The single utterance of the therapist, “horrenjus,” reveals a mode of the participant-observer stance, of necessity a kind of straddle in which the therapist stands outside and over against the world — including his patient — and yet enters into an interpersonal relation with his patient. He accomplishes the feat in this case through a kind of indulgent playfulness, tempered effectively, as McQuown comments, by his use of his pipe. The playful irony of “horrenjus!” pronounced with an exaggerated vaudeville-British propriety, expresses mock scandal at the patient’s decision to approach the woman in his dream, a device which serves at once to neutralize the patient’s anxiety and to extend to him a friendly hand: Come join me in a bit of good-natured deprecation of the Puritan streak in our culture. Yet, as sincerely warm as the therapist may feel toward his patient, there is hardly a second when his own objective placement in the world is not operative.* In fact, the very act which expresses his friendliness, the horrenjus! and the indulgent pipe-fondling behavior, also serves to set him gently but firmly apart as an elite-member, a tolerant Thalesian revolutionary who has made it his business to stand over against a sector of reality and study it according to the objective method.
The stance of the pure scientist is that of objectivity, a standing over against the world, the elements of which serve as specimens or instances of the various classes of objects and events which comprise his science. The behavior of the scientist, like any other mode of symbolic behavior, also implies a dimension of intersubjectivity; this is, of course, the community of other scientists engaged in the same specialty. Whether he is working with a colleague or alone, publishing or not publishing, the very nature of the scientific method with its moments of observation, concept formation, hypothesizing, verification, is a making public, a formulation for someone else.
But in the psychiatric interview the objective stance of the scientist with its attendant community of other scientists is overlaid by a second interpersonal relation, that of the therapist with his patient. This relation differs from that between the therapist and his colleagues. The latter is a Thalesian community, which is set apart from the everyday world by its esoteric knowledge of the underlying principles of some world phenomena. The relation between the therapist and his patient is, or at least might be, very much in the world. It might be called a Samaritan-Jew dyad — one man in trouble and another man going out of his way to help him.
The world of the patient and his being-in-the-world. This patient is in his world in a way wholly different from that of his therapist, yet it is a way which is heavily influenced by the presence of science in the world. The patient, let me postulate, is the sort of person who has also adopted the objective point of view but has adopted it secondhand. He is convinced that the scientific world view is the right way of looking at things, but since he is not a scientist and does not spend his time practicing the objective method, his objective-mindedness raises some problems. Deprived of the firsthand encounter with the subject matter which the scientist enjoys, he is even more apt than the scientist to fall prey to what Whitehead called the “fallacy of misplaced concreteness”* and so to bestow upon theory, or what he imagines to be theory, a superior reality at the expense of the reality of the very world he lives in. His problem is not, as is the scientist’s, What sense can I make of the data before me? but is instead, How can I live in a world which I have disposed of theoretically? He is like the schoolgirl who, on seeing the Grand Canyon for the first time, is unimpressed, either because she has already “had” it in geology or because she has not yet had it. Such a misplacement of the concrete is a serious matter because, although one may dispose of the world through theory, one is not thereby excused from the necessity of living in this same world. This patient’s mode of life is open to considerable anxiety and he is apt to conceive of his predicament and its remedy in the following terms: I am having trouble living in the world which I see objectively; therefore I shall apply for relief to the very source of my world view, the scientist himself. His seduction by theory is such, however, as to place him almost beyond the reach of the therapist. Paradoxically, it is his veneration of psychiatry which all but disqualifies him as a candidate for psychiatric treatment. For it is a necessary condition of the therapist’s method that he abstract to a degree from the individuality of his patient and see him as an instance of, a “case of,” such and such a malfunction.* But the patient is peculiarly prone to extrapolate a methodology into a way of living. He is pleased when the dream he offers to the therapist turns out to be a recognizable piece of pathology. He does not conceive a higher existence for himself than to be “what one should be” according to psychiatry. But science cannot tell one how to live; it can only abstract some traits from a number of people who do manage to live well — he has read no doubt that one should have an “integrated personality” or that one should be “creative” or “autonomous,” and the like. But the patient who sets out to become an integrated personality has embarked on a very peculiar enterprise. An almost intractable misunderstanding is apt to arise between therapist and patient. It is of this order: The therapist offers the assistance of the method and technique of his science and hopes that the patient can make use of it to become the individual he is capable of becoming. But the patient in his anonymity labors under the chronic misapprehension that he is trying to become “one of those”—that is, an integrated personality. The patient as good as asks: Am I doing it right now? Am I not now an individual in my own right?
The intersubjective community. The character of the community in this example may be inferred from the foregoing. The community is a special instance of the I-you dyad in which the inclusion of the patient implies a significant exclusion. The exclusion is significant because of its function in therapy. Although the encounter is that of a sick man supplicating a healer, a special status is conferred upon the patient by virtue of the technique itself. I may be sick and I may have come to a doctor for help, the patient is saying, but this is no ordinary therapy in which all I have to do is hold still while the doctor works on me; this is analysis. And a good bit of the exchange between therapist and patient consists of the patient’s acceptance of the therapist’s invitation to come see it all from where he sits, as a tolerant pipe-fondling Thalesian, to share in the analyst’s understanding of symptoms, social behavior, culture — an understanding obtained by an elite technique to which to a degree the patient can, by reason of his own gifts, also aspire. Although he may have failed and so needs help, he enjoys a privileged status vis-à-vis the people out there in the street. They don’t know what we know. They don’t even know about themselves what we know about them. Thus the we-community of scientists — I, the therapist, and you, the patient but also now the surrogate scientist — can become a useful therapeutic instrument by means of which the patient’s low self-esteem is offset by Thalesian insights into himself and the society he lives in.
The interpersonal process is a multilevel one. Some estimation of its immense complexity is made possible by realizing that there occurs at one level the interaction between organisms which the behaviorist speaks of. Conversation is still a space-time journey of energy exchanges between organisms in all its molecular complexity. But this interaction is overlaid by the molar structure of symbolic behavior. Symbolic behavior is in turn as many-tissued as there are participants in the language event and as there are media of communication. The world and the being-in-the-world of the therapist collide with the world and the being-in-the-world of the patient. The possibilities of communication failure are unlimited. Yet it is not sufficient to say that one man says something and another man hears and understands or misunderstands, agrees or disagrees, rejoices or is saddened. It is also necessary to ask and try to answer such questions as: In what mode does the listener receive the assertion of the speaker? In what mode does he affirm it? In what way does his own mode of being-in-the-world color and specify everything he hears?
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