Dave: (Part 1)

It is in playing and only in playing that the individual child or adult is able to be creative and to use the whole personality. It is only in being creative that the individual discovers the Self (D.W. Winnicott).

The dynamics of therapy are in the Personhood of the therapist (Betz & Whitehorn).

These two ideas have been part of my meditations on psychotherapy for many years. I have written several papers about the Use of Self in Therapy in a series of books edited by Michelle Baldwin.  I wrote the essays primarily for therapists, but the central ideas can be adapted to thinking about the experience of being human, they apply to marriage and they apply to parenting.  My writing style here is mildly non-logical. There is a lack of clarity, be­cause I am trying to understand something by writing about it.  It is imperfect.

A number of years ago I worked with the idea that I am the sum of my relationships. Then I came to believe I am an “I” which is more than the sum of my relationships. Others refer to this “I” as the True Self, the Core Self, or simply the Self. In my musings I figured out that in addition to this I, the Self, there is a system of social selves, a community of selves. The social selves are roles that we play. We all have multiple personalities. Personalities are context dependent.The social selves are how we are known. No one knows our core self.


Personhood is constituted by the relationship between the “I”, the core Self with the capital “S” and the social self(s). There is tension between I the social self(s). Social self(s) are embodied in social roles. Most of us have at least eight to twelve social roles.  Some of my social roles include husband, father, grandfather, musician, psychiatrist as therapist, supervisor, psychiatrist as diagnostician, teacher, musician, friend, writer, bon vivant. There are others that exist in my imagination only: novelist, woman. Some others are dormant but can be returned to active duty when necessary, airplane pilot, cement finisher. All of the social roles do not get along with one another, e.g., both psychiatrists are embarrassed by the musician, the bon vivant thinks the diagnostic psychiatrist is a pretentious jerk and ignores him in social situations. The husband and father are close buddies with a lot in common.

As an example of what I mean by a social role or a social self, on the wall of my office there are certificates indicating I am a physician and a psychiatrist. But in this framework I can say, I am not a Psychiatrist, I am a man who has learned to play the role of Psychiatrist.

When I use the word “Self,” I am referring to a Core Self, the Self I refer to when I say “I”. I cannot “know” this Self because I am this Self . In order to know this Self, I would have to get outside of it, and I can’t get outside of it. I don’t “know” myself, but I am familiar with the Self that is me.

Each of the social self(s) [note: they refuse to be grammatically correct “selves,” they insist on being slightly idiosyncratic self(s)], are connected with the core self, but with varying degrees of intensity. Personhood refers to the relationship, or the tension in the relationship between the “I” and the Social Self(s). Social Self(s) are embodied in social roles.The dynamic tension in the relationship between any social self (role) and the core self is what I refer to as “‘Personhood.”  This connection is most critical in social roles that have to do with caring; parent, teacher, therapist and spouse.

People who maintain congruence and integrity between social self(s) and Self are likely to be full-fledged persons. My view, of course, is that communities are healthier when comprised of more people who have strong congruity between the Self and the social self(s). The distance between Self and social role is likely to be more distant and disrupted when political aims (including financial aims) are involved. Thus, full-fledged persons are not necessarily good leaders.

The social self(s) or social roles are partially created by society to serve its needs. In a more specific way, the social self(s) are in great part created by membership in institutions. And they are partly created by other relationships (It is in this sense I am the sum of my relationships). How the social roles are enacted is colored by the core Self (I), which has limited involvement in society. The social self(s) have the capacity to adapt to situations. The Self has virtually no capacity for adaptation.

The relationship between social self and core Self is disrupted in people who are loosely connected to their society, for example, college freshmen, new military recruits, injured athletes, laid-off workers (even executives) are susceptible to being viewed as psychotic. This is what happened to Beatrice in my earlier post, Out of Darkness: Therapy for a Depressed Young Woman. She was more than depressed. The relationship between her social self(s) and her Self was disrupted when she was diagnosed with and treated for ovarian cancer. In the title I said she was depressed in order to keep the essay more accessible to our readers. “Seriously depressed” is how she would have been characterized by most.

The Self is constant and consistent and changes little. The Self is like my computer with its, to me, mysterious operating systems. My fantasy is that the Self (I) is pretty much fully installed by age 5. However, most people have only limited access to the Self and its capacities. Experience increases access to more of the Self, or, contrariwise, traumatic experience can impair access to more of the Self. As we mature we gain more and more access to our Self. We never know the self but we become more familiar with more of it. One goal of psychotherapy is to gain more access to more of my Self.



I used this metaphorical representation of attending to Self in an earlier post. If this isn’t a new idea, consider it a refresher course

Like most of you I have a computer that came with an abundance of software programs installed. When I first developed a relationship with a computer I got fairly good at using the word proces­sor program. Then I had to figure out how to use e-mail in order to correspond with some friends. When I need to learn something new, I begin with hesitancy, anticipating the inevitable series of frustra­tions. I make mistakes but those mistakes lead to learning and in the end, I know more of my computer. In the same way, experience leads us to more knowledge of the Self with the capital “S.” Experience produces demands and frustrations and ultimately learning (by the way, traumatic expe­rience can produce injury that may block learning). As time goes on, experience accumulates, and pushes learning about the Self. Psychotherapy can be the experience that leads to learning about Self, but more often, psychotherapy is a catalyst for change. Or therapy becomes a template for how to get something out of our own experiences with a meaningful other person.

This could be a distraction or it may be helpful to know that this way of thinking is stimulated by my multiple experiences in working with families with schizophrenia and serious psychosomatic illness. The way these ideas translate into schizophrenia is that instead of a genetically based chemical imbal­ance, I think of schizophrenia as a desperate, forced immersion in I. The psychotic person loses connection with their own social self(s), and thus loses other social connections. Support, a relationship based on non-manipulative caring, is required to make it back to the surface. However, in the immersion, damage may occur that is not easily reversed.

What does this mean about psychotherapy with schizophrenia? For me, it means working with families, the therapist pressures the family together and in that way neutralizes the schizo­phrenic’s desperate rampage to bring about change. The family’s anxiety- or anger-driven attempts to be therapeutic to its own member is interrupted. I pressure all family members to acknowledge their own pain and by turning them toward the labyrinth of themselves. The process, when it works, moves the schizophrenic person out of their isolation by restoring links to social self(s).

It is difficult to attend to these processes. Deeper symbiotic/sym­bolic connection with patients is involved. The process pressures the Self of all who are involved. The process inevitably provokes disturbing symptoms in the therapist.) The Self of the therapist can become temporarily disoriented. The experience chal­lenges identity and competence and leads to questioning the very meaning of the Self. And, as I noted above, it is much more likely to succeed in the presence of the family. For me, this is what makes this kind of work so compelling.

I have been paying attention to I; the searching is a clumsy, but crucial, counterbalance to mass culture. Psychotherapy emerges as a means to recover access to the I, but psychotherapy as a process is taken over by industrializing pressures in culture, neutral­ized. Remembering I, looking for I is to enter a labyrinth of dark­ness, deception, and meaninglessness. But it is exactly in this descent into meaninglessness, without panic, but with the impeccable eyes of the searcher, that the meaning of life and relationships is deepened. It is humbling to write in this way. I hope I said some­thing interesting, if not helpful to you.







Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s