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Many patients seek help in the midst of what the author of this article calls a “progressive crisis,” set off by already initiated or accomplished, self-defined progress in life (p. 40). This progress, according to the author, is a response to the “press of life,” and represents “the product of synergy between certain internal strivings for a fuller life and the consequences of living in a socio-economic environment of liberal democracy,” leading to “an expansion of the range of individual personal experience” (p. 44).
There are some common themes, the author notes, in how the internal “press of life” affects the individual in such a context. These include the compulsion to try again, the pursuit of a sense of true self, and the closely related movement toward the depressive/historic position.
The author argues that treatment, “rather than facilitating new experience and personal growth,” “usually and optimally” works to “catch up with the implications and consequences of changes that have already taken place,” and to “resolve the complex emotional fallout from these developments” (p. 49). Such fallout usually occurs in the form of “complex grief” (p. 49). The author notes that in his experience, the more one focuses on such grief, “the less one need concern oneself with matters of splitting and projection” (p. 52). In this way, he says, one aims more toward consolidation of growth and prevention of symptomatic regression than toward the promotion of growth.
The author considers the patient's “curiosity about his life” to be the mainspring of treatment (p. 52). “Explanation, interpretation,