Dr Chessick uses the metaphor of a television set in order to illustrate Freud's notion of the therapist's unconscious as a receptive organ for the transmitting unconscious of the patient. The therapist listens to the patient's transmissions on five different channels, represented by five orientations, stances, modes, or models, among which the therapist must switch back and forth on the patient's initiative. Furthermore, Dr. Chessick shows how to validate interventions in order to be sure that the therapist has indeed heard correctly. The five "channels" are: Freud's drive/conflict/defence orientation, still primary and preferred; the object relations approach of Klein and Bion and others; the phenomenological or sociocultural approach of Fromm, Sartre, Lacan, Foucault and others; Kohut's self psychology and the works of Fairbairn, Winnicott, Gedo, R.D. Laing and others; and the interactional school, exemplified by the work of Sullivan and Gill.
All of these orientations attend to the crucial significance of infantile and childhood experience, the existence of a dynamic unconscious, free association, the role of the Oedipus complex, early self-objects, transference and countertransference, and the primary role of the analyst's interpretive function. Empathic listening and understanding is at the base of any listening stance. However, each channel carries different implicit beliefs about psychological development, psychic change and curative factors. The basic maturity and human qualities of the therapist, together with the therapist's thorough personal psychoanalysis are fundamental requirements. The author uses the first seven sessions of Freud's famous case of the "Rat Man" to annotate all of the five modes. This proves valuable in illuminating Freud's technical moves. Kohut's presentation of the case of Mr. Z. is used to illustrate listening to narcissistic patients from the self-psychological point of view. It highlights differences between interpretations made on the basis of these five listening stances.
The author illustrates the dangers of listening from only one channel or stance, no matter how expert a listener may be in the use of that single channel. The concluding chapter of the book addresses the difficult task of how to teach listening skills to student therapists.