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by Scott R. Ahles
Johns Hopkins University Press, 2004
Review by Leo Uzych, J.D., M.P.H. on Sep 1st 2005

Our Inner World

    In Our Inner World, the still-arid fields of psychodynamics and psychotherapy are watered refreshingly by the knowledge-laden, insightful streams flowing from the considerable intellectual acumen of Scott R. Ahles, a psychiatry professor (at the University of California, San Francisco).  The modestly stated goal, of Ahles, is to teach some basic principles of psychodynamics and psychotherapy to trainees in:  psychology, psychiatry, counseling, and social work.  And veritably, readers of this enthralling book open a portal revealing absorbing scholarship of likely interest to those covetous of traversing the oft-turbid world of psychodynamic psychotherapy.

   In an engrossing, contemplative manner, the book adroitly explains how a psychologically-revealing picture may potentially be painted of a person's inner world; and how knowledge and understanding of such paintings may be of invaluable clinical assistance with respect to artfully molding treatments tailored finely to fit a particular person's inner world, in a way conducive to promoting inner balance as well as healthy relationships with others.  In the course of this masterfully-crafted primer, Ahles skillfully navigates some of the quite-demanding pathways, of psychodynamics and psychotherapy, in a way designed well to facilitate better understanding of psychologically rooted maladies, and how, in a clinical sense, to efficaciously treat them.  The book surely is a great intellectual boon to those seriously interested in unraveling, and garnering some understanding of, interjoined strands collectively comprising the tapestry of psychodynamic psychotherapy.

   The writing power of Ahles, coupled with Ahles's well-developed research skills, drench the pages of the text with a rather-intense abstruseness.  Stylistically, the book is unabashedly academic in nature, and well constructed for didactic purposes.  Truly, Ahles's painstaking study of some of the roots of psychopathology is a trough from which luminous intellectual light pours forth.  Problems of psychological origin are illumined brightly in part by the expert use of instructive clinical cases.  Indeed, the clinical case presentations, grafted expertly into the textual body, are highly valuable appendages, of the book's structural anatomy.  Additionally, artful "figures", crafted by Ahles, suffuse the text, and embellish very materially the text's didactic value.  A listing of references, adjoining the text, may function usefully as a sort of bridge, assisting research-focused readers intent on traveling down the path of further study of particular sub-niches, of the expansive realm of psychodynamic psychotherapy.

   Structurally, three "parts" are the mainstay pillars, upholding the book's structural foundation.  The book, it should be understood, is not an all-comprehensive primer on psychodynamics and psychotherapy.  Rather than sketching exhaustively the full gamut of the multifarious variants showing collectively the wide panorama of psychodynamic theories and psychotherapeutic techniques, Ahles, instead, in workaday fashion, etches the lineaments of selected concepts and theories germane to psychodynamic psychotherapy.  In part one, tentacles of rapt attention extend to:  an explication of selected concepts tied to attachment theory; a pithy discussion of several concepts interlinked to affect theory; a delineation of the concept of primitive mechanisms of defense; scrutiny of the concept of arrest of the separation-individuation process; engaging discussion of object-relations theory; and terse, informed demarcation of some of the contours of:  id, ego, and superego.

   The trandscendent aim of the handiwork of intellectually skilled artisan Ahles is to utilize selected concepts allied to psychodynamic psychotherapy in a way potentially helpful with respect to casting light on a person's inner representational world.  The crux confronting Ahles is to craftily use interfused concepts so as to create, in a sense, an at least somewhat, psychologically lucid picture of a person's inner representational world.  As envisaged by Ahles, the illumining of a person's inner representational world, facilitated hopefully by the weaving together of disparate-yet-kindred concepts of manifold psychological theories, may, in turn, contribute possibly in helpful fashion to the effectual treatment of emotional dysfunction embedded in a particular person's inner world.  The foregoing is the core message imparted by the first part of the book.

   The development of a healthy sense of self, and the development of healthy relationships, are given center-stage attention in the second part of the book.  Working hard, Ahles pursues a study of development, endeavoring to demystify linkages potentially binding developmental interactions to psychologically rooted problems, in a context relevant generally to illumining a person's inner world.  In an intellectually energizing way, Ahles adumbrates the development of sense of self and of interpersonal relationships, including discussion of psychopathologic problems immersed in the potentially tempestuous waters of the development of self, and examination of psychopathology linked, in origin, to problematic development of relationship ability.

   The last part of the book, in an instructive manner, seeks to elucidate some of the profundities of psychotherapy by means of deft dissection and examination of clinical cases, which comprise the corpus of several chapters.  The sundry clinical presentations are used adroitly to flesh out relevant psychodynamic concerns and pertinent psychotherapeutic interventions.  The interventions, of a psychotherapeutic nature, recounted in the various case presentations are generally described engrossingly.  Overall, in the respective clinical presentations, Ahles does a superb job of examining the relative clinical efficacy of multifarious psychotherapeutic techniques, when applied to difficult, real-life circumstances.

Exuding emboldening intellectual doughtiness, Ahles lucidly, and absorbingly, plumbs the challenging depths of psychodynamics and psychotherapy.  Ahles's laborious, and quite-skilled, hewing of the somewhat-amorphous corpus of psychodynamic psychotherapy should be immensely enriching to: mental-health practitioners, engaged in clinical work; researchers curious about the considerable challenges of variegated psychodynamic theories and diffuse forms of psychotherapy; social workers; and, not least, students aspiring to imbibe knowledge about psychodynamic psychotherapy.

 

© 2005 Leo Uzych

 

Leo Uzych (based in Wallingford, PA) earned a law degree, from Temple University; and a master of public health degree, from Columbia University.  His area of special professional interest is healthcare.