The Unanswered Self

In this remarkable blend of academic scholarship and clinical wisdom, Candace Orcutt compellingly describes the pioneering and seminal work of James Masterson on a spectrum of personality disorders. As the highly informative text and rich case material demonstrate, his writings were clearly ahead of their time, and thus his psychotherapeutic contributions are perhaps even more relevant today. On a personal level, having the good fortune of working closely with Jim and sharing our numerous common therapeutic and scientific interests was one of the highlights of my professional life.; Allan Schore, author of Right Brain Psychotherapy and The Development of the Unconscious Mind; Dr. Orcutt’s brilliant, creative and theory-bent mind is more than evident in her new book, The Unanswered Self ... Her profound level of training in and understanding of the works of Freud, Masterson, Winnicott and other psychodynamic and developmental theorists, and her experienced and deeply-felt knowledge of the [nature and] impact of trauma [and dissociation] on the developing self, stand at the heart of this book….[The] synthesis of these varied approaches to the psychodynamics and psychotherapy of Oedipal and pre-Oedipal disorders culminates in the author’s own original answers to some very old and very deep clinical and theoretical questions.; Judith Pearson, Ph.D., Director, The International Masterson Institute; This remarkable book could only be written by a close associate of James Masterson over the years, who was also a thoroughly competent clinician, and who was well-read enough to create her own overview of the field. Dr. Candace Orcutt clearly meets this three-fold requirement. In this book she reviews the “Masterson Approach” in considerable detail. Her main point is that the Masterson Approach has a deeper structure to it, a part of which has remained under-emphasized in the field. The deep structure in the Masterson Approach is that the sub-phases of Margaret Mahler’s separation/individuation phase include the developmental tasks typically failed by patients with developmental arrests and personality disorders. The three sub-phases of separation/individuation are: the hatching or differentiation sub-phase, the practicing sub-phase, and the rapprochement sub-phase. In the Masterson Approach, as detailed by Dr. Orcutt, these sub-phases correspond to the developmental stages of the schizoid, narcissistic, and borderline personalities, respectively. Each sub-phase description is followed by richly illustrated case examples that clearly explain the developmental task and best how to repair the developmental deficit. Dr. Orcutt concludes her book by arguing that Masterson only came to appreciate later in his professional life the role of the schizoid personality with its potential correspondence to Mahler’s developmental studies. That omission curtailed the inclusion of the concepts of dissociated parts and shifting self-states when their integration would have both benefited the Masterson Approach and helped to remedy their under-recognition in the field. The last chapters on dissociated parts and unacknowledged trauma are brilliant. Dr. Orcutt has created a masterful synthesis of the past fifty years of the clinical field, especially relevant to the treatment of personality and major dissociative disorders.; Daniel P. Brown, Ph.D., Harvard Medical School, author of Memory, Trauma-Treatment, and the Law, and Attachment Disturbances in Adults