Great Psychotherapy Quotes

One is a great deal less anxious if one feels perfectly free to be anxious, and the same may be said of guilt.

if it weren’t for errant passion, death, despair, and loss, the great bulk of art would never have been born.

Surely this sense of betrayal is what Robert Frost had in mind when he wrote: "Forgive, O Lord, my little jokes on Thee/And I'll forgive Thy great big one on me." io

There are a great number of ego defenses, and the combinations and circumstances in which we use them reflect on our personality. Indeed, one could go so far as to argue that the self is nothing but the sum of its ego defenses, which are constantly shaping, upholding, protecting, and repairing it. The self is like a cracked mask that is in constant need of being pieced together. But behind the mask there is nobody at home.

Psychotherapy/educational cults, which have enjoyed great popularity, purport to give the participant “insight” and “enlightenment.” Commercial cults play on people’s desires to make money. They typically promise riches but actually enslave people, and compel them to turn money over to the group. None of these destructive cults deliver what they promise and glittering dreams eventually turn out to be paths to psychological enslavement.

There’s no reason, on paper at least, why I need these pills to get through life. I had a great childhood, loving parents, the whole package. I wasn’t beaten, abused, or expected to get nothing but As. I had nothing but love and support, but that wasn’t enough somehow. My friend Erin says we all have demons inside us, voices that whisper we’re no good, that if we don’t make this promotion or ace that exam we’ll reveal to the world exactly what kind of worthless sacks of skin and sinew we really are. Maybe that’s true. Maybe mine just have louder voices. But I don’t think it’s as simple as that. The depression I fell into after university wasn’t about exams and self-worth, it was something stranger, more chemical, something that no talking cure was going to fix. Cognitive behavioral therapy, counseling, psychotherapy—none of it really worked in the way that the pills did. Lissie says she finds the notion of chemically rebalancing your mood scary, she says it’s the idea of taking something that could alter how she really is. But I don’t see it that way; for me it’s like wearing makeup—not a disguise, but a way of making myself more how I really am, less raw. The best me I can be.

A great many of our patients have conflicts in the realm of intimacy, and obtain help in therapy sheerly through experiencing an intimate relationship with the therapist. Some fear intimacy because they believe there is something basically unacceptable about them, something repugnant and unforgivable, Given this, the act of revealing oneself fully to another and still being accepted may be the major vehicle of therapeutic help.

There is a difference between what I actually want and what I want to have fantasies about. (...) There is a part of my imagination which is a playground, a playground in which I am queen. It fulfils my need to have a fantasy land, and that need may be born of creativity as well as lack or repression. Our fantasies are about exploration and experimentation and the power of the imagination. Looked at intelligently, they can reveal a great deal. But there is a difference between fantasising and thinking about our hopes for the future.

Yes, great looks will get a woman’s attention, but in the end she wants to be the pretty one.

One of the great paradoxes of life is that self-awareness breeds anxiety

A great deal of distress could be avoided, then, if we could learn to withdraw ‘morality’ from the private world of our feelings and to concentrate instead on the rights and wrongs of our conduct.

Great literature survives, as Freud pointed out in his discussion of Oedipus Rex,18 because something in the reader leaps out to embrace its truth. The truth of fictional characters moves us because it is our own truth.

The, world is not, as a great existential philosopher has seen it, a manuscript written in a code we have to decipher. No, the world is no manuscript which we are asked to decipher, but cannot; it is, rather, a record which we have to dictate ourselves.

In psychotherapy, a child is never told, “You are a good little boy.” “You are great.” Judgmental and evaluative praise is avoided. Why? Because it is not helpful. It creates anxiety, invites dependency, and evokes defensiveness. It is not conducive to self-reliance, self-direction, and self-control, qualities that demand freedom from outside judgment. They require reliance on inner motivation and evaluation. Children need to be free from the pressure of evaluative praise so that others do not become their source of approval. Isn't

To explain everything as the result of a single factor which, moreover, is fixed by fate, has a great advantage. For then no task seems to be assigned to one; one has nothing to do but wait for the imaginary moment when the curing of this one factor will cure everything else.

The I Ching insists upon self-knowledge throughout. The method by which this is to be achieved is open to every kind of misuse, and is therefore not for the frivolous-minded and immature; nor is it for intellectualists and rationalists. It is appropriate only for thoughtful and reflective people who like to think about what they do and what happens to them -- a predilection not to be confused with the morbid brooding of the hypochondriac. As I have indicated above, I have no answer to the multitude of problems that arise when we seek to harmonize the oracle of the I Ching with our accepted scientific canons. But needless to say, nothing "occult" is to be inferred. My position in these matters is pragmatic, and the great disciplines that have taught me the practical usefulness of this viewpoint are psychotherapy and medical psychology. Probably in no other field do we have to reckon with so many unknown quantities, and nowhere else do we become more accustomed to adopting methods that work even though for a long time we may not know why they work. Unexpected cures may arise from questionable therapies and unexpected failures from allegedly reliable methods. In the exploration of the unconscious we come upon very strange things, from which a rationalist turns away with horror, claiming afterward that he did not see anything. The irrational fullness of life has taught me never to discard anything, even when it goes against all our theories (so short-lived at best) or otherwise admits of no immediate explanation. It is of course disquieting, and one is not certain whether the compass is pointing true or not; but security, certitude, and peace do not lead to discoveries.

Therapy, for us, is related to a growth process that takes place naturally in lives and in families. We assume that the will and the need to expand and integrate experience are universal; and the family that enters psychotherapy is simply one in which that natural process has become blocked. Therapy is a catalytic “agent” which we hope will help the family unlock their own resources. Therefore, we place great emphasis on the family’s own initiative, assuming that if they cannot discover their own power to change themselves, therapy will have no enduring effect. Like

centered psychotherapy.) At the same time, logotherapy defocuses all the vicious-circle formations and feedback mechanisms which play such a great role in the development of neuroses. Thus, the typical self-centeredness of the neurotic is broken up instead of being continually fostered and reinforced.

The Bible warns about religious transformations that may appear good and therefore deceive many: 'For Satan himself is transformed into an angel of light. Therefore it is no great thing if his ministers also be transformed as the ministers of righteousness; whose end shall be according to their works.' (2 Corinthians 11:13-14)

Societal pressures work to pull you up to the line of psychological adequacy, and psychotherapy can be used when society falls short. But these aims are far too low. Falling within the current normal range of psychological health is nothing to aspire to. We are interested in far exceeding this line - in psychological greatness.

One of the blessings of easy communication between the great cultures of the world is that partisanship in religion and philosophy is ceasing to be intellectually respectable. Pure religions are as rare as pure cultures, and it is mentally crippling to suppose that there must be a number of fixed bodies of doctrine among which one must choose, where choice means accepting the system entirely or not at all. [...]. Those who rove freely through the various traditions, accepting what they can use and rejecting what they cannot, are condemned as undisciplined syncretists. But the use of one's reason is not a lack of discipline, not is there any important religion which is not itself a syncretism, a "growing up together" of ideas and practices of diverse origin.

However one may interpret this culturally, the upshot is the same: people carry within them a great number of wishes to which they react passively and which they hide. Stoicism, in our day, is not strength to overcome wishes, but to hide them. To a patient who, let us say, is interminably rationalizing and justifying this and that, balancing one thing against another as though life were a tremendous market place where all the business is done on paper and tickertape and there are never any goods, I sometimes have the inclination in psychotherapy to shout out, “Don't you ever want anything?” But I don't cry out, for it is not difficult to see that on some level the patient does want a good deal; the trouble is he has formulated and reformulated it, until it is the “rattling of dry bones,” as Eliot puts it. Tendencies have become endemic in our culture for our denial of wishes to be rationalized and accepted with the belief that this denial of the wish will result in its being fulfilled. And whether the reader would disagree with me on this or that detail, our psychological problem is the same: it is necessary for us to help the patient achieve some emotional viability and honesty by bringing out his wishes and his capacity to wish. This is not the end of therapy but it is an essential starting point.

My great-grandmother raised nine children to adulthood in a world without supermarkets, refrigerators, or washing machines. She did not have much time to search for “unconditional love” or “commitment,” because she was too busy practicing it herself. Most of her life was taken up with the unceasing procurement and preparation of food for her husband and children. Yet she got along fine without romance novels, child custody gamesmanship, or psychotherapy; she was, I am told, always cheerful and contented. This is something beyond the imagination of barren, resentful feminists. It is the satisfaction which results from knowing that one is carrying out a worthwhile task to the best of one’s abilities, a satisfaction nothing else in life can give. We are here today because this is the way women used to behave; we cannot continue long under the present system of rotating polyandry.

there is something in it, inasmuch as logotherapy, in comparison with psychoanalysis, is a method less retrospective and less introspective. Logotherapy focuses rather on the future, that is to say, on the meanings to be fulfilled by the patient in his future. (Logotherapy, indeed, is a meaning-centered psychotherapy.) At the same time, logotherapy defocuses all the vicious-circle formations and feedback mechanisms which play such a great role in the development of neuroses.

I believe that all learning is relational. Teachers who try to teach without first having created a positive relationship with their students may only be wasting much of their great knowledge. Establish an encouraging relationship with a child, and you can teach him or her almost anything. Establish a strong therapeutic alliance with your client, and he or she might even be willing to build new neuronal pathways that indicate that trust, love, and unconditional worth are possible for him or her too.

logotherapy, in comparison with psychoanalysis, is a method less retrospective and less introspective. Logotherapy focuses rather on the future, that is to say, on the meanings to be fulfilled by the patient in his future. (Logotherapy, indeed, is a meaning-centered psychotherapy.) At the same time, logotherapy defocuses all the vicious-circle formations and feedback mechanisms which play such a great role in the development of neuroses. Thus, the typical self-centeredness of the neurotic is broken up instead of being continually fostered and reinforced.

I started to question what was being taught—I didn’t get much guidance in medical school or residency on what to do when your patient can’t pay for health insurance or when she has lost childcare for the third time in two months and is being fired from her job. Instead, I was taught to prescribe medications or provide psychotherapy for issues that were clearly systemic. While there is certainly a great need for both of these medical interventions, the lack of attention to the inhumanity of our social policies left me feeling powerless—just like my patients.

One of the great paradoxes of life is that self-awareness breeds anxiety. Fusion eradicates anxiety in a radical fashion—by eliminating self-awareness. The person who has fallen in love, and entered a blissful state of merger, is not self-reflective because the questioning lonely I (and the attendant anxiety of isolation) dissolve into the we. Thus one sheds anxiety but loses oneself. This is precisely why therapists do not like to treat a patient who has fallen in love. Therapy and a state of love-merger are incompatible because therapeutic work requires a questioning self-awareness and an anxiety that will ultimately serve as guide to internal conflicts.

When problems of transference are involved, as they usually are, psychotherapy is, among other things, a process of map-revising. Patients come to therapy because their maps are clearly not working. But how they may cling to them and fight the process every step of the way! Frequently their need to cling to their maps and fight against losing them is so great that therapy becomes impossible, as it did in the case of the computer technician. Initially he requested a Saturday appointment. After three sessions he stopped coming because he took a job doing lawn-maintenance work on Saturdays and Sundays. I offered him a Thursday-evening appointment. He came for two sessions and then stopped because he was doing overtime work at the plant. I then rearranged my schedule so I could see him on Monday evenings, when, he had said, overtime work was unlikely. After two more sessions, however, he stopped coming because Monday-night overtime work seemed to have picked up. I confronted him with the impossibility of doing therapy under these circumstances. He admitted that he was not required to accept overtime work. He stated, however, that he needed the money and that the work was more important to him than therapy. He stipulated that he could see me only on those Monday evenings when there was no overtime work to be done and that he would call me at four o’clock every Monday afternoon to tell me if he could keep his appointment that evening. I told him that these conditions were not acceptable to me, that I was unwilling to set aside my plans every Monday evening on the chance that he might be able to come to his sessions. He felt that I was being unreasonably rigid, that I had no concern for his needs, that I was interested only in my own time and clearly cared nothing for him, and that therefore I could not be trusted. It was on this basis that our attempt to work together was terminated, with me as another landmark on his old map. The problem of transference is not simply a

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.

depression in its major stages possesses no quickly available remedy: failure of alleviation is one of the most distressing factors of the disorder as it reveals itself to the victim, and one that helps situate it squarely in the category of grave diseases. Except in those maladies strictly designated as malignant or degenerative, we expect some kind of treatment and eventual amelioration, by pills or physical therapy or diet or surgery, with a logical progression from the initial relief of symptoms to final cure. Frighteningly, the layman-sufferer from major depression, taking a peek into some of the many books currently on the market, will find much in the way of theory and symptomatology and very little that legitimately suggests the possibility of quick rescue. Those that do claim an easy way out are glib and most likely fraudulent. There are decent popular works which intelligently point the way toward treatment and cure, demonstrating how certain therapies—psychotherapy or pharmacology, or a combination of these—can indeed restore people to health in all but the most persistent and devastating cases; but the wisest books among them underscore the hard truth that serious depressions do not disappear overnight. All of this emphasizes an essential though difficult reality which I think needs stating at the outset of my own chronicle: the disease of depression remains a great mystery. It has yielded its secrets

Logotherapy focuses rather on the future, that is to say, on the meanings to be fulfilled by the patient in his future. (Logotherapy, indeed, is a meaning-centered psychotherapy.) At the same time, logotherapy defocuses all the vicious-circle formations and feedback mechanisms which play such a great role in the development of neuroses. Thus, the typical self-centeredness of the neurotic is broken up instead of being continually fostered and reinforced. To be sure, this kind of statement is an oversimplification; yet in logotherapy the patient is actually confronted with and reoriented toward the meaning of his life. And to make him aware of this meaning can contribute much to his ability to overcome his neurosis.

In supportive work, the therapist cedes great control to the patient. It may seem otherwise. The therapist is setting limits, perhaps implicitly commenting on the patient's behavior or sense of self, and so forth, and on the surface it seems that the therapist is taking responsibility for the patient's progress. but all this activity leads nowhere except, if we succeed, to stability. In supportive therapy, change arises in a more or less miraculous way , through the patient's suddenly feeling secure enough to move in a certain direction, perhaps one unanticipated by the therapist. It is this pathless quality of supportive work - the degree of blind faith it requires of the therapist - that makes it most uncomfortable.

As soon as ever a philosophy begins to believe in itself, it always creates the world in its own image. It cannot do otherwise. Philosophy is this tyrannical impulse itself, the most spiritual iteration of the Will to Power, the Will to 'creation of the world anew', the Will to the causa prima. As Philosophies emerge from the cave of shadows & symbols, they insist this world too is the work of symbol & shadow; a mystery to be solved. But we cannot know our world in any empirical sense; the five we have been given, allow us to see a minute fraction of the electromagnetic spectrum, & our senses of smell, taste, & hearing leave us no better off than the three blind English scholars, confronted with an African Elephant, something their learning has failed to acquaint them with. As they each report from their stations around the beast, one of them gropes the tail, certain he holds a vine. Another wrestles with the powerful trunk, equally certain it must be a python, or some other breed of tree-dwelling snake, just as their third peer has examined the strange bark of the animal's leg. Together they conclude that even without their eyes, tactility & logic have revealed a jungle tree, it's branches dangling vines and a powerful snake. In passing, he had even cheated, feeling one of its great, broad ears, which could only logically a great, broad, leaf, swaying in the breeze. Two of the three scholars declared the 'truth' a prank to discredit them. We are those blind men, blind to the realities that science has often flawed & misleading methods of 'seeing' the whole elephant. But science remains a tool; the most powerful tool we possess in freeing ourselves from the willful blindness of religion & political faith, but a tool nonetheless. It will have to evolve, & avoid the dogmatic attitudes which already corrupt it. The name of science is given to the pseudo-science of psychology & psychotherapy, which certainly promise to be useful down the road, but are incapable of producing repeatable results, and fails even to produce identical variables. Everything about Psychology & the social 'sciences' belong in the realm of Philosophy, but weakness & corruption, followed by the call of greed, power, & control have allowed this intellectual toxin to exert a dangerous influence; next to Religious cults, Psychology-based cults like NXIM are growing rapidly.

The predominant thoughts and feelings of a pregnant woman are lodged in some of the major chakras of the unborn baby. They will therefore affect the character of the unborn baby. To produce better babies, it is very important for a pregnant woman to see and hear things that are beautiful, inspiring, and strong. The feelings and thoughts should be harmonious and progressive or positive. Anger, pessimism, hopelessness, injurious words, negative feelings and thoughts should be avoided. It is advisable for a pregnant mother to read books that are inspirational like the biographies of great yogis or great people, books on spiritual teachings, mathematics, sciences, business and languages. All of these will have beneficial effects on the unborn baby and will tend to make the baby not only spiritual, but also sharp-minded and practical.

Although psychotherapy and writing are distinct in many ways, they are two fields whose great resource is the vast plains of the unconscious mind and how this landscape gets translated into words. As a writer, you are often asking your mind to dream while awake, and if remembering dreams is difficult in general, then it seems to follow that it would be sometimes grueling to conjure up the murky depths on call, eyes open. (Robert M. Young) calls it madness, which is a strong word, but it's not a bad one in exaggeration, because he's talking about creating a safe and bound space in which to explore all sorts of darknesses that collect in the recesses of the mind. He's talking about what we do not understand, or know about, or have control over. And the unconscious, if treated well, is the writer's very good friend. Allowing it room is crucial. Allowing it structure can be the safest way to access it without feeling overwhelmed.

Far away in the heavenly abode of the great god Indra, there is a wonderful net that has been hung by some cunning artificer in such a manner that it stretches out infinitely in all directions. In accordance with the extravagant tastes of deities, the artificer has hung a single glittering jewel in each “eye” of the net, and since the net itself is infinite in all dimensions, the jewels are infinite in number. There hang the jewels, glittering like stars of the first magnitude, a wonderful sight to behold. If we now arbitrarily select one of these jewels for inspection and look closely at it, we will discover that in its polished surface there are reflected all the other jewels in the net, infinite in number. Not only that, but each of the jewels reflected in this one jewel is also reflecting all the other jewels, so that there is an infinite reflecting process occurring…. [I]t symbolizes a cosmos in which there is an infinitely repeated interrelationship among all the members of the cosmos. This relationship is said to be one of simultaneous mutual identity and mutual inter-causality. (Francis Cook)56

Commercial industrialism promised Western man a paradise on earth, described in great detail by the Hollywood Myth, that replaced the paradise in heaven of the Christian myth. And now psychology must replace them both with the myth of paradise through self-knowledge. This is the promise of psychology, and for the most part the psychotherapists are obliged to live it and embody it. But it was Rank who saw how false this claim is. "Psychology as self-knowledge is self-deception," he said, because it does not give what men want, which is immortality. Nothing could be plainer. When the patient emerges from his protective cocoon he gives up the reflexive immortality ideology that he has lived under-both in its personal-parental form (living in the protective powers of the parents or their surrogates) and in its cultural causa-sui form (living by the opinions of others and in the symbolic role-dramatization of the society). What new immortality ideology can the self-knowledge of psychotherapy provide to replace this? Obviously, none from psychology-unless, said Rank, psychology itself become the new belief system.

We are all already dying, and we will be dead for a long time. 5. Nothing lasts. 6. There is no way of getting all you want. 7. You can’t have anything unless you let go of it. 8. You only get to keep what you give away. 9. There is no particular reason why you lost out on some things. 10. The world is not necessarily just. Being good often does not pay off and there is no compensation for misfortune. 11. You have a responsibility to do your best nonetheless. 12. It is a random universe to which we bring meaning. 13. You don’t really control anything. 14. You can’t make anyone love you. 15. No one is any stronger or any weaker than anyone else. 16. Everyone is, in his own way, vulnerable. 17. There are no great men. 18. If you have a hero, look again: you have diminished yourself in some way. 19. Everyone lies, cheats, pretends (yes, you too, and most certainly I myself). 20. All evil is potential vitality in need of transformation. 21. All of you is worth something, if you will only own it. 22. Progress is an illusion. 23. Evil can be displaced but never eradicated, as all solutions breed new problems. 24. Yet it is necessary to keep on struggling toward solution. 25. Childhood is a nightmare.

Psychoanalysis has suffered the accusation of being “unscientific” from its very beginnings (Schwartz, 1999). In recent years, the Berkeley literary critic Frederick Crews has renewed the assault on the talking cure in verbose, unreadable articles in the New York Review of Books (Crews, 1990), inevitably concluding, because nothing else really persuades, that psychoanalysis fails because it is unscientific. The chorus was joined by philosopher of science, Adolf Grunbaum (1985), who played both ends against the middle: to the philosophers he professed specialist knowledge of psychoanalysis; to the psychoanalysts he professed specialist knowledge of science, particularly physics. Neither was true (Schwartz, 1995a,b, 1996a,b, 2000). The problem that mental health clinicians always face is that we deal with human subjectivity in a culture that is deeply invested in denying the importance of human subjectivity. Freud’s great invention of the analytic hour allows us to explore, with our clients, their inner worlds. Can such a subjective instrument be trusted? Not by very many. It is so dangerously close to women’s intuition. Socalled objectivity is the name of the game in our culture. Nevertheless, 100 years of clinical practice have shown psychoanalysis and psychotherapy not only to be effective, but to yield real understandings of the dynamics of human relationships, particularly the reality of transference–countertransference re-enactments now reformulated by our neuroscientists as right brain to right brain communication (Schore, 1999).

I well remember the first great hemp shop that was opened in San Francisco around 1976. It was essentially a long wooden bar with stools for the customers. On the bar itself were a few large crocks containing the basic and cheaper forms of the weed—Panama Red, Acapulco Gold, Indian Ganja, and Domestic Green. But against the wall behind the bar stood a long cabinet furnished with hundreds of small drawers that a local guitar maker had decorated with intricate ivory inlays in the Italian style. Each drawer carried a label indicating the precise field and year of the product, so that one could purchase all the different varieties from Mexico, Lebanon, Morocco, Egypt, India, and Vietnam, as well as the carefully tended plants of devout cannabinologists here at home. Business was conducted with leisure and courtesy, and the salesmen offered small samples for testing at the bar, along with sensitive and expert discussion of their special effects. I might add that the stronger psychedelics, such as LSD, were coming to be used only rarely—for psychotherapy, for retreats in religious institutions, and in our special hospitals for the dying.

The first is that fourteen major mental illnesses are now treatable. Two of them are curable, either by specific forms of psychotherapy or specific drugs. The two curable ones—people always ask—are probably panic disorder and blood and injury phobia. So the first great thing that psychology and psychiatry did in our lifetime was to be able to relieve an enormous amount of suffering.

given a clear enough understanding of the causes of distress – an initial liberating break from the mystifying production of a century of psychology – there is not a great deal of need for psychotherapy itself.

The lesson for psychotherapy is that the therapist may well have as great an impact through her presence as she does through her problem-solving skills. Especially when the root of the patient’s emotional predicament lies in the basic fault, in experiences that were preverbal or unremembered and that left traces in the form of absence or emptiness, the therapist’s ability to fill the present moment with relaxed attentiveness is crucial. It is not just that such patients tend to be extraordinarily sensitive to any falseness in relating, but that they need this kind of attention in order to let themselves feel the gap within themselves. It is much too threatening otherwise.

Each person is an island unto himself, in a very real sense; and he can only build bridges to other islands if he is first of all willing to be himself and permitted to be himself. So I find that when I can accept another person, which means specifically accepting the feelings and attitudes and beliefs that he has as a real and vital part of him, then I am assisting him to become a person: and there seems to me great value in this.

As I look at it now, I was peeling off layer after layer of defenses. I’d build them up, try them, and then discard them when you remained the same. I didn’t know what was at the bottom and I was very much afraid to find out, but I had to keep on trying. At first I felt there was nothing within me—just a great emptiness where I needed and wanted a solid core. Then I began to feel that I was facing a solid brick wall, too high to get over and too thick to go through. One day the wall became translucent, rather than solid. After this, the wall seemed to disappear but beyond it I discovered a dam holding back violent, churning waters. I felt as if I were holding back the force of these waters and if I opened even a tiny hole I and all about me would be destroyed in the ensuing torrent of feelings represented by the water. Finally I could stand the strain no longer and I let go. All I did, actually, was to succumb to complete and utter self pity, then hate, then love. After this experience, I felt as if I had leaped a brink and was safely on the other side, though still tottering a bit on the edge. I don’t know what I was searching for or where I was going, but I felt then as I have always felt whenever I really lived, that I was moving forward.

began this book by observing that death anxiety rarely enters the discourse of psychotherapy. Therapists avoid the topic for a number of reasons: they deny the presence or the relevance of death anxiety; they claim that death anxiety is, in fact, anxiety about something else; they may fear igniting their own fears; or they may feel too perplexed or despairing about mortality. I hope that I have, in these pages, conveyed the necessity and the feasibility of confronting and exploring all fears, even the darkest ones. But we need new tools-a different set of ideas and a different type of therapist-patient relationship. I suggest that we attend to the ideas of great thinkers who have faced death forthrightly and that we build a therapeutic relationship based on the existential facts of life. Everyone is destined to experience both the exhilaration of life and the fear of mortality.

Every psychotherapist not only has his own method—he himself is that method...The great healing factor in psychotherapy is the doctor’s personality” (1945, p. 88).

Logotherapy focuses rather on the future, that is to say, on the meanings to be fulfilled by the patient in his future. (Logotherapy, indeed, is a meaning-centered psychotherapy.) At the same time, logotherapy defocuses all the vicious-circle formations and feedback mechanisms which play such a great role in the development of neuroses. Thus, the typical self-centeredness of the neurotic is broken up instead of being continually fostered and reinforced. To be sure, this kind of statement is an oversimplification; yet in logotherapy the patient is actually confronted with and reoriented toward the meaning of his life. And to make him aware of this meaning can contribute much to his ability to overcome his neurosis.

Logotherapy focuses rather on the future, that is to say, on the meanings to be fulfilled by the patient in his future. (Logotherapy, indeed, is a meaning-centered psychotherapy.) At the same time, logotherapy defocuses all the vicious-circle formations and feedback mechanisms which play such a great role in the development of neuroses. Thus, the typical self-centeredness of the neurotic is broken up instead of being continually fostered and reinforced. To be sure, this kind of statement is an oversimplification; yet in logotherapy the patient is actually confronted with and reoriented toward the meaning of his life. And to make him aware of this meaning can contribute much to his ability to overcome his neurosis. Let me explain why I have employed the term “logotherapy” as the name for my theory. Logos is a Greek word which denotes “meaning.” Logotherapy, or, as it has been called by some authors, “The Third Viennese School of Psychotherapy,” focuses on the meaning of human existence as well as on man’s search for such a meaning. According to logotherapy, this striving to find a meaning in one’s life is the primary motivational force in man. That is why I speak of a will to meaning in contrast to the pleasure principle (or, as we could also term it, the will to pleasure) on which Freudian psychoanalysis is centered, as well as in contrast to the will to power on which Adlerian psychology, using the term “striving for superiority,” is focused.

In families in which parents are overbearing, rigid, and strict, children grow up with fear and anxiety. The threat of guilt, punishment, the withdrawal of love and approval, and, in some cases, abandonment, force children to suppress their own needs to try things out and to make their own mistakes. Instead, they are left with constant doubts about themselves, insecurities, and unwillingness to trust their own feelings. They feel they have no choice and as we have shown, for many, they incorporate the standards and values of their parents and become little parental copies. They follow the prescribed behavior suppressing their individuality and their own creative potentials. After all, criticism is the enemy of creativity. It is a long, hard road away from such repressive and repetitive behavior. The problem is that many of us obtain more gains out of main- taining the status quo than out of changing. We know, we feel, we want to change. We don’t like the way things are, but the prospect of upsetting the stable and the familiar is too frightening. We ob- tain “secondary gains” to our pain and we cannot risk giving them up. I am reminded of a conference I attended on hypnosis. An el- derly couple was presented. The woman walked with a walker and her husband of many years held her arm as she walked. There was nothing physically wrong with her legs or her body to explain her in- ability to walk. The teacher, an experienced expert in psychiatry and hypnosis, attempted to hypnotize her. She entered a trance state and he offered his suggestions that she would be able to walk. But to no avail. When she emerged from the trance, she still could not, would not, walk. The explanation was that there were too many gains to be had by having her husband cater to her, take care of her, do her bidding. Many people use infirmities to perpetuate relationships even at the expense of freedom and autonomy. Satisfactions are derived by being limited and crippled physically or psychologically. This is often one of the greatest deterrents to progress in psychotherapy. It is unconscious, but more gratification is derived by perpetuating this state of affairs than by giving them up. Beatrice, for all of her unhappiness, was fearful of relinquishing her place in the family. She felt needed, and she felt threatened by the thought of achieving anything 30 The Self-Sabotage Cycle that would have contributed to a greater sense of independence and self. The risks were too great, the loss of the known and familiar was too frightening. Residing in all of us is a child who wants to experiment with the new and the different, a child who has a healthy curiosity about the world around him, who wants to learn and to create. In all of us are needs for security, certainty, and stability. Ideally, there develops a balance between the two types of needs. The base of security is present and serves as a foundation which allows the exploration of new ideas and new learning and experimenting. But all too often, the security and dependency needs outweigh the freedom to explore and we stifle, even snuff out, the creative urges, the fantasy, the child in us. We seek the sources that fill our dependency and security needs at the expense of the curious, imaginative child. There are those who take too many risks, who take too many chances and lose, to the detriment of all concerned. But there are others who are risk-averse and do little with their talents and abilities for fear of having to change their view of themselves as being the child, the dependent one, the protected one. Autonomy, independence, success are scary because they mean we can no longer justify our needs to be protected. Success to these people does not breed success. Suc- cess breeds more work, more dependence, more reason to give up the rationales for moving on, away from, and exploring the new and the different.

But as the correspondence progresses, it becomes obvious that now, unlike earlier with his mother, he can perceive and articulate his needs more and more clearly, that although he is in constant danger of subordinating his need to be a writer and to be alone to bourgeois ideals of familial happiness, he never succumbs to this danger. In the end, he knows he can never give up his writing without giving up himself, and he accepts the consequences. Since it is not possible for him to go on writing in the world from which he comes without suffering from guilt feelings, he pays for his decision by becoming ill. 5. Kafka's insight into the origins of his tuberculosis can help us in our attempts to understand psychosomatic illnesses and their societal context. Don't we as therapists make it difficult for patients to live their own lives if we have preconceived ideas about what constitutes happiness, psychic health, social commitment, altruism and goodness in a person? According to these conventional standards, still very prevalent today, Franz Kafka was a neurotic or an eccentric, whom a psychotherapist would be tempted to "socialize" in order to enable him to marry Felice. One of my goals in this chapter is to make clear how absurd such an attempt would be. A visionary of rare greatness and dept came into being, and it is obvious that his attempts to adhere to bourgeois norms were bound to fail. Whether humankind cares to pay heed or not, the prophetic power of "In the Penal Colony" endures (...) because he took his own experiences seriously and thought them through to their bitter end. Advocates of manipulative strategies in psychotherapy could counter my views by saying that not everyone has the talent of a Franz Kafka and that most people seek help because they would like to get along better with others, because they suffer from their symptoms, want to improve their relationships, cannot being themselves to marry, and the like. I would reply that these were precisely the complains Kafka had. It would be disastrous, however, not to perceive the longing to find one's true self inherent in these complains.

Without a coherent sense of a self, without the order that produces our identity, the world around us will also become more chaotic and feel less amenable to our wants and needs, or as Jean Piaget explains: “We organize our worlds by first organizing ourselves.” If the shocks to the patterns of our life are serious enough, and if we cannot find a way to absorb them, we become susceptible to a psychological breakdown due to the intense emotionality that arises in the face of a disintegrating self: “When novel experiences greatly exceed the individual’s capacities to balance, feelings of being overwhelmed are common. Episodic or chronic disorder and “breakdown” may result.” Michael Mahoney, Constructive Psychotherapy

Traditional psychotherapy gives “problems” great reality. An enormous amount of time and energy is frequently expended trying to get rid of emotions that would simply pass through, like changing weather, if we weren’t judging them to be a problem to be solved, or a statement about a “me” rather than about a moment. Years can be spent trying to change a negative self-image into a positive one without ever questioning whether an image is really who we are. Clients want to feel better, and they come to a therapist in order to effect that change. That is fine. But while a positive self-image may feel better, it is just as limiting, untrue, and temporary as any other image. What is here beneath the image? “What is actually true?” becomes a much more interesting question than “How can I manipulate life, ‘me,’ ‘you,’ or ‘them’ to feel/be a certain way?

Jung was wholehearted in his view that the analyst’s personality is central to the success of an analysis: “Every psychotherapist not only has his own method—he himself is that method . . . the great healing factor in psychotherapy is the doctor’s personality.” He also stressed the equality of the analytic relationship, “in which the doctor, as a person, participates just as much as the patient. . . . We could say without too much exaggeration that a good half of every treatment that probes at all deeply consists in the doctor examining himself, for only what he can put right in himself can he hope to put right in the patient.

The first and foremost task for the therapist is to create an accepting and empathic context, which in itself has great therapeutic value because for many people it is a novel and deeply gratifying experience to be accepted and listened to respectfully.

There is one final reason for putting out this book, a motive which means a great deal to me. It has to do with the great, in fact the desperate, need of our times for more basic knowledge and more competent skills in dealing with the tensions in human relationships.

Words were originally magic, and the word retains much of its old magical powers even today,” Freud wrote in 1920. “Therefore let us not underestimate the use of words in psychotherapy.

And then, after years of being dismissed as a soft science, talk therapy, too, has seen a reconsideration as studies have shown that for some people, therapy creates profound changes in the brain—as pronounced, in some cases, as psychiatric medication. “Psychotherapy is a biological treatment, a brain therapy,” said Nobel Prize–winning psychiatrist and neuroscientist Eric Kandel in 2013. “It produces lasting, detectable physical changes

A two-year government-funded study published in the American Journal of Psychiatry has shown that early intervention after “first breaks”—or the first time experiencing the profound symptoms of serious mental illness—involving antipsychotic medication management combined with a “comprehensive, multi-element approach,” which includes family support and psychotherapy, created the best outcomes.