ABSTRACT
In the course of his daily work, the psychotherapist comes to know a considerable number of people extremely intimately. This is surely one of the most rewarding and interesting aspects of the job. Those who practise psychotherapy as a more or less full-time occupation come to know more people more intimately than do members of any other profession. Moreover, psychotherapists know their patients far better than they know their own friends or colleagues, and often better than they know their own spouses or children. Although sexual intimacy appears to many people to be the closest kind of human intimacy, I do not think this is the case. Whilst sexual intimacy often encourages other kinds of intimacy – hence, the war-time convention of the 'beautiful spy' who is used to extract secrets from the enemy officer – a sexual relation may not only render verbal relations less necessary, but also create an illusion of mutual understanding which shatters when the sexual partnership comes to an end. The practice of psychotherapy has made me aware that many husbands and wives know rather little about one another, even when their sexual relationship is satisfactory. Although the psychotherapist is debarred from certain areas of knowledge about his patient because he neither lives with him nor sleeps with him, he is, if he is at all skilled at his profession, likely to acquire more intimate knowledge of his
patient than anyone else ever has or will. This is largely a consequence of the time which the therapist gives to each individual he treats; a span unlikely to be matched in any other kind of relationship: and also to the fact that the intimacy is necessarily one-sided. During the time of the therapy, the therapist puts himself at the patient's disposal and refrains from talking about himself. This feature of psychotherapy is difficult to match outside the confessional. The psychotherapist's purpose is to increase the patient's self-knowledge, both by acting as a reflecting mirror in which the patient may descry himself and also by gradually building up a coherent picture of the patient's personality by making the interpretative connections discussed in Chapter 5. Such a picture can only be drawn after prolonged enquiry. This chapter is designed to explore some of the factors which may interfere with the psychotherapist coming to know his patient as intimately as he needs to do, and also to delineate the kind of attitude toward patients, emotional as well as intellectual, which, to my mind, the psychotherapist should seek to cultivate. In what follows, I assume that the psychotherapist possesses enough intelligence to see connections and make reasonable interpretations; that he is a reliable, consistent person who aims at professional standards; and that he has a genuine interest in human problems and therefore some capacity for empathy.
