Clinical Psychology Quotes

The reality is that the lives of the smallest patients are in our hands, and their clinical condition can change in an instant. No matter how many times you are involved in situations such as this, the physical stress and anxiety as well as the emotional and psychological effects of being immersed in that environment are dramatic and lasting on the human body, mind, and central nervous system. These effects are severe, and I firmly believe that they are cumulative over your lifetime.

Man (and woman) has an infinite capacity for self-development. Equally, he has an infinite capacity for self-destruction. A human being may be clinically alive and yet, despite all appearances, spiritually dead.

he wanted to do, to be, to feel- and could not; he wanted sense, he wanted purpose- in Freud's words, 'Work and Love'.

Clinical psychology tells us arguably that trauma is the ultimate killer.Memories r not recycled like atoms and particles in quantum physics. they can be lost forever. It’s sort of like my past is an unfinished painting and as the artist of that painting,I must fill in all the ugly holes and make it beautiful again.

Tell me, where did you get your clinical psychology degree from? Oh, that's right. The University of Bullshit.

Donald Trump has been called, by psychologists and clinical psychologists, over and over again, a narcissist with multiple sociopathic and psychopathic tendencies.

44. [...] later that afternoon, a therapist will say to me, "If he hadn’t lied to you, he would have been a different person than he is." She is trying to get me to see that although I thought I loved this man very completely for exactly who he was, I was in fact blind to the man he actually was, or is. 45. This pains me enormously. She presses me to say why; I can’t answer. Instead I say something about how clinical psychology forces everything we call love into the pathological or the delusional or the biologically explicable, that if what I was feeling wasn’t love then I am forced to admit that I don’t know what love is, or, more simply, that I loved a bad man. How all of these formulations drain the blue right out of love and leave an ugly, pigmentless fish flapping on a cutting board on a kitchen counter.

As a counterpoint to sociopathy, the condition of narcissism is particularly interesting and instructive. Narcissism is, in a metaphorical sense, one half of what sociopathy is. Even clinical narcissists are able to feel most emotions are strongly as anyone else does, from guilt to sadness to desperate love and passion. The half that is missing is the crucial ability to understand what other people are feeling. Narcissism is a failure not of conscience but of empathy, which is the capacity to perceive emotions in others and so react to them appropriately. The poor narcissist cannot see past his own nose, emotionally speaking, and as with the Pillsbury Doughboy, any input from the outside will spring back as if nothing had happened. Unlike sociopaths, narcissists often are in psychological pain, and may sometimes seek psychotherapy. When a narcissist looks for help, one of the underlying issues is usually that, unbeknownst to him, he is alienating his relationships on account of his lack of empathy with others, and is feeling confused, abandoned, and lonely. He misses the people he loves, and is ill-equipped to get them back. Sociopaths, in contrast, do not care about other people, and so do not miss them when they are alienated or gone, except as one might regret the absence of a useful appliance that one has somehow lost.

Perhaps the strangest thing about this illusion of control is not that it happens but that it seems to confer many of the psychological benefits of genuine control. In fact, the one group of people who seem generally immune to this illusion are the clinically depressed, who tend to estimate accurately the degree to which they can control events in most situation.

Continued observations in clinical psychological practice lead almost inevitably to the conclusion that deeper and more fundamental than sexuality, deeper than the craving for social power, deeper even than the desire for possessions, there is a still more generalized and universal craving in the human make-up. It is the craving for knowledge of the right direction - for orientation.

As a clinical psychologist, I am regularly confronted with the brutal truth that we are all lie.

Misinformation about the Bible's answers to these issues has led to much wrong teaching about boundaries. Not only that, but many clinical psychological symptoms, such as depression, anxiety disorders, guilt problems, shame issues, panic disorders, and marital and relational struggles, find their root in conflicts with boundaries.

Neurology and psychology, curiously, though they talk of everything else, almost never talk of ‘judgment’—

You might be scared to start. That’s natural. There’s this very real thing that runs rampant in educated people. It’s called “impostor syndrome.” The clinical definition is a “psychological phenomenon in which people are unable to internalize their accomplishments.” It means that you feel like a phony, like you’re just winging it, that you really don’t have any idea what you’re doing.

The human brain has a safety switch that gets engaged by traumatic exposure and experiences. It’s similar to being in shock but we remain there until it’s long over. We detach. We create degrees of separation between ourselves and what we feel, think, perceive, and ultimately, this impacts not only our worldview but also our perception of self. Clinically, this is called “Dissociation.

Although the client-centered approach had its origin purely within the limits of the psychological clinic, it is proving to have implications, often of a startling nature, for very diverse fields of effort.

Does psychiatrists’ ability to prescribe drugs give them an advantage over psychologists in places where psychologists cannot prescribe them? Not always. Drugs can be useful, but relying entirely on them can be a mistake. Whereas a typical visit to a clinical psychologist includes an extensive discussion of the issues troubling the client, many visits to a psychiatrist are briefer sessions that focus on checking the effectiveness of a drug and evaluating its side effects.

I learned a long time ago in the outpatient clinic to make no distinction –as some condescending doctors still do –between ‘real’ or ‘psychological’ pain. All pain is produced in the brain, and the only way pain can vary, other than in its intensity, is how it is best treated, or more particularly in my clinic, whether surgery might help or not.

Identity confusion is defined by the SCID-D as a subjective feeling of uncertainty, puzzlement, or conflict about one's own identity. Patients who report histories of childhood trauma characteristically describe themes of ongoing inner struggle regarding their identity; of inner battles for survival; or other images of anger, conflict, and violence. P13

Over time, the grueling job of a mother requires one to learn everything from patience to clinical psychology. When you are "in the fire," it is sometimes hard to recognize the value of what you are learning. But the da-to-day refining process--the problem solving, crisis resolution, mental stretching, mess clean-ups, sleep deprivation, and loving more than you thought possible truly makes you into a smart, aware, beautiful refined individual. The great secret is appreciating the refined person you are becoming through your trials.

Human emotions have deep evolutionary roots, a fact that may explain their complexity and provide tools for clinical practice. The Nature of Emotions (2001)

We only experience a fraction of the reality we are a part of. What if we turn our eyes toward the interior of reality? Is it possible that the interior follows the patterns of the exterior? Might our state of consciousness reflect only a fraction of what may be potentially experienced?

You might be scared to start. That’s natural. There’s this very real thing that runs rampant in educated people. It’s called “impostor syndrome.” The clinical definition is a “psychological phenomenon in which people are unable to internalize their accomplishments.” It means that you feel like a phony, like you’re just winging it, that you really don’t have any idea what you’re doing. Guess what: None of us do. Ask anybody doing truly creative work, and they’ll tell you the truth: They don’t know where the good stuff comes from. They just show up to do their thing. Every day.

mirror neurons are active when a person is recognizing their own face...the very act of self-reflection may have been made possible via mirror neurons, which allow us to reflect on an internal representation of self.

The major goal of the Cold War mind control programs was to create dissociative symptoms and disorders, including full multiple personality disorder. The Manchurian Candidate is fact, not fiction, and was created by the CIA in the 1950’s under BLUEBIRD and ARTICHOKE mind control programs. Experiments with LSD, sensory deprivation, electro-convulsive treatment, brain electrode implants and hypnosis were designed to create amnesia, depersonalization, changes in identity and altered states of consciousness. (p. iii) “Denial of the reality of multiple personality by these doctors [See page 114 for names] in the mind control network, who are also on the FMSF [False Memory Syndrome Foundation] Scientific and Professional Advisory Board, could be disinformation. The disinformation could be amplified by attacks on specialists in multiple personality as CIA conspiracy lunatics” (P.10) “If clinical multiple personality is buried and forgotten, then the Manchurian Candidate Programs will be safe from public scrutiny. (p.141)

Dissociation is the ultimate form of human response to chronic developmental stress, because patients with dissociative disorders report the highest frequency of childhood abuse and/or neglect among all psychiatric disorders. The cardinal feature of dissociation is a disruption in one or more mental functions. Dissociative amnesia, depersonalization, derealization, identity confusion, and identity alterations are core phenomena of dissociative psychopathology which constitute a single dimension characterized by a spectrum of severity. Clinical Psychopharmacology and Neuroscience 2014 Dec; 12(3): 171-179 The Many Faces of Dissociation: Opportunities for Innovative Research in Psychiatry

What could we do? What should we do? 'There are no prescriptions,' Luria wrote, 'in a case like this. Do whatever your ingenuity and your heart suggest. There is little or no hope of any recovery in his memory. But a man does not consist of memory alone. He has feeling, will, sensibilities, moral being - matters of which neuropsychology cannot speak. And it is here, beyond the realm of an impersonal psychology, that you may find ways to touch him, and change him. [...] Neuropsychologically, there is little or nothing you can do; but in the realm of the Individual, there may be much you can do.

This exile is a fascinating symbolic act from our modern psychoanalytic viewpoint, for we have held in earlier chapters that the greatest threat and greatest cause of anxiety for an American near the end of the twentieth century is not castration but ostracism, the terrible fate of being exiled by one’s group. Many a contemporary man castrates himself or permits himself to be castrated because of fear of being exiled if he doesn’t. He renounces his power and conforms under the great threat and peril of ostracism. — Rollo May, “The Tragedy of Truth About Oneself” (The Psycology of Existence: An Integrative, Clinical Perspective by Kirk Schneider and Rollo May), pp. 14-15

In the past ten years there had been truly amazing advances in those areas of research – psychopharmacology, biochemistry, psychosurgery, clinical psychology – that directly and indirectly contributed to the less reputable but nonetheless hotly pursued science of mind control.

I offered to pass along information about NEHSA to Heidi so she can let her patients know about it. I don’t have any scientific or clinical data to back this up, but I think snow-boarding is the most effective rehabilitative tool I’ve experienced. It forces me to focus on my abilities and not my disability, to overcome huge obstacles, both physical and psychological, to stay up on that board and get down the mountain in one piece. And each time I get down the mountain in one piece, I gain a real confidence and sense of independence I haven’t felt anywhere else since the accident, a sense of true well-being that stays with me well beyond the weekend. And whether snowboarding with NEHSA has a measurable and lasting therapeutic effect for people like me or not, it’s a lot more fun than drawing cats and picking red balls up off a tray

For a few years after we either reach herd immunity or have a widely distributed vaccine, people will still be recovering from the overall clinical, psychological, social, and economic shock of the pandemic and the adjustments it required, perhaps through 2024. I’ll call this the intermediate pandemic period. Then, gradually, things will return to “normal”—albeit in a world with some persistent changes. Around 2024, the post-pandemic period will likely begin.

The two psycho-analytic theories were in a different class. They were simply non testable, irrefutable. There was no conceivable human behav­iour which could contradict them. This does not mean that Freud and Adler were not seeing certain things correctly: I personally do not doubt that much of what they say is of considerable importance, and may well play its part one day in a psychological science which is testable. But it does mean that those ‘clinical observations’ which analysts naively believe confirm their theory cannot do this any more than the daily confirmations which astrologers find in their practice. And as for Freud’s epic of the Ego, the Super-ego, and the Id, no substantially stronger claim to scientific status can be made for it than for Homer’s collected stories from Olympus. These theories describe some facts, but in the manner of myths. They contain most interesting psychological suggestions, but not in a testable form.

The potent mix of Nietzschean philosophy, psychology, history, and clinical practice was leading him into new territory

Dreaming can be understood as another form of consciousness that requires its sibling, waking consciousness, to imbue it with meaning

the brain is not idle, passively receiving information, but produces perceptual expectations influencing how sensory information is ultimately interpreted

The issue of addiction has spread like wildfire and it is affecting every corner of this globe

In former days, people frustrated in their will to meaning would probably have turned to a pastor, priest, or rabbi. Today, they crowd clinics and offices. The psychiatrist, then, frequently finds himself in an embarrassing situation, for he now is confronted with human problems rather than with specific clinical symptoms. Man’s search for a meaning is not pathological, but rather the surest sign of being truly human. Even if this search is frustrated, it cannot be considered a sign of disease. It is spiritual distress, not mental disease.

In the next six years, I discovered that my principal and my Jungian therapist were both right. There was no reason to limit myself, to let my age restrict my choices. I listened to what my life was asking of me, and in 1974 I earned an MA in educational psychology from the University of Texas–El Paso, and in 1978 a PhD in clinical psychology from Saybrook University.

DID may be underdiagnosed. The image derived from classic textbooks of a florid, dramatic disorder with overt switching characterizes about 5% of the DID clinical population. The more typical presentation is of a covert disorder with dissociative symptoms embedded among affective, anxiety, pseudo-psychotic, dyscontrol, and self-destructive symptoms, and others (Loewenstein, 1991). The typical DID patient averages 6 to 12 years in the mental health system, receiving an average of 3 to 4 prior diagnoses. DID is often found in cases that were labeled as "treatment failures" because the patient did not respond to typical treatments for mood, anxiety, psychotic, somatoform, substance abuse, and eating disorders, among others. Rapid mood shifts (within minutes or hours), impulsivity, self-destructiveness, and/or apparent hallucinations lead to misdiagnosis of cyclic mood disorders (e.g., bipolar disorder) or psychotic disorders (e.g., schizophrenia).

I think more people would stay active in church, if they didn't get so offended by the actions of members. Sometimes, you have to view places of worship as free mental health clinics, in order to deal with the piety or hypocrisy. Parishioners are a wounded souls in various stages of healing, who are being treated by angels, with credentials from the University of Hard Knocks. Some take their therapy seriously and try to practice what they learned. Yet, others down the sacrament like a healing dose of Prozac, with no other effort required. When you keep this in mind, you won't feel so annoyed by the personalities you encounter.

Logan looked at her and wondered how someone so beautiful could be so oblivious to their own beauty, how someone so smart could be so foolish to the extent of their own intellect and how someone so loving and compassionate could ever think she wasn’t worthy of love? It was like watching a blind man trapped and wandering aimlessly and helplessly in a scorching hot desert unable to see the small puddle of water that lay just a foot away. The only difference was that she had eyes. Two beautiful ones, yet she could not see. Is that what madness was? Was it to be able to view and appreciate every form of beauty but to be blind to the value and exquisiteness of one’s own? Logan believed in many forms of insanity but he knew in that instant watching her trembling frame on the train tracks that hers, that her illness, surpassed any clinical or psychological term known. Maybe she did suffer from depression or bipolar or schizophrenia. Who knew? All he was certain of in that moment that she suffered from no greater illness than the blindness of the heart.

Psychologisation describes the emphasis on psychological factors where there is little or no evidence to justify it (1). It's a process where relevant findings are ignored or downplayed in favour of data from incomplete examinations, flawed research or anecdotal reports. In a clinical context, differential diagnoses may be dismissed prematurely while psychological explanations are readily accepted. Psychologisation does not refer to situations where there is sound evidence that psychological factors play a significant role, or where all the arguments are discussed and the psychological explanations are deemed the most persuasive.

Humans perceive the world as subjects, yet we are also objects composed of the same material that we are perceiving from. Our attempts to sense the reality hidden behind veils, is very much like a game of hide and seek.

n sum, let us enter a plea for clinical clinicians who can distinguish unconscious depression from conscious despair, paranoia from adaptive wariness, and who can tell the difference between a sick man and a sick nation.

Hikikomori cases are often best treated through clinical treatments that support the psychological growth of the person in withdrawal as well as adjustments to the environment, including the environment provided by the family.

Audio of interview - http://www.youtube.com/watch?feature=... "No I haven't been in a ceremony but I've seen the marks on them, I've seen the terror they're in and I've seen how they were before such events happened and how they are when they speak about it, how consistent they are in other things they say, so that there has been no reason from a psychological point of view to doubt their capacity to give good evidence, but its the police who need to find the proper corroboration." - Dr Valerie Sinason, Clinic for Dissociative Studies, London - talks about Private Eye magazine's suggestion that she "invented" the story published in the Express and that no abuse existed

Basically, a case conceptualization is a method for understanding and explaining a client's concerns and for guiding the treatment process. It functions like a "bridge" to connect assessment and treatment with clinical outcomes.

No one can live with only a clinical, psychological, or historical vision of the world. There must be a capacity to recreate, renovate, renew... too much lucidity creates a desert, and one has to find water again, to replant, reseed.

Consider the hypothetical case of a man who can have anything he wants just by wishing for it. Such a man has power, but he will develop serious psychological problems. At first he will have a lot of fun, but by and by he will become acutely bored and demoralized. Eventually he may become clinically depressed. History shows that leisured aristocracies tend to become decadent. This is not true of fighting aristocracies that have to struggle to maintain their power. But leisured, secure aristocracies that have no need to exert themselves usually become bored, hedonistic and demoralized, even though they have power. This shows that power is not enough. One must have goals toward which to exercise one's power.

I picture myself confined within my clinical cell, time slowly dripping down the four walls, forming puddles of dirty sludge that will slowly come up to drown me. Until then, I am existing in an infinite space where delusion is married to reality.

There's major depression, and then there's clinical depression. Major depression is what makes you jump off a bridge. I have clinical depression. I jump out of first story windows. It's the psychological equivalent of lying on a bed of rubber nails.

From the moment they're recruited to the time they're 'rescued' and deported, trafficked women are terrorized. Every single day they face a world stacked heavily against them. Their only friends are the dedicated women and men who form the thin front line against trafficking--an often thankless job. Those working for nongovernmental aid agencies and organizations are the real heroes in this bleak morass. Still, their work is merely a Band-Aid solution. In the vast majority of cases, NGO workers report that their funding is ad hoc and wholly inadequate to meet even basic needs. If we truly want a fair shot at saving these women, we need to open not only our minds but also our wallets. We need to focus on programs that care compassionately for the victims and we need to implement them immediately, worldwide. The most urgent priorities are safe shelters and clinics equipped and staffed to offer medical and psychological treatment. We need to understand that most of these women have been psychologically and physically ripped apart. And we need to be prepared for the fac thtat most have been infected with various sexually transmitted diseases.

If we are to presuppose that the universe is inherently material, that we are emergent organisms from this universe and by nature we seek and generate meaning, meaning itself becomes a substructure of the universe. To think otherwise is to dissociate ourself from the universe, which contradicts the latter belief

As the renowned clinical psychologist Dr Anne Cooke put it to me in conversation: ‘The mental illness narrative encourages us to see mental health problems as nothing to do with life and circumstances, so no wonder we don’t look at structural or social causes; and of course this perspective is a great fit with the current neoliberal approach – where individuals have to reform themselves to fit with existing social structures.’ The trouble with programmes that are blind to the perils of such adaptations is that they essentially neuter political reflection on why distress proliferates in our schools, certainly when compared to schools in most other developed nations.

The difficulties in diagnosing DID result primarily from lack of education among clinicians about dissociation, dissociative disorders, and the effects of psychological trauma, as well as from clinician bias. This leads to limited clinical suspicion about dissociative disorders and misconceptions about their clinical presentation. Most clinicians have been taught (or assume) that DID is a rare disorder with a florid, dramatic presentation. Although DID is a relatively common disorder, R. P. Kluft (2009) observed that “only 6% make their DID obvious on an ongoing basis” (p. 600). - Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p4-5

As a recent editorial in the Journal of Clinical Oncology put it: "What we must first remember is that the immune system is designed to detect foreign invaders, and avoid out own cells. With few exceptions, the immune system does not appear to recognize cancers within an individual as foreign, because they are actually part of the self.

Many of the benefits of CBT (cognitive behavioral therapy) can be obtained without going into therapy. There are a number of self-help books, CDs and computer programs that have been used to treat depression and some of these have been tested in clinical trials with positive results. I can particularly recommend these two books. One is 'Control Your Depression', the lead author of which is Peter Lewinsohn, a Professor of Psychology at the University of Oregon. ... The other book that I can recommend with confidence is 'Feeling Good' by the psychiatrist David Burns. 'Control Your Depression' emphasizes behavioral techniques like increasing pleasant activities, improving social skills and learning to relax. 'Feeling Good' puts greater emphasis on changing the way people think about themselves. But both books include both cognitive and behavioral techniques.

[W]e are basically more similar to our patients than we are different from them. The psychological mechanisms in pathological states are merely extensions of principles involved in normal developmental functioning. Doctor and patient are both human beings. [...] [C]ountertransference in the psychiatrist and transference in the patient are essentially identical processes - each unconsciously experiences the other as someone from the past.

The objective world around us extends far beyond what we can sense and perceive. Only a sliver of information is received and understood, and not passively so; in fact, we do so rather actively. That sliver of information is transformed and filtered through non- conscious processes that actively select what we end up perceiving consciously. We are always more than we are aware of and there is always more happening than we can be conscious of.

Although the terminology implies scientific endorsement, false memory syndrome is not currently an accepted diagnostic label by the APA and is not included in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). Seventeen researchers (Carstensen et al., 1993) noted that this syndrome is a "non-psychological term originated by a private foundation whose stated purpose is to support accused parents" (p.23). Those authors urged professionals to forgo use of this pseudoscientific terminology. Terminology implies acceptance of this pseudodiagnostic label may leave readers with the mistaken impression that false memory syndrome is a bona fide clinical disorder supported by concomitant empirical evidence.(85)... ... it may be easier to imagine women forming false memories given biases against women's mental and cognitive abilities (e.g., Coltrane & Adams, 1996). 86

Therapy is a two-person relationship demanding both interaction and exploration of that interaction; real feelings and mutual disclosure about the feelings evoked in the therapy interaction are necessary. Today many progressive psychoanalytic institutes have abandoned the old blank screen model in favor of a new model—the real two-person relationship—and published clinical investigations of that phenomenon—”intersubjectivity” or “two-person” psychology—are now commonplace in the professional literature.

because studies also show that we women often hold anger in our bodies. Unacknowledged or actively repressed, anger takes its toll on us. Numerous psychological studies have unequivocally shown that women who mask, externalize, or project their anger are at greater risk for anxiety, nervousness, tension, panic attacks, and depression. A growing number of clinical studies have linked suppressed anger to serious medical conditions such as high blood pressure, heart disease, gastrointestinal disorders, and the development of certain cancers.

Even without world wars, revolutions and emigration, siblings growing up in the same home almost never share the same environment. More accurately, brothers and sisters share some environments — usually the less important ones — but they rarely share the one single environment that has the most powerful impact on personality formation. They may live in the same house, eat the same kinds of food, partake in many of the same activities. These are environments of secondary importance. Of all environments, the one that most profoundly shapes the human personality is the invisible one: the emotional atmosphere in which the child lives during the critical early years of brain development. The invisible environment has little to do with parenting philosophies or parenting style. It is a matter of intangibles, foremost among them being the parents’ relationship with each other and their emotional balance as individuals. These, too, can vary significantly from the birth of one child to the arrival of another. Psychological tension in the parents’ lives during the child’s infancy is, I am convinced, a major and universal influence on the subsequent emergence of ADD. A hidden factor of great importance is a parent’s unconscious attitude toward a child: what, or whom, on the deepest level, the child represents for the parents; the degree to which the parents see themselves in the child; the needs parents may have that they subliminally hope the child will meet. For the infant there exists no abstract, “out-there” reality. The emotional milieu with which we surround the child is the world as he experiences it. In the words of the child psychiatrist and researcher Margaret Mahler, for the newborn, the parent is “the principal representative of the world.” To the infant and toddler, the world reveals itself in the image of the parent: in eye contact, intensity of glance, body language, tone of voice and, above all, in the day-today joy or emotional fatigue exhibited in the presence of the child. Whatever a parent’s intention, these are the means by which the child receives his or her most formative communications. Although they will be of paramount importance for development of the child’s personality, these subtle and often unconscious influences will be missed on psychological questionnaires or observations of parents in clinical settings. There is no way to measure a softening or an edge of anxiety in the voice, the warmth of a smile or the depth of furrows on a brow. We have no instruments to gauge the tension in a father’s body as he holds his infant or to record whether a mother’s gaze is clouded by worry or clear with calm anticipation. It may be said that no two children have exactly the same parents, in that the parenting they each receive may vary in highly significant ways. Whatever the hopes, wishes or intentions of the parent, the child does not experience the parent directly: the child experiences the parenting. I have known two siblings to disagree vehemently about their father’s personality during their childhood. Neither has to be wrong if we understand that they did not receive the same fathering, which is what formed their experience of the father. I have even seen subtly but significantly different mothering given to a pair of identical twins.

ME/CFS has been classified as a neurological disease by the WHO since 1969 [59] and a growing number of researchers theorize that ME/CFS might be a neuro-immunological condition [60–63]: yet the BPS framework does not account for ME/CFS as a neurological or immunological disease – instead, much of the pro- BPS model literature on ME/CFS adopts what Nassir Ghaemi terms the ‘eclectic approach’; whereby everything appears important, all bio, all psycho, and all social factors [33]. Yet in clinical practice (the BPS framework), there is strong emphasis on psychological interventions (CBT and GET).

No day passes that the mail does not flood the doctor’s office with suggestions about what to use in his clinical practice. My desk overflows with gadgets and multi-coloured pills telling me that without them mankind cannot be happy. The propaganda campaign reaching our medical eyes and ears is often so laden with suggestions that we can be persuaded to distribute sedatives and stimulants where straight critical thinking would deter us and we would seek the deeper causes of the difficulties. This is true not only for modern pharmacotherapy; the same tendencies can also be shown in psychotherapeutic methods.

While some accused and convicted child molesters have inappropriately influenced the media, the public, and many in the clinical and legal professions by claiming that traumatic amnesia does not occur in child sexual abuse, workers in the field of trauma psychology have accumulated solid empirical evidence over the past 100 years that it does occur and is common. Its existence and natural history are documented throughout the clinical literature. from: Traumatic amnesia: The evolution of our understanding from a clinical and legal perspective, Sexual Addiction & Compulsivity: The Journal of Treatment & Prevention, Volume 4, Issue 2, 1997

The sixteenth-century artist Albrecht Dürer famously depicted Melancholy as a downcast angel surrounded by symbols of creativity, knowledge, and yearning: a polyhedron, an hourglass, a ladder ascending to the sky. The nineteenth-century poet Charles Baudelaire could “scarcely conceive of a type of beauty” in which there is no melancholy. This romantic vision of melancholia has waxed and waned over time; most recently, it’s waned. In an influential 1918 essay, Sigmund Freud dismissed melancholy as narcissism, and ever since, it’s disappeared into the maw of psychopathology. Mainstream psychology sees it as synonymous with clinical depression.[*1]

Now sensitiveness to the state of mind of the public is a difficult thing to achieve or maintain. Any man can tell you with more or less accuracy and clearness his own reactions on any particular issue. But few men have the time or the interest or the training to develop a sense of what other persons think or feel about the same issue. In his own profession the skilled practitioner is sensitive and understanding. lhe lawyer can tell what argument will appeal to court or jury. “The salesman can tell what points to stress to his prospective buyers. The politician can tell what to emphasize to his audience, but the ability to estimate group reactions on a large scale over a wide geographic and psychological area is a specialized ability which must be developed with the same painstaking self-criticism and with the same dependence on experience that are required for the development of the clinical sense in the doctor or the surgeon. The significant revolution of modern times is not industrial or economic or political, but the revolution which is taking place in the art of creating consent among the governed. Within the life of the new generation now in control of affairs, persuasion has become a self-conscious art and a regular organ of popular government. None of us begins to understand the consequences, but it is no daring prophecy to say that the knowledge of how to create consent will alter every political premise. Under the impact of propaganda, not necessarily in the sinister meaning of the world alone, the only constants of our thinking have become variables. It is no longer possible, for example, to believe in the cardinal dogma of democracy that the knowledge needed for the management of human affairs comes up spontaneously from the human heart. Where we act on that theory we expose ourselves to self-deception and to farms of persuasion that we cannot verify. It has been demonstrated that we cannot rely upon intuition, conscience or the accidents of casual opinion if we are to deal with the world beyond our reach.

Though we have been trained as psychologists, we have each found it necessary to defect from professional interpretations focused entirely on individuals and families, and on mental constructs separated from the cultural, social, and economic worlds in which they are embedded. We do not want families to assume that the role of psychology is to help individuals and families adapt to the status quo when this present order contributes so massively to human misery, psychological or otherwise. Our psychology should not exist in a vacuum of disconnected theory, where classrooms, research, and clinical encounters are considered apart from conflicts and suffering in society, where personal history is severed from the historical context and social institutions one has inherited.

There appears to be a close connection between these skin disorders (acne and warts) and the emotions. As with virtually all of these mind-body processes, there is no laboratory proof of the causative role of emotions, but there is certainly a mountain of clinical evidence. Acne is one of the common "other things" that people with TMS have had or continue to have even while they're having back trouble. And then there's the story of the man who developed an itchy rash under his wedding band that disappeared as soon as he separated from his wife. Other gold rings did not produce a similar rash. It has been suggested that other skin disorders like eczema and psoriasis are related to the emotions. I am inclined to agree but have no evidence one way or the other. (page 195)

The evening with its lamps burning The night with its head in its hands The early morning I look back at the worried parents Wandering through the house What are we going to do The evening of the clinical The night of the psychological The morning facedown in the pillow The experts can handle him The experts have no idea How to handle him There are enigmas in darkness There are mysteries Sent out without searchlights The stars are hiding tonight The moon is cold and stony Behind the clouds Nights without seeing Mornings of the long view It's not a sprint but a marathon Whatever we can do We must do Every morning's resolve But sometimes we suspected He was being punished For something obscure we had done I would never abandon the puzzle Sleeping in the next room But I could not solve it

Most of my patients have already gone through some form of psychotherapeutic treatment, usually with partial or negative results. About a third of my cases are suffering from no clinically definable neurosis, but from the senselessness and emptiness of their lives. It seems to me, however, that this can well be described as the general neurosis of our time. Fully two-thirds of my patients have passed middle age. It is difficult to treat patients of this particular kind by rational methods, because they are in the main socially well-adapted individuals of considerable ability, to whom normalization means nothing. As for so-called normal people, I am even worse off in their regard, for I have no ready-made life-philosophy to hand out to them. In the majority of my cases, the resources of consciousness have been exhausted; the ordinary expression for this situation is: “I am stuck.

The History of Social Anxiety The fact that some people are shyer than others has been observed since ancient times. However, the medical community didn’t become interested in this condition until the 1970s, when Philip Zimbardo founded the Stanford Shyness Clinic. At the time, many professionals believed that shyness was a natural state that children eventually outgrew. Zimbardo showed that shyness actually is a widespread psychological problem that has deep and lasting effects on those who suffer from it. This new awareness led to a great deal of research into the causes and treatment of social anxiety. Today, the condition is in the spotlight. Ads in magazines and commercials on television tell about social anxiety and advertise medications to treat it. People are becoming more open about discussing when they feel anxious and feel less ashamed about asking for help. The time has never been better for you to try to overcome your social anxiety.

I have practiced psychotherapy, family therapy, and hypnotherapy for over 25 years without a single board complaint or law suit by a client. For over three years, however, a group of proponents of the false memory syndrome (FMS) hypothesis, including members, officials, and supporters of the False Memory Syndrome Foundation, Inc., have waged a multi-modal campaign of harassment and defamation directed against me, my clinical clients, my staff, my family, and others connected to me. I have neither treated these harassers or their families, nor had any professional or personal dealings with any of them; I am not related in any way to the disclosures of memories of sexual abuse in these families. Nonetheless, this group disrupts my professional and personal life and threatens to drive me out of business. In this article, I describe practicing psychotherapy under a state of siege and places the campaign against me in the context of a much broader effort in the FMS movement to denigrate, defame, and harass clinicians, lecturers, writers, and researchers identified with the abuse and trauma treatment communities….

Should you operate upon your clients as objects, you risk reducing them to less than human. Following the culture of appropriation and mastery your clients become a kind of extension of yourself, of your ego. In the appropriation and objectification mode, your clients’ well-being and success in treatment reflect well upon you. You “did” something to them, you made them well. You acted upon them and can take the credit for successful therapy or treatment. Conversely, if your clients flounder or regress, that reflects poorly on you. On this side of things the culture of appropriation and mastery says that you are not doing enough. You are not exerting enough influence, technique or therapeutic force. What anxiety this can breed for some clinicians! DBT offers a framework and tools for a treatment that allows clients to retain their full humanity. Through the practice of mindfulness, you can learn to cultivate a fuller presence to the moments of your life, and even with your clients and your work with them. This presence potentiates an encounter between two irreducible human beings, meeting professionally, of course, and meeting humanly. The dialectical framework, which embraces contradictions and gives you a way of seeing that life is pregnant with creative tensions, allows for your discovery of your limits and possibilities, gives you a way of seeing the dynamic nature of reality that is anything but sitting still; shows you that your identity grows from relationship with others, including those you help, that you are an irreducible human being encountering other irreducible human beings who exert influence upon you, even as you exert your own upon them. Even without clinical contrivance.

The psychological impact of trauma in both the military and civilian arenas has been documented for well over 100 years [1], but the validity of the traumatic neuroses and their key symptoms have been continuously questioned. This is particularly true for posttraumatic amnesia and therapeutically recovered traumatic memories. Freud’s [2] abandonment of his seduction theory was followed by decades of denial of sexual trauma in the psychoanalytic and broader sociocultural realms [3]. Concomitant negation of posttraumatic symptomatology was noted in regard to the war neuroses, emanating equally from military, medical and social spheres [4]. Thus, Karon and Widener [5] drew attention to professional abandonment of the literature on posttraumatic amnesia in World War II combatants. They considered this to be due to a collective forgetting, comparable to the repression of soldiers, but instead occurring on account of social prejudices. He further noted that the validity of memories was never challenged at the time since there was ample corroborating evidence. Recent research confirms the findings of earlier investigators such as Janet [6], validating posttraumatic amnesia of both civilian and military origin. Van der Hart and Nijenhuis [7] cited clinical studies reporting total amnesia for combat trauma, experiences in Nazi concentration camps, torture and robbery. There is also increasing evidence for the existence of amnesia for child sexual abuse. Thus, Scheflen and Brown [8] concluded from their analysis of 25 empirical studies that such amnesia is a robust finding. Since then, new studies, for example those of Elliott [9], have appeared supporting their conclusion. This paper examines posttraumatic amnesia in World War I (WWI) combatants. The findings are offered as an historical cross-validation of posttraumatic amnesia in all populations, including those subjected to childhood sexual abuse.

I have chosen to use the terms lesbian existence and lesbian continuum because the word lesbianism has a clinical and limiting ring Lesbian existence suggests both the fact of the historical presence of lesbians and our continuing creation of the meaning of that existence I mean the term lesbian continuum to include a range—through each woman’s life and throughout history—of woman-identified experience; not simply the fact that a woman has had or consciously desired genital sexual experience with another woman. If we expand it to embrace many more forms of primary intensity between and among women, including the sharing of a rich inner life, the bonding against male tyranny, the giving and receiving of practical and political support; if we can also hear in it such associations as marriage resistance and the ‘haggard’ behavior identified by Mary Daly (obsolete meanings ‘intractable,’ ‘willful,’ ‘wanton,’ and ‘unchaste’ a woman reluctant to yield to wooing’)—we begin to grasp breadths of female history and psychology that have lain out of reach as a consequence of limited, mostly clinical, definitions of ‘lesbianism.’ Lesbian existence comprises both the breaking of a taboo and the rejection of a compulsory way of life It is also a direct or indirect attack on male right of access to women But it is more than these, although we may first begin to perceive it as a form of nay-saying to patriarchy, an act or resistance It has of course included role playing, self-hatred, breakdown, alcoholism, suicide, and intrawoman violence; we romanticize at our peril what it means to love and act against the grain, and under heavy penalties; and lesbian existence has been lived (unlike, say, Jewish or Catholic existence) without access to any knowledge of a tradition, a continuity, a social underpinning The destruction of records and memorabilia and letters documenting the realities of lesbian existence must be taken very seriously as a means of keeping heterosexuality compulsory for women, since what has been kept from our knowledge is joy, sensuality, courage, and community, as well as guilt, self-betrayal, and pain.

Virtually every version of CBT for anxiety disorders involves working through what’s called an exposure hierarchy. The concept is simple. You make a list of all the situations and behaviors you avoid due to anxiety. You then assign a number to each item on your list based on how anxiety provoking you expect doing the avoided behavior would be. Use numbers from 0 (= not anxiety provoking at all) to 100 (= you would fear having an instant panic attack). For example, attempting to talk to a famous person in your field at a conference might be an 80 on the 0-100 scale. Sort your list in order, from least to most anxiety provoking. Aim to construct a list that has several avoided actions in each 10-point range. For example, several that fall between 20 and 30, between 30 and 40, and so on, on your anxiety scale. That way, you won’t have any jumps that are too big. Omit things that are anxiety-provoking but wouldn’t actually benefit you (such as eating a fried insect). Make a plan for how you can work through your hierarchy, starting at the bottom of the list. Where possible, repeat an avoided behavior several times before you move up to the next level. For example, if one of your items is talking to a colleague you find intimidating, do this several times (with the same or different colleagues) before moving on. When you start doing things you’d usually avoid that are low on your hierarchy, you’ll gain the confidence you need to do the things that are higher up on your list. It’s important you don’t use what are called safety behaviors. Safety behaviors are things people do as an anxiety crutch—for example, wearing their lucky undies when they approach that famous person or excessively rehearsing what they plan to say. There is a general consensus within psychology that exposure techniques like the one just described are among the most effective ways to reduce problems with anxiety. In clinical settings, people who do exposures get the most out of treatment. Some studies have even shown that just doing exposure can be as effective as therapies that also include extensive work on thoughts. If you want to turbocharge your results, try exposure. If you find it too difficult to do alone, consider working with a therapist.

Treating Abuse Today 3(4) pp. 26-33 TAT: I see the agenda. But let's go back: one of the contentions the therapeutic community has about the Foundation's professed scientific credibility is your use of the term "syndrome." It seems to us that what's happening here is that based solely on anecdotal, unverified reports, the Foundation has started a public relations campaign rather than a bonafide research effort and simply announced to the world that an epidemic of this syndrome exists. The established scientific and clinical organizations are taking you on about this and it's that kind of thing that makes us feel like this effort is not really based on science. Do you have a response to that? Freyd: The response I would make regarding the name of the Foundation is that it will certainly be one of the issues brought up during our scientific meeting this weekend. But let me add that the term, "syndrome," in terms of it being a psychological syndrome, parallels, say, the rape trauma syndrome. Given that and the fact that there are seldom complaints over the use of the term "syndrome" for that, I think that it isn't "syndrome" that's bothering people as much as the term "false." TAT: No. Frankly it's not. It is the term "syndrome." The term false memory is almost 100 years old. It's nothing new, but false memory syndrome is newly coined. Here's our issue with your use of the word "syndrome." The rape trauma syndrome is a good example because it has a very well defined list of signs and symptoms. Having read your literature, we are still at a loss to know what the signs and symptoms of "false memory syndrome" are. Can you tell us succinctly? Freyd: The person with whom I would like to have you discuss that to quote is Dr. Paul McHugh on our advisory board, because he is a clinician. TAT: I would be happy to do that. But if I may, let me take you on a little bit further about this. Freyd: Sure, sure that's fair. TAT: You're the Executive Director of the False Memory Syndrome Foundation - a foundation that says it wants to disseminate scientific information to the community regarding this syndrome but you can't, or won't, give me its signs and symptoms. That is confusing to me. I don't understand why there isn't a list.

Beauty Junkies is the title of a recent book by New York Times writer Alex Kuczynski, “a self-confessed recovering addict of cosmetic surgery.” And, withour technological prowess, we succeed in creating fresh addictions. Some psychologists now describe a new clinical pathology — Internet sex addiction disorder. Physicians and psychologists may not be all that effective in treating addictions, but we’re expert at coming up with fresh names and categories. A recent study at Stanford University School of Medicine found that about 5.5 per cent of men and 6 per cent of women appear to be addicted shoppers. The lead researcher, Dr. Lorrin Koran, suggested that compulsive buying be recognized as a unique illness listed under its own heading in the Diagnostic and Statistical Manual of Mental Disorders, the official psychiatric catalogue. Sufferers of this “new” disorder are afflicted by “an irresistible, intrusive and senseless impulse” to purchase objects they do not need. I don’t scoff at the harm done by shopping addiction — I’m in no position to do that — and I agree that Dr. Koran accurately describes the potential consequences of compulsive buying: “serious psychological, financial and family problems, including depression, overwhelming debt and the breakup of relationships.” But it’s clearly not a distinct entity — only another manifestation of addiction tendencies that run through our culture, and of the fundamental addiction process that varies only in its targets, not its basic characteristics. In his 2006 State of the Union address, President George W. Bush identified another item of addiction. “Here we have a serious problem,” he said. “America is addicted to oil.” Coming from a man who throughout his financial and political career has had the closest possible ties to the oil industry. The long-term ill effects of our society’s addiction, if not to oil then to the amenities and luxuries that oil makes possible, are obvious. They range from environmental destruction, climate change and the toxic effects of pollution on human health to the many wars that the need for oil, or the attachment to oil wealth, has triggered. Consider how much greater a price has been exacted by this socially sanctioned addiction than by the drug addiction for which Ralph and his peers have been declared outcasts. And oil is only one example among many: consider soul-, body-or Nature-destroying addictions to consumer goods, fast food, sugar cereals, television programs and glossy publications devoted to celebrity gossip—only a few examples of what American writer Kevin Baker calls “the growth industries that have grown out of gambling and hedonism.

ever. Amen. Thank God for self-help books. No wonder the business is booming. It reminds me of junior high school, where everybody was afraid of the really cool kids because they knew the latest, most potent putdowns, and were not afraid to use them. Dah! But there must be another reason that one of the best-selling books in the history of the world is Men Are From Mars, Women Are From Venus by John Gray. Could it be that our culture is oh so eager for a quick fix? What a relief it must be for some people to think “Oh, that’s why we fight like cats and dogs, it is because he’s from Mars and I am from Venus. I thought it was just because we’re messed up in the head.” Can you imagine Calvin Consumer’s excitement and relief to get the video on “The Secret to her Sexual Satisfaction” with Dr. GraySpot, a picture chart, a big pointer, and an X marking the spot. Could that “G” be for “giggle” rather than Dr. “Graffenberg?” Perhaps we are always looking for the secret, the gold mine, the G-spot because we are afraid of the real G-word: Growth—and the energy it requires of us. I am worried that just becoming more educated or well-read is chopping at the leaves of ignorance but is not cutting at the roots. Take my own example: I used to be a lowly busboy at 12 East Restaurant in Florida. One Christmas Eve the manager fired me for eating on the job. As I slunk away I muttered under my breath, “Scrooge!” Years later, after obtaining a Masters Degree in Psychology and getting a California license to practice psychotherapy, I was fired by the clinical director of a psychiatric institute for being unorthodox. This time I knew just what to say. This time I was much more assertive and articulate. As I left I told the director “You obviously have a narcissistic pseudo-neurotic paranoia of anything that does not fit your myopic Procrustean paradigm.” Thank God for higher education. No wonder colleges are packed. What if there was a language designed not to put down or control each other, but nurture and release each other to grow? What if you could develop a consciousness of expressing your feelings and needs fully and completely without having any intention of blaming, attacking, intimidating, begging, punishing, coercing or disrespecting the other person? What if there was a language that kept us focused in the present, and prevented us from speaking like moralistic mini-gods? There is: The name of one such language is Nonviolent Communication. Marshall Rosenberg’s Nonviolent Communication provides a wealth of simple principles and effective techniques to maintain a laser focus on the human heart and innocent child within the other person, even when they have lost contact with that part of themselves. You know how it is when you are hurt or scared: suddenly you become cold and critical, or aloof and analytical. Would it not be wonderful if someone could see through the mask, and warmly meet your need for understanding or reassurance? What I am presenting are some tools for staying locked onto the other person’s humanness, even when they have become an alien monster. Remember that episode of Star Trek where Captain Kirk was turned into a Klingon, and Bones was freaking out? (I felt sorry for Bones because I’ve had friends turn into Cling-ons too.) But then Spock, in his cool, Vulcan way, performed a mind meld to determine that James T. Kirk was trapped inside the alien form. And finally Scotty was able to put some dilithium crystals into his phaser and destroy the alien cloaking device, freeing the captain from his Klingon form. Oh, how I wish that, in my youth or childhood,

For some people, anxiety presents when our unconscious pushes through. The repression of sad or angry feelings emerge and the anxiety symptoms, similar to the fight or flight response, protect you from those intense emotions.” Levon didn’t understand at first. It was too clinical. Then she explained it to him in terms that appealed to the psychologically-challenged: when true feelings that are too hard to cope with want to come out—ones that are deeply rooted in our unconscious—they often present in the form of anxiety.

Psychology and Sociology Psychoanalysis deals with individuals, not with groups. Efforts to generalize clinical findings to collective behavior always encounter the difficulty that groups have a life of their own. The collective mind, if there is such a thing, reflects the needs of the group as a whole, not the psychic needs of the individual, which in fact have to be subordinated to the demands of collective living. Indeed it is precisely the subjection of individuals to the group that psychoanalytic theory, through a study of its psychic repercussions, promises to clarify. By conducting an intensive analysis of individual cases that rests on clinical evidence rather than common-sense impressions, psychoanalysis tells us something about the inner workings of society itself, in the very act of turning its back on society and immersing itself in the individual unconscious.

[C]lients seen in public mental health centers and general clinical practices are often more complex and potentially more challenging to work with than those who are screened and selected to participate in randomized clinical trials (RCTs; Briere & Lanktree, 2011; Lanktree et al., 2013; Spinazzola, Blaustein, & van der Kolk, 2005; Westen, Novontny, & Thompson-Brenner, 2004) and may be less responsive to RCT-developed treatment methodologies (Zayfert et al., 2005).

Both experimental and clinical psychology have proved beyond a shadow of a doubt that the human nervous system cannot tell the difference between an actual experience and an experience imagined vividly and in detail.

We cannot learn what causes violence and how we could prevent it as long as we are thinking in the traditional moral and legal terms. The only questions that this way of thinking can ask take the form: "How evil (or heroic) was this particular act of violence, and how much punishment (or reward) does the person who did it deserve?" But even if it were possible to gain the knowledge that would be necessary to answer those questions (which it is not), answers would still not help us in the least to understand what causes violence or how we could prevent it — these are empirical not moral questions. It is only by approaching violence from the point of view of empirical disciplines, as a problem in public health and preventive medicine, including social and preventive psychiatry and psychology, that we can acquire knowledge as to the causes and prevention of violence — by engaging in clinical, experimental, and epidemiological research on violent and non-violent behavior, the people who behave in those ways, and the circumstances under which they do so.

Depression cannot be described in terms of 'normal psychology'; only the somewhat general term of "depressedness" can be understood in the sense of this anergic (i.e. incomprehensible by normal mentality) mood. In mild cases, the patients appear almost more apathetic than actually depressive; in severe cases, however, deep suffering develops.

There are several books that describe the horrendous health effects of snoring and sleep apnea. They explain how these afflictions lead to bed-wetting, attention deficit hyperactivity disorder (ADHD), diabetes, high blood pressure, cancer, and so on. I’d read a report from the Mayo Clinic which found that chronic insomnia, long assumed to be a psychological problem, is often a breathing problem.

No wonder phenomenology could be exciting. It could also be perplexing, and often it was a bit of both. A mixture of excitement and puzzlement was evident in the response of one young German who discovered phenomenology in its early days: Karl Jaspers. In 1913, he was working as a researcher at the Heidelberg Clinic of Psychiatry, having chosen psychology over philosophy because he liked its concrete, applied approach. Philosophy seemed to him to have lost its way, whereas psychology produced definite results with its experimental methods. But then he found that psychology was too workmanlike: it lacked philosophy’s grand ambition. Jaspers was not satisfied by either. Then he heard about phenomenology, which offered the best from both: an applied method, combined with the soaring philosophical aim of understanding the whole of life and experience. He wrote a fan letter to Husserl, but in it admitted that he was not yet quite sure what phenomenology was. Husserl wrote back to him, ‘You are using the method perfectly. Just keep it up. You don’t need to know what it is; that’s indeed a difficult matter.’ In a letter to his parents, Jaspers speculated that Husserl did not know what phenomenology was either. Yet none of this uncertainty could dim the excitement. Like all philosophy, phenomenology made great demands on its practitioners. It required ‘a different thinking’, Jaspers wrote; ‘a thinking that, in knowing, reminds me, awakens me, brings me to myself, transforms me’. It could do all that, and also give results.

According to experts in the Mayo Clinic, positive thinking will enhance your life, minimize depression and stress levels, give you more immunity to the common cold, improve your overall psychological and physical well-being, boost your cardiovascular health and protect you from cardiovascular disease.

Fortunately, I had no idea at the time what a messy business clinical psychology was or I might have opted for pure research, an area where I’d have control over my subjects and variables. Instead, I had to learn how to be flexible as new information trickled in weekly. I had no idea on that first day that psychotherapy wasn’t the psychologist solving problems but rather two people facing each other, week after week, endeavouring to reach some kind of psychological truth we could agree on.

This dynamic, this ‘striving to preserve identity’, however strange the means or effects of such striving, was recognized in psychiatry long ago—and, like so much else, is especially associated with the work of Freud. Thus, the delusions of paranoia were seen by him not as primary but as attempts (however misguided) at restitution, at reconstructing a world reduced by complete chaos.

He faced me as he spoke, was oriented towards me, and yet there was something the matter—it was difficult to formulate. He faced me with his ears, I came to think, but not with his eyes. These, instead of looking, gazing, at me, ‘taking me in’, in the normal way, made sudden strange fixations—on my nose, on my right ear, down to my chin, up to my right eye—as if noting (even studying) these individual features, but not seeing my whole face, its changing expressions, ‘me’, as a whole. I am not sure that I fully realized this at the time—there was just a teasing strangeness, some failure in the normal interplay of gaze and expression. He saw me, he scanned me, and yet...

He recognized a portrait of Einstein because he picked up the characteristic hair and moustache; and the same thing happened with one or two other people. ‘Ach, Paul!’ he said, when shown a portrait of his brother. ‘That square jaw, those big teeth— I would know Paul anywhere!’ But was it Paul he recognized, or one or two of his features, on the basis of which he could make a reasonable guess as to the subject’s identity?

...he approached these faces— even of those near and dear—as if they were abstract puzzles or tests. He did not relate to them, he did not behold. No face was familiar to him, seen as a ‘thou’, being just identified as a set of features, an ‘it’. Thus, there was formal, but no trace of personal, gnosis. And with this went his indifference, or blindness, to expression. A face, to us, is a person looking out—we see, as it were, the person through his persona, his face.

I had stopped at a florist on my way to his apartment and bought myself an extravagant red rose for my buttonhole. Now I removed this and handed it to him. He took it like a botanist or morphologist given a specimen, not like a person given a flower. About six inches in length,’ he commented. ‘A convoluted red form with a linear green attachment.

It’s just like the eating,’ she explained. ‘I put his usual clothes out, in all the usual places, and he dresses without difficulty, singing to himself. He does everything singing to himself. But if he is interrupted and loses the thread, he comes to a complete stop, doesn’t know his clothes—or his own body. He sings all the time—eating songs, dressing songs, bathing songs, everything. He can’t do anything unless he makes it a song.

Can you not see artistic development— how he renounced the realism of his earlier years, and advanced into abstract, nonrepresentational art?’ He had indeed moved from realism to nonrepresentation to the abstract, yet this was not the artist, but the pathology, advancing—advancing towards a profound visual agnosia, in which all powers of representation and imagery, all sense of the concrete, all sense of reality, were being destroyed. This wall of paintings was a tragic pathological exhibit, which belonged to neurology, not art. And yet, I wondered, was she not partly right? For there is often a struggle, and sometimes, even more interestingly, a collusion between the powers of pathology and creation.

Jimmie both was and wasn’t aware of this deep, tragic loss in himself, loss of himself. (If a man has lost a leg or an eye, he knows he has lost a leg or an eye; but if he has lost a self—himself—he cannot know it, because he is no longer there to know it.)

Clearly, passionately, he wanted something to do: he wanted to do, to be, to feel—and could not; he wanted sense, he wanted purpose...