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The history of Western civilization is, in one sense, a story of progress from faith to reality testing. Alongside the current tendency of a return to religious ritualism, man is gradually discovering more about nature and how to control it. Through reality testing, for example, we no longer accept the idea that one becomes ill because of evil spirits. We have advanced to the point where we can often pinpoint the exact bacteria that are the cause of many diseases. Further, we know enough about science to prevent and cure many others. Additionally, we have had an explosion in technology that exemplifies our ability to bend nature to our will, making what had previously been fantasies into reality. These are examples of man's direct control over our environment through scientific knowledge and our understanding of cause and effect, rather than illusory control through faith.
It is safe to assume that in the foreseeable future, the part of our lives that is governed by faith will gradually be reduced as the amount of information gathered by science increases still more.
In psychotherapy, however, we have an interesting paradox. The stated goal for our patients is increased use of reality testing, that is, a greater reliance on a scientific approach to reality, and less reliance on magical thinking and faith. Because I work primarily with borderline and psychotic patients, my work requires me to be even more devoted to those factors than therapists who work with less seriously ill patients. But in general, we want our patients to experiment in order to discover whether the consequences of their behavior are what they suppose.
On the other hand, we want a new patient to trust us, if for no other reason than that it is difficult to work with a patient who does not. Further, we often assume that a patient's skepticism is part of his illness.
Frequently, the literature supports us in these attitudes. The Grunebaums (1980) say for example: “trust is the basis of mental health an