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I encountered my first psychiatric patient some 50 years ago, as an intern at Los Angeles County Hospital, the first night I was on call on the psychiatric service. I was awakened at 3 A.M. by an ungodly racket, and I rushed from my room onto the ward. There I saw a tiny wizened old lady, with grey straggly hair down to her waist, holding at bay about a half-dozen nurses and attendants. This latter-day witch was spitting at them, wildly brandishing a cane, and screeching epithets and curses in Yiddish, such as “A choleriyah auf dir!”, meaning, “You should contract cholera”, and other more colourful curses, one translated to mean, “You should be like a chandelier - hang by day and burn by night!”
I tried vainly for some time to calm her, but my fledgling professional demeanour eventually crumbled into feelings of helpless frustration. I bellowed at her as loud as she was screaming at me, “Soll sein shah!”, roughly meaning, “Shut up!” The effect was magical. She became quite still, shuffled over to me and peered into my face for some moments, then asked quietly, “Are you my brother, Sol?” With all of my 22-year-old authority, I said, “Yes, now go to bed.” And she quietly complied. Thus was I introduced, two years before starting my analytic training, to the power of transference, though not exactly to its analytic use.
Since that first powerful teaching exposure, much has changed in my views on psychoanalysis, and certainly in my approach to patients. Yet, since my analytic training, there is much that has remained unchanged. I still hold to what I believe are the core concepts of psychoanalysis: that all behaviour is determined and motivated, that mentation is predominantly