8月26日 晚上19:23--20:17
Introduction
The ideas here in presented stem, for the most part, from my day-to-day clinical work with patients as they struggled to avoid or to gain ever greater levels of maturity.
Consequently, this book contains portions of many actual case histories. Confidentiality is essential to psychiatric practice, and all case descriptions, therefore, have been altered in name and in other particulars so as to preserve the anonymity of my patients without distorting the essential reality of our experience with each other.
There may, however, be some distortion by virtue of the brevity of the case presentations. Psychotherapy is seldom a brief process, but since I have, of necessity, focused on the highlights of a case, the reader may be left with the impression that the process is one of drama and clarity. The drama is real and clarity may eventually be achieved, but it should be remembered that in the interest of readability, accounts of the lengthy periods of confusion and frustration inherent in most therapy have been omitted from these case descriptions.
I would also like to apologize for continually referring to God in the traditionally masculine image, but I have done so in the interest of simplicity rather than from any rigidly held concept as to gender.
As a psychiatrist, I feel it is important to mention at the outset two assumptions that underlie this book. One is that I make no distinction between the mind and the spirit, and therefore no distinction between the process of achieving spiritual growth and achieving mental growth. They are one and the same.
The other assumption is that this process is a complex, arduous and lifelong task. Psychotherapy, if it is to provide substantial assistance to the process of mental and spiritual growth, is not a quick or simple procedure. I do not belong to any particular school of psychiatry or psychotherapy; I am not simply a Freudian or Jungian or Adlerian or behaviorist or gestaltist. I do not believe there are any single easy answers. I believe that brief forms of psychotherapy may be helpful and are not to be decried, but the help they provide is inevitably superficial.
The journey of spiritual growth is a long one. I would like to thank those of my patients who have given me the privilege of accompanying them for major portions of their journey.
For their journey has also been mine, and much of what is presented here is what we have learned together. I would also like to thank many of my teachers and colleagues. Principal among them is my wife, Lily. She has been so giving that it is hardly possible to distinguish her wisdom as a spouse, parent, psychotherapist, and person from my own.
SECTION 1 Discipline
Problems and Pain
Life is difficult.
This is a great truth, one of the greatest truths. It is a great truth because once we truly see this truth, we transcend it.Once we truly know that life is difficult-once we truly understand and accept it-then life is no longer difficult. Because once it is accepted, the fact that life is difficult no longer matters.
Most do not fully see this truth that life is difficult. Instead they moan more or less incessantly, noisily or subtly, about the enormity of their problems, their burdens, and their difficulties as if life were generally easy, as if life should be easy.
They voice their belief, noisily or subtly, that their difficulties represent a unique kind of affliction that should not be and that has somehow been especially visited upon them, or else upon their families, their tribe, their class, their nation, their race or even their species, and not upon others. I know about this moaning because I have done my share.
Life is a series of problems. Do we want to moan about them or solve them? Do we want to teach our children to solve them?
Discipline is the basic set of tools we require to solve life's problems. Without discipline we can solve nothing...
The first of the "Four Noble Truths" which Buddha taught was "Life is suffering."
some dis~~ecan solve only some J~E?-~!~,IE-~.: With total discipline we can solve alJ.l?r2fireifu.. What makes life difficult is that the process of confronting and solving problems is a painful one. Problems, depending upon their nature, evoke in us frustration or grief or sadness or loneliness or guilt or regret or anger or fear or anxiety or anguish or despair. These are uncomfortable feelings, often very uncomfortable, often as painful as any kind of physical pain, sometimes equaling the very worst kind of physical pain.
Indeed, it is because of the pain that events or conflicts engender in us all that we call them problems. And since life poses an endless series of problems, life is always difficult and is full of pain as well as joy. Yet it is in this whole process of meeting and solving problems that life has its meaning. Problems are the cutting edge that distinguishes between success and failure. Problems call forth our courage and our wisdom; indeed, they create our courage and our wisdom. It is only because of problems that we grow mentally and spiritually. When we desire to encourage the growth of the human spirit, we challenge and encourage the human capacity to solve problems, just as in school we deliberately set problems for our children to solve.
It is through the pain of confronting and resolving problems that we learn. As Benjamin Franklin said, "Those things that hurt, instruct." It is for this reason that wise people learn not to dread but actually to welcome problems and actually to welcome the pain of problems.
Most of us are not so wise. Fearing the pain involved, almost all of us, to a greater or lesser degree, attempt to avoid problems. We procrastinate, hoping that they will go away. We ignore them, forget them, pretend they do not exist. We even take drugs to assist us in ignoring them, so that by deadening ourselves to the pain we can forget the problems that cause the pain. We attempt to skirt around problems rather than meet them head on. We attempt to get out of them rather than suffer through them.
This tendency to avoid problems and the emotional suffering inherent in them is the primary basis of all human mental illness. Since most of us have this tendency to a greater or lesser degree, most of us are mentally ill to a greater or lesser degree, lacking complete mental health. Some of us will go to quite extraordinary lengths to avoid our problems and the suffering they cause, proceeding far afield from all that is clearly good and sensible in order to try to find an easy way out, building the most elaborate fantasies in which to live, sometimes to the total exclusion of reality.
In the succinctly elegant words of Carl Jung, "Neurosis is always a substitute for legitimate suffering."
But the substitute itself ultimately becomes more painful than the legitimate suffering it was designed to avoid. The neurosis itself becomes the biggest problem. True to form, many will then attempt to avoid this pain and this problem in
turn, building layer upon layer of neurosis. Fortunately, however, some possess the courage to face their neuroses and begin usually with the help of psychotherapy-to learn how to experience legitimate suffering.
In any case, when we avoid the legitimate suffering that results from dealing with
problems, we also avoid the growth that problems demand from us. It is for this reason that in chronic mental illness we stop growing, we become stuck. And without healing, the human spirit begins to shrivel.
Therefore let us inculcate in ourselves and in our children the means of achieving mental and spiritual health. By this mean let us teach ourselves and our children the necessity for suffering and the value there of, the need to face problems directly and to experience the pain involved. I have stated that discipline is the basic set of tools we require to solve life's problems. It will become clear that these tools are techniques of suffering, means by which we experience the pain of problems in such a way as to work them through and solve them successfully, learning and growing in the process.
When we teach ourselves and our children discipline, we are teaching them and ourselves how to suffer and also how to grow. What are these tools, these techniques of suffering, these means of experiencing the pain of problems constructively that I call discipline? There are four: delaying of gratification, acceptance of responsibility, dedication to truth, and balancing. As will be evident, these are not complex tools whose application demands extensive training.
To the contrary, they are simple tools, and almost all children are adept in their use
by the age of ten. Yet presidents and kings will often forget to use them, to their own downfall. The problem lies not in the complexity of these tools but in the will to use them. For they are tools with which pain is confronted rather than avoided, and if one seeks to avoid legitimate suffering, then one will avoid the use of these tools. Therefore, after analyzing each of these tools, we shall in the next section examine
the will to use them, which is love.
Delaying Gratification
Not too long ago a thirty-year-old financial analyst was complaining to me over a period of months about her tendency to procrastinate in her job. We had worked through her feelings about her employers and how they related to feelings about authority in general, and to her parents specifically. We had examined her attitudes toward work and success and how these related to her marriage, her sexual identity, her desire to compete with her husband, and her fears of such competition. Yet despite all this standard and painstaking psychoanalytic work, she continued to procrastinate as much as ever.
Finally, one day, we dared to look at the obvious. "Do you like cake?" I asked her. She replied that she did. "Which part of the cake do you like better," I went on, "the cake or the frosting?" "Oh, the frosting!" she responded enthusiastically. "And how do you eat a piece of cake?" I inquired, feeling that I must be the most inane psychiatrist that ever lived. "I eat the frosting first, of course," she replied.
From her cake-eating habits we went on to examine her work habits, and, as was to be expected, discovered that on any given day she would devote,the first hour to the more gratifying half of her work and the remaining six hours getting
around to the objectionable remainder. I suggested that if she were to force herself to accomplish the unpleasant part of her job during the first hour, she would then be free to enjoy the other six. It seemed to me, I said, that one hour of pain
followed by six of pleasure was preferable to one hour of pleasure followed by six of pain. She agreed, and, being basically a person of strong will, she no longer procrastinates.
Delaying gratification is a process of scheduling the pain and pleasure of life in such a way as to enhance the pleasure by meeting and experiencing the pain first and getting it over with. It is the only decent way to live.
This tool or process of scheduling is learned by most children quite early in life, sometimes as early as age five. For instance, occasionally a five-year-old when playing a game with a companion will suggest that the companion take first
turn, so that the child might enjoy his or her turn later. At age six children may start eating their cake first and the frosting last. Throughout grammar school this early capacity to delay gratification daily exercised, particularly through the performance of homework. By the age of twelve some children are already able to sit down on occasion without any parental prompting and complete their homework before they watch television. By the age of fifteen or sixteen such behavior
is expected of the adolescent and is considered normal. It becomes clear to their educators at this age, however, that a substantial number of adolescents fall far short of this norm. While many have a well-developed capacity to delay
gratification, some fifteen- or sixteen-year-olds seem to have hardly developed this capacity at all; indeed, some seem even to lack the capacity entirely. These are the problem students.
Despite average or better intelligence, their grades are poor simply because they do not work. They skip classes or skip school entirely on the whim of the moment. They are impulsive, and their impulsiveness spills over into their social life as well. They get into frequent fights, they become involved with drugs, they begin to get in trouble with the police. Play now, pay later, is their motto. So the psychologists and psychotherapists are called in. But most of the time it seems too late.
These adolescents are resentful of any attempt to intervene in their life style of impulsiveness, and even when this resentment can be overcome by warmth and friendliness and a nonjudgmental attitude on the part of the therapist, their impulsiveness is often so severe that it precludes their participation in the process of psychotherapy in any meaningful way. They miss their appointments. They avoid all important and painful issues. So usually the attempt at intervention
fails, and these children drop out of school, only to continue a pattern of failure that frequently lands them in disastrous marriages, in accidents, in psychiatric hospitals or in jail.
Why is this? Why do a majority develop a capacity to delay gratification while a substantial minority fail, often irretrievably, to develop this capacity. The answer is not absolutely, scientifically known. The role of genetic factors is unclear.
The variables cannot be sufficiently controlled for scientific proof. But most of the signs rather clearly point to the quality of parenting as the determinant.
