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IN A REVIEW of my experience as a psychotherapist, I find that it has been marked, in many instances, by a peculiar—and intriguing—quality. I refer to the absence of enthusiasm—or to the presence of ill-concealed or openly displayed antagonism—characteristic of divers people who are led (for one reason or another) to have something to do with me professionally. Although colleagues, friends, and others may (within limitations) speak well of me and, on occasion, urge someone to see me in consultation, a number of those who are (or eventually become) my patients would shun me if they could. Often I meet with someone who is (at best) reluctant to become a patient, in which case I find myself to be the unwanted therapist, now confronted by problems of influence, persuasion, and coercion.
In the more conventional tradition of medical practice (or the healing arts), I should not expect to have to deal with matters involving force, but rather with events customarily occurring in the following sequence:
a.Someone notices that his effectiveness in living is decreased, or altered in ways that are painful or troublesome and often not clearly understood by him. Should he himself overlook such changes, they may be observed and brought to his notice by those who are in some way affected by them.
b.He may then speak to others about his observations (except in situations in which concealment might seem to be required by custom and prejudice) and in ensuing discussions decide that "something is wrong"; that is, he may be confirmed as one having an "ailment."
c.Being thus defined or identified as possibly being sick, he becomes