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REVIEWS: Effective Psychotherapy

Effective Psychotherapy: The Contribution of Hellmuth Kaiser has appeared in four editions: in Spring 1965, July 2012, August 2014, and March 2018.

Each edition has had its own distinct cover (starting with first and going on to fourth edition covers):




I have always appreciated Dr. Hellmuth Kaiser’s contributions and look forward to the opportunity of reviewing the new edition of Kaiser’s writings.

Marianne Horney Eckardt, M.D., Cofounder and former President of the American Academic of Psychoanalysis and Dynamic Psychotherapy; Editor, The Adolescent Diaries of Karen Horney. Personal communication, December, 2011, offered for quotation here.


I had been struck, listening to Kaiser’s lecture, by the acuteness of his understanding of the patient and the quiet directness and simplicity of his communication ... Almost from the beginning [of entering into therapy with Kaiser], I found this experience remarkable, even exciting, both as a patient and as a therapist myself ... I gradually realized that it was not mere consistency, but the scope of his attention that was different. It was a more encompassing attention than I had been used to. It particularly included notice of how I said what I said ... In short, his attention was not totally absorbed in what I was producing, but was also on me, as I was producing it ... After several years of therapy with Kaiser and a year or so spent in supervision with him, we became friends.

David Shapiro, “Autobiographical Notes,” in Craig Piers, ed., Personality and Psychopathology: Critical Dialogues with David Shapiro (2011), pp. xiv-xv. Quoted with kind permission of Springer Science+Business Media, LLC.

[In Kaiser’s] innovative psychotherapy ... the therapist disavows explicit pedagogy, interpretation, confrontation or strategic maneuvers as therapeutic activity.
      The Kaiserian method incorporates a position by the therapist whereby the patient is regarded as being literally free to do in the therapy hour whatever he pleases. The only limitations are those determined by the therapist’s personal needs and interests, such as time, financial arrangements, self-protection, etc. Beyond the therapist’s personal limitations, the situation and the relationship are left essentially free and unstructured and the therapist’s activity becomes simply sharing with the patient those of his reactions to the patient’s behavior that he deems appropriate ... The relationship offered by the therapist consists solely of “communicative-intimacy” and his activity consists of freely responding behaviorally and verbally to the patient’s verbal and nonverbal behavior ... the intent of the therapist is not to confront the patient, but rather, to share with the patient the therapist’s impressions and reactions to his behavior.
Louis B. Fierman, M.D., Freeing the Human Spirit (2002), pp. xiii, xv.

Kaiser’s innovations remain remarkably fresh ... No advances in psychotherapy, no amount of biological reductionism, can obviate the need for individuals to learn to tolerate their boundedness. No change in the conditions of treatment removes the therapist’s obligation to allow patients finally to say what they mean.
Peter D. Kramer, M.D., Foreword to Louis B. Fierman, M.D., The Therapist is the Therapy (1997), p. xiii. Quoted with kind permission of the publisher, Jason Aronson, Inc., and the Rowman & Littlefield Publishing Group.

After a long hiatus, the second edition of Hellmuth Kaiser’s book edited by Dr. Louis Fierman, Effective Psychotherapy, has been issued. It was long overdue. The second edition has added a group of essays by clinicians who either knew or worked with Drs. Kaiser and Fierman. These essays are richly informative, heuristic, and encourage a reevaluation of our theories and perspectives about the nature of psychotherapy and the process and dynamics of the treatment dialogue.
     Hopefully respect for Kaiser’s contribution to psychoanalytic theory and practice will be acknowledged and he will take his rightful place in the pantheon of psychoanalytic theorists and practitioners. Many books have been written about theory and clinic methodology but few have presented what I consider the crux of the process: the chemistry of the human relationship not between patient and therapist but between the two human beings and their struggle “to know themselves in depth.” In my many years of practicing psychotherapy, the catalytic agent has always been what Kaiser refers to as “communicative intimacy” (or the sharing by both parties of the effort to resolve conflicts and to remove the blocks to realizing their capacity to live in an authentic self actualizing state).
     Kaiser in a boldly imaginative manner delineates and animates this complex process. Kaiser offers compelling clinical vignettes and a creative theatrical scenario to cogently present his impressive point of view. It encourages clinicians to explore and utilize their capacity for “communicative intimacy” and catalyze the therapeutic process to facilitate the development of a more effective psychotherapy.
Maurice Shilling, M.D., psychiatrist, Temecula, CA, Life Member of the American Psychiatric Association and 50-year psychotherapeutic clinician; reviewed here, November, 2012.

[The] occasions are rare when one comes upon a man who leaves a really important mark on one’s life. They are rarest when the source of the impression lies ... in his steadfastness in the search for truth and evidence that, after hard effort, he has succeeded in finding it ... Hellmuth Kaiser, who died in 1961, was such a person ... That we have the book at all is testament not only to the esteem in which Kaiser was held by [Fierman, Enelow, and Adler], but also to the force and evident promise of his formulations ... The book can be read and reread with profit by all members of the mental health professions ... Kaiser’s ideas will prove particularly tonic to case-workers, especially those in difficult settings and desperate for some basis on which one might try to make every contact with a client at least a step in the right direction ... this is the major contribution to psychotherapy of the decade.
Review by Norman A. Polansky, Ph.D., American Journal of Orthopsychiatry (April, 1966).

Dr. Fierman is to be congratulated ... Briefly and simply stated, the short first and third essays have to do with Kaiser’s contention that the psychotherapeutic encounter’s validity is greatest when there is honest directness of communication between patient and therapist ... It can be read as a clinical treatise about problems in psychotherapy, in which case it has a store of rewards.
Review by John W. Higgins, M.D., American Journal of Psychiatry (April, 1966).

This is an interesting and thought-provoking book ... Dr. Fierman does us a service by providing us with this controversial work by Kaiser, with an afterword and evaluation by the editor, and a biographical foreword ... The shorter papers demonstrate Dr. Kaiser’s theoretical orientation nicely ... certainly a novel theory, presented in an unusual way ... Certainly he deserves to be studied and heard.

Review by Roy R. Grinker, Jr., M.D., Archives of General Psychiatry (June, 1966).

It is apparently very disquieting and unstabilizing to have basic precepts questioned, particularly when one has struggled for some time to put down the questions and uncertainties which have arisen during the training periodand particularly during the [subsequent] years of practice [as a psychiatrist].
      How doubts and conflicts can be utilized in a healthy and constructive manner is demonstrated in a new book, Effective Psychotherapy: The Contribution of Hellmuth Kaiser . . . This engrossing book contains the sum total of the writings in English of Hellmuth Kaiser, who for a period of time practiced as an analyst in Hartford. The three papers here collected are both entertaining and informative on a number of levels, serving most of all to permit the reader to have a look into the mind of an analyst struggling with the problems of how best he could understand and treat his patients..

Review by Leo H. Berman, M.D., Connecticut Medicine (August 1966).

[The] therapist’s task is to encourage the patient to accept responsibility for his words and deeds and to promote authenticity in his communications. As his communications become more genuine, his loneliness decreases and his relationships with others become generally more satisfying. The sole means advocated by Kaiser to bring about these changes is to establish and maintain a communicative intimacy with the patient ... [Those] who practice psychotherapy or counseling will be well rewarded by a careful reading. It provides rich insights ... Kaiser’s description of his treatment strategies and tactics, valuable additions to most therapists’ armamentarium, is as clear as it is convincing.

Review by John Paul Brady, M.D., The Annals of the American Academy of Political and Social Science (September, 1966).

This book, Effective Psychtherapy, is a treasure. Every clinician is constantly engaged with the questions of when, how, and why to respond to the patient. Kaiser provides an opportunity to look into his thinking and to share his process of articulating and explicating feelings and questions that we all have, but which we may recognize only partially or dimly, or even not at all until someone else identifies them. They may be questions that we have even articulated albeit fleetingly.
      Kaiser allows us to grapple with these matters and engage them in non-mysterious ways (so much of our teaching is either based on detailed but fantastical theory or on suggestive authority). Teaching of technique (interaction) barely exists in psychoanalytic institutes and is left to the vagaries of individual case supervision. It tends to be abstract and tied to theoretical formulations. This is a serious gap in training and I believe Kaiser’s book should be considered essential reading in every institute to convey how process could actually and should actually be thought about.
      Incidentally, despite the apparent sharp divergence of Kaiser’s thinking from psychoanalysis, I see no discord between the principles that Kaiser establishes and the essential elements of the psychoanalytic enterprise.

Sam Izenberg, M.D., FRCP(C)—Fellow of the Royal College of Physicians of Canada; Assistant Professor of Psychiatry, University of Toronto; Faculty and Chair of Ethics Committee, Toronto Institute of Contemporary Psychoanalysis; reviewed here, March 2018.


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