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Carlson, D.A. (1990). The Mind in Disorder. Psychoanalytic Models of Pathology: By John E. Gedo. Hillsdale, NJ: The Analytic Press, 1988. 251 pp.. Psychoanal Q., 59:279-283.

(1990). Psychoanalytic Quarterly, 59:279-283

The Mind in Disorder. Psychoanalytic Models of Pathology: By John E. Gedo. Hillsdale, NJ: The Analytic Press, 1988. 251 pp.

Review by:
David A. Carlson

John Gedo takes a fresh, provocative turn in this, his seventh book. From 1973 with Models of the Mind, co-authored by Arnold Goldberg, until Conceptual Issues in Psychoanalysis in 1986, he has elaborated a clinically derived replacement for metapsychology and sought to redefine the scope of psychoanalytic practice. Many of our best writers have reviewed and debated his work, creating a secondary literature that is in itself an excellent mosaic of recent psychoanalytic thinking.

In The Mind in Disorder, Gedo calls for a new, psychoanalytically derived diagnostic nomenclature, arguing that new techniques seem about to demonstrate what is tissue- and chemical-based and what is not, leaving adaptive disturbances to be described by depth psychology. He keeps his earlier conceptual schema, but now focuses more on the autonomous functions, their curtailment or loss, and their involvement in conflict.

"Obligatory repetition" has been a cornerstone of his earlier work. Here he joins it with "apraxia," a failure to attain an autonomous function due to inadequate nurturing or constitutional factors. He uses obligatory repetition and apraxia to account for a range of pathologies; e.g., symbiotic needs are a reflection of failure to attain a necessary skill and will disappear when the patient is suitably instructed.

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