Five composite patients are used by Dr. Jacobs to represent the psychiatrist-patient exchange. At their best, they demonstrate how problems and personalities are approached differently, why the therapist tries to maintain a helpful distance, how some patients respond dramatically while others seem ill-suited for insight treatment. There's 14-year-old Cathy. mute and unyielding until a game of checkers opened up communications. Or Douglas Welborn, a middle-aged executive whose apparent personality disintegration signified a sloughing off of unwanted roles. And Dolores Kenwick, a hospital patient whose psychological health deteriorated just as her surgical recovery seemed imminent. Dr. Jacobs also introduces Amy Novec, a young woman with terminal cancer who tried all her options in her last months, and Fred Emory, the most recalcitrant and capricious of the lot: he resisted almost all interpretations and found a tentative peace after injury in a riot. Dr. Jacobs discusses issues as they arise (can a psychiatrist treat a patient he dislikes?), shows how misjudgments can upset these often fragile balances, and keeps the jargon to a minimum. A bit stiff and unremarkable overall--he tends to talk in high-falutin prose--but instructive and uncluttered.