenberg, Lachmann, and Fosshage 1992): (a) physiological requirements, (b) attachment and affiliation, (c) assertion and exploration, (d) the need to react aversely through antagonism or withdrawal, and (e) the need for sensual and sexual pleasure. Where these motivations come from is not clear, but they are certainly not biological in the sense that Freud thought “drives” were biological. Why there are five such motivational systems rather than, for example, Greenberg's two (1991), remains unanswered.

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