How Psychotherapy Works : Process and Technique » (1st Edition)

Joseph Weiss is a training analyst at the San Francisco Psychoanalytic Institute, Clinical Professor of Psychiatry at the University of California Medical Center in San Francisco, and Co-director (with Harold Sampson) of the San Francisco Psychotherapy Research Group. He received his baccalaureate degree from Harvard, his medical degree from the University of Cincinnati Medical School, and was trained in psychoanalysis at the San Francisco Psychoanalytic Institute, where he became a training analyst in 1962. He is also currently in private practice in San Francisco.

In the landmark volume, THE PSYCHOANALYTIC PROCESS, Joseph Weiss presented a bold, original theory of the therapeutic process. Now, in HOW PSYCHOTHERAPY WORKS, Weiss extends his powerful theory and focuses on its clinical applications, often challenging many familiar ideas about the psychotherapeutic process.

Weiss' theory, which is supported by formal, empirical research, assumes that psychopathology stems from unconscious, pathogenic beliefs that the patient acquires by inference from early traumatic experiences. He suffers unconsciously from these beliefs and the feelings of guilt, shame, and remorse that they engender, and he is powerfully motivated unconsciously to change them. According to Weiss's theory, the patient exerts considerable control over unconscious mental life, and he makes and carries out plans for working with the therapist to change his pathogenic beliefs. He works to disprove these beliefs by testing them with the therapist. The theory derives its clinical power not only from its empirical origin and closeness to observation, and also from Weiss's cogent exposition of how to infer, from the patient's history and behavior in treatment, what the patient is trying to accomplish and how the therapist may help. By focusing on fundamental processes, Weiss's observations challenge several current therapeutic dichotomies--"supportive versus uncovering," "interactive versus interpretive," and "relational versus analytic."

Written in simple, direct language, Weiss demonstrates how to uncover the patient's unconscious plan and how the therapist can help the patient to carry out his plans by passing the patient's tests. He includes many examples of actual treatment sessions, which serve to make his theory clear and usable. The chapters include highly original views about the patient's motivations, the role of affect in the patient's mental life, and the therapist's basic task. The book also contains chapters on how to pass the patient's tests, and how to use interpretation with the patient. Dr. Weiss also provides a powerful theory of dreams and demonstrates how dreams can be utilized in clinical practice.

This distinguished volume is a major contribution that will profoundly affect the way one conceptualizes and practices therapy. Theoreticians, investigators, and clinicians alike will find it enlightening reading.

W. Robert Aber

This book intends to present a comprehensive theory of psychotherapy technique and process from a modern psychoanalytical perspective. In doing this, the author presents a general psychoanalytical theory of psychopathology and personality functioning. The purpose is to develop in detail the implications of the author's theory of psychopathology (presented in detail in an earlier work) for the practice of psychotherapy. This is a valuable objective, given that although psychoanalytical theory has moved well beyond Freud, writings about the conduct of the therapist have lagged behind. The author in my view has met his objective. This book is intended for both students and practitioners of insight-oriented psychotherapy. The author is an experienced psychoanalytical therapist with much teaching and research experience. The book is attractive and logically organized. It includes a feature rarely seen in texts discussing psychotherapy technique: empirical data supportive of the author's theories and technical prescriptions. This book is intended primarily to be a nuts-and-bolts guide to conducting therapy from within the author's theory. There are many clinical examples, and thorough attention is given to the reasons behind the interpretations and other interventions made by the therapists in the examples. The author frequently overstates the distinctions between his therapy approach and approaches derived from other recent advances in psychoanalytical theory. He has thus not taken a scholarly approach to placing his ideas in historical context in such a way as to trace their lineage and demonstrate his debt to many previous thinkers. Nonetheless, this is an excellent book that meets itsobjectives and that will be quite useful both to therapists in training and experienced clinicians.