Am J Psychiatry 1996; 153:7-10
Copyright © 1996 by American Psychiatric Association
Psychotherapy, revelation, science, and deep thinking
T Nadelson
Psychiatry Service, Boston VA Medical Center, USA.
Psychodynamic psychotherapy has evolved in the 30 years since John Nemiah
was the author's mentor in the endeavor. It has always occupied an
epistemologic position somewhere between the scientific standard of physics
and the postmodern or poststructuralist view that the search for truth
using language is totally futile. However, the awkward niche that
psychotherapeutic practice occupies is closer to literary imagination than
"hard science." The use of such imagination was presented 25 years ago by
John Nemiah in his paper on "Deep Thinking." The poet's "revelation ... not
discovered by the rational intellect alone" often imparts in
psychotherapeutic practice a compelling urgency toward a previously
unrealized choice. Such vision is, however, always located at the periphery
of acceptable scientific theory. Psychotherapists persist, often with
doubts, because their place is reflective of humanity's awkwardness.
Evolution and civilization mutually enfold the human ability to resonate to
the anguish of others as well. A species altruism directed toward repair of
human problems is coupled with the skills of affectively linked "deep
thinking." There is a continuing marginalization of such efforts, which now
need to be cared for deeply.
