Key Concepts in Psychotherapy

432 Pages·1970·9.552 MB·English

by  Erwin Singer

Key Concepts in Psychotherapy
by E R W I N S I N G E R
With a Foreword by Edward S. Tauber
Second Edition
BASIC BOOKS, INC., PUBLISHERS
NEW YORK I LONDON
First Edition published by Random House in 1965
© i965 by Random House, Inc.
© 1970 by Basic Books, Inc.
Library of Congress Catalog Card Number: 78-110104
SBN: 465-03708-9
Manufactured in the United States of America
73 74 75 76 10 9 8 7 6 5 4
Grateful acknowledgment is made to the fallowing for permission to quote
material from the works listed:
Doubleday & Company, Inc. From Goethe's FAUST, translated
by Walter Kaufmann. Copyright © 1961 by Walter Kaufmann.
Harvard University Press. From Susanne Langer, PHILOSOPHY
IN A NEW KEY. Copyright, 1942, 1951, i957 by the President
and Fellows of Harvard College.
The Hogarth Press Ltd. From Sigmund Freud, THE STANDARD
EDITION OF THE COMPLETE PSYCHOLOGICAL WORKS
OF SIGMUND FREUD, revised and edited by James Strachey.
And to Basic Books, Inc., publishers of THE COLLECTED
PAPERS OF SIGMUND FREUD.
Houghton MifHin Company. From C. R. Rogers, CLIENT­
CENTERED THERAPY ( 1951), and COUNSELING AND
PSYCHOTHERAPY ( 1942).
International Universities Press. From S. Tarachow, AN
INTRODUCTION TO PSYCHOTHERAPY ( 1963).
Macmillan & Co., New York, and Routledge & Kegan Paul Ltd.,
London. From M. Buber, BETWEEN MAN AND MAN ( 1954).
W. W. Norton & Company, Inc. From Otto Fenichel, M.D., THE
PSYCHOANALYTIC THEORY OF NEUROSIS. Copyright, 1945,
by W.W. Norton and Company. From Harry Stack Sullivan, M.D.,
THE INTERPERSONAL THEORY OF PSYCHIATRY.
Copyright, 1953. by The William Alanson White Psychiatric
Foundation. And from THE PSYCHIATRIC INTERVIEW.
Copyright, 1954. by The William Alanson White Psychiatric
Foundation.
The Public Trustee and The Society of Authors, London. From
Bernard Shaw, MAJOR BARBARA and SAINT JOAN.
The Ronald Press. From Franz Alexander and Thomas Morton
French, PSYCHOANALYTIC THERAPY. Copyright, 1946, The
Ronald Press Company.
The University of Chicago Press. From Frieda Fromm-Reichmann,
PRINCIPLES OF INTENSIVE PSYCHOTHERAPY. Copyright
© i950, by The University of Chicago.
F OR HE L ENE
F O R E W O R D
To PRESENT AN INTRODUcrION TO PSYCHOTIIERAPY IS NO EASY
task. The contents of this type of book are addressed to students
of psychology and psychiatry and cognate fields, who have had
many years of background preparation behind them. They are
electing a career in a field which is still young but has under­
gone significant development in roughly three quarters of a
century, since it was set into motion by the giant contributions
of Sigmund Freud. Freud tempered man's curious aversion to
penetrating his inner life. Concern with mental health is now
no longer suspect; in fact, the motivation to resolve psycho­
logical conflicts and to accept psychotherapy has become a
widespread attitude in our present culture. Mental health
programs are completely respectable and figure seriously in
overall community planning in many parts of the Western
world.
But what about the preparation of those who are going to
assume the responsibility for the treatment of psychological
and emotional problems? Instruction in the art and science
of psychotherapy calls for constant reappraisal of its content
and format. Historically its design has been mainly tutorial,
partly because the practice of psychotherapy itself has been a
person-to-person transaction. The patient has taught the psy-
(viii] FOREWORD
chotherapist much of what he has had to learn. Out of this in­
tegration the therapist has additionally learned to bring his own
resources into play so that he could gradually come to be of
increasing use to the patient's growth. The experienced thera­
pist is now in a position to guide the student of psychotherapy
more effectively in the inquiry into his patient's problems and
can define more clearly what can improve the probability
of a successful outcome of therapy.
Specifically, how has Dr. Singer set about accomplishing that
mission? In my opinion, he has located a mode of presentation
which is at once sensible and inspired, simply because it taps
what is alive in all of us. He rejects oversimplification, talking
down to the reader, or pontification. His approach brings to my
mind the new math-the modern pedagogical paradigm for
mathematical instruction. In the search for what might be
usefully taught to the student embarking on the study of
mathematics, our present generation has witnessed a startling
discovery-namely, that instead of memorizing blindly arith­
metic rules, the child could assimilate basic principles of the
foundations of mathematics. As a consequence, the beginner
could grasp what the subject was about: the parts began to fall
into place; these pragmatic procedures were no longer tedious,
meaningless rituals; an exciting landscape began to emerge.
Courage to search further, to continue the adventure, has
displaced the earlier more usual experience of drudgery, tacit
bewilderment, and inadequacy feelings. The child's readiness
to unfold and respond to this challenge is to the credit of those
inspired and daring enough to test out the possibilities.
Just as are those teaching the new math, Dr. Singer, through­
out his presentation, is always mindful of the basic qualities
inhering in the human situation for valid problem solving. In
psychotherapy a cardinal postulate is to be in touch with the
roots of feeling, thought, and experience. Merely to teach the
programming of procedures, although important, will lead
nowhere since the technical understanding of the transaction
is insufficient and will perpetuate illusory interchange. So much
of the pathway of therapy consists in meeting up with the
Foreword [ ix ]
unexpected that flexibility in therapist and patient alike, foster­
ing open-endedness, is crucial. The flexibility in therapy as in
mathematics resides in or rests on grasping the fundamental
assumptions. Perhaps the analogy between the teaching of
mathematics and psychotherapy is strained because most of us
are not concerned with developing into professional mathema­
ticians; however, the best preparation for a potential future,
whatever it be, is still a sound principle. In the case of the
psychotherapist, his field is his profession and his patient will
not show significant growth unless the therapist conveys the
need for the patient's "professional" involvement in his own
life.
I believe that somewhere in us there is a profound yearning
to come close to the core of ourselves, to what is around us,
to how we think, to our inner reflections. We begin with a
ready responsiveness to what is authentic even if this character­
istic or quality is not already in our own awareness. There is a
sensed excitement or pleasure usually not accessible to verbali­
zation when substantive ideas enter the immediacy of our
experience.
I believe that Dr. Singer has captured in many ways what
these core issues are for us who want to grasp the human situ­
ation. The essence of what troubles the therapist about himself,
his patient, and the enterprise is thoughtfully and authentically
presented. The student is not shielded from the minute he
opens his mind to the study of psychotherapy. The central
issues-indeed, the key concepts-are presented to encourage
the student's urge to discovery. Dr. Singer cuts through contro­
versial issues: he is not preoccupied with taking sides, expedi­
ency, or premature assurances of therapeutic outcome. Yet the
spirit of the book is not an eclectic compilation of themes:
Dr. Singer has his point of view, one which rests on deep
respect for living itself as an art that requires constant reflec­
tion, engagement, and activation from within. The author has
dexterously avoided the hazards associated with any profound
inquiry into the human situation. Addressing oneself in depth
to any topic draws one precariously to the brink of exhortation,
[x] FOREWORD
moralizing, and propagandizing, but I believe the author has
successfully transcended all these sins because he has a faith
in man's drive to health.
-EDWARD s. TAUBER, M.D.
WILLIAM ALANSONW IDTE INSTITUTE
New York City
March, 1965
PREF ACE TO THE SECOND EDITION
THE REISSUE OF THIS SOMEWHAT EXPANDED EDmON OF MY BOOK
first published about five years ago fills me with a sense of
profound satisfaction. Of course my vanity is gratified-and
what author even if he happens to be a psychoanalyst can
deny that vanity is one of his human failings. But of more
consequence is my joy occasioned by the evidence that this
book dealing with issues and concepts vigorously attacked
from several quarters was received with enough interest to
warrant a second edition. Hopefully, my book has and now
will continue to help keep alive concern with a discipline
whose demise has been predicted for quite a while by many.
The main thrust of attack on intensive psychoanalytically
(in the broadest sense of the term) oriented psychotherapy
comes from two distinct groups of social scientists and mental
health practitioners, though, clearly, the members of each of
these groupings are not monolithically in agreement with
each other.
The first large grouping sharply critical of psychoanalytic
psychotherapy is made up of people advocating various types
of community mental health programs. They are individuals
who, motivated by sincere and urgent concern about the
psychological well-being of large segments of American so­
ciety, advocate new approaches to the solution of emotional
[ xii ] Preface to the Second Edition
difficulties as they manifest themselves in certain strata of our
population. These critics believe that the intrapsychic and
interpersonal conflicts traditionally examined and explored by
psychotherapists are manifestations of disturbances in white
middle- and upper-class society. Therefore, they maintain,
traditional psychotherapeutic avenues are irrelevant for mil­
lions of impoverished whites and blacks whose social and cul­
tural backgrounds vary significantly from those of middle­
class America; the issues that they must resolve in their lives
are, allegedly, different. In effect, these critics advocate that
psychologists and psychiatrists concentrate on helping great
numbers of people solve their social, educational, and eco­
nomic reality problems. While some would let it go at that,
leading to Professor Shatan's fear that community mental
health programs may become the stretcher bearers of a
bankrupt society, others go further and insist that this help
can aid people in developing pride, resolution, and a readiness
for political activism, eventuating in large-scale political and
social reorganization.
This orientation, sparked by the ever more apparent crisis
of the sixties, has led a good many theorists and practitioners
to the advocacy and exercise of a professional socio-psycho­
logical activism whose results cannot yet be foretold, though
there is some evidence that, despite temporary chaos, good
will come from it. But this recognition also leads to the devel­
opment of important questions: Are psychologists and psy­
chiatrists the people best equipped to work in these areas, and,
if they are not, should their training be reorganized so as to
equip them for such activities? Social workers, especially those
dealing with community organization work, political scientists,
sociologists, and a host of other professionals have long been
active in this area. Would not the demands of the critics of
contemporary psychologists and psychiatrists require that
these people change their professions? Perhaps they should,
perhaps these professions are obsolete-but it also seems to
many that there is room for both community activism and
psychotherapeutic work. These functions may be carried out
by different individuals or they may represent distinctly