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This paper is an attempt to record some of the fundamental concepts which have evolved in me during the past fifteen years of psychoanalytic practice and continuing study of Karen Horney's writings. I am also particularly indebted to the teachings of Dr. Harold Kelman, and to what I have read of the writings of Dr. Abraham Maslow and various students of Zen Buddhism.
The first premise from which my thinking devolves is that selfhood develops in all human beings. Selfhood subsumes meaning-and-value-in-process. Each of us is a whole inner world which shows immense variation in orderliness, openness to perception, and integrity. The entropy of this inner universe or self-system varies from person to person and also within the same individual from time to time throughout his life. Entropy refers to the unavailable energy in a thermodynamic system. What energy exists within the self is incalculable and unavailable energy in the self-system is potentially a decreasing quantity. In most human beings, however, entropy increases with time; the decline of physical vitality with time is obvious. Also, human beings become set in their thinking and ways. Nevertheless, with constructive shifts in attitude, energy does become available to the inner world of the self. I met a gentleman who was what is termed “a self-made man.” He radiated the attitude which he expressed as follows: “It really don't matter so much what you got. What counts is how much you get outa what you got!” This seems to me to get precisely to the heart of the matter.
A whole unique inner world organizes within the evolving human being. This takes place within the physical organism which, however, can be remarkably inefficient in using itself. I want to emphasize this most basic sense of the complexity and of the ultimate mystery of things.
It has always seemed to me that an earnest study of medicine or any of the basic sciences related to it should bring one to a position of humility. However, I find this far fro