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THE OTHER SIDE OF THE COUCH by Gail Albert

THE OTHER SIDE OF THE COUCH

The Healing Bond in Psychiatry

By Gail Albert

Pub Date: July 1st, 1995
ISBN: 0-571-19869-4
Publisher: Faber & Faber/Farrar, Straus and Giroux

 Based on interviews with 12 articulate and seemingly skillful clinicians, a close study of the craft (first) and science (second) of psychiatry and psychotherapy. Albert, executive director of New York City's Project for Psychiatric Outreach to the Homeless, writes extensively here on the desirability and clinical benefits of therapeutic empathy. In one of many insightful and evocative passages, she notes that ``to really understand the whole person in all his moment-by-moment buzzing presence, the psychiatrist has to let the reality of the patient build up inside her, moving beyond [diagnostic] categories to feel her way emotionally into the other's world.'' Simultaneously, she warns, the clinician must beware of overidentifying with the patient, must balance being empathic with being ``probing and intrusive'' in helping the patient explore subconscious currents of desire and conflict. In 17 succinct, straightforward, and jargon-free chapters, ranging from the background of modern psychiatry to ``The Necessity of Love'' (the clinician's for the patient), Albert explores the unique, emotionally intense, and strangely asymmetrical nature of the therapeutic bond. ``The Real Relationship,'' possibly her best section, examines nonverbal factors in therapy, such as the analyst's health, office decor, and ability and willingness to reveal some of his or her own vulnerabilities. The book's major flaw is that it somewhat romanticizes psychiatry and, in particular, the experience of psychoanalytic psychotherapy. The very self-aware clinicians she cites repeatedly reveal a more nuanced attitude: Therapist and patient alike have to work hard to establish and maintain a healing bond. Albert's idealistic approach also causes her to give somewhat short shrift to such problems as analysts who overcharge or cling to patients they should terminate. Nonetheless, the author's skillful interviewing, synthesis, and organization of materialand her subjects' apparent clinical depth and thoughtfulnessmake for a rewarding work.