Some time ago a patient remarked about his irritation with the solicitations of a friend who, because the patient was ill, in bed, called him three times during a 24-hour period to see how he was doing, waking him up with each and every phone call. The patient was grumbling about how people aren't really concerned about others so much as they are anxious about themselves, that it is only their own problems that lead them to be solicitous of others. He was, without knowing it of course, commenting on the familiar psychoanalytic defense of altruism as a disguise for other feelings or as an expression of unconscious need. The patient took it even further, saying that there is no such thing as real concern for others; everything is for the individual. When asked about this in relation to his family, he could think of no instances that would demonstrate his conviction, but he remained convinced all the same.

As psychoanalysts we can easily make a case for this patient's