The foregoing(前述的) is a minor example of what those people with the courage to call themselves patients must go through in more major ways, and often many times, in the process of psychotherapy. The period of intensive(集中地) psychotherapy is a period of intensive growth, during which the patient may undergo(经受) more changes than some people experience in a lifetime. For this growth spurt(喷射) to occur(产生), a proportionate(成比例地) amount of “the old self” must be given up. It is an inevitable pan of successful psychotherapy. Infact, this process of giving up usually begins before the patient has his first appointment with the psychotherapist. Frequently, for instance, the act of deciding to seek psychiatric attention in itself represents a giving up of the self-image “I’m OK.” This giving up may be particularly difficult for males in our culture for whom “I’m not OK and I need assistance to understand why I’m not OK and how to become OK” is frequently and sadly equated with “I’m weak, unmasculine and inadequate.” Actually, the giving-up process often begins even before the patient has arrived at the decision to seek psychiatric attention. I mentioned that during the process of giving up my desire to always win I was depressed(沮丧地). This is because the feeling associated with giving up something loved-or at least something that is a part of ourselves and familiar-is depression(沮丧). Since mentally healthy human beings must grow, and since giving up or loss of the old self is an integral(必要地) part of the process of mental and spiritual growth, depression is a normal and basically healthy phenomenon(现象). It becomes abnormal or unhealthy only when something interferes(妨碍) with the giving-up process, with the result that the depression is prolonged(拖长) and cannot be resolved by completion of the process.
There are many factors that can interfere(妨碍) with the giving-up process and, therefore, prolong(拖长) a normal, healthy depression into a chronic pathologic(病理的) depression. Of all the possible factors, one of the most common and potent(强大的) is a pattern of experiences in childhood wherein(其中) parents or fate, unresponsive(无反应的) to the needs of the child, took away “things” from the child before he or she was psychologically ready to give them up or strong enough to truly accept their loss. Such a pattern of experience in childhood sensitizes(使敏感) the child to the experience of loss and creates a tendency far stronger than that found in more fortunate individuals to cling to “things” and seek to avoid the pain of loss or giving up. For this reason, although all pathologic(病理的) depressions(沮丧) involve some blockage(阻塞) in the giving-up process, I believe there is a type of chronic neurotic depression that has its central root a traumatic(创伤的) injury(损害) to the individual’s basic capacity to give up anything, and to this subtype of depression I would apply the name “giving-up neurosis.”
A leading reason for people to think about seeking psychiatric attention is depression. In other words, patients are frequently already involved(卷入) in a giving-up, or growth, process before considering psychotherapy, and it is the symptoms of this growth process that impel(驱使) them toward the therapist’s office. The therapist’s job, therefore, is to help the patient complete a growth process that he or she has already begun. This is not to say that patients are often aware of what is happening to them. To the contrary, they frequently desire only relief from the symptoms of their depression “so that things can be as they used to be.” They do not know that things can no longer be “the way they used to be.” But the unconscious knows. It is precisely because the unconscious in its wisdom knows that “the way things used to be” is no longer tenable(站得住脚的) or constructive that the process of growing and giving up is begun on an unconscious level and depression is experienced. As likely as not the patient will report, “I have no idea why I’m depressed” or will ascribe(归因于) the depression to irrelevant(不相干的) factors. Since patients are not yet consciously willing or ready to recognize that the “old self” and “the way things used to be” are outdated, they are not aware(意识到) that their depression is signaling(发信号) that major change is required for successful and evolutionary adaptation(适应). The fact that the unconscious is one step ahead of the conscious may seem strange to lay readers; it is, however, a fact that applies(适用于) not only in this specific instance but so generally that it is a basic principal of mental functioning(心理功能). It will be discussed in greater depth in the concluding(最后的) section of this work.
Recently we have been hearing of the “mid-life crisis.” Actually, this is but one of many “crises,” or critical states of development, in life, as Erik Erikson taught us thirty years ago. (Erikson delineated(描绘) eight crises; perhaps there are more.) What makes crises of these transition(过渡) periods in the life cycle(生命周期)-that is(也就是说), problematic(有问题的) and painful-is that in successfully working our way through them we must give up cherished notions(观念) and old ways of doing and looking at things. Many people are either unwilling or unable to suffer the pain of giving up the outgrown(过大的) which needs to be forsaken(遗弃). Consequently they cling, often forever, to their old patterns of thinking and behaving, thus failing to negotiate(成功越过) any crisis, to truly grow up, and to experience the joyful sense of rebirth(重生) that accompanies(伴随) the successful transition(过渡) into greater maturity. Although an entire book could be written about each one, let me simply list, roughly(粗略地) in order of their occurrence(发生), some of the major conditions(条件), desires(欲望) and attitudes(态度) that must be given up in the course of a wholly successful evolving(进化的) lifetime(一生):