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Editorial
In This Issue
Quentin Rae-Grant
(PDF)

Original Research
Quality of Life in OCD: Differential Impact of Obsessions, Compulsions, and Depression Comorbidity
Mario Masellis, Neil A Rector, Margaret A Richter
(PDF)

A Pilot Study of a Parent-Education Group for Families Affected by Depression
Mark Sanford, Carolyn Byrne, Susan Williams, Sandy Atley, Ted Ridley, Jennifer Miller, Heather Allin
(PDF)

Differentiating Symptoms of Complicated Grief and Depression Among Psychiatric Outpatients
John S Ogrodniczuk, William E Piper, Anthony S Joyce, Rene Weideman, Mary McCallum, Hassan F Azim, John S Rosie
(PDF)

Filicidal Women: Jail or Psychiatric Ward?
Line Laporte, Bernard Poulin, Jacques Marleau, Renée Roy, Thierry Webanck
(PDF)

Phenomenology and Comorbidity of Dysthymic Disorder in 100 Consecutively Referred Children and Adolescents: Beyond DSM-IV
Gabriele Masi, Stefania Millepiedi, Maria Mucci, Rosa Rita Pascale, Giulio Perugi, Hagop S Akiskal
(PDF)

A Multicentre Prospective Controlled Study to Determine the Safety of Trazodone and Nefazodone Use During Pregnancy
Adrienne Einarson, Lori Bonari, Sharon Voyer-Lavigne, Antonio Addis, Doreen Matsui, Yvette Johnson, Gideon Koren
(PDF)

Brief Communication
Clozapine Treatment in Patients With Prior Substance Abuse
Deanna L Kelly, Elizabeth A Gale, Robert R Conley
(PDF)

The Effect of Peer Support on Postpartum Depression: A Pilot Randomized Controlled Trial
Cindy-Lee Dennis
(PDF)

Book Reviews
(PDF)

Psychological Aspects of Women’s Health Care: The Interface Between Psychiatry and Obstetrics and Gynecology. 2nd Edition.
Reviewed by
Vera Lantos, MD, FRCPC

Introduction to Functional Magnetic Resonance Imaging: Principles and Techniques.
Reviewed by
Jimmy Jensen, PhD,
Shitij Kapur, MD, FRCPC, PhD

Planification et évaluation des besoins en santé mentale.
Revue par
Raymond Tempier, MD

Clinical Interaction and the Analysis of Meaning: A New Psychoanalytic Theory.
Reviewed by
Paul Ian Steinberg, MD, FRCPC

Evidence and Experience in Psychiatry. Volume 2: Schizophrenia.
Reviewed by
Mary V Seeman, MD

Schizophrenia Revealed: From Neurons to Social Interactions.
Reviewed by
Emmanuel Stip, MD

How’s Your Marriage? A Book for Men and Women.
Reviewed by
Karl M Tomm, MD FRCPC,
Cynthia A Beck, MD MASc FRCPC

L’extermination des malades mentaux dans l’allemagne nazie.
Revue par
Frédéric Grunberg, MD

Physicalism and Its Discontents.
Reviewed by
Dorian Deshauer, MD FRCP

Letters to the Editor
(PDF)

Zenker’s Diverticulum and Psychosis in the Elderly

Anorgasmia and Withdrawal Syndrome in a Woman Taking Gabapentin

Stage-Oriented Trauma Treatment Using Dialectical Behaviour Therapy

Sexual Sadism With Lust-Murder Proclivities in a Female?

Topiramate-Induced Suicidality

Bright-Light Therapy in Somatization Disorder

Venlafaxine-Induced Delirium

New Dosage-Reduction Regime to Avoid Paroxetine Discontinuation Syndrome

Risperidone-Induced Galactorrhoea: A Case Series

Gamma Hydroxybutyrate Withdrawal in an Orthopedic Trauma Patient

Version française de la Wender Utah Rating Scale (WURS)

Book Review

Psychotherapy

Clinical Interaction and the Analysis of Meaning: A New Psychoanalytic Theory. Theo L Dorpat, Michael L Miller. Hillsdale (NJ): The Analytic Press; 1992. 326 p. US$49.95.

Review by Paul Ian Steinberg, MD, FRCPC
Edmonton, Alberta

This text has the double merit of being both very scholarly and of exercising an important influence in the practice of psychoanalysis and psychodynamic psychotherapy. The first section, “Critique of Classical Psychoanalytic Theory,” contains chapters on Freud’s theory of cognition, primary process, unconscious fantasy, and unconscious pathogenic beliefs. Dorpat states, “nearly exclusive focus on the intrapsychic domain obscures the profound and complex ways in which the analyst is implicated in the clinical phenomena he seeks to study and to interpret” (p xiii). The authors successfully demonstrate the importance of object relations and the interactional perspective in understanding and interpreting patient communications and actions, looking not just vertically to the depths of the patient’s psyche for the causes of behaviour but also horizontally at the individual’s interactions with the environment. They indicate that little attention is given to the actual interactions between patient and therapist and to how the patient unconsciously evaluates and represents these interactions. The second section, “Interactional Theory,” contains chapters on basic principles of mental organization and development, the mind in operation, defense and psychopathology, and process and technique and concludes with a clinical study. Miller focuses on “how a patient’s psychopathology is expressed and the types of interactions in which he or she engages the analyst and in the meaning that the patient assigns to these interactions” (p 98). He applies Piaget’s 5 classes of operational schemes, showing how they “organize the elements of lived experience into mental structures called schemata” (p 111).

“Applications and Exemplifications” describes the intersubjective system of reciprocal mutual influence of transference and countertransference. The chapter explains the significance of self-fulfilling prophecies in projective identification. A revised theory of defenses is proffered, which recognizes the role played by object relations in the development, internalization, and maintenance of defensive activity. A concluding chapter uses case vignettes to illustrate the contribution to dream formation made by patients’ unconscious meaning analysis of recent events.

Each of the 3 sections of this book begins with an introduction that describes the goals of the section and the way in which the authors reach the goal. This book is well organized and convincing; the authors arrive at their conclusions in a logical manner. Although I noticed several typographic errors, the writing is clear and concise, carefully referenced, and packed with ideas. The authors convincingly present their revision of psychoanalytic theory in a nontendentious way. Throughout, the scholarship and clinical ideas being presented are of very high quality. This is essential reading for anyone practising psychoanalysis or a dynamic form of psychotherapy. It is refreshing to read authors who diverge from Freud, showing where recent discoveries in various scientific disciplines demonstrate some of his conclusions to be incorrect, without either walking on eggs or trying to show that their divergence was implied in Freud’s work, as if Freud could never be wrong. Each chapter is broken up into several short subchapters that help readers organize their thoughts, making the contents of the book more digestible. This is important, because rarely have I seen a book with so much meat in it. This book certainly bears more than a single reading.

Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé