It is now over four years since the first edition of this book was published and, one might say, "Much has changed while much has stayed the same." The sources of change are various. I have been honored by a number of detailed reviews of this work by others in the field. 1 Numerous colleagues, in Buffalo and elsewhere, have shared their thoughts with me about this work and its subject matter. Most significantly, a couple of years back my book was the focus of a reading group of local scholars and clinicians where it was reviewed, roughly a chapter per meeting, and all sorts of differences of emphasis as well as view were presented to me. In fact, to the extent that this second edition improves on its predecessor, these colleagues should be acknowledged and thanked: Jack Freer, M.D.; Jan Harszlak, M.A.; Charles Jack, M.A.; Paul Johnson, Ph.D.; Janet Kaye, J.D.; Bogda Koczwara, M.D.; Dan Lazenski, J.D.; Sue LaGaipa, R.N., M.A.; Gerald Logue, M.D.; Sherrie Lyons, Ph.D.; Tim Madigan; Adrianne McEvoy; James Moran, Ph.D.; Daniel Pollock, Ph.D.; Ann Poutler; Carolyn Siegel; and Anthony Szczygiel, J.D.
I am sure, however, that I am not the first author who has been torn between the tendency to try to "improve on the original" in a subsequent edition of a work and the feeling that the initial product has its own "rights," as it were, and changes should be sparing.
For those especially who took the time to read the original edition, I hope it will be sufficient here to simply say that I eventually resolved the preceding tension as follows: major substantive changes have not been made to this work. It contains the same basic argument, in roughly the same form and sequence as the first edition; its main conclusions also remain the same. What is different is my attempt, particularly by responding to the questions and criticisms of colleagues, to remove unclarity and confusion in the text, as well as to