Don't be put off reading this book by the introduction. I almost was. It is as if it had been written by someone other than the person who wrote the rest of the book. What do you make of sentences such as:
Spitz further observed that infants who had better mothering (better than what?) tended to experience greater difficulty (greater than who?) once they were able to distinguish from other caretakers (I think she means distinguish their own mothers from other caretakers) as they approached the issue of separation anxiety. (p. xii)
How does a child "approach the issue of separation anxiety?" This is psycho-babble of the worst kind. However there is more; e.g.,
From the depressive position, he seeks to have some agent or institution succor in the form of tenuous self esteem (p xiii).
However, if you read on you will find your efforts nicely rewarded.
This book is of interest to our readership because its basic premise is that manic depressive disorders originate in the pre and peri-natal period. Unfortunately, Sandra Landsman never succeeds in proving this point. The best that can be said about her clinical presentation is that her clients' problems seem to have started prior to birth. But why these people should have developed into manic-depressives instead of phobics or obsessive compulsives or psychosomatics, etc., is never explored. In other words, is there a constellation of forces that would drive an individual towards developing one set of defenses as opposed to another? This is a crucial question to every dynamically oriented psychotherapist. The book seems to promise to address this question, but to my disappointment, never does.
Some of Sandra Landsman's case studies make one wonder about her diagnoses. For example, with Tammi (p. 32-33): "Her pretense was no good, she felt as if she didn't exist as a baby. Not that she was dead . . . but that she simply wasn't there . . . She pretended that the lifeless baby was really her while the 'real' Tammi was hidden." Now that represents a lot of denial and splitting not usually seen in manic depressives. The author's next illustration, Erika, fits even less the usual manic depressive dynamic picture. "Anything that wasn't the 'good little girl,' she separated from herself. . . she deposited parts of herself as she developed, in separate rooms in her cave. As life overwhelmed her, she created one persona after another to cope with her family." On the basis of this information, I would tend to diagnose her as suffering from multiple ego states or even multiple personality with depressive episodes.
However, there is lots of good stuff here. I found Landsman's therapeutic approach, described in great detail, most interesting. Her "photogenic exercises" were new to me. I think they could be beneficial in regressive work. Her "aquagenesis" with affirmations followed by clients spending some time drawing is very reminiscent of rebirthing and again could be most helpful to anyone whether they were manic depressive or not.
In my opinion, the book does not live up to the promise of its subtitle The Development, Diagnosis and Treatment of Manic-Depressive Structure. It touches on all those topics but lacks depth and specificity. A more critical editor could have done wonders for this book, because the material is all there, it just needs more work.