Quinodoz, J.M. (1993) The taming of solitude -separation anxiety in psychoanalysis. Routledge:London. 211pp. £14.99.
This is the latest text (No. 20) from the new library of psychoanalysis. The adherence to Freud prevails throughout and Quinodoz offers a convincing re-reading of Mourning and Melancholia (Freud, 1917) highlighting Freud's use of the concept of 'object', placing it in the context of the work of Melanie Klein. This book then is an orthodox objects relations exegesis examing the role of separation anxiety in psychoanalysis. This in itself presents few difficulties, indeed the development of ideas is thoughtful and well written with recourse to clinical vignettes throughout. However, for a while I was left feeling I was reading a revivalist text rather than something new. This was until I reached chapter six when Quinodoz offers a wide range of psychoanlytic theories about separation anxiety including the theories of Fairbairn, Anna Freud, Winnicott, Kohut, Spitz, Mahler and Bolby. Quinodoz offers a neat, if not over ambitious, attempt to draw these theoreticians together under a post-Kleinian umbrella. In the end, though I like the project of theoretical convergence, there is too much arguing about fine tunings in psychoanalysis.
If I do have a problem with this text though it is it's applicability. For Quinodoz, the nuances of separation anxiety are such that he asserts that psychoanalysis should preserve the norm of seeing patients four or five times per week (p. 152). When Quinodoz talks about his four-times-a-week patients it leaves me feeling rather remote, that the psychoanalytic intelligentsia are distant and rather out of touch with the reality of psychoanalytic psychotherapy, in the public sector for instance. I admit that this remoteness is not always the case with books from the "New Library", for instance Segal's book (No. 12) is brilliantly accessible, but I feel less comfortable about Quinodoz. Personally I do favour a rather traditional adherence to psychoanalytic theory but I do not see out-patients four times a week and I do not see them on a couch. Maybe I should and perhaps I should ask if this would this make a difference? Would a more intensive treatment impact upon the length neccessary to influence a positive outcome, or indeed would a more intensive treatment in inexperienced hands like mine in fact be detrimental? Perhaps there are one or two tentative research questions here. There is, of course, an over-riding question about the reality of resources available that looms over such issues. But my concern about the remoteness of this text is couched in a much more specific concern that I have about the future of psychonalytic psychotherapy. Will the purist approach of the Institute of Psychoanalysis, that Quinodoz represents here, continue to filter down to practitioners in the public sector, or will psychoanalysis in the market place disappear in to an ever more élitist capsule that only the rich can ride. If this is the case then the influence of traditional psychoanlysis will in all likelihood decrease until it becomes a bygone remnant of better times. This is perhaps a rather fatalistic conclusion to a brief review of a buoyant psychoanalytic text book.
Gary Winship
Psychotherapy Dept.,