Rich in clinical detail, this book examines therapeutic communication styles and their effect on the outcome of treatment. Paul Wachtel presents examples of crucial moments in the therapeutic process and several things the therapist could say in response, each with different consequences and implications for the overall treatment. Examining the way psychic problems originate, persist, and evolve, Wachtel illuminates the dynamic processes that perpetuate problematic relational patterns in the patient's history and suggests communication strategies that lead to their resolution. Integrating psychodynamic theories with insights and discoveries from other approaches, the author presents a new theory of psychological disorder and change. A concluding chapter by Ellen Wachtel, a couples therapist, extends the ideas presented in the book to work with couples. This volume will be very useful for clinical psychologists, psychiatrists, counseling psychologists, social workers, psychiatric nurses, pastoral counselors, and marital and family counselors.