This is a bad book which I found highly irritating. To support this judgment fully would require a lengthy article if not an entire book, and the work merits neither such space nor effort. Accordingly, I will limit myself to a few remarks about what seem to me its most grievous faults.
It is a large book (548 pages), but its themes are few: psychotherapy is in a terrible state; dreams and feelings should be the therapist's main concern; and, a certain kind of group therapy is the answer to making effective quality treatment available to the large population that needs help but is presently being served either poorly or not at all. These themes are repeated relentlessly.
The book claims originality ("we present much useful clinical material not found elsewhere" ) and a foundation in research. Regarding the former, the old adage "what is good is not new, and what is new is not good" applies; and, de Schill offer no real support (and, indirectly, some evidence against the latter claim (e.g., the time-frame of his "research" on group therapy).
I cannot identify a readership for this book. On the one hand, as de Schill says, it is not intended as a scholarly work (31, 97). For example, most of it is a highly repetitious and motley rehash of old literature; citations of sources often are missing; key relevant critical literature is not mentioned; the book is sprinkled with strange anecdotes--e.g., about the Grand Duke Nikolai Nikolajewitch's selection of his guards (265--re selection of therapy candidates); and, to professionals the bulk of the criticism will be familiar and old. On the other hand, I cannot see well-educated nontherapist readers or other lay persons wanting to wade through such a bulky book that is tediously repetitious, haphazardly organized, self-aggrandizing, full of sarcasm, and rigidly dogmatic.
The sarcasm in the book is particularly odious. For example, de Schill calls Erik Erikson "a vociferous purist and self-proclaimed saint" (135), says of Irving Yalom that "we are glad to learn [that he] can do much better" (than Freud) (161), and condemns certain "acclaimed theorizers," saying (concerning the milling crowd of their admirers) that "it is true that 'the higher the monkey climbs, the more you see his rear" (401). He makes comparable inappropriate, unprofessional remarks about numerous other well known therapists, including Kohut, French, Karasu, Shengold, and Grotjahn; and, he notes generally that other therapist's views of dreams "betray utter ignorance," are "irresponsible," and deserve to be answered with "harshness" (98-99). de Schill has no doubts about the absolute truth of his knowledge and judgements.
Here is a partial list of further grievous faults. de Schill idly and stridently criticizes (and misquotes) Freud on the interpretation and use of dreams in therapy, offering his own dogma instead (e.g., 149, 193, 196, 215, 229-233; having criticized orthodoxy in psychoanalysis in numerous publications, I do not automatically take exception to well-conceived critiques of Freud, but in this instance I see no reason for giving preference to de Schill's poor arguments and alternative dogma based on his own experience); de Schill's few original proposals include a bizarre recommendation to "creat[e] a three-dimensional representation of the unconscious [dynamics]" which, he claims, is a necessity in psychotherapy (439-453); he acknowledges a key shortcoming of group therapy, namely, that one must give up using free association (which some of us see as indispensable in analytic therapy--e.g. Barratt, 1993, 1994; Thompson, 2000, 2001; Bollas, 1999; Berger, 1991, 1996), but dismisses the issue in two brief sentences (510-511).
I close by noting that the lack of credibility brought about by this book's many and significant technical and stylistic faults is augmented by certain puzzling inconsistencies and evasions concerning the book's lineage: (1) Its publication date is given as 2000, but a 1994 review is cited on page 10 of the book's companion volume (de Schill and Lebovici, 1999[?]). (2) That companion book is given as a 1997 publication in a publisher's mailing and in de Schill's list of references (520), but subsequently he (530) cites a 1994 review. (3) de Schill's book has two long "introductions," by Robert Stoller and John Gedo. The author says that these were written in response to his invitation to write introductions, but there are grounds for questioning this claim; Stoller died in 1992, and Gedo's "introduction" is an (unacknowledged) reprint of chapter 12 in Gedo, 1984. And finally, (4) Part II, "The quest for affordable and effective psychotherapy" (471-520), reprinted from de Schill and Lebovici, 1997, acknowledges that it was "written in cooperation with Denise LaHullier," but there is no information about the nature or extent of their respective contributions and collaboration; unfortunately, instances of such absences of information about substantial cited materials are scattered throughout. I can see no redeeming virtue in this strange work.
© 2001 Louis S. Berger
Barratt, B.B. 1993. Psychoanalysis and the Postmodern Impulse: Knowing and Being since Freud's Psychology. Baltimore, MD: Johns Hopkins University Press.
____________. 1994. Critical notes on the psychoanalyst's theorizing. Journal of the American Psychoanalytic Association 42:697-725.
Berger, L.S. 1991. Substance Abuse as Symptom: A Psychoanalytic Critique of Treatment Approaches and the Cultural Beliefs that Sustain them. Hillsdale, NJ: Analytic Press.
Berger L,S. 1996. Toward a non-Cartesian psychotherapeutic framework. Philosophy, Psychiatry, & Psychology 3: 169-184.
Bollas, C. 1999. The Mystery of Things. New York: Routledge.
de Schill, S., & Lebovici, S. (Eds.), 1997 [?]. The Challenge for Psychoanalysis and Psychotherapy: Solutions for the Future. London: Jessica Kingsley.
Thompson, M.G. 2000. 'Free association:' A technical principle or model for psychoanalytic education? Psychologist Psychoanalyst 20: 1-13.
Thompson, M.G. 2001. The enigma of honesty: The fundamental rule of psychoanalysis. Free Associations 47: 1-45.
Louis S. Berger's career has straddled clinical psychology, engineering and applied physics, and music. His major interest is in clinical psychoanalysis and related philosophical issues. Dr. Berger's publications include 3 books (Introductory Statistics, 1981; Psychoanalytic Theory and Clinical Relevance, 1985; Substance Abuse as Symptom, 1991) and several dozen journal articles and book reviews. A manuscript comparing praxial and technologically based psychotherapies is being completed.
We have received the following reply concering Louis Berger's
review. The reply is by Monroe W. Spero, M.D., Chairman of the
Professional Board at the American Mental Health Foundation.
The author of the book, Stefan de Schill, is director of research
for the AMHF.
I regret to say that this is a most inaccurate book review. To
anyone who has read the book, Berger's comments are off the mark.
It is evident that he spent much effort to create a case.
Berger makes numerous non-factual statements in his review.
One has to wonder about Berger's motives for attacking Crucial.
It is obvious that the work struck a raw nerve in Berger. Why?
To cite a few sentences from Professor Fabian Schupper's review
of this book:
"What a welcome breath of fresh air
.Dr. de Schill's
work stands as a much-needed expert correction to the mountain
of highly speculative and unanchored theory building in the field
of psychoanalysis and psychotherapy. On the basis of numerous
cogent examples, he demonstrates the need for an expert clinical
approach as the indispensable tool for understanding the unique
psychological makeup of the individual. This stands in marked
contrast to the facile practice of generalizing broad 'theory'
to every patient, regardless of his or her individuality in structure
and dynamics. I don't know of any analyst more capable of understanding
and formulating very complex concepts in a clear and cogent manner."
Berger's anger appears to be related to two circumstances.
1. He is the author of a number of writings on psychoanalytic
theory. See the description of his latest book Psychoanalytic
Theory and Relevance: What Makes a Theory Consequential for Practice?
by The Analytic Press: "Berger grapples with the nature of
'consequential' theorizing, i.e., theorizing that is relevant
to what transpires in clinical praxis. By examining psychoanalysis
as a genre of 'state process formalism' - the standard form of
scientific theory - he demonstrates why contemporary theorizing
inevitably fails to explain crucial aspects of practice. Then,
drawing on theories of affect, the nature of first-language acquisition,
and the philosophical aspects of free will and determinism, he
offers pragmatic recommendations for arriving at a theory more
relevant to practice."
2. de Schill, in Crucial, severely criticizes the ever-increasing
use of easy-to-learn and easy-to-practice but inadequate treatment
methods in psychotherapy and psychoanalysis. He discusses in detail
a great number of writings by professionals promoting such approaches.
Berger, however, aligns himself with many of these authors, giving
their names, and defending them by censuring de Schill for his
criticism of them. All these therapists, even though well-known,
according to de Schill's analysis of their work evidence little
competence. In his book, de Schill extensively describes the talents
he states a psychotherapist must possess and what skills he or
she needs to acquire.
To answer Berger's inaccuracies would take many pages. Thus, we
will select significant examples.
Berger claims that the themes of the book are few, namely three.
Not at all: the book covers basic and essential issues of psychotherapy,
often using writings in psychotherapy as illustration. Furthermore,
considerable attention is given to improved methods for selecting
trainees and the need for creation of a new specialized professional
curriculum for psychotherapists. In the same paragraph. Berger
indicates that de Schill claims that a certain form of group therapy
is the "answer to the large population that needs help."
de Schill never makes such a claim. He merely indicates that the
American Mental Health Foundation over a number of decades can
help a considerable number of patients, including many who previously
would not have been considered for group treatment. The major
part of the book, however, is devoted to the discussion of topics
of relevance to individual therapy as well as to groups.
Berger states that an underlying theme is "what is good is
not new, and what is new is not good." One finds it difficult
to discover a basis for such an assertion.
Quoting Berger: "de Schill notes generally that other
therapists' views of dreams 'betray utter ignorance,' are 'irresponsible,'
and deserve to be answered with 'harshness.' (emphasis added).
This is another one of Berger's misrepresentations. He gives the
impression that de Schill's comments refer to all therapists using
dreams therapeutically. The fact, however, is that de Schill speaks
in the highest terms of a number of very important therapists
who work with dreams. The three quotes of de Schill cited above
by Berger are in no way general but specifically apply merely
to five neurobiologists who declare that dreams do not have any
meaning and thus no value in psychotherapeutic work. Since these
professionals hold important university positions, these assertions
have considerable influence on students.
Later, Berger speaks about "evasions" - but where are
they? Dr. de Schill is straightforward in his opinions and writings,
and to the point in his comments.
Then the reviewer questions de Schill's statement that the two
introductory chapters were obtained in response to Dr. de Schill's
invitations to these authors. Berger appears to imply that de
Schill has lifted the chapters from some other books. The truth,
however, is that both these authors have made special efforts
to tailor their chapters to this work. I herewith send copies
of their letters to the editor of Metapsychology.
And so it goes.
Berger's tirade is an indication of the reaction experienced by
many who feel criticized by de Schill's book. His comments are
in stark contrast to the many laudatory reviews by outstanding
authorities, some of which are reprinted on the dust jacket. On
the other hand, it is quite apparent that Berger fails to comprehend
the scope and the essence of de Schill's book.
And a last statement: a reviewer is entitled to express his or
her opinion but not to misrepresent the contents of a book.
January 8, 2002
Monroe W. Spero, M.D., Chairman, Professional Board, American
Mental Health Foundation
April 4, 2002
Louis Berger has declined the opportunity to respond to Monroe
Spero's letter, but he stands by his original review of Crucial
Choices, Crucial Changes. In support of his review he directs
readers to another review by Scott Wetzler, Ph.D., in the American
Journal of Psychiatry, 159(3):509-10.