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traditional therapeutic relationship with a Westerner. Transference and Empathy inAsian-American Psychotherapy will be useful for experienced clinicians. The case stud-ies are excellent. They serve as tools to gain practical perspectives of the intricaciesinvolved in a therapeutic relationship with clients whose values and cultural back-ground are different from those of middle-class Westerners. However, in order tounderstand the concepts presented, one needs a good grasp of the theory andpractice issues involved in the processes of transference, countertransference, andempathy. This book might be difficult to understand for students with little clinicalexperience.

As an Asian clinician, I received a strong personal message from both books.Although I live and practice Asian cultural values and beliefs, my professionaltraining has led me to become oriented to think like a Westerner. Both books remindme of the need to be Asian oriented when dealing with Asian-American clients.

All the Mothers Are One: Hindu India and the Cultural

Reshaping of Psychoanalysis

By STANLEY N. KURTZColumbia University Press, New York, 1992, 384 pages; $45.00;ISBN 0-231-07868-4.

Reviewed byJancis Long, Ph.D.Semmelweis Medical University, Budapest, Hungary

This book offers a significant contribution to psychoanalytic theory, anthropology,and the growing but still inchoate field where they try to come together. It raises the

question: What is wrong with psychoanalytical theory that its uniquely deep psychologicalhypotheses seem unable to handle cross-cultural variation in life experiences?

All the Mothers Are One challenges the Western concept of self, consequently,promoting the culture-bound concept of self. Kurtz utilizes a detailed observationalmethod combined with analysis of anthropological ethnography to document his

theses. His major contributions are his suggestions for restructuring psychoanalysisto make it more culturally inclusive.

All the Mothers Are One deepens the concept of culture-bound self by discussing

the Hindu self as part of a larger whole entity. This concept is presented as opposed

to the egocentric view of the self as a single entity. Kurtz elaborates his argumentsthrough the psychology of religion and Hindu family life. Therefore, a centraltheme in All the Mothers Are One is that deities and people are simultaneouslyconceived as individual entities and as integral parts of a larger whole or group.Kurtz believes that this theme operates in the Hindu psyche and in the Hindufamily at a profound level of experiencing the self and others. The self as part of alarger whole entity is contrary to Western psychoanalytic theory, which advocatesthe self and other representations of separation and individuation, fears of mergerwith or separationfrom the other Kurtz concludes that the rigid psychoanalytic view ofthe role of self and other object representations in identity formation prevents usfrom fully comprehending the Hindu multiple mothering system and its subse-quent impact on human development.

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By presenting the psychology of religion intertwined with Hindu family, thebook examines Hindu village family life as illustrative of non-Western experiencesof life. It advocates resolving the tension between the egocentric self (the self asindividualistic, solid, separate, and autonomous) and the sociocentric self (the selfas fluid, interdependent, and interconnected), and between individuality and inter-changeability. Kurtz proposes that we use psychoanalytic theory to direct our atten-tion to infant sexuality, unconscious processes, and formation of inner structurethrough the representation of self and other in early childhood; but at the sametime criticize psychoanalytic theory for the narrowness of its hypotheses on develop-ment.

Specifically, Kurtz studies the inclusion of the child (after his or her earliestyears) in a group of in-law mothers who share caretaking and have responsibilitiesand authority to make demands on the child. The concept of in-law mothers mayresemble the practice of multiple mothering prevalent among many families ofcolor in the United States. Kurtz believes that the psychological impact of such agroup (and a child's passage from an exclusive relationship with birth mother toin-law mothers) may lead to experiences of psychological growth different from"normative" Western ones. Among these Western experiences "normalized" by psy-choanalysis are the separateness and unreliability of mother (Melanie Klein); thenegotiation of the passage from entitled narcissism to healthy self-regard; the devel-opment of the Oedipus (Electra) complex; and gender identification without mul-tiple parental figures.

Kurtz argues that as a sociocultural pattern, multiple mothering carries psychicdimensions more pervasive and interesting than the psychoanalytic deficit modelsuggests, and provides mechanisms for mitigating the intrapsychic problems pre-sented by this situation. He argues that (a) psychoanalysts and psychodynamicallyoriented clinicians have not considered the possibility that the mother-child closephysical attachment in the early years may occur without the emotional intensityassumed in the Western level of physicality; (b) that Hindu birth mothers gentlypush their child toward the group, breaking the intense mother-child dyad; and(c) that in-law mothers welcome the child into the group and offer less infantilepleasures of group membership to compensate for the loss of exclusive relationshipwith the birth mother.

So what solutions does Kurtz offer for a "restructured," "culturally reshaped"psychoanalysis? First, he suggests we consider the possibility of numerous culturallydistinctive paths of development, then construct these experiences according totheir function within a context. As an example, he suggests focusing on the rewardsand punishments offered to the child to substitute "mature" pleasures for "imma-ture" ones. Kurtz has shown an essential difference between the sublimations andidentifications that "resolve" the Western preoedipal crises and the kinds of "renun-ciation" and rewards presented to the Hindu child moving from birth mother to in-law mothers. Kurtz offered another non-Western example from the TrobriandIslands, where there is neither a forceful demand for the abandonment of imma-ture pleasure nor a subtle prompting to unforced renunciation. Rather, the child isin effect seduced out of immature pleasure by a process Kurtz calls polysexualiza-tion which stimulates the child at a higher level of maturity than that to which he orshe is accustomed.

Second, a restructured psychoanalysis should consider far more deeply the roleof the collective (persons, deities, others) in an individual's inner representations,as well as different groups in different contexts.

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Kurtz's third suggestion for a culturally reshaped psychoanalysis is less devel-oped, bolder, and certainly more controversial. Love, he proposes, is the hithertounnamed culprit underlying the cultural inflexibility of the existing theory. Heviews this inflexibility as the Western assumption about the universality of love, theexclusive components and valuation of a single other, and the mother-child dyad inwhich the growing child comes to experience love. Kurtz believes that love andempathy in the Western sense have little to do with family bonds, child-rearingpractice, or intrapsychic structure in many non-Western societies. However, theyhave everything to do with psychoanalytic theory, which may be seen as beingprimarily about "the complex ways that love and sex come together and are tornapart." Psychoanalysis is biased toward a Western concept of love, denormalizing(or devaluing) other cultural expressions of attachment and affiliation. We should,therefore, rethink love in different cultural contexts.

I believe that Kurtz's analysis is a beginning step; however, we need to deal withour own ethnocentrism and countertransference before we can develop more in-clusive theories and practice.

In a House of Dreams and Glass

By ROBERT KLITZMANSimon and Schuster, New York, 1995. 366 pages; $24.00;ISBN 0-671-73450-4.

Review by Maria Oquendo, M.D.New York State Psychiatric Institute

In a fascinating and engrossing account of his experience of psychiatric residencytraining, Dr. Klitzman depicts the harrowing process of becoming a member of theunique subculture of psychiatry. Through a highly personal story of the transforma-tion that he undergoes from idealistic, naive medical student to incisive, thoughtfulpsychiatrist, Dr. Klitzman gives both an overview and critique of psychiatric training.The author is able to step back from this process, which has clearly shaken many ofthe basic assumptions that he had made of himself, psychiatric patients, and theprocess of becoming a psychiatrist, and analyze it in a thoughtful, insightful fashion.

In a House of Dreams and Glass narrates the author's experience of learning totake care of psychiatric patients in a large city hospital. His descriptions of inpatientpsychiatry, outpatient treatment, emergency services, consultation-liaison inter-ventions, and his own psychoanalysis provide a well-rounded view of the many facetsof the profession of psychiatry that the trainee must understand and eventuallymaster. Although descriptions of patients are frequently detailed and clinically apt,Dr. Klitzman manages to present sophisticated material in a style that is accessibleto the lay reader. Nonetheless, the book provides a valuable point of view to theexperienced clinician as well. Dr. Klitzman gives life to the process of altering self-perception through changes in fund of knowledge, identification with mentors,and integration of aspects of those role models that he considers positive.

This book is relevant as a description and analysis of psychiatric training as aprocess that is not only about learning factual material, theoretical constructs, and

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