Drive, Ego, Object, and Self: A Synthesis for Clinical Work

The subtitle of this book is completely accurate - "a synthesis for clinical work." Fred Pine appears to be the first to succinctly interweave the theories of drive, ego, object, and self into a coherent theory from a clinical, theoretical, and development approach to psychology. He uses the analogy of the blind man and the elephant to orient the reader to why there has been so much conflict within psychoanalytic circles, and even in psychology as a whole. Pine begins this book going through the four psychologies form a theoretical perspective. He does not spend this section diving the 4 into groups or subgroups but by trying to shine light on the metaphorical elephant in the areas of psychoanalysis, clinical work, developmental process, personality structure, and motivation. I recommend the reader to pay special attention to the chapter on motivation, as I have not seen anyone lay out a theory along these lines. Pine next spends a significant proportion of the book describing entire courses of therapy with various patients and how the 4 psychologies are necessary at different times with the same patient. I especially like how he uses interpretation and explains why some interpretations fall on "deaf ears" while others are life changing. He proposes that (besides from the interpersonal domains), interpretation needs to be in the right domain of the 4 psychologies for the patient to "hear" it. Pine interweaves his clinical experience into applied areas of pathology, ego defect and deficiency, and the infant and symbiosis. I like his example of the difference between ego defect and ego deficiency. The former involves areas of weakness in structure while the latter is an actual deficit (which means it is missing). I also appreciate Pine's work with the infant and how certain infants and parental figures lead to magnification of significance to "merger moments, for others orality, or toilet training, or gender confusion, or sexual curiosity, or triadic rivalries." In other words, this period of development lays the foundation for certain areas of emphasis and areas of defect in later adulthood. As you probably can see from the extent of this review, I was a HUGE fan of this book. Pine concludes the book with a postscript, discussing certain reactions to his theories. I found myself easily following into the group of students that he described as saying, "What's all the fuss about?". In essence, today's psychologists and students have been familiarized with most of these domains of psychoanalysis. Also, we live in a postmodern society that can sit with ambivalence and not see things as either/or but complimentary. I see Pine arguing voraciously for the need for all of the 4 domains and speaking to an audience that needs proof and validity, instead of an audience that is OK with conflictual theories at times, though he argues and I believe they are just different parts of the elephant.

Pine's book provides a good overview of his metapsychology reformulated for clinical practice.