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The Psychoanalytic Model of the Mind.: Elizabeth L. Auchincloss, MD (2015) Arlington, VA American Psychiatric Publishing. 332 pp.

Carreño, Teresa MD

The Journal of Nervous and Mental Disease: March 2016 - Volume 204 - Issue 3 - p 244
doi: 10.1097/NMD.0000000000000438
Book Reviews

Private Practitioner Psychoanalyst Voluntary Clinical Assistant Professor Department of Psychiatry and Behavioral Sciences University of Miami Miller School of Medicine Miami, FL

The Psychoanalytic Model of the Mind is a book dedicated by Dr. Elizabeth L. Auchincloss to her students. She describes the book as “the result of a course by the same name that I have taught to students in the Department of Psychiatry at Weill Cornell Medical School since 1987” (p. xxiii). Its goal: “to explain how the psychoanalytic model of the mind works and how it contributes to the care of people with mental suffering” (p. xv). The psychoanalytic model is then described as “the most complex model of mental functioning ever invented for clinical purposes” (p. xv).

This book is a clear, coherent, and creative work that first explains and then integrates different schools of psychoanalytic thought in a language that is understandable to new students of psychodynamic theory. Dr. Auchincloss presents to the reader a historical unfolding of our current psychodynamic understanding of the mind, while contextualizing it with other points of view, including neurobiological, cognitive, and cultural perspectives.

The book opens by asking basic questions such as: “What is Psychoanalysis?” (p. 4) “What is a Model?” (p. 5), and “Why Do We Need a Model of the Mind?” (p. 7). At times it reads like a story: it points out that the psychodynamic model is young, and that its birth was contemporary with the discovery that the basic unit of brain structure is the neuron. It tells the story of how around that time, Sigmund Freud, a curious neurologist and neuropathologist, was struggling to treat the debilitating symptoms of what was then called hysteria, a poorly understood condition. In attempting to understand this ailment, he realized he must develop his theory of mind apart from the limited neurobiological understandings of his time. It describes how, after his discovery of the unconscious mind and development of the Topographic Theory (1900), he recognized the clinical limitations of his own perspective. Freud then put his first theory aside and developed the structural model of id, ego, and superego (1923). The author describes how his youngest daughter, Anna Freud, remained true to her father’s theory while making her own significant contributions. During that time, also in Great Britain, Melanie Klein was developing Object Relations Theory, which was then viewed as an alternate theory to that of Sigmund Freud’s. As a result, the understandable rivalry between the two kept the perspectives separate. Meanwhile, Heinz Kohut was developing his own theory of Self Psychology in the United States. Other significant theorists and their perspectives are introduced amidst this story. Woven into this context, the author presents key aspects of each theory that remain viable and clinically relevant in psychotherapeutic work today.

The book is separated into five parts: Foundations, The Topographic Model, The Structural Model, Object Relations Theory and Self-Psychology, and Integration and Application. In the first four parts, the four main psychoanalytic theories are contextualized and explained. In part five, the theories are integrated and their clinical application is introduced. This is accomplished in a manner that is clear and concise for a student of psychodynamics.

The chapters are organized as follows: The psychodynamic material to be described is put into historical context, new technical terms to be introduced in the chapter are listed, complex theoretical concepts are described in clear language, and the new terminology is defined elegantly in the flow of the writing. Finally, the newly introduced theoretical perspective is placed in the context of biological, cognitive, and cultural schools of thought.

To assist with the integration of theories, a chart of “core dimensions” (Chapter 4, p. 57) is introduced that applies to the four models of psychoanalytic thinking: the Topographic Model, the Structural Model, the Object Relations Model, and Self Psychology. These categories are considered the “Key Domains of Mental Functioning” (p. 58) and include topography (conscious or unconscious elements), motivation, structure/process, development, psychopathology, and treatment. One would have to read the book to see how this unifying organization is utilized to cleverly integrate the theories in the last chapter.

I would recommend this book to students of psychology, sociology, philosophy, or to anyone who is curious about conceptualizing profoundly the workings of the human mind. It would be an excellent textbook for an introductory course in Psychoanalytic/Psychodynamic Psychiatry and Psychology. Dr. Auchincloss introduces, condenses, and integrates a vast, global, dense, and complex literature into an understandable and workable introductory model. This synthesis is clearly a product of years of teaching, and evidences rich interaction with students and discussions ripe with mutually engaging thoughts and questions. I expect it will inspire this spirit of curiosity in its readers and leave them thirsty for more.

Teresa Carreño, MD

Private Practitioner


Voluntary Clinical Assistant Professor

Department of Psychiatry

and Behavioral Sciences

University of Miami

Miller School of Medicine

Miami, FL

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The author declares no conflict of interest.

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