Self-Alienation: Dynamics and Therapy

During the Past decade, psychoanalytic therapy has become more difficult because more patients show an increasing degree of inner dissociation and emotional withdrawal. The age of hysteria was followed by the age of psychosomatics in which anxiety and conflict were mainly expressed in physical symptoms. In our times this has been followed by the age of alienation. The main characteristic of today's patient is his estrangement from himself. I am referring here not only to the extreme: the ambulatory schizophrenic so common today, whose automatized and mechanized shell personality enables him to function and survive surprisingly well in our present automatized and mechanized society. I am thinking of the majority of our neurotic patients. Here the alienation reveals itself—to use Horney's description—in “the remoteness of the neurotic from his own feelings, wishes, beliefs and energies. It is a loss of the feeling of being an active, determining force in his own life. It is a loss of feeling himself as an organic whole … an alienation from the real self.”1

Alienation has social and individual aspects which can be found in the two original meanings of the term. With emphasis on the social aspect, the estrangement from others and the environment, the concept of alienation was created by Hegel and later by Marx, who saw man become estranged from others and from his work under the impact of the Industrial Revolution. With emphasis on the individual aspect, the estrangement from the self, the concept of alienation was used in the last century and is being used now in some countries as connoting mental illness per se.

The pathogenic effect of social and cultural factors which reinforce and perpetuate the process of self-alienation is evidenced by comparative cross-cultural anthropological studies. I have mentioned some of these factors in my introduction to this Symposium. However, to find the primary roots and the dynamics of self-alienation we have to study the e