This book, which focuses on the psychotherapist's interventions, presents the basic critical activity of the therapist. It applies two predominant paradigms–conflict and deficit–in the treatment of a wide range of patients. The therapist must address and deal with conflictual concomitants as well as developmental derailments because the patient is a product of both. Excerpts of verbatim dialogue are offered to articulate the course of psychotherapeutic interaction as a successive series of co-created communications. Explicit commentaries, interwoven throughout the text, inform the reader of the practitioner's rationale for the particular stand taken (for better or worse) at each moment of the therapeutic process. They provide an intimate vehicle through which to listen to, and understand, the clinician's inner voice during the real-life practice of psychotherapy. Pathology and practice reside on a continuum. Conflict theory does not apply solely to the neuroses, nor does object relations apply only to borderline disorders, and self theory need not be reserved for narcissistic disturbances. The hysterical patient can have ego deficits as well as sexual conflicts; similarly, the depressive patient can show self deficiencies as well as unresolved conflictual problems. Moreover, conflicts are not necessarily restricted to oedipal phases nor deficits to preoedipal ones. Dr. Karasu delineates a clinical approach by which psychotherapy can be geared toward remedying both the underlying psychological deficits (lacks) and the conflicts (wishes/fears) in the progressive maturation and adaptation of an individual. He effectively integrates the major psychodynamic models. No single school can meet the needs of the practitioner in interaction with all patients. Psychotherapy practice for the future will be based on the individual patient's developmental pathology and problems, deficits and conflicts, defenses and compromise formations, unfulfilled needs and unfinished tasks, as well as the level of adaptation and
