ABSTRACT
One of the most valuable and therapeutic tools used in treatment is self-observation. Self-observation involves encouraging the people therapists working with to be co-investigators of themselves. B., a 35-year-old banker, presented to treatment with certain painful symptoms. He suffered from much self-doubt about the quality of his work, and felt unrecognized. B. began to develop symptoms consisting of "intrusive thoughts" of stabbing her with a knife, pushing her down a flight of stairs, and hitting her in the head with a phone. He felt enormously guilty and panicked over these thoughts, which he experienced as totally foreign, disgusting, horrifying, and from another world. He had previously developed other symptoms, which had begun earlier in adult life. He was afraid of traveling, especially far away. He felt anxious about going on vacations. Another set of symptoms was triggered by a physical symptom of his own.
