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Book Reviews   |    
Psychodynamic Psychotherapy: A Practitioner's Guide
Reviewed by Daniel Schneider, M.D., M.A.
Psychiatric Services 2005; doi: 10.1176/appi.ps.56.5.621
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by Nancy McWilliams; New York, Guilford Press, 2004, 353 pages, $45

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The task of writing a primer for those who are training in psychotherapy would appear to be daunting. Distilling what could easily fill a many-volume library into a single, clearly written text that readers will find both stimulating and practical is no small feat. As a resident in a psychiatry program who is just embarking on my own psychotherapy training, I am all the more aware of the many questions that run through a beginner's mind and the difficulty of finding clear answers. In the process of struggling with some of those questions, I was handed this book by my supervisor, who noted that it claimed to be a text for those in training and asked me to write a review from that perspective.

Psychoanalytic Psychotherapy: A Practitioner's Guide is written in an easy, conversational style and took me barely a weekend to read. The author fills the text with a number of lively anecdotes and patient histories that effectively keep the reader's attention during the process of being educated. The more important question, however, is whether the content of the book delivers in terms of being an adequate teaching resource for the beginning therapist.

The author, Nancy McWilliams, states in her preface her intention to create a text that would be of use for therapists of all persuasions. However, it would be a mistake for a reader to expect too much of this claim. Although McWilliams does discuss issues of universal relevance, such as fees and missed appointments, I don't feel as though I came away from the book with a better understanding of nonpsychodynamic styles of therapy. However, the author was successful in fostering a better grounding in the goals and general orientation of psychodynamic psychotherapy, and, as the book's title might imply, that should be the expectation of anyone who is considering reading this book.

As a beginner, I think this basic grounding was one of the main assets of the book. There is a sense when one begins therapy of being set adrift. You lack confidence in what you are doing and why. Over the course of this book, a theme emerges that provides some sense of what the reader can hope to obtain with a psychodynamic approach and the rationale behind using it. I want to be careful here not to minimize the practical points and suggestions given throughout. I suspect, as I gain more experience, that these practical aspects will be useful to me as well. Yet, at this point in my training, I found it most helpful to have a chance to observe how the author approached a variety of patients and situations as well as to have the chance to note the underlying assumptions brought up about treatment in her examples. Overall, this book was an enjoyable and informative book and well worth the read.

Dr. Schneider is a resident in combined psychiatry and neurology at the University of Massachusetts in Worcester.

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