What sets off the termination of analysis and psychodynamic therapy from the variety of endings that enter into all human relationships? So asks Herbert J. Schlesinger in _Endings and Beginnings: On Terminating Psychotherapy and Psychoanalysis_, a work of remarkable clarity, conceptual rigor, and ingratiating readability. Schlesinger situates termination - which he understands, variously, as a phase of treatment, a treatment process, and a state of mind - within the family of "beginnings and endings" that permeate one another throughout the course (...) of therapy. For Schlesinger, therapeutic endings cannot be aligned with the final phase of treatment; ending-phase phenomena are ongoing accompaniments of therapeutic work. They occur whenever patients achieve some portion of their treatment goals and supervene when therapy stagnates. Small wonder that an assessment of the patient's relationship to time and capacity to end therapy are key aspects of diagnostic evaluation. By linking beginning and ending phases not to the chronology of treatment but to the patient’s experience of it, Schlesinger brings revivifying insight to a host of psychodynamic concepts. Nor does he shy away from a trenchant critique of the instrumental “medical model” of psychiatric and psychotherapeutic training, which militates against the therapeutic exploration of treatment endings. Schlesinger's exemplification of how to begin treatment from the point of view of ending; his sensitive delineation of the mid-treatment "ending" crises characteristic of "vulnerable patients"; his richly woven case vignettes illustrating various "ending" contingencies and permutations - these inquiries are gems of pragmatic clinical wisdom. _Endings and Beginnings_ distills lessons learned over the course of a half century of practicing, teaching, and supervising psychotherapy and psychoanalysis and is a gift to the profession. (shrink)

Considering that getting along in civil society is based on the expectation that people will do what they say they will do, i.e., essentially live up to their explicit or implicit promises, it is amazing that so little scientific attention has been given to the act of promising. A great deal of research has been done on the moral development of children, for example, but not on the child’s ability to make and keep a promise, one of the highest moral (...) achievements. What makes it possible developmentally, cognitively, and emotionally to make a promise in the first place? And on the other hand, what compels one to keep a promise when there seems to be no personal advantage in doing so, and even when harm can be predicted? How do we know when a promise is offered seriously to be taken at face value, and how do we understand that another is only a polite gesture, not to be taken seriously? In _Promises, Oaths, and Vows: On the Psychology of Promising_, Herbert Schlesinger addresses these questions, drawing on the literature of moral development in children; the psychotherapy of a patient who regularly broke promises that were unnecessary in the first place; those who were regarded as "promising youngsters" who did not fulfill their "promise"; and those who feared making a promise, a commitment, or a threat out of fear that, once made, the utterance would take on a life of its own and could never be taken back. Furthermore, he illustrates his conclusions by examining the widespread use of promising in classical literature, such as Greek drama and the plays of Shakespeare, as well as the motivating and reifying power of the promise in Western religious traditions. With a style honed over the penning of two previous books, Schlesinger once again produces a work grounded in a firm analytic sensibility, but which also retains the wit and candor of the seasoned analyst. His seminal investigation of this all but neglected topic in the clinical literature is as timely as it is scholarly, and – with the title firmly in mind – _Promises, Oaths, and Vows_ is assured to be a worthy addition to any clinician’s library and a provoking investigation into Nietzsche’s notion of man as "the animal who makes promises.". (shrink)