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Kleiner's Counselling in Marital and Sexual Problems. A Clinician's Handbook. Edited by R. F. Stahmann and W. J. Hiebert. Second Edition. Baltimore: Williams & Wilkins. Pp 375. $16.95.

'Gestalt techniques were in part designed to counter alleged errors in psychoanalytic technique and theory. . . . The Gestalt challenge may serve as a helpful stimulus in re-raising in novel ways the views of flexibility, empathy, concreteness, presentpast emphasis and the capacity and autonomy of the patient, in addition to its offering new techniques in psychoanalysis.' In this way Steven Appelbaum, a traditional psychoanalyst, sums up his reaction to Gestalt therapy in the final chapter of this handbook. It is a pity that it is the final chapter. The modern practice of Gestalt has its roots deep in the psychoanalytical field with its modern-day founder, Fritz Perls. His own background, after training with Horney and Reich, is as a training analyst and the founder in 1935 of the South African Institute for Psychoanalysis. Much of his time was spent in psychiatric practice in the army and as a practising psychoanalyst. For this reason Gestalt therapy needs to be examined closely against its own background. Appelbaum points out that Gestalt therapy shares similar assumptions about the relationship of body to personality to those found in the theory of psychoanalysis, but has exploited them more fully. He shows the way in which Gestalt appears to have something to offer in tackling the resistances of the patient, a more direct way of examining dream material, a broader concept of free association, while at the same time it has tended to minimize the role of transference in treatment. He finds that it has much to offer the practising analyst without contradicting any of his theoretical constructs. He feels that the reason that there has been so little interflow between the Gestalt therapists and the psychoanalysts is that both groups tend to see in each other caricatures of the warded-off parts of themselves; the uptight, rigid, buttoned down, hyperintellectual, unfeeling, materialistic, hidebound psychoanalyst; the sloppy, child-like, fuzzy-faced, fuzzy-minded Gestalt therapist. At times some of the articles in this book would tend to give some validity to the latter description, but this need not impede the broadminded members of the former group from being selective in their reading. The handbook gives an overall view of both the initiator of modern Gestalt, Fritz Perls, and what might be called the post-Perls era. It shows the many ways in which the general principles of Gestalt may be applied and used alongside a number of other forms of therapy, even of Organizational Development. The prime object of this form of therapy is to avoid 'talking about' emotions and difficulties, whether past or present, but rather to live them out in a present tense dialogue in such a way that the emotions themselves are reclaimed. When this happens, the individual arrives at the point of resistance, the 'impasse' as it is called. It is often here that the creative imagination of the therapist is called upon to help the individual work through the impasse, uncover the real feelings underneath the phoney ones, and complete the 'unfinished business' by continuing the dialogue in fantasy. There is an immediacy about this form of therapy, a more direct dealing with the persons involved in the original drama than the more time-consuming process of allowing the same feelings to develop in the transference situation, and working them through there. For this reason many see the process as shortening the therapy, dealing with the emotions more immediately, and by-passing the major problems of resolving the transference. While this handbook has much to commend it as a collection of major works in the process of Gestal t, and is of immense value if read in the light of its last chapter, it still leaves me with a major problem. Where the criticism of normal psychotherapy levelled by the Gestalt school is that it has become too intellectualized, and remains in the cognitive field, Gestalt often appears merely to explore the emotional field and ignore the cognitive. It is for this reason that I am sorry the book contains no reference to the work of Eugene Heimler (Survival in Society, 1975), who has included in his system the use of the tape recorder. Following his system, I have found that there is a vital element added by recording any of the Gestalt fantasies and playing them back to the patient. The patient may then bring to bear his cognitive processes and become aware of the interpretations himself: This fulfils more exactly the process of interpretation as Freud saw it. Gestalt techniques have much to offer every form of therapy, whether psychoanalytical or behavioural, and this handbook will be a useful resource for those who wish to extend their techniques and of value to those who are already interested in the subject.