Auchincloss starts with a fanfare: ‘The psychoanalytic account of how the mind works is the most complex model of mental functioning ever invented for clinical purposes’ (p. xv). Based on her Cornell course for trainee psychiatrists, the author sifts this ‘complexity’ into three manageable chunks: ‘topographical’ (Sigmund Freud's fundamental distinction between the conscious and unconscious); ‘structural’ (ego psychology, arising from Freud's ‘tripartite’ model of ego, id and superego); and ‘object relational’ (assembling the disparate theories of Melanie Klein, John Bowlby, Heinz Kohut and Otto Kernberg, who were united in their emphasis on the interpersonal aspects of the developing mind). Contrasts and overlaps between the three threads are presented in useful tables. Appendices summarise the various defence mechanisms and provide a glossary of all the main psychoanalytic terms. All will appeal to would-be psychiatrists in search of an accessible account to guide them through exams.

Despite there being much to admire about this book, its very clarity and certainty also manifest its weakness; the sheer unconsciousness of the unconscious lies latent, like a heartless textbook of cardiology. The author wants to please everybody – traditional psychoanalysts of all schools, cognitive–behavioural therapists and hard-nosed neuroscientists all get a nod – and amidst this even-handedness, the discriminatory power of science gets lost. For example, in discussing Kleinian object relations theory, Auchincloss describes psychosis as a developmental failure to differentiate between self and other, despite 7 pages earlier conceding (in a footnote) that ‘psychosis is no longer conceptualized as reflecting difficulties in mother–infant interactions’. Despite the author's best efforts, there is also a backwards-looking feel to this book; 70% of her references are from before 2000. Finally, among a sparse collection of well-worn psychoanalytic clinical examples – such as the ubiquitous physician whose Oedipal conflict impedes his career – conspicuous by its absence is a sense of how psychoanalytic approaches can help, as indeed they can, those afflicted with borderline personality disorder, obsessive–compulsive disorder or major depressive disorder.

In conclusion, while good things abound in this book, disappointment must also be recorded. Whether this view represents destructive envy in your reviewer or constructive depressive position thinking, readers – of whom there deserve to be many – will decide.