ABSTRACT
Clinicians spend their lives struggling to hear our patients as they reluctantly reveal themselves. Problems arise in part from success, with difficulties heightened by pluralism. It is useful to keep in mind the underlying vicissitudes of demands for self-satisfaction and desires for exploring outward. Behind convergences and divergences lies the restless marriage between narcissism and scientific curiosity. When narcissism is secure or, even better, mature, clinicians are free to venture farthest in their inquiries. When their narcissism is threatened, open-minded, outward-looking inquiry deteriorates into a politics of identity. The chapter deals with the extreme of radical schools, where vanity overpowers open-minded curiosity. Development of separate schools can lead to difficulties that result from parochialism, from group dynamics and the structure of organizations, and from the impact of new ideas and new groups on language. For instance, self psychology adds much to our understanding of the ways a person handles essential need for recognition and regulation of esteem.
