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Meyers, R.W. (1990). Multiple Realities in Clinical Practice: By John S. Kafka. New Haven: Yale University Press. 1989. Pp. 199.. Int. J. Psycho-Anal., 71:731-732.
(1990). International Journal of Psycho-Analysis, 71:731-732
Multiple Realities in Clinical Practice: By John S. Kafka. New Haven: Yale University Press. 1989. Pp. 199.
Review by: Robert W. Meyers
Although a shared commonsense reality is the basis of ordinary communication, different reality organizations are seen in normal life, in neurotic patients, and, most strikingly, in psychosis. It is to the origin, development, and clinical understanding of these multiple realities that this book is devoted. However, this wide-ranging work also deals with issues of perception, time, ambiguity, rituals, and animate-inanimate distinction. To the theoretical exploration of a variety of clinical phenomena, John Kafka, an analyst who has had a long experience in the treatment of schizophrenia, applies ideas from philosophy, epistemology, physics, and neurobiology. This is a heady speculative brew which must be read carefully; the propositions, as the author states, are difficult.
Kafka proposes that multiple realities are organized along certain axes; a spatial-temporal axis, a size-of-organism axis (primarily from individual to family or group), and an animate-inanimate axis. The spatial aspect corresponds to the concrete and inanimate whereas the temporal is more related to the psychological and animate. In the temporal context he discusses the centrality of time for many psychoanalytic issues, the most important for the analyst being the restructuring of past experience in the present.
His basic assumptions regarding perception and reality are developed in the second chapter, which is a combination of two of the author's earlier papers. (In fact, substantial portions of this book are almost verbatim reproductions of his previously published papers.
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