The Psychoanalytic Quarterly, 21, 1952, No. 1: Gregory Zilboorg. 'The Emotional Problem and the Therapeutic Role of Insight.'

The lack of clarity that attaches to the concept of insight is due to the fact that the term has two opposed meanings, a psychiatric and a psycho-analytical one. To the psychiatrist insight is something positive which can be acquired and consists

of an intellectual awareness of motives, etc., accompanied by 'appropriate' affect and 'emotional understanding'. What constitutes an appropriate accompanying affect for intellectual insight and what the 'emotional component' of intellectual understanding is, is never defined. This view of insight is responsible for the popular but erroneous beliefs that a patient will lose his symptoms when he discovers what caused them and that insight is something that a therapist can give his patient. The psycho-analytical view of insight is that it is a state of ego functioning which arises naturally when the patient is freed of the surplus of unconscious affects which prevents him feeling what he feels and seeing what he sees. It appears as a byproduct of psychological liberation and 'should be considered as the ultimate and crowning point of integration of ego functioning'. From this point of view there can be no question of 'giving' insight.

What is the nature of the insight that is necessary for the preservation of good therapeutic results? It is obviously not solely a question of the strength of the ego, since there are individuals with strong ego organization whose neurotic character is undeniable. It is indeed, Zilboorg suggests, personalities of this kind with a 'smugly integrated ego' who in our professional and academic circles are 'largely responsible for such purely intellectual concepts as emotional or unconscious insight' and 'for the neat yet loosely knit interpretations of cultural, racial, or national patterns'. Psychotherapies based on this kind of intellectualism, in which the therapist actively dispenses insight, constitute a return of repressed resistances to depth psychology, however much they may masque