Goals in Therapy

Our goal in therapy is determined by our concepts of emotional health and neurosis as well as by our basic view of human nature. Emotional health, as seen from a holistic-dynamic viewpoint, is much more than mere absence of neurotic anxiety and symptoms. The wisdom of our language points the way to a more comprehensive concept. “Health” is derived from “hal,” “hale,” which means whole. To heal means essentially to help a patient to become a whole, an in-dividual, no longer divided by acquired inner conflict, able to experience and accept his whole self and capable of realizing his inherent capacity for self-fulfillment, love, and work.

In the light of such a holistic concept, relief of mental or psychosomatic symptoms appears to be a limited goal. This goal is often achieved by sacrificing more total, vital goals such as the enjoyment of a full life and of intimate emotional and physical involvement with others. Symptom relief is here accomplished by restriction of living. The patient withdraws from interpersonal relationships and thereby avoids situations which might cause anxiety and conflict. This is a neurotic solution which severely limits self-fulfillment. Horney saw it basically as an expression of resignation. Too much of the total goal is here being relinquished.

Another goal in therapy, which reveals itself as too limited and even misleading, is that of “adjustment.” Adjustment to what? Adjustment to reality—or, rather, the capacity to face the reality of oneself and of others—is indeed an important aspect of emotional health. But adjustment to the existing environment and its specific values cannot, in my opinion, be considered a valid goal. Conventional values vary too much with time and place to provide a reliable criterion of health. They are heteronomous and interfere with the autonomy of the individual. A goal of adjustment does not foster the development of the self. It often flattens it and paralyzes spontaneity and creativity. Conforming also covers