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The editorial board of this journal has invited me to say something about the process of writing On Learning from the Patient (1985), where it came from, what moved me to write it and some of the responses to the book since its publication.
The conscious conception of the book began with the title. This occurred to me as it were out of nowhere, but I soon began to realise that it encapsulates a central theme of my professional life - as social worker, as psychotherapist and later as psychoanalyst. During the writing I also began to realise that I had been thinking around the ideas in it for nearly thirty years.
Quite early in my life I had noticed two apparently contradictory forces operating within me. On the one hand I felt that I had to question everything -particularly anything that was presented to me as a dogmatic ‘given’; on the other hand I was looking for certainty. In those days I thought of security in terms of being sure - knowing rather than not-knowing.
For a while, before going to university, I tried belonging to a group of fundamentalist Christians. They actively fostered a belief that they could offer the certainty which I was then seeking; and, by contrast, all error and doubt could be relegated to others. (In those days I did not know about projection.) I therefore planned to read theology with a view to becoming a priest.
However, before beginning to read theology at Cambridge, I initially did one year of anthropology. This helped to open my eyes to the incredible diversity of life; and I began to discover the ‘otherness’ of others - far beyond my previous imaginings. I also began to realise that, in any attempt to understand people and societies so different from ourselves, we have to approach that task without preconception. If too much weight is given to what is already known, then the unknown remains elusive - and attempts at understanding introduce their own distor