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Klar, H. (1992). Nuances of Technique in Dynamic Psychotherapy: By Mardi J. Horowitz. Northvale, N. J.: Aronson, 1989, xii + 274 pp., $30.00.. J. Amer. Psychoanal. Assn., 40:902-904.

(1992). Journal of the American Psychoanalytic Association, 40:902-904

Nuances of Technique in Dynamic Psychotherapy: By Mardi J. Horowitz. Northvale, N. J.: Aronson, 1989, xii + 274 pp., $30.00.

Review by:
Howard Klar, M.D.

How do psychotherapists decide what to say to their patients? And, how do they determine how to say it? Horowitz's book addresses these questions in a measured, thoughtful, and enlightening way. He offers the dynamic psychotherapist a detailed look at how theory can productively guide clinical practice, as well as a glimpse of an imaginative psychoanalytic thinker and practitioner at work.

Mardi Horowitz has been a voice for a scientifically based psychoanalysis for more than two decades. He does not simply preach the need for psychoanalysts to study the validity and efficacy of their theoretical and therapeutic principles and to appreciate the need for these principles to be congruent with the research findings of other related disciplines. He conducts the studies and has been willing to examine and retool his theory according to their results. The current work is not primarily a research study; it is a collection of papers written between 1968 and 1986 addressing a common theme: how do the style and capacities of the patient determine the therapist's choice of intervention? For Horowitz, the match between the therapist's choice of intervention and the patient's individual characteristics is the overarching technical dilemma in psychotherapy.

He argues that therapeutic technique ought not forge a procrustean mold into which a patient is forced; rather, technique requires a fluid approach guided by basic principles, and tailored to the patient's character, temperament, symptoms, the stage and type of treatment, as well as the phase of therapeutic alliance and transference.

The first of the two sections comprising the book looks at the nuances of the therapeutic process. It addresses four different aspects of the therapeutic process: interpretation, working through, the therapeutic alliance, and the role of visual imaging. In these chapters Horowitz writes with simplicity and clarity, always attending to the details of the therapeutic encounter. In therapy, as in life, the truth of things is in the details.

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