VOLUME 1. Mobilizing the Self

Part 2. Manipulating the Self

V. The modified situation

All experiments thus far have been concerned with becoming aware of processes which are basic to the integrated functioning of the human organism. They apply to everyone. Now we come to experiments dealing with processes which occur chronically only when the organism is malfunctioning. They are “abnormal.” It is their prevalence in a person’s behavior that justifies calling him “neurotic” or “psychotic.” However, granted certain kinds of upbringing and certain life-situations (which, in varying degree, have been encountered by every one of us) they are inevitable.

This is not equivalent to saying that since they are so common, we need not be concerned about them. Those writers of abnormal psychology textbooks who draw a sharp line between “normal” and “abnormal”—they are virtually extinct at last—reveal themselves to be confluent with “the authorities,” whose concept of “normal” is so impoverished as to be synonymous with “conspicuously respectable.”

There is now nearly universal agreement that every person in our society has his “neurotic trends,” “unresolved conflicts,” or “areas of maladjustment.” Where the informed disagree is not with respect to the ubiquity of neurosis but in regard to what should or can be done about it. The orthodox Freudian, following hard upon what the master set down in Civilization and its Discontents, resigns himself to repression as the price we must pay for civilization. Others, more optimistic as regards the long-view, can, nevertheless, foresee nothing more hopeful than many generations of slow amelioration. Because of the lack of widely available therapeutic techniques and anything more than drop-in-the-bucket methods of social prophylaxis, they use pussyfooting manners of speech for fear of being, as they think, unduly alarmist and upsetting. Were a tested remedy at hand which could be applied wholesale, we may be sure that they would more frankly publicize the epidemic status of the disease.

Still others, with Messianic fervor—and this present work will not fail to be classified as such—bring forth from time to time some simple nostrum and say, “Do this, and the world is saved!”

A major problem for all forms of psychotherapy is to -motivate the patient to do what needs to be done. He must return to “unfinished business” which he left unfinished in the past because it was so painful that he had to flee. Now, if he is encouraged to go back and finish it, it is still painful; it reactivates his misery, and from the short-run view, it is still to be avoided. How can he be kept at the task—ultimately, how can he keep himself at the task— when there is such a quantity of unpleasantness to live through?

To this question no positive answer exists today for most persons. An unknown number, perhaps a majority, believe they would have no troubles if the world would just treat them right. A smaller contingent does have, at least at times, a vague recognition that they themselves are responsible for the ills that beset them, at any rate in part, but they lack techniques for coping with them other than the old threadbare resolutions “to do better,” or moral maxims. Or they displace problems from their true arena to a spurious one which allows a great show of busyness and suffices, at least, to let off steam. A very small number take their troubles to an “expert,'’ hopeful that some magic formula will be uttered and their personal devils exorcised.

Of those who start treatment most do not continue. Their cases are not discharged by the therapist but are self-terminated. Many, when magic is not forthcoming from one therapist, try another, then another, and another. Among myriad ways of expressing dissatisfaction with one’s doctor a very common one is to the effect: “He doesn’t understand my case.” Perhaps he does not, and there may be merit in shifting. But most patients, perhaps all, wish in some degree to prescribe to the therapist how he shall cure them—and this prescription does not include that they shall suffer in the process!

For surgical and pharmacological forms of medical treatment the patient can be perfectly passive, and it is better if he is. He may receive an anesthetic and wake up with the operation over. The notion that treatment should be administered to a passive patient generalizes to notions of how it ought to be possible to cure a neurosis. The latter, however, is not “organic” but “functional.” While the patient is not so naive as to suppose there can literally be surgical removal of his symptoms, he is likely to feel that little more should be necessary on his own part than to bring the body. Once he presents himself, the doctor—perhaps with the aid of hypnosis— ought to be able to fix him up.

Since it is, nevertheless, the patient himself who must change his own behavior and thus effect his own cure, all methods of psychotherapy give rise to what, in professional jargon, are called “disappointment reactions.” These usually stem from realizing after a time that the therapist actually expects one to do hard work and undergo pain. As a matter of fact, without being fully aware of it, one may have sought out the therapist in the hope of acquiring exactly the opposite, namely, a better way of escaping work and avoiding pain. To discover that therapy involves concentrated doses of what one sought to be relieved of seems as absurd as to take the ailment and apply it as treatment.

In the fortunate case what happens is that, before the patient develops a disappointment reaction strong enough to make him terminate treatment, he learns that the hard work is not mere drudgery. However far removed it may at first seem from what he thinks is urgent and therefore the place to start, he gradually gains orientation and perspective. He comes to see particular symptoms as merely surface manifestations of a more general and complicated system of malfunctioning which underlies and supports them. Though now, in a way, the job looks bigger and will obviously take longer than originally supposed, it does begin to make sense.

Likewise, with respect to the pain involved, he comes to see that this is not pointless, needless pain. He begins to appreciate the rough-hewn wisdom of the advice to get back on a horse, when thrown, and successfully ride him off. The patient’s situation is different in that he has, perhaps, avoided his particular horse for a long time; years, perhaps, or even most of a lifetime. Nevertheless, if healthy functioning requires that he learn to ride and manage a certain kind of horse that has thrown him in the past, the only way he can possibly do this is to make approaches to the horse and then, sooner or later, get into the saddle.

Although the therapist keeps leading the patient back to that which he wishes to avoid, he usually is milder and more considerate with him than the patient himself or than his friends and relatives. Their attitude is one of demanding that he snap out of it, stop pampering himself, and take the hurdle, whatever it is, in a blind, compulsive rush. The therapist, on the contrary, is at least as much interested in the avoidance itself as in what is avoided. Whatever the superficial appearances, where there is the tendency to avoid something, this tendency exists for good and sufficient reasons. The job is to explore and become fully aware of these grounds for avoidance. This is called “analyzing the resistance.” How the patient experiences and verbalizes these grounds will change, perhaps dramatically, as therapy progresses. With the change, not just in how he talks, but in how he feels himself and experiences his problems, he can make further and further “approaches” as he feels the initiative and strength to do so until he settles his neurotic difficulties once and for all.

The strategy of motivating the patient to continue therapy is usually not particularly taxed at the very beginning. There is at that time the so-called “honeymoon period,” when what is uppermost is the satisfaction of having made a start after an interval of vacillation, the opinion that one’s therapist is wonderful, the conviction that one will be the brightest, the fastest-moving, in short, the most remarkable patient he has ever had, and that one will now blossom forth as that radiant, inimitable personality that one has always felt himself potentially to be.

It is when the “honeymoon” is over that the motivation problem becomes critical. One has worked so hard, been so cooperative, been the model patient, and yet—well, there is so little to show for it! The glamor is gone, and the road still stretches far ahead. In Freudian analysis this is likely to be the time of “negative transference.” The therapist, who at first seemed so all-knowing and all-powerful, has revealed his feet of clay. All he knows is more of the same, and the same is getting tiresome. In fortunate eases such discontent with one’s doctor breaks into the open as reproaches, disparagement, or even wrathful denunciation. When this occurs, it usually clears the air, and the case may then settle down for the long haul. If it does not—if the patient is “too polite,” “too considerate,” “too understanding” to attack the therapist outright— the ease is likely to clog up with unexpressed resentment and be terminated by the patient.

For the most part, the patient’s progress in therapy is not aided and abetted by the persons he sees in everyday life. He may, of course, be fortunate enough to have friends and acquaintances who have themselves benefited from therapy, in which event it is not so difficult for him to maintain belief in the value of continuing. If, on the other hand, he lives with relatives who construe his action as a reflection on the wholesomeness of the family relationships, who view it as “weakness” to be treated for something “mental,” or who, to the extent that he progresses, find it less and less easy to domineer, exploit, overprotect, or otherwise be in neurotic confluence with him, he will have to struggle against veiled or open pressures to make him cease and desist from this “foolishness.” Many patients succumb to such emotional blackmail levied upon them by “normal” associates.

As the effectiveness of psychotherapy has come to be more generally recognized, this situation has improved somewhat. Nevertheless, even though one may have a verbal understanding of what is involved in psychotherapy and a naturalistic conception of its rationale so that one does not boggle over giving it lip-service at a distance, when it comes close enough to interfere with one’s own life—for instance, through changes forced in one’s relationship to a friend or relative who is in therapy or through the heightened “temptation” to try it out oneself—then, to the extent that one is neurotic, one must fight it—for it is aggressive toward the neurotic ‘way of life’. The neurotic’s resistance to psychotherapy, whether he is actually a patient or simply someone entertaining an opinion on the subject, constitutes his counter-aggression against psychotherapy. He feels threatened by it. And, as a neurotic, so he is’ What could be more natural—and, with certain qualifications, healthy—than that he should fight back?

All that has been remarked above has centered around formal psychotherapy—that is, the situation where therapist and patient confront each other face-to-face. Now how does the matter stand with respect to your continuing to do the work involved in these experiments? They provide you with instructions whereby, if fully followed through, the crux of what goes on in formal therapy may lx: reenacted by the single person. But it is difficult to keep going!

Perhaps already, in the foregoing work on orienting the self, you have uncovered strong resistances against continuing. You are certain to encounter stronger objections to doing experiments still to come, for they involve going a step further and taking decisive action in your life-situation.

As you have found out already, this work leads you to the discovery that the human organism functions in a manner which is at odds with conventionally held notions about human nature. These traditionally established opinions, however, have been so deeply trained into all of us and have been so invested with feelings of moral rightness that their modification—even when our own firsthand experience confronts us with this necessity—seems wrong and worthy of condemnation.

There will be times in the work to come when, if you let it break through, your anger will flare against us for intimating that you possess feelings and entertain fantasies which, by your lifelong standards of what is proper, will seem despicable. At such moments you will be tempted to cast aside these experiments in disgust— and should you actually do so, certainly no-one could say that it was not your privilege. On the other hand, if your occasional assumption that we are “dangerous crackpots” does not lead you to such a summary breaking off of our relationship, we are certain that you will sooner or later arrive at a more positive evaluation, for you will have acquired new values without the loss of any of the old ones which were of any real importance to you.

During your moments of wrath against us it would be best if you could express it to us face to face. Since that is not practicable, the next best thing will be for you to fire it off to us in written form via our publisher. If “too polite” for that, then write the letter anyhow, even if you then consign it to your wastebasket. Whatever you do, try to get it off your chest!

We are personally responsible for whatever discomfort you experience in doing these experiments in the sense that, in recommending them to you, we commit an aggressive act aimed at your present status quo and whatever complacency it affords. That we act “with the best of intentions” or “for your own good” is beside the point. A certain highway is said to be paved with good intentions, and your life has been cluttered with meddlers who claimed to act for your own good.

In the experiments to come we shall make use of a formulation of behavior which, briefly stated, is as follows: various excitements, colored with pleasure, aggression or pain, energize the organism to make contacts and creative adjustments in its environment. It is by feeling and contact that the organism grows and expands its boundaries. Every neurotic mechanism is an interruption of some kind of excitement—a prevention of its further development. As explained previously, anxiety is the consequence of such interruption. Rather than risk the new, unknown contact, the neurotic withdraws into a contactless (unaware) confluence with his “safe” habitual functioning.

Three important mechanisms with which we shall work are retroflection, introjection and projection. These could be considered as defining three different types of “neurotic character,” since they have their beginning in different life experiences and are rooted in different physiological functions. However, even if one of these mechanisms should predominate in us over the others, we all use every one of them. Since our approach is an all-round one, you need not, hypochondriacally, ask yourself whether you are a typical “retroflector,” “introjector,” or “projector” for, by proceeding with all the abstract possibilities of environment, sensation, body, feeling, speech, and the various characteristic resistances, you will, regardless of what your particular “diagnosis” may be, develop areas of integrated functioning that will then facilitate still further integration.