Courage and Masochism in Psychotherapy

When presented with the opportunity to contribute to the Esther Menaker Festschrift, the topic that immediately came to mind was that of courage and its relationship to the psychotherapeutic situation. The analysis of this association was immediate. To being with, the theme of courage is implicit in the content of Dr. Menaker's work — her formulations of masochism, will, creativity, technique all involve courage as a dimension. Perhaps more importantly, courage is represented in the form her work has taken. Her ideas and observations are uniquely hers, neither fitting cleanly into the mold of others nor conforming to fashion. Dr. Menaker does not equivocate or obscure the boldness of her thought. On the contrary, she writes clearly and directly, forcing the reader to take a position on the often controversial issues she raises. And, more personally, if forced to summarize the fruits of two years of supervision — during which by word and experience, Dr. Menaker helped me confront my patients on their terms and develop my own capacity for construction of a therapeutic environment with insight into my own needs for security and relief from anxiety as background — I would use one word, courage, though not as a quality attained but an apperception of an ideal to be emulated.

The psychoanalytic literature contains many references to the difficulties inherent in the practice of “the impossible profession” (Greenson, 1966) but the word courage appears infrequently. This is ironic given that essential to the identity of the psychoanalytic movement is what Sulloway (1979) terms “the myth of the hero,” represented in the image of Sigmund Freud as the courageous revolutionary.

For lack of a psychoanalytic definition, the dictionary must suffice. Webster's (1976) notes that the word courage derives from the Latin, cor, meaning heart, and defines it as “the attitude or response of facing and dealing with anything recognized as dangerous, difficult or painful,