Should You Leave?: A Psychiatrist Explores Intimacy and Autonomy--And the Nature of Advice

Those who read Kramer's 1993 bestseller, Listening to Prozac, won't be surprised to find him occasionally flying the Prozac colors again in his latest, a self-described ""odd hybrid of fiction, non-fiction and self-help."" But Kramer generally limits his discussion of psychopharmaceuticals in this fascinating philosophical and psychological study of what makes relationships thrive or wither, concentrating instead on fictional case histories and an exhaustive review of 19th- and 20th-century theories of intimacy and community. When it comes to love, Kramer, a Brown University psychiatry professor who also has his own private practice, is a frank, but not unambivalent, advocate of sticking it out. He argues that couples who were compatible enough to commit to each other in the first place are probably well enough matched to succeed in the long haul as well, albeit not, in some cases at least, without some serious interpersonal spadework. In this he takes issue with the contemporary premium on autonomy, whose varying levels of boosterism he examines in everyone from Ralph Waldo Emerson, SYren Kierkegaard and Ann Landers to such analysts as Murray Bowen, Carl Rogers and Leston Havens. He also looks at some proponents of connectivity, including philosopher Stanley Cavell, analyst Carl Whitaker and 1970s feminist psychoanalyst Jean Baker Miller, who argued that ""autonomy is a delusion."" Even Kramer's excessive handwringing over both the inherent tackiness of relationship manuals and his profession's historic censure of advice-giving can't dilute the pleasure to be had from this thoughtful, finely nuanced work. Kramer is that rare psychoanalytic theorist who is as comfortable invoking Tillie Olsen as Freud, and his composite case histories have the verisimilitude and insight that is the hallmark of the best--and truest--fiction. (Sept.)