Regarding the Other

With this, the last of my regular "Clinician's Corner" columns, it would be impossible for me to overstate the delight I have had in playing in so luxuriously welcoming an intellectual playground. I was recently asked to provide a brief statement summarizing my central views after my half century of clinical experience, and my response then seems fitting for my last regular clinical statement in this scholarly arena.

Dum spiro spero. While I breathe I hope, and one thing I hope is that I continue to learn. Conclusions are only views held "so far," for experience is always unfolding, always still becoming. Thus, what I say now is my last column but not a last word, and that is so despite the half century that has led to this moment. It is, nonetheless, what I think at this moment.

The psychoanalyst's task is facilitating the introspection and self-mastery of the analysand, paying particular attention to the exposure and exploration of unconscious forces, always working in the service of the other. Consequently, philosophy and psychoanalysis are not allied professions but are like a single college course in which philosophy is the lecture section and clinical analysis the laboratory.

Reflection on years spent in the clinical laboratory has led me to hold profound respect for three foundational principles: individuality, otherness, and outsiderness. They are not the only tenets that can be drawn from practice, but they are essential.

First, individuality. Even within the context of our common humanity, no two people are the same. Clinical work demands appreciation of the singularity, the particularity, the distinctiveness of each person. Humanity is infinitely variable, so no single point of view can ever capture a person's exceptionality. Yes, analytic theories are fully valuable in reminding us of just those aspects of life that are most hidden or that we least want to consider. Nonetheless, no theory can ever suffice, can ever be fully true to individuality. Psychoanalytic theories, conceptualizations, and categorizations can never validly be used to blur differences or in any way to obscure individual uniqueness. Theory must always bend to individual specialness, never the other way around.

Second, otherness. As a result of the patient's individuality, the fundamental clinical principle from which all other principles of technique derive is regard for otherness. This means the analyst's profound and genuine in-the-marrow regard for the authenticity of the patient's self as a unique other, a singular other's self as valid as the analyst's own.

The analysand is the central person in any analysis, and the analyst must always bear in mind that he or she is the other person's other, one specifically engaged to be a professional assistant. All of the technical principles of analytic technique are logical derivatives of the analyst's remembering why he or she is there.

Forgetting this makes it too easy to slide into the distressingly common occupational hazard of the analyst's coming to believe that the analyst could lead the patient's life better than the patient can.

And third, outsiderness. Regardless of the comfort and early security brought by good mothering, we are all born into a world of newness and strangeness where everybody else is here ahead of us. Everyone else knows more of the rules of the game, of how the world works and what things mean, than do we. From the start, others are always bigger and more knowing. On a deep level, each of us is always an outsider, always in part feeling more vulnerable than the other ever seems to be.

The analyst's own sense of outsiderness can never be allowed self-servingly to dull full respect for the patient's own sense of strangeness. As much as both analyst and analysand strive to be close to and to know each other, they can only validly do so if each does so in a way that respects the ultimate chasm of separateness on the rim of which all of us live. And as close as the two may come in interacting, in sharing experiences with maximal openness...