The Moment in Psychotherapy

In The Psychotherapy of schizophrenic patients the distinctions between patient and psychotherapist are bolder in relief and more critical than they are with neurotics. These distinctions early led to the widely accepted belief that a transference is impossible with a schizophrenic patient. To do psychotherapy successfully with such patients, it is necessary for us to examine these distinctions to see how the gap might best be bridged. In the past we have tended to avoid such examination by using hypothetical diagnostic constructs in a Procrustean way. This essay is concerned with only one facet of the problem; but one which basically cuts across the existential relationship of patient and psychotherapist. By this I mean time, or temporality.

Time is a subtle, enveloping concept that serves culture well and has been accepted by the layman as something immutable as the air we breathe or the rays of the sun which shine upon us. It may, in fact, be the best single mark of acculturation, and certainly occupies a central position in the dilemma of modern man, i.e., the human condition. To be time-bound is to be culture-bound by definition. One has only to experience the timelessness of a country such as Spain to perceive the shackles we all wear. More recently, psychology and psychiatry have been concerned with the length of psychotherapy and have sought ways of reducing it. Thus, we have short-term therapy, group therapy, family therapy, multiple therapy, and even therapy which takes place in a single hour—all designed to speed things up. Not much thought, however, has been given to the meaning of time within the therapeutic setting itself—to its dynamic meaning to the individual participants. We are more and more forced to the possibility that schizophrenia may be an existential disorder1 and, as such, may be one product of culture—a product, however, deemed pathological. Can it be that the experience of time is related to schizophrenia, that a new perspective about tem