Psychoanalysis and the Self: Toward a Spiritual Point of View

by John E. Mack, M.D.

Listen to the Boston University Institute for Philosophy and Religion presentation, Toward a Spiritual Point of View in Psychoanalysis, from which this essay was developed (mp3)

Not very long ago I had a dream
So bright and glowing it startled me
Into a great glow of transcendental joy.
The dream? Everything around me black as sin
I, walking toward some unknown goal,
My body virginal in youth and pure,
Naked, rosy and quite beautiful.
And from me emanated shining light;
While all about me I could dimly see
Small swarthy men with evil weaponry,
Arms thrust out to mutilate and kill,
Ready to slash through my integrity.
But as they came within my numinosity
They melted into darkness and were gone
And I walked on, untroubled and serene.
—Harriet Robey,
aged 90, Freudian trained psychiatric social worker,
“reared without belief in God.” August, 1991

The title of this paper relates to a 1959 article by David Rapaport and Merton Gill, entitled “The Points of View and Assumptions of Metapsychology.”1 Rapaport and Gill suggested that there are five fundamental points of view which inform psychoanalytic theory and practice and the psychodynamic psychotherapies that derive from psychoanalysis. These are (1) the dynamic point of view, which concerns the direction and magnitude of psychological forces; (2) the economic point of view, which has to do with the distribution and transformation of psychological or emotional energies; (3) the structural point of view, which describes the more or less permanent configurations of the psyche, or those which are slow to change; (4) the genetic point of view, which concerns propositions about psychological origins and individual development; and (5) the adaptive point of view, which demands that psychodynamic explanations take into consideration our relationship to the environment and questions of survival in the external world. I argue that depth psychology is now in need of a sixth, a spiritual, point of view in order to understand more fully the psyche and conditions of human life as we now experience them.

The above assumptions are based on too limited a view of the psyche and have been unable, therefore, to provide a basis for addressing many of the fundamental problems that we now confront in clinical, social, and political settings. Addictive disorders, child abuse and other forms of domestic violence, the variety of complex conditions brought together as personality disorders, the increased reliance on affect-muting psychotropic drugs and the turning away of many patients from traditional therapies to “holistic” or “alternative” treatment approaches (which themselves include spiritual elements), reflect profound unmet emotional hungers that psychoanalysts and other mental health professionals are finding difficult to understand and treat within established theoretical frameworks and therapeutic parameters. Contemporary self psychology, pioneered by Heinz Kohut and his followers,2 reflects this basic dissatisfaction within the field. Psychologist Philip Cushman has applied the term “empty self” to sum up this contemporary sense that something is wrong or missing.3 At the same time, out-of-control global crises of human origin, such as the rampant destruction of the living environment, the spread of ethno-national violence, and the proliferation of weapons of mass destruction, are forcing us to reexamine the nature of the psyche or self and our relationship to nature and one another, individually and collectively.

Spiritual matters are by nature subjective and complex. They are difficult to discuss within a scientific or empirical framework. But spiritual experience is so fundamental a dimension of the inner lives of human beings throughout the world, and the language of spirituality so universal a way of speaking, that the task is worth undertaking.

Spirituality is often associated with dramatic personal events, such as religious conversions,4 and other peak “highs” or mystical experiences, which we tend to disparage. Yet as Barbara Marx Hubbard has written,

What sexuality was to the Victorian Age, mystical experience is to ours. Almost everyone experiences it, but almost no one dares to speak about it. We have been dominated by a scientific, materialistic culture which has made us feel embarrassed about our natural spiritual natures. Yet we read that sixty percent of the American people have had mystical experiences. We are a nation of repressed mystics!5

But most spiritual experiences are less dramatic and more subtle. They have in common the sense that there is another reality beyond that which is immediately manifest to our senses or reason. This reality is numinous, that is, mysterious and containing or filled with a power that is beyond comprehension, called “divine” when it seems to contain something of a wondrous nature or higher value beyond ourselves.

Also fundamental to religious experience and to an apprehension of the divine is the sense that the universe is not simply a chance creation or a random flux of matter and energy, but that there is some sort of design, or even intention. The nature or direction of this intentional design is, however, beyond our knowing. Paradoxically the way to get a little closer to knowing is to acknowledge our not knowing and the depths of mystery it embodies. When a sense of the divine becomes embodied in a single feature or a multiplicity of beings, people speak of God or gods. The spiritual world is also reflected in the myths that native people have created since before the beginnings of recorded history to set forth their experiences of the powers that reside in nature. Through myths the inner domain of human consciousness is connected to the surrounding world. Shamans are selected for their knowledge of and special access to the world beyond the manifest. The great powers of this world, often perceived in the spirits of animals, are used for healing purposes. Artists sometimes experience the process of their creativity as occurring beyond themselves, tapping into a source in nature from which they draw that is shaped by their efforts but exists in another realm.

Small children also have quite ready access to this spirit world — or have not yet had these experiences dismissed or reasoned away. I recently met with a three-year-old girl who told me of her “real” world, a world filled with animal and human figures commingled in a complex melange of elements from the hylotropic anti holotropic realms. For her the foxes and bears of the mythic domains were as real as the day-to-day life with her parents and brother. Yet she was in no way psychotic; she was able to navigate admirably at school and at home and was considered by her teachers to be a model child.

Disturbing emotions, such as great fear and sadness as well as exaltation and joy, darkness as well as light, are associated with the spiritual realm, which may account for some of our resistance to opening ourselves to its reality. Psychoanalyst Hans Loewald has described clearly the way we distance ourselves from the depths of religious experience and the reason for this:

Psychoanalysts tend to consider the idea of eternity, religious experiences connected with it, as well as the “timeless” experiences I described, in pragmatic fashion as useful and often necessary defenses, or as mental sanctuaries people must have to cope with the fear of death, castration, and with the trials, tribulations, and the transitoriness of human life. I do not doubt the truth of this view. But it is not the whole truth. I believe that “intimations of eternity” bring us in touch with levels of our being, forms of experiencing and of reality that themselves may be deeply disturbing, anxiety-provoking to the common-sense rationality of everyday life.6

Spiritual or religious experience calls forth the language of the sacred, words like soul, spirit, transcendence, reverence, and faith. Psychoanalysts and other dynamically oriented psychologists have tended to be uncomfortable with this language. Because the sense of merger or fusion with the mother in early infancy, recaptured in the therapeutic setting, has qualities much like the sense of oneness of mystical experiences, we have sometimes made the error of equating the two phenomena, reducing profound religious consciousness to infantilism or childish wish-fulfillment. Freud himself denied the reality of the spiritual domain in his own experience.7 Recent writings on this subject have been much more sophisticated and open to the significance of these matters.8

Many of us in the West, who have been educated in both our families and our schools in the epistemologies of rationalism and empiricism, have found ourselves cut off from the realms of the sacred, whereas virtually all other peoples throughout history have experienced its presence and central importance in their lives. According to historian of religions Mircea Eliade, “All history is in some measure a fall of the sacred, a limitation and diminution.”9 The separation of self from nature and the divine, of which nature is a supreme manifestation,10 may be one of the great negative achievements of Western civilization, one which we are now desperately striving to undo before it is too late. How and why we have done this to ourselves are questions which take us beyond the reach of this paper. The answers lie in the extreme development of reason and empiricism — of which technology is a derivative — for the purpose of controlling and dominating one another and all of nature, at the expense of feeling and the intuitive ways of knowing that might have helped us live in greater harmony with other peoples and the natural world.

What, then, would be a spiritual point of view? It would include the following elements:

1. An attitude of appreciation, or a sense of awe, toward the mysterious in nature, including our own natures, and toward all of creation, resisting the tendency to explain the motives behind spiritual experience or belief. In Eliade’s words, “There is always a kernel that remains refractory to explanation, and this indefinable, irreducible element perhaps reveals the real situation of man in the cosmos.”11 Joseph Campbell in his interviews with Bill Moyers spoke of the tendency to reduce mystery. “The mystery has been reduced to a set of concepts and ideas,” he said, “and emphasizing these concepts and ideas can short-circuit the transcendent, connoted experience. An intense experience of mystery is what one has to regard as the ultimate religious experience.”12

2. Opening ourselves to the experience of the cosmos and of all beings in nature as sacred. This has little to do with idealization or the denial of hostility or aggression. It is, rather, about reverence or respect, an openness to the possibility of value that is hidden from our perception. In Christian theology this attitude, when applied to human beings, is sometimes called “exaltation” or a sense of the exalted nature of humankind.13

3. The application of a cosmological as contrasted with a materialist perspective on reality. This means thinking and experiencing systematically and opening ourselves to the possibility that there is a design and, if not harmony, at least appropriate relations in nature, including human relationships.

4. A subjective sense of hesitation or doubt, especially in the clinical setting, appreciating that this does not reflect unassertiveness or obsessionalism but facilitates a deepening of the therapeutic dialogue. In the words of Christian theologian Glen Tinder, “hesitation expresses a consciousness of the mystery of being and dignity of every person.”14

5. A distrust of all human-made institutions, even as we will, of necessity, participate in them. This includes psychoanalytic institutes and departments of psychiatry and other professional organizations as well as political entities, such as nations. and even churches. For institutions may be essential in carrying out basic societal functions, but by requiring of us an identification with their purposes, rules, and reward systems, they may obstruct our relation to the numinous or holotropic and to spiritual experience itself. Institutions may stand as vehicles for expressions of congealed power on the part of individuals and groups, and will, perhaps inevitably, find the self-empowering experience of contact with the divine as threatening or subversive. For spiritual experience by its very nature ties us to the primary power in nature; elevates the confidence of individuals in their own thoughts, emotions, and perceptions; and diminishes blind loyalty to any humanly built structures. Established churches and other institutions may, paradoxically, be especially distrustful of spiritual experience and direct contact with the divine, since their power and reason for existing derive from their role as intermediaries setting the conditions of appropriate congregation and worship, while interpreting the nature of the divinity.

6. In the clinical setting a spiritual point of view means the development of an attitude toward emotionally troubled patients or clients that is less medical or pathology-focused while stressing nevertheless, the healing function of the therapeutic enterprise and the relief of suffering. The distinction here is subtle, a matter of emphasis. It means stressing our connection with our patients, rather than the differences, the shared fate and common source of our mutual pain and experience of what it is to be human. Personal growth and empowerment, even “enlightenment,” would receive relatively greater emphasis than conflict resolution or cure.15 As in the case of community psychiatry when it became a formal discipline in the 1960s, many of us will realize that we have been including a spiritual point of view in the practice of our discipline all along. We just have not called it that.

Increasing numbers of clinical practitioners, including psychoanalysts or psychoanalytically-oriented psychotherapists, and their clients are following what in religious traditions had been called a “spiritual path.” Many are returning to the formal religions of their families, sometimes interpreting them in new ways, or joining other churches or religious groups, in order to discover or rediscover the spiritual core of the self from which they feel they have become disconnected. Others find the beginnings of a spiritual opening in psychoanalysis itself, sometimes modified by its practitioners, or in more traditional psychotherapies. The popularity of alternative forms of psychotherapy which emphasize spiritual techniques and opening is related to the spiritual hunger discussed at the beginning of this paper. The burgeoning in the West of meditation practice, largely derived from Eastern religions, and of spiritual retreats, also reflects the spiritual awakening and transformation that is occurring in our society. Buddhist theory and practice, with its emphasis on mindfulness and upon living in harmony with nature, has been particularly attractive to American clinicians, some of whom combine psychotherapy with Buddhist spiritual methods. Psychedelic substances, such as LSD and psilocybin mushrooms, which have the capacity to undo the culturally programmed obstacles to spiritual experience, though largely still illegal in the United States, have been important agents of spiritual opening and transformation for many psychotherapists. Increasing numbers of voices within the mainstream of American society are arguing that these agents should be made legal, at least for those conducting responsible research, in order to understand human behavior or neuropsychological functioning.16

A spiritual point of view requires that we modify or extend our notions of the self. Self is a bridging concept, joining psychology with sociology, philosophy, and religion. When used in a religious context, it is sometimes spelled with a capital S to suggest a vast, sacred, and ineffable domain. In recent years the ways that self is thought of in psychology and in religion have come closer together. Within psychoanalytic psychology self has connoted something which, though abstract, is fairly literal and bounded, a structure not very different front ego, the property of discrete individuals. The total self is an aggregate of more or less cohesive self-representations, both a locus and a source of agency Self in a spiritual sense is something more mysterious or mythic, a space or possibility, a ground of being or source connected with the divine. Self in this sense is not discrete or limited to an individual, but a kind of fluid potential through which one connects with other selves and all of reality. There is even talk now of an “eco self” to indicate a flowing connection of a person with nature. The self in a spiritual sense is the locus of wounding and pain but also of transcendence and transformation.

Although self must remain an abstraction, we need to posit some such notion to account for the subjective sense that we exist. Through self we connect with others and with all of nature, and in this sense self is both a social or communal and a somewhat mystical concept. Buddhist poet and monk Thich Nhat Hanh speaks of “interbeing” to express this related or intersubjective aspect of self, while psychoanalyst George Klein uses the awkward but descriptive phrase “we go” to capture the social or connecting subjectivity of self.17

This connecting self is associated with desire, especially the desire to merge or fuse with another, or, as in the case of mystical experience, longing for oneness with all of creation or with God. There is a paradox for the self in this merger, for its fulfillment requires the death of the self or ego (in the psychological, small s sense), but from this death experiences of rebirth emerge. The cycles of ego death and rebirth, both terrifying and sublime, lie at the root of primary spiritual experience and have their first psychological analog in the phases of the birth process which are alternately largely blissful and secure (intrauterine life), terrifying and overwhelming (the crushing experience of passage through the birth canal), and sublime and transcendent (delivery and emergence into the world).18

Erik Erikson in some of his later writings has focused on the significance of the sense of I in religious or spiritual experience.19 For Erikson the sense of I is a spiritual notion in that it derives from a core of personality that lies deeper or beyond psychosocial identity. It is the “place” (language fails us here) where Self connects beyond itself to something greater, with the divine or transcendent, and human beings discover their oneness with being itself. It is from the sense of I that existential issues derive: questions of life, death, and rebirth, or what Erikson calls the psychology of “ultimate concern.”20 According to Erikson, the I is at the “Center,” “where the light is.”21 From the sense of I we derive our deepest values and intentions. It is the experiential core of identity behind the internalizations that create the sense of self in its purely psychosocial connotation. This deepest “place” of self is also associated with a sense of ultimate stability (perhaps because through the sense of I we are, ultimately, connected with the divinity), cohesiveness, and wholeness. Conversely, the absence of a core sense of I or self is associated with fragmentation and personality disruption. The tension between fragmentation and wholeness is a fundamental dilemma of contemporary life, at least in Western countries, and thus has important therapeutic implications.

The explicit inclusion of a spiritual point of view has significant implications for the practice of psychoanalysis and psychodynamic psychotherapy, although many of the elements that I would designate as belonging in this category are already becoming part of the way therapists function in the clinical setting. A spiritual view implies an attitude toward the patient or client as a person of special value. Inequalities of power are built into the therapeutic setting — accommodation, for example, to the therapist’s schedule or differences of accessibility — but they need to be acknowledged as part of the clinical reality and not analyzed simply as elements of resistance or transference distortion. The enabling or empowering dimensions of the therapeutic relationship would receive relatively more emphasis in the healing process as compared to interpretation and insight. The transforming power of human connection, and of empathy and love, although always recognized as important in psychotherapy, would be more openly recognized and developed.22

A greater openness and sharing of one’s own experiences, as appropriate, becomes a more accepted part of the therapeutic work, including admitting mistakes or apologizing for difficulties our own blindnesses or inadvertent actions may have caused or aggravated. The attitude of not knowing, of mystery and uncertainty discussed above, would be applied to the work with clients. Paradoxically this attitude is likely to bring forth greater awareness on the part of both client and therapist of hitherto unknown dimensions of self. In addition to elements in the unconscious warded off by specific defenses, this attitude of openness and not knowing can create a greater awareness of those culturally imbibed habits of thought — opinions, assumptions, and institutionally imposed ways of perceiving the world — that are unconscious by being so much a part of our daily lives (rather the way a fish might be unaware of the water it swims in) but restrict our ability to live and choose freely.

Wounds, loss, separation, grief, trauma and emotional deprivations are the pathogenic forces of human life. Addressing the lasting impact of these forces and events that have occurred at various stages of a person’s life is the bedrock of psychotherapcutic work from all of the psychoanalytic points of view. Once again, a spiritual point of view would bring a different emphasis. Established psychodynamic approaches tend to be concerned with the resolution of conflict, the repair of hurts and trauma, and the achievement of, or return to, a baseline of normal functioning. A spiritual point of view stresses — paradoxically again — the transformative power of the affects associated with biographical wounds and other disturbing historical experiences. The spiritual element derives from the belief, which lies at the boundary between experience and faith, that each person possesses within him or herself a potential for wholeness. This does not mean, of course, that human beings do not have defects (especially biologically based ones), limitations, and irreparable wounds. It is, rather, a point of view which gradually establishes its validity through enabling greater wholeness. When therapy is conducted through a spiritual point of view the language of the sacred may creep into one’s speech — words like soul, divine, transcendent, and mystical — as if no other way of speaking can quite capture the ineffable quality of this domain.

An emphasis on wholeness as a therapeutic objective carries with it the implication that some expression of social responsibility, or work for the larger human community, is part of a positive outcome. A commitment to the human future comes, inevitably, to be added to Freud’s idea that a successful result in therapy is reflected in the ability to love and to work. This relates once again to our notion of self as connected with other selves, interrelated in an implicit web of ties that must, inevitably, expand our identifications. beyond the boundaries of our families and ethnic groupings. The extraordinary success and healing power of AA and Twelve-Step work derives from this recognition of interconnectedness, beyond the individual. The program of repair and community service that constitute the later steps of AA are directed at an expansion of spiritual growth. The twelfth step is introduced with, “Having had a spiritual awakening as a result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.”23

Another important dimension of the interconnectedness that lies at the heart of spiritual experience is the sense of continuity over time and the ties we feel to previous generations.24 Native peoples place much more emphasis generally than we do in the West upon temporal continuity and planning for future generations. Psychiatrist Arthur Kornhaber has attributed the extraordinary strength of feeling between grandparents and grandchildren (and also great-grandparents and great-grandchildren) to the spiritual bond that connects us across generations. I have rarely seen such unmitigated joy as when my wife’s mother at her eighty-fifth birthday party returned to the party after being called to the phone and announced with her arms thrown wide (a gesture none of us had seen her make for many years) and her eyes glistening, “I’m a great-grandmother.”

Kornhaber tells the story of seven-year-old Annie, whom he had brought with several other elementary school children to visit a nursing home as part of an intergenerational program linking the two institutions. Annie went up to a seemingly lifeless old woman in a corner of the room, who, it turned out, had known her grandfather. In a few moments the woman was vitalized, transformed, “spirited.” When Kornhaber asked Annie what site had done site replied, “Nothing at all, she just combed my hair.” He concluded,

This spiritual dimension of the self not only contains love, wonder, and joy but has the capacity to ‘illuminate” and “transform” the young and the old. Children seem to sense the spiritual qualities of older people and can transform what society generally sees as useless people into valuable elders. The child’s view confers power and influence on the aged, who are often ignorant of their own influence. But when love is present, children are blind to the wrinkles that so often blind everyone else.25

Nonordinary or altered states of consciousness (largely unknown in the modern West, which has largely cut itself off from experience of the divine, but quite familiar to native peoples throughout the world) have extraordinary value in regaining spiritual power and recognition. These states can be achieved by methods which include hypnosis (abandoned by Freud with vast historical consequences for the therapeutic enterprise), meditation, mind-altering or “psychedelic” drugs used in the appropriate context, and psychoanalytically derived approaches which permit a suspension of linear consciousness and the emergence from the unconscious of elements of the holotropic or transpersonal realm.

Of particular value in this regard is the holotropic breathwork method developed by Stanislav and Christina Grof, which utilizes deep rapid breathing, evocative music, focal body work, and mandala drawing to gain access beyond the biographical level of experience to the perinatal period and the transpersonal realms, where feeling connection becomes possible with objects, creatures, and spirits that is not available to us in ordinary (hylotropic) states of consciousness. Thousands of therapists and their clients have found the Grof method to be a useful way to gain access to the healing power that lies in these deeper levels of the psyche. The holotropic breathwork method has a good deal in common with the traditional healing methods that shamans have used throughout the world, connecting their native “clients” with the transformative powers of animal spirits and other mythic forces that hold meaning in a particular culture. Perhaps the remarkable hold that our relationship with pets often has, represents a vestige of the lost connection with the power of animal spirits in human life.

Most of the therapeutic methods that utilize nonordinary states of consciousness to access deeper realms of consciousness have in common an emphasis on the healing power of forces that are already present within the individual, a kind of inherent wisdom of the body/mind or soul. The therapist, healer, or spiritual healer in this context acts as a facilitator, a holder of the therapeutic ground, bringing forth what is already there but inaccessible to consciousness as the result of barriers erected by wounds or traumas from the past, or the restrictions of consciousness that are inherent in, or imposed by, Western society.

The threats on a global scale confronting us and much of the earth’s life can be thought of as a spiritual crisis, for at its core it represents the separation of human beings from one another and of humankind from nature. The crisis is double-edged. On the one hand we must face massive destruction from wars in which technologically advanced weaponry, including nuclear devices, can cause death and suffering on a vast scale. At the same time we are experiencing a slower extinction of life through the erosion of the ecosystems that are themselves the life forms which support biologically more advanced organisms. What are the sources of these interrelated destructive processes, and how can we respond?

The global crisis derives from the techno-materialism of Western culture (and of those that imitate us in the search for power and a better life) which has now reached an extreme of destructiveness incompatible with the sustaining of life. The archetypal polarities of connection or closeness on the one hand and distancing and separation on the other are inherent dimensions of human nature. But the twin materialist quests for control of the Earth’s limited physical resources and for absolute security through the dominance of advanced weaponry have exaggerated these polarities to the extent that they have become a terminal threat to life.

Erik Erikson has called the extreme differentiation of one human group from another to the extent of denying the humanity of the other group “pseudospeciation.”26 Pseudospeciation reflects above all a kind of large group egotism, through which a people seeks to elevate its collective self-regard at the expense of another. Theologian Glen Tinder has described this process well.

Idealism in our time is commonly a form of collective pride. Human beings exalt themselves by exalting a group. Each one of course exalts the singular and separate self in some manner. In most people, however, personal pride needs reinforcement through a common ideal of emotion, such as nationalism. Hence the rise of collective pride. To exalt ourselves, we exalt a nation, a class, or even the whole of humanity in some particular manifestation like science. Such pride is alluring. It assumes grandiose and enthralling proportions yet it seems selfless, because not one person alone but a class or nation or some other collectivity is exalted. It can be at once more extreme and less offensive than personal pride.27

The polarizing and dichotomizing tendencies of the human mind become exaggerated in the context of hatred and fear. Ethnonational conflicts, with their complex histories of killing, loss, and grief, deepen these polarities in vicious cycles of destruction, rage, and distrust unless new leadership intervenes that can heal and transcend the conflicts. Traditional leaders are likely to accentuate the polarities by calls to just or holy wars in which the forces of good are perceived as attached exclusively to ones own cause and all negativity to the other’s. The language of religion can be especially dangerous when placed in the service of these polarities, as it amplifies their emotional intensity by invoking the greater powers of the universe on behalf of the interests and conflicts of a particular group.

What is called for then is a means of discovering a wider human identity, not one that denies the polarities of nature and human feeling, but one that integrates them in a larger sense of purpose and connection. This shift would continue the process of spiritual transformation already taking place that is manifest now in the multitude of global initiatives that are striving to discover authentic international partnerships while respecting the uniqueness of ethno-national and cultural traditions. For individuals this process requires the discovery of a true core self of I through which we connect beyond ourselves to diverse others. This too is essentially a spiritual task. In Erikson’s words, “Here an overweening conscience can find peace only by always believing that the budding ‘I’ harbors a truthfulness superior to that of all authorities because this truth is the covenant of the ‘I’ with God, the ‘I’ being more central and more persuasive than all parent images and moralities.”28 To achieve this evolution in practical terms will mean, at the least, a deliberate educational program aimed at teaching children, adolescents, and adults how to resist the threats, blandishments, and exhortations of traditional leaders who choose to play upon our polarizing tendencies, chiefly through manipulating the mass media, for the purpose of maintaining enmities and justifying the wars they create.

Lee Atwater when he was facing death found a “new spiritual presence” in his life:

My illness helped me to see that what was missing in society is what was missing in me: a little heart, a lot of brotherhood. The ’80s were about acquiring — acquiring wealth, power, prestige. I know. I acquired more wealth, power, and prestige than most. But you can acquire all you want and still feel empty. What power wouldn’t I trade for a little more time with my family? What price wouldn’t I pay for an evening with friends? It took a deadly illness to put me eye to eye with that truth, but it is a truth that the country, caught up in its ruthless ambitions and moral decay, can learn on my dime. I don’t know who will lead us through the ’90s, but they must be made to speak to this spiritual vacuum at the heart of American society, this tumor of the soul.29

Human beings grow when, in the confrontation with death, they are enabled to discover a new personal perspective, sacrificing their egoism before it is the body’s time to die. This is what Eastern religions refer to as ego death. We are all, in literal terms, facing our own death. But what will be required of us, individually and collectively, for us to know the “spiritual vacuum” of our society? How can the transforming power of the confrontation with death on such a scale as we now confront on Earth be experienced so that we may arrest the destruction we are creating for ourselves and much of our planet’s life without having to reach, like Atwater, the point of no return? It seems to be a question worth asking, for the preservation of the planet is a fight worth fighting.

J.M. Coetzee in his novel about South African apartheid and its wounds, metaphorically titled The Age of Iron, to describe an imperviousness to feeling and caring, gives these words to a dying white woman whose death is linked symbolically to the death of the culture:

Such a good thing, life! Such a wonderful idea for God to have had! The best idea there had ever been. A gift, the most generous of all gifts, renewing itself endlessly through the generations.30

It is the responsibility of each of us to discover ourselves more fully, to become conscious of “Self,” “Self-Conscious” in the larger sense that can ensure life will, indeed, be renewed through the generations.


1. David Rapaport and Merton Gill, “The Points of View and Assumptions of Metapsychology,” in The Collected Papers of David Rapaport. ed. Merton M. Gill (New York: Basic Books, 1977).

2. Heinz Kohut, The Analysis of the Self, Psychoanalytic Study of the Child, monograph no. 4 (New York: International Universities Press, 1971); Patti H. Ornstein, ed., The Search for the Self: Selected Writings of Heinz Kohut 1950-1978 (New York: International Universities Press, 1978), vol. 1; Arnold Goldberg, ed., Advances in Sell Psychology (New York: International Universities Press, 1980).

3. Philip Cushman, “Why the Self Is Empty,- American Psychologist 45 (1990): 590-611.

4. Chana Ullman, The Transformed Self: The Psychology of Religion Conversion (New York: Plenum Press. 1989).

5. Barbara Marx Hubbard, The Hunger of Eve (Eastbound, Wash.: Island Pacific Northwest, 1989), pp. 179-80.

6. Hans W. Loewald, Psychoanalysis and the History of the Individual (New Haven and London, Conn.: Yale University Press, 1978), P. 69.

7. Sigmund Freud, “Civilization and Its Discontents,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, ed. James Strachey (London: Hogarth Press. 19,30). p. 65.

8. Ana-Maria Rizzuto, The Birth of the Living God: A Psychoanalytic Study (Chicago. University of Chicago Pr 1979); W.W.Meissner, Psychoanalytic and Religious Experience (New Haven, Conn.: Yale University Press, 1984); Loewald. Psychoanalysis; Arthur Deikman. The Observing Self: Mysticism and Psychiatry (Boston: Beacon Press, 1982); Joseph H. Smith and Susan A. Handelman, eds., Psychoanalysis and Religion (Baltimore- Johns Hopkins University Press. 1990), vol. 2. K. Wilber, Eye to Eye: The Quest ]or the New Paradigm (Garden City, N.Y.: Anchor Rooks. 1983).

9. Mircea Eliade, Shamanism: Archaic Techniques of Ecstasy, Bollingen Series 76 (Princeton, N.J.: Princeton University Press, 1974), p. 19.

10. Thomas Berry, The Dream of the Earth (San Francisco: Sierra Club Books, 1990).

11. Eliade, Shamanism, p. 14.

12. Joseph Campbell (with Bill Moyers), The Power of Myth (New York: Doubleday, 1988), p. 209.

13. Glen Tinder, “Can We Be Good Without God?” Atlantic. December 1989, p. 78.

14. Ibid., p. 85.

15. John E. Mack, “Changing Models of Psychotherapy: From Psychological Conflict to Human Empowerment,” Center for Psychological Studies in the Nuclear Age, Cambridge. Mass., 1990; John E. Mack, “Toward a Psychology for Our Time,” in Psychology and Social Responsibility: Facing Global Challenges, ed. Sylvia Staub and Paula Green (New York: New York University Press, 1992).

16. Winifred Gallagher, American Health, December 1990, pp. 60-67.

17. George S. Klein, Psychoanalytic Theory: An Exploration of Essentials (New York: International Universities P. , 1976).

18. Stanislav Grof, Beyond the Brain (New York: State University of New York Press. 1985).

19. Erik H. Erikson, “The Galilean Sayings and the Sense of Yale Review (Spring 1981): 321-62, Hetty Zock, A Psychology of Ultimate Concern (Amsterdam: Rodopi, 1990). 20. Zock. A Psychology. 21. Erikson, “Galilean Sayings.”

22. Alfred Margulies, The Empathetic Imagination (New York: W. W. Norton & Co., 1989).

23. Alcoholics Anonymous: Twelve Steps and Twelve Traditions (New York: Alcoholics Anonymous World Services, 1977). p. 109.

24. Arthur Kornhaber, Between Parents and Grandparents (New York: St. Martin’s Press, 1986).

25. Arthur Kornbaber, Vital Connections: The Grandparenting Newsletter, (Fall 1990), p. 2.

26. Erik H. Erikson, Gandhi’s Truth (New York: W W Norton & Co.. 1969).

27. Tinder, “Can We Be Good?” p. 78.

28. Erikson, Gandhi’s Truth, pp. 117-18.

29. Lee Atwater and T. Brewster, “Lee Atwater’s Last Campaign,” Life, February 1991, p. 67.

30. J.M. Coetzee, The Age of Iron (New York: Random House, 1990), p. 109.

  • John E. Mack, M.D. was a Pulitzer Prize-winning author and professor of psychiatry at Harvard Medical School.

Psychoanalysis and the Self: Toward a Spiritual Point of View
was originally published in Boston Univ. Studies in Philosophy & Religion Vol. 13, Selves. People, and Persons: What Does it Mean to Be a Self?, Ed. L.S. Rouner, Univ. of Notre Dame Press, Notre Dame, Indiana. 1992, pp 169-186.

  Subject Area: Psychiatric Arts