Detached, alienated people, many of them functioning with a pathologically developed false self, barely navigate life's challenges. Our cultural emphasis on autonomy and separateness has led to a retreat from valuing interpersonal, communal dependence and has greatly contributed to a rise in the number of people whose suffering is often expressed in addictions and personality disorders. Using actual patient material including diaries and letters, Karen Walant's Creating the Capacity for Attachment shows how 'immersive moments' in therapy-moments of complete understanding between patient and therapist-are powerful enough to dislodge the alienated, detached self from its hiding place and enable the individual to begin incorporating his or her inner core into his or her external, social self.

Review:

Walant has added a missing piece to the therapeutic puzzle. She stresses the central need for intellectual and emotional immersion in the therapeutic process both for the patient and the therapist. Walant demonstrates her techniques using moving case histories of patients suffering from psychiatric illnesses, as well as those affected by addictions. Her use of well-chosen quotes fro the world of literature, poetry, and religion makes reading the book a sheer pleasure as well as an intellectual adventure....--Samuel C. Klagsbrun, M.D.

This book provides clear, practical guidelines for the therapist to help patients restore the lost capacity for attachment. It is especially noteworthy that Dr. Walant describes how the therapist may effectively utilize the patient's participation in twelve-step programs as a part of a psychodynamic treatment approach. This is an important book that I highly recommend for clinicians at all levels of experience....--Jeffrey Seinfeld, Ph.D.

In this scholarly, sensitive book, Karen Walant systematically examines psychodynamic paradigms for understanding development and applies her analysis to the needs and problems of substance-dependent individuals. She provocatively underscores the failureof classical psychoanalysis to attune to what shapes infantile behavior and its profound effects on adult adaptations. In its place she offers rich material from childhood observations and adult clinical encounters to present a refreshing psychoanalytic model that better explains the distress and characteristic defenses that lead to maladaptive solutions. The insight that she provides guides the reader in more successfully understanding, accessing, and modifying addictive vulnerability...--Edward J. Khantzian, M.D.

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