Turning Points in Dynamic Psychotherapy: Initial Assessment, Boundaries, Money, Disruptions and Suicidal Crises
Salman Akhtar, M.D.
1 Jan 2009
'Putting aside the narcissistic-masochistic aspiration of authoring a text on all the intricacies of in-depth psychotherapy, I have chosen to address five areas of difficulty in this enterprise. This relatively restricted focus has made it possible to tackle matters in their true complexity and intrigue. The loss of breadth is thus compensated by the gain in depth. The areas I have chosen to explicate pertain to initial assessment, boundaries, money, disruptions, and suicidal crises. Over three decades of clinical experience has taught me that most problems in the course of dynamic psychotherapy involve these areas; their proper understanding and management is key to productive therapeutic work. Each chapter of this compact book tackles one of these areas in detail, outlining not only the conceptual issues at hand but also the technical strategies that emanate from them...'While theoretical grounding does serve as a preamble for delineation of its technical strategies, the book is replete with clinical vignettes and explicatory comments that illustrate the interventions I am proposing as useful. The final tendency involves the fact that the book is not intended to break fresh ground in any sort of dramatic manner; it is aimed to introduce the younger generation of therapists to ways of thinking and working that I, and many others like me, have found clinically useful. I have written it in the hope that some patients of the younger colleagues and students who read it might end up receiving better care as a result. My fervent scribbling is nothing but a therapeutic intervention, even though made indirectly and through the changed attention and voice of other therapists towards their patients. Its goal is to help others help still others better.'- From the author's introduction