This book is probably the best examination of the relationship between attachment theory and psychoanalysis written in recent memory. Fonagy candidly describes the differences that exist between psychoanalysis and attachment theory while drawing attention to specific shared points of departure. Scholars who have read Fonagy's chapter in "The Handbook of Attachment" will recognize this material (read: the book is a bound version of the chapter.) An essential read in either form.

I thought this book covered most of the important theories in psychoanalysis and linked them in a cosntructive way with attachment theory. It tries to demonstrate that psychoanalytic thinking and attachment theory are not as far appart as people sometimes assume. It is also good at showing that there are major differences between the two. It provides a good summary of the research base of attachment theory.

The Nobel Prize for Medicine has been given to psychiatrists three times--once for lobotomies, once for injecting the blood of tertiary syphilitics into schizophrenics, and once for discovering certain neurotransmitters. Both of the first "accomplishments" were hailed to such heights solely for their clinical effectiveness, since no one even pretended that science could explicate their effectiveness.

In all of medicine (except, apparently, psychiatry), a distinction between science--which tries to understand what is true--and clinical studies--which ascertain what works--is fairly standard. That's because "what works" may be ill-understood or completely misunderstood and ultimately not very wise--an idea need not be true to be effective, a procedure need not be based on true ideas to "work," and what "works" may turn out to have undesirable effects on other systems.

If you are unconcerned with the distinction between truth and effectiveness, this book is very good. If, however, you know that historically very terrible things have been shown to "work" to the satisfaction of the doctors, you may find the emphasis on effectiveness very troubling.

The book by Roth and Fonagy is a comprehensive and balanced summary of research on psychotherapy. Principly it covers outcome studies and is organised according to DSMIV diagnostic groups. It also covers a bit of process research, particularly the research on therapeutic alliance. There is much to recomnd the book: it is accurate, comprehensive, well written and balanced. It also offeres excellent summaries and impications ections at the end of each chapter. I don't know of a better summary of psychotherapy outcome research.

This book would lend itself well to a research oriented graduate course on clinical psychology and treatment. It is also an excellent resource for writing lectures. Practicing clinicians should find it invaluable. It is concise and synthesizes an extensive body of research well (with appropriate and useful references). Selling points include specifics on clinical description, prevalence, co-morbidity, and history for each disorder covered. Reviews (and summaries) of treatment efficacy are excellent. -W. Born

Fonagy, et al present a thorough and careful reconsideration of the nature and etiology of psychological symptoms and syndromes. They integrate the latest relational concepts of psychoanalytic thinking with the latest concepts of neuropsychology. The result is both radically new and consistent with the best of the foundations of psychoanalyis (Pierre Janet's 19th century understanding of the role of trauma; Freud's pre-recantation focus on trauma).

The writing varies from chapter to chapter, apparently with different authors (not identified by chapter). It is consistently relevant and worthwhile, but some chapters are clearly written and easy to follow, while others are a bit turgid and require dedicated attention.