You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
A Chinese physician who lived 4,000 years ago wrote, “The present world is a difficult one. Grief, calamity and evil cause inner bitterness. There is disobedience and rebellion. Evil influences strike from early morning until late at night. They injure the mind and reduce its intelligence and they also injure the muscles and the flesh.”
Man has not changed much over the centuries; quite possibly he is getting worse. In larger numbers he is interacting with politicians, community leaders, educators, police, and the family. When he seeks individual help, he encounters the psychotherapist, who, in turn, encounters him. All these encounters elicit emotional stress. The stress can be painful and even “injurious,” as our Chinese colleague put it. The nature of the injury can be described in terms of the therapist as anxiety, depression, anger, reproach, as well as other, more subtle, forms of manipulation by the emotionally hungry, needy, and sometimes predatory patient.
The therapist must be fully conscious of the needs of his or her patient, and fully aware of the tactics he uses in an attempt to repair himself. If he is not, the therapist may find he has taken over the pathology of his patient within himself to such an extent that the therapist himself feels “sick.”
I began a psychiatric residency in 1927 when there was little available knowledge on psychotherapy, either of the in-patient or out-patient variety. The work was largely history taking, making diagnoses, and making recommendations for disposal of cases. The writings of Sigmund Freud and his contemporaries were available, however, describing mental function as well as how mental development