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BookREVIEW: Beginnings in Psychotherapy

BeginningsA Guidebook for New Therapists
Seth Eichler
London: Karnac Books, 2010
pp128, £19.99 (paperback)

Review by Uta Blohm

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This is a very readable book that offers an introduction to the work of a psychotherapist. While I had thought it would be about how to manage beginnings in psychotherapy, it is in fact aimed at psychotherapists who are starting out and those who are thinking of becoming therapists. As I am a beginner myself I enjoyed reading it; it touches on many issues involved in the therapeutic process such as the therapeutic alliance and endings as well as beginnings.

The author has worked as a psychotherapist (and psychoanalyst) in the United States for twenty-seven years. He feels passionately about what he does, which comes across in his writing. His theoretical underpinnings are analytic (Freudian) and he explains basic concepts such as transference, counter-transference, regression and resistance very well, often with practical illustrations. He also discusses the various choices a therapist has to make – there is for example a chapter on the choice between gratification and deprivation – and points to some practical issues – such as money, time and missed sessions – and the possible meanings these may have for different people. There is also a section on tools and techniques as well as one that explains the process of listening and possible interventions. Silence, ambiguity and free association and even the use of the couch are introduced.

Eichler explains how, in his experience, insight brings relief from pain. This is somewhat different to the relational style of working I have been trained in and it was useful to be reminded that an important part of the work involves making the unconscious conscious. From the author’s perspective it is the aim of therapy to strengthen a patient’s ego, which tends to be driven by their id, often consisting of childhood experiences. He encourages patients in their own self-observation and also educates them on the therapeutic endeavor, which he considers a mutual enterprise. One third of the book comprises case studies, which I found the most interesting to read even though they also raised some questions. For example, I was wondering what he meant when he explained how he traces a patient’s homoerotic desires to childhood problematic experiences. Another case study illustrates in a very helpful way, how one can make use of dreams in the therapeutic process through joint interpretation.

The author certainly believes in his work and I tend to agree with his statement that: “One of the fundamental pleasures in our field is the pursuit of truth” (p5). I am not so sure however whether ”Because of this goal our field will always endure” (p5).

This is good book that I would include in the reading lists of students who are doing a foundation year as well as those who are about to see their first clients.

Rev. Dr. Uta Blohm is a United Reformed Church Minister in her fourth year of psychotherapy training at the Minster Centre. She works as a hospital chaplain and holds a PhD in Religious Studies.