Clinical Theory & Practice
When working with young children, the language of therapy should be the language of action. I often have children stand near each other to see who is taller, who smiles wider, and so on, to help them feel as participants. Salvador Minuchin, Mastering Family Therapy.
When power becomes a focus in itself, energy is channeled into weaponry, influence into control, investment into greed and healing into self-aggrandizement. William Miller & Stephen Rollnick, Motivational Interviewing.
Theory is a useful servant but a bad master. Liable to produce orthodox defenders of every variety of the faith. We ought always to set light to theory and be on the look-out for ways of improving it in the light of therapeutic practice. It is therapeutic practice that is the real heart of the matter. Harry Guntrip, Object Relations, Psychopathology and the Clinical Situation.
To find a good parent at the start is the basis of psychic health. In its lack, to find a genuine "good object" in ones analyst is both a transference experience and a real life experience. In analysis as in real life, all relationships have a subtly dual nature. All through life we take into ourselves both good and bad figures who either strengthen or disturb us, and it is the same in psychoanalytic therapy; it is the meeting and interacting of two real people in all its complex possibilities. Harry Guntrip, Object Relations, Psychopathology and the Clinical Situation.
Whenever I began to have doubts of the correctness of my wavering conclusions, the successful transformations of a senseless and muddled dream into a logical and intelligible mental process in the dreamer would renew my confidence of being on the right track. Sigmund Freud, New Introductory Lectures in Psychoanalysis (1933)
much sanity that has a symptomatic quality, being charged with fear or denial of madness, fear or denial of the innate capacity of every human being to become unintegrated, depersonalized and to feel that the world is unreal. D.W. Winnicott, 1945.
It is a mistake to make a frame-work of theory and proceed to fit the patient into it. The function of theory is to help the analyst's weaknesses on extra-analytical occasions, and is of use to the patient in this indirect fashion only. Theory is the hypothetical skeleton on which we seek to reassemble the array of facts and their relationships which our minds cannot otherwise hold in any ordered cohesion. But we never shall build up a human being in this way, or even create any close resemblance to the living interaction of living psychic tissue. To have theory in our minds in the hours of analytical treatment when we are in actual contact with the individual patient's mind, and when we have the opportunity of learning directly from it, is to barter possible strength for the props of weakness. It blocks that free working of our own unconscious which, as we know, is our one way of understanding the working of the patient's unconscious. M. Nina Searl, Some Queries on Principles of Technique (1936)
It is easy to see what is wrong in our patients but a lot more difficult to see what is right, what is preserved. To learn to look for what is preserved is of great importance and is the point driven home to us by the conception of autonomy: whatever was once achieved is never lost. Any achievement noted anywhere in the case history, any valid perception, any single bit of knowledge, any differentiated feeling, any success, indicate to us that somewhere there was once something that can serve again as a nucleus of a new departure, providing we can reach it, free the synthetic forces, and progress from there to further self-discoveries of the best in the patient's essential social nature. This is the point no patient fully expects and that many of us do not fully appreciate in ourselves: there are persevering secondary autonomous structures and there is a basic sociability, and there are primary autonomous ego apparatuses even in our sickest patients. David Rapaport, Clinical Implications of Ego Psychology. In The Collected Papers of David Rappaport (1954).
We took a young woman with severe memory loss and helped her forget she ever had it. The title in a full page ad by Mount Sinai Hospital in the New York Times Magazine (1/22/2006)
. . . it is in the process of “knowing” one's patient through direct relatedness, as distinguished from frustrating, gratifying, containing, empathizing, or even understanding him, that those aspects of self which cannot “speak” will ever find a voice and exist as a felt presence owned by the patient rather than as a “not-me” state that possesses him. Philip M. Bromberg (1994) “Speak! That I May See You”: Some Reflections on Dissociation, Reality, and Psychoanalytic Listening
The ability of a patient to take in and seriously consider the analyst's perception of him is possible only if another reality (or truth) being held in a dissociated state is not being invalidated as a tradeoff. The patient doesn't need to be “agreed with” or need a heroic attempt at self-disclosure by the analyst. What is required is that the multiple realities being held by different self-states find opportunity for linkage. The most powerful medium through which this takes place is the analyst's ability to recognize that his feelings about his patient are not his personal property, and that his own feelings and his patient's are part of a unitary configuration that must be linked in the immediacy of the analytic relationship in order for the multiple realities within the patient to become linked through cognitive symbolization by language. Philip M. Bromberg (1994) “Speak! That I May See You”: Some Reflections on Dissociation, Reality, and Psychoanalytic Listening
There is no way that one's personal narrative of “who I am” ever changes directly; it cannot be cognitively edited and replaced by a better, more “adaptive” one. Only a change in perceptual reality can alter the cognitive reality that defines the patient's internal object world, and this process requires an enacted collision of realities between patient and therapist. Philip Bromberg (1996). Standing in the Spaces: The Multiplicity Of Self And The Psychoanalytic Relationship
We go away from our parents and then back to our parents. Suddenly one understands them, recognizes them as human beings, and in that moment, one has grown up. Ingmar Bergman.
How selfhood begins with a walking away,
His scorn of the great is repeated too often to be real; no man thinks much of that which he despises. Samuel Johnson, Lives of the English Poets.
Our capacity for denial is enormous. Irwin Yalom, The Theory and Practice of Group Psychotherapy (1995).
Man is an intelligence, not served by, but in servitude to his organs. Aldous Huxley, Themes and Variations, Variations on a Philosopher (1950).
There is a way that I have come to see evil. A person relinquishes parts of himself and retains one fragment of his total humanity. The cleverest can represent that fragment as the whole person. The people around him don't realize he is not accountable in the same way others are, that he doesn't experience himself in the same way. There is an emptiness that can give place to anything, that permits behavior unacceptable and unthinkable to others. Mia Farrow, (1994).
You have many enemies, that know not
It is remarkable by how much a pinch of malice enhances the penetrating power of an idea or an opinion. Our ears, it seems, are wonderfully attuned to sneers and evil reports about our fellow men. Eric Hoffer, The Passionate State of Mind (1955)
If a man has a mind to beat his dog, he can easily find a stick. Anonymous
The more one analyses people, the more all reasons for analysis disappear. Sooner or later one comes to that dreadful universal thing called human nature. Oscar Wilde The Decay of Lying (1891).
We have lost the art of living; and in the most important science of all, the science of daily life, the science of behaviour, we are complete ignoramuses. We have psychology instead. D. H. Lawrence, Etruscan Places, (1932).
I love men, not for what unites them, but for what divides them, and I want to know most of all what gnaws at their hearts. Guillaume Apollinaire
Hate traps us by binding us too tightly to our adversary. Milan Kundera
When angry, count ten, before you speak; if very angry, an hundred. Thomas Jefferson Decalogue of Canons for observation in practical life, no. 10. Included in letter, 21 Feb. 1825, to Thomas Jefferson Smith.
If I knew for a certainty that a man was coming to my house with the conscious design of doing me good, I should run for my life. Henry David Thoreau Walden, (1854).
There seems to be a presence-chamber in my mind where full consciousness holds court and where two or three ideas are at the same time in audience, and an antechamber full of more or less allied ideas, which is situated just beyond the full ken of consciousness. Francis Galton
I am struck by the way people behave on the Tube. They look at each other beadily and inquisitively, and something goes on in their thoughts which must be equivalent to the way dogs and other animals, when they meet, sniff each others arses and nuzzle each others fur. Graham Swift
As a general rule, people, even the wicked, are much more naïve and simple-hearted that we suppose. And we ourselves are, too. Fyodor Dostoevsky, The Brothers Karamozov.
Self-love forever creeps out, like a snake, to sting anything which happens . . . to stumble upon it. Lord Byron
Man is the only animal that blushes. Or needs to. Mark Twain, Following the Equator, (1897).
We construct a narrative for ourselves, and thats the thread that we follow from one day to the next. People who disintegrate as personalities are the ones who lose that thread. Paul Auster (1989)
If a person comes to know a theory about his behavior; he is no longer bound by it, but becomes free to disobey it. Leo Tolstoy, Anna Karenina.
" we are all much more simply human than otherwise " Harry Stack Sullivan (1950).
I can't count the times she told me..."Your father, you know, could not abide dandelions. He had to rid the lawn of every one."...As she made the same remark many times over the months, I got the strange but certain feeling that all their bitter arguments through the years and decades, all the painful wrenching and tearing they inflicted on themselves for so long, that all of that--very little of which my mother specifically remembered--had distilled and resolved in her present mind to a difference over dandelions. It may have been a kind of oblique coming to terms, the best she may have been capable of as her past receded into what must have felt like a dream to her, a dream lived by someone who was and was not her... John Daniel, Looking After (1996)
If you hate a person, you hate something in him that is part of yourself. What isnt part of ourselves doesnt disturb us. Hermann Hesse
Such is man that if he has the name for something, it ceases to be a riddle. Isaac Bashevis Singer
Heavn has no Rage like Love to Hatred turnd,
Man has demonstrated that he is master of everythingexcept his own nature. Henry Miller, The Air-Conditioned Nightmare, (1945).
Memory itself is a fabricator, a spinner of yarns, a poet and a liar. John Daniel, Looking After (1996)
Children begin by loving their parents; as they grow older, they judge them; sometimes they forgive them. Oscar Wilde, The Picture of Dorian Gray.
Whenever a friend succeeds a little, something in me dies. Gore Vidal
The heart has reasons that reason cannot comprehend. Blaise Pascal
A man has as many social selves as there are individuals who recognize him. William James, The Principles of Psychology.
There are strings in the human heart that had better not be vibrated. Charles Dickens, Barnaby Rudge.
A wonderful fact to reflect upon, that every human creature is constituted to be that profound secret and mystery to every other. Charles Dickens, A Tale of Two Cities.
Men make use of their illnesses, at least as much as they are made use of by them. Aldous Huxley
Family relations pertain to a plane where the ordinary rules of judgment and conduct do not apply. They are a labyrinth of tensions, quarrels and reconciliations, whose logic is self-contradictory, whose ethics stem from a cozy jungle, and whose values and criteria are distorted like the curved space of a self-contained universe. It is a universe saturated with memories--but memories from which no lessons are drawn; saturated with a past which provides no guidance to the future. For in this universe, after each crisis and reconciliation, time always starts afresh and history is always in the year zero. Arthur Koestler
I've never heard of a crime which I could not imagine committing myself. Goethe
How strange are the tricks of memory, which, often hazy as a dream about the most important events of a man's life, religiously preserve the merest trifles. Richard Burton, Sind Revisited (1877)
Man's mind is so formed that it is far more susceptible to falsehood than to truth. Desiderius, Praise of Folly, ch. 45 (1509).
Dogs and Daffodils alone retain their sanity, Virginia Wolfe
Suicide is prepared within the silence of the heart, as is a great work of art. Albert Camus
Disrespect is the weapon of the weak and a defense against one's own despised and unwanted feelings, which could trigger memories of events in one's repressed history. And the fountainhead of all contempt, all discrimination, is the more or less conscious, uncontrolled, and covert exercise of power over the child by the adult. Alice Miller, The Drama of the Gifted Child, 1981.
We are all perpetually smoothing and rearranging reality to conform to our wishes; we lie to others and to ourselves constantly, unthinkingly. When, occasionally--and not by dint of our own efforts but under the pressure of external events--we are forced to see things as they are, we are like naked people in a storm. There are a few among us--psychoanalysts have encountered them--who are blessed or cursed with a strange imperviousness to the unpleasantness of self-knowledge. Their lies to themselves are so convincing that they are never unmasked. These are the people who never feel in the wrong, who are always able to justify their conduct, and who in the end--human nature being what it is--cause their fallible fellow-men to turn away from them. Janet Malcom, In the Freud Archives (1983)
The virtuous man contents himself with dreaming of that which the wicked man does in actual life. Plato
There are no "good" or "bad" people. Some are a little better or a little worse, but all are activated more by misunderstanding than malice. A blindness to what is going on in each other's hearts. Stanley sees Blanche not as a desperate, driven creature backed into a last corner to make a last desperate stand—but as a calculating bitch with "round heels." . . . Nobody sees anybody truly but all through the flaws of their own egos. That is the way we all see each other in life. Tennesee Williams
"You come to see what you want to see, but you never come to know." Kinky Friedman
It's stimulating to dislike someone, don't you think? Ilia Kazan
The problem of self-identity is not just a problem for the young. It is a problem for all the time. Perhaps the problem. It should haunt old age, and when it no longer does it should tell you that you are dead. Norman MacLean (Found in his notes from 1984)
If it were given to our bodily eyes to see into the mind of another, we would judge a man far more often by what he dreams than by what he thinks.... The dream, which is all spontaneity, takes and keeps the impress of our mind. Nothing emerges more directly and with more sincerity from the very depths of our soul than our unreflective and unconfined aspirations.... Our chimeras are what resemble us most. Victor Hugo, Les Miserables
If we do not dream by night, we shall have nothing to correct by day. Robert Oppenheimer
Functionally, to their small, relatively helpless offspring, the parents are omnipotent and omniscient figures, colossal giants. Their relative size alone is awesome, not to mention their amazing capabilities. To a child two feet tall, a five-foot six-inch parent would be like a fifteen-foot giant to that parent or to anyone of the parent's height. Whatever these huge figures say, goes. Whatever they convey is absorbed as the truth, including their sense of the child's worth and of the child's right to be an agent, a choosing subject, in the world. Such innocent absorption of "reality" occurs in something akin to a "critical period," a time of illusion before the child's reflective consciousness has developed enough to illuminate the parents' and the child's own severe limitations. Irwin Z. Hoffman, Ritual and Spontanety in the Psychoanalytic Process (2001)
In order to function normally, man has to achieve, from the beginning, a serious constriction of the world and of himself. We can say that the essence of reality is the refusal of reality. What we call neurosis enters precisely at this point: Some people have more trouble with their lies than others. Ernest Becker, The Denial of Death (1973)
Man literally drives himself into a blind obliviousness with social games, psychological tricks, personal preoccupations so far removed from the reality of his situation that they are forms of madness--agreed madness, shared madness, disguised and dignified madness, but madness all the same. Ernest Becker, The Denial of Death (1973)
There is a pain -- so utter / It swallows substance up / Then covers the Abyss with Trance / So Memory can step around -- across. . . Emily Dickinson
" In sooth, I know not why I am so sad / It wearies me; you say it wearies you / But how I caught it, found it, or came by it / What stuff 'tis made of, whereof it is born / I am to learn." William Shakespeare, The Merchant of Venice
Happy families are all alike; every unhappy family is unhappy in its own way. Leo Tolstoy
There is a sort of jealousy which needs very little fire, it is hardly a passion, but a blight bred in the cloudy, damp despondency of uneasy egoism. George Eliot, Middlemarch
The memory has as many moods as the temper, and shifts its scenery like a diorama. George Eliot, Middlemarch
Samuel Johnson, the great 18th Century English wit, loved to tell the story of challenging Mrs. Macaulay, "a great republican," to prove her sincerity about social equality by asking her footman to dine at her table. ("She has never liked me since. Sir, your levellers wish to level down as far as themselves; but they cannot bear levelling up to themselves.")
The source of all humor is not laughter, but sorrow. Mark Twain
There's some folks that, if they don't know, you can't tell 'em. Louis Armstrong
His familiarity with his colleagues all these years turned out to be curdled ignorance that had become deceptive habit. And was it indeed important—really important—to know what they thought? Was it only because of his bleary head that he didn't know that or was he becoming aware of a strangeness that had always existed, but had been hidden behind social rituals? Pascal Mercier, Night Train to Lisbon
Shame is the internalized gaze of a displeased parent. Alice Miller, The Drama of the Gifted Child
I could not forbear to reproach myself for having so long neglected what was unavoidably to be done, and of which every moment’s idleness increased the difficulty. Samuel Johnson
Faust complained about having two souls in his breast, but I harbor a whole crowd of them and they quarrel. It is like being in a republic. Otto von Bismarck
It is fateful and ironic how the lie we need in order to live dooms us to a life that is never really ours. Ernest Becker, The Denial of Death
For life is at the start a chaos in which one is lost. The individual suspects this, but he is frightened at finding himself face to face with this terrible reality, and tries to cover it over with a curtain of fantasy, where everything is clear. It does not worry him that his “ideas” are not true, he uses them as trenches for the defense of his existence, as scarecrows to frighten away reality. Jose Ortega y Gasset
There is no secure answer to the awesome mystery of the human face that scrutinizes itself in the mirror; no answer, at any rate, that can come from the person himself, from his own center. One’s own face may be godlike in its miraculousness, but one lacks the godlike power to know what it means, the godlike strength to have been responsible for its emergence. Ernest Becker, The Denial of Death
As I go on in this life, day by day, I become more of a bewildered child; I cannot get used to this world, to procreation, to heredity, to sight, to hearing; the commonest things are a burthen. The prim, obliterated, polite surfaces of life, and the broad, bawdy, and orgiastic—or maenadic—foundations, form a spectacle to which no habit reconciles me. Robert Louis Stephenson
What consoles me is that I am beginning to consider madness as an illness like any other, and that I accept it as such. Vincent van Gogh, 1889, in a letter to his brother, Theo.
Lunacy, like the rain, falls upon the evil and the good; and although it must forever remain a fearful misfortune, yet there may be no more sin or shame in it than there is in an ague or a fever. Inmate in the Royal Glasgow Asylum, 1860.
Even a paranoid can have enemies.
It's both baffling and an outrage when mental failing occurs in a loved one, because the ailment can't be located in leg or heart or liver. It's not the body but she who is failing, the person inhabiting the flesh, the one we have loved and trusted and thought we knew. When a loved one loses her health, it is a sadness. But when she even begins to lose her mind, it's a sadness and a betrayal, an emblem of our deepest fear. John Daniel, Looking After (1996)
In short, my friends, what I find that I am saying is that our schizophrenic patient is actually experiencing inadvertently that same beatific ocean deep which the yogi and saint are ever striving to enjoy: except that, whereas they are swimming in it, he is drowning. Joseph Campbell, Myths To Live By, Chapter X, Schizophrenia: The Inward Journey.
A wounded deer--leaps highest-- Emily Dickinson
Our normal waking consciousness, rational consciousness as we call it, is but one special type of consciousness, whilst all about it, parted from it by the flimsiest of screens, there lie potential forms of consciousness entirely different. William James, The Varieties of Religious Experience.
In the life of children there are two very clear-cut phases, before and after puberty. Before puberty the childs personality has not yet formed and it is easier to guide its life and make it acquire specific habits of order, discipline, and work: after puberty the personality develops impetuously and all extraneous intervention becomes odious, tyrannical, insufferable. Now it so happens that parents feel the responsibility towards their children precisely during this second period, when it is too late: then of course the stick and violence enter the scene and yield very few results indeed. Why not instead take an interest in the child during the first period? Antonio Gramsci, letter, 25 Aug. 1930, to his brother (published in Gramsci: Letters from Prison.
Nothing is as practical as a good theory. Kurt Lewin
Whenever two people meet there are really six people present. There is each man as he sees himself, each man as the other person sees him and each man as he really is. William James
Psychoanalysis is an attempt to examine a persons self-justifications. Hence it can be undertaken only with the patients cooperation and can succeed only when the patient has something to gain by abandoning or modifying his system of self-justification. Thomas Szasz The Second Sin, Psychoanalysis (1973). .
I hope that Freud and his pupils will push their ideas to their utmost limits, so that we may learn what they are. They cant fail to throw light on human nature, but I confess that he made on me personally the impression of a man obsessed with fixed ideas. I can make nothing in my own case with his dream theories, and obviously "symbolism" is a most dangerous method. William James
Let us admit that psychoanalysis, for the time being, is a rather untidy discipline, still finding its way. Hans Loewald
Analysis begins when the patient runs out of things to say. Unknown source.
Freud may be less loved now than at any time since his 1909 arrival in the U.S.A. to give a series of lectures. ("They don't know it," he is supposed to have remarked to Jung, surveying the crowd waiting to greet him at the dock, "but I'm bringing them the plague.") A.O. Scott
It is not the content of the information conveyed to the patient, not the substance of the interpretations and interventions made, not the correctness of the therapist's conjectures, nor even the therapist's compliance with demands to "mirror" the patient or to be his or her ideal that is pivotal: It is decisive for the progress of the therapeutic endeavor that the patient experience an ambience in which he or she feels respected, accepted and at least a little understood. Ernest S. Wolf, Treating the Self (1988)
Analysis almost seems to be the third of those "impossible professions" in which one can be quite sure of unsatisfying results. The other two, much older established, are the bringing up of children and the government of nations. Sigmund Freud (1939) Analysis, Terminable & Interminable
A woman who is very anxious to have children always reads storks instead of stocks. Sigmund Freud (1901) Psychopathology in Every Day Life
Now, we know too well the subtle and ubiquitous quality of the defensive potential of the human personality, and when an analyst becomes doctrinaire, it is reasonable to assume that it is not the patient alone who is trapped in a defense. This is especially true if the analyst tends to ignore, in the face of contrary evidence, that the patient's decision to undertake an analysis and continue in it contains collaborative strivings and growth impulses. Benjamin Wolstein, "Observations of Countertransference" in Essential Papers on Countertransference, Benjamin Wolstein (Ed.).
The ego is not master in its own house. Sigmund Freud (1917) A Difficulty in the Path of Psychoanalysis
What progress we are making. In the Middle Ages they would have burned me. Now they are content with burning my books. Sigmund Freud (1933)
The great question that has never been answered, and which I have not yet been able to answer, despite my thirty years of research into the feminine soul, is "What does a woman want?" Sigmund Freud
For one who lived among enemies so long:
Freud is the father of psychoanalysis. It had no mother.Germaine Greer (1970) The Female Eunuch
Let me say at once that I reject completely the vulgar, shabby, fundamentally medieval world of Freud, with its crankish quest for sexual symbols (something like searching for Baconian acrostics in Shakespeares works) and its bitter little embryos spying, from their natural nooks, upon the love life of their parents.Vladimir Nabokov (1955), Russian-born U.S. novelist, poet. Speak, Memory
Aided and abetted by corrupt analysts, patients who have nothing better to do with their lives often use the psychoanalytic situation to transform insignificant childhood hurts into private shrines at which they worship unceasingly the enormity of the offenses committed against them. This solution is immensely flattering to the patientsas are all forms of unmerited self-aggrandizement; it is immensely profitable for the analystsas are all forms pandering to peoples vanity; and it is often immensely unpleasant for nearly everyone else in the patients life.Thomas Szasz. The Second Sin,"Psychoanalysis" (1973)
Psychoanalysis pretends to investigate the Unconscious. The Unconscious by definition is what you are not conscious of. But the Analysts already know whats in itthey should, because they put it all in beforehand. Saul Bellow The Deans December, (1982).
All that remains to the mother in modern consumer society is the role of scapegoat; psychoanalysis uses huge amounts of money and time to persuade analysands to foist their problems on to the absent mother, who has no opportunity to utter a word in her own defense. Hostility to the mother in our societies is an index of mental health.Germaine Greer The Change: Women, Aging and the Menopause, (1991).
It must be said at the outset, that we do not yet possess a theory that explains how psychoanalysis works" A. Modell, (1990).
It can be only a pleasure to me if I happen upon familiar matters which everyone understands, for my main object is to collect everyday material and utilize it scientifically. I cannot conceive why wisdom, which is, so to speak, the sediment of everyday experiences, should be denied admission among the acquisitions of knowledge. For it is not the diversity of objects but the stricter method of verification and the striving for far-reaching connections which make up the essential character of scientific work. Sigmund Freud, Psychopathology of Everyday Life
The untrustworthiness of the assertions of children is due to the predominance of their imagination, just as the untrustworthiness of the assertions of grown-up people is due to the predominance of their prejudices. For the rest, even children do not lie without a reason, and on the whole they are more inclined to a love of truth than are their elders. Sigmund Freud, A Phobia in a Five-Year-Old Boy (1909)
And Hans deeply loved the father against whom he cherished these death-wishes; and while his intellect demurred to such a contradiction, he could not help demonstrating the fact of its existence, by hitting his father and immediately afterwards kissing the place he had hit. We ourselves, too, must guard against making a difficulty of such a contradiction. The emotional life of man is in general made up of pairs of contraries such as these. Indeed, if it were not so, repressions and neuroses would perhaps never come about. In the adult these pairs of contrary emotions do not as a rule become simultaneously conscious except at the climaxes of passionate love ; at other times they usually go on suppressing each other until one of them succeeds in keeping the other altogether out of sight. But in children they can exist peaceable side by side for quite a considerable time. Sigmund Freud, A Phobia in a Five-Year-Old Boy (1909)
Whoever is familiar with the nature of neurosis will not be astonished to hear that even a man who is very well able to carry out analysis upon others can behave like any other mortal and be capable of producing violent resistances as soon as he himself becomes the object of analytic investigation. When this happens it serves to remind us again of the dimensions which the mind has in regard to its depth, and it does not surprise us to find that a neurosis is rooted in mental strata that were never penetrated by psychoanalysis. Sigmund Freud, On Beginning the Treatment (1913)
Year after year, Freud listened to patients whose affectional life had somehow gone wrong. He characterized "a completely normal attitude in love" as the confluence of "two currents," the "tender and the sensual." There are those who cannot desire where they love and cannot love where they desire, people thus afflicted experience this split as a grievous burden. Freud regarded tenderness without passion as friendship, passion without tenderness as lust. One principal aim of psychoanalysis is to provide realistic lessons in love and bring its two currents into harmony. Peter Gay, Freud, A Life for Our Time (1988)
One dislikes the thought of abandoning observation for barren theoretical controversy, but nevertheless one must not shirk an attempt at clarification. It is true that notions such as that of an ego-libido, an energy of the ego-instincts, and so on, are neither particularly easy to grasp, nor sufficiently rich in content; a speculative theory of the relations in question would begin by seeking to obtain a sharply defined concept as its basis. But I am of opinion that that is just the difference between a speculative theory and a science erected on empirical interpretation. The latter will not envy speculation its privilege of having a smooth, logically unassailable foundation, but will gladly content itself with nebulous, scarcely imaginable basic concepts, which it hopes to apprehend more clearly in the course of its development, or which it is even prepared to replace by others. For these ideas are not the foundation of science, upon which everything rests: that foundation is observation alone. They are not the bottom but the top of the whole structure, and they can be replaced and discarded without damaging it. The same thing is happening in our day in the science of physics, the basic notions of which as regards matter, centres of force, attraction, etc., are scarcely less debatable than the corresponding notions in psycho-analysis. Sigmund Freud, On Narcissism, An Introduction (1914)
Theoretically, it is interesting how insidious the id can be. How it can dissemble, apparently following the commands of the ego and the superego, but in secret preparing its revenge and then suddenly triumphing over these apparently higher courts. Then the old emotional conflict breaks out, and the apparently subdued mourning for the great loss which one suffered so many years ago makes itself felt again. Freud says that the unconscious knows no time; but as a consequence the unconscious can know no growing old. These are the dangerous impulses which one inwardly fears, for in such a psychic state associations, transferences, and all the other unconscious processes gain the upper hand. From a letter from Sergei Pankejeff (The "Wolf-Man" from Freud's most famous case) to the psychoanalyst, Muriel Gardiner (1956)
It was a surpirse to find that an increase in the unconscious sense of guilt can turn people into criminals. But it is undoubtablely a fact. In many criminals, especially youthful ones, it is possible to detect a very powerful sense of guilt which existed before the crime, and is therefore not its result but its motive. It is as if it was a relief to be able to fasten this unconscious sense of guilt on to something real and immediate. Sigmund Freud, The Ego and the Id (1923)
After all, much of what Freud said about our unconscious was alarming. If he was right, there are desires in our dark cauldrons of hatreds and sweaty yearnings that no one would let loose upon humanity. But psychoanalytic practice proceeds as if knowledge (and the care of the analyst) will lead to goodness, at least for those who come into therapy because they are unhappy. Rieff underestimated the degree to which analysts see the attempt to achieve authenticity as an ethical stance. Analysts do seem to want genuinely to believe that if you know and accept yourself, you will be loving to others. In the footsteps of Hannah Arendt, they want to presume that evil is not done by those who learn to think and feel. T.M. Luhrmann, Of Two Minds (2000)
"Psychoanalysis helps people," a senior analyst reflected to me once (I had heard him defend a notorious analyst once at a public meeting on the grounds that she had meant well, even though she had acted naively and to disastrous effect), "but its truths are not appetizing. you get a sense of man's fallibility and the constant way in which he tries to protect himself through illusion. In the acceptance of oneself, there is a giving up of the grandiose fantasies that one could be anything or that there will be this idealized parental figure who will take care of everything. You give up the sort of everyday dishonesty that gets people by. The positive side is that you can bear it alone, you can stand on your own feet, you can accept the failures of your spouse, your work, and your own capacity, and find a way of making a place for yourself that is fulfilling. The psychoanalytic experience can confront you with your dishonesty, the sort of everyday dishonesty that gets people by." T.M. Luhrmann, Of Two Minds (2000)
It is almost humiliating that, after working so long, we should still be having difficulty in understanding the most fundamental facts. But we have made up our minds to simplify nothing and to hide nothing. If we cannot see things clearly we will at least see clearly what the obscurities are. Sigmund Freud, Inhibitions, Symptoms and Anxiety (1926)
It is precisely the minor differences in people who are otherwise alike that form the basis of feelings of strangeness and hostility between them. It would be tempting to pursue this idea and to derive from this `narcissism of minor differences' the hostility which in every human relation we see fighting successfully against feelings of fellowship and overpowering the commandment that all men should love one another. Sigmund Freud (1918)
The patient must find the courage to direct his attention to the phenomena of his illness. His illness must no longer seem to him contemptible, but must become an enemy worthy of his mettle, a piece of his personality, which has solid ground for its existence, and out of which things of value for his future lfe have to be derived. The way is thus paved ... for a reconciliation with the repressed material which is coming to expression in his symptoms, while at the same time place is found for a certain tolerance for the state of being ill. Sigmund Freud, Remembering, Repeating & Working Through (1914)
Thus, a dream frequently has the profoundest meaning in the places where it seems most absurd. In all ages those who have had something to say and have been unable to say it without danger to themselves have gladly donned the cap and bells. He for whom the forbidden saying was intended was more likely to tolerate it if he was able to laugh at it, and to flatter himself with the comment that what he disliked was obviously absurd. Dreams behave in real life as does the prince in the play who is obliged to pretend to be a madman, and hence we may say of dreams what Hamlet said of himself, substituting an unintelligible jest for the actual truth: "I am but mad north-north-west; when the wind is southerly I know a hawk from a handsaw" (Act II, sc. ii) Sigmund Freud, Interpretation of Dreams (1899)
In both psychoanalysis and life, we perceive reality through a veil of unconscious infantile fantasy. Nothing we say or do or think is ever purely 'rational' or 'irrational,' purely 'real' or 'transferential.' It is always a mixture. The difference between analysis and life is that in analysis--in this highly artificial, extreme, bizarre, stressful, in some ways awful situation--these infantile fantasies come into higher relief than they do in life, become accessible to study, as they do not in life. The purpose of analysis isn't to instruct the patient on the nature of reality but to acquaint him with himself, with the child within him, in all its infantility and its impossible and unrepudiated and unrepudiatable longings and wishes. Terms like 'the real relationship' and 'therapeutic alliance' and 'working alliance' simply obscure and dilute and trivialize the radical nature of this task. Janet Malcolm, Psychoanalysis: The Impossible Profession (1980)
When approaching the unconscious--that is, what we do not know, not what we do know--we, patient and analyst alike, are certain to be disturbed. Anyone who is going to see a patient tomorrow should, at some point, experience fear. In every consulting room there ought to be two rather frightened people: the patient and the psychoanalyst. If they are not, one wonders why they are bothering to find out what everyone knows. Wilfred Bion, Brazilian Lectures (1990).The first distortion of truth in "the myth of the analytic situation" is that analysis is an interaction between a sick person and a healthy one. The truth is that it is an interaction between two personalities.... each personality has its internal and external dependencies, anxieties, and pathological defenses; each is also a child with his internal parents; and each of these whole personalities--that of the analysand and that of the analyst--responds to every event of the analytic situation [p. 132]. Heinrich Racker, Transference & Countertransference (1968).
No one who, like me, conjures up the most evil of those half-tamed demons that inhabit the human breast, and seeks to wrestle with them, can expect to come through the struggle unscathed. Sigmund Freud, Fragment of an Analysis of a Case of Hysteria (1905)
By no device can the treatment be anything but the product of mutual influence, in which the whole being of the therapist as well as that of the patient plays its part.... For two personalities to meet is like mixing two chemical substances; if there is any combination at all both are transformed. Carl Jung
Fundamentally, patient and analyst negotiate the meanings that are cocreated between them. It could be said, too, that interpretations are negotiated between patient and analyst, that we negotiate the location of the resistances, that we negotiate the quality of our relationships with patients, and that we negotiate the construction of a psychoanalytic narrative. Similarly, we might think of the affective climate in the consulting room, the relative amount of talk or silence, and the psychological distance between patient and analyst all as products of interactional, conscious, and unconscious negotiation, a meeting of minds. Lewis Aron, A Meeting of Minds (1996)
There is a thing known as "classical psychoanalysis": the analyst has an analytic situation in which he practices analysis; he has patients who are suitable patients and gives them suitable, certified-correct interpretations. I have never known that state. The analytic situation is the situation which the particular practitioner finds is adequate for himself. Wilfred Bion, Brazilian Lectures (1990).
I find myself for a moment in the interesting position of not knowing whether what I have to say should be regarded as something long familiar and obvious or as something entirely new and puzzling. But I am inclined to think the latter. Sigmund Freud, Splitting of the Ego in the Process of Defense (1940)
What asylum doctor has not had his own attack of madness by dint of continual association with madmen?. . . But before that, what obscure inclination, what dreadful fascination had made him choose that subject? Marcel Proust
I think that my parents were crazy, and I think that, somehow, being psychiatrists kept them in line. They used it as a protection. They're both quite crazy, but their job gave them a really good cover. A child of psychiatrists
By listening too readily to accepted theories, and to what they lead the practitioner to expect, it is easy to become deaf to the unexpected. When a therapist thinks that he can see signs of what is familiar to him, he can become blind to what is different and strange. Patrick Casement, Learning from the Patient.
Always this same morbid interest in other people and their doings, their privacies, their dirty linen, always this air of alertness for personal happenings, personalities, personalities, personalities. Always this subtle criticism and appraisal of other people, this analysis of other people's motives. If anatomy presupposes a corpse, then psychology presupposes a world of corpses. Personalities, which means personal criticism and analysis, presuppose a whole world laboratory of human psyches waiting to be vivisected. If you cut a thing up, of course it will smell. Hence, nothing raises such an infernal stink, at last, as human psychology. D. H. Lawrence, St. Mawr (1925)
We all hope that our patients will finish with us and forget us, and that they will find living itself to be the therapy that makes sense. D.W. Winnicott, 1968
We have yet to write the history of modern psychotherapy in a way that approximates the complication of motives from which it suffers. Phillip Rieff, 1963
Psychopharmacology is the great, silent dominatrix of contemporary psychiatry. It is what psychiatrists do that other mental health professionals cannot do; and as mental health jobs become defined more by their professional specificity, more and more psychiatrists spend more of their time prescribing medication. T.M. Luhrmann, Of Two Minds (2000)
The achivement of insight is as deep and radical and complex a procedure as the cutting out of a tumor. Insight isn't superficial--it isn't simply learning something mildly interesting about yourself. It is becoming yourself. It's finding your way to the child in yourself, it is a profound recognition. And it takes a tremendous amount of work on the part of both the therapist and the clinet to negotiate this achievement. Janet Malcolm, Psychoanalysis: The Impossible Profession (1980)
To the extent that the psychotherapist conceives of himself or herself merely as offering a service based upon technical expertise, doing therapy can be a relatively comfortable way to make a living. To the extent, however, that the therapist conceives of his or her role, correctly in my view, as combining technical expertise with a special quality of love and affirmation, one that derives part of its power from the inheritance of the mantle of clerical authority, the occupation can be a source of some unspoken and usually disclaimed embarrassment. The exchange of a presumptively transformative form of love for money can be painfully awkward, particularly in light of the therapist's awareness of his or her personal limitations and self-serving motives. Ultimately, these aspects of the therapist's identity must not only be overcome but also transformed into a wellspring of therapeutic action. Such a transformation is made possible by attention to the dialectic (i.e., the interdependence and interweaving) of, on the one hand, the therapeutic ritual, which raises the therapist to a special level of power and authority, and, on the other hand, the therapist's spontaneous personal participation, which reveals him or her to be a person like the patient: merely mortal, potentially caring, creative, generous, and wise, but also, just as surely, narcissistic, vulnerable, affirmation-seeking, and partially blind. The transformation is made possible, too, by the understanding that coming to terms with the way in which the therapist is a "poor substitute" for all-powerful, loving parents, for the benevolent gods, holds the key to maximizing potentials for committed living, since there is no love object or object of interest that can ever be more than a "poor substitute" for that impossible ideal. Even more generally, the peculiarities and absurdities of the therapeutic situation (e.g., the exchange of money for love) are seen as analogous to the peculiarities and absurdities of life itself (paying with one's mortality for the privilege of living at all) so that in coming to terms with the one there is leverage for coming to terms with the other. Irwin Hoffman, Ritual and Spontaneity in the Psychoanalytic Process (1998)
The client needs an experience, not an explanation. Frieda Fromm-Reichmann
There are times when I am completely at odds with what I do here, because I am not by any shake of a stick any kind of a leader. Whenever the responsibility becomes heavy, I appeal to my brothers, and whatever the big heavy issue is at the moment, miraculously some form of solution is developed--most times not by me. If you follow it back, it's someone who has been touched by Vietnam. I pretty much count on it now. That is the commonality of the experience, that thousands, hundreds of thousands, even millions of people were touched by this. Whether you're a Vietnam vet or an antiwar protester, it doesn't matter. This is about being an American, this is about what you learn in a fourth-grade civics class, this is about taking care of our own, this is about my brother. This feels very personal to me. That feeling of isolation, it's gone. I'm so connected into it, it's therapeutic to me. Ken Smith, A Vietnam veteran who is now the director of a model shelter and rehabilitation program for homeless veterans.
I read about a case in the newspaper. A man had admitted he raped a little girl twice. The child was brought to the sentencing hearing because the therapist thought it would be good for her to see the man led away; she would see that crimes do get punished. Instead, the judge allowed a parade of character witnesses. He said there really are two victims in this courtroom. I thought I was going to go berserk with the injustice.... That was such a turning point. The rage and the sense of holding someone accountable. I saw that it was a necessary thing. It wasn't that I needed a confession. I needed to do the action of holding someone accountable. I wanted to break the denial and the pretense. So I said, I will join that lawsuit. I'll do it for that little girl. I'll do it for my brothers and sisters. And I think a little voice said, "You should also do it for you." Quote from an interview reported in Trauma & Recovery by Judith Herman (1992)