The pathology of incestuous fixation depends obviously on the level of regression. In the most benign cases there is hardly any pathology to speak of expect, perhaps, a slight overdependence on and fear of women. Dr. Freud’s thinking was based on an evolutionary scheme of libido development, from the narcissistic to the oral-receptive, oral aggressive, anal-sadistic, to the phallic- and genital-character orientations. According to Dr. Freud the gravest type of mental sickness was that caused by a fixation on (or regression to) the earliest levels of development of the libido. As a consequence, for example, regression to the oral-receptive level would be considered a more severe pathology than regression to the anal-sadistic level. In my experience, however, this general principle is not born out by clinically observable facts. The oral-receptive orientation is in itself one that is closer to life than is the anal orientation; hence, generally speaking, the anal orientation could be said to be conducive to more severe pathology than the oral-receptive. Furthermore, the oral-aggressive orientation would seem to be more conducive to severe pathology than the oral-receptive, because of the element of sadism and destructiveness involved in it. As a result, we would arrive almost at a reversal of the Freudian scheme. The least severe pathology would be that connected with the oral-receptive orientation, followed by more severe pathology in the oral-aggressive and in the anal-sadistic orientations. #RandolphHarris 1 of 18

Assuming the validity of Dr. Freud’s observation that genetically the sequence of development is from the oral-receptive to the oral-aggressive to the anal-sadistic orientation, one would have to disagree with his standpoint that fixation on an earlier phase means more severe pathology. However, I believe that the problem cannot be solved by the evolutionary assumption that the earliest orientations are the roots for the more pathological manifestations. As I see it, each orientation in itself has various levels of regression, reaching from normal to the most archaic pathological level. When it is combined with a generally mature character structure, that is, a high degree of productivity, the oral-receptive orientation, for instance, can be mild. On the other hand, it can be combined with a high degree of narcissism and incestuous symbiosis; in this case the oral-receptive orientation will be one of extreme dependency and malignant pathology. The same holds true as regards the almost normal anal character in comparison with the necrophilic character. Therefore, to determine pathology not according to the distinction between the various levels in libido development, but according to the degree of regression which can be determined within each orientation (oral-receptive, oral-aggressive, et cetera). It must furthermore be kept in mind that we are dealing not only with the orientation which Dr. Freud sees as being rooted in the respective erogenous zones (modes of assimilation), but also with forms of personal relatedness (like love, destructiveness, sado-masochism) which have certain affinities to the various modes of assimilation. #RandolphHarris 2 of 18

Thus, for instance, there is an affinity between the oral-receptive and the incestuous, between the anal and the destructive orientations. There also exists an affinity between biophilia and the “genital character” and between incestuous fixation and the oral character. The deeper the regression in each orientation, the more the three tend to converge. In the state of extreme regression, they have converged to form what I have called the “syndrome of decay.” On the other hand, with the person who has reached an optimum of maturity, the three orientations also tend to converge. The opposite of necrophilia is biophilia; the opposite of narcissism is love; the opposite of incestuous symbiosis is independence and freedom. The syndrome of these three attitudes I call the “syndrome of growth.” Now suppose, for example, that an individual has a neurotic need for absolute independence. After recognizing the trend and learning something of its origins one would have to spend quite a while understanding why only this way is open for reassurance, and how it manifests itself in one’s daily living. One would have to see in detail how this need expresses itself in one’s attitude toward physical surroundings, how it takes the form, perhaps, of an aversion to obstructed views, or an anxiety that arises when one sits in the middle of a row. One would have to know how it influences one’s attitude toward dress, as evidenced by such signs as sensitivity toward girdles, shoes, neckties, or anything that may be felt as a construction. One would have to recognize the influence of the trend on work, shown perhaps in rebellion against routine, obligations, expectations, suggestions, a rebellion against time and against superiors. #RandolphHarris 3 of 18

One would have to understand its influence on love life, observing such factors as an incapacity to accept any ties or a tendency to feel that any interest in another person means enslavement. Thus an estimate would gradually crystallize as to the various factors which in greater or less degree serve to touch off the feeling of coercion and to force one to be on one’s guard. The mere knowledge that one has a great wish for independence is not nearly enough. It is only when one recognizes its all-inclusive compelling force and its negativistic character that one can muster a serious incentive to change. Thus the therapeutic value of the second step is, first, that it strengthens a person’s willingness to conquer the disturbing drive. One begins to appreciate the full necessity for change, and one’s rather equivocal willingness to overcome the disturbance turns into an unambiguous determination to grapple with it seriously. This determination certainly constitutes a powerful and valuable force, indispensable for effecting any change. However, even the most vigorous determination is of little avail without the ability to carry it through. And this ability is gradually increased as one manifestation after another is clearly seen. While a person is working at the implication of the neurotic trend one’s illusions, fears, vulnerabilities, and inhibitions are gradually loosened from their entrenchments. As a result one becomes less insecure, less isolated, less hostile, and the resultant improvement in one’s relationships with others, and with oneself, in turn makes the neurotic trends less necessary and increases one’s capacity to deal with it. #RandolphHarris 4 of 18

This part of the work has the added value of kindling an incentive to discover those factors that impede a more profound change. The forces thus far mobilized have helped to dissolve the power of the particular trend and thereby to bring about certain improvements. However, the trend itself and many of its implications are almost sure to be closely bound up with other, possibly contradictory, drives. Therefore the person cannot fully overcome ones difficulties by working only at the substructure developed around a particular trends. Clare, for instance, lost some of her compulsive modesty through the analysis of that trend, but certain of its implications were out of reach at that time because they were intertwined with the morbid dependency and could be tackled only in conjunction with that further problem. This third step, the recognition and understanding of the interrelations of different neurotic trends, leads to a grasp on the deepest conflicts. It means an understanding of the attempts at solutions and of how these attempts have meant only a deeper and deeper entanglement. Before this part of the work is reached the person may have gained a deep insight into the component parts of a conflict, but still have adhered secretly to a belief that they could be reconciled. One may have realized deeply, for instance, the nature of one’s drive to be despotic and also the nature of one’s need to be applauded for superior wisdom. However, one has tried to reconcile these trends by simply admitting occasionally the despotic drive without having the least intention to change it. One has expected secretly that the admission of the despotic trend would allow one to continue it and at the same time win one recognition for the amount of insight shown. #RandolphHarris 5 of 18

Another person who strove for superhuman serenity, but also was driven by vindictive impulses, has imagined that one could be serene for the larger part of the year but spare out a sort of leave of absence when one could indulge in one’s vindictiveness. It is obvious that no fundamental change can take place as long as such solutions are secretly adhered to. As the third steps is worked through, it becomes possible to understand the makeshift nature of these solutions. The therapeutic value of this step lies also in the fact that it makes it possible to disentangle the vicious circles operating among the various neurotic trends, the ways in which they reinforce one another as well as the ways in which they conflict with one another. Thus it means an understanding at last of the so-called symptoms, that is, the gross pathological manifestations, such as attacks of anxiety, phobias, depressions, gross compulsions. One often hears statements to the effect that what is really important in psychotherapy is to see the conflicts. Such statements are of the same value as a contention that what is really important is the neurotic vulnerability or rigidity or striving for superiority. What is important is to see the whole structure, not more and not less. Existing conflicts may sometimes be recognized quite early in the analysis. Such recognition, however, is of no avail until the components of the conflicts are thoroughly understood and diminished in their intensity. Only after this work has been accomplished, do the conflicts themselves become accessible. #RandolphHarris 6 of 18

No amount of knowledge can fulfill the expectations of a detailed and definite direction of the road to be taken in analysis. One reason for this is that the differences among people are too great to allow the pursuit of any prescribed path. Even if we should assume that there is but a limited number of discernible neurotic trends existing in our civilization, say fifteen, the possible combinations of such trends would be practically infinite. Another reason is that in analysis we see not one trend neatly separated from another, but the sum total of entanglements; a flexible ingenuity is therefore necessary in order to isolate the components of the picture. A third complication is that often the consequences of the various trends are not apparent as such but are themselves repressed, thus making recognition of the trend considerably difficult. And, finally, analysis represents a human relationship as well as a common research. It would be a one-sided comparison to think of an analysis as an exploratory trip in which two colleagues or friends are engaged, both as much interested in observing and understanding as in integrating the observations and drawing the inferences. In analysis the patient’s peculiarities and disturbances—not to speak of the analyst’s—are vitally important. One’s need for affection, one’s pride, one’s vulnerability, are just as present and as effective in this as in other situations, and in addition the analysis itself inevitably elicits anxieties and hostilities and defenses against insights that threaten one’s safety system or the pride one has developed. #RandolphHarris 7 of 18

While all these reactions are helpful, provided one understands them, they nevertheless render the process more complex and less susceptible of generalization. The assertion that to a large extent each analysis must produce its own sequence for tackling problems may be intimidating to apprehensive souls, particularly to those who need a guarantee that they are always doing the right thing. They should keep in mind, however, for their own reassurance, that this sequence is not artificially created by the analyst’s clever manipulation but occurs spontaneously because it lies in the nature of the problems that one becomes accessible after another one is solved. In other words, when anyone analyzes oneself one will usually take the steps described above by merely following the material that presents itself. It will sometimes happen, of course, that one touches upon questions that at the time being are not answerable. At such points an experienced analyst will probably be able to see that the particular subject is beyond the reach of the patient’s understanding and is therefore better left alone. Let us assume, for instance, that a patient who is still deeply immersed in convictions of one’s absolute superiority over others brings up material suggesting that one has a fear of not being acceptable to others. The analyst will know that it would be premature to tackle as yet the patient’s fear of rejection, because the latter would regard it as inconceivable that such a superior being as one believes oneself to be could possibly have such a fear. Many other times the analyst will recognize only in retrospect that, and why, a problem was not accessible at a certain point. In other words, one, too, can proceed only by trial and error. #RandolphHarris 8 of 18

While much is recorded as to the basic identifying characteristics presenting symptomatology, and official diagnosis of the hospitalized psychiatric patient, the patient whose problems are treated exclusively on an outpatient basis has so far not been a regular subject for comprehensive census taking. This is not to say that we do not know the forms that psychoneurosis may take so far as symptom patterns are concerned, or something of the particular problems associated with treatment of the discriminably diagnosable outpatient syndromes, and something of the rate of response to psychotherapy. Much of this information is discursive and clinical, even when it represents statical accumulation of the experience of a particular clinic it rarely goes beyond the diagnostic grouping of patients. We do not have a truly comprehensive and representative picture of the broadly identifying characteristics of the consumers of psychotherapy, including the content of their problems, that goes beyond specification of such ubiquitous presenting complaints as depression and anxiety. In the absence of more information about these persons it is difficult to imagine that we can provide either specifically or adequately for their needs. Unless, of course, in our approach to mental health education, we are meaning to create a consumer demand for the particular product we feel they need! Let us consider what is known about the actual and potential candidates for psychotherapy. Our information is primarily general description for which psychotherapy is thought to be a primary treatment—the psychoneurotics. #RandolphHarris 9 of 18

A scientifically based medical attack upon the neuroses as medical problems is hampered by the nonobjectivity, ambiguity, and inclusiveness of the diagnoses. A corollary of this fact is the absence of explicit statements of exclusion: When organic illness is not a factor, when psychic disturbance of psychotic proportion is ruled out, what patterns of disturbance or discomfort (or degrees of these) may be encountered that do not qualify for the label “neurosis”? Put another way, does the presence of mental conflict or the experience of anxiety or the condition of emotional depression constitute ipso facto a neurosis? Or, must the proper diagnosis of a neurosis entail consideration of the arousing circumstances, the duration, and the severity of these conditions? There is no clear consensus on these questions among psychiatric authorities. Note again that the formal definitions emphasized the character of the person’s response and subjective experience and generally ignore the situational matrix to which the person is responding. In practice this means that a patient, without the presenting symptoms and history which would support some other diagnosis, who presents oneself to an appropriate “mental health expert” with complaints of depression, conflict, or anxiety is likely to be diagnosed as psychoneurotic—even though any “hallmark” symptoms such as hysterical conversions, phobias, obsessions or compulsions may be absent. In a sense, these are “self-diagnosed” patients who are accepted by the therapist without much concern for whether they technically qualify as psychoneurotics. All of these factors contribute to the nonspecificity of a diagnosis of psychoneurosis and this nonspecificity must be kept in mind when considering the following data. #RandolphHarris 10 of 18

While the great majority of neurotics are treated exclusively on an outpatient basis, there are some whose illness is of such severity or whose life situation is so devoid of support that hospitalization is necessary. According to our research, the average neurotic patient was 38 years old at the time of hospital admission. Two thirds of the neurotics were in the 20-44 age range at admission. At all ages, the admission rates were higher for females than males. Psychoneuroses are relatively more prevalent among the higher economic classes. With gender and age controlled for a standard population having a base age of 25 and over, the rate of first admissions with diagnosed psychoneurosis was at a minimum among those with little or no formal education and increased progressively to a maximum among patients who attended college. Among the hospitalized neurotics, there was a clear preponderance of single, widowed, and divorced patients over married patients. The excess of single patients was greatest among those over age 35. In one of the very rare reports on the clientele of private psychiatrists, descriptions are given of the general characteristics of 100 unselected, consecutive cases seen in office practice. Sixty percent of these patients were between the ages of 20 and 40. Slightly more than half (54 percent) were men, and slightly more than half were married (52 percent). Eighty percent were of Protestant faith. One third of these patients were office workers or skilled labourers; only 12 percent held professional jobs. One third of them had been referred to the psychiatrists by other patients; nearly one fourth were self-referrals. #RandolphHarris 11 of 18

The major compliant presented by these patients were nervousness, tension, and depression; other complaints included insecurity, self-consciousness, and shame or confusion regarding gender. Only half of these patients were diagnosed as psychoneurotic, but psychotherapy was recommended for 70 percent of them. Forty percent of this sample made but s single visit. Of those who undertook outpatient treatment the average cost of the treatment was $7,500 per year. Specific diagnoses were not under investigation but it is a reasonable presumption that the majority of these patients were neurotics. The following generalizations may be proposed from this study: The typical psychiatrist sees preponderantly more female than male patients. By contrast, psychologists and social workers tend to have clients of both genders in equal numbers. The complete age range is represented in the clients of three professions. However, the number of psychiatrists who specialize in patients under age 15 is very small, while one out of five psychologists concentrates on this age group. In contrast to the social workers and psychologists, many more psychiatrists have a clientele in which persons over the age of 40 predominate. The complete range of educational achievement is represented in the patients seen by all three professions. Psychiatrists are relatively inexperienced with patients having less than an eighth-grade education, while social workers very rarely carry-on individual therapy with college graduates or persons with postgraduate education. #RandolphHarris 12 of 18

All occupational levels are represented in the psychotherapy cases of the three professional groups as are all income levels. Certain occupational groups (exempli gratia, domestic and personal service, and agriculture, forestry, and fishing) have very little representation in the case loads of these psychotherapists. Other occupational groups (exempli gratia, professional, and managerial-office jobs) have a high frequency among the patients. Prevalence of Maladjustment: Over one third of the sample when queried about previous sources of unhappiness made reference to economic or material considerations, including their jobs. Two out of every five respondents indicated their primary source of worry to be in the economic or material sphere. Nearly one out of every five persons sampled reported that they had at some time in their past felt an “impending nervous breakdown.” Less than half of these persons felt that their problem was relevant for outside help. Nearly 40 percent of these persons reported their problems as external, exempli gratia, illness, death, work tension, finances. Factors Related to Maladjustment: While the genders did not differ in the frequency with which they reported unhappiness, the women more frequently reported worry, fear of breakdown, and need for help. In general, women reported suffering from more symptoms, both physical and psychological, than did the men of the sample. With increasing amounts of education, there is an increase in symptoms which express immobilization, inertia, and an attitude of passivity. This syndrome of immobilization is more prevalent among the younger persons than the older. #RandolphHarris 13 of 18

Greater distress is reported by women than by men in all adjustment areas—they are more disturbed in general adjustment, in their self-perceptions, in their martial and parental functioning. This gender difference is most marked at the younger age intervals. “Psychological anxiety” symptoms are found most frequently at the two extremes of the income distributions. Occupational status is less related to over-all adjustment than are education and income. The unmarried (whether single, separated, divorced, or widowed) have a greater potential for psychological distress than do the married. A feeling of impending breakdown is reported more frequently by the divorced and separated females than by any other group of either gender. In general, single women experienced less psychological discomfort than do single men. Factors Related to Seeking of Help: With respects to readiness to seek help for personal distress, the more highly educated persons surpass all other groups. The highly educated are more introspective, orient themselves toward life in terms of self-questioning rather than unhappiness or dissatisfaction express concern over the personal and inter-personal aspects of their lives, predominate in psychological rather than physical symptoms. It is if particular interest to note that the highly educated people more often go for help despite the fact that they express more happiness and satisfaction on the adjustment indices than do the less educated people. #RandolphHarris 14 of 18

Of those persons who actually sought help, over half reported problems in the area of personal relationships. Most commonly the problem was with a spouse and was less frequently ascribed to the relationship than to a defect in either the respondent (23 percent) of the spouse (25 percent). First step toward clear-mindedness: to grasp the extent to which we have been seduced—namely, it could have been exactly the other way around: The unknown World could perhaps be a stupid and more trivial form of existence—so constituted as to make us long for “this World.” The other World,far from accommodating our desires, which would find no satisfaction there, could be among a host of things that make this World possible for us: coming to know it would be a way of making ourselves happy. The true World: but who is it that tells us that the apparent World must be worth less than the true one? Des not our instinct contradict this judgment? Does not man perpetually create a fictious World because he wants to have a World better than reality? Above all: why does it ever occur to us that our World is not the true one? After all, the other World could be the “apparent” one (in fact, the Greeks, for example, conceived of a realm of shadows, an apparent existence alongside true existence). And finally: What gives us the right to estimate, as it were, degrees of reality? That is something different from an unknown World—that is already wanting to know something of the unknown. The “other,” the “unknown,” World—good! However, to say “true World” means “to know something about it”—that is the opposite of the assumption of an x-World. #RandolphHarris 15 of 18

The World x could be in every sense more tedious, more inhumane, and less worthy than this World. It would be something else again to assert that there are x Worlds, id est, every possible World besides this one. However, that has never been asserted. The word “wiles” in the original means “methods,” and bears in its varied forms the thought of craft, artifice or trickery. To “work wiles” is to outwit, or to methodically go in pursuit. The ultimate negative’s war on the saints can be summed up in the phrase “the wiles of the ultimate negative.” He does not work in the open but always being cover. The method of his deceiving spirits are adapted to each one, and they have a skill and cunning gained by years of experience. Generally, the wiles are primarily directed against a person’s mind or thoughts, so, unless the believer has yielded to known sin, most of the workings of the Ultimate negative in one’s life may be traced back to a wrong thought or belief admitted into one’s mind and not recognized to be from deceiving spirits. For is a believer thinks that all that the ultimate negative does is manifestly bad, the ultimate negative has only to clothe himself with “good” to gain full credence with that man. The way, therefore, is a war of deceit and counterfeit, and only those who seek the fullest truth from God about God, the ultimate negative, and themselves can stand against the Deceiver’s wishes. The more common solution to the Christ-and-culture problem is to unite somehow the extremes of the first two types. This center position, therefore, acknowledges the goodness of creation, the radical character of sin, the necessity of human cultural activity, and the primacy of grace. However, the reconciliation of these opposing principles can be achieved in several different ways. #RandolphHarris 16 of 18

One way is by a synthesis of the two, which we term the Christ-above-culture type. According to the synthetic view, there is a gap between Christ and culture that accommodation Christianity never takes seriously enough, and the radicalism does not try to overcome. Its starting point is the doctrine that Jesus as the Christ did not come to abolish the law and prophets, but to fulfill them. It is exemplified in history by the theology of Clement of Alexandria and Thomas Aquinas. The synthesis holds that grace builds on and perfects nature, that the Creator and the Saviour are one. Jesus as the Christ is above culture as its fulfilment and crown. We drive for unity between Christ and culture with an insistence upon grace. However, the unity is effected by a vertical structuring that is divided into layers, and this is repugnant because it resembles the natural-supernatural framework which we detests. The synthesists regards cultural efforts as a mere propaedeutic for the culmination of Christianity in a future afterlife. Furthermore, as Niebuhr observes, the synthesis tends to view his own culturally conditioned synthesis as absolute, so that Jesus as the Christ who is above culture as its fulfilment has been first whittled down to the proportions of the prevailing culture. The result is a cultural conservatism which is akin to idolatry. When we say, “The Father alone is God,” such a proposition can be taken in several senses. If “alone” means solitude in the Father, it is false in a categorematical sense; but if taken in a syncate gorematical sense it can again be understood in several ways. #RandolphHarris 17 of 18

For if it excludes (all others) from the form of the subject, it is true, the sense being “the Father alone is God”—that is, “He who with no other is the Father, is God.” In this way Augustine expounds when he says (De Trin. Vi, 6): “We say the Father alone, not because he is separate from the Son, or from the Holy Ghost, but because they are not the Father together with Him.” This, however, is not the usual way of speaking, unless we understand another implication, as though we said “He who alone is called the Father is God.” However, in the strict sense the exclusion affects the predicate. And thus the proposition is false if it excludes another in the masculine sense; but true if it excludes it in the neuter sense; because the Son is another person than the Father, but not another thing; and the same applies to the Holy Ghost. However, because this diction “alone,” properly speaking, refers to the subject, it tends to exclude another Person rather than other things. Hence such a way of speaking is not to be taken too literally, but it should be piously expounded, whenever we find it in authentic work. We do not say absolutely that the Son alone is Most High; but that He alone is Most High with the Holy Ghost, in the glory of God the Father. I pledge allegiance to the flag of the United States of America, and to the republic, for which it stands, one nation, under God, indivisible, with liberty and justice for all. Happy is the man that has regard for the poor; the Lord will deliver him in the day of evil. Every day, the Sacramento Fire Department displays bravery, strength, honesty, determination and compassion for the lives of others. Please kindly donate to the Sacramento Fire Department. You donation will greatly benefit the welfare of the community. #RandolphHarris 18 of 18

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