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The juxtaposition of pages 181 and 182 of Dr. David I. Joseph's Listening for a Lifetime: The Artful Science of Psychotherapy perfectly captures the experience of reading this charming, vexing, insightful, occasionally obtuse, intermittently illuminating, and sometimes frustrating book. The verso contains the entirety of a chapter titled “Emptiness and Deadness,” while the recto features its own one-page chapter, “Inhuman, Animalistic, Monstrous … .” In this compilation of 61 “riffs on … aphorisms” (p. 215) culled from half a century of psychiatric and psychoanalytic practice, “Emptiness and Deadness” represents the best not only of what Dr. Joseph has to offer but of how he offers it:
Although suffused with suffering, a patient's experience of emptiness and deadness overlays thoughts and feelings they cannot allow themselves to know, bear, or share with another. … Emptiness and deadness are harrowing, sorrowful experiences, but they are better tolerated than the unrelenting anguish and despair that spring from an unconscious aliveness that is filled with hatred, shame, and guilt. (p. 181)
This strikes me as the distillation of a profound idea, the kind of concise description of a searing aspect of the wounded psyche at which only a practitioner with decades of experience can arrive.
Meanwhile, on the opposite page, Dr. Joseph writes, tautologically,
At first blush, a phrase such as “I am not myself” is simply another way of expressing that one is in a state of mind that contrasts sharply, usually
Alex Lewin, New Center for Psychoanalysis. 520 South Sepulveda Boulevard, #306, Los Angeles, CA 90049
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Page 407distressingly, with one's usual sense of self. Woven within the phrase, however, is the wish that a particular state of mind, such as deep sadness or unsettling irritability … is not an integral aspect of oneself. (p. 182)
Here, Dr. Joseph's reliance on aphorism obfuscates rather than clarifies. He distinguishes “sense of self” from “an in