| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ALL ISSUES | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Book Reviews |
Key Words: Book Reviews
Intriguing, serious reading, this volume is no textbook on training, nor yet an autobiographical odyssey. Rather, it is an edited compendium of unpublished addresses, including many clinical vignettes, on the attributes of the psychotherapist and the nature of depth psychotherapy, together with a specific viewpoint reviewed below. Part One (seven chapters) is called Personal Qualities; Part Two (eight chapters) is called Professional Dilemmas (i.e., clinical challenges). The author, trained as a psychoanalyst in Britain, practices and teaches in Australia. He has already published four books, which I hope to track down.
This is a difficult book to summarize. I elect to review four themes or theses running through it:
1. Training. Symington takes psychotherapy most seriously. He would have four years of full-time training in a curriculum to include not only wide technical reading, but also great literature and courses on religion, as well as supervised clinical work. The "invention model" of personal creativity is to be stressed over the "academic model" of thorough knowledge. He offers no specifications for technique.
2. Psychotherapy and Psychoanalysis. "Psychotherapy means healing of the soul," a process very distinct from psychoanalysis, whose goal is self-knowledge. But this emphatic distinction evaporates in the text itself, where psychotherapy and psychoanalysis are indistinguishably interwoven.
Psychotherapy is to be lengthy and hard, reconstructive work. Nonanalytic methods, even Kohut's propositions, are treated roughly as superficial. And despite Symington's strong interest in interpersonal transactions, there is no mention of group psychotherapy.
3. Creative Self-Understanding. This element is at the center of psychotherapy. For both therapist and patient it is tool, goal, touchstone for process and outcome; it is the therapist's shield and buckler with difficult patients. The centrality of self-understanding explains, I believe, why Symington's initial professions give way to a homogenization of psychotherapy and psychoanalysis.
Other attributes of the psychotherapist (which can be fostered by training) include courage, which fortifies the therapist against pain, both patient's and therapist's, and militates against fleeing from or denying the truth. And there are also imagination and curiosity, without which "it is not possible for someone to be a safe psychotherapist." (Wish I'd written that!)
4. Psychotherapy and Religion. Here we have the true distinctiveness of this book. The psychotherapy movement is "in moral crisis" (bankruptcy, stagnation). It has lost the revolutionary spirit in which Freud challenged Victorian puritanism. Indeed, for this mindless, knee-jerk, superego-laden attitude, particularly around sexual matters, psychotherapy has now substituted an equally mindless, knee-jerk permissiveness, or "nominalism."
Psychotherapy "needs a religious principle." Symington notes that the undertaking of psychotherapy is a moral decision and goal-setting is a moral judgment; the patient is morally responsible for attending to his or her mental health. In the search for the real self—for healing of the soul—the detailed analysis of values, value conflicts, and the nature of the good are of the essence. A tyrannical superego is always the sign of a fragmented personality; a mature conscience is the barometer and guiding light of a unified and healthy personality. All these are religious concerns!
Psychotherapy needs dialogue—difficult and prolonged if necessary—with religious minds. The place of conscience in proper mental health needs new scrutiny. Practically, psychotherapy has a real opportunity to help in the major area rather neglected by the great religions; namely, guidance on issues of human intimacy and sexuality. This area is of great relevance in today's postindustrial, increasingly urbanized and alienated society.
Who should read this book? It is too heavy, and not operational enough, for beginners or trainees. Philosophers of psychiatry, psychotherapy, religion, and pastoral care would, I think, get a great deal from it. Two kinds of psychotherapists (and analysts) really should read it. First, there are experienced journeymen knowledgeable in their craft, perhaps tired, jaded, skeptical about what they are doing, and needing just such a stimulus as this book offers. Second, trainers, teachers, and clinical supervisors would also, I believe, get a new slant on what they are passing on to a new generation of therapists. Such a perspective is welcome in these days, when psychotherapy is in danger of becoming more and more a mere commodity to be bought and sold.
Footnotes
Dr. Powles is Emeritus Professor of Psychiatry, Queen's University, Kingston, Ontario, Canada.
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ALL ISSUES | SEARCH | TABLE OF CONTENTS |
