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Hoppe, K.D. (1990). Integration and Self-Healing: Affect, Trauma, Alexithymia: Henry Krystal, M.D., with contribution John H. Krystal, M.D., Analytic Press, Hillsdale, NJ, 1988, 383 pp., $39.95.. J. Amer. Acad. Psychoanal., 18(4):678-680.

(1990). Journal of American Academy of Psychoanalysis, 18(4):678-680

Integration and Self-Healing: Affect, Trauma, Alexithymia: Henry Krystal, M.D., with contribution John H. Krystal, M.D., Analytic Press, Hillsdale, NJ, 1988, 383 pp., $39.95.

Review by:
Klaus D. Hoppe, M.D., Ph.D.

Henry Krystal, well-known and renowned as editor and author of Massive Psychic Trauma (1968), Psychic Traumatization (1971), and numerous chapters and papers, presents in this opus magnum his experiences with trauma, affect, and alexithymia, based upon publications since 1974 and amplified by new chapters on affect, reality, therapeutic considerations in alexithymia, as well as a chapter on assessing alexithymia by his son, John H. Krystal.

Henry Krystal starts with the essential statement: Alexithymia is the single, most common cause of poor outcome or outright failure of psychoanalysis and psychoanalytic psychotherapy. The reasons that this glaring problem has escaped recognition for so long is part of the mystique and paradox of emotions.

The first part of Krystal's book is devoted to this mysterious experience of emotion, which is used as synonymous with affect, whereas feeling is understood as the subjective experience of emotions and as a part of one's own self. Krystal distinguishes cognitive, hedonic, “expressive,” and activating affective components, and deals with affect tolerance, with love, instead of Freud's choice of anxiety as a model affect, and with the genetic development of affects, especially in adolescence. Most important seems to me his delineation of hedonic elements and their correlation with activating aspects of affects.

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