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Rachlin, H.L. (1967). Psychotherapy. A Dynamic Approach: By Paul A. Dewald. New York: Basic Books, Inc., 1964. 307 pp.. Psychoanal Q., 36:307-308.

(1967). Psychoanalytic Quarterly, 36:307-308

Psychotherapy. A Dynamic Approach: By Paul A. Dewald. New York: Basic Books, Inc., 1964. 307 pp.

Review by:
Hyman L. Rachlin

This book is a compilation of material which Dr. Dewald has presented to psychiatric residents. As he states in his introduction, 'the inexperienced psychotherapist is in need of a theoretical frame of reference and orientation to the problems and techniques of psychotherapy'.

The book is divided into three main sections. The first deals with psychodynamics, the second with psychopathology, and the third with the problems and techniques of psychotherapy. The material in the first and second sections is presented in a concise, well-summarized manner, using the basic tenets of psychoanalysis as a unifying framework. The well-selected case material adds quality to the specific problem under discussion. Suggested reading following each chapter is especially helpful.

In the last section, which comprises two thirds of the book, Dr. Dewald presents the problem of therapy as a kind of spectrum: at one end are certain types of patients requiring supportive treatment, and at the other end are those that can be treated with insight-directed therapy. He admits that the latter might benefit from analysis, but for innumerable reasons such treatment is not feasible. He differentiates between supportive and insight-directed therapy, and outlines the maneuvers in therapy under the headings of strategy, tactics, and respective roles of the patient and therapist. He states that in supportive therapy the defense mechanisms of the patient are not to be disturbed and the transference situation kept to a minimum. Interviews are spaced and even cut short according to the patient's needs and ability to tolerate interventions. The insight-directed therapy, as outlined by him, follows the basic concepts of psychoanalysis but modifies the technique so that the therapist actively manipulates the process in a face-to-face position and has less frequent interviews. He permits the development of the transference but not to the point of developing a transference neurosis, and the regression is not to go beyond the level of the latency period.


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