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Sacks, J.H. (1998). Unknowing Advice: A Review of Intricate Engagements: The Collaborative Basis of Therapeutic Change by Steven A. Frankel, M.D. Northvale, NJ: Jason Aronson, 1997. 262 pp.. Contemp. Psychoanal., 34(4):658-661.

(1998). Contemporary Psychoanalysis, 34(4):658-661

Unknowing Advice: A Review of Intricate Engagements: The Collaborative Basis of Therapeutic Change by Steven A. Frankel, M.D. Northvale, NJ: Jason Aronson, 1997. 262 pp.

Review by:
Jeffrey H. Sacks, D.O.

Afew years ago, Dr. Frankel found himself stalemated in several ongoing clinical situations. This richly textured book documents his professional and personal response to the challenges of those situations. He was led to reexamine his classical psychoanalytic roots, to explore relational theory, and to evolve his own hybrid collaborative theory of therapy and change. His thoughtfully, systematically, and candidly presented personal evolution can help clinicians at all levels to orient their practices in today's evolving world of psychoanalysis.

Several patients posed the initial challenge to his classical stance. One woman refused the couch and demanded to speak unseen by the analyst. Abstinent analytic effort seemed only to frustrate another patient. In a third case, Dr. Frankel realized the need to “directly help and advise” the patient through a crisis, if the therapy was to survive.

Forced to question abstinence as the primary stance of the therapist, and transference clarification as the major vehicle of change, Dr. Frankel over time came to see the rupture and repair of the analytic relationship as essential for change. He grew to accept “lifelong seeking of emotional support” as desirable, with personal competence and autonomy no longer fixed end points. He discovered the mutuality of change and the collaborative basis of therapeutic work. This book documents his theoretical and personal journey.

Already twenty years into a successful career, Dr.

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