The Thaw

Dorrance Publishing; Pittsburgh, 2000
142 pages
$13

Paul Genova, M.D.'s collection of essays, The Thaw, begins with a Cree Indian poem about a goose frozen in a lake. The narrator tells us, "The goose is frozen in the lake. I'm going to thaw it out."

The goose in the poem has a "frightened look in its eyes," and its wings are broken-but the narrator vows to help free the bird, so that it can join "the others [who] left without it." This poem provides a compelling metaphor both for the psychotherapeutic process-which helps the patient's soul take wing-and for Genova's book, which helps the reader locate the deep well of humane values underlying our profession.

The 24 essays in The Thaw are wide-ranging and ambitious, covering everything from the crucial role of dreams in psychotherapy to the resilience of a traumatized African-American woman. Many of these essays originally appeared in Psychiatric Times, but Genova has provided useful retrospectives for each piece, sometimes reflecting his evolving insights over the years. Genova's comprehensive intelligence is not afraid to take on the complexities of Jungian archetypes (in his essay "The Endless Walk of the Fool") or the everyday pleasures of Lewiston, Maine, with its "gas-station coffee" and "Bathtub Madonnas."

Throughout these essays, Genova shows his impatience with simplistic dichotomies and polarizing absolutes. This is evident in his many reflections on the complex role of medication in psychiatry. As he notes in his essay, "God or Vending Machine?" "It would be easier (but a lot less interesting) if the partisans for or against a simplistic biological psychiatry had a monopoly on the truth." Genova understands that no one has such a monopoly and is comfortable navigating the eddies of therapeutic ambiguity. In his essay, "The Coming Polarization of Psychotherapy," he goes so far as to provide a table of false polarities-what he defines as "limiting preconceptions about psychotherapy held by therapists and/or patients." Genova's therapeutic approach aims at extracting the best essence from both psychodynamic and biological approaches and using them pragmatically and judiciously to help the patient. No reader will agree with all the conclusions in his book, but any therapist would be enriched by them. The Thaw reveals a clinician whose goal is always to free the frozen psyche, allowing it to rejoin the larger, warmer world.

(The Analytic Press has released the 2002 edition of Dr. Genova's The Thaw: Reclaiming the Person for Psychiatry--Ed.)

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