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By ABRAHAM A. LOW, M.D. Founder of Recovery, Inc.

RECOVERY, INC. The Association of Nervous and Former Mental Patients


Since this book was first published in 1950,
certain significant changes have taken place in
Recovery, Inc. in relation to its growth and management.
It has, therefore, become necessary to supplement
some of the information given in the "Concise
Outline of Recovery's Self-Help Technique" which
begins on page 16. Before setting out these changes it
should be stated that the purpose or aim of Recovery,
Inc. remains the same: to prevent relapses in former
mental patients and to prevent chronicity in nervous
However, the future refinements in the method
made by Dr. Low after 1950, and the new independent
character of the organization since the death of
Dr. Low, have made the following revisions necessary.
(1) With regard to the description of meetings as
stated on page 20, Recovery meetings are now open
to the public in community buildings. (2) The social
activities as described on page 25 are no longer part of
the Recovery method. Before his death, Dr. Low
considered it best to allow only a mmimum of Recovery
sponsored social activities and to emphasize a
maximum of training in the self-help techniques.
(3) With regard to the description of Recovery
branches outside Chicago as stated on pages 28 and 29,
the list has grown enormously. Recovery groups
are now functioning in most States and in several
Canadian provinces.
Recovery, Inc. was founded and directed by Dr.
Low, and during its formative years was a professionally
supervised association. However, with his customary
insight, Dr. Low was constantly working
toward the development of techniques that would
allow the organization to stand as an independent
self-help lay group without professional supervision.
Toward this end, in 1952, Dr. Low established the
panel example method at Recovery's Headquarters
in Chicago. This method serves as a model for all
Recovery panels throughout the entire organization.
Continued on Back Flap
Cloth Price $10.95

MOV 1982 i
BftJMAY 28 1983
HKl MAY 25 1984


Founder of Recovery, Inc.


Founder of Recovery, Inc.

All Rights Reserved
Twenty- Third Prin ting 1981
ISBN: 0815800010
Library of Congress Catalog Card Number: 57-12246

The Mother of My Children
A Mother to My Patients

National Headquarters
Recovery, Inc.
The Association of Nervous
and Former Mental Patients
116 South Michigan Avenue
Chicago, Illinois 60603

9. FEELINGS ARE NOT FACTS . . . . .108


PHYSICIAN . . .260
Insistence on Change of Diagnosis 267
Insistence on Change o Diagnosis 275
DIAGNOSIS . . .284
. . . .291
. . .296
CONTROL . . .304

. . .326
MEANS ........ 376
GOAL 381

The present volume is meant to give an account of the psychotherapy
methods evolved in the past fifteen years by Recovery,
Inc., a non-profit group whose purpose it is to train post-psychotic
and psychoneurotic persons in the practice of psychiatric self-help.
An extensive report on the association's history, scope of activity
and mode of operation was offered in 19431
. A concise but fairly
comprehensive description was published in 19492
The contents of the book are in the main reproductions of
panel discussions conducted by the ex-patients and group psychotherapy
interviews held by the author with his private patients
in the years 1944 to 1949. Several essays on "sabotage" have been
added, describing the manner in which patients offer resistance
to the physician's instructions. The bulk of the material was previously
published in the "Recovery Journal" and "Recovery
News," issued by Recovery, Inc. and edited by the author. It
deals with a system of group psychotherapy evolved by the writer
since 1933.
Psychotherapy, individual or group, is invariably based (1) on
a philosophy, (2) on techniques. In years past, the field was dominated
by three main philosophies and techniques: Freud's psychoanalysis,
Adler's individual psychology, and Jung's approach
which, because of its vagueness and mysticism, defies precise classification.
More recently, the psychoanalytic doctrine has taken
the lead and all but crowded out its erstwhile rivals. It established
1 Low, Abraham A., The Techniques of Self-Help in Psychiatric
After-Care, Chicago, 1943, Recovery, Inc., 3 volumes.
2 Low, Abraham A., Recovery, Inc., A Project for Rehabilitating
Post-Psychotic and Long-Term Psychoneurotic Patients, published in
"Rehabilitation of the Handicapped," page 213, New York, 1949, the
Ronald Press Company. The latter article has been incorporated, with
the publisher's permission, as a revised reprint in the present volume,
page 16.

its hegemony in universities and philanthropic foundations and
gained unquestioned prominence in the province of psychotherapy.
The doctrine appears to be in firm control in the official
psychiatric organizations, in the mental hygiene activities of the
national government, in the veterans administration, presumably
also in the hospitals of the armed forces. Official psychotherapy,
in the United States today, is essentially psychoanalysis.
The author rejects the psychoanalytic doctrine both as philosophy
and therapeutic technique. In point of philosophy, he
cannot share the view that human conduct is the result of unconscious
drives, sexual or otherwise. To his way of thinking,
adult life is not driven by instincts but guided by Will In emphasizing
the priority of Will over Drives he is merely echoing the
principles and teachings of the late Professor Emil Kraepelin,
founder of modern psychiatry, and those of the late Professor
Wilhelrn Wundt, father of modern psychology. Quite proudly
he claims also to echo the voice of common experience and common
sense. Whatever may be meant by drives, be they instinctual
cravings (the favorite psychoanalytic term), or emotional
trends, desires, wishes, yearnings and leanings, they all eventuate
in impulses, acting or ready for action. To the author it is inconceivable
that adult human life can be ordered without a Will
holding down impulses. What precisely is meant by the term
Will is amply demonstrated in the text.
In point of psychotherapeutic techniques, psychoanalysis must
be accounted a failure on the evidence of its own testimony. The
most startling defect is the insignificant number of patients which
can be reached by the method. The Chicago Institute for Psychoanalysis,
for instance, has been able to report no more than 319
patients treated six months or longer during a ten year period
The Menninger Clinic of Topeka, Kansas, tops this record of
poor productivity with a report
4 of 100 patients similarly treated
3 Institute for Psychoanalysis, Ten Year Report, 1932-1942, Chicago.
Knight, Robert P., Evaluation of the Results of Psychoanalytic
Treatment, American Journal of Psychiatry, volume 98, page 434, November

for six months or longer in the course of ten years, 1932-1941.
In order to fully appreciate the story told by these astonishing figures
one must remember that the two institutions are generously
staffed and richly financed. Knight
, tabulating the results of
treatment as published by the psychoanalytic institutes of Berlin,
London, Topeka (ten year surveys) and Chicago (five years)
was unable to quote more than 660 cases treated for upward of
six months in the four clinics during a ten year period (five years
in Chicago). Of this total, 363 patients were treated in Berlin,
114 in Chicago, 100 in Topeka, 74 in London. Stating it otherwise,
the productivity of the psychoanalytic techniques, as reported
from four leading clinics, ranged, in point of the number
of patients carried per year, from 7.4 (London) to 36.3 (Berlin).
Figures of this kind admit of one conclusion only: The psychoanalytic
techniques are available for a small fraction only of the
multitude of post-psychotic and psychoneurotic patients. The
reason for its restricted availability is the egregious amount of
time needed for the administration of the treatment, an overall
average of hundreds of hours being required for each individual
patient. For patients cared for in private practice there is the
added handicap that the time-consuming process involves a necessarily
exorbitant expense. Whether the emphasis be on the time
factor or the cost element, in either case, the method is all but
unavailable for the masses of patients.
Aside from its limited availability for numerically significant
groups of patients, psychoanalysis is also, again on the evidence
of its own testimony, therapeutically ineffective. Knight
, assaying
the therapeutic results obtained in 660 analyses conducted for
six months or longer in the institutes of Berlin, London, Chicago
and Topeka, tells us that 183 patients (27.7 percent) were considered
"apparently cured"; 186 (282 percent) were "much improved";
291 (44.1 percent) were either somewhat improved, or
worse, or showed no change. Needless to say, a 27.7 percent
yield of "apparently cured" patients, even adding the 28.2 percent
of the "much improved" contingent, constitutes a serious in

dictment for any psychotherapeutic method. Oberndorf5
is authority
for the statement that 40 percent of the
"psychotic cases
treated by psychoanalysis plus institutional regime at the Menninger
Clinic" were discharged as cured. He comments that this
is also the percentage of those "discharged as cured from mental
hospitals in the United States." It is well known, however, that
the forty percent figure for cures of state hospital patients represents
the spontaneous recovery rate. Is it permissable, then, to
draw the inference that, for psychotic patients at any rate, the
results of psychoanalytic treatment are identical with their spontaneous
chances for "outgrowing" their psychosis? Taking
either the hint offered by Oberndorf or the disappointing figures
supplied by the above mentioned statistics, the conclusion seems
inescapable that psychoanalysis has failed as a therapeutic technique.
It is not intended here to criticize psychoanalysis with a view to
extolling the work of Recovery, Inc. But inasmuch as the psychoanalytic
method has well nigh monopolized the field of psychotherapy
it is incumbent on a diverging approach to measure its
record of accomplishment against that of the recognized procedure.
A few simple figures culled from the files of the author
will demonstrate that the combination of office treatment with
the group methods practiced in Recovery, Inc. achieves a range
of availability which dwarfs that of psychoanalysis.
Between January 1, 1946 and December 31, 1947, in a representative
two year period, the author was able to examine in his
office a total of 425 new patients. Deducting from this figure
those patients who did not return after the initial examination
(140) and those who suffered from somatic or neurological conditions
(24), there remained 261 subjects who were available for
psychotherapy^ Of this final group, 156 were given treatment
for six months or longer. In other words, employing the method
described in this book, one man was enabled to give active psy-
5 Oberndorf, C. P., Consideration of Results with Psychoanalytic
Therapy, American Journal of Psychiatry, volume 99, page 374, November

chiatric care to a considerable multiple of the patients serviced in
a comparable period by large staffs of psychoanalytic institutions.
Clearly, the Recovery method is vastly superior to psychoanalysis
in the matter of availability to the masses of patients seeking
psychiatric care.
As concerns the therapeutic effectiveness of the Recovery techniques,
as distinguished from mere availability, it is sufficient to
point to the basic character of the organization: the members
know one another; they meet frequently and regularly in classes
and at parties; they get together in family gatherings and consort
socially; they form sewing clubs, -bowling parties and dancing
teams; many of them spend evenings or Sundays together, dining
or visiting theatres and amusement places. One can readily
surmise what would happen if no more than a negligible 28
percent of the lot would finally reach the status of "apparently
cured." The organization would explode in no time. Instead,
the association, staffed by one physician, financed without outside
assistance, shunning though not completely escaping publicity,
has prospered close to fifteen years. This record speaks for itself.
It needs no statistics to support its claims.

Recovery, Inc. was founded, November 7, 1937, by thirty expatients
who regained their health after receiving shock treatments
and/or other therapies at the Psychiatric Institute of the
University of Illinois medical school, the predecessor of the present
Psychiatry Department of the Illinois Neuropsychiatric Institute.
The author was at the time the assistant director of the
Institute. Between 1937 and 1940 the organization limited its
services to the patients admitted to the wards of the Psychiatric
Institute. In fall of 1940 it expanded its work to include the
psychoneurotic patients of the out-patient department. In September
1941 the group severed its connection with the University
of Illinois medical school and established headquarters of
its own in the Chicago Loop District where it is now located at
116 South Michigan Avenue. In the years since 1942 the bulk
of its membership was recruited from the author's private practice.
As is evident from this brief description, Recovery, Inc. has
had the opportunity to try out its techniques (1) with an intramural
patient population, (2) with an out-patient group, (3) with
private patients. The object of the organization, apart from its
tendency to save time for the physician and money for the patient,
is to help prevent recurrences in mental diseases and to
forestall chronicity in psychoneurotic conditions. Its techniques
place the emphasis on self-help.
6 Revised reprint, with the publisher's permission, of a paper contributed
by the author to "Rehabilitation of the Handicapped," a volume
issued, 1949, by the Ronald Press Company, New York. The paper
bore the title, "Recovery, Inc., A Project for Rehabilitating Post-Psychotic
and Long-Term Psychoneurotic Patients."

After leaving the hospital the mental patient is supposed to be
restored to health. This is true in most instances if by mental
health is meant the absence of delusions and hallucinations, of
violent impulsiveness and indifference to group standards. But
returning home the patient still suffers from restlessness, tenseness
and preoccupation. His inability to relax is aggravated by
the sense of being stigmatized. Many returned patients are so
suspicious of being watched or mistrusted that even simple inquiries
like "how do you feel?" or "how are you today?" are
likely to cause irritation. These innocent questions may suggest
to the patient that the reality of his recovery is doubted. Feeling
stigmatized, the patient becomes self-conscious and introspective.
On a given night he might have difficulty falling asleep. This is
apt to alarm him. The alarm increases the difficulty of sleeping.
Then more alarm, more sleeplessness and more alarm yet. A
vicious cycle is thus set going which may keep the patient from
properly resting night after night. Other vicious cycles may soon
establish themselves. The patient notices a sense of fatigue which
in itself may be as insignificant as any sensation of fatigue experienced
by the average person. But feeling stigmatized he
correlates his tiredness with the possibility of a relapse, and the
more he dreads the relapse the more intense becomes his fatigue;
the heavier the fatigue the more haunting the fear of the relapse.
One patient had a nocturnal itch after returning home, another
complained of a twitch in one arm, a third felt a hair on the
tongue. Experiences of this kind are distressing enough to conjure
up the vision of an impending relapse. The experiences become
far more terrifying when the patient observes, for instance, that
the arm suddenly begins to shake in automatic motion or when
"awful flashes" shoot across the eye. Patients reported an "electric
buzz running through the muscles," that "the tongue lay
stiff in the mouth," that "my own voice sounded strange," that
"the ear felt pushed in," that "I can't seem to hear myself when
I speak." Palpitations, numbness, head or chest pressures, dizziness,
difficulty of concentration, dimness of vision, air-hunger,

headaches, nausea and scores of other disturbances were reported
by numerous patients. Observations of this sort may give rise
to the vicious cycle which has the familiar character of the symptom
increasing the fear and the fear intensifying and perpetuating
the symptom. While there are no statistics to substantiate
the claim it is fair to assume that many recurrences of mental
ailment are the direct result of these "residual symptoms" which,
fanned by the fury of the vicious cycle, produce anxieties and
panics which finally necessitate the much dreaded recommitment.
Recovery, Inc. insists that the patient, prior to leaving the hospital,
attend group psychotherapy classes in which he is given adequate
instruction how to face the threat of the residual symptom and
the pressure of stigmatization. At the same time, the members
of the family are urged to attend discussion courses in which
similar instruction is offered. In this manner the pre-discharge
care prepares for the after-care effort.
Most residual symptoms from which the returned mental patient
is likely to suffer are similar to or identical with the
common complaints voiced by psychoneurotic patients. Hence,
the possibility of treating both groups by the same method. The
psychoneurotic patients admitted to Recovery, Inc. belong in
the category of chronic, protracted cases mainly. Patients with
symptoms of a few months' duration are rarities in the ranks of
the group. Most members have a record of from two to twenty
years of suffering. These "experienced sufferers" have made the
rounds of physicians and clinics and were assured on numerous
occasions, explicitly or by implication, that some therapeutic
measure will cure them. The assurance never materialized with
the result that they no longer believe a cure possible. They know,
however, that some or most of the past therapies had a transient,
palliative effect. The palpitations were milder after a reassuring
talk; the dizziness yielded to a sedative. Hence, they treasure
the "pep-talk" or the prescription. In order to secure these elusive
aids they must complain; they must convince the physician that

they "really" suffer, that their pains are not imaginary, that they
can "positively not stand" their fatigue. To get a hearing from
the doctor is all the more important because at home their complaints
are likely to be met with impatience or ridicule. Complaining,
then, becomes a vital part of -their daily routine. In
the course of years they develop the consummate art of the "expert
complainer." What these long-term patients crave is a sympathetic
ear which, after years of griping, they can no longer secure
from their relatives and friends. They delight in a lengthy
discussion of their fears and frustrations. Their ideal is to be
explored, analyzed, sounded and probed. Essentially they have
decided that their case is beyond repair. What they expect is a
hearing, perhaps some temporary relief, but not a final cure. The
"chronicity" of this group has little to do with the nature of the
symptoms, with diagnosis or etiology; it is self-appointed defeatism.
Since Recovery places the emphasis on the self-help action of
the patients, it must ignore investigations and explorations which
are not within the province of inexperienced lay persons. Complexes,
childhood memories, dream experiences and subconscious
thought play little part in the class interviews conducted by the
physician and are entirely eliminated from the self-help effort
carried on by the patients. The psychoneurotic individual is considered
a person who ' for some reason developed disturbing
symptoms leading to ill-controlled behavior. The symptoms are
in the nature of threatening sensations, "intolerable" feelings,
"uncontrollable" impulses and obsessive "unbearable" thoughts.
The very vocabulary with its frenzied emphasis on the "killing"
headache, the dizziness that "drives me frantic," the fatigue that
"is beyond human endurance" is ominously expressive of defeatism.
The first step in the psychotherapeutic management of
these "chronic" patients must be to convince them that the sensation
can be endured, the impulse controlled, the obsession
checked. Unfortunately, the physician is far from convincing.
His attempt to "sell" the idea of mental health arouses the "sales
resistance" of the patient. "The physician doesn't dare tell me
the truth," muses the patient. "It would be against his ethics

to declare me incurable." The resistance is easily overcome in
the group interview. The fellow sufferer who explains how
he "licked" his frightful palpitations after years of invalidism
cannot possibly be suspected of trying to sell something. That
"colleague" is convincing. He convinces the novice that "chronic"
conditions are not hopeless.
On three separate days each week the patients take part in
group discussions, either as panel members or listeners. On Wednesday,
family gatherings are held in private homes in the various
neighborhoods of Chicago. The patients are sub-divided into
seven neighborhood groups, each comprising from ten to twenty
families. Three such family groups function on the Northside,
two on the Southside, one on the Westside of the city; one serves
the West suburbs. On the occasion of the family meetings panels
of three or four experienced members discuss a chapter of the author's
three volumes on self-directed after-care or an article from
the now discontinued Recovery Journal or from its successor,
the Recovery News. The theme is centered on the topic of symptoms
and the proper means of conquering them. The physician
is not present at the family gatherings although he reserves the
right to attend occasionally to check on the effectiveness of the
procedure. Reports are currently conveyed to him by the panel
leaders. Tuesday evening is devoted to a group psychotherapy
class, conducted by the physician. Saturday afternoon, a public
meeting takes place at Recovery headquarters, 116 South Michigan
Avenue. It is attended by the patients, their relatives and
friends. The first half hour is given over to a panel discussion
similar to that held at the Wednesday home gatherings. In the
second half the physician delivers an address in which he sums
up the conclusions reached by the panel, approving or correcting
their statements. The panel members are led by a panel leader.
Patients are required to attend classes and meetings for at

least six months. The average patient experiences a considerable
improvement in the first or second week of participation in the
program. But the improvement is, as a rule, as short-lived as was
the relief which the patient used to gain from the visits to clinics
and doctors1
offices. No meetings are held on four days of the week.
During these days the novice is apt to suffer a "setbadc." He is again
tortured by "that awful fatigue" or has been unable "to sleep a
wink for three nights in succession," or the fear of doing harm
to the baby reappears after it was gone for a short while. Every
patient is warned to be on guard against the unavoidable setback.
He is cautioned to contact a veteran Recovery member
immediately after the symptom has reappeared. The assurance
offered by the veteran is in accord with the language used by the
physician, and the interpretations given to the novice coincide
with those used in the physician's classes and in his writings.
New members are assigned to veterans whom they may call in
distress. The veteran functions in the capacity of the physician's
"aide." The contact is generally made by telephone but may be
done by a personal visit to the aide's home. If the result is not
satisfactory the novice is permitted to call on the leader of his
local panel. If this is ineffective he may contact the chairman of
the organization who serves as deputy to the physician. Finally
he may call the physician. The effectiveness of the scheme is
evidenced by the fact that few instances are recorded in which
the physician was called by novices.
If the patients are to help and teach one another they must be
instructed to use a language which is not confusing. This is
particularly important because language, if used glibly, tends to
be alarmist and defeatist. By dint of its defeatist insinuations,
language frequently engenders tenseness which reinforces and
perpetuates symptoms. To avoid the fatalistic implications of
the language used by the patient the physician must supply a
terminology of his own in matters of health. There are many
languages. Features and gestures speak. So do symptoms. Their

language is a one word idiom: DANGER. This is called the
"symptomatic idiom." Accepting the suggestions of the symptomatic
idiom the patient considers the violent palpitations as presaging
sudden death. The pressure in the head is viewed as due
to a brain tumor. The tenseness is experienced as so "terrific*
that the patient fears he is going to "burst." His fatigue does
not let up "one single minute," and "how long can the body
stand it?" In these instances, the implications of the symptomatic
idiom are those of an impending physical collapse. If phobias,
compulsions and obsessions dominate the symptomatic scene the
resulting fear is that of the mental collapse. After months and
years of sustained suffering the twin fears of physical and mental
collapse may recede, giving way to apprehensions about the impossibility
of a final cure. This is the fear of the permanent handicap.
The three basic fears of the physical collapse, mental collapse
and permanent handicap are variations of the danger theme
suggested by the symptomatic idiom.
Another source of defeatism is temper. The patients are taught
that temper has two divisions. The one comes into play when
I persuade myself that a person has done me wrong. As a result
I become angry. This is called the angry or aggressive temper,
which appears in various shades and nuances: resentment, impatience,
indignation, disgust, hatred, etc. The other variety of
temper is brought into action whenever I feel that I am wrong.
This gives rise to moral, ethical and esthetic fears or to the fear
of being a failure in pragmatic pursuits. I am afraid that I sinned,
failed, blundered, in short, that I defaulted on a moral, ethical or
esthetic standard or on the standard of average efficiency. This is
called the fearful or retreating temper which may express itself
in many different qualities and intensities: discouragement, preoccupation,
embarrassment, worry, sense of shame, feeling of
inadequacy, hopelessness, despair, etc. The fearful temper is
likely to lead either to a feeling of personal inferiority or to the
sentiment of group stigmatization. Whether it be of the angry
or fearful description, temper reinforces and intensifies the symp

torn which, in its turn, increases the temperamental reaction. In
this manner, a vicious cycle is established between temper and
symptom. The temperamental reaction is kept alive mainly by
the unsympathetic and unthinking attitude of the relatives. By
means of coarse statements or subtle innuendo they provoke loud
explosions or silent agonies on the part of the patient. They tell
him to use his will power, implying that he makes no effort to
get well. With this, they indict him as a weakling, worse yet, as
purposely shamming disease. They urge him to "snap out of it,"
indicating that the symptoms are so easy to deal with that a
mere snap would shake them out of existence. Other insinuations
frequently levelled against the psychoneurotic or former
mental patient are equally disconcerting. Complaining of fatigue
he is told not to be lazy; mentioning his "awful palpitations,"
he is admonished to be a man. The net result of this concerted
environmental assault is that the patient is continually angry at
his detractors and, gradually accepting their insinuations, becomes
ashamed and fearful of himself.
In telling the patient that wrong was done to him or that he
is wrong his temper speaks to him. The language which it uses is
called the temperamental lingo. Its vocabulary is limited to the
terms "right" and "wrong." Unless the patient learns to ignore
the threats, warnings and incitements of the temperamental lingo
he will be the victim of angry outbursts and fearful anticipations.
His tenseness will be maintained and intensified; new symptoms
will be precipitated and old ones fortified. Temper is most dangerous
when it plays on the symptom itself. By labelling sensations
as "intolerable," feelings as "terrible," impulses as "uncontrollable"
the lingo discourages the patient from facing, tolerating
and controlling the reaction. The very sound of the labels ("intolerable,"
etc.) is apt to rouse fear and defeatism. All a patient
has to do is to call a crying reaction by the name of "crying
spell," and no effort will be made to check the burst of tears.
The word "spell" suggests uncontrollability. Make the patient
substitute "crying habit" for "crying spell," and the impossibility
of stemming the flood at least will not be taken for granted.
Similarly, if the patient raves about the "splitting" headache,

the dizziness that "drives me mad," the pressure that "I can't
stand any longer," the fatalism of diction is bound to breed a
despondency of mood. In order to prevent the temperamental
response the patient must be trained to ignore the whisperings
of his temperamental lingo.
The combined effects of symptomatic idiom and temperamental
lingo are checkmated if the patient is made to use the physician's
language only. The members of the Association call it
proudly the "Recovery language." The most important parts
of its vocabulary are the words: "sabotage" and "authority."
The authority of the physician is sabotaged if the patient presumes
to make a diagnostic, therapeutic or prognostic statement.
The verbiage of the temperamental lingo ("unbearable," "intolerable,"
"uncontrollable") constitutes sabotage because of the assumption
that the condition is of a serious nature which is a
diagnosis; or, that it is difficult to repair, which is a prognosis.
It is a crass example of sabotage if the claim is advanced that,
"my headache is there the very minute I wake up. I didn't have
time to think about it. It came before I even had a chance to
become emotional. How can that be nervous?" A statement of
this kind throws a serious doubt on the validity of the physician's
diagnosis and sabotages his authority. Likewise, it is a case of
self-diagnosing and consequently sabotage to view palpitations
as a sign of a heart ailment, of head pressure as meaning brain
tumor, of sustained fatigue as leading to physical exhaustion.
Once the physician has made the diagnosis of a psychoneurotic
or postpsychotic condition the patient is no longer permitted to
indulge in the pastime of self-diagnosing. If he does he is practicing
sabotage. Patients are expected to lose their major symptoms
after two months of Recovery membership and class attendance.
If after the two month period the handicap persists in its
original intensity the indication is that sabotage is still in action.
The patient still listens to the suggestions of the symptomatic
idiom fearing impending collapse and permanent handicap. Or,
he gives ear to the verbal vagaries of the temperamental lingo,

feeling helpless in the face of suffering. Clinging to his own
mode of thinking he sabotages the physician's effort.
Contrary to expectation, it is comforting to the patient to be
called a saboteur. Considering himself as such he knows that
he has "not yet" learned to avoid resisting the physician. The
"not yet" is reassuring. It suggests that in time he will learn.
The patients encourage one another to wait until they get well.
They warn one another against impatience. The most effective
slogan handed down from veteran to novice is, "Wait till you
will learn to give up sabotaging."
If the patient is to check his sabotaging propensities he must
be trained to "spot" the inconsistencies and fallacies of his own
language whether it is merely conceived in silent thought or
given formulation in vocal speech. To this end, a system of "spotting
techniques" was evolved by means of which the members
learn to reject the suggestions of the symptomatic idiom and the
temperamental lingo whenever a symptom or a temperamental
reaction occur. An extensive though necessarily incomplete description
of the spotting techniques is furnished in part 3 of this
The social calendar of the organization is remarkably crowded.
The activities are largely spontaneous, little supervised. Practically
all events, be they group psychotherapy classes, public
meetings or family gatherings, are somehow linked to sociability.
After a group psychotherapy class the patients form small groups
heading for the nearest drug store or restaurant where they rehash
the theme discussed in class or chat about private affairs. The
most stimulating social event is the "kaffeeklatsch" following
immediately upon the Saturday afternoon public meeting. After
the panel and the physician have finished their discussions the
assembly hall is speedily converted into a sort of lounge. The
patients, relatives and friends seat themselves around small tables
and are treated to coffee and cake. Mothers and fathers then ex

change views about the progress of their still suffering or already
recovering offspring. The patients join the chat, and the atmosphere
is one of mutual encouragement, gratitude and hopefulness.
The "kaffeeklatsch" may last an hour or longer. The
physician moves from group to group, engaging in brief conversations
or listening to the stories and views presented by members
and guests. This informal mingling with patients and relatives
provides the physician with information which he could
hardly obtain otherwise. The men and women speaking to him
are spontaneous, divorced from the official and cramping situation
of the interview carried on in the ordinary examining room.
Mrs. Jones reports an incident which she observed in Mrs. Smith's
home on the occasion of the last family gathering. The account
is unreflective, reportorial, descriptive. These casual chats with
the members are an invaluable means of acquainting the physician
with the personal details of his patients' home life.
The family gatherings are similarly patterned. A panel discussion
of about thirty minutes is followed by a modest repast
furnished by the family in whose home the meeting is held.
The physician does not attend the family panels but is currently
kept informed by the panel leaders about what transpires about
adjustment or maladjustment of the patients and about the quality
of home life prevailing in the particular family. The panel
leaders meet with the physician once a month to receive special
training in the matter of conducting the panels. This is again
an occasion when a vast mass of information is conveyed to the
physician about the home life of the patients. It need hardly be
stressed that the type and quality of information which the
physician is thus enabled to collect is vastly superior to that obtained
in his examining room while interviewing and questioning
parents or relatives.
The members seem to have an almost unquenchable thirst for
social contacts. They visit one another in their homes; they go
together to shows and concerts, meet for lunches, for short trips,
for joint visits to museums or parks or for plain walks. Some
groups have regular schedules for bowling, bam dancing, hiking
and swimming. The families of one Northside and one South

side group formed sewing circles. Consciously or unconsciously,
the trend is to break through the dismal isolation and loneliness
which have always been the blight of neurotic or post-psychotic
existence. The patients state it explicitly that formerly they
merely existed, now they live again. Formerly they were lonely
individuals, now they are thoroughly integrated with the rich,
pulsating life of a closely knit group. A happy outlet for this
burning desire for sociability is afforded
by the informal afternoon gatherings which take place
at Recovery headquarters, 116 South Michigan Avenue. Au number
of veterans, housewives mainly, volunteer each to spend one
afternoon a week in the Recovery office, supervising the activities
of that afternoon. Patients or relatives working in the Loop district
drop in, partake of simple refreshments and spend time
chatting or asking advice or seeking reassurance for disturbing
symptoms. The physician's office is two blocks distant. New patients
are asked to visit the Recovery office immediately after
the termination of the initial examination. There they are met
by the other patients and given information about the work of
the organization. Panics, anxieties and apprehensions are easily
soothed by the calming influence of meeting other patients who
having suffered similar disturbances are now presenting the
picture of good health.
Membership, at three dollars per year, is open to any psychoneurotic
or former mental patient. At this writing (January
1950) the membership stands at 376. About 75 percent of the
total is secured from the author's private clientele. The organization
is financed by membership fees, donations, proceeds from
the sale of Recovery literature, collections at meetings. The organization
is almost but not quite self-sustaining. The yearly deficit
is met by the author.
April 1948 the organization moved to its present larger quarters.
With a considerably increased rental and the necessity for
new furniture and office equipment it was deemed wise to create

a guarantee fund. The members responded promptly and generously
to an appeal for contributions. The goal was 5,000 dollars,
and close to 4,400 were collected.
The affairs of the organization are conducted by a board of
three directors, all ex-patients. Mrs. Annette Brocken, ex-patient
and assistant principal of a Chicago public school, is president of
the organization and chairman of the board of directors. Serving
with her are a vice-president, a secretary, a treasurer and six
councilors. The author does not hold office, but functions as the
medical director. An ex-patient is the editor of the "Recovery
News." Another ex-patient holds the position of the executive
secretary doing all the routine work including dictation and typing.
This is the only salaried employe. The monthly compensation
is almost nominal.
Between 1938 and 1941 the organization published a bimonthly
magazine, "Lost and Found." The author was the editor contributing
the bulk of articles. The pages of the magazine were
devoted mainly to a thorough discussion of the influence of
domestic temper on the fortunes of the patients. In 1943 this
material was issued in book form in three volumes entitled, "The
Techniques of Self-Help in Psychiatric After-Care." The issue is
now exhausted after a total sale of close to 1,000 copies.
June 1946 to June 1947 the "Recovery Journal" was published.
In consequence of rising cost of printing it was discontinued after
the eleventh issue. It was succeeded by a phototyped news sheet,
the "Recovery News," which appears eight times a year. Each
issue contains a contribution from the author. Subscription is
included in the membership fee and 2.00 dollars per year for
non-members. A second edition of the "Self-Help Techniques"
is in preparation.
Eight branches of Recovery, Inc. are now functioning outside
the Chicago area. Following are their locations and dates of formation:
Muscatine, Iowa (1946), Brighton, Michigan (1947),
Evansville, Indiana (1950), Louisville, Kentucky (1951), St.

Louis, Missouri (1951), Burlington, Iowa (1951), Denver, Colorado
(1951), Dixon, Illinois (1951) . Other branches are in the process
of formation. The Denver branch is superintended by a local
psychiatrist, the others are led by ex-patients. The members meet
regularly in their homes, read the Recovery literature, cite examples
from their own experience and conduct panel discussions
which are modelled after the pattern established in Chicago. The
branches are visited by officers of the Chicago organization in
intervals of about six months, and the leaders of the branches, in
turn, come to Chicago to attend meetings and to perfect themselves
in the techniques of panel leadership.
It was stated that the objectives of the organization are (1) to
help reduce the incidence of relapses in mental ailment and to
prevent chronicity in psychoneurotic conditions, (2) to save
time for the physician and expense for the patient. It would be
easy to furnish imposing tables detailing percentages of improvements
and failures. Tabulations of this kind, posing as objective
statements, are usually nothing but subjective opinions no
matter how heavily they are buttressed by charts and graphs.
They are particularly objectionable if compiled without the benefit
of a well organized long-range follow-up investigation. Since
the latter was not available no computation was attempted. Nevertheless,
reasonably valid conclusions as to the therapeutic effectiveness
of the system can be drawn from the very nature and
structure of the organization. The patients and relatives know
one another and if relapses or continued chronicity were frequent
occurrences the membership would inevitably become discouraged
and lose confidence. An unfortunate event which took
place in October 1947 illustrates the point with striking force. A
well known member of the group relapsed into a depression
and one morning ran into the path of a speeding train. It was
not clear whether the fatal incident was suicide or accident.
Nevertheless, something in the nature of a demoralization swept
the organization. Several of the ex-patients developed severe re

actions. One of them had to be hospitalized. The fact that this
has been the only instance of suicide, if such it was, in a period
of close to fifteen years during which many hundreds of manicdepressive
patients had joined as active members ought to be
considered an eloquent testimony to the therapeutic efficiency
of the system. This system would rapidly disintegrate if it failed
to accomplish its therapeutic objectives. Statistical evidence does
not seem required to demonstrate its success.
Statistical figures, however, are available in support of the organization's
second objective, i.e., its endeavor to effect substantial
economies in the physician's time and the patient's expense.
Due to the fact that the patients are disciplined there is little
quibbling and arguing in the physician's office which means that
the so-called "resistance" to his explanations and directions is
reduced to a minimum. This alone allows an impressive saving
in time. Another time-saving factor is the massive instruction
given the patients in classes and meetings and the insistence on
continual study of the physician's writings. With resistance restricted
and the patient coming to the office reasonably well instructed
the private interview can be terminated in a surprisingly
small space of time. As a general rule, the author manages to see
from four to five patients during one hour of his office time.
Accordingly, the charges for the brief visit can be held to a moderate
figure. In addition, the intensive class training and the
equally intensive patient-to-patient contact make it possible to
achieve improvements after a relatively short period of treatment.
The total charges are thus lowered considerably. All patients
are required to visit the physician's office for six consecutive
months after the initial examination. They are seen once a week
during the first month, once in two weeks in the second month.
During the third through the sixth month the office visits are
reduced to once every four weeks if symptoms and difficulties are
significantly ameliorated, but the two week ratio continues if
improvement lags. The average number of visits in 1947 was
11.9 per patient in a representative six month period. The maximum
was 23 visits, the minimum was 5, the median was 12.


A Panel Discussion Conducted by Patients
Frank (panel leader) : The panel is ready to start and we are
taking our material from the lecture entitled "The Wrong-
Fearing Temperament." What we are going to discuss is the
dilemma which means a difficulty of making decisions. Has
anybody an example of having trouble making up his mind?
Tillie: Some time ago I went to Field's and wanted to get a
dress for my little daughter Doris. I couldn't make up my mind
between two dresses. I looked at both dresses and felt confused.
And when I can't make up my mind I get a tightness in my left
side and when I get this I feel like letting everything go. But
this time I just took one and felt comfortable. Then I went
to the socks department and I thought I would get size nine.
But I thought they were too big and I was in a confusion again.
The tightness came back and I got flushed and felt I couldn't
breathe. I was on the point of throwing the socks down and
leaving the store but Doris said if they didn't have size eight
and a half she was going to take size nine. So she made the
decision for me. Then the tightness stopped immediately and
I felt comfortable. Six months ago once the tightness had started
all kinds of other symptoms would have come on and I
would have been in a panic all day and maybe for several days.
Today my panics last a short while, and they aren't a bit as
severe as they used to be.
Maurice: I used to make conflicts and dilemmas out of things
the average person wouldn't think to make an issue of, for instance,
going to a movie or getting a hair-cut. I would make a
start, then I'd think should I really go? Then I might pick
up a book and read. After a few minutes I would feel I should
go to the barber's. Then I would put it off again and so it would

take me hours to make a simple decision. Months ago I remember
I went to the library and I would be in a conflict about
what books to take out, and for days I looked over books and
never took one out. That made me tense and disgusted because
I couldn't make up my mind. Today I can decide in a few
Carol: My two children have been sick the past two weeks.
I thought it would be nice if my husband would suggest eating
out tonight. A year ago I wouldn't have the nerve to make the
suggestion. I would have been sore at my husband if he didn't
make the suggestion himself. This time I said, "How about it,"
and he was agreeable. But even now I don't know whether
it was right to ask him. I get so tense when I have to ask for
Frank: All this tenseness derives from the fact that we don't
want to make up our mind. We are afraid well have to blame
ourselves. We'd rather pass the buck. But we have to learn to
make decisions and to take chances that we may be wrong.
You know the doctor tells us we must have the courage to be
wrong in the trivialities of every day life.
Carol: I have another example. I have to take my wash to
the laundry to have it ironed. Several months ago I used to
be tense on the way home because I had to rush back to prepare
lunch for the children and I was afraid I wouldn't make it in
time. So I used to put off making the trip to the laundry and
let it go day after day till we were most out of laundry. Today
I just do it and if I feel tense on the way back I say to myself,
"What of it?" The tenseness isn't so bad anymore anyhow.
Frank: These are examples of trivial conflicts and the very
fact they are so numerous keeps us in constant tension and the
tenseness, of course, produces symptoms. I will give you an
example of my own. As you know I am the editor of the Recovery
News* and there is an article I am planning on writing
but I keep putting it off. Monday night I was home and I
*The "Recovery News" was a mimeographed sheet which was edited
by Frank Rochford in 1945 and early 1946. It was the predecessor of
the "Recovery Journal."

thought I would start on the article but didn't feel like doing it.
Suddenly it became important for me to read the daily paper.
Ordinarily I don't read it more than twice a week. But now
it seemed I had to read it immediately. And so I got myself the
Tribune, and read it thoroughly. After I was through with it
I noticed the Sunday Tribune was still on the table from the
day before. I got a hold of that and read it, again very thoroughly.
Ordinarily I hardly throw a look at it. This you can
call procrastination. But the point is I didn't make up my mind
to do something that I didn't feel like doing. I haven't been
able to lick this procrastination of mine as thoroughly as I
would like to. But I am gradually getting it under control, and
on that Monday evening when I kept putting off writing I
finally made up my mind and wrote and finished the article.
Don: I used to buy medicine from a drug store in the neighborhood.
The clerk there knows about my condition because
I told him. Now I am sorry that I told him because I feel uncomfortable
when I have to go there to buy medicine. Of course,
it is the stigma. When I need the medicine I put off going to'
the drug store. On several occasions I was pretty sick with my asthma
but rather than talk to the clerk I endured sickness.
Finally I needed the medicine badly and my first thought was
again to put it off. But then I said to mystelf, "No sir, you know
you will be tense all day if you don't make up your mind to
face that clerk." And if I am tense I get all kinds of symptoms,
fatigue, sleeplessness and tremors. So I went and got the medicine
and after that I felt I had done something worth while.
Otherwise I would have suffered all day.
Physician's Comment on a Panel Discussion
The central theme of today's panel was fear, more particularly,
the fear of making a decision. Tillie feared deciding between
two pairs of socks, Maurice feared taking a book from the library,
and Carol, Frank and Don quoted similar fears of deciding,
choosing, taking a stand and reaching a conclusion.

Frank surmised that all the issues and problems, conflicts and
dilemmas listed by the panel members were sheer trivialities.
But the fact is that Tillie, while grappling with her difficulty,
developed panics and confusions and all manner of frightening
symptoms. To her the danger of making a wrong decision did
not appear at all trivial. It loomed in her mind as a matter of
momentous importance. She thought of serious consequences
and grave responsibilities; she anticipated failure and disaster.
In other words, her imagination was on fire.
If there were no imagination there would be few panics and
anxieties. And without panics and anxieties nervous symptoms
would die away. No nervous patient would ever fear collapse
unless his imagination told him that palpitations, air-hunger and
chest pressure spell the danger of imminent death. Nobody
would ever shiver at the thought of "another sleepless night"
except that imagination paints a lurid picture of the fatal results
that a mythical sleeplessness has on health. I may mention
the fanciful notions which patients entertain about the dreadful
effects of "nervous fatigue," and you will realize that the idea of
danger created by your imagination can easily disrupt any of
your functions. If this is true it is clear that the nervous patient
is served by an imagination which is out of bounds, rampant,
unbalanced. If the balance is to be restored the patient will have
to acquire a working knowledge of how his imagination functions.
Clearly, all I can offer in a brief address is a sketchy account
of its mode of operation.
Imagination is either busy or idle. If idle it is bored, if busy
it is interested and either stimulated or frustrated. Its business
is to notice, observe and interpret events. Once the event is
noticed imagination is aroused or stirred. It may then evince
rising concern or stirring excitement. The concern will lead to
further investigation and deepened interest, finally yielding
some important or trivial discovery. The excitement will give
rise to feelings, sentiments and emotions. Note here that concern,
excitement, interest, feelings are intimately associated with
the function of imagination.
What imagination notices, observes and interprets are events,

facts and situations occurring outside or inside the body. Those
taking place outside the body, in external environment, "strike"
the senses of vision, hearing or touch and are "grasped" by them.
This is the "sensory grasp" of outer experience. The events
occurring inside the body, in internal environment, "affect" our
deep sensibility and are noticed by intuition. This is the "intuitive
grasp" of inner experience. We may then say that imagination
is busy interpreting the facts of outer and inner experience.
In the one sphere it makes use of sense perception, in the other
of intuitive understanding.
In interpreting the meaning of events imagination classes
them as either indifferent or significant to our welfare. The
significant events are felt or thought of, that is, imagined as endangering
or securing our welfare. In this manner imagination
produces the sense of security or insecurity. If behavior is to be
adjusted imagination must interpret events in such a fashion that
the sense of security materially overbalances the sense of insecurity.
Once this is accomplished an imaginative balance establishes
After interpreting an event imagination renders an opinion
which is in the nature of a tentative suggestion or a first guess.
It suggests, for instance, or guesses that the person approaching
you is a friend. The opinion is, then, that the situation is one
of security. Under such simple circumstances, imagination is
hardly likely to go astray. The situation is such that it calls for
little or no imaginative appraisal. The sensory grasp is sufficient
for proper identification. After the friend reaches you his features
may strike your eye as being changed. You imagine they express
anxiety. This is another imaginative guess. If you accept
it you may be inclined to offer sympathy or aid. Suppose now
that your guess was wrong. The offer of sympathy was then
misplaced and may be resented. The tentative opinion rendered
by imagination misled you to an incorrect conclusion and an
equally unwise decision to act. In order to avoid premature conclusions,
decisions and acts of this kind the opinion, suggestion
or guess offered by imagination must be verified. I may mendon
briefly that verification makes use of logic, past experience

and of that singular capacity of the mature human mind to observe
elements which contradict or support an opinion after it
has been formed.
It is the tragedy of the nervous patient that after years of
suffering he develops an unbalanced imagination the first guesses
of which tend distressingly and consistently to interpret inner
and outer experiences in terms of insecurity. The greater tragedy
is that the first guesses are accepted sight unseen without an
attempt at verification. Unable to resist its suggestions the patient
becomes the victim of his imagination. An incessant stream
of insecurity suggestions is poured forth with rapid-fire velocity
leading to a continuous succession of wrong opinions, conclusions
and decisions. The final result is that the patient, realizing
that his first guesses tend to be either wrong or harmful comes
to fear forming an opinion, reaching a conclusion, making a
decision. In a sense, his fears are based on good logic. In most
instances, imagination has misled and deceived him. On a
hundred or thousand occasions it told him that his sensations
will lead to collapse. The suggestion never materialized. How
can that imagination be trusted? Whenever a symptom made
its appearance, whether palpitations or numbness or dizziness,
imagination suggested invariably that this was the last gasp,
that an emergency was on. The patient went into a panic,
clamored for instant help, insisted that the doctor be summoned
without delay. When the relatives, aware of the "nervous"
nature of the spell, hesitated to call the physician, perhaps in
the dead of the night, the patient passed into a violent burst of
temper, and the wish had to be granted. But the moment the
physician arrived his mere presence or calm manner dispelled
frequently both symptom and temper in a trice. The deceitfulness
of his imagination was here clearly demonstrated to the
patient. It lied to him, led him to wrong conclusions, to hasty
decisions. It produced temper, caused unnecessary expense,
created domestic friction. Worst of all, it undermined his selfrespect
and made him look ridiculous. Trusting an imagination
of this kind, it would seem, is impossible.
There were other experiences that made for distrust. Neigh

bors mentioned a remedy, or the patient read about it in the
daily paper or heard of it over the radio. No sooner was the
drug called to his attention than his imagination was absurdly
fired with hope and enthusiasm. In the course of years he spent
more money on pills and capsules than his meager finances warranted.
Trusting the suggestions passed on by his ever lively
imagination he consulted numerous physicians, wandered from
clinic to clinic. He made costly trips because a change of climate
was supposed to be beneficial. He went to sanitariums, watering
places. He even had himself "checked at Mayo Brothers."
His record of inept conclusions and ludicrous decisions is impressive,
indeed. That record was inspired by his imagination,
whose erratic and capricious counsel has been the ruin of the
patient's reputation. How can he ever base a decision on its
dubious recommendations?
It happened at times that he was free from symptoms for a
few days, sometimes for a week, rarely a longer period. Then
this imagination spoke the language of security. It suggested
that he was cured, that the symptoms were gone for good. On
these occasions he concluded he was well and decided to "do
things." He resumed his social life, visited friends, played cards
with them, went fishing and automobiling. Occasionally, he
ventured to return to work. The result of these efforts was
dismal disappointment. Without any warning, "out of a blue
sky," the palpitations recurred "worse than ever," right while
he was engaged in a "grand game of poker." Or, he suddenly
fainted while he worked on the bench. There was no escape
from these dreadful symptoms. His imagination, even when
it preached security, invariably led him straight into insecurity.
How can he ever trust it? How can he depend on its first
guesses or final conclusions? And without dependence how
can there be deciding or acting? His life is doomed to be a
stark tragedy, a bleak and barren existence, mechanical, tedious,
We shall revert to the experience Tillie had in the store. When
she was unable to make up her mind whether to buy a smaller
size sock her daughter Doris came to her assistance and made

the decision for her. "Then the tightness stopped, and immediately
I felt comfortable," Tillie said. But if a little child
can guide the nervous patient out of confusion and bafflement
the solution for his difficulties seems to be close enough at hand
Every patient has either children or mothers or friends. It
should be easy or at least feasible to assign to them the task of
making decisions and reaching conclusions. Unfortunately, the
device does not work. Men and women have pride, and that
pride is readily shaken, wounded and challenged. The fact
that Doris had to make the decision for her was a severe blow
to the mother's self-respect. It served to emphasize her tragic
inability to act, to decide, to be self-sufficient. It accentuated
the helplessness and wretchedness of her existence. Doris' intervention,
it is true, relieved the symptoms of tightness and discomfort.
Now Tillie's physical person felt secure for the brief
period of a few minutes. But her moral and intellectual personality
was made to feel more insecure than before. The next
decision to be made was certain to reveal an increased distrust
of herself and of her imagination.
To trust imagination means to let it perform its functions
of dreaming, hoping, anticipating. If Tillie had given free play
to her fancy she would have planned the purchase of Doris'
dress days or weeks in advance. She would have pictured in her
mind, that is, in her imagination how beautiful the child would
look in a dress of a certain style, cut or color. She would have
anticipated flattering compliments from neighbors and friends.
She would have beamed with joy at the thought of Doris5 delight
when finally presented with the garb. On an evening
walk with her husband she would have strolled along the
show windows, viewing patterns, tentatively accepting some, rejecting
others. All along her thought would have dwelled
fondly and proudly on the details of the situation when, a week
or two ahead, she would arrive at home with the garment
neatly wrapped in a box. The surprise, the breathless suspense,
the ceremonial of unwrapping, the gasp of astonishment ringing
from the child's lips, the kiss of gratitude, the eagerness to slip
into the dress immediately and eye it in the mirror. All of this

and many others dreams, hopes and anticipations would have
currently crowded Tillie's brain, continually feeding and occupying
her imagination. This is precisely the point I meant to make.
The acts of planning, dreaming, hoping and anticipating keep
imagination busy and occupied, interested and stimulated. They
prevent idleness and boredom. And if imagination is properly
kept from being idle or bored there is no or little occasion for
restlessness or irritability. And without restlessness and irritability
symptoms do not stand much of a chance of being maintained
or precipitated. Had Tillie permitted her imagination to
be occupied with dreams and hopes her chest would have currently
swelled with pride and her heart would have habitually
expanded with joy. Instead her chest became the seat of agonizing
pressure and her heart was rocked by wild palpitations
because her imagination was allowed to busy itself with fears
and anxieties mainly or solely. What prevented her from keeping
her imagination fruitfully occupied was her preoccupation
with terrors and panics, with symptoms and distress, in short,
with the idea of insecurity. And if an imagination is more or
less constantly preoccupied with ideas of insecurity it will be
deprived of the opportunity to occupy itself with those dreams,
hopes and visions from which ideas of security originate. If
this happens the imaginative balance will be disturbed, the
thoughts of insecurity will drown out the ideas of security, and
anxious preoccupation will cancel out the pleasurable occupations.
The result will be a paralyzing fear of deciding, planning,
initiating and acting. But without decisions, plans, action and
initiative there is no possibility of developing pride, self-reliance
and self-sufficiency. It was the sustained preoccupation with
ideas of insecurity that prevented Tillie from acquiring even
that modicum of self-trust that prompts the trivial decisions of
daily existence.
You will understand now that if the nervous patient is to
regain his lost imaginative balance his preoccupations with
ideas of insecurity will have to give way to occupations with
thoughts of security, that is, with hopes, dreams and pleasurable
anticipations. You will also understand that hopes, dreams and

joyful anticipations are the very warp and woof of decisions,
plans and conclusions. And if you ask how you can manage to
rout your preoccupations my answer will be of the simplest
kind: Stop listening to the threat of the symptomatic idiom and
the imbecilities of the temperamental lingo and your imagination
will again be able to indulge in its stimulating occupations and
you will be in a position to make decisions, draw conclusions,
formulate plans without fearing the dreadful consequences suggested
to you by temper and symptom. Learn to use the Recovery
language of self-confidence and fearlessness and your
imagination will be freed of the deadweight of panics and
anxieties. Thus delivered it will once again occupy itself with
thoughts of security and ideas of self-sufficiency.

A Panel Discussion Conducted by Patients
Frank (panel leader): We will discuss today the article on
"Temper and Insight." It says there that in a temperamental
deadlock people are not quarreling over real issues but over
whether one person is right and the other wrong. I shall give
an example. A number of times on the panel I mentioned that
my mother does not set the breakfast table. One item that is
particularly irritating to me is the sugar bowl. It seems to me
it is always empty. It is certainly not a matter of great moment
whether it is filled or not; it only takes a few seconds to fill it.
The fact is I have to fill it practically every morning. Before I
had my Recovery training this used to irritate me no end. I felt
I had the right, as a son, to have the sugar bowl filled but I was
denied that right. Ridiculous as it may sound, my mother and
I were in a deadlock over this issue of the sugar bowl until I
applied the Recovery language and knew that right and wrong
are phony issues in domestic life. I now fill die sugar bowl
every other day or so and each time it makes me feel good to
know that I don't get worked up over trivialities any rtiore. I
think I now have insight into the phony nature of temper.
Tillie: Several months ago I had an argument with the lady
upstairs. I wanted to make a telephone call and when I took off
the receiver she was talking so I thought 111 wait a while. I
waited fifteen minutes, and she was still talking. Then I heard
her say to the party, "Somebody is trying to get on the phone."
I said, "I would like to make a call and I have been waiting
fifteen minutes already." She said, "All right, go ahead," and
hung up with a bang. Soon after I was finished with the call
she came downstairs and asked, "What's the matter? Is something
burning?" I said, "No, but I have to go shopping and

had to make that call.
1 ' She got very excited so I said, "If you
don't quiet down I will not talk to you." That made her mad.
She said, "You have no right to tell me to get off the line. I
would never think o doing such a thing. I have too much
character." I said, "Are you telling me I have no character?" I
lost my temper then and I gave it to her all right. After she
left I called Gertrude and she said, "You can't afford to lose
your temper because of your health." I didn't just like that
and I still thought I was right. But I was awfully tense all that
day and I had my air-hunger again and that pressure around
the chest and the symptoms did not disappear for more than
a week. A couple of days ago I met this lady again. The building
is ours and I asked her politely to please tell her boy to keep
off the grass. Then she said my daughter Doris caused much
more damage to the lawn than her son. This time I smiled and
refused to get into an argument. I was sore but the after-effect
lasted just a short time.
Ada: A few weeks ago my husband suggested we go to the
movies and this particular movie was a mile from home. It
was a nice Sunday and he thought we should walk. One thing
I can't stand is strolling. I want to walk fast and get there because
I am tense. So I told him I wouldn't stroll. He said he
rushes all week and on Sundays he likes to take a slow walk
and refuses to be rushed. This all happened within two blocks
and he said, "I am sick and tired of arguing, and we'll get
on a street car." We did and I was angry. But when the show
started I forgot all about the argument and I didn't work myself
up as I should have done if that had happened a year ago. At
that time, I wouldn't have talked to him for several days or I
would have thrown up to him that he was inconsiderate and
selfish and didn't care whether I suffered.
Frank: I think that what Tillie and Ada said illustrated what
I brought out about right and wrong being a phony issue. Tillie
talked for about five minutes but I didn't hear one sentence
that had to do with objective realities. And Ada didn't say a
word about the actual facts of walking. She didn't bring out
the fact that the distance was too far to walk or that it was

necessary to walk faster to get there in time. All of this didn't
matter. The issue was whether one person would get his way
or the other.
Ann: Several months ago my husband's sister came through
Chicago and had to wait sixteen hours for her train east. So
we invited her to spend the night with us. My son offered to
let his aunt use his room and he would sleep upstairs. I got
flustered because I did not know whether I could clean the
house in time. It seemed too much of a job for me to get my
son's room ready. So I set about cleaning and I was quite pleased
with the effort I made. The room looked really like a guest room.
To be sure that it remained clean I asked my boy not to go
into the room. But, lo and behold, before long Johnny was in
the room, and his dog with him, and the boy was eating pretzels.
I lost my temper and gave him a real tongue-lashing. A
few minutes later when I was vacuuming the living room rug
I suddenly felt fatigued. It seemed I couldn't go on. It was
such an effort. I wanted to lie down, but suddenly it dawned
on me that the tired feeling had come on so suddenly that it
was, of course, the result of my temper. I took up the work again
and the fatigue was gone in no time. I think that the insight
that the fatigue was a mere feeling helped me get rid of it.
Ada: Something happened this morning where my Recovery
training gave me insight into my temper. Our janitor dislikes
children, and when he sees them on the sidewalk he pushes them
around. I used to argue with him about it but don't do it any
more, as a rule. There is an empty lot near our house and the
boys and girls play there. This morning my boy and five others
were playing there, and the janitor came along and said he
would call the police, and my boy came up crying. He was
afraid he would go to jail. I was furious. The janitor has
nothing to do with the empty yard and it was none of his
business to chase the children. I ran into the bedroom and
pulled up the window. The janitor was there and I was ready
for him. Then I felt my palpitations and tenseness and I decided
I was doing wrong to show temper. I spoke to my boy
and told him to go out and play and not to mind the janitor.

Later on my way to Recovery I saw the janitor on the street
but I paid no attention to him and went my way and saved
myself the palpitations and the discomfort.
Physician's Comment on a Panel Discussion
What the patients sitting on the panel presented so dramatically
can be summed up in simple language. In former days,
they said, we responded with temper to trivial irritations. There
was a severe after-effect with mounting tenseness, with symptoms
and agonies of suffering. Today we still indulge our tempers,
but the occasions are few, the after-effect is short, and symptoms
and suffering are transient and mild. Frank, with his flair
for terse and compact expression, gave the proper phrasing to
the change in reaction when he remarked that he has now "insight
into the phony nature of temper." He made another
thought-provoking statement when he surmised that "in a
temperamental deadlock people are not quarreling over real
issues but over whether one person is right and the other wrong."
But what precisely determines whether a person is wrong or
right and whether an issue is real or unreal?
When Tillie cut in on the neighbor's telephone conversation
was she wrong? And when the woman at the other end of the
line hung up with a bang was she right? Frankly, neither you
nor I nor anybody else can answer these questions intelligently.
Tillie could easily marshal the most compelling reasons for
proving that the intrusion was justified. She had been waiting
a long time, and her call was important while the "lady upstairs"
was merely chatting, wasting her own time and imposing
on other people who were busy and in a hurry. But the neighbor
on the upper floor would have no difficulty arguing back that
Tillie's interference was plainly an act of deliberate provocation,
uncalled for and inexcusable. Are Tillie's arguments right and
real? Are the lady's counter-arguments wrong and unreal?
Where is the judge who could render a decision as to who is
the villain and who the victim?

Let us take a closer look at the matter. Tillie interrupted the
conversation of her neighbor. That neighbor gave every indication
that she had not finished conversing. She clearly intended
to continue but was forced by Tillie's intervention to cease
speaking. Leaving the question of right and wrong to one side
for the present, the situation seems to be clear: The will of one
person conflicted with the will of another person. Force was
pitted against force, power clashed with power. As it hapened
the one person yielded, the other triumphed. This was
a fight, a show of strength or weakness, a contention for the
possession or use of an object (telephone wire). Why inject the
issue of right and wrong? Why not rather speak the plain,
unadorned, honest and sincere language of warfare, competition,
constraint and compulsion? In that language, the thing
was a tussle, a test of strength, a resort to force.
Tillie waited fifteen minutes before she finally broke in on
the conversation. The impulse to use force was certainly operative
during these long-drawn-out fifteen minutes. But it was
kept in check. The inclination to exercise power was curbed
during the period of hesitation. It was only after her patience
snapped that Tillie released the impulse. Why did she wait?
Why did she beat down her own pressing inclination? The
answer is plain: Tillie knew that using force meant to disturb
the peace among neighbors. She knew that the real and only
issue was peace or power, force or friendship, not the wholly
irrelevant question of right and wrong.
Tillie knew she was using force, but she claimed she exercised
a right. The use of force was a fact, the claim to exercise
a right was an opinion. You may say she thought or assumed
or guessed she had a right to use force. But it was merely
a thought, an assumption only, nothing but a guess; and
thoughts, assumptions and guesses of this kind are imagined.
The right which Tillie claimed was a figment of imagination,
the force which she used was a fact of realistic experience. If
Tillie's reaction is somehow typical of temperamental outbursts
in general, then, we may conclude that in temper a right is subjectively
claimed and force objectively used.

A claim ought to be verified. An opinion ought be tested,
proved and substantiated. That calls for a judge. Who is to be
the judge in matters o temper? And even if there were a
iudge all he could do would be to hand down an opinion. His
opinion may be final; it may compose and terminate the fight.
But it would be nothing more than an opinion rendered by a
dulv constituted court instead of by the contending parties.
True enough, the judge's opinion is supposed to be impartial,
unbiased, based on evidence, testimony, records and documents.
But no matter how heavily documented and how scrupulously
unbiased the court decision may be, nevertheless, it is and remains
an opinion. After the verdict is pronounced one legal opinion
has been substituted for two private opinions. The lawsuit may
then be "settled" and "decided." But the question of who was
right and who wrong still remains open. The loser may claim
with good logic that the judge erred and justice miscarried.
He may even contend that the law is wrong. You see here
that the issue of right and wrong cannot be determined, not
even by law. It can only be "decided" and "settled" by a court
order. Right and wrong are always opinions, assumptions, suppositions,
conjectures, speculations. That means, they are guesses,
subjective, imaginative, unreal.
Opinions interpret facts. It ought to be clear to you by now
that both the opinions and interpretations are guesses, hence,
imaginations. It ought to be just as clear that facts are realities.
Temper contains one opinion and many facts. The opinion is
that of right and wrong. The facts are the sensations, feelings,
impulses and acts (verbal and muscular) which are experienced
or expressed in the temperamental sequence. In Tillie's altercation
with the neighbor the facts were dynamic, impetuous,
fierce. On the other hand, the opinion of right and wrong was
pale, trite, hackneyed. In spite of that Tillie's attention was almost
exclusively focused on her temperamental opinion while
the facts of her sensations, impulses, feelings and acts went
unobserved or unheeded. Yet, her sensations were pressing,
her feelings boiling, her impulses overpowering and her acts
menacing and stormy. Her heart palpitated, her knees shook,

her throat contracted, and her voice trembled; she was well
nigh convulsed with rage, hostility and fury. But these facts
received no or little mention in her report about the telephone
conversation. All she claimed was that she was kept waiting,
that her intentions were frustrated and her plans thwarted.
She thought of the wrong only that was done her, of the rights
that were denied her. She was certainly not concerned about
the fact that she used force and that she disturbed the peace.
But force and peace are the outstanding facts of life. Force
means that feelings, impulses and acts are given ruthless expression
without regard for the rights of others. Peace means that
these same elements are properly controlled in deference to the
sensibilities, interests and claims of others. We may say: Tillie's
thoughts were narrowly focused on one restricted opinion: that
she was right and the neighbor was wrong. But of the facts
of the situation she was not at all aware. Her insight was
warped. It was centered on a personal opinion but ignored the
objective facts.
You remember that after the telephone call was finished the
outraged neighbor appeared in Tillie's apartment. This was
the occasion for another temperamental bout in the course of
which, Tillie says, "I lost my temper and gave it to her all right."
She then called Gertrude who told her, "You can't afford to
lose your temper because of your health." This was an admonition
to consider the realities of symptoms, sensations and feelings
as matters of first importance and to ignore the "phony"
theories of right and wrong. Tillie's reaction was defiant: "I
didn't just like that," she said, "and I still thought I was right."
The phrase, "I still thought . . ." is revealing. It reveals that
Tillie refused to accept the insight offered by Gertrude. She
obviously realized that Gertrude's counsel was sound and realistic
but decided that she wanted temper and not health. The
reason for the blunt refusal was that she "didn't just like that."
You see here why our patients, prior to being trained in Recovery
techniques, struggle against acquiring insight. They don't
like it. They don't like insight because it deprives them of the
excitement, drama and vitality of soul stirring and heart warm

ing fights. Fights provide the stir of action that is so sorely
missing in the fears, confusion and helplessness that characterize
the lives of our patients. Fights give them the sense of living
that has fled from the boredom of their daily existence. They
offer the opportunity to display vigor, strength, decision, eagerness,
determination, all of them elements which are painfully
lacking in a drab routine of hopelessness and paralysis of will.
Our patients want agitation and stimulation, not equilibrium
and peace. They want exhilarating theories, not balancing
realities. They crave the use of force, not the adjustment of
sensations, feelings and impulses. If you tell them that their
unbridled tempers will upset health and disturb peace their
verbal or mental reply is: "I shall rather disturb peace and lose
health than give up temper." It is the crowning glory of Recovery
that it was able to reverse this formula and to make
patients adopt the principle that temper must be eliminated
because it is the sworn enemy of peace and health. This radical
change in attitude was beautifully demonstrated by Tillie in an
encounter which she had with the same neighbor several months
later when, challenged to a fight, she "smiled and refused to
get into an argument." She "was sore but the after-effect lasted
just a short time." Behavior was finally guided by the realities
of peace and health, not by sentimental cravings for excitement
and intellectual considerations for fictitious theories.

A Panel Discussion Conducted by Patients
Annette (Panel leader) : The subject for today's panel is taken
from the article entitled "Temper as Craving for Symbolic Victories."
Has anyone an example?
Frank R.: I can give an example that shows two sides of the
story, that is, the difference in the results whether temper is or
is not controlled. The other night I walked home with Harriette
and met my mother on the street. She had a letter to mail. I
offered to let Harriette mail it so I could carry the bundles.
But mother asked me to mail it. As usual, she had to have her
own way. I lost my temper and grabbed Harriette and said,
"Let's go," leaving mother to mail the letter. After that I was
pretty angry for a short while but it was all over soon. In
former years I would have tried to justify myself; I would have
been furious about the domineering ways of my mother, but this
time I didn't do anything of the kind. The incident was closed
as far as I was concerned. Later on when mother came home I
spoke to her and she did not answer. A year ago or so I would
have got angry again but that evening I simply kept quiet.
At supper mother hardly ate anything and after the meal was
over she cried. Of course, I didn't like that but since as you all
know there is a deadlock between us I couldn't do anything
about it. As I said before there is a difference in results between
now and before. Before I had my Recovery training
the deadlock led to endless quarrels because neither of us would
give in. Now I keep quiet and while the deadlock persists
there is no argument. More than that, in former days I would
have been angry and stayed angry for a long time and incidentally
I wouldn't have felt like eating, either, but on this
particular night I ate as usual.

Annette: In other words, both you and your mother would
have staged a contest as to who would starve most and say least.
Well, you say that this time you faced the fact that the manner
in which you acted might have been wrong and temperamental.
You refused to prove that you were right. That is of course the
best way for cutting short arguments.
Tillie: I was in the subway last Saturday and sat down pretty
close to the corner and after I was seated a woman entered the
coach and wanted to squeeze in right between me and the
corner. She persisted and made me move. I was provoked but
I moved although there was plenty of room in the coach. I felt
my temper going up and I would have liked to tell the person
a thing or two. But then I began to get tense and I knew that
I had to stop working myself up. So I thought, after all, this
is a public conveyance and anybody can sit where he wants to.
So when I thought of that my tenseness left and I stopped
working myself up.
Annette: What was it that made you stop your temperamental
reaction ?
Tillie: I noticed the tightness in my side. When I get that
I feel choked. Then I can't stay in a closed room. That Saturday
in the subway if the tightness and choked feeling had kept up
a few more minutes I would have wanted to get off the train.
So I stopped working myself up, and the sensations left.
Sophie: Before I had my Recovery training, when I called
my children from the outside to come and eat they usually
didn't respond to the first or second call. Then I would get this
tightening in my throat or a pressure in my head and my temper
would rise and the symptoms would get more severe. After I
got into Recovery I learned I had to control my temper in order
to check this irritation. Now I call the children a half dozen
times and I can call in the same level of voice and my temper
doesn't rise any more. In the past when I used to work myself
up I always feared that something would burst in my head for
Annette: I will quote an example of my own. An elderly aunt
of mine, we shall call her Aunt Jane, was the type of person

who enjoyed temper tangles. She had never lived with anyone,
but during the depression we had to take her into our home.
When she came I decided I'd make an effort to get along with
her. I felt I could do that because she confessed to be fond of
me. But what I actually did was to try to convince her that she
was wrong and that of course ended up in pretty terrific temperamental
outbursts on both our sides. One time, after a rather
heated argument, I awoke in the middle of the night with a
very odd sensation in my abdomen. I felt as though something
awful had happened and I was going to burst. I was frightened
but did not know at that time that these were nervous symptoms.
But the sensations followed so regularly on temperamental
spats I couldn't help realizing that they were closely associated
with my temper. Several years later after I had undergone
a good deal of Recovery training I had occasion to get in contact
with Aunt Jane again. A friend of mine let me use her
car and I invited Aunt Jane to join us on an automobile ride.
This time I had a good opportunity to notice how I had
changed while my aunt had not. Whenever I found myself
wanting to prove her wrong and myself right I knew at that
very moment that all I was out to accomplish was a symbolic
victory. I stopped short instantly and instead of getting provoked
myself or getting her worked up I merely answered her
remarks with "maybe" or "is that so?" The argument didn't
even get started. On leaving the car my aunt was obviously
irritated and said, "I am just worn out. I never spent such a
boring day in my life." And if that remark didn't provoke me
into a sharper answer I realized that I must have learned the
technique of giving up the battling for trivial symbolic victories.
Carol: About this temper. I think it is grand that we have
been drilled to get rid of it. In my case it is when I am with
Pete, my husband, and I start to blow off steam. Pete, who
knows Recovery, then says, "Temper!" and that puts me on the
right track again. A year ago or so I would be provoked
with him when he would say, "Temper!" and I would snap
back, "What of it if I have a temper." After that I would usually

let off a honey of temper. But now I know he helps me check
it. And when I feel my temper rising I cut the feeling down
and it doesn't have a chance at all.
Annette: In conclusion I would like to say that the panel
members meant to bring out that we all got into temperamental
situations. In former days before we had our Recovery training
we would have exploded or fretted with a long-drawn-out
after-effect. During the explosion we would have had the momentary
satisfaction of letting off steam. That would give us
a momentary sense of relief. Besides that we would have had
the pleasure of feeling ourselves in the right and the other
person in the wrong. It is these two pleasures letting off steam
and feeling in the right that our physician calls the "dual
premium placed on temper." The trouble is that this "dual
premium" is short-lived, lasting only a few moments. But then
it is followed by an after-effect which may last hours or even
days. In that period of the after-effect we suffered many distressing
symptoms. I know that I for one learned that the few
moments of pleasure enjoyed during the immediate effects
are not worth the hours and days of suffering I endured during
the after-effect.
Physician's Comment on a Panel Discussion
A letter was to be mailed and, as a result, an ugly street scene
developed and a family group took their evening meal in the
dead silence of a sullen mood. Tears were shed and feelings
were crushed. And all the commotion, confusion and agony
were caused by a letter to be mailed. But a letter is a sheet of
paper and as such utterly incapable of rousing tempers and
offending feelings. No issue was involved. The contents of the
letter were not challenged; the propriety, wisdom, advisability
of its being mailed were not questioned. It was simply a fight
about nothing, a struggle for a scrap of paper, a fight without
an issue, a fight for the sake of fighting. How is it that men
and women of mature age engage in fights "for nothing?"

Obviously, mature years do not necessarily mean mature thinking
or adult acting.
A fight is centered around an object and rooted in a motive.
In the case of Frank and his mother the object was the letter.
What was the motive? A motive is a force that makes muscles
move. Suppose the letter which the lady wanted to mail was
addressed to a friend. Then the thought of the friend, the desire
to communicate with her, the intention to please her supplied
the motive that made Frank's mother walk into the street
and move toward the mail box. If Frank and his wife Harriette
had not entered upon the scene the letter would have been mailed
without ado and we would have no difficulty understanding
the object of the walk, its motive and its successful execution.
We would say that an act of behavior was manipulated correctly,
or that its purpose aimed correctly at its proper goal.
After Frank and Harriette made their appearance the muscles
of the letter carrying lady suddenly deviated from the goal of
the mailbox, the purpose of mailing was forgotten or neglected
and aiming was directed toward something that had essentially
nothing to do with the original purpose. A new purpose intervened,
changed the goal and redirected the aiming.
The original purpose was to communicate with another person,
to give pleasure, to show consideration. The motive here
was service. And service serves the end of peace; it creates good
will and promotes the welfare of the group. This motive of
service and group welfare was suddenly shelved after the arrival
of Frank. A fight ensued, and its motive was hostility, competition,
domination. What prompted that change in attitude?
What is it that makes a person abruptly shift from a disposition
to serve to a disposition to dominate?
Whenever you are alone in the privacy of your own home
you are master of your dispositions. You may do as you please
and may release whatever disposition you wish to express provided
you keep within the bounds of law, morals and ethics. If
your present disposition is to undress you may disrobe at will,
If you wish to rest you may lie down on the couch; if you desire
to sing, to whistle, to eat or read, to keep the eyes open or

closed there is nobody to check you, no standard to impose restrictions
on your whim or caprice. Under conditions of privacy
you are in unquestioned control of your decisions and enjoy the
exclusive and uncontested right to act as you choose. Being
the master of your destiny and a law unto yourself you are
sovereign. That sovereignty of yours is severely curtailed the
moment you step out into the street. Now you are subject to
rules which restrict your rights and put a check to your dispositions.
You cannot, for instance, place a couch in the middle
of the street and take your afternoon rest there. Even should
the street be empty you would not be permitted to use it as
your private dwelling place. Outside your home your conduct
is required to conform to regulations, customs and traditions
even if no legal, moral or ethical issues are involved. The reason
is that out in the street you may meet other people and once
you are among people you are the member of a group, and in
a group you are rule-bound and lose your sovereignty, at least,
part of it. In a group the members are fellows with equal rights
demanding that their rights be respected by the fellow members.
This is called fellowship and is opposed to sovereignty.
Fellowship means service, self-restraint and respect for the rights
of others. Sovereignty means or may mean the reverse: domination,
unrestricted power and disregard for the needs, desires
or rights of others. Fellowship is the principle of group action,
sovereignty that of individualism. To the extent that a sovereign
recognizes other persons as his fellows he loses the prerogatives
of sovereignty. To the extent that a group of fellows grants
to any of its members the status of sovereignty it weakens the
principle of fellowship.
Groups are either loose assemblages, for instance, a crowd in
the street, or a close knit organization like the family. The closer
a group is organized the more is it pervaded by the spirit of fellowship.
There is hardly a trace of fellowship in the street
crowd; there should be a maximum of it in the family. All
kinds of groups could be ranged between the street crowd and the
family with varying degrees of fellowship governing their
mutual relations. On this scale, a group of friends ought to be

held together by a far greater measure of fellowship than, let
me say, a group of co-workers in a shop, and the group of
co-workers should score a higher rating in fellowship than a
group of voters attending a political meeting. The point that I
wish to make is that the family ought to rank highest in point
of fellowship among all closely organized groups. In a family
fellowship ought to be at its maximum, sovereignty at it lowest
possible minimum. That this is not so is clearly evidenced by
the almost universal prevalence of domestic temper.
When Frank met his mother he offered to mail the letter.
Behind this offer was a desire or determination to be helpful or
courteous or considerate. The act expressed the motive of service,
that is, the spirit of fellowship. Frank has frequently stated
in panel discussions that he and his mother do not get along
well together. They live in a more or less continuous temperamental
deadlock, in an atmosphere of strife, spite and bitterness.
You may conclude, therefore, that Frank's offer was
a polite gesture rather than a genuine eagerness to be of help.
But in group life an insincere gesture of generosity and fellowship
is far more valuable than an outspoken expression of
enmity and a brutal assertion of one's sovereignty. No doubt,
the rebuff offered by Frank's mother was sincere. It was based
on sincere bitterness and sincere hostility. Sincerity of this kind
is anything but an asset. A group is interested in peace and
order. And peace and order are destroyed or disrupted by the
temperamental expressions of anger, vindictiveness and bitterness.
A temperamental outburst is sincere, of course. So are
murder and burglary. They are based on genuine and sincere
desires to kill and rob. That the mother was sincere in her
rude reaction to Frank's offer of fellowship was no credit to
her. That reaction was dictated by the mother's will to have
her own way, by her insistence on domination and her determination
to assert her sovereign rights. As such it served
the ends of unrestricted individualism, not those of rule-bound
group life. It was based on the principle of soveriegnty, not of
This is not an attempt to exonerate our friend Frank. He

practiced his share of rudeness and sovereignty when in a temperamental
act of brusqueness he "grabbed Harriette and said,
let's go.*' Both mother and son are currently disposed to display
excesses of domestic temper exercising their disposition
to assert their sovereign rights and ignoring the needs for
fellowship, mutuality and toleration. What interests us here is
the close relation that exists between the workings of an aggressive
temper, on the one hand, and the spirit of sovereignty
and fellowship, on the other. The members of the panel spoke
of symbols and symbolic victories. One of the most pernicious
symbols is that of sovereignty. Frank's mother imagined, perhaps
unknown to herself, that she represented or symbolized
sovereignty in her dealings with the members of her family.
Her will to assert her sovereignty provoked the resistance of
her son with the result that family life was turned into a
battlefield of temperamental dispositions in which both mother
and son craved the glory of symbolic victories and both effectively
frustrated one another's ludicrous ambitions. In the end,
a cruel, implacable deadlock developed in which feelings and
sensibilities were ruthlessly slaughtered and fellowship was
made a shambles. The realistic objects of the incessant fights
were invariably such trivialities as a letter to be mailed or a
sugar bowl to be filled. The symbolic goal was the craving to
assert sovereign rights. The inevitable results were tears, crushed
feelings and refusals to eat or otherwise to share and to practice
The deadlock between Frank and his mother is undoubtedly
extreme. It is characterized by an extreme insistence on the exercise
of unrestricted sovereignty and an equally extreme refusal
to practice fellowship. Deadlocks of more moderate intensity
were mentioned by the other members of the panel Annette
was in deadlock with her sour-dispositioned aunt, Sophie with
her boisterous youngsters, Carol with her soft-spoken and wellintentioned
husband. All of them were in one way or another
embroiled in the tug-of-war of domestic temper, all of them
had in previous years indulged in the cruel game of craving
symbolic victories in the battle for their sovereign rights, and

all of them had an unenvious record of tears shed, feelings
crushed and meals taken in the dead silence of sullen moods.
But all of them told you in unmistakable language that for
them the concept of sovereignty has been finally exposed as an
empty, silly and childish symbol and fellowship has become
a living, mature and concrete reality. Even Frank, the helpless
party to a relentless and apparently incurable deadlock, was
able to state that before he had his Recovery training "the
deadlock led to endless quarrels because neither of us would
give in. Now I keep quiet and while the deadlock persists there
is no argument." In his home, fellowship is not reestablished,
but the peace destroying symbolism of sovereignty has been
routed and with it Frank's symptoms of fatigue and sleeplessness.
And if it is true that Recovery training is capable of
laying the ghost of sovereignty, then, we may be pardoned for
claiming that our system of self-help is the sovereign means for
promoting fellowship.

A Panel Discussion Conducted by Patients
Frank (panel leader) : I will start off with an example. When
I first came to Recovery I had so many symptoms I did not
know where to start first. My symptoms were all pretty strong
and I did not know which was the weakest. My main symptom
was nervous fatigue. Today I know it is not muscular fatigue
but merely a sense of being tired. At that time I had difficulty
sleeping. It took me anywhere from an hour to three hours to
get to sleep, and after I got to sleep I would wake up every
hour or so, and this went on practically every night. I also had
practically no appetite and had to force myself to eat. I also
had blurring of vision, numbness in the arms and legs and
pressure in the head. A noise in the ears bothered me a lot. On
top of it I had difficulty making up my mind, and the simplest
decision gave me trouble. Finally I had to give up my job and
did not work for four years before I joined Recovery. Even
after I came to Recovery it looked like a pretty hopeless job.
Then I remember our doctor once saying in class that it is the
minor symptoms that must be worked on first. But I couldn't
tell a minor symptom when I saw one. Today I know that it
is not so much the weakest symptom that must be handled
but the* simplest method that must be used. And the simplest
method is control of muscles. Ever since I use my muscles
to walk on, fatigue or no fatigue, I am no longer troubled with
that awful tiredness. And since I have been using my muscles
not to toss in bed I have no trouble sleeping.
Harriette: Every now and then when I am talking with
new patients they are surprised when I tell them that I was
pretty sick for over fifteen years and am now well. They say

maybe you were not as sick as I am. Of course everyone thinks
they were the sickest person in the world but I think I was
very sick all the time before I came to Recovery. I can remember
in high school I got my famous headaches and nausea and
fatigue and dizzy spells and weak spells and palpitations and
my ears ached and my eyes blurred and my throat choked.
And I would go to a doctor and he would prescribe a tonic
or say I needed a rest and then maybe I'd be feeling better for
a short while and then another series of symptoms would come
along. Each time the new series would come they would be
intensified until about six years ago they got so bad I decided to
quit work. For the next two years I went around to doctors
and clinics and had all sort of X-Rays taken and all kinds of
medicine prescribed. But the trouble kept getting worse. So
after I had gone all round to every place and even went to
consult a doctor in Montana I talked again to the family physician
and he recommended I should go to Chicago and consult
our doctor who, my family physician said, treated his patients
with a new method. He meant the classes and Recovery. Well,
three weeks after I came to Chicago I was working part time.
After four months I worked full time and have been working
ever since, that is, over four years. I can say I feel better than
I ever felt in my life and no amount of money could ever pay
for what I learned in Recovery.
Frank: Can you say that you attacked your symptoms at their
weakest point?
Harriette; I don't know that. But the doctor told me to use
my muscles. So I forced myself to eat when I felt nauseated
and forced myself to walk when I felt exhausted. It wasn't easy
but what helped me was that I accepted the authoritative knowledge
of our doctor. I know our doctor would not ask me to
do these things if they could do harm.
Christine: My main trouble was a terriffic feeling of depression
and fatigue which I thought was the hardest thing to overcome.
When I got up in the morning I thought I could hardly
move and needed rest. But soon I learned that muscles could

be commanded to move but that didn't work the first few
times. I had to practice a number of mornings and what helped
me most was the example of other patients when they were
interviewed in classes. I thought what they can do I should
be able to do, too. And so I said to myself in the morning you
certainly can make your hands and feet work. What helped me
was, like with Harriette, that I accepted the doctor's authoritative
knowledge that my fatigue was in the mind and not in the
muscles. My mildest symptom, I think, was that I had to force
myself to eat. When I felt my throat was dry and I couldn't
swallow a bite I remembered that muscles can be commanded
to work and kept on eating. So I think I probably worked on
the mildest symptom by the method which to me was the
easiest to use.
In the further course of the panel Phil recounted how he
suffered from a lack of self-confidence after leaving the hospital,
how he was afraid he made too many mistakes. "If I would
get a wrong number on the telephone or forget to pick up a
pencil I thought I was going back to the Psychopathic Hospital."
As a consequence he kept out of the way of people and experienced
great hesitancy doing simple jobs. Finally he learned
he could always "command the muscles no matter how weak
the mind is." He then reported a recent experience. He was
driving his car and on stopping threw the door shut leaving
the ignition key inside. When some time later he reached into
his pocket he missed the key and knew he had left it in the
car. He felt embarrassed. He knew he would have to phone
his brother to ask for the reserve key. But then he would have
to "admit I made a mistake and would have to look foolish."
In former days he would have thought of calling a towing service
to have the car pulled in or would have considered some other
foolish move, trying by every desperate means to cover up his
inadequacy. This time he simply forced himself to use his
muscles, called his brother, got the reserve key and didn't feel
embarrassed at all.

Physician's Comment on a Panel Discussion
When Harriette told recent members o Recovery that she
recovered her health after fifteen years of futile search for a
remedy she met with skepticism. Had she told the doubters
that her main means of recapturing health was the use of her
muscles their skepticism would have turned into outright cynicism.
That the mind governs muscles is a truism accepted even
by the most sophisticated mentality. But that muscles can be
made to mold and influence mental activity sounds incredible
to the skeptic and laughable to the cynic. Fortunately, our patients
do not belong to the group of "advanced thinkers," and
to their plain common sense and unpolished way of viewing
things the humble muscle commands as much dignity as the pretentious
brain cell They know that if in a nervous ailment
central management breaks down the peripheral rank and file
may be ready or can be trained to "take over." And so, when
in the lives of Harriette, Frank, Christine, Phil and many hundreds
of Recovery members the machinery of central management
was thrown out of gear, the muscles were trained to hold
the line until management could be reorganized and revitalized.
After the muscles had demonstrated their ability to keep
the concern going the self-confidence of the brain was restored
and the body regained its capacity for concerted action and
balanced adjustment. To the skeptic such "pinch-hitting" of
the muscles for the brain may sound incredible, and to the cynic
it may appear laughable. But skepticism and cynicism are
off-shoots of intellectualism, and Recovery stands for realism,
plain common sense and an unspoiled way of viewing life.
At the time when Harriette joined Recovery she suffered
from a condition in which her brain had almost, ceased giving
directions to the muscles. If any guidance was supplied it was in
the form of fearful anticipations, gloomy misgivings and dismal
threats. The brain had retreated from active management of the
body. It cowered away in abject defeatism, shivered at the
thought of giving orders and trembled at the prospect of having

to take the initiative and to shoulder responsibility. There were
tasks to be finished, decisions to be made and actions to be
planned but the brain, paralyzed by fear, terrified the muscles
into helpless inactivity and the inner organs into chaotic functioning.
Harriette was tortured by "headaches and nausea and
fatigue and dizzy spells, by weak spells and palpitations." Her
ears ached and her eyes blurred and her throat choked, and for
solid years her brain warned her not to walk when she felt
dizzy, not to work when she was fatigued, not to eat when
she experienced her nausea. The sense of hopelessness in the
brain created an attitude of helplessness in the muscles. Action
was held in abeyance, life was suspended.
After fifteen years of unrelieved agony Harriette learned in
Recovery that if the brain defaulted on its managerial duties
the muscles can be made to "take over" and to "pinch-hit" for
the cringing cerebral manager. At first she had her doubts.
The method seemed too simple. When her nervous fatigue
made her feel exhausted and her brain threatened that the
next step meant unfailing collapse how was she to force her
muscles to venture into that next step that might lead to destruction?
But then she heard a patient recite in a class interview
how she had routed her fears by "commanding the muscles"
to do what they dreaded to do. That patient had developed the
habit of growing panicky at the mere sight of a knife, fearing
to do harm to the baby. During the interview I urged the patient
to practice touching knives and assured her that the mere
act of contacting or handling the "dangerous" object was certain
to convince the jittery brain that there was no reason for
jitters. The resoluteness of the muscles would conquer the
defeatism of the brain. The patient accepted my suggestion,
practiced touching knives and purged the brain of its fears. "I
would have never believed," the patient exclaimed, "that such
a simple method could cure my fears. But it did." Other patients
reported similar experiences. One of them was afraid
of crossing the street. Stepping out of the house meant to set
going a chain of frightening symptoms, palpitations, sweats, dizziness,
muscular weakness and dimness of vision. The brain

sounded the customary alarm, warning of a dire emergency.
After due instruction the patient learned to brave the empty
threat of the sensations and the defeatist babble of the brain.
He compelled his muscles to walk on, and convinced his cowardly
cerebral manager that no danger existed and that the
warning signals flashed by the brain cells were false alarms not
to be taken seriously. After Harriette witnessed several class
demonstrations of this kind she decided to give the method a
fair trial with the result that she worked part time after three
weeks of practicing muscle control and engaged in full-time activity
after another four months. The brain had been convinced
by the muscles that all that was required to shake off nervous
fears was to make the muscles do what the brain feared to do.
That the brain receives the greater part of its knowledge
from the muscles ought to be plain to anyone who is not blinded
by the glamor of fanciful theories. Knowledge means experience,
and the bulk of our experience stems from our actions, and
our actions are carried out by our muscles mainly. I do not
wish to deny that a great deal of experience is gathered from
vision and hearing, touch, smell and taste. But the type of
knowledge secured from these sources is chiefly informative.
Practical knowledge, the knowledge of how to behave, of wfiat
to do at a certain time in a given situation comes to you from
acting and practicing, that is, from the activity of your muscles.
With regard to that variety of knowledge and experience that
tells you what to do and what not to do there can be hardly
any doubt that the muscles are pre-eminently the teachers and
educators of the brain. It is true that after the brain has received
from the muscles its education about things practical it stores,
analyzes and codifies the items of knowledge which it has
acquired. It sorts them according to their importance and
value, their harmfulness and innocence, their promise of success
and threat of failure. It formulates rules and standards and
elaborates an imposing system of logic and wisdom for the sound
guidance of conduct. But the fundamental teaching and educating
are done by the muscles. That a flame causes a burning
pain the child learns after the muscles have touched the burn

ing object. Once the pain and burn have been experienced
through muscular action the brain forms the rule that the
finger must be kept at a safe distance from flames. The relationship
is clear: Muscles teach the brain, and the brain, enriched
by knowledge, guides the muscles.
Before Harriette fell victim to a nervous ailment her brain
had acquired a generous store of useful knowledge from the
countless muscular acts of behavior which she had practiced
in a busy childhood and active adolescence. From these endless
series of muscular reactions her brain derived a set of rules,
principles and policies which regulated her daily activities. One
rule was that headaches, nausea, dizziness, palpitations and
symptoms of a similar kind are average happenings not calling
for emergency reactions. Another rule was that if doubts arose
as to whether any of the symptoms were of an average or
emergency character a physician possessed of authoritative knowledge
should be consulted. A third rule, we may assume, was
that the dictum of the freely chosen physician was to be accepted
as sound guide for thinking about and acting on the inner experience.
These rules had served Harriette well. They told
her what to worry about and what to ignore, and they settled
her opinions, beliefs and convictions about health. But after
she developed her nervous incapacity she forgot the previously
well established rules, indulged in self-diagnosing and produced
sustained fears, panics and vicious cycles. Eating, sleeping, walking,
conversing were now considered as acts fraught with
danger. The brain was crammed with ideas of threatening collapse
and impending disaster. All her opinions, beliefs and
convictions gained from previous muscular behavior were
drenched in a flood of defeatism. Fear ideas and emergency
impulses poured forth from an intimidated brain down to the
leaderless muscles, and action turned into inactivity, initiative
into paralysis of will, self-confidence into helplessness and hopelessness.
When after fifteen years of an agonizing existence
Harriette decided to consult me, my problem was to convince
her brain that eating could be done in spite of the threat of
nausea, that nocturnal restlessness and brain storms were no

bar to normal sleep performance, that brisk walking was perfectly
compatible with "nervous exhaustion" and that a lump
in the throat was no impediment to well articulated speech 01
to resolute swallowing. It was at that time that "commanding
the muscles" was prescribed as the proper remedy. As was
mentioned Harriette was at first skeptical. But when in classes
and at Recovery meetings her skepticism melted she commanded
her muscles to lie quietly in bed when she was tense and restless,
to walk on when she felt exhausted, to eat when the mere
sight of food produced nausea, and to speak forcefully when
the throat felt choked. And after the muscles swung into action,
disregarding the "symptomatic idiom" of the organs, Harriette's
brain was instantly convinced that exhausted muscles can do
a fine piece of walking, that a weary body can lie motionless in
bed until sleep supervenes, that a stomach harried by the prospect
of nausea can be made to take in food without sending it back,
and that a throat, drained of its moisture and contracted to a
pin-point, could be induced to voice a well-modulated speech.
With continued practice of systematic muscle training the brain
finally was rid of its defeatism and invigorated by a newly
gained conviction, mustered the courage to resume leadership
and to reinstate the ancient set of rules, policies and principles
for healthy conduct. Harriette's muscles had re-educated her
Had Harriette retained her skepticism she would have refrained
from practicing muscle control, and defeatism would
have nullified or retarded her cure. Unfortunately, too many
patients persist in their skepticism, scorning the use of a method
which appears "too simple" to promise results. One such patient
recently tried to challenge my statements about the role of
muscles in shaping conduct with the question, "But, doctor, I
don't suffer from palpitations or dizziness or fatigue. My
trouble is an obsession. How can muscles cure an obsession?"
The obsession from which the lady suffered was one of jealousy.
The patient knew that her husband was a model of matrimonial
loyalty, but could not shake off the thought that he was unfaithful.
She was told: "I grant that yours is what is called an ob

session. But i you ponder the meaning of the word you will
realize that what obsesses your brain is an idea. You know
from experience that ideas come and go. How is it you cannot
get rid of your idea? How is it that it 'obsesses' you and occupies
your attention all the time? The reason is that the actions of
your muscles feed this idea and reinforce it incessantly preventing
it from leaving the brain as ideas ordinarily do. Command
your muscles not to act on the obsession, and it will die of inanition.
What you do is to keep the thought of jealousy alive
by means of your muscular action. You rummage in the pockets
of your husband's clothes to find evidence of his philandering.
When you arrive home you search rooms, garret and basement
to discover tell-tale objects left by an unwelcome visitor. You
spy on your husband's activities, telephone his office numbers of
times to check on his whereabouts, scrutinize his mail and notebooks
and keep a close watch on every one of his movements.
When he arrives in the evening, you subject him to a relentless
bombardment of quizzes, questions and suspicions. All of
this is done by your muscles. Every search, every act of watching,
every sequence of questioning intensifies your tenseness and
keeps your attention forcefully riveted on the obsessive idea.
That idea would die a natural death within a short time, as ideas
commonly do, if you permitted it to expire. But the action of
your muscles keeps it alive, prolonging your suffering and refusing
to let your brain find its normal equilibrium. The surest
way to make the obsession depart from your brain is to command
your muscles not to ask questions, not to telephone your husband's
office, not to launch into endless searches of rooms, pockets,
drawers and notebooks. In your case, the muscles, if properly
restrained, would not only re-educate the brain, they would also
give it the much-needed breathing spell and would relieve it
of the well nigh intolerable tenseness under which it is placed
through the action of your muscles."
I could quote numerous other examples illustrating the many
uses to which the method of muscle control lends itself in its
task of either convincing the brain that defiance of symptoms is
possible and harmless, or relieving it of pressures caused by

morbid preoccupation with disturbing ideas and impulses. But
my time is up and I shall close with the assurance that what
Harriette did can be done by every nervous patient and that
the simplicity of the method which she used ought to be no
occasion for skeptical shrugs and cynical sneers. Precisely because
the method is simple it is prompt, effective and convincing.

A Panel Discussion Conducted by Patients
Annette (panel leader) : The subject for today's panel is taken
from the article "The Myth of Nervous Fatigue." When I became
ill I was always exhausted. When I came home after a
day's work I felt as though I had to crawl into bed. Many
an evening I thought I was too tired to eat and so I did not
eat. I just crawled into bed and stayed there. The doctor prescribed
a program of rest and I followed it faithfully. Returning
from work at about 4 o'clock in the afternoon I went to bed
and sometimes I slept and sometimes I did not. I got up for
supper and went right back to bed again. The first few days
I got a little relief, but very little. Very soon I felt just as tired
lying in bed and resting. Of course, I thought the fatigue was
physical. I thought I was gradually losing my vitality and resistance.
But I went on with the program, spending more and
more time in bed and doing fewer and fewer things. But I
felt more exhausted than ever. Physicians had told me my
condition was that of a nervous exhaustion and I formed the
idea that the nerves in my body were exhausted and shriveled
and incapable of performing their job. When I came to the
Illinois Research Hospital I was told in classes that my trouble
was not fatigue but self-disgust and discouragement. I didn't
like that very well because I knew how my muscles felt and
it didn't just sound right that disgust and discouragement
should make them feel exhausted. But as I continued to attend
classes I became convinced that our physician was right and I
learned to be more objective about my symptoms. After I returned
home from the hospital I wanted to move a large piece
of furniture and did not want to wait until my husband came

home. So I did the job and moved it and then I decided to
move the other pieces and when my husband came home, instead
of being in a state of exhaustion I felt fine. After that experience
I was convinced that, as our doctor says, nervous fatigue is in
the mind and not in the muscles. Any other example ?
Gertrude: I have one. The other day I got up early, about
a quarter to six and started my ironing. About eleven thirty I felt
tired and thought I couldn't go on another minute. I became
quite dizzy and had the idea, "I've got to lie down because if
not Fll faint." I thought I was exhausted from being up so
early. But in a second I realized that what was really the matter
was that I did not want to finish the ironing. I had a few shirts
to do which I don't enjoy doing. So I said to myself this is a
nervous fatigue and lying down will not help any and also
will not get the Droning done and I kept right on. It did not
take more than five minutes and the fatigue was gone, so I realized
it was a mental fatigue.
Annette: Did you have experience with this sense of fatigue
in previous years?
Gertrude: I had it practically all the time when I was first
sick. Even on days after I had a good night's sleep I used to
be so fatigued I would lie down and rest. But then I felt just
as fatigued no matter how long I rested. I could never figure
out the reason till I got my Recovery training and learned that
this nervous fatigue was nothing to worry about. Now I am
interested in things and don't get bored so easily, and so I
don't feel fatigued any more.
Christine: When I was ill my strongest symptom was I
would get up in the morning feeling so fatigued I had all I
could do to wash my face and put my clothes on. When I
came to Recovery I learned that was discouragement and selfdisgust
but I still sabotaged at times and whenever I did not feel
well I said I needed rest. Every doctor had told me I needed
a rest cure. The other day I felt miserable and tense and tired
and I thought I just couldn't get dressed. But I made up my
mind to go to the Recovery office to have a cup of coffee with

the other girls:* But I felt so draggy I didn't think I could
make it. But I went and when I left I felt fine and all fatigue
was gone.
Annette: Walking to the Recovery office involved a walk of
about six blocks. Do you think you would have attempted a
six-block walk, let me say a year ago, when you faced this intense
feeling of fatigue?
Christine: No, my legs used to get weak and shaky and they
felt like they were going out from under me and I really
thought I couldn't walk. I was afraid I would collapse if I
forced myself to walk. But last week, after my daughter's
wedding, I felt plenty fatigued after all the activity and excitement.
But I carried on. I said to myself, "If it is nothing but
the sense of discouragement it doesn't matter. And if it is muscle
fatigue it will disappear."
Marcelle: When I first got out of the hospital I felt terribly
fatigued in the morning. I had to get my husband's breakfast
but went right back to bed the moment he left. I would stay
there till eleven or twelve o'clock and when I got up I felt just
as tired as if I had not rested at all. After I got my Recovery
training I knew that this was a feeling of discouragement, and
our doctor had told me I should take brisk walks, fatigued or
not fatigued. And I did that and felt fine. At times I still sabotage
and stay in bed in the morning but that is getting less and
Frank R.: Before I had my training in Recovery I was always
tired. I always wanted to go to bed. But I couldn't sleep. I
dreaded lying in bed struggling to sleep. So I put off going
to bed till one or two o'clock. Finally I would doze off but I
would be awake at five o'clock. When I joined Recovery and
heard about nervous fatigue being just discouragement I was
very skeptical about that. I had had that fatigue so many years
*Every afternoon between two and five, two members of Recovery
volunteer their time to supervise activities at the Recovery headquarters.
Members drop in and spend the afternoon in the company of other
patients. Coffee and cake are served on this occasion.

that I was convinced it was real muscle fatigue. But I listened
to our doctor and practiced ignoring the fatigue. Today I go to
bed early and have no trouble sleeping and feeling refreshed
in the morning.
Rose E.: I used to hate to get up and make my husband's
breakfast. But I did it anyhow. But the minute he left I would
just fly back to bed again. I would lie there for an hour or two
and feel worse than before. Then I joined Recovery and learned
that the tiredness is nothing but a sensation and I can now
ignore it and do my work even if I sometimes feel tired. I have
practiced that and found it to be so. I found it is just nervous
fatigue and it leaves.
Physician's Comment on a Panel Discussion
Annette felt tired and thought the "fatigue was physical."
She then formed the idea that her nerves were "exhausted and
shriveled and incapable of performing their job." After she
was told in classes that nervous fatigue has its source in the patient's
sense of discouragement and self-disgust she "didn't like
that very well because I knew how my muscles felt." With this
she formulated the familiar philosophy of nervous patients which
can be condensed in two sentences: I fed tired; hence, I am
tired, and I thinly my muscles are exhausted; hence, they are.
On the basis of this philosophy, patients are convinced that
what they feel is real and what they think is right. And it is
the supposed reality of what they feel and the presumed rightness
of what they think which keeps patients from ironing and
dressing and preparing the breakfast. Protesting solemnly that
their nerves are "incapable of performing their jobs" they do a
perfect job at coddling their feelings and pampering their
thoughts. Pronouncing their coddled feelings real and their
pampered thoughts right they prepare the groundwork for manufacturing
a self-made incapacity.
I want you to know that this is a philosophy, confused and
absurd, it is true, but a philosophy, nevertheless. My patients

claim they suffer from frightening sensations, overpowering impulses,
torturing thoughts and devitalized feelings. But I tell
them that this is a half-truth at best; that what they actually
suffer from is their philosophy. And if their philosophy is based
on the assumption that in their spells and tantrums their feelings
are real and their thoughts are right, well, that is precisely
the philosophy of temper. In the ordinary burst of temper,
whether it be presymptomatic or postsymptomatic,* you feel
the insult or injury was a "real" outrage, and ihin\ you are
"right" in considering it a deliberate hurt.
If I speak of a philosophy I do not refer to a complex system
of thought as described in textbooks. What I have in mind
is what has been called the philosophy of life. Let me add
immediately that I know three philosophies of this kind only:
realism, romanticism and intellectualism. If in the pursuit
of your daily activities you coddle your feelings you will act
as a romantic; if you pamper your thoughts your conduct will
be that of an intellectual. Your behavior will then be governed
by feelings whose telltale story has been hastily believed, or by
thoughts whose immature suggestions were uncritically accepted.
In either case, your action will be guided by the subjective
promptings of your inner experiences instead of by the objective
requirements of outer reality. If you were a realist you would
give first consideration to the actual facts of the prevailing situation
and would not hesitate to suppress your thoughts or
shelve your feelings if you found they conflicted with the realities
of the situation. I shall illustrate the point presently.
You enter a bakery shop intent on buying a cake. The requirements
of the situation are such that you must stand in line
and wait. No doubt, you will not relish the prospect. You will
be provoked, and will experience irritation, discomfort and
impatience. These are the subjective feelings with which you
respond to the realistic facts of the situation. We shall call it
the feeling response. Before long your thought processes swing
into action. You surmise that the saleslady could certainly move
*About presymptomatic and postsymptomatic see Part 3, page 292.

a trifle faster. And the customer who is just being served could
indeed speed up her selection without insisting on being shown
all varieties of cookies in the show case. How inconsiderate
people are! And what kind of government is this anyhow! A
year after V-J Day and still this nuisance of wartime restrictions,
scarcities and rationing! This is your thought response,
as intuitive, impulsive and spontaneous as was your feeling
response. I doubt whether any human being endowed with
normal sensibilities will avoid the feeling of irritation and the
thought of frustration in a situation of this kind. Be he realist,
romantic or intellectual, he will respond with aroused feelings
to an imposition and with critical thoughts to the persons who
prolong or aggravate the frustration. He would not be "human"
if he responded otherwise. In point of inner responses men are
alike. They differ only in their readiness to convert their inner
responses into open reactions. The realist is inclined to control
his feeling and thought responses; the romantic and intellectual
tend to express them. It is all a matter of your philosophy (of
life), and if your philosophy is realistic you will exercise control;
if it is romantic your feelings may be expressed the moment
they are aroused; if it is intellectual your thoughts will
tend to be voiced the very instant they are born.
A philosophy tells you which goals to choose and how to
aim at them. You who are readers of our Recovery literature
know that goals are of two kinds: group and individualistic. The
realist aims at group goals mainly. His ambition is to adjust
his conduct to the requirements of group life. In the instance
of the visit to the bakery shop he considered himself a member
of the group of shoppers. He knew that by expressing his
feelings of irritation or his thoughts of resentment he was bound
to arouse the enmity of some members of that group. And
antagonizing the group meant maladjustment. If his goal was
to create good will in the group he had to curb his individualistic
inclinations to express his inner responses. He exercised control
and remained adjusted. To the romantic and intellectual person
the good will of the group means little. Group standards are
odious restrictions to their craving for individualistic expression.

In the episode at the bakery shop the romantic would not have
hesitated to voice his indignation with a candid and perhaps
studied indifference to the sensibilities of others. He prides
himself on being frank and above-board. "What is wrong about
expressing a feeling?" asks the romantic enthusiast for frank
expression and forthwith, without scruple or hesitation, he rolls
off a list of his likes and dislikes regardless of whether they
are offensive, tactless and out of place. He will tell you, without
mincing words, that your furniture is not properly arranged,
that if he had planned a house like yours the rooms or entrances
or exits would have been differently placed. If it is a
woman romantic she will intimate plainly that she has no taste
for your jewelry and that her way of cooking a roast is different
and "if you want to get a real coat let me take you to my tailor."
It is all an expression of feelings and if in the process the feelings
of others are hurt, well, it is about time they got used to language
that "comes straight from the shoulder." Presently, this unrestrained
talker will steer the conversation into the channels of
sickness, hospitalization, operations. She will revel in gruesome
recollections of the "excruciating pains" she suffered without
being able to convince her husband or physician that the pain
was "real." What agonies she went through. She felt pain and
tugging and pulling in the lower abdomen. "It was there, I
felt it all the time. But they thought it was my imagination.
Finally I got my physician to take me to the hospital, and on
the operating table they found. adhesions all over." Her feelings
had told her she had a tumor or something of the sort, and it
was "really" there.
I could go on indefinitely describing the amusing though by
no means harmless mouthings of these romantic souls. I could
portray their lust for complaining, their zeal for being considered
a martyr. But it would merely illustrate the fact that their
philosophy is one of reckless expression of feelings. These feelings
are coddled and treasured and magnified and thrust at
every innocent listener who consents to be an audience.
I shall now give you a brief account of the intellectual mentality,
the counterpart of the romantic soul. His stock in trade

is the insistence, repeated tirelessly and ruthlessly, that he is
right, that you better take his advice, that he could have told
you how to avoid trouble if you had only cared to listen to him.
Thinking that he is right he promptly assumes that the others
are wrong. Hence, he delights in correcting the statements and
opinions of those about him. He is critical, aggressive, meddlesome.
He not only knows things but knows them better than
others. His views are advanced and modern, theirs are standpattish
and outmoded. His supreme delight is to change things,
to reform laws and institutions, to do away with the old and to
create something new; hence, he is impatient with tradition, custom
and standards. He knows how to arrange things, how to
plan them, how to predict and prevent. Enjoying a self-appointed
monopoly in correct thinking he is eager to mend and "reform"
the defective thought processes of others. These others are backward,
benighted, reactionary. He is forward-looking, enlightenend,
progressive. The essence of his attitude is that he knows
and is right and that the others are ignorant and wrong. And
if they are wrong it is his duty to tell them. There is no reticence
about this intellectual. He talks and argues and fights for his
opinions. His pet ideal is "free speech," not only in the political
scene where it may have a legitimate place, but also in social and
domestic contacts where it merely serves the purpose of shocking
settled convictions and established views. Waiting in line
at the bakery shop the intellectual would or might let loose a
stirring tirade of criticism against "that bunch of stuffed shirts"
and their "red tape." He might inveigh against the greed of
the "vested interests" and the oppression of the common people.
Voicing their thoughts and opinions, particularly if they are
shocking to the "lethargy" of the "standpatters," is a consuming
passion with these right-thinking and enlightened intellectuals.
I do not wish to be misunderstood to imply that my patients
are generally addicted to a romantic or intellectual philosophy
of life. Presumably, some of them are, but so are some members
of every group. At any rate, I am little concerned about the
political, economic or social views of my patients. What interests
me is their philosophy with regard to symptoms and temper

The fact is that my patients, prior to receiving training in Recovery,
have been stubbornly romantic about their symptoms
and emphatically intellectual about their temper. They coddled
their defeatist feelings of "really" being exhausted and of "really"
not having slept a wink for months, and pampered their thoughts
of having the "right" to wail and complain and make extravagant
demands on relatives and friends. What the panel members
demonstrated convincingly is that persistent and systematic
training in the realistic principles of Recovery is the superb
means of ridding our patients of the pretentious pseudo-philosophies
of decadent romanticism and arrogant intellectualism in
their dealings with their common inner experiences.

A Panel Discussion Conducted by Patients
Annette (panel leader) : The subject of today's panel discussion
is taken from the interview entitled "Average Existence and
Exceptionality." The doctor speaks there of desirable and undesirable
exceptionality. Has anybody got an example?
Ann: I had a silly fear similar to the one described in the
article. My sister told me something that had happened to a
neighbor. He had been hurt in an accident. I got the idea I
was responsible for that accident. But I knew immediately it
was a delusion and was ready to wait till it would disappear.
You know, I mentioned it on previous panels, that I get delusions
of this kind but I have learned to handle them. But this
time all of a sudden I laughed hysterically. That frightened me.
After I hung up I had the fear that my sister would know my
behavior was maladjusted. I called Rosalie, and she told me
how she handled a similar story of an accident. I again got this
idea that I was responsible. Rosalie said, "You know what you
are doing? You are misinterpreting an event. You know that
nobody in this world would think he is responsible for an accident
he heard of. And if you think you are responsible you
think you are not like other people. You think of yourself as
exceptional." That helped me. And last Saturday when I had
that feeling again that I was responsible for what somebody
did I had no fear in connection with it and it just disappeared.
Annette: Ann has learned in Recovery that even delusions
can be controlled if you know how to eliminate the idea of
danger. Such delusions are ideas. And our physician has told
us repeatedly that ideas come and go if you do not add the
thought of danger. Ann has proved that is correct.

Ann: Of course, I don't handle them right yet. Just thinking
of these fears and bringing them out on the panel gives me
tremors. I have some right now but I can control them.
Annette: Several weeks ago I had a trying day and I was
quite tired and somewhat irritable. I had stayed up late and
when I went to bed my feet were very cold. I mentioned it to
my husband but he did not reply. I resented that. A little while
later I got a cramp in my foot but I didn't tell my husband perhaps
from fear that he might not be any more sympathetic than
he was to my first complaint. I became tense and felt that I
thought of danger but did not know exactly what kind of danger
was in my mind. Later the cramp went away, and it was then
that I recalled that a very close friend of mine had died that
week and that there had been a blood clot in the leg. Today
it is clear to me that the blood clot suggested to me that my
cramp was dangerous. As I now know through my Recovery
training, the patient likes to complain of something spectacular
and exceptional. When I had the cramp I should have thought
of an innocent pain or muscle fatigue. But as our physician
says, the nervous patient will not settle for anything less than
a rare, incurable or hopeless ailment. I think that after that
experience I understand now why we think of the spectacular
and exceptional.
Gertrude: One of the ideas I had was the thought of death.
In Recovery I learned that we cannot be exceptions and if the
average man and woman can think of death we can, too. But
in the beginning I was afraid of the thought. Now I can think of
death as the average person does. I live only a short distance
from three cemeteries, but most of the time I am not even aware
of their being there.
Carol: If I am among people I feel I want to be tops, but
I feel I am not genuine. Our physician has told me that means
I hope to be exceptional but fear that I am not even average.
On the train I think the people are watching me. I know now
that this is what our doctor calls the sense of undesirable exceptionality.
I also want to be an exceptional mother but I don't

handle it right. I feel I have to watch Susie, my little daughter,
every minute of the day. But the other day when a neighbor
girl came over and asked whether Susie could have lunch with
her I got objective about it and let her go.
Annette: What happened when you went against your desire
to keep an eye on Susie?
Carol: At first I had all kinds of wild thoughts of danger.
But then I said, "All right, I am going to say 'no' to my sensations
and feelings and be like my neighbor." I was tense but
I dropped the sense of exceptionality and was no longer afraid
of being average.
Sophie: The other day I went to the basement to do my
washing. The children were home from school. I said, I am
going downstairs, and don't you make noise. As soon as I went
the noise started. I became furious. I shouted up to them
to stop that noise. But they made such a racket they didn't hear
me. I felt so frustrated I felt like crying. I dropped the linen
and I couldn't move for a few minutes. It seemed to me I was
paralyzed. But then I stopped and looked into myself and said,
"What are you doing?" I was setting an exceptional standard
for my children not to make noise. When I recognized I had
that standard the tenseness left me and I went on with my work.
Frank: I can give an example. It is not so dramatic. It happens
frequently that I have something to do, and I just don't
want to do it and I don't know why. I just can't get started.
I am now working on the Recovery News and it is necessary
to type up the stencil. It is a simple job but it takes me a week
or more to warm up to it. I think it is because I don't think
it is good enough. I guess my standard is too high and I still
think in terms of exceptionality. When I realized that I just
made up my mind that I would type up the stencil and I did
it in no time. If I hadn't done the work I would have condemned
myself and got more tense. After I finished it I felt quite proud
of myself and there was no vicious cycle as there usually is when
I procrastinate.

Physician's Comment on a Panel Discussion
When Ann, in distraction, turned for help to Rosalie she
was warned not to consider herself different from other people.
If she did she thought of herself as exceptional and not as being
like other people. I shall ask: Do you really believe that anyone
with a spark of vitality and ambition will content himself
with being "like other people?" To have no other qualities
than the ones found "in other people" means to be colorless,
ordinary, dull, perhaps common and commonplace. Who would
relish the reputation of being unimaginative, impersonal, nondescript?
People wish and crave to have distinction, singularity,
personality and character. They shudder at the thought of being
just a cipher, one of many, nothing but average. What men and
women actually hope, boast and pretend to be is exceptional.
And if my patients think of themselves as being not just average
they do what everybody does. Why do I then urge them to shed
their sense of exceptionality?
Exceptionality is a hope, a dream, an illusion, that means, an
imagination. Averageness is the reverse; it is a subtle fear, a
sober fact, a disillusioned self-appraisal, that means a plain, uninspiring
reality. People hope to be exceptional and fear to be
nothing but average. If you choose to live in a world of hopes,
dreams and illusions you are a sentimentalist; if you prefer the
realm of factual existence and everyday life you are a realist. But
you are not permitted to make a choice or to state your preference.
You are what you are: sentimental and realistic, imaginative
and matter-of-fact at the same time. What counts is the
proportion, balance and ratio. Does your realism outweigh
your sentimentalism ? Or does the balance tilt in the opposite
direction ?
I am fond of believing that my patients represent a wholesome
and desirable cross-section of the general population. If that is
true their personalities are as well or ill balanced between sentimentalism
and realism as those of their relatives, neighbors and

friends. They feel just as exceptional and are just as average
as the social set to which they belong. When they deal with
their children, their wives, mothers and fathers they indulge in
a pardonable sense of exceptionality taking pride in the supposedly
superior qualities of their family, clan, race. But I doubt
whether my patients carry this sentimental bias into the regions
of business, social activities and home management. There they
are exactly as realistic and average-minded as the situation requires.
The sentimental trend exhibited in one sphere of life
is neatly balanced by a corresponding realistic attitude governing
their activities in other spheres. There is solid balance, sound
proportion, sane ratio.
If I ask my patients to be realistic instead of sentimental; if
I insist that they renounce their romantic sense of exceptionality
in favor of sober self-accounting in terms of averageness I refer
to the attitude they are supposed to take with regard to their
symptoms. There they must not indulge in sentimental dreams
of exceptionality; there thy must plant themselves solidly on
the ground of realistic averageness. If the average person experiences
pressure in the head he does not permit himself to
be rushed into a hysterical panic. He suffers but remains calm.
True, my patients suffer from conditions that are not average
in intensity and duration. Nevertheless, I ask them to retain
their balance even in the face of extreme agonies. Ann demonstrated
with singular clarity how this can be done. She had a
delusion and manipulated it as an average experience. How
could she manage to think she was "like other people" at the
very moment her brain was the seat of a delusion? Do people
have delusions "on an average?" What Ann did was exceptional.
It was the exact reverse of what could be expected "on an average."
She turned realist and was calm and poised in a situation
that was frightening, exceptional and extraordinary. With this
she carried the principle of averageness to the very limits of
plausibility and possibility. Such feats are possible in Recovery,
and in Recovery they are no feats. There they are average
occurrences, the result of patient and systematic training. What
Ann demonstrated was that under our system of training senti

mentalism can be so thoroughly overbalanced by realism that
even under exceptional circumstances the sense of averageness
can be made to assert itself successfully.
Delusions are, of course, outside the domain of realism. And
there can be no objection to ranging them among the sentimentalities
of thoughts or wishes. If a patient claims to be
Napoleon, if another thinks he is being observed and watched
and spied on as if he were an important personage you may
call the one a delusion of grandeur and the other a delusion of
persecution. But in essence it is romanticism and sentimentalism.
Annette and Gertrude mentioned no delusions. They reported
their experiences with the fear of a blood clot, the dread of
dying. Is the fear of a blood clot sentimental? Average people
certainly worry about death and vascular accidents. And if
Carol worried about her daughter Susie and Sophie became
furious about the noise made by her children and Frank
couldn't get himself to warm up to a simple job what is the
warrant for calling these reactions sentimental or exceptional?
Take the case of Annette. Her feet felt cold and developed a
cramp. This was an experience of discomfort and pain. The
experience as such had all the earmarks of averageness. What
could be more average and commonplace than cold feet and
crampy muscles? There is no distinction, no glamor, no excitement
in coldness and crampiness. The incident is so trivial
that it cannot excite interest. It could certainly not be used
as the subject for a telling story. But the moment Annette conceived
the suspicion that the cold feet and crampy muscles might
be the result of a blood clot, well, there was the plot for an exciting
story that could stir the imagination. With a mere chilly
skin and cramping muscle her experiences were drab, trivial,
uninteresting, uneventful. But with a clot, there was danger,
excitement, drama. A blood clot is not everyday life; it is a dire
emergency, a tragedy, perhaps a good story. To reach the dizzy
heights of emergency and tragedy Annette had to infuse the
elements of temper and emotionality into an event that was
otherwise plain, simple and devoid of thrill.
Take now the case of Carol. She was worried about the health

of her daughter Susie. On the face of it no sentimentalism
seems to be involved in a mother's concern about the health
of her child. A concern of this kind is realistic and average.
Even if Carol felt she had to watch the daughter "every minute
of the day" the sentiment was still within the scope of average
anxiety although decidedly overdone. But when Carol carried
her apprehensiveness to the extent of refusing Susie to be
watched by neighbors whom she knew to be responsible people
she displayed an unrealistic distrust in the reliability of the
average person and indulged in what she calls herself a sense
of "undesirable exceptionality." She set herself up as the only
person to whom Susie's welfare could be entrusted. She alone
had the requisite sense of responsibility. The others could not
be relied on. Moreover, she conceived of Susie as a child that
needed special watching, extraordinary care, exceptional supervision.
With this she injected into everyday life concepts and
sentiments of exaggerated duties and responsibilities that have
no place there. Suppose Susie, while attending a luncheon in
a nearby home hurt her leg or felt a "tummy ache" or got involved
in a fracas with the other children; the hostess could certainly
be credited with ample sense of duty and responsibility
to take proper care of the situation. You see, Annette and Gertrude
exaggerated the importance of their own bodily feelings
and sensations and became emotional. Carol gave herself over
to a vastly exaggerated sentiment of duty and responsibility and
became sentimental. You will now understand what the terms
emotionalism and sentimentalism imply. Emotionalism means
that plain and innocent sensations, impulses or feelings aroused
by events of average intensity are conceived as so alarming that
nothing short of an extraordinary fear reaction seems to suit
the situation. Sentimentalism means that equally plain and
average experiences are viewed as so exalted and valuable that
nothing short of an excessive sense of duty and responsibility
can meet the requirements of the momentous event.
Average life consists of trivialities mainly. Average home life,
for instance, calls for buttons to be sewed, dishes to be washed,
children to be watched, pain and discomfort to be endured. All

of this is routine, offering little stimulation or excitement and
providing a great deal of irritation, a good measure of drudgery
and some amount of suffering. Occasionally there is a birth or
wedding, sickness or death. Then the routine is interrupted
by an exceptional event but is resumed in all its deadly monotony
as soon as the event has passed. The irritation incidental
to this sort of routine life is patiently borne by persons who are
not too irritable. But nervous patients are unfortunately blessed
with an excess of irritability. As a result, the average irritations
of routine existence are well nigh "unbearable" to them. They
hate the routine chores. Routine, to them, is an infliction. It
inflicts disturbing sensations, confusions, doubts and anxieties.
To the average housewife the breaking of a glass is a plain
occurrence not to be fussed over. It causes a mild irritation that
is easily disposed of by the consideration that the loss is trivial
and replacement easy. But to the nervous housewife the breakage
may suggest that she is inadequate, that all effort is futile,
that the inefficiency, incoordination and lack of attention revealed
by the dropping of the glass are beyond hope. She may now
become provoked at herself and work herself up to a pitch of
excitement and emotionalism. Or, she may bring into play the
sentiment of self-pity and condemn herself as a neglectful person,
oblivious to duty and responsibility. The sentimentalism of selfblarne
may finally produce a panic. Then sentimentalism and
emotionalism join hands to create exceptional fury in response
to an event of average triviality.
The excessive irritability of my patients predisposes them to a
grotesque hatred of routine. With the average housewife,
sewing buttons and darning socks do not figure as exalted tasks
or sources of great excitement. They are chores, devoid of
thrill and inspiration. But the darning is done for the husband,
the sewing for the son. Being meant for the ones she loves
the activity acquires a significant meaning in the eyes of the
housewife. Every stitch and every patch has the meaning of
doing something necessary, useful and valuable. Life is still
a chore and unpleasant routine, but the routine is now meaningful,
important, perhaps even vital. The inherent meaning of

the work creates enjoyment. The enjoyment provides stimulation,
gives a sense of living, a feeling of accomplishment. Added
to the feeling of joy and satisfaction is the realization that the
mending and patching constitute a duty performed and responsibility
discharged. In this manner, the feeling of joy is
supplemented by the sentiment of dutiful and responsible activity.
Life of this kind is one of sustained feeling and sentiment.
It is vibrant, stimulating, perfused with zest and interest.
We may draw the same picture of the average man working
in a shop or at an office desk. The work itself may be a boring
and dull routine, repetitious and tiring. But if done with an
eye to its usefulness and meaningfulness in terms of maintaining
the family the otherwise uninteresting job assumes the aspect
of importance, dignity, duty and responsibility. The shop or
office routine as such may give no stimulation, but the thought of
the ones for whom they are performed produces the feeling of
joy and the sentiments of responsibility, dependability and consistency.
You will realize now that for routine to become palatable
and acceptable it must be capable of supplying a moderate
amount of feelings and sentiments. The feelings are mainly
those of joy, satisfaction and stimulation. The sentiments are
those of duty and responsibility and their attendant sense of
dependability, consistency, dignity and self-importance. Viewed
against this background the nervous patient is in a pitiable condition.
When the housewife, incapacitated by a nervous ailment,
sets out on her sewing performance her fatigue interferes with
the nirnbleness of her movements. The muscles feel heavy, the
fingers cramp, the lids droop wearily. Being determined to finish
the job she may continue the dreary occupation. But the work
is done mechanically; every stitch requires the utmost in effort;
the needle lies limp between the fingers, the garment flops to
the floor. She picks it up, resumes the sewing, but she has to
use every ounce of her flagging energy to perform the simplest
movement of the hand. Finally she gives up in despair. There
is no use trying to do something for husband and child. This
life of daily routine is an endless torture, squeezed dry of every

drop of joy, drained of every semblance of importance, usefulness
or value. There is no possibility of experiencing feelings or
sentiments in this atmosphere of utter futility and helplessness.
Unable to infuse feelings and sentiments into the routine of
daily activity the nervous patient endeavors to eliminate routine
from life altogether. The formula is simple: There must be
nothing trivial, meaningless, unimportant in the sphere of daily
existence. Everything must be drenched in a flood of feelings
and sentiments. Plain conversations, questions and answers must
not be tolerated. They must be converted into a stirring argument
or an intense fight or a pathetic complaint. The fight
makes room for feelings of indignation, the complaint provides
the setting for sentiments of self-pity or self-blame. All of it is
absurdly exaggerated and morbidly intensified. But the illusion
is created that feelings and sentiments are again governing the
daily activities. That the feelings have degenerated into wild
emotionalism and the sentiments into vapid and shallow sentimentalism
does not count. Life is again pulsating, vital, important.
True, its vitality and importance have been derived
from an underhanded trick that falsifies feelings and sentiments
into something that only remotely resembles them. But the
fact is that the life-pulse, no matter how shaky, has been restored
and vitality, no matter how empty, has been recaptured.
Trick or no trick, life is or seems worth living again.

A Panel Discussion Conducted by Patients
Annette (panel leader) : Today we want to discuss a problem
which most of us faced during our sickness or in the process of
getting well. It is a problem closely akin to sabotage. Sabotage
has many different forms, and one of them bears on a condition
when we experience a general letdown, a feeling as though we
had no interests, no feelings, no spontaneity. Everything we
do during this condition requires a tremendous effort. This
makes us unhappy and despondent. Any examples?
Regina: You described my trouble; only I think the symptoms
were much worse than you described them. I had that awful
feeling of fatigue as if I couldn't even get out of bed. I didn't
want to. I couldn't eat or sleep, and the household tasks I did
before were such an ordeal. I couldn't even fill the sugar bowl.
I almost got into a panic when I thought of it. I had a fatigue
that seemed unbearable. I had to drag myself all the time.
After I came to Recovery our physician said you are not tired.
If I went downtown I would walk around for ten minutes and
think I had to sit down. But the doctor told me that wasn't
fatigue; it was just a feeling of fatigue. Now I walk for hours
and it doesn't bother me. I don't even have the feeling of
fatigue any more.
Annette: When you had to go through the movements of
getting the sugar and filling the bowl, did that look like an
impossible task to you?
Regina: It certainly did. If I even looked at the sugar bowl
it made me nervous and tense. Every time I looked at it I
wondered is that much sugar gone again? Will I have to fill
it again?

Annette: When you had to go through this tremendous
struggle, what conclusion did you draw about your illness?
Regina: I felt hopeless and was sure there just wasn't any cure.
I blamed myself for letting myself go like this, and the more
I blamed myself the worse I got. I know now that I set up
a vicious cycle.
Annette: After you got into Recovery how did you handle
Regina: The doctor told me to walk and do things regardless
of the fatigue. And I learned that I slept even if I didn't know
I did, and all of that helped me. But in the beginning it was
hard. For a few days I accepted the doctor's assurance. But
then I sabotaged and thought that was good for others and
not for me. I thought nobody felt like I did. But then I heard
other patients describe the same difficulties in the interviews
and panels. That gave me great relief. And I read the books
and went to meetings and finally I got well.
Frances: When I was sick I had two small children and
I got so I didn't want to take care of them. The house was a
mess and the children were neglected and I would run out of
the house and go to my sister's and I had the feeling I wanted to
go back right away but didn't know how. I tried many times
to do something but I just couldn't. Frequently I would just
lie down and wouldn't get up. I remember how awfully hard
it was for me to wash dishes. I would stand by the sink and
felt I was going to topple over and everything was going blank.
When I was with people I felt a sort of wave of darkness coming
over me and I felt like fainting. Finally I avoided people
and wouldn't see them. That was three years ago. But two
weeks ago an uncle came from California and about thirty
members of the family met at my sister's and I remembered
the feeling of self-consciousness I used to have with even two
people. And here I was with thirty people and I enjoyed myself
and played cards with them all night and won eighteen
dollars and, I tell you, it was very comfortable.
Annette: It seems to have been profitable, too.

Frances: Three years ago they could have given me a million
dollars and I couldn't enjoy it.
Annette: How did your illness affect your feelings toward
your children and your husband and other members of the
Frances: I can hardly understand it now. But at that time I
had no feelings for my children or for my husband or for anybody
else. I had no interests and nothing gave me enjoyment.
Today it's different, and my husband often remarks about
how enthusiastic I can be.
Annette: I wish to mention an experience I had many times
when I was ill at the hospital. Getting out of bed, as you described,
was such an effort, and going to eat my meals seemed
as though I couldn't get the food down. My husband brought
me jig saw puzzles which I used to enjoy. I started to work
one, picked up a piece, looked at it and thought this is too much
for me. It seemed every time I picked up a piece I had to
make twice the effort to move it from place to place. When my
husband visited me the nurses would say, "Oh my, you have
a nice husband," and one attendant said, "My, you must get
well for such a nice husband," and I realized that was correct
but I had no feeling about it. During the first few months I
was indifferent to whether he came to see me or not. I certainlv
did not look forward to visiting days. But gradually my feelings
returned but in a peculiar way. One day I still did not feel any
particular enthusiasm about having visitors but on another day
should my husband not arrive at the expected time I got sore
because he was late. I then realized that my indifference was
lifting. After returning home my interests were not very active
immediately. I did the simple tasks because I knew they had to
be done. If I kept the place clean it was not because I enjoyed
it but because it was my duty. I assure you that today when I
clean my apartment I get a sense of pleasure seeing it clean.
I get spontaneous feelings now. I didn't get them for a long
time after leaving the hospital and did things "from duty and
necessity" as our physician says. Had it not been for my Re

covery training I am afraid I would have gotten into a vicious
cycle watching myself and thinking I am not improving; noticing
the sluggish feelings and worrying about them; seeing
things neglected and blaming myself for it. The more I would
have worried the worse, I expect, would the condition have
been; the worse the condition the more worry. In those days
the most distressing thought was that I would never again
have the capacity to feel, that I would never again be enthusiastic
about things. Today I know this was a prognosis and sabotage.
Frank B.: A few months ago everything looked hopeless to me.
I had intense fatigue and would spend about three days a week
in bed or take afternoon naps of about four hours. I wasn't
working and the worst thing was I still had the idea I was
railroaded into the state hospital eight years ago when I first
got sick. I was afraid to go to see a doctor because he might
say I was nervous and I thought I wasn't and he would put me
in the hospital again. But finally I went to see a doctor and
he said it was nervous fatigue and I should rest. But the more
I rested the more tired I felt. I watched my diet and that didn't
help either. I got worse and worse. I thought that when my
nerves are fatigued I'd better quit swimming which I enjoy
very much, I also stopped going out socially and everything
was an ordeal. But since I joined Recovery I go swimming a
few times a week and go out socially and I am seriously considering
going to work. A few weeks ago if the doctor had
told me I would be doing these things again I would not have
believed it.
Annette: Did you find you got over these difficulties immediately
after joining Recovery?
Frank B.: No, I had to be satisfied with small gains. Going out
socially was still a big problem. K*it after I learned to be sociable
with the members of Recovery I gradually enjoyed myself
with outside groups. In Recovery I learned to throw off the
stigma. That wasn't easy because I had been picked up by
the police and brought to the hospital by them. Now I feel that's
the past and I think of the future. Of course, I am still sabotaging
every once in a while. But I am just a rookie yet.

Physician's Comment on a Panel Discussion
Rcgina had difficulty eating, walking, sleeping. Everything
she did required effort, even the act of filling the sugar bowl.
Annette had similar complaints and summed them up correctly
as a "lack of spontaneity." When then Frances and Frank
added their reminiscences of past ordeals they merely contributed
a new chapter to the old story. The story is that of having
dragged along for months or years without initiative, zest or
interest, i.e., without spontaneity and having regained spontaneity
through the self-help techniques practiced in Recovery. To be
spontaneous means to have no difficulty making up
one's mind, to carry out one's plans and decisions, to feel like
doing something and get it done, and all of this means vitality.
The patients described a condition in which they lacked vitality
when they were ill and regained vitality after they recovered
Previously they felt lifeless and spiritless: now they live with
spirited alertness. I grant that a person who does not feel the
pulse of life, a person who has no affection, no anticipation, no
sense of accomplishment, I grant that such a person is helpless.
What more dramatic picture of helplessness can be drawn than
the scenes in which Regina could not bear the thought of having
to fill the sugar bowl or Annette could not command sufficient
vitality to move a little piece of cardboard (jig-saw puzzle) from
one place to another? At the time they were certainly devoid
even of a shred of vitality. Theirs was a mechanical existence,
not a dynamic life.
When Annette lacked the strength to move a little scrap of
paper she had a right to feel weak, helpless and unhappy. She
had also the right to feel distressed when she noticed that her
feelings were low or gone. But when she became despondent
and thought she "would never again have the capacity to feel"
and "would never again be enthusiastic about things" she permitted
herself to predict future developments, and this she had
no authority to do. As she said herself, "Today I know this was
a prognosis and sabotage."

A patient is competent to describe his present condition, his
pains, pressures and palpitations, his lack of strength and vitality,
his fears, panics and compulsions. If he wishes to place the
label of "helplessness" on any of these experiences I shall not
quarrel with him. I have not seen a patient who was not
helpless, totally or partially. Patients are helpless to stop their
pressures, they are helpless when they find themselves seized
with air-hunger or night terror. And if any patient claims to be
helpless I shall not challenge the correctness of his statement.
But when a patient declares himself hopeless I shall warn
him that he has presumed to make a prognosis and has trespassed
into my territory. The physician alone is capable of deciding
whether a condition is hopeless or hopeful. The patient who
assumes the diagnostic or prognostic function of the physician
sabotages his authority. The patient can declare himself helpless
but he has no right to pronounce himself hopeless. Description
is the domain of the patient, prediction is the province of the
I well remember the time when Regina and Frances sat
in my office reciting their tales of woe. There was a great deal
of description, but most of it was prediction. They predicted
that they could not get well; that they were doomed to lead
a lifeless existence; that the hope I held out for them could
never materialize. If I mentioned that she slept better and this
was indication of a beginning improvement, Frances hastened
to correct me, "But doctor, last night was terrible again. How
long can I stand that?" If I ventured to suggest that my patients
had to wait but got well in the end, the retort was, "But doctor,
they are not as run down as I am." All my reassuring statements
were promptly swallowed up in a rebuttal sentence that
invariably had the phrasing, "But doctor . . ." Both Frances and
Regina were confirmed "but-knockers." I had merely to voice a
positive thought and it was immediately knocked out by a
negative answer. I presented them with a hopeful prognosis,
and they swept it aside with a dire prediction of hopelessness.
I shall ask you to visualize the situation in my office when a
depressed patient sits opposite me. We discuss a condition but

we never meet. Whatever I may say is instantly disputed or
discarded by my opponent. But the patient is no opponent.
He is a wretched creature begging for help. He insists on help,
he clamors for it, protests he "would do anything to get it."
If he is not my opponent why does he oppose me so vehemently?
If he is ready to "do anything to get help" why does he not
do that "little something" I ask for: to drop his pessimistic and
accept my optimistic view? Views are thoughts and can be
dropped, other views can be adopted in their place. If that
can be done why does the patient refuse to do it?
I have given much thought and study to this absurdity of
clinging to a harmful view when acceptance of a helpful view
was certain to give relief. I have seen women who go through
depressions each month before or during or after their menstrual
periods. They are depressed and helpless but do not indulge
in doom prophecies. The reason is clear; their depressions
are of short duration, and a rich past experience has taught them
to be optimistic about relief to be expected. My nervous patients
come to me after months and years of suffering. Their pessimistic
views have gained depth and strength. Their pessimism
has become a habit, hardened and crystallized by continued
practice. Such habits pervade the organism, color every
move and thought of the person and are not easily dislodged.
You can observe such habits of thought everywhere and at
all times. These days particularly it is not difficult to spot
prophets of doom right at your elbow, at home, in the neighborhood,
in the shop. You have heard all kinds of gruesome predictions
in the past few years. Things in general were painted as
utterly hopeless. The country is going to pot; inflation is certain
to come, or it is here already to stay; democracy cannot
survive. These gloom peddlers "knew" that our country could
not possibly win the war; that industry would never catch
up with the demands of the armed forces; that the end of the
war would see an incurable rise in unemployment. The fact
that their predictions fell flat did not discourage the soothsayers.
Although promptly disavowed by actual developments
they nevertheless continued to roll off new gloom stories from

their never-resting assembly lines. All these people had imbibed
the view of pessimism; the view hardened and crystallized
into a stubborn habit of thought, until finally the habit acquired
such momentum that evidence to the contrary was powerless to
shake it.
Everybody is pessimistic and optimistic at the same time. In
the ordinary mature person the two views are so balanced that optimism
outstrips pessimism. This is true of every habit. Everybody
is both generous and miserly, cautious and bold, loving and
hating, forgiving and vengeful, appreciative and critical. It is in
the very nature of human habits that they range themselves in
pairs the one member of which is antagonistic to the other. Pessimism
and optimism are nothing but such a pair of mutually antagonistic
features. Everybody is pessimistic and optimistic at the
same time. Once a person has matured the antagonistic habits
have attained their balance. Then we have two varieties of persons,
the ones mature and realistic in whom generosity, caution,
love, forgiveness, appreciation and optimism overbalance miserliness,
boldness, hate, vengefulness, criticism and pessimism; the
others infantilistic and emotional in whom the negative features
prevail. Before Frances and Regina came to consult me they lived
a life of balance in which the positive trends outweighed their
negative antagonists. After they drifted into their depressions
the negative features took the lead and dominated their habit
structures. They became extreme in their reactions and lost
their balance.
The calamity is that when two traits join to form a pair of
habits (pessimism optimism, miserliness generosity) the more
undesirable trend (pessimism, miserliness) is pushy and aggressive
and always ready to assert itself. It is easy to throw off a
good habit. All you need is consistent poor example. A life-long
habit of honesty can be destroyed in short order by bad company
or cajolery. Your well established habit of caution can be easily
weakened or shattered by the ridicule of the "smart set." This
is difficult with poor habits. If you are addicted to nail biting
you know how desirable it is to drop it; you know that it is
harmful to your standing in your group; you are eager and
determined to abandon it, and yet how difficult it is to discard

it. I am not going to tell you the reason for this distressing
tenaciousness, with which bad habits cling to their useless existence.
I merely mean to point out the fact that the more ugly
or disturbing is a habit the stronger is its hold on the individual.
Pessimism is an ugly and upsetting habit of this kind. It disturbs
balance and renders behavior ugly and melancholy to behold
or endure. Were it necessary to fortify my argument with
another example it could easily be borrowed from the field of
drinking. It is easy to induce a sober person to become an alcoholic.
But try to steer a drinker back to sobriety and you will
realize the strength of poor habits and the weakness of good
All my patients have acquired bad habits. The good habits
which used to balance them have been swept aside. Previously
when the patient had a pain or pressure he bore it with patience. Now
he demands instant relief. The habit of endurance has
given way to that of self-indulgence. In the same manner, habits
of courage yielded to fearful anticipations; trust in one's body
functions was replaced by an abysmal distrust of the organs.
In the course of months and years the undesirable habits acquired
strength and cunning and tenacity. If the patient attempts
to fight them off he finds himself confronted with a
ruthless, stubborn and obstinate force. He puts up some resistance
but soon realizes that his good intentions are no match
to the resourcefulness of his opponent. He feels helpless, despairs
of ever being able to regain his balance and conceives the
idea of hopelessness. If that happens, then, the balance between
the antagonistic habit traits of optimism and pessimism is
destroyed and the patient is reduced to an existence of mechanical
action. Regina and Frances, Annette and Frank demonstrated
how the balance can be restored and how life can be
made to regain its vigor and vitality. All they did was to refrain
from sabotaging the physician's authority. He alone knows
which ailments are hopeless and which are hopeful. To cure
a nervous illness means to rid the patient of his pernicious tendency
to sabotage the physician's effort. Once this is done the
patient has learned that Helplessness does not mean Hopelessness.


A Panel Discussion Conducted by Patients
Annette (panel leader) : The subject of today's discussion is
entitled, "Constitution, Environment and Temper." When I
was sick I did not know what was constitution and temper.
About temper I thought I knew something but I did not. What
I knew was the explosive temper, flying off the handle, perhaps
throwing things, at least throwing words excitedly and viciously.
In Recovery I learned that temper takes in everything that
is an individualistic trend and opposes a group standard. For
the patient, temper means particularly everything that goes
against the standard set by his physician. Two factors disturbed
me a great deal when I was sick. They were: what kind of a
constitution I had and what kind of environment I lived in
and would return to after I left the hospital. In Recovery I
learned that if I had a weak constitution that did not mean I
had to keep it that way. I learned how to strengthen my constitution.
I was surprised to find that the way to strengthen my
nervous constitution was to avoid tenseness and to handle it
properly when it developed. One Sunday my husband called
for me at the hospital and we went to the Recovery meeting
that was held at the hospital in those days. After the meeting
we went to the zoo. The street car was crowded and someone
jostled me and I became irritated and at the same time fearful.
I did not have enough Recovery training yet to know that this
was a trivial incident over which I shouldn't work myself up.
I felt hurt and stepped on. I interpreted the simple incident
as meaning I was the type of person who would never be able
to take care of herself in a crowd. I felt I did not know how to
stand up for myself. Todav I know that I let myself drift into
a vicious cycle between temper and tenseness but I did not have

enough training then to know just how to stop it. By the time
I arrived at the zoo I was extremely tense. I thought, how can
I ever start out again in this world if I am going to be upset
like this over every trivial instance? I am much too sensitive,
perhaps because I have a nervous constitution. But if my constitution
was weak what could I do about it? Before long I
felt a blurring of vision and a tightness in the abdomen and
worried about eating the dinner and was most uncomfortable.
About a year later I was standing one evening with my husband
in front of a show window, and a woman shouldered her
way between us. My reaction was not to give an inch, to stand
my ground and not permit anybody to push me around. But
no sooner had I become aware of the impulse to stand on my
rights when I began to laugh. I instantly knew this was
a trivial incident, and I was determined not to stand on my
rights and to make myself uncomfortable and to produce tenseness
and symptoms. As far as I am able to determine that meant
one thing to me, that during my Recovery training I had learned
to ignore that matter that I called my constitutional sensitiveness,
to be indifferent to my rising temper and to let my feelings
rise and fall I knew that both constitution and temper are
nothing unchangeable.
Phil: I told the folks here before that I had some sort of
nervous trouble when I was about twelve years old. I was
already in the eighth grade and was supposed to graduate but
for some silly reason I did not want to go to high school and
tried to flunk. But I was not successful though I made a good
effort to flunk and graduated. All through high school I had
trouble with teachers and argued with father and mother and
when I was at college I developed the habit of telling people
where to get off. My father had made a very good fraternity
but I was not wanted by them because I was too cocky. So I
made up my mind I was going to show these fellows a thing or
two and demonstrate to them that I could lick them any time.
To make the story short, I studied hard to show them off; I
got on the magazine staff and did a good job at writing. I
joined the dramatic club and did well there. I was always busy

flitting from one activity to the other. I was hardly ever in my
room during the day. My roommate said, "You don't want a
roommate, Phil, you just want somebody to help pay the rent."
But finally it caught up with me. When the examination
came I was all exhausted. I would lie in bed for hours unable
to sleep. That was the time I did not know yet that sleep has
little to do with health. So I fretted over my insomnia and
that made matters worse. In the end I broke and had to come
back to Chicago. I can see now clearly that my nervous constitution
was not equal to the strain and my sassy behavior was
all a matter of temper.
Annette: After your breakdown did you stop trying to top
everybody ?
Phil: That kept on. I did not learn from that experience till
I came to Recovery. Then I learned to be average and humble
and get along with people. I think it is getting into my blood
to be average and plain.
Annette: You have learned in Recovery that the sense of
importance is perhaps stimulating but does not make for balance.
And to preserve your health you need balance. And the
sense of averageness gives you balance.
Phil: I have a pretty reasonable balance now. I am not tense
any more. I gave up making a human dynamo of myself.
Anna: My case is mostly one of temper. Until lately I had
quite a bit of trouble sleeping. I used to wake up in the middle
of the night, felt tense and had all kinds of disturbing thoughts
and sensations. The minute I woke up I felt an electric current
going through my body, and I got disgusted with myself and
got sore at the doctor and everybody else. Then while lying there
my mind would argue with the doctor and I would say how
long did I have to suffer like that, and I would diagnose my
own case and ask how does the doctor know I will get well,
and I would go on arguing that way back and forth.
Sometimes I would lie in bed till daybreak and work myself
up to a vicious cycle. But lately I thought I better start
practicing what I learned in Recovery. So now when I wake up
in the middle of the night I just lie there and don't work my

self up and I relax and wait till I fall asleep. Sometimes it
takes quite a while but it is not as bad as it was when I used
to work myself up. At times I fall asleep in half an hour or
sooner, and in the morning I feel all right. I know now that
working myself up makes the condition worse.
Annette: When you woke up and it felt like an electric
current, how did you handle that?
Anna: Before I practiced Recovery I would get sore at myself
and the longer I would argue with myself the longer it
would take before I could sleep. Now I no longer work myself
up and I don't diagnose my own case and I know the doctor
said I will sleep if I don't worry about sleep, and if I lie in bed
for hours I will sleep part of the hours. I know now that it
is true.
George: When I was little I would get myself worked up
so much that I would take my fists and hit myself on the head.
All through public school and high school and college I made
life miserable for myself and my parents. I practiced the angry
and fearful temper. Last December, shortly after I came to
Chicago to join Recovery, I experienced a good example of what
I think is fearful temper. I must mention I could never hold
a job before getting the Recovery training. In December I was
working for a Loan Company, and again I felt like quitting
because I didn't like the work. I stayed home and thought I
should call the boss but I didn't. Frankly, I don't think he
missed me much. But the next day I asked Frank to call the
office and tell the boss I was too sick to work. But Frank talked
me out of this. He said that is sabotage. And then it came to
me that the doctor said if you fear to do something you do not
fear the thing but your sensations; you fear being embarrassed
or self-conscious. And the cure is to do what you fear to do
and to brave the sensation. So I phoned the office and the boss
just asked me to come back soon. That only proved that the
doctor was right and that I was afraid of my own embarrassment.
After that I felt embarrassed on several occasions but
faced it and did not try to ease out of it.
The other day I went through an experience of angry temper.

I was waiting for a train on the Elevated platform and I wanted
to go to Evanston and a train was just coming in. A motorman
was standing on the platform and I asked him whether it was
an Evanston train. The fellow looked mean and did not
answer and didn't even look at me. I asked him again and he
didn't answer. Finally I said, "I am talking to you/' and he
said, "I don't have to tell you anything, buddy," and I got angry
and said, "You are nothing but a doggone conductor." But
there was lots of noise, and I guess he didn't hear it. The good
thing was my temper didn't carry over, and in about two minutes
I was laughing at myself and I had no after-effect. Two
or three years ago I would have been proud that I had the
nerve to tell him off but this time I felt a little ashamed.
Annette: It seems a bit silly, but we do not prescribe perfect
behavior. In Recovery we say we must learn a lot about temper
but we will not perform one hundred percent. If you have a
temper outburst, be sure if you immediately recognize that the
explosion is silly and childish then the possibility that you will
be ready for another temper outburst at the slightest provocation
is reduced greatly and therefore you are not going around
tense all the time like I used to be, ready to be on the defense
and to stand on your rights in senseless trifles. If you can laugh
at yourself immediately after the outburst then you are relaxed.
Any other example? If not I will bring the panel to a close.
Physician's Comment on a Panel Discussion
Annette was jostled by a street car rider and as a result felt
irritated and tense for hours and ultimately developed blurred
vision, tightness in the abdomen, disturbance of appetite and
general discomfort. She recounted this example when dealing
with the topics of constitution, environment and temper. Undoubtedly,
the jostling man was her environment. But what
he jostled was Annette's muscles. It was nothing but a jostle,
a jar, perhaps a jolt. How is it possible that a mild encroachment
of this sort produced serious derangements of vision, appe

tite, abdominal function and general well-being? Was Annette's
constitution so weak that a trivial push from the outside could
cause a violent upheaval of her inner organs? It does not seem
at all likely that mild pressure against her muscles should occasion
such a severe inner reaction.
The jostling street car rider was environment to Annette.
But by the same token, Annette was environment to the jostling
man. His muscles pushed her muscles. And it will be useful
for you to know that men and women are environment to one
another and that the one acts on the other by means of muscles.
Even if they speak or merely look the speaking and looking are
done by the muscles of the mouth and the eyes. But if environmental
effects proceed from muscle to muscle how is it they
reach down to the inner organs and even to the depths where
the thoughts, moods, impulses and sensations of the personality
are embedded? For Annette did not merely respond with organic
distress (vision, digestion and tenseness); she was also
irritated, fearful, "felt hurt and stepped on,*' doubted whether
she "could ever start out again in this world." Her muscles
were merely jostled, but her inner organs were profoundly upset,
and her personality was thrown out of equilibrium. How
was it possible for a trivial environmental event to release such
wide-spread effects?
You who have gone through the process of Recovery training
know that the careless street car rider did not merely jolt Annette's
muscles; he also jolted her temper. And temper is the
bridge over which environmental irritations can reach across
the muscles to the inner organs and to the depth of the personality.
Along this road it penetrates to the domain which we
call internal environment.
Roughly speaking, everything that exists or lives outside your
muscles is external environment, everything that is inside your
muscles is internal environment. Your home and its furniture,
your father and mother, your friends and neighbors, your employers
and employes together with a host of innumerable
things, conditions and persons make up your outer environment.
But inside you there is the inner environment, far more potent

and vital, more readily disturbed and shaken than anything
outside you. This inner environment is made up of your internal
organs, on the one hand, and your personality functions,
on the other. The latter are your feelings and moods, thoughts
and decisions, sensations and impulses. Let your outer environment
be disturbed by war, bereavement, fire or financial loss,
and the chances are that you will bear the shock and emerge
from it unscathed. But let your impulses be deranged, your
sensations get out of control, your feelings become the seat of
fear, envy and jealousy, your thoughts the prey of torturing
obsessions, and the resulting commotion is likely to unsettle
your nervous constitution.
Annette experienced another jostling episode a year later
when a woman pushed her in front of a show window. She
felt irritated again, but this time for a moment only. The next
moment she laughed, and the irritation passed. There was no
effect on the inner organs, no jolting of her personality functions.
You will instantly realize the difference. In the first
instance, in the street car, the environmental irritation was
reacted to with temper; in the second instance, before the show
window, the response was directed and mitigated by a sense of
humor. The sense of humor, born of indifference to irritations
even if they are severe, prevented the emergence of temper
which takes annoyances seriously even if they are trivial.
We may conclude that the trivial irritations of external environment
they comprise the bulk of irritations in general
can be approached either with temper or with a sense of humor.
If the approach is temperamental the inner organs and the personality
functions of the internal environment will be thrown
into commotion; if the approach is humorous the internal environment
will be spared the anguish of frustration and the
agony of disordered functions. The jostling or jolting will be
felt by the muscles only; it will be prevented from spreading
through the muscles to the inner confines of the personality
there to work havoc with emotions and sensibilities. But in
order to prevent this spread you must learn how to control
your temper and to develop a sense of humor. In Recovery you

have learned that temper is your worst enemy, humor your best
The experiences of Phil, Anna and George fit into the same
pattern. Before they underwent Recovery training their approach
to environment was temperamental. It caused them no
end of distress, unsettled their inner functions and unbalanced
their personalities. Phil was or felt rejected by the men and
women in his external environment. He took the rejection
seriously and decided to demonstrate to his adversaries that he
"could lick them any time." He became "cocky" and "was
going to show these fellows a thing or two." This was temper.
Instead of humorously ignoring external environment he fretted
over the rebuff and girded for a fight. The result was a disorder
of inner functions and derangement of personality. His
temper landed him in the hospital. Today he has acquired a
sense of humor, and the rebuffs suffered at the hands of external
environment hardly cause a ripple in his inner life.
Anna had difficulty of sleeping, and was troubled with all
kinds of disturbing thoughts and sensations. The electric current
running through her body was a severe disturbance, indeed.
She became disgusted with herself and "sore at the doctor and
everybody else." The temperamental approach to environmental
irritations reached here a climax. It engulfed the entire sweep
of environmental existence. She was disgusted with and sore
at her own person, her own personality and "everybody" outside
her. How was it possible for Anna to reduce this torrential
force of her temper to the level of calm detachment? In
the face of electric currents shooting through her body, in the
presence of threatening thoughts and violent sensations how did
she manage to drop her temperamental fears and angers and replace
them with a sense of humor? For the present, I merely
wish to state that she did and that it can be done. As Anna
says, "I know now that is true."
The account which George gave of his temperamental exploits
brings back to my mind the day, about six months ago, when
I received a letter from him inquiring whether training in Recovery
was likely to cure his condition. Since this involved

moving from the West coast to Chicago I hesitated to encourage
the move in view of his history of temperamental maladjustment
since childhood. But here he is, and his temper is under control
although at times it still slips from under control as in
his altercation with the "doggone conductor." Well, it is an
instance of uncontrolled temper if such a remark is made, but
it is an inspiring exhibit of a good sense of humor if the author
of such unrestrained behavior can subsequently report the incident
and laugh about it. Moreover, George experienced merely
the immediate effect of his outburst but mastered the aftereffect
when he laughed soon after the explosion. He laughed
at himself and refused to take seriously the importance of his
own dear self. With this he practiced the Recovery system of
self-discipline which insists that temper is the outcome of an
inner arrogance which sets itself up as judge as to who is right
and who is wrong. This arrogance is due to the sense of one's
own importance and cannot be overcome unless the sense of
humor is cultivated to the point where humility, plainness and
averageness take the place of arrogance, exceptionality and selfimportance.
Annette, Phil, Anna and George demonstrated that internal
environment can be protected successfully against the dangers
of emotional agitation if the patient learns to control his temper.
This is an important enough accomplishment. But the abiding
value of a demonstration of this kind is that it emphasizes a
principle that has general application. We live in the age of
technique and boast that we have conquered time and space
and matter and nature. Perhaps it is true that we have accomplished
all of this. But of what good are conquests if they play
solely in the field of external environment, leaving internal environment
prostrate and helpless to be ravaged by the onslaughts
of unbridled tempers? Of what good is your automobile if all
it has brought you is the possibility of experiencing your palpitation
at a speed of fifty miles an hour? Are you interested in
external speed or in inner peace? You hear it stated these days
on every street corner and in every newspaper column that moral
progress has not kept pace with technological advance. Well,

it is truer to say that the emphasis on technological progress
made us forget the importance of progressing in the domain of
morale. Recovery has reversed the proportion, and the reversed
position was given beautiful expression by the members of the
panel. To us at any rate, control of our internal environment
is infinitely more important than all the possible triumphs we
may be able to score over external environment.

A Panel Discussion Conducted by Patients
Annette (panel leader) : I remember a distressing sensation
which gave me no end of alarm. It was a severe cramping or
pain in the side of my abdomen. It was so severe that when it
hit me I felt I could not walk. I had the same sensation on
numerous occasions and was always afraid it would return. I
know now that anticipating its return made matters worse. I
was alarmed when I had the sensation and was perhaps more
alarmed when I didn't have it but anticipated its return. After
six years of almost constant suffering I finally went to the hospital
but the doctor couldn't find anything wrong with me physically
and sent me to the Illinois Research Hospital. It was then that
I came under our physician's care and joined Recovery. It was
only then that I realized that it was not the sensation that
caused all the discomfort but the panicky feeling that something
terrible was about to happen.
At the time I felt like something would burst in my side. I
was sure I wouldn't be able to stand it, that I would go to pieces.
When the doctor told me, "Your sensation is distressing but
not dangerous," it took me quite a while before I understood
what he meant. I had to take his word for it but I continued
to feel something awful was going to happen. Today the sensation
comes back occasionally. I have a slight twinge in my
side even right now. In former days I would have been concerned.
Today I know and know for sure that the sensation
is merely distressing and not at all dangerous. I no longer anticipate
trouble. Any other example?
Margaret: Recently I had company from out of town. I
hadn't seen them for two years so I asked them to dinner. The
cooking and the preparations were too much for me, and I got

quite excited. I had again that pressure in my chest, and the
palpitations were just awful. And I got a terrible pain in my
head and my eyes smarted, and every time I turned my head
it cracked. A year ago I would have become panicky and my
husband would have called the family physician, and I would
have fussed and stewed for days. This time I knew they were
symptoms and they were distressing but not dangerous.
Annette: Did you go ahead with what you had to do?
Margaret: I felt like giving up but I didn't. I knew there
was no danger.
Mary: Yesterday I was invited to spend the afternoon with a
friend. I took my little nephew along and had no trouble at
all making the trip. I didn't feel nauseated as I used to feel on
street car rides. By seven o'clock I got ready to leave the party.
As soon as I reached the street my legs started to give in and
my heart pounded and my stomach flew around and I looked
at my nephew and didn't know what to do. My first thought
was to rush back to my friend's house and ask somebody to
bring me home. But I knew these were symptoms and the
sensations were not dangerous and I just stood there waiting
till the symptoms would disappear. But I couldn't even wait
because my nephew looked up at me and asked, "Aunt
Mary, aren't we ever going home?" I was still very uncomfortable.
But I took the next street car and we got home without
Annette: This is a beautiful example how you can be very
uncomfortable and can manage to stand the discomfort if you
keep in mind the physician's authoritative knowledge that you
are not in danger. Any other example?
Caroline: I had a very gratifying experience this morning
after my husband and I got up. He said, "What's the matter,
don't you feel good today?" I asked, "Why?" He said,
"You are very quiet today." Usually I am very talkative in
the morning and, for that matter, all day. I have always a
desire to talk about my symptoms and I guess I drive people
nuts. This constant talk about my symptoms is sabotage. I know
that but I haven't been able to check it so far. This morning I

decided to stop talking and complaining and kept quiet. So
I said, "I have a pain in my head but I know it will go away."
We then talked of something else and I couldn't help but realize
how different it was than a year ago. A year ago I would
have said I have a terrible pain and I would have been sure
I had a brain tumor and the doctor just won't tell me and I
don't know what to do and if Recovery and our physician can't
help, who can? But this morning I stopped that.
Before I came to Recovery when I had this particular pain
in my head I would give in and go back to bed and my husband
would bring me a hot water bottle and it seemed that
made the pain worse and then he would bring me an icebag
and in the meantime I would work myself up and he would
suggest I take an aspirin but that did not help. After I came
to Recovery regularly and talked to the other members of the
group I learned to handle this sympton. This morning my
husband offered to go to the store for me as he always does
when I complain of my headache. Usually I become dramatic
and say that my pain is so severe that I can't- even think what
I want from the store. This time I merely said, "Give me a
few minutes and I will write the list."
Annette: Here we see Recovery training at its best. Not because
Caroline did so much better this time and is improving,
but because Caroline has learned to make fun of herself and
her symptoms. She has gained insight and knows now that she
dramatizes her symptoms. She knows she plays a game and
plays for attention. She has learned not to take herself and her
symptoms seriously. This is a great advance. Any other examples?
Gertrude: As most of you know, my husband has been discharged
from the service. Before he went in I was quite sick
and one of my difficulties was getting his breakfast. I would
have a terrible feeling of helplessness when I would make it
and I would say I can't do it. I would then get a feeling of
tightness in my throat and feel like crying. On these mornings
I used to have a feeling of unreality. I would feel alone and
things looked changed and distant and I felt I was changing.

When my husband was discharged and came home I made up
my mind I was going to do my job and he gets up at five-thirty.
I anticipated this feeling of helplessness but even so I got up
and I just felt fine. I discovered I was just looking for things
but they didn't happen. Really I was only anticipating a danger
but there wasn't any if I didn't anticipate it.
Annette: I had similar experiences with the feeling of unreality
and with anticipating. You know our physician tells
us that anticipation is nothing harmful but it must be calm
and not fearful. You may anticipate a palpitation. But don't
think of it as dangerous. I remember one day I had to take
some responsibility about a social function being given by Recovery
and I was the social chairman and had to arrange for a picnic
grove. I didn't like being on the job but I knew it was good
for me. About a day before the picnic was scheduled I became
very uneasy. I thought I had to appear at my best at
the picnic and what will happen if I get some extremely distressing
sensations? I may get this dizzy feeling and a sense
of unreality. With me this is a feeling as though I couldn't
really feel things. I would handle them and although I knew
I touched them I had the feeling I didn't touch them. I realized
I had a fearful anticipation and knew I was not supposed
to anticipate in fear. But I had difficulty shaking off that fearful
anticipation so I called another member of Recovery. I said I
know I shouldn't anticipate danger and maybe I was merely tense
as anybody might be preparing a picnic. This member then said,
"You think you are merely tense but I can tell by your tone
of voice you are quite anxious about that symptom and the
fact it may return." Then she said, "Why, you can handle
that. You have handled it before." Then she told me how she
used to be fearful and she learned not to anticipate danger. I
realized then how the older members of Recovery did things
and I was not experienced yet and didn't know yet how to
handle that anticipating. But with months of practice I soon
learned how to anticipate calmly. What helped me most to
overcome this anticipating was the thought that I was average
and not supposed to do an exceptional job. You know the

doctor always tells you the average people you meet are not
critical. If you make a mistake they will know that people on
an average do make mistakes. They will not condemn you.
We must always keep in mind how we judge other people. I
they commit a blunder we think nothing of it. We do not
think they are imbeciles. We simply notice the fact that somebody
made a mistake and know that people do make mistakes.
As the doctor says, "People are tolerant with others but they
may be intolerant with their own mistakes." We nervous and
former mental patients must learn to become tolerant toward
our own mistakes. We must not want to be exceptional It is
time now to bring the panel to a close.
Physician's Comment on a Panel Discussion
As I listened to the panel and heard one patient after another
repeat that sensations are distressing but not dangerous, it occurred
to me that nothing could symbolize more beautifully
the close union that exists in Recovery between patient and
physician than this fundamental Recovery principle that sensations
are merely distressing but not dangerous. The patient
alone knows how distressing is his sensation; the physician
alone knows how harmless and devoid of danger it is. The
patient knows his feelings, the physician knows the diagnosis.
Annette, suffered cramps, Margaret had chest pressure and
palpitations, Mary, Caroline and Gertrude were stricken with
headaches, vomiting, tightness in the throat and feelings of
unreality. Each had their own assortment of symptoms, and
it would be absurd to assume that Annette felt Margaret's palpitations
or Margaret experienced Annette's cramps. You see,
sensations and feelings are intensely personal and subjective
and are known to him only who happens to experience them.
You may say that a feeling is known to the person only who
feels it. To the outsider it is unknown unless he is told about
it. His knowledge of other people's feelings is hearsay knowl

edge. With regard to the patient's feelings the physician is an
outsider who cannot attain anything but hearsay knowledge
of what the sufferer experiences. Without being told he would
not know that the patient has palpitations unless he counted
the pulse. He could certainly not know how intense, threatening
and tormenting they are.
Contrast now this highly personal and subjective quality
which we call feeling with its celebrated counterpart thought.
If Margaret had the thought that the sun was shining or spring
was in the air she would have no difficulty communicating her
idea to Annette. If Annette agreed to and accepted Margaret's
idea the two would share it, and there could be no doubt that
both knew exactly what they meant by sunshine and spring
and air. But suppose the two spoke of cramps. To the one
the word may convey the experience of a wild panic, to the
other that of a mild twinge. You see the difference: thoughts
can be exchanged, accepted or rejected like an objective commodity.
Feelings are strictly personal and singular, incapable
of being exchanged or shared.
The basic distinction between feelings and thoughts is the
physician's dilemma and the patient's calamity. It is the main
reason why patient and physician have so much difficulty understanding
one another. The physician speaks the language
of thought, and the patient replies in the language of feeling.
How can they meet? Take, for instance, the matter of sleep
and sleeplessness. I know that patients who complain of insomnia
get their due share of sleep. But after the patient
awakens he feels for certain he has "not slept a wink." My
thought about sleeplessness is founded on expert studies and
thorough knowledge and can be communicated to any patient.
But will he accept it? Will he consent to share it with me? I
tell him he slept, but being fagged out and listless he is told
by his feelings that he has not slept. Will he listen to the language
of the physician or to that of his feelings? You know
the answer given in Recovery. If the patient is inclined to cooperate
he will be guided by the physician's thought. If he is
ready to sabotage he will consult his feelings. Whether he does

the one or the other means all the difference between health
and suffering.
Another example of the clash between the patient's feelings
and the physician's thoughts: My thoughts about "nervous
fatigue" and "nervous exhaustion" are known to you. The
patient merely feels fatigued but is not. His "fatigue" is a
psychological feeling and not a physiological condition. Being
discouraged and "having nothing to live for" or to "look forward
to" he arises in the morning with the dreadful anticipation
of one of those drab and depressing days in which he will
have to perform a deadly routine without zest or inspiration.
The monotony and lifelessness of that day stares him in the
face. Being discouraged and "sick and tired of it all" he cannot
relax; his muscles feel heavy and limp. The physician
knows it is discouragement and self-disgust but the feelings of
the patient speak forcibly and persuasively of a real, physiological
fatigue. Who will the patient listen to? To his physician
or to his feelings? The answer is the same as with sleep: the
patient is inclined to accept the verdict of his feelings and to
sabotage the physician's authority.
I want you to know that your feelings are not facts. They
merely pretend to reveal facts. Your feelings deceive you. They
tell you of danger when there is no hazard, of wakefulness
when sleep was adequate, of exhaustion when the body is merely
weary and the mind discouraged. In speaking of your symptoms
your feelings lie to you. If you trust them you are certain
to be betrayed into panics and vicious cycles.
I said that your feelings lie to you, that they deceive and
betray you. How can that be? How can feelings be true or
false? If you are sad what has that to do with truth, deception
or treachery? Feelings are either experienced or they are not.
They are present or absent but never true or false. Thoughts
alone possess the quality of truth and falseness. And if the
patient's feelings tell lies they do so because an incorrect and
deceptive thought is attached to them. The deception is accomplished
by the thought, not by the feeling. The panel
members expressed this relation between thought and feeling

with convincing plainness. One after another they stated that
before joining Recovery they thought of their panics as dangerous,
but now they thin\ of them as merely distressing. You
see, a panic is a feeling of extreme distress which annexes either
the thought of danger or that of harmlessness. The panics
experienced by patients are not pure feelings, they are overlaid
and modified and taken captive by a thought. If the annexed
is that of danger a vicious cycle will develop and the
panic will be prolonged. If the thought is that of security the
panic will be stopped abruptly. It all depends on whether the
patient will accept the physician's thought of security or his
own thought of danger. If this be so, then, it is no longer a
question whether the physician's thought ought to prevail or
the patient's feelings. It is no longer the problem of thought
versus feeling but of one thought versus the other. The patient
is not asked to change his feelings or to discard them or to
disavow them. He is merely asked to substitute the physician's
thought for his own. You will now understand the meaning
of my introductory statement that the Recovery slogan "Sensations
are distressing but not dangerous" symbolizes the close
union between patient and physician. If it is assumed that the
physician approaches the patient with an objective thought
and the patient reciprocates with a subjective feeling the two
could never meet. Feelings cannot be exchanged or shared.
If the patient were nothing but distressed or sad or despondent,
the physician's thought could hardly reach him. Communication
and mutual understanding would be blocked effectively.
But if the feeling experienced by the patient is reduced to a
"quarter-feeling" of despair, associated with a "three-quarterthought"
of danger, then, the physician's thought of security
can easily meet the patient's thought of danger. It can modify
or eliminate it. In Recovery this has been done with singular
success. As the panel members quoted themselves: In former
years they entertained their own thoughts that the panic was
dangerous. Now they accept the physician's thought that it
is merely distressing.

A Panel Discussion Conducted by Patients
Annette (panel leader): The subject for today's panel is
"The Vicious Cycle of Panic." We all had to deal with panics
and may have to deal with them occasionally even after we
have improved. I remember the first panic I experienced. Shortly
before I went to the hospital I awoke at night with a numbness
in my arm. I looked in the mirror and it seemed to me I
saw a slight swelling in the side of my nose. Looking on the
swelling in the nose I became more painfully aware of the
numbness in the arm. Suddenly I was gripped with fear. I
rushed into the bedroom where my aunt was sleeping and said,
I feel my arms are paralyzed. The moment I said this the
numbness seemed to spread all over my face. My aunt offered
to call a doctor. That scared me more. I felt as though I
couldn't get my breath, as if each breath was the last. While
my aunt called the doctor I began to tremble. The numbness
disappeared now but the trembling continued. Then the
tremor went and the numbness returned. Then the numbness
passed and the tremor came back. By that time the doctor arrived
and after examining me carefully said he could not find
anything wrong. He prescribed a sedative and rest. The next
morning I was tired but I dragged myself to go to work. After
that I dreaded the thought of numbness. I was always in fear
of it. I developed the vicious cycle. If I only thought of the
numbness it was there. And each time I thought I was going
to die. Then I went to the hospital and came in contact with
Recovery and attended the physician's classes. There I learned
that sensations are distressing but not dangerous. It took me
a long time to understand that fully. I remember once I had a

slight numbness and kept repeating, a sensation is not dangerous;
it is not dangerous. I repeated that again and again but
finally I got sore and decided it didn't help. Then I thought
what else can I do? I started out again chanting it isn't dangerous,
it isn't dangerous and I did not work myself up to a vicious
cycle. One night I awoke with a sensation that I felt in every
muscle of my body, something like you feel when the elevator
drops slightly. I got tense and weak and felt like waking my
husband to ask him for a glass of water. But I remembered
my Recovery training and knew that if I gave way to the
impulse to awaken him that meant I was helpless and needed
help. And that meant that I was on the way to establish a
vicious cycle. I knew if I was to control the vicious cycle I
must not act on the impulse. It was difficult to restrain myself.
So I lay quietly, but then I got mad because there my
husband slept peacefully while I was so uncomfortable. I was
provoked at the idea that I had to curb my desire to call for
help. But I didn't give in. Suddenly I remembered the doctor
had told us the best way to calm down is to do something
absolutely unemotional, something that has definitely nothing
to do with excitement and temper, something that is utterly
objective. So 1 said to myself, "I am going now to view this
sensation objectively and without fear. I shall look at my sensation
as I would look at an object." I asked, "Where is that
sensation? Where do I feel it most? In my arms, or in my
stomach or legs? Just exactly what kind of a sensation is it?
Could I describe it? I had by now become objective, indeed.
And then something extraordinary happened. When I set out
to look at the sensation and to describe it it was gone the very
moment I started to look at it, and I fell asleep. In the morning
I felt refreshed and proud of my accomplishment. Has
anyone else got an example?
Gertrude: One of my most distressing symptoms when I was
sick were palpitations. One night, shortly after I joined Recovery
the palpitations were just terrifying. I remembered that
all the doctors I had visited had told me my heart was in good
condition. Our Recovery physician had given me the same

assurance. But when I had the palpitations I felt that was my
last minute, and I was going to collapse. The more I became
alarmed the faster did the heart beat, and the faster it beat the
greater was my alarm. I know now I worked myself up into
a glorious panic. The palpitations seemed intolerable. I got
tremors and my hands perspired. I felt weak and shaky and
was positive something dreadful was going to happen. Like
Annette, I thought of waking my husband and when I saw him
lying there I was tense and irritated because I thought there he
is sound asleep and I almost dying from agony. I jumped out
of bed and jumped quite heavily hoping the noise would wake
him. But he continued to sleep. I slipped back into bed, giving
loud sobs and breathing heavily, but he slept on. Finally it
occurred to me that that was all sabotage. I remembered the
doctor asked us to do nothing about sensations, that they were
distressing but not dangerous. So I tried to lie in bed quietly.
But then it seemed I did not sleep all night. Now I recalled
what the doctor told us about sleep, not to toss and to know that
sleep has little to do with health and if you lie in bed for
hours you sleep part of these hours even if you feel you haven't
slept at all. Finally I fell asleep. On the following nights it
got better and better. I felt more secure because gradually I
accepted the doctor's authoritative knowledge that sensations are
distressing but not dangerous.
Annette: The point is that you kept practicing night after
night till it produced results. This continuous practicing is
not easy but it can be made easier if you talk to others in Recovery
and find they have gone through the same experiences
and got their sensations under control. Any other example?
Ada: When I first broke I was terribly afraid I lost my mind.
Later when I joined Recovery the doctor assured me it was a
case of nerves but I couldn't believe it. One Saturday afternoon
I was to come to the panel discussion, and my sister made some
remark about my condition and I misinterpreted it as doubting
my mentality. I thought they all knew I was mentally ill but
they are not going to tell me. The more fearful I got the more
tense I was, and the more tense the more fearful. One of my

symptoms was vomiting. It had improved but now I vomited
again. That scared me more and I called Rosalie. I told her
I was positive something was wrong with my mind. But she
said, "Did the doctor say so?" I said, "No." Then she said,
"That's your own diagnosis, and you know we must not diagnose."
That reassured me, and I went to the panel and got
more assurance. Several months later I met my mother-in-law
and she asked me how I was. I said I felt fine and she said,
"One thing I can tell you; that sickness you have doesn't run
in my family." At this I developed a temper and it took me
some time to check the vicious cycle. A month ago I saw my
sister-in-law, the daughter of the mother-in-law, that made that
remark about "in our family." She told me she had seen her
doctor because she had pains and felt run down and irritable.
He told her he couldn't find anything wrong with her and it
was a case of nerves. "The idea of that doctor," she said, "To
call my condition a case of nerves." It so happened that I saw
her mother about the same time. I inquired about her daughter,
and she let loose against that doctor who had the crust to say
that her daughter was a "case of nerves." "My daughter," she
said, "is very sick and has extreme pain and can hardly drag
herself to work, and that doctor, mind you, calls that nerves."
I remarked that I had a case of nerves and got well and suggested
that her daughter come to see my nerve doctor. "That is
all right for you," she said, "but not for my daughter." This
time I smiled and there was no temper and no panic
Annette: What Ada wanted to explain is that in the first
encounter with her mother-in-law she had a flare of temper
which developed a strong immediate effect. To this she added
an after-effect that lasted for hours and maybe days because
it was aggravated by a vicious cycle. When she met the motherin-
law the second time the temperamental flare was slight, the
immediate effect was mild, and the after-effect did not come
off. As a consequence the whole flare blew over quickly, and
no vicious cycle developed. Ada was able to do that because of
her Recovery training. If these terms of the "temperamental
flare," "immediate effect" and "after-effect" are not clear to some

of our listeners I shall advise you to read volume 3 of the "System
of Self-Help." Any other example?
Sophie: I don't know what would have happened to me if
Recovery had not come my way. One day an idea got stuck
in my brain, the idea of losing my mind. With that I developed
a pain in my head, and the stronger the idea became the stronger
got the pain, and I worked myself up into a vicious cycle. Finally
I landed in the hospital where I got three months of shock
treatment. When I came home I had a battle on my hands. I
wasn't well at all and still had the pain and the fear of losing
my mind, and then I got all kinds of other symptoms. My
husband was impatient, and I don't blame him, either. I complained
all the time, and of course he couldn't stand it. Then I
met Gertie, and she told me about Recovery. But my husband
had by this time got sick of it all, and he wouldn't listen. He
said he was all through, and he wouldn't let me go to see
another doctor. But from what Gertie told me I knew Recovery
was my real chance. At first I didn't believe what I
heard at the meetings. But when I noticed others getting well
I decided to stick to Recovery whether my husband wanted
it or not. And now I can truthfully say I never felt better in
my life.
Annette: What is your husband's attitude now?
Sophie: He knows I am well, and he rather likes to come to
meetings himself. His family is now won back, too. They used
to say there was no hope for me, and for him to put me away
somewhere. Now they don't say that anymore.
Annette: Is there any other example?
Ted: It appears that the vicious cycles I get into are relatively
mild ones. I have no panics or excessive fears. But to me
they appear extremely distressing and they last a long time. I
form an idea of danger, that I am helpless and a sissy, that is,
that I am a weak fellow that won't show gumption. I think
I have been in this sort of mild vicious cycle for many, many
Annette: How does it affect you?
Ted: In the presence of other people I have the sensation

of fatigue and a heaviness in my muscles like I would rather
sit still in one position for a long time instead of moving and
looking around me. Since I have joined Recovery I have learned
to reject the idea I am a sissy. I am now a member of a young
people's group at church, and before I joined Recovery I couldn't
do that.
Annette: It Is late now, and we will bring this excellent panel
discussion to a close.
Physician's Comment on a Panel Discussion
I shall limit myself to discussing the remark about objectivity
made by Annette in the latter part of her example when she
said she remembered the physician had told her "the best way to
calm down is to do something absolutely unemotional, something
that has definitely nothing to do with excitement and
temper, something that is utterly objective." She then proceeded
to look at the sensation as she might look at an object. "I asked,"
she continued, "where is that sensation? Where do I feel it
most? In my arms, or in my stomach or legs? Just exactly
what kind of a sensation is it? Could I describe it?" But when
she thus transported herself into a mood of objectivity the sensation
"was gone the very moment I started to look at it, and
I fell asleep." With the simplicity characteristic of Annette she
added that when she awoke in the morning she felt proud of
her accomplishment.
Annette had indeed reason for feeling proud. What she had
accomplished was to demonstrate the fundamental principle
of Recovery that symptoms can be conquered by means of
simple and innocent procedures initiated by the patient, i.e.,
through self-help. The particular principle of self-help mentioned
by Annette was formulated several years ago when one
day our friend Frank Rochford recounted a simple and innocent
experience he had while thinking about and observing his
fatigue sensation. Frank's account was approximately as fol

lows: "You tell us we have to have patience. We have to wait
patiently till the sensation disappears. Well, the other day I
felt fatigued again. I knew I had to wait, so I pulled out my
watch to see how long I would have to wait. While I was looking
at the watch counting the minutes and seconds I suddenly
noticed that I no longer felt this fatigue. Next time I tried
that stunt with the watch again but I couldn't count the time
because before I could look at the hands of the dial the tired
feeling was gone."
Frank conquered an intractable sensation through objectivity,
and Annette stopped a blazing panic with the same simple
means. And I told you repeatedly that the wildest temper outburst
can be checked instantly if you take the objective attitude
that you are not the judge as to who is right or wrong. I could
extend indefinitely the list of occasions in which disturbances
can be disposed of without much ado by adopting an objective
view. You have pressure in the head and shudder at the thought
of a tumor. Then you substitute my objective diagnosis for your
fanciful imaginings, and the pressure is relieved.
What, then, is objectivity? And what is the reason for its
magical effect on nervous symptoms? I shall ask you to view
this conference table where I am just now delivering my address.
I shall describe it as being about one yard and two inches
in height, having a brown color, four legs, two drawers, adding
a few other items of a similar nature. This mode of description
deals with height, color, number of legs and drawers, and I
could mention as further descriptive details the position of the
table relative to walls and windows, the number of chairs it
will accommodate, and the hardness or softness of its wood.
If this is all I say then everyone of you could easily verify my
statements simply by using a tape measure or by touching and
looking at the table, i.e., by the use of your senses. You will
now agree that one criterion of objectivity is the possibility of
verifying a statement, either by measurement or by sense perception.
Suppose now that while speaking of this conference table I
display feeling. I dwell tenderly on the moments of great in

spiration which I experience when I behold this eager audience
of patients rapturously listening to my remarks. I may go on
in the same emotional vein, extolling the singular value of Recovery
activities of which this table is a symbol, or the great deeds
of human salvation which have been performed right here from
this table. If I continue in this exalted style you will realize that
what I say has nothing to do with measurements and sense
perception. It is an account, flowery and exaggerated, of my
personal and subjective feelings, not a description, plain and
unadorned, of the unemotional and objective qualities of the
table. My first report (of color, height, distance, hardness and
softness) was objective because, employing measurement and
sense perception, I steered clear of emotion. My second report
was subjective because, eliminating measure and sense, I emphasized
feeling. Objectivity, then, means (1) employment
of measurement and sense perception, (2) elimination of feeling
and emotion.
I have answered my first question which asked: What is objectivity?
I shall now try to give the answer to my second question:
What is the reason for its magical effect on nervous symptoms?
One thing ought to be clear to you by now. If the
patient is to be objective he must rid himself of emotion. But
why should he do that? What is wrong with having emotions?
What is wrong even with having fears, angers, indignations?
Eliminate fear and you lose the valuable qualities of caution, foresight
and premeditation. Throw out your anger, and you will
deprive your personality of its capacity to be aroused to action
by personal insults and group crises. Without emotion you are
chilly, unresponsive, uninspired and uninspiring. Emotions are
values, and I do not think of inveighing against them, except
in regard to nervous patients and nervous symptoms. Emotions
have their rightful place in the family, in religion, civic life,
business and politics. Moreover, emotions are of two kinds. On
the one hand, there are love, devotion and affection, enthusiasm
and sympathy, the sense of fellowship and the spirit of selfeffacement.
These are the emotions of stimulation. They stimulate
the organs of the body into more vigorous breathing, digest

ing and heart action. They operate to raise and harmonize
the functions of the organism. On the other hand, there are
fear and consternation, anger and indignation, envy, jealousy
and disgust. These are the emotions of frustration. They lower
the functions of the body and throw them out of equilibrium.
The emotions of stimulation create stimulating tenseness; the
emotions of frustration create frustrating tenseness. I do not
have to tell you that you cannot go far enough in cultivating
stimulating emotions and their attending stimulating tenseness.
You cannot go wrong if you do your utmost to dwell on
them, to enhance and coddle them to your heart's delight. Should
you be "gripped" by any of these stimulating emotions just
permit yourself to become warm and responsive, emotional and
subjective. But if you are seized, as is the case in a panic, with
the frustrating emotions of fear, anger and despair, with jealousy
and envy, with indignation and disgust then you must bend all
your energies to becoming and remaining cool, chilly, unemotional
and objective.
Annette demonstrated how this can be done. She was in the
throes of a panic and passed through the whole gamut of frustrating
emotions. Fear, anger, indignation, self-disgust and despair
rocked her body down to every cell and fiber. An overwhelming
amount of frustrating tenseness was produced pressing
on the nervous system and creating symptoms which caused
more fear and therefore more tenseness till the vicious cycle swept
her organism to a climax of agony. This vicious cycle was maintained
only as long as she allowed herself to be emotional, i.e.,
subjective. The moment she began to ask the objective questions,
"Where is that sensation? Where do I feel it most? Could
I describe it?" she changed subjectivity into objectivity, became
unemotional and calmed dowti a1 *-.jst instantly. What she did
was essentially to apply measurements and sense observation to
processes of inner experience and to eliminate emotionality from
the field of bodily functions. The remedy was simple and innocent
and represented the most consummate technique of psychiatric
You remember I meant to say a word or two about the magical

effect of objectivity on nervous symptoms. But i I called Annette's
performance "simple and innocent" how is it possible
to consider it magical? Magic may be innocent, but is it simple?
Well, if you conceive of a task as utterly complex and impossible
of accomplishment then you will think it miraculous and magical
if a simple move "does the trick" of accomplishing it. You
see, patients have a way of viewing their panics as uncontrollable,
i.e., they consider control of emotionalism as a task
"impossible of accomplishment." Annette demonstrated that
objectivity wipes out emotionalism. Once she established an objective,
unemotional attitude "it was no trick" to quash the panic
in an instant. But that emotionalism can be removed instantly
once you have become unemotional ought to be considered perfectly
natural and not at all magical.
Annette forgot to mention one item that may sound casual
but is of great significance. She forgot to state that she practiced
the method of objectivity on numerous occasions prior
to the panic which she described during the panel discussion.
She had frequently tried to be objective but failed. Success
came to her after many unsuccessful trials. Credit is due to
her not so much for the final triumph but rather for her refusal
to be discouraged by so many previous failures. What she
did was to practice faithfully and untiringly the method of
trial and failure till finally she acquired an amazing skill of
handling the method of trial and success. Many of our patients
have made an effort to apply the self-help method of objectivity
but met with initial failure and gave up. Annette persisted after
many failures and finally scored a signal success.


Claire, on the Saturday panel, recounted how several
weeks ago her husband told her he had to leave town for
a number of days. She knew it was a business trip which
could not be postponed. Nevertheless, she was thrown into
a panic at the prospect of being left alone. She felt a heat
wave sweeping over her body, her throat choked, the heart
raced and the entire body felt limp. She was tense and
dizzy and weak. She said nothing and could hardly have
said anything because she was terror stricken. But her husband
noticed the disturbed feelings and upbraided her for
being selfish and inconsiderate. In the course of the panel
discussion she stated that her husband "obviously didn't
care how I felt." Later she added that she was able to stop
her feelings by applying her Recovery training. She spotted
the panic as an instance of temper and self-pity, hence, as
sabotage. The spotting produced instant relaxation. "I was
surprised," she said, "that I was able to control my feelings
as quickly as I did. I think I am learning how to handle
my feelings.
1 '
Claire became terrified at the thought of her husband leaving
town. The terror meant to her that her feelings were disturbed.
The disturbed -feelings were noticed by the husband who upbraided
her presumably for failing to control her feelings. That
suggested to Claire that her feelings were not properly appreciated.
Recovering her composure she was surprised to find that
control of feelings was easy. In the end she concluded that her
Recovery training had served her well in the matter of handling
her feelings. After listening to this report of an incident in which
feelings fairly leaped over one another I must confess that the
dexterity with which Claire manipulated feelings is surprising,

indeed. And I shall ask: did Claire deal with feelings? Or
did she play on something which she merely called by that
name ?
What happened to Claire was that she suffered a scare. Previous
to the scare she was reasonably calm. Being calm her condition
was that o relaxation. Her thoughts were relaxed. They
were focused on the little household cares of cooking and shopping,
or they reviewed the trivial happenings of the preceding
day or dwelt on the funny dream she had the night before.
There was no stewing over issues, no worry about problems,
no conflict of ideas, no confusion of plans. The feelings were
in the same state of relaxation, and she experienced neither fear
nor anger, nor excessive joy nor inmoderate grief. The relaxed
thoughts produced a serene spirit, the relaxed feelings gave rise
to a mood of comfort. Whenever a person is serene and comfortable
his inner organs tend placidly and peacefully to their
functions of circulation, respiration, digestion and elimination.
Hence, no violent sensations, no choking, air-hunger or nausea.
We may say that when Claire was serene and comfortable her
sensations were just as relaxed as were her thoughts and feelings.
With no disturbance rocking the body there was no occasion
for the impulses to become turbulent and impetuous so that
the total of her experience (thoughts, feelings, sensations and
impulses) was that of calm, rest and composure. We conclude
that prior to being struck with terror Claire's total experience
was that of security producing a state of relaxation.
I want you to understand what is meant by the word "total
experience." Our body has only two ways of experiencing a
situation. No matter what is the nature of the situation, it is
approached either with a sense of security or one of insecurity.
If your attitude happens to be that of security your entire body
will partake of that experience. Your thoughts, feelings, sensations
and impulses, your inner organs, outer muscles and skin,
even your tiniest fibers and most minute particles of tissues
will share in the total experience of security which now governs
your body. Experiencing security they will all be largely devoid
of strain, tenseness, commotion and excitement. Barring certain

organic diseases, no human experience is possible, even thinkable,
which^ thoughts express security and impulses are restless
and erratic. Nor is it feasible that at one and the same time
feelings should be relaxed and sensations disturbed and muscles
taut. The just prevailing sense of security may be mild or exalted;
the experience of insecurity may be moderate or severe.
But whatever may be its degree or intensity the entire body
is affected. It is a total experience. A total has parts and the total
experience has its part experiences. I have mentioned them already.
They are thoughts, feelings, sensations, impulses. These are the
dominant parts of the total experience. If any of them become
disturbed the disturbance will spread to the other members of the team.
If any of them is pacified the entire team will regain calm and peace
and the disturbance will be stopped. This calming and stopping
of disturbances is what is generally referred to as "control" (of
disturbances). You will now understand that if you wish to
control the total experience of insecurity you must use a method
which will control, that is, stop and calm any one of the dominant
parts of that experience. Control one dominant part, for
instance, the confused thoughts, and the rest of the team (feelings,
sensations and impulses) will follow suit. The dominant
part which Claire chose for control was her feeling of terror and
despair. She claims that after this feeling was calmed and
stopped the sensations, thoughts and impulses quieted down and
she relaxed. But I shall ask: how can feelings be stopped,
calmed or controlled? Which method did Claire use for controlling
them? Feelings are spontaneous; they rise and fall
and run their course, and no deliberate effort will ever put a
halt to their spontaneous progression. Obviously, Claire did
not control her feelings but some other dominant part of her
total experience of insecurity.
That feelings and sensations cannot be stopped, calmed or
controlled by deliberate effort ought to be familiar to you because
I have emphasized the fact on numerous occasions. I told
you repeatedly that thoughts and impulses alone are subject to
control. Evidently, when Claire "applied her Recovery training"

she applied it to her thoughts and impulses, not to her feelings
or sensations. I shall repeat: two inner experiences only are
subject to control: thoughts and impulses. I shall add that one
factor only is capable of controlling them: the Will The inference
is that when Claire put a check to her total experience o
insecurity the feat was accomplished through the intervention
of her Will. It was her Will which exercised control over her
thoughts, perhaps also over her impulses, perhaps over both.
Emphatically, it did not and could not control feelings and sensations.
You remember I mentioned frequently that the Will has one
function only: it rejects or accepts ideas and stops or releases
impulses. In either case, it says either "yes
or "no" to the idea
or the impulse. Suppose an idea lodges itself in the brain suggesting
danger. It is then for the Will to judge and decide
whether or not danger exists. If the Will accepts (says "yes
the idea of danger, then, the thought of danger will mobilize
feelings of insecurity and will release in their wake rebellious
sensations and vehement impulses. The total experience will
then be that of insecurity. Conversely, if the Will decrees that
no danger threatens the thought of insecurity will be discounted
and feelings, sensations and impulses will retain their customary
equilibrium. You will understand now that ideas rising in the
mind oiler suggestions to which the Will replies with "yes"
or "no." This has been called the denying and affirming function
of the Will. The same function may be exercised by the
Will in response to impulses releasing them with a "yes" and
restraining them with a "no." How is it that this process of
denying and affirming can be used for thoughts and impulses
only and not for feelings and sensations? You will grasp that
readily if you will consider what precisely the words "yes" and
"no" mean when employed in connection with an inner experience.
When the Will disposes of the thought of danger by
rendering the verdict "no" the denial can be expressed as saying,
"No, there is no truth to this suggestion of danger. Perhaps,
there is not even a probability or possibility of it." Similarly,
when an impulse presses for action and the Will interposes its

veto it says in essence, "No, this impulse is undesirable, and its
action will prove unwise and harmful.'* No such ratings in
terms of truth and falseness, desirability and harmfulness, wisdom
or folly are possible in the instance of feelings and sensations.
If a person is seized with grief or stimulated by joy it would
be senseless for the Will to claim that the joy is false or the
grief impossible. Feelings are either experienced or not experienced.
Their existence, wisdom and probability cannot be denied
or affirmed. The same holds for sensations. If the head
aches it would be absurd for the Will to object that, "No, this
is no headache. It is unwise, untrue or improbable." Clearly,
if the Will is to intervene in order to control the total experience
of insecurity its "no" cannot be directed to feelngs and sensations.
Instead, it must address itself to thoughts and impulses.
We can now sum up our analysis of Claire's reaction. When
her husband announced his planned trip the idea of danger
leaped into Claire's brain. The thought of danger mobilized
feelings of insecurity, threw sensations into violent uproar and
released a host of turbulent impulses (to cry out in despair or
shout in anger, to argue, protest, run). When this happened
Claire's Will was inactive and the thought of insecurity was
accepted. The result was that the body was thrown into the
total experience of insecurity. Suddenly she remembered her
Recovery training and presumably recalled the Recovery motto
that sensations are distressing but not dangerous. Now the
thought of "no danger" dominated her brain and she decided
to ignore or deny the existence of danger. Her Will had been
alerted and said "no." The "no" calmed her thought processes
and the calm communicated itself to sensations, feelings and
impulses. The total experience was now one of security. When
Claire noticed that'her body had relaxed so miraculously she felt
the need for explaining the miracle and in doing so she employed
the clumsy and incorrect language of the man in the street.
According to this language feelings are subject to control. Had
she used the Recovery language she would have surmised that
her total experience of insecurity had been remedied by the
intervention of the Will which said "no" to the idea of danger

with the result that one dominant part of the experience was
brought under control and spread the effect to the other parts.
Claire had done the right thing but, trying to explain it, called
it by the wrong name.

The Saturday panel discussed the subject of "Real Sensations
and Fantastic Interpretations." Phil, as one of the
discussants, mentioned how in previous days when he was
not yet "sold on Recovery" his pressures, dizzy spells and
confusions made him neglect his work till finally hospitalization
was the only way out of trouble. "These symptoms,"
he said, "have not disappeared altogether. They still bother
rne every once in a while. But now when I have them I
remember what Dr. Low has told us frequently: "You can
throw off any nervous symptom at any time for a few seconds
or minutes if you spot them as distressing but not
dangerous. The symptom will come back in the next minute
or so. But you can get rid of it again for a short while, and
then again and again and before long you will be rid of the
trouble for hours or for days. The symptom will return and
keep returning but in the end you will bring it under control
by plugging away at it." Phil then continued, "That was
hard for me to believe. It just didn't seem to make sense
that an awful head pressure would disappear if I made an
effort to spot it. But I can tell you that when I have these
symptoms now all I have to do is to practice Dr. Low's
rule and before long they are gone."
When Phil set out to practice my rule why was it hard for
him to believe it would work? Why did he feel it made no
sense ? Nervous symptoms are the result of tenseness and if you
"spot them as distressing but not dangerous" you dismiss the
idea of danger; and without the thought of danger in your brain
you feel safe; and if you feel safe you relax; and if you relax
you lose your tenseness; and with tenseness gone the symptom
disappears. What can be more simple, what more easy to be

lieve and more thoroughly in accord with sense? And if this
is so, why did my rule appear senseless and unbelievable to Phil?
Clearly, Phil thought of nervous symptoms as afflictions which
require complex and elaborate means for conquering them. He
obviously shared the current view that in order to deal effectively
with a nervous complaint the patient must be subjected to
a searching investigation for the purpose of unravelling hidden
mysteries of thought and tracking down the crafty maneuvers
of mischief brewing emotions. If this were true my rule would
be naive, unsophisticated, unbelievable and decidedly unsuited
to the purpose. But it may be that what is really naive and
unbelievable is the modern trend to view thought as mysterious
and emotion as mischievous. And I shall advise you to reject
this contemporary superstition that your thoughts are forever
scheming against your welfare and your feelings continually
plotting against your health. I shall grant that in our present-day
setting leadership is lacking and confusion rampant. And with
the amount of confusion governing this world of ours it is easy
to get thoughts muddled and feelings confounded. But Recovery
refuses to be modern, and the leadership which it supplies aims
precisely at teaching you how to conquer confused ideas and
perturbed emotions through simplicity of thinking and humility
of feeling.
I instructed Phil to stop thinking of danger and to command
his muscles to relax. His head pressure suggested to him that
he was losing his mind. I told him he will not lose it Two
ideas were presented to him. Of these he chose one. There was
nothing to prevent him from choosing the other. Get it into
your heads that a human being has the power to choose what
to believe and what not to believe. This power to choose is
called the Will. The main beliefs between which the Will must
choose are that in a given condition you are either secure or
insecure. If you accept the thought that your head pressure
is the result of a brain tumor you have formed the belief of
insecurity. If instead you choose to think of a mere nervous
headache you have rejected the belief of insecurity and put in
its place that of security. Why did Phil think he was unable

to swap thoughts? He had been swapping them all his life.
For upward of thirty years he had practiced the game of accepting
ideas, rejecting them, exchanging the one for another,
dropping them and picking them up just as he wished, wanted
and chose. The swap was usually effected with facility and
rapidity; sometimes it required hard work and long pull. But
whether easy or difficult the wanting was practiced and the
choice made. What made Phil believe that all of a sudden he
had lost the capacity for wanting and choosing? And as to
commanding your muscles to do your bidding? This is done
every second of your daily activity. You want to sit down and
do it. You wish to stand and rise from your seat. You decide
to make a trip, to enter business, to marry, to save a life or sacrifice
your own and you carry out your decision either instantly
or after hesitation and deliberation. Nothing is needed for the
successful execution of these acts and plans but Will and choice.
And thoughts and muscles are made to obey the dictates of Will
and choice. Why did Phil assume he could not choose "at will"
to direct his thoughts and to command his muscles?
Beliefs are frequently stubborn and obstinate. They may
become fixed offering resistance to the summons of the Will.
This is particularly the case if the belief has persisted for years.
You know how difficult it is for me to shake your beliefs that
you are doomed, that your heart will give out, that your fatigue
will lead to exhaustion. Muscles are just as likely to develop
obstinacy. They tend to acquire set patterns of behavior preferring
certain well grooved acts and avoiding others. Just
think of the habits of procrastination, of twiches and spasms,
of restlessness and sluggishness, and you will realize that muscles
are not always pliant tools in the hands of the Will. In order
to pry loose the resisting beliefs and rebellious muscles attempt
after attempt must be made to dislodge them from their comfortable
berth and to force them to give up resistance. The resistance
may be so strong that the attempts to break it must
be repeated in innumerable trials before success is achieved. This
requires the Will to use a great deal of power in continued strenuous
practice. Hence, the terms "will power" and "will practice."

By exercising its power the Will masters its task and learns how
to rearrange beliefs and redirect muscles. Having gone through
the learning process the Will gains experience and becomes an
expert Will
In our days of modern progress this learning process with its
inherent will practice has been largely abandoned. Children are
seldom taught to exercise will power for the mastery of reading
and writing. Things are made easy for them. The schools
supply all manner of "aids" to help them avoid exertion. The
same holds true for work done in the fields of commerce and
industry. A person entrusted with a commercial or industrial
job is not likely to be subjected to the grinding procedure (learning
process) of apprenticeship. Instead, he is "broken in" by the
expedient of accelerated courses in which a number of manipulations
are demonstrated to him. This method of giving hurried
demonstrations (to the senses) and facile explanations (to the
intellect) instead of thorough training (to the Will) has permeated
most spheres of our daily existence. A few flimsy explanatory
phrases, and the housewife "learns" how to use a
machine for sewing, cooking, washing, cleaning. A few perfunctory
demonstrations "teach" the buyer of an automobile how
to run it. In all of this, modern men and women imbibe the
lasting impression that technique has eliminated the necessity
for learning, patient application and practice of will. Most devastating
to the learning process and to the exercise of will power
has been the contemporary trend to spoonfeed information. In
radio forums, newspaper columns, popular magazines and sundry
other vehicles of public "education" brief discussions are offered
by obscure persons of doubtful authority in which weighty issues
are hurriedly "explored" and speedily solved by versatile
analysts, columnists and essayists. The learning process is
scrapped and replaced by a growing habit of passive listening
and easy acceptance.
Without the benefit of a Will trained to choose beliefs and
direct muscles the men and women of our generation have lost
faith in the correctness of their decisions and the relevancy of
their plans. They drift along in the shifting currents of a rush

ing existence with little knowledge of how to approach issues or
tackle problems. Having neglected or evaded the discipline of
the learning process they lack the "know-how" of pursuing
tasks, of aiming at goals and accomplishing purposes. Faced
with difficult situations they feel helpless. As a result, the modern
tendency has been to shy away from responsible pursuits
and to entrust their proper execution to "experts." These go
by the name of "specialists" who are supposed to possess the
requisite "know-how" for solving problems. The specialist is
expected to formulate plans for the rearing of children, to make
decisions for marriage and divorce, to determine the degree of
vocational fitness, to advise in matters of dieting, budgeting,
housekeeping, love making, reading selections and what not.
With the spread of specialism, self-help and self-management
have ceased to play a significant part in the present-day domestic,
marital and social scene. The habit of rushing to the
expert for advice has resulted in a vicious cycle of helplessness:
the more the expert's aid is solicited the more helpless is the
applicant bound to feel;, the greater the helplessness the more
urgent the need for further consultations; the more frequent
the consultations the more poignant the sense of helplessness.
In the end, an individual emerges who has a stunted Will, a
meager "know-how", and a famished sense of resourcefulness,
in short, Modern Man, the pathetic creature of an extraneous
Will, without plans or directions of his own and in abject dependence
on forces outside his inner self.
I am not a reformer and have no intention to crusade against
the modern mania for undisciplined "self-expression" in a life
of senseless speed and meaningless change. My duty is to treat
patients, not to cure the ills of the age. But my patients are
unfortunately exposed to the detrimental influence of the spirit
of the age. That spirit is inimical to the process of learning, to
patient striving and persistent willing. If I am to teach my patients
to dismiss their settled beliefs of insecurity; if I am to
direct them to give orders to their muscles and have them properly
executed; if I am to train them to practice self-help and
not to depend on the questionable expertness of outsiders; if

I am to accomplish all of this I must first divest their minds
o the modern fallacy that being shown a method means learning
it, that witnessing the demonstration of a skill means acquiring
it. With machines this may be feasible; with life tasks it is
impossible. My patients will have to realize what former generations
always knew: that a life task can be mastered only
through a gruelling, exacting learning process in which all the
resources of the Will must combine to achieve final fulfillment.
Health is a task of this kind. It can be secured only if the
patient's Will initiates a system of ceaseless trials and trials and
trials until in the end the task is accomplished. If this is done
even the most stubborn belief will yield to the influence of the
learning process, and the most sluggish muscle will obey the dictates
of the Will.

In a recent panel discussion Phil stated: "All my life I
have had difficulty with my handwriting. When I had to
write anything or sign a paper I became tense and the
strain made it impossible for me to write clearly. I always
thought I just couldn't help it. I get nervous and can't
write, that's all In Recovery I have learned that everybody
can command his muscles to move. And now when
my hand tenses up while I am writing I know I can make
the muscles of my hand to move calmly instead of racing
ahead with the scribbling and then the tenseness will pass . . . ."
Phil, in his pre-Recovery days, had the conviction he could
not write and the certainty he could not help it. His credo was
"I can't do it, that's all." After joining Recovery he discovered
that convictions and certainties can be discarded and credos can
be changed. When he changed his belief and dropped his conviction
which method did he employ?
Phil's fingers were never paralyzed. Hence, he was able to
write. But for some reason he developed a sense of embarrassment
and self-consciousness about the act of writing. The selfconsciousness
produced tenseness which caused the fingers to
go into a mild spasm whenever they were made to wield the
pen. The spasm may have given rise to some sort of a cramping
sensation. That created discomfort. In order to avoid discomfort
he avoided writing. He feared to write because he dreaded
the discomfort it entailed. But the more he feared it the more
annoying grew the discomfort; the greater the discomfort the
more intense the fear. In the end, the vicious cycle, relentlessly
fanning both fear and discomfort into extremes of agonies, made
Phil believe that smooth, effective and painless writing was

What seemed impossible to Phil was not the act of writing but
rather the necessity to face, tolerate and endure the discomfort
connected with it. This is an important conclusion because it
describes the pattern which applies to every nervous fear. Some
of my patients go to bed with the fear of not sleeping. They
think they fear sleeplessness because it ruins health. But what
actually frightens them is the torture, that is, the discomfort of
lying awake in the dreadful stillness of the night. Or, a patient
becomes panicky on entering a street car. He thinks his fear
is that of threatening collapse. But what actually scares him
is the prospect of being tormented during the ride by palpitations,
choking sensations, dizziness and sweats. Again, it is the anticipation
of discomfort and nothing else that causes the apprehension.
I could easily quote hundreds of situations in which nervous
patients are convinced that what they fear are certain acts
or certain occurrences while, in point of fact, the only fear they
experience is that of a discomfort which they conceive of as
"unendurable" or "intolerable" or "unbearable." To put it bluntly:
nervous fear is the fear of discomfort.
Phil disposed of his fear of writing by commanding the
muscles to carry out the requisite movements. In Recovery, he
said, he learned that everybody can do that. But a command is
not a method. I shall ask: How did Phil learn to make his
muscles obey his command? Long before he knew of Recovery,
long before Recovery existed he had issued commands to his
muscles to write but they balked. On a thousand occasions he
had made his fingers pick up the pen and run it across the
paper but the order miscarried. The fingers shook and the pen
tottered. The product of his painful effort was an illegible
scribble, not a clear script. Why did his muscles defy his command
in prc-Recovery days and heeded it promptly after he
passed through Recovery training? Which is the Recovery
method of making muscles obey directions?
In his pre-Recovery days Phil issued orders to his muscles
to perform the act of writing. Had he done nothing else there
can be no doubt that the writing would have been accomplished.
But while giving directions to his fingers his mind was obsessed

with the thought that writing was an "unendurable" torture
and that he could not go through with the task. Your muscles
will not move, of course, if you suggest to them the fear that
the movement will lead to disaster. The very thought of disaster
("unendurable" torture) will block motion. Fear even if mild
makes muscles tremble and the trepidation thwarts proper execution.
If you want your muscles to carry out your commands
you must not scare them into anxiety and hesitation. To strike
the muscles with fear and then to ask them to act with precision
is absurd. My patients are guilty of this absurdity. Gripped with
a grotesque fear of discomfort they first tell the muscles that the
contemplated action is impossible or fraught with danger and
then command them to act. The muscles, with a better logic, release
a tremor and bungle the job. Whenever that happened to
Phil in his pre-Recovery days he felt hopeless and concluded "I
cannot write. That's all." But that is not all by any means. The
"I cannot" ought to read more correctly "I care not." Phil could
write very well but did not care to bear the discomfort of a painful
and difficult writing with fingers scared into fumbling and
trembling. In Recovery he was trained to face, tolerate and endure
discomfort and once he learned to be uncomfortable without
wincing he gained confidence and passed on to his muscles
the assurance that writing was possible though uncomfortable.
The muscles, then, swung into action without tremor or delay.
The method which was here at work was plainly and simply
authentic Recovery method of making recalcitrant muscles obey
If the nervous patient is to rid himself of his disturbing symptoms
he will have to cultivate the Will to bear discomfort. Time
was when bearing discomfort was considered part of life, a part
accepted by everybody and practiced everywhere. Children were
reared with an eye to making them stand up under hardship.
Heavy labor, sustained exertion, privations and drudgery were
regarded as incidental to the sweat and toil of daily existence and
were borne with patience, resignation and humility. But in our
days comfort is hailed as something in the nature of a supreme

achievement. It is cherished, worshiped, idolized. When we
catalogue the accomplishments of our age the first item we are
likely to point to with mounting pride is the fact that our modern
technique has eliminated drudgery from the daily routine,
We boast self-complacently of the labor saving devices which a
busy industry rolls off its assembly lines in bewildering profusion.
The housewife is daily assailed by the advertiser's exhortation to
escape the "backbreaking" drudgery of homework. Billboards
flatter you that "electricity is your servant." Your kitchen and
bathroom are choked with gadgets meant to do away with the
discomfort of effort and exertion. Educators rack their weary
brains to ease the "uncomfortable" task of acquiring school
knowledge. Mothers and fathers have learned to shun the discomfort
of staying home with their babies. Youngsters resenting
the discomfort of rules and coventions are in feverish haste to cast
of? age-old restraints. I shall ignore the fact that automobiles have
abolished the effort of walking, that typewriters have disposed
of the inconvenience of writing and that an elaborate push-button
system prevents us effectively from working off our unspent
energies on household chores and office jobs. All of this may be
rated as an unavoidable development, perhaps even desirable in a
limited sense. What is more important is that this process of
removing effort and creating mechanical comforts is being
acclaimed as a value and cultural achievement. We take a childish
pride in our "modern progress," extol with boyish conceit
our "high standard of living." We class as "backward" and "unprogressive"
countries which lack the mechanical comforts which
we enjoy. In all of this, the cult of comfort is recommended
as the royal road to superior culture. The pursuit of comfort
is glorified and the facing of discomfort discouraged. In this
modern scheme of life the Will to bear discomfort has no place.
If comfort is raised to the level of a value or ideal discomfort is
necessarily looked upon as something not to be tolerated and
endured, as something that is definitely not part of life, certainly
no necessary part of our "modern life."
I do not wish to convey the impression that I am opposed to
the use of such mechanical conveniences as refrigeration, elec

tricky and gasoline. If anyone wishes to introduce these or
kindred comforts into home or shop he has my blessing. But
he will have to know that this type of legitimate comfort is
merely useful and not at all valuable. In those departments of
life which are governed by valuations the cult of comfort is decidedly
misplaced. If you want to maintain the values of health
and self-respect, of initiative and determination, of character
and self-discipline, what you will have to learn is to bear the
discomfort of controlling your impulses, of steeling your Will,
of curbing your temper. This calls for an attitude which far
from exalting the virtues of comfort places the emphasis where
it belongs: on THE WILL TO BEAR DISCOMFORT. When
Phil embraced the Recovery doctrine that discomfort, even in
our "advanced" days, is a thing to be patiently borne, bravely
faced and humbly tolerated he discovered forthwith that his "I
cannot" write was nothing but an "I care not" to be uncomfortable.
He then revised his distorted valuations, braced himself
against that part of life which means discomfort and realized
to his amazement that with the emphasis properly shifted things
were done more efficiently and life was quite comfortable again.

Frances, on the Saturday afternoon panel, reported that
when her sister got married not so long ago she was asked
to help with the arrangements for the wedding. "I knew
that I have a strong desire to run things. So I decided I was
going to check that desire because I didn't want to get tense
and develop symptoms. But things went wrong at the reception
and I got tense anyhow. I felt I had to take a hand
and began to run around and gave orders and told everybody
what to do. Right then I felt my temples got tightened
and my neck was painful. Suddenly I remembered what
Dr. Low told us about spotting a reaction and stopping
it before it has a chance to produce a vicious cycle. I then
spotted my restlessness and sat down and kept sitting. The
tightness and pain disappeared in no time. In former days
I would have rushed around the hall all afternoon and
evening and would have tried to direct everybody and get
things done, and I would have believed that all the responsibilities
were on me and I would have gotten nowhere except
into more tenseness and more symptoms. In the end
I would have been exhausted and coming home would have
thrown a honey of a tantrum."
What Frances described may be called restlessness or aggressiveness,
or a meddlesome disposition, or a tendency to be domineering.
But what precisely drove Frances to display her rush
of energy and her burst of activity? Was it a chaotic volley of
impulses? Or was it rather a well ordered though by no means
balanced philosophy? Let me tell you that it was a philosophy,
wild, stormy and untamed, but aiming at what philosophies
generally aim: to guide conduct and misconduct.
I told you repeatedly about philosophies (of life) and having

studied my writings you ought to be well acquainted with the
three philosophies which I distinguish: Realism, Intellectualism,
Romanticism. When Frances permitted herself to flit through
the reception hall, skipping from guest to guest, pestering the
one with unsolicited advice, the other with an uncalled-for direction,
messing up things and getting nothing done she answered
clearly to my description of the romantic busybody. This
type of an eternally rushing and pushing personality, the lively
and energetic and mercurial "go-getter," is the ever-present and
unavoidable "live-wire" at gatherings, meetings, club functions
and receptions, and the power which drives this self-exhausting
volcano is called ambition. Why was Frances ambitious to push
people, to advise and direct them, to pester and impose on them?
Ambition, well conceived and sensibly pursued, is the breath
and spark of life. Mothers are ambitious to train their children
"properly." And businessmen are moved by the ambition to
take "adequate" care of sales and purchases, of customers and
employes. And physicians ought to be guided by the ambition
to render the "right" kind of service to their patients. And a
hostess* ambition should be to provide "suitable" entertainment
for her guests. You see here that ambition means the determination
to do what is "proper" and "adequate" and "right" and
"suitable" with reference to the job in hand. The job is the
goal which you have set for yourself, and unless you are
determined to "go about" it with ambition you may not employ
the proper, adequate, right and suitable means toward achieving
it. Which was the goal Frances set for herself? Did she
"go about" it with the proper, adequate, right and suitable
means? I may here mention parenthetically that the word ambition
is derived from the Latin verb "ambio" which means to
"go about" a job, a task, a plan.
I quoted the ambitions of the mother, the businessman, the
doctor and the socially active woman. Ambitions of this kind
aim at long-range goals, lasting a lifetime or a goodly portion
of it. While pursuing his long-range endeavor, a person is bound
to strike against obstacles, resistance, ill-will, frustration. It
takes strength, perseverance and courage to face and fight these

difficulties. On many occasions, the individual faced with a
forbidding obstruction to his effort, will become discouraged.
Then he needs ambition to bear the strain and continue the
march toward his goal. Take the case o the mother. If the
children are unruly or ailing or somehow deficient; or, if the
mother happens to be self-conscious and timid, doubtful of her
capacities or fearful of her responsibilities, then, she may develop
a sense of frustration, confusion and discouragement. But discouraged
or not, the maternal task must go on. No matter how
threatening the obstacle or how severe the strain the mother must
continue "going about" her job. For this she needs ambition,
the ambition to give the "right," "proper" and "adequate" care
to the children and "to do right" by husband and home. You
will now understand that ambition is needed for long-range
goals. On the other hand, short range-goals, usually of a simple
nature and extending over a brief period of time, can hardly
ever strain the energies and persistence of a person because they
require very little of them. Moreover, short-range goals, as a rule,
are of little importance, and if in reaching out for them, your
perseverance gives out, no great harm is done. Nothing of significance
is involved in the goal of taking a swim, or going to
a show, or visiting a friend. And if for some reason you wish
to forego or postpone the activity you may do so without any
serious consequence. But mothers cannot forego or postpone
the task of caring for the children. Nor can physicians or businessmen
afford to drop or neglect their business or profession.
And even the hostess is not permitted to deal lightly with her
social engagements because her club meetings and dinner parties,
although in themselves short-range, are woven into the longrange
fabric of sociability, reputation and prestige. Summing up:
ambition is indispensable for long-range goals, especially if they
are important. For short-range goals, an unambitious, carefree
attitude will be sufficient and perfectly "right and proper."
Frances, entrusted with a relatively unimportant, short-range
task, went at it with an ambition which would have graced any
responsible, long-range endeavor. For some reason, presumably
irrelevant, she felt that "things went wrong," that she "had to

take a hand," and that "all the responsibilities" were on her.
This is exactly the philosophy of petty romanticism. The romantic
person is intoxicated with his own importance. His feelings,
experiences and observations appear to him to be singular,
exquisite, interesting; hence, he feels important. Being important,
he knows how to do things. He knows what is "proper"
and "right" and "adequate." He knows, but the others do
not. These others are not important. They do not know how
to do things "right." When they try, things tend to "go wrong." When
this happens the romantic soul feels impelled and obliged
to "take matters in hand," to show people how things are done,
to direct them, advise them, push them around.
After Frances had done her quota of directing, advising ana
pushing, her temples tightened, her neck pained and her
muscles tensed. We may be certain that it was not her ambition
to accomplish such disastrous results. What kind of results
did she expect? What precisely was the object of her ambitious
meddling? In order to answer this question intelligently we
shall have to realize that ambitions are of two kinds: the one
aims at gratifying personal inclinations; the other tends to discharge
social obligations. We shall call them the personal and
social ambitions, respectively. Either of them carries its own reward.
If you manage to give free rein to your inclinations; if
you impose your will on people; if you are successful in pushing
them around, directing and advising them; if they meekly submit
to your "leadership," you feel vital and dynamic. This gives
you a feeling of glamor and grandeur, a sense of power and
importance. Nothing more delightful can happen to a romantic
soul. Every particle of it craves the thrill of glamor and power.
The misfortune is that men and women seldom relish the
privilege of being pushed around. They react strongly, resent
the intrusion and rebuff the intruder. If this takes place, the
illusion of glamor bursts and the sense of power collapses and
all that remains is weariness, defeat and humiliation; and if
the romantic person, thus deflated, chances to be a nervous patient
the final outcome of the romantic adventure is likely to
be a storm of symptoms; tightenings and tensings and spasms

and pains. This was the reward which came to Frances when
she launched out into a reckless spree of what we may now call
romantic ambition. She exercised glamor and power and reaped
humiliation and defeat as reward. The romantic ambition, proceeding
from unrestrained personal inclinations, landed her in
frustration and agony.
Compare now Frances' romantic ambition with the ambition
displayed by the mother anxious to tend her children. This
mother feels important because her objective and realistic task
is important. She may feel grandeur and glory but only because
she conceives of her realistic and objective goal as grand
and glorious. You see the difference. In Frances' mind her
own person figured as the center of importance, and her own
personal qualities appeared to be reflecting glamor and grandeur.
The mother derives whatever reward she expects from a realistic
accomplishment in a group, in the group of her family. Hers is
a realistic ambition founded on the proper discharge of social
obligations. In contrast, Frances' ambition was romantic instead
of realistic and was based on personal inclination .instead
of social obligation.
In point of distorted views Frances is not alone among my
patients. They all are romanticists (or romanto-intellectualists)
with romantic ambitions and romantic, unrealistic goals. If
there is any realistic pursuit it is health. It is long-range and
calls for the exercise of extreme patience and relentless perseverance.
But my patients treat health as a short-range goal, demanding
instant relief and quick cures. Their sense of importance
impels them to crave a ludicrous amount of attention.
Their suffering, instead of being borne silently, is continually
broadcast as "exceptional" agony. They do not ask for help
as humble persons would but demand it as is the right and
privilege of important personages. They feel singular and are
convinced that theirs is "the only case" of its kind. They think
of their frustrations and conflicts as "interesting" and expect
to have a prodigious amount of exploring, probing and analyzing
wasted on them. Their impulses impress them as so powerful
that they consider them "uncontrollable." With all of this, they

enter a claim of being "different" from the general run of sufferers.
If their claim is not acknowledged they prove the uncontrollability
by throwing what Frances calls a "honey of a tantrum."
They pamper their feelings, coddle their thoughts, which
points to the conviction that their experiences are different,
singular, powerful, exceptional, interesting, that is, romantic.
After going through training in Recovery, they gradually learn
to do what Frances did. They spot and stop their romantic
inclinations and engage in a course of action which has due regard
for social obligations. After they have learned the techniques
of spotting and stopping they acquire a philosophy of
life which values realistic goals and scorns romantic ambitions.
Frances travelled this road from unrestrained romanticism to
disciplined realism with the result that her ambitions are now
centered around home and children and husband instead of
on chimerical efforts to hunt for glamor, power and self-importance.
Her reward is a peaceful life, with health and happiness
compensating copiously for the lost illusion of glamor and
the self-deception of importance.

Mona, on the Saturday panel, reported that some time ago
before she even knew the name of Recovery she waited
her turn to purchase meat. When the butcher called "next"
a woman answered who had entered after Mona. "I got
red in the face, my heart raced, my throat tightened and I
turned to the woman and told her I was first. She mentioned
something about people sleeping which made me mad and
spoke to the butcher in a foreign language which made me
more mad yet. I got so confused that when the butcher called
my name next I could not think what I had come for and
bought a piece of meat that I really didn't want just to get
out of the store quickly. All that afternoon I couldn't forget
what nerve that woman had and how yellow I was ....
I worked myself up and became so tense and irritable that
when my little daughter asked a question I pushed her
back in anger. That made me feel more sore at that woman
because she had made me abuse my child. For hours I
talked about that awful woman and told the story to everybody
who would listen . . . ." Mona then added that since
she joined Recovery she has had similar experiences, but
she spotted both symptoms and temper immediately and
when she felt like telling the story to "everybody who would
listen" she commanded her speech muscles not to move.
What Mona described could easily furnish the material for
a big volume. The story it would tell is that of temper producing
symptoms and disturbing adjustment. This would be nothing
new to you. However, two brief chapters of that hypothetical
volume would bear quoting. The one might carry the heading,
"She was wrong." This would be an intellectual judgment. The

other could be fittingly worded, "I was yellow" and would
constitute a romantic declamation. Which adds up to the conclusion
that Mona, our dear, plain thinking and soft speaking Mona,
was addicted, in her pre-Recovery days, to the type of thought
which we call intellectual and the type of feeling which we call
romantic. Like Mona, all our patients have been intellectualist
and romanticist prior to their Recovery training and have adopted
a realistic philosophy only after they joined our group.
I told you repeatedly that the judgment "He is wrong" cannot
be passed except by a duly appointed judge. And in social
or domestic "differences of opinion" there is no judge to decide
whose opinion is right and whose wrong. But I see already
how your eyes flash and your speech muscles twitch to protest
emphatically that the woman who edged ahead of Mona was
"clearly in the wrong." Does it require a judge to brand that
woman's behavior as outrageous and impossible and unquestionably
offensive? That woman used unfair means to secure
an advantage over a neighbor; she employed aggressive tactics,
was pushy, reckless, rudely inconsiderate. How can anybody
deny that Mona was right and that woman wrong? Well, I
offer the denial and will presently produce the reasons.
At the time of the incident Mona was in the throes of a depression
which had lasted close to five consecutive years. She
was self-conscious, preoccupied, hardly able to think of anything
but her physical torture and mental anguish. Many of you
who have gone through a depression know that in a condition
of this kind everything is done with the utmost effort. The
simplest acts of walking, speaking, thinking, are executed with
the greatest difficulty. Finally, even listening to plain conversations
and trying to understand what people say becomes a fatiguing
exertion. At this stage the patient ceases concentrating on
what he hears or sees and is continually preoccupied with his
worries and anxieties, his helplessness and seeming hopelessness.
With concentration gone he does not attend to the business in
hand. His thoughts wander, his alertness suffers. When his name
is called he may not hear it. His turn for an assigned task is at
hand but he has all but forgotten the purpose of his waiting.

That's what happened to Mona in the butcher shop. Preoccupied
and with her attention wandering she missed her turn and
stood wool-gathering. Perhaps "that woman" paused to see
whether somebody would step forward and when nobody stirred
concluded that she was next in line and quite properly placed
her order with the butcher. The order might have been given
in a vigorous, sonorous voice which aroused Mona from her preoccupation.
When now Mona contended for her "rightful" turn
and insisted that she was "wrongfully" passed by, the remark
made by "that woman" about people sleeping was rather discourteous,
but was it "wrong?"
Mona knew that she tended to be preoccupied, inattentive,
dreaming. In the preceding five years she had amassed a prodigious
record of tasks neglected, things forgotten, remarks not
heard. She knew her defect of not hearing, seeing and recalling
properly. When at the butcher's she missed her cue her first
thought should have been that something went "wrong" because
of her nervous condition; that her attention had wandered again
as it had on so many previous occasions. Instead, she jumped
to the conclusion it was "that woman" who caused her to lose
her "rightful" place. You see, even in this "clear-cut" case there
are two sides to the story, and it would take a very wise judge
to decide which was the right and which the wrong side. Mona
looked at her own side of the story only. The part of the story
which could have been told by "that woman" was thoroughly
neglected. It is the distinctive mark of the so-called intellectual
to emphasize or over-emphasize one side of an issue only,
usually his own side, and to look away from the other side.
Much of what I have told you in the past ten years about temper
can be safely condensed in the one concise formulation: temper
is, among other things, the result of an intellectual blindness
to the "other side of the story."
When Mona exclaimed, "How yellow I was," she stepped from
the sphere of intellectualism into the realm of romanticism. I
do not know precisely how the colloquial expression "yellow"
came to acquire the meaning of cowardly, low-spirited and fainthearted
behavior. But somehow it must have derived from

the idea that a "he-man's" blood must be red and not yellow,
or that a man must be able to get "red in the face" or "see red"
in order to lick the fellow who dares step on his toes. This
romantic view assumes that excitement is the spice of life, that
if you want your daily existence to be interesting and stimulating
you will have to assert yourself and draw first and strike fast.
You must show red blood and not a green yellowish bile. Be
that as it may, you will realize that temper is born from the
intellectual theory that you are the judge to decide who is
right, and from the romantic conviction that a person is not
worth his salt if he shirks a fight. If you object that a woman
of Mona's type, endowed with a disarming sweetness of manner,
could hardly be charged with intellectual rudeness and
romantic combativeness I shall remind you that temper has
precisely this effect that for the duration of the outburst, it abolishes
refinement of culture putting in its place the coarseness
of raw nature.
Why did Mona feel the urge to rant about her experience for
hours and tell her story "to everybody who would listen?" A
story endlessly repeated becomes stale and hackneyed and monotonous.
The listener is bound to respond with weariness, boredom
and disgust. If Mona's objective was to convince her listeners,
to gain their consent and endorsement a concise recital
of the episode would have served the purpose far more effectively
than the tiresome rehashing of the story which the countless rehearsals
were certain to deprive of its freshness and plausibility.
Let me state briefly that this ceaseless recounting of experiences
is at the root of what may be called the "complaint hobby." My
patients are generally addicted to this hobby, and Mona, in her
pre-Recovery days, was one of its devotees.
The main pride of the average person is that his views, opinions,
plans and decisions are right, sensible and practical. Essentially,
this is a claim that the thought processes are solid,
that they can be depended on to prove true, in short, that their
premises and conclusions are valid. This may be called the
intellectual claim to validity. A parallel ambition o the average
individual is to prove to himself or to others that his heart is "on

the right spot," that he is emotionally responsive, ready to fight
for his rights and to defend his convictions. His feelings and
sentiments, he insists, are generous, noble, vigorous and vital.
This is the romantic claim to vitality.
The abiding distress o the nervous patient is precisely his
inability to trust the validity of his thoughts or to have pride
in the vitality of his feelings and sentiments. He states it as his
opinion that his suffering is unbearable and is not even listened
to. He repeats untiringly that he is doomed, that he is threatened
with collapse, but his predictions, failing to come true,
are ultimately laughed at. The fact that he cannot secure a respectful
hearing is proof positive that the validity of his statements
is doubted or ridiculed or rejected. His feelings and sentiments
share the same melancholy fate. He protests that his
interests in family, business and social obligations are as vigorous
and vital as ever; that he neglects them only because of his
handicap, but is told to quit being lazy and to use his will-power.
With this, his vitality is indicted. He aches to prove that he is
both valid and vital, but his words fall on deaf ears and his
pleas meet with dull responses. Exposed for years to the skepticism
and ridicule of those around him he finally accepts their
verdict that he is basically lacking both qualities. Then comes
the temperamental spell It works a miraculous transformation.
All of a sudden he is aroused to a fit of anger. He fumes and
raves; he is indignant and fairly panting for a fight. What else
can that be but strength, vigor and vitality? And that insult
that was hurled at him by "that rascal" was clearly and undoubtedly
an injustice, an unprovoked attack. That he is right
and the other fellow wrong cannot possibly be questioned. In
a "clearcut case" of this kind, who but a fool or knave could
challenge his premises and conclusions? The temperamental
spell re-establishes as with magic his intellectual claim to validity
and his romantic claim to vitality. No wonder he is eager to
rehash and rehearse and repeat the story to "everybody who
would listen." He has found a convincing story and interested
listeners, and he is going to make the utmost of the opportunity.

Lucille, on the Saturday panel, reported that some time
ago she bought an ashtray and "just loved the looks of it."
She showed the new acquisition to her sister Martha expecting
to be complimented on her good taste. But the sister,
little impressed, burst out laughing. "Why," she exclaimed,
"that's no ashtray. It is something to hang on the wall.
Don't you see it has a hole in it?" An argument developed,
Lucille insisting it was an ashtray "for sure" and the sister
claiming with equal insistence that it was a wall decoration
"at best" and "certainly not an ashtray." Lucille was upset.
"I hated to admit that I had made such a silly mistake. But
I checked my temper and refused to continue the argument
.... A few weeks later I was in the same store where I purchased
the dish and saw it was still on sale there. Just for
curiosity I asked the salesman what kind of an article it
was. "Why," he said, "these are ashtrays." I felt the impulse
to rush home and tell my sister that she had been wrong
but that would have led to an argument again and might
have given me my symptoms. When I arrived home I said
nothing about my conversation with the salesman and felt
proud that I could exercise self-control."
What Lucille and Martha fought about was not the ashtray
or its possession or its value. The contest was to decide who of
the sisters was more competent in discerning the meaning of the
otherwise paltry and insignificant object and finding the proper
name for it. As such it was a matching of wits in which the
question at issue was: Who knows better? Whose is the superior
intelligence? Bursting with contemptuous laughter Martha
indicated that in her mind Lucille figured as a dunce, a person
who did not know the difference between an ashtray and a wall

plate. Lucille, with the humility born of persistent Recovery
training, retired into silence, tacitly admitting that perhaps she
did not know, that perchance her intelligence had its limitations.
To admit one's limitations is humility, to insist on one's superior
knowledge is vanity. Martha was vain, Lucille was humble.
I well remember the time when Lucille used to come to my
office complaining about her choking and sweating and palpitating,
her air-hunger and pains and numbness. All I had to
do was to inquire about her recent experiences at home to find
the unfailing source of her symptoms and distress. It was invariably
battles with her sister, her son and husband about sheer
trivialities in which she was "sure she knew and was right" and
the others contested her claim and were equally "sure she did
not know and was wrong." From these battles about superior
knowledge Lucille emerged regularly prostrate with agony and
weariness and torturing symptoms. In those days the vanity
of proving her superior knowledge rocked her body with endless
turmoil and torment. Today, with a humble awareness of
her average limitations, her body is in repose and her mind at
peace. Which method effected this transformation of a vain
superiority hunter into a humble person mindful of her average
You who have gone through the process of training in Recovery
techniques know that the method is that of spotting.
From what you have been taught in Recovery you know that
everybody, not only my patients, has the natural impulse to
prove the superiority of his thinking abilities (intellectual validity)
and to demonstrate the exquisite quality of his strength,
forcefulness and prowess (romantic vitality). Both impulses
result from claims. The intellectual person claims he knows
better how to -think, the romantic individual has the equivalent
claim to know better how to act. Both insist they "know" and
know better. This claim to know better, being a claim, is nothing
but a pretense, a vanity. The trouble is that your brothers and
sisters and friends have the same variety of claims and vanities,
belonging as they do to the same universal tribe of romantointellectuals
who people this globe of ours. All you have to

do is to advance your claim of superior knowledge and they will
promptly feel that their identical claim was challenged. Your
statement will be hotly contested and stiffly resisted. This merry
exchange of claims and counterclaims we call temper, and its
essence is that vanities clash and pretenses collide. The violence
of the clash and the heat of the collision produce anger; the
anger gives rise to tenseness which, in nervous patients, precipitates
symptoms. If my patients are to be rid of their symptoms
they must learn to dispense with the vanities of claiming superior
knowledge and to cultivate the humility of realizing their limited
efficiency in thinking and acting. This requires continuous
and unrelenting spotting, the pre-eminent method of self-control
taught you in Recovery.
In order to spot your temper correctly you must give up your
claim to know, to know more and know better. This ought to
be easy. It ought to be easy to drop a claim which is nothing
but a pretense, a vanity, an illusion. The tragedy is that the
illusion of superior knowledge provides you with stimulation,
excitement, thrill. It gives you an opportunity to fight, to score
a victory, to prove your shoddy excellence and spurious value.
Your symptoms make you feel helpless. They deprive you of
your vitality, of zest and self-confidence. Dragging along day
after day, tired, weary, listless, despairing of ever again experiencing
the thrill and rapture of being alert and dynamic you
crave the exhilarating sense of being vigorous, vital and selfassured.
As it is, with your symptoms straining your energies,
with your nervous fatigue sapping your efficiency, you miss the
spark of life, the stimulation of interest, the throb of spontaneity.
You would do anything to recapture that delightful feeling of
being alive, active and forceful. Along comes the occasion for
a temper outburst. You feel challenged to maintain your claim
to superiority. True, it is nothing but a claim, a preten-se and
vanity. But if it promises to restore, even for a few minutes,
your waning sense of vitality you will plunge into the fray and
again live through the rapture and ecstasy of fighting and proving
to yourself that your vitality, far from being exhausted, is
again brimming with energy, throbbing with life. If a miracle

of this kind can be performed by the sheer claim to know better,
well, let it be a pretense, a vanity and
It has the mysterious
capacity to restore vitality and spontaneity and if spotting
it correctly is likely to undo its effect you ^
will strain every
nerve to avoid spotting. You will rather retain your symptoms
than relinquish the supreme thrill of a rejuvenated vigor.
And memory is fresh yet of the days when I grappled with
Lucille trying to persuade her that the thrill provided by the
tantrum is nothing but a momentary exhilaration certain to
be followed by intensified suffering and aggravated symptoms.
She listened and seemed convinced but when the occasion for
a temper reaction arose she craved the thrill and yielded. One
day she came to my office beaming with joy. She told the story
of how she felt provoked by a neighbor, how her temper rose
and she controlled it. "After that/' she continued, "I was relaxed
and as comfortable as never before. I really felt proud
of myself." She had hardly completed the sentence when a
shadow settled on her face. "Doctor/' she said, "if I feel proud
of myself doesn't that mean that I am vain instead of humble?"
I asked her, "Is a mother vain if she is proud of her child? A
wife if she adores her husband? A citizen if he basks in the
glory of his country?" And I went on explaining that to be
proud of actual and realistic accomplishments is desirable and
valuable. What the mother prides herself on is the effort and
labors and deprivations which the raising of the child entailed.
She is proud of her self-effacing or self-control. And if a wife
is proud of her husband be certain that what she has in mind
is his accomplishments which are the result and product of his
self-control, and similarly with the citizen extolling the virtues
of his nation. These virtues are an index to the labors, successes
and exploits of past generations which were secured at the cost
of vigorous group discipline and collective self-control. Lucille
understood. As I continued my explanations she grasped the
fact that every act of self-control produces a sense of self-respect.
This self-respect is a form of pride. Another form of pride
is vanity. The latter does not point to actual and realistic
accomplishment, to no effort or self-discipline. It is merely a

claim, pretense and illusion. Lucille learned the distinction between
the two varieties of pride, the one realistic, the other
illusional. Realistic pride leads to self-respect, repose and relaxation,
illusional pride or vanity, to self-torturing, momentary
thrill and enduring tenseness. In nervous patients it leads in
addition to perpetuation of symptoms.
Many a patient has told me, "I have learned to control my
temper outbursts. I no longer want the victories of vanity and
prefer the peacefulness of humility. But my fears are still active."
With the one patient it is the fear of collapse, with the
other the fear of the permanent handicap. These fears do not
seem to stem from the vanity of knowing better. To the contrary,
a fear appears to be the expression of a shrinking and
retreating disposition, hence, to be related to humility rather
than vanity. But when I try to explain to a patient that his
fears are groundless; that they are due to a thought of insecurity
in his brain; that he can dispose of this thought if he accepts
my authoritative knowledge; that he can brave his fatigue and
step out forcefully without any danger of collapse; when I tell
him that his so-called sleeplessness is a myth; that even if he
feels he hasn't slept, nevertheless, he did a good deal of sleeping
and perhaps of snoring; when I confront him with the store
o my knowledge about these subjects and point to my solid
experience of half a lifetime he argues and opposes and clings
stubbornly to his notions and engages in insipid verbal fencing
and knows better. He knows he has not slept a wink last
night; he knows the fatigue is "real" and not nervous; he is
certain his head pressure is the result of hypertension. And when
I take his blood pressure and assure him that it is within normal
limits and nothing to worry about he is likely to counter with
the exclamation, "But doctor, when I arn in your office I relax
and my blood pressure goes down. I am sure it will go up
the moment I step out on the street." You see, whether it is
the angry or fearful temper the situation is the same. The
patient "knows better." He is an arch romanto-intellectual who
knows and is sure and cannot be convinced without a long,
drawn-out struggle. If he is to be cured he must be trained to

assume a humble attitude and to divest himself o the vanity
of knowing. The road to humility leads through spotting to the
determination to abandon the craving for the divine thrill of
knowing better.

Betty, on the Saturday afternoon panel, reported that
several weeks ago she had an appointment to see Dr. Low
at his office. "I had to wait from 2:30 to 4:00 P.M. Then
I had to go shopping for a belt and a pair of shoes. After
that I had to go to the insurance office and to be there before
closing time. At the department store I had to spend
time picking the merchandise I wanted. Then it took more
time yet before the saleslady took care of the purchase. I got
to the insurance office just five minutes beiore closing time.
By now I had a severe head pressure, and when I was on
the street it occurred to me that I had to get a few things
for supper and that after supper I had to attend the monthly
Recovery meeting of the panel members in the evening. The
head pressure became worse and I felt exhausted. Finally
I arrived home, trembling and sweating and palpitating.
Then I noticed that my husband had not returned from
work although it was past his usual time. My first thought
was that something had happened to him. My symptoms
became worse. Then I remembered my Recovery training
and thought I shouldn't anticipate danger. Instantly I felt
better . . . ."
Betty, in an emotional upheaval, summoned forth a slogan
she had learned in Recovery and obtained instant relief. Experiences
of this kind are now commonplace among our members.
They know that all they have to do to stop emerging
symptoms is to spot their emotionalisms and to refuse to accept
the suggestions of doom and disaster offered by their temperamental
lingo. And if Betty managed to secure instant relief
from her spotting the conclusion seems inevitable that she spotted
correctly and applied the appropriate technique taught her in

Recovery. But Recovery techniques and Recovery maxims stem
from me, your physician, and if it is true that I ever taught
Betty or anyone else not to anticipate danger I must have been
dreaming or utterly careless in the choice of my words. How
can anybody be alive and avoid anticipating danger? To be
heedless of danger is a sure prescription for running straight
into it. Just cross streets and turn corners unmindful of the
dangers of a busy traffic and I will not want to be responsible
for what might happen to you some day. Clearly, Betty applied
a Recovery slogan correctly but in quoting it distorted its phrasing.
No wife worth the name can avoid uneasy thoughts and
anxious anticipations if her husband is unduly late in arriving
at the customary time. The image of an accident, of collapse and
even misgivings about foul play must of necessity arise in her
brain if she is possessed of affection and imagination. In a situation
of this kind the thought of possible danger is the unavoidable
and proper response. No teaching of any kind, Recovery
or otherwise, will ever be able to eliminate this response which
is necessary for life and desirable for human relations. The
question is how a person experiencing the response of apprehension
will react to the experience. Will he worry with reflective
calm? Or, will he work himself up to a burst of emotional
hysteria? If he permits himself to become emotional and
hysterical, then, the original response of plain worry has been
"worked up'* or "processed" into a temper reaction. What patients
are taught in Recovery is to curb their tempers and to leave
the original responses to run their course, that is, to let them
rise and fall, come and go. Temper keeps them rising and
coming and prevents them from falling and going.
What I here call "Original Responses" are the ordinary run
of thoughts, feelings, sensations and impulses which, in the
average individual, come and go, rise and fall. They are inherited
and constitutional. A dog jumps at you unexpectedly.
You are startled, and the startle is an original response which
everybody is likely to experience in an event of this kind. It
would be absurd to tell you not to get startled. The response

is rooted in your racial inheritance, embedded in your constitution.
It is original, natural, hardly changeable. Another example :
your ear is assailed by a harsh word or your eye by a disdainful
gesture. If you are at all responsive you will feel hurt or insulted
or shocked. That is again your original response, just
as constitutional and refractory to change as is the startle occasioned
by the dog's jump. Original responses of this kind are
without number. The pity aroused by suffering, the joy and
warmth produced by a smiling infant, the enthusiasm created
by a stirring speech, the delight felt at the sight of a friend, the
anger provoked by an affront, the impulse to run in the face
of dangerthese and a multitude of others are all original
responses. The sum total of original responses which a person
is possessed or capable of are called his temperament. Temperament
means that a person is sensitive, receptive, impressionable
to events inside and outside him. If your temperament is receptive
and impressionable your original responses will be many
and varied; if it is dull they will be few and static. It is temperament
which responds to events with readiness or sluggishness,
warmth or coolness, sympathy or aversion, interest or indolence,
thrill or chill.
When Betty, arriving home, found her husband missing the
thought struck her that something might have happened to him.
Every wife would or should have experienced the same response
provided her temperament was endowed with the average qualities
of warmth, affection and tenderness. If Betty's temperament
was of this description she had to feel concern,, worry or
misgivings. You see here that when temperament stirs feelings
are apt to rise. In the present instance, the feeling was that of
worry. Betty might have acted on this natural and original
response of worry. She might have telephoned to the husband's
place of employment or to any locality at which she could have
reasonably expected him to stop on his way home. Had she
done that her original response would have guided her to a
rational, sane, well adjusted reaction. Or, she might have analyzed
the situation in the light of previous experience and reflected
that her husband's arrival had been delayed frequently

in the past by overtime work, by a traffic jam or by a decision
to have his hair trimmed before setting out on his homebound
trip. This again would have led to a rational and sane reaction.
Betty would have simply waited, calmly and patiently. But
Betty's temperament was not disposed to release the responses
of calm and patience. She is or was a nervous patient, and if
the temperament of a nervous patient stirs it is likely to develop
temper. And you know that temper is incompatible with
calm and patience. Temperament raises mild and moderate
fears, worries, angers and joys. But temper acts differently. Its
responses are always vehement, immoderate, excessive and even
explosive. In her pre-Recovery days, Betty responded to disappointments
with temper. After she had gone through her
Recovery training her responses became again those of her native
temperament, calm, even, sane. In former days her temperament
led her straightway into hysterical emotionalism. Now it produces
feelings of average intensity. Formerly, when disappointed,
her temper suggested a grave emergency. Now her
temperament merely hints at a possible average danger. To
think of danger calmly is undoubtedly wholesome and necessary
in life in general but particularly so in the hustle and bustle
of our metropolitan life. Why, then, did Betty think she
"shouldn't anticipate danger?" Obviously, she confused two
types of anticipation, those generated by a wild temper and
those inspired by a mild temperament. In Recovery she was
taught not to entertain hysterical anticipations in response to
average dangers which merely call for gentle and moderate
worry. When she met with the average situation mentioned in
her panel example her temperament produced the original response
of concern. But unwittingly and following a year-long
tendency she thought of a dire emergency and developed temper.
The result was that her "symptoms became worse." Now
she remembered her Recovery training, spotted her temper and
felt instant relief. She acted correctly but when she reported
the event she used a wrong phrasing. She claimed she spotted
and stopped her temperament when, in actual fact, she put a
stop to her temper. She applied properly the Recovery techniques

for curbing temper but misquoted the implied principle when
she presumed to have checked her temperament.
My patients will do well to ponder the lesson of this clearcut
distinction between temperament and temper. Afflicted
with nervous ailments they are extremely sensitive and the original
responses of their native temperament are aroused by actions,
statements and events which other people, less impressionable,
would overlook and ignore. Somebody maintains silence
in their presence. Instantly my patients are likely to construe
the reaction as slur or indifference or neglect. Or, they commit
a minor blunder or sustain minor losses, failures or defeats.
The average person would take these insignificant mishaps in his
stride and not a ripple of excitement might cross his temperament.
But my patients are apt to respond with self-blame, embarrassment
or a sense of inefficiency. This is in itself no
calamity and merely indicates that my patients are unfortunately
blessed with temperaments which pour forth endless streams
of original responses. The responses as such are no wise different
from those experienced by men and women not the victims
of nervous trouble. Everybody may at any time feel slurred
or neglected and may on occasion indulge in self-blame and a
sense of embarrassment. With the average person such common
inner disturbances are readily forgotten or dismissed. But with
my patients there are no minor or common disturbances. Every
disturbance has to them the major aspect of an urgent emergency.
And if an emergency is thought of emotion is mobilized
and temper released. Minor apprehensions are then fanned into
major explosions, into panics and tantrums. These dramatic
or dramatized developments can be checked if the patient is
trained to regard his worries, embarrassments, misgivings and
forebodings as what they really are: the innocent outpouring
of a temperament which has been sensitized by an endless career
of suffering and has acquired the habit of producing an unbroken
succession of harmless original responses. The nervous patient
will have to learn to be tolerant of his responses and to refrain
from processing temperament into temper.

Florence, on the Saturday panel, spoke with surprising
candor about her marital life. "I was always jealous of
my husband/' she said. "All he had to do was to invite
some girl to ride home with us from church and I became
jealous and felt very insecure. Before I joined Recovery I
did not know that this was temper. I felt I had a right to
ask my husband not to pay attention to any woman but me.
But when I got my Recovery training I learned that I was
not the judge to decide who was wrong and who right.
Today I know that when the jealousy gets a hold of me I
feel irritated but nobody is wrong. I have learned to let
the irritation run its course, and it does that in a few
minutes. And after my jealousy is gone I feel good and
feel proud that I am able to control it. In this manner I endorse
myself and that makes me feel better yet. In former
days when the jealousy came over me it produced a blurring
of my eyes and gave me a headache that would last for
days and my married life was a mess all the time. Today
I have very few of the symptoms and both I and my husband
lead a much happier life than we ever did before I joined
Florence suffered from jealousy for many years but did not
know it was temper. That was before her Recovery training
and at that time she merely "felt" insecure. She also "felt" she
had a right to be jealous. I shall ask: Who or what did Florence
"feel" for? The answer is: She felt for her own security and
for her own rights. She showed little if any feeling for the husband's
security which was gravely threatened by her jealousy,
and for his rights which were ruthlessly ignored when he was
forbidden to extend simple courtesies to a fellow church mem

her. And my conclusion is: Florence, in her pre-Recovery
days, had feelings for her own dear Self only whenever the
jealousy took hold of her. The feelings for the husband were
either absent or feebly operating. Yet, the couple had formed
a life partnership. They were united in matrimony, and the
marital union, assuredly, called for mutual feelings, for sharing,
communicating and exchanging. Instead, whenever she was in
the throes of jealousy, Florence made her feelings flow out
toward her own Self only; the partner's Self was denied its
legitimate share of consideration and affection. If the concern
about security and rights was at all the outcome of feelings
they were certainly self-centered and not group-centered. And
self-centered feelings (self-pity, self-blame, self-disgust, self-importance)
are temper, of course. For you, the members of Recovery,
this is commonplace and needs no explanation.
Florence aimed her jealousy at her husband. Since he was her
partner in their marital group the feeling was group-oriented
although in a superficial sense only. But it declared the other
person as wrong and oneself as right, and that quality stamped
it as unquestionably temperamental. Her jealous temper led
Florence to be resentful, sullen, suspicious, indignant, perhaps
also hostile and vengeful. All these feelings tie in with jealousy,
their main characteristic being that they adjudge the other person
as wrong and oneself as right. Though they must be
classed among the group-directed responses, nevertheless, they
are tempers.
Many of you remember the time, some eighteen months ago,
when Florence first joined Recovery. None of you realized
that she was of a jealous disposition. How could you know?
She never showed temper when she was with us. She was unfailingly
sweet, considerate, patient, forever willing to be helpful.
As a member of our group, she displayed a vast capacity for
joy and enthusiasm, affection and forbearance, devotion and
selflessness, fellowship and compassion. Needless to say, these
were feelings, group-centered with regard to their aim, genuine
in intent, sincere in application. As such, they were emphatically
not temperamental. Her affection had, of course, no impli

cation of somebody being branded as wrong and herself extolled
as right. Feelings of this kind whose exclusive tendency
is to benefit and serve the group go by the name of sympathetic
responses. They may properly be called the feelings of sympathy.
By their very nature they cannot be suspected as furnishing the
material out of which temper is woven.
You will also remember that at times Florence appeared in
our midst with drawn features and a worn look. Her mood
was depressed, and her depression, we know now, was largely
the result of her physical ailment. In these periods of depression
her countenance reflected silent grief, a soft resignation, a touching
sadness. But there was no wailing and complaining, no
self-pity or self-blame. Nobody was assessed as wrong, nobody
as right. She just suffered in placid resignation. Feelings of
this kind signify a lowering of the feeling tone, from joy to
grief, from sympathy to apathy. They are known as the apathetic
responses and may be fittingly called the jeelings of apathy.
My opportunities for observing Florence were limited to
office, classes and meetings. I had no occasion to study her behavior
in such casual situations as encounters with sales persons
and elevator operators, in chats with neighbors and friends,
at card games and on visits to theatres. What was the nature of
her responses in these contacts? We know that Florence is a
warm person, easily stimulated and eagerly responding. So we
may take it for granted that in most instances her reaction was
mainly that of sympathy. Occasionally, more particularly when
her severe physical ailment dulled and lowered her receptiveness,
her attitude might have been that of apathy. But when
an idle sales girl, busy with her make-up, kept her waiting impatiently
at the counter; when a neighbor was sharp and a
friend neglectful; when her bridge partner spoke in a sarcastic
vein, or when an unmannered person, with tactless remarks and
distasteful noises, prevented her from enjoying a show, we may
safely assume that she was a prey to irritation, annoyance or
outright anger. Under circumstances of this sort it was more
than likely that she was chilled in her sympathy, roused from
her apathy and seized with antipathy. Was this a feeling? Or,

was it temper? The answer is plain: if she was merely irritated
and annoyed it was a more or less unadulterated feeling;
if she proceeded to condemn the offender as wrong and to exalt
herself as right it was temper. You will now understand that
feelings are of three kinds: sympathy, apathy, antipathy, either
toward oneself or others. Temper is of one kind only: antipathy,
against oneself or the other person, plus the judgment of right
and wrong. On the basis of these formulations we may sum
up the meanings of the various reactions displayed by Florence.
When she was moved by jealousy she was resentful, sullen,
suspicious, indignant, perhaps hostile and vengeful. This was
antipathy plus judgment of right and wrong, hence, temper. When
she was free from jealousy she responded with genuine
or tolerably genuine feelings of either sympathy, apathy or antipathy
with no judgment of right and wrong marring the
relative purity of the responses. This was feeling without admixture
of temper. As everybody does, Florence expressed both
feeling and temper.
Feelings should be expressed. This does not mean they ought
to be acted on or acted out. It merely means they should be
communicated to or shared with somebody who can be trusted
to understand them. If the feelings are those of sympathy their
expression will create good-will and, thus, further the interests
of the group. If they are those of apathy or antipathy their expression
will give relief to the person oppressed by them. Obtaining
relief, the oppressed person will be purged of antisocial
trends, and the ends of the group will thereby be promoted.
This is different with temper. Feelings can be reported. They
lend themselves to matter-of-fact discussion and calm appraisal.
But temper, involving a claim to being right, cannot be reported
objectively, calmly and matter-of-factly. It invariably
leads to arguments, debates and rebuttals. Even close relatives
and intimate friends, asked to pass a verdict on the justifica
tion of a temper outburst, may and frequently do voice disapproval,
criticising the uselessness or harmfulness of the explosion.
If the temperamental person resents the rebuff a new
temper reaction is released, this time involving the relatives and

friends. The result is that the temperamental hothead obtains
no relief from his tension and group life is disturbed. Temper
should be checked and controlled. It should not be given any
expression at all. It should merely be avoided or, once it has
occurred, it should be prevented from recurring. Feelings call
for expression, temper for suppression.
Florence needed training in Recovery to learn that temper is
different from feeling. Why did she fail to make the distinction
herself? She has a keen intelligence and a refreshing willingness
to learn by experience. Her intelligence could have told
her that most feelings are noble, that even those that lack the
attribute of nobility are not likely to injure the group. By the
same token, she could have discovered, by sheer use of her
native intellect, that temper, far from being identical with feeling,
is its very opposite. It is positively ignoble and disrupting
group life. And should she have consulted her past experience
she could have easily learned the fact which I mentioned, that
feelings, when communicated, give relief while temper has no
such effect. How is it her intellect and experience failed her?
The answer is that men and women derive their views not
merely from their own observations but mainly from public
opinion. And contemporary public opinion has fostered a type
of thought which glamorizes temper by the clever trick of identifying
it with feeling. The trick is of an engaging simplicity.
Temper and feeling, in the present-day psychological jargon,
are deftly lumped together under the common name of emotion,
and emotion is nimbly interpreted as feeling. The next
step in the argument, assiduously promoted by modern psychologies,
is that emotions, being the driving power in the human
economy, are infinitely more important than intellect. And
since intellect is generally considered as a valuable function
the conclusion drawn by the average person (and by professionals)
is that emotions being superior to intellect must also
be of superior value. With this, emotion is not only glamorized
but also raised to the rank of dignity and nobility. This view,
given wide currency by recognized professions, leading universities
and philanthropic foundations, has found its way into the

channels of communication with the result that dailies, weeklies
and monthlies, radio, film and television fairly vie with one another
in the gentle art of catering to unbridled tempers carefully
avoiding the odious word and slyly substituting the terms
"emotion" or "emotional experience." Antisocial impulses, born
from dark temperamental dispositions, are then portrayed as
"just emotions," as "plainly human," indeed, as of valuable "human
interest." True, these emotions (read: tempers) may also
be troublesome; they may cause tenseness, maladjustment and
symptoms. But the newer psychologies have wisely anticipated
this unfortunate inconvenience and provided a suitable remedy
by spreading the gospel of "free expression" of "emotional"
frustrations and aggressions. That this vicious doctrine of free
expression has had a prominent share in the spread of both
individual and social tenseness and of all kinds of antisocial
trends is plain but will not be elaborated here. What interests
me at this point is the deplorable fact that my patients have
been exposed to the sinister influence of this modern dogma of
the identity of temper and feeling and have been reached by
the insidious propaganda carried on by textbooks, by the stage
and the press to the effect that ungoverned emotions (read: aggressive
tempers) can be cured by the expedient of "free expression."
Well, Florence, under the influence of an utterly irresponsible
public opinion, gave formerly "free expression" to her
temper and almost wrecked her marriage. Today, when through
old-fashioned Recovery teaching she has recovered her mental
balance, she expresses her feelings but suppresses her temper and
with temper curbed, her feelings, properly communicated and
shared, spread their warmth and glow over a happy marital

Ada thought she was rid of the fear of being alone in
her home. For years her sister who occupies the apartment
next door was not permitted to leave unless she took Ada
with her. But "for the past couple of months," Ada related,
"my sister left me alone, and I handled myself very
well." This splendid record of improvement was suddenly
interrupted by that severe reaction which is known to our
patients as the well nigh unavoidable setback. On the morning
of the panel discussion, Ada's sister announced she was
going to a luncheon. Instantly "a ball of fire shot into my
face. I felt dizzy; my heart palpitated, and the room was
going around and around. I meant to plead with my sister
not to leave. But I had too much Recovery training to do
that* I rushed to the phone and called Rosalie. She reassured
me. But soon after my sister was gone I felt tense
and fearful. Before long I had myself worked up into a
panic. I dashed at the phone and called my husband. He
suggested a walk, but I was so weak I could not drag my
body. At that moment I thought of our Recovery training
and became disgusted with myself. I felt ashamed that
I had practiced such dreadful sabotage. When this thought
struck me I felt calm all of a sudden, picked up my sewing
and kept sewing till after lunch. And now I am here sharing
in the panel, and I am all right."
Ada's experience illustrates three points: (1) that patients
after they recover, are apt to have setbacks; (2) that the setback,
usually mild, may attain the violence of a panic; (3) that
with proper Recovery training, even the wildest panic can be
broken in a fraction of a second. I told you frequently that in my

very extensive experience I have met few nervous patients who
did not suffer from setbacks after they improved. Therefore, it is
of the utmost importance for all of you to know how to deal
with setbacks, more particularly, how to deal with them if they
threaten to develop into a panic.
A panic must be broken, abruptly and decisively. If it is
permitted to go on unchecked the danger is it will leave the
patient discouraged and demoralized. He may then give up the
fight for health, reflecting that "what's the use struggling if even
Recovery cannot help me." The result will be the defeatist belief
that once a nervous ailment becomes "chronic" it is incurable.
You know that our Recovery language calls this the "fear
of the permanent handicap."
In the ordinary man's language, as distinguished from Recovery
usage, the word "panic" connotes a condition in which
a person is gripped by a violent fear that is overwhelming and irresistible.
It is a fierce storm that lashes the organs of the body
into a frantic burst of palpitations, sweats, dizziness, air-hunger,
tremors, tenseness and weakness. If that storm is overwhelming
how are you going to check it? If it is irresistible how will
you resist it?
Common language speaks of "irresistible" impulses, emotions,
tantrums and spells. Recovery denies emphatically that
any inner experience of the nervous patients is irresistible. It
knows of situations only that were not resisted. This refers
to common everyday experiences, the common tantrum, the common
crying spell, the common anger and common fear. All
of them can be resisted, none are irresistible.
Diseases cannot be resisted. If a patient is seized with a prolonged
depression of his mood I shall not tell him to resist the
depression. He needs expert medical treatment. But a depression
of this kind is not a common everyday experience. A few
other experiences may fall into the same category. If a mother
loses her child her sadness may have an irresistible quality.
This is perhaps true also of the condition of "being in love."
Whether human beings, except in certain brain diseases, can
develop a truly "irresistible" rage I do not know but I have

reason to doubt it. You will realize that the grief of the mother,
the infatuation of the lover and the blind rage of the person
ravaged by brain disease are not common, everyday situations.
The tantrums and panics which our patients experience in
the course of a setback are common, everyday occurrences;
they are the result of nothing more unusual than temper. Ada
suffered from an ordinary, commonplace temper outburst and
"worked herself up" till she drifted into a panic. Soon she felt
ashamed and disgusted with herself and dropped the panic as
you would a silly thought.
Thoughts can be formed and reformed; they can be accepted
and rejected; they can be retained and dismissed. Feelings are
of a different make. You cannot change, reject or dismiss them.
They descend upon you, and you must wait until they depart.
Ada formed a temperamental idea, worked it up to a pitch,
then rejected and dismissed it.
Ada was enabled to perform this feat because of her Recovery
training. In the language of Recovery, temper is distinct from
genuine feeling. The sadness of the bereaved mother is a
genuine feeling. That feeling is original, primary and pure. In
contrast, temper is derived, secondary and adulterated. I shall
try to explain these terms. Every feeling has thoughts attached
to it. A sad person is bound to think that the world is flat and
stale. In this instance, the feeling of sadness produces the
thought of staleness. It is not so that the bereaved mother
forms first the thought that the world is stale and, consequently,
falls prey to sadness. The reverse is true: she is first sad and
then thinks the world stale. The feeling of sadness is original,
the thought of staleness is derived from the feeling of sadness.
You can express the same relation between feeling and thought
if you substitute "primary" for "original," and "secondary" for
"derived." You will then understand that, in the instance of
the mother, the feeling of sadness is primary, and the thought
of staleness secondary.
The terms "purity" and "adulteration" are easily explained.
The mother feels sad, pure and simple. She is not angry, fearful,
jealous or envious. She has no desire to dominate others,

to be consoled by them. She is just sad, and her feeling Is not
contaminated by an admixture of other feelings. It is original,
primary and pure, i.e., genuine.
Contrast now this genuine feeling of sadness with Ada's temper
tantrum. In Ada's own words, after the sister left, "before
long I had myself worked up into a panic." The feeling did
not descend on her; she "worked" on it, produced it and fanned
it into a lusty fire by means of inflammatory thoughts. What precisely
was the nature of her thoughts? Ada says it \tats the idea
of being left alone, the idea of helplessness, the idea of perhaps
needing help and not getting it. If that was true she could
easily remedy the situation; visiting a friend or merely going
for a walk, or to a show would have cured the loneliness. Instead,
she "worked herself up." We know what that means. It
means that Ada now gave herself up to all kind of sinister
thoughts. "The nerve to leave me alone. They know I can't
stand it. What do they care how I feel? All my sister thinks
of is her own pleasure. My suffering means nothing to her.
Etc., etc." You see, the train of ideas that set temper afoot
and keep it growing are the familiar resentments and indignations
that find their simple expression in the temperamental
phrase, "They are wrong." Dwell on this thought, expand and
deepen it, and the sky is the limit to which you may "work yourself
up." Ada had the idea of herself being right and the sister
wrong. That thought produced a feeling which, being derived
from a thought, was not original; and being adulterated with
resentment, indignation and vindictiveness, was not pure. Lacking
the qualities of originality and purity it was not genuine.
A thought produced it, and a thought could drop it.
Ada, a loyal member of Recovery and devoted disciple of its
teachings, knows the meaning of temper. She knows that the
thought, "I am right, and they are wrong," is an utter absurdity.
She has undergone thorough Recovery training and undoubtedly
has discarded the arrogant attitude of being a judge on the rightness
and wrongness of actions. If she has learned anything she
certainly learned the Recovery principle that right and wrong
must be no issues in domestic and social contacts. If, in her

tantrum, she endeavored to revive a thought that she had discarded
she obviously tried to deceive herself into believing
something she no longer believed. You heard me frequently
state that temper is an effort to deceive oneself into the belief
that somebody is right and somebody else wrong. Ada tried
to practice the temperamental self-deception but did not succeed.
All she accomplished was to "work herself up." The
emotional flame which she was able to fan into existence had
a great deal of sentimental smoke and verbal fury but lacked
the genuine fire of feeling. A mere breath of1 common sense
suddenly remembered from her Recovery training extinguished
the weak conflagration, and when cool reasoning cleared away
the smoke of excitement Ada noticed that not even embers and
ashes were left. She was calm, resumed her sewing and "kept
sewing till after lunch.
5 * The emotional storm was nothing
but shallow and empty self-deception. The feeling that steered
it was shallow; the thought that directed it was empty.
Whether pure and genuine feelings exist anywhere in this
imperfect life of ours is doubtful, the only possible exceptions
being the instances cited above. Even a mother's love for her
child is ordinarily adulterated with the sense of possessiveness;
the lover's affection is frequently contaminated with some stirring
of jealousy or vanity. There is perhaps no purity, hence no
genuineness, in the sphere of common human feelings. And
if I tell my patients that their temperamental feelings of anger,
fear, disgust lack genuineness I merely wish to remind them that
their explosions, tantrums, impulses and obsessions share the
fate of all human feelings. They are mixed and adulterated
with other feelings and overlaid with all manner of thought.
Not being genuine they lack the irresistible force that is credited
to genuine feelings. Being largely directed by thought they can
be originated and dropped at will as any thought can. Keep
that in mind, and you will have little difficulty disposing of your
temperamental upheavals.

Clara, in the course of a panel discussion on "Sabotaging
Sleep," commented on her difficulties of sleeping which
she experienced prior to her Recovery training. "I would
awaken from a nightmare; I was shaking and sweating
and my heart pounded and I felt as if nothing in the room
looked familiar. I was sure I was dying. The first thought
I had was to awaken my husband and ask him to hold my
hands .... There was no rest for me. I felt scared and
was waiting for that something awful to happen .... Today
when I awaken at night I instantly know that my sensations
are not dangerous. I wait and though I am not comfortable
I lie still in bed and do not think of waking my husband.
In a short time I fall asleep again."
When Clara was "sure" she was dying she asked her husband
to hold her hands. Then she waited "for that something
awful to happen." But it would seem that if death threatens
it would be wiser to summon a physician than engage in the
serene practice of holding hands. From this I conclude that
Clara was not at all sure she was dying. Indeed, the inference
is inescapable that she was "sure" she was not dying. You
may question the propriety of casting doubt on Clara's account.
Is Clara a liar? Assuredly, she is not, A liar deceives others.
What Clara did was to deceive herself. She believed something
which, judged by the standards of genuine experience, is impossible.
She thought "for sure" she was dying, but she did not
experience the fear of death.
Clara spoke of a nightmare, of shaking and sweating. The
look of things had changed and she was scared. All of this points
unmistakably to fear. And if I stated that she did not experience
the fear of death what kind of a feeling was it that produced

all these frightening reactions? It certainly was a fear and most
intense at that. Why do I refuse to call it the fear of death?
I told you that Clara with the "certainty" of death in her mind
asked her husband to hold her hands. Suppose a baby is seriously
ill, and the mother makes ready to go to a dance. You
will conclude that this mother has strong feelings for dancing
but none or very dull ones for the fate of her child. How did
you arrive at your conclusion? You observed an act (the mother
preparing for a dance) and gathered that a feeling (for the
baby's fate) was weak or missing. The point I wish to make
is that a given act may or may not fit into the pattern of its
underlying feelings. Or, acts and feelings may or may not match.
Clara's act (of holding hands) was not properly matched with
her professed feeling (of fearing death).
An act expresses a feeling and a thought at the same time.
The act of tending the baby, for instance, expresses the mother's
feeling of love and also her thought of what the baby needs
or what is best for it. In this combination, the feelings and
thoughts are the inner experiences, and the acts their outer
expressions. If an act expresses a feeling in its true and real
significance then the meaning of the act matches the meaning of
the feeling. If the matching is thorough we say that the outer
act gave genuine expression to the inner feeling. This is different
with thoughts. They are not judged from the viewpoint
of genuineness. Instead, they are considered as either sincere
or lacking sincerity. If an act really and truly matches the
meaning of the inner thought the expression is said to be sincere.
If act and thought fail to match the expression is insincere.
When Clara, awakening with what she calls the terror of death,
roused her husband to hold her hands did her act of behavior
express genuine feeling and sincere thought? Did her outer
act match her inner experience?
A mother craving amusement while her baby is sick may
feel some sort of affection for her suffering offspring. But her
act of going to a dance does not match the feeling of motherly
love. It matches another feeling, namely, the feeling of boredom
and the love of excitement. If, while preparing for the outside

engagement, she explains in so many words that, after all, a
competent nurse is in attendance and the physician within easy
reach her act of speech expresses an insincere thought. That
thought is not focused on the welfare of the baby; it is merely
offered as a face-saving excuse for an inexcusable neglect. The
inner experience and outer expression mismatch. The feeling
lacks genuineness, the thought bears the mark of insincerity.
The real meaning of Clara's behavior ought to be clear by
now. The feeling of approaching death, if genuine, can only be
matched by a life-saving act, for instance, an emergency call
to a physician or the instant rush to a hospital. Holding hands
is no such life-saving performance. All it can be reasonably expected
to give is comfort. If what Clara craved was to be comforted
her feeling must have been that of discomfort, perhaps a
very intense and torturing sort of discomfort. Even if you add
that she feared not to be able to stand up under the "terrific"
strain, if you add further that the harrowing vision of a night
of never-ending torment caused an almost unbearable fear,
nevertheless, the feeling was that of discomfort, nothing else.
It was not a genuine feeling of threatening death. That Clara
was "sure" she was dying contributes nothing to the situation.
Feeling and act were decidedly mismatched. Was her thought
of death sincere? Well, I have no record of what she expressed
in words about the kind of thought which dominated her brain
at the time. But it would be easy to reconstruct her thinking
processes on the basis of experience with a multitude of patients
in similar pseudo-emergencies. Their first thought was that
the husband will again refuse to believe their protestations,
that the reality of their agony will be doubted, that their anxious
outcry will not be taken seriously. But with a sincere thought
of impending death the only consideration that will match the
inner experience is the necessity for securing instant help and
not the desire to be believed. No doubt, Clara's feeling of death
approaching was not genuine, her thought of life ebbing away
was not sincere.
Feelings lacking the mark of genuineness and thoughts devoid
of the touch of sincerity are the commonest features in the lives

o average individuals who being just plain average are neither
leaders nor saints nor heroes. Lack of genuineness and sincerity
are indeed the warp and woof of daily existence. And
if Clara is frequently insincere in her chats with neighbors and
in her dealings with tradespeople, i following the common pattern
she displays little genuineness in her devotion to civic
virtues and social obligations she is just average with all the
failings and deficiencies characteristic of average endeavors. But
Clara is a nervous patient endowed with a nervous system that
is unduly sensitive to tenseness, and if she practices insincerity
and lack of genuineness with regard to her symptoms she will
misinterpret discomfort as meaning danger and the result will
be panics and vicious cycles. With reference to his symptoms
a nervous patient must be genuine in feeling and sincere in
In order to practice a suitable degree of genuineness and
sincerity patients must be made to know that their inner experiences
if applied to symptoms are woefully lacking these
qualities. To know one's inner experiences means to gain insight,
and insight requires spotting. The very moment the
feeling of fear stirs in his body and the corresponding thought
of danger rises in his brain the patient must instantly spot the
condition as one of severe discomfort with no danger attached.
Continuous spotting disposes of insincerity and lack of genuineness.
What Clara demonstrated and demonstrated with
singular force was that after a relatively brief training period
in Recovery she is now able to spot her frightening inner experiences
as being nothing but silly emotionalisms or inane
rationalizations. Having acquired these insights she is in a
position to redirect her acts and to match them properly with
her experiences. When she said, "Today when I awaken at
night I instantly know that my sensations are not dangerous,"
she merely indicated that she masters the techniques of spotting
and that her outer acts are now well matched to the meaning
of her inner experiences.

During a panel discussion on "Temper and Insight" the
following example was offered by Bernice: Several weeks
ago my husband went with his buddy to a nearby tavern
to watch the football game on a television set. I asked him
when he would be back and he said about four o'clock.
When 4 o'clock came I got dressed as I expected him to be
home any minute. Well, 4:30 came and no Bill. Five
o'clock came and Bill wasn't home yet* I became temperamental
and began to work myself up. I thought he doesn't
care how I feel and he thinks more about that d . . . football
game than he does about me. Before long I had palpitations,
tightness in the stomach and pressure in the head.
I thought of calling up the tavern and tell Bill that I
wouldn't stand for the way he treats me. By that time I
was very uncomfortable. Suddenly it came to me that this
was sabotage. I said to myself you think he is wrong and
you are right. But in Recovery we learn there is no right
or wrong in domestic life. There are only irritations and
discomfort and we must not judge who is right and who
wrong. So I said these things will happen in married life
and it wasn't worth working myself up over it. Pretty soon
I calmed down. About six o'clock Bill walked in. I asked,
"Is this 4 o'clock?" He looked at me and said, "When I
say 4 you should know I mean 6." I was irritated but I
didn't make an issue of it. Before I had my Recovery training
I would have told him exactly how I felt, how wrong
he was to do that to me and I wouldn't have spoken to
him for days. But then I would have developed all kinds of
symptoms and would have suffered from them for weeks.

When Bill kept Bernice, his wife, waiting for two solid hours
without troubling to call her he was undoubtedly rude. But
was rudeness his intention? Did he mean to be rude? Most
of you know Bill and none of you will hesitate to credit him
with a gentle disposition, with the will to please, to help and
to make himself liked. And if his main features are as I said
why does he neglect to practice them in his approach to Bernice?
You may be inclined to be charitable and explain Bill's lack of
consideration on the basis of his keen interest in football and
television. You will then argue that he became wrapped up in
the fascinating spectacle on the screen and naturally forgot
wife and home. Suppose this is true and the whole incident
the result of an innocent lapse of memory. But when in response
to his wife's reproach he had the incredible impertinence to
proclaim, "When I say 4 you should know I mean 6," no explanation
in the world could possibly atone for the crudity of
that reply. Then you will no doubt revise your charitable opinion
about his being two hours late and will grant that the delay
was inexcusable and certainly called for an apology which Bill
failed to offer. And taking it all in all you will agree that Bill,
our gentle and likable Bill, was rude in the one instance and
savage in the other. And the question arises: Did Bill intend
and plan to display rudeness and recklessness? Did he mean
it? Was it his deliberate will to insult his wife, to crush her
feelings ?
Putting it into different words this is what Bill intended to
convey to Bernice: "If I say something I may mean something
else. What precisely I mean is my sole concern. I am the boss
and I do not have to account for my actions." If you read this
meaning into his statement you will understand why I call it
rude and savage. Married life calls for sharing, and Bill denied
Bernice her due marital share. With this he launched a rude
and savage attack on the very foundation of the marital structure.
Was that his intention? Did he really mean to muzzle
Bernice and to deny her the status as a wife? Was it his
deliberate will to wreck his marriage?
Marriage is a Will. It is the will to share experiences, to enjoy
and suffer together, to plan jointly and to act in concert. All

of it is called companionship which is a Will, the will to be
and remain companions. Implying jointness and togetherness
and sharing, companionship rules out individualism which implies
self-centeredness, inconsiderateness and single-handed action.
Nobody can be a companion and an individualist at the
same time or in the same situation or relationship. But that's
precisely what Bill intended to be. He wanted to be married
and single-acting, companion and individualist, all in one piece.
His scheme of life was based on two mutually exclusive Wills:
the will to companionship and the will to individualism.
I want you to know that everything in life that is of significance
and value is a Will. Friendship is the will to have and
keep friends. To be and remain on amicable terms with your
neighbors calls for the will to cultivate neighborly relations.
Citizenship is the will to be a desirable citizen, honesty the will
to honest dealing, fairness the will to practice fair procedure.
You cannot be understanding unless you free yourself of the
will to misinterpret, to find fault, to be captious or literal In
the same sense, thinking is the will to draw correct conclusions
from solid premises. There is the will to doubt, to believe, to
be well. Even plain possessions constitute wills. Your house
expresses the will to ownership, your garden the will to add
charm to your life, your automobile the will to enjoy legitimate
comforts. Needless to add that religion, education, race and
nationality, and countless other trends, strivings and ambitions
are all Wills.
You will readily understand the reason why I stress this
matter of the Will as a force which permeates all significant
phases of our daily lives if you realize that the contemporary
and modern tendency is to place the emphasis on emotions,
drives and instincts as the main power which governs human
action. We in Recovery will have nothing of a theory which
relegates life, more particularly life in a group, to blind instincts
and capricious drives. We have solidly embraced a viewpoint
which considers action as based or capable of being based
on deliberate plans and settled decisions, on reasoned conclusions
and firm determinations. And plans, decisions, conclu

sions and determinations are guided by the Will; they are not
or do not have to be driven by instincts. This is in the nature
of an aside remark, but a very vital sort of an aside.
The wills which I mentioned before are centered around the
needs and requirements of group life. They are called grouporiented
or group-centered. Opposed to them are the wills which
are centered around the individual or personal self. They are
individualistic or self-centered. The desire to be in a tavern instead
of at home, to spend time with a chum rather than with
one's wife is a self-centered Will. It may be unobjectionable at
times, but it is self-centered, nevertheless. In order to be groupcentered
you must control or hold down your self-centered desires
and cravings, that is, your individualistic trends and drives.
The control is exercised by the Will
Once you have declared the will to join hands with another
person, in marriage or friendship or business, or even in a mere
act of casual conversation or some fleeting and transient endeavor,
you have tied your hands and have assumed the obligation
to act jointly, to share with the partner and to consider his or
her needs, tastes and feelings. Henceforth you are no longer
free and independent. You are committed to your obligation
and have lost the freedom to enact individualistic behavior. In
our democratic order there is ample room for free action and
independent conduct. Nobody is forced to work or marry or
practice friendship or worship or vote. And if you avoid obligations,
partnerships and group ties, then, you retain a good
measure of freedom to indulge your personal tastes and your
self-centered inclinations provided they do not clash with law or
morals. But even in our democratic way of life, while you
are free to shun certain obligations, once you assume them
you tie yourself and lose your independence. Democracy means
freedom of choosing (within certain limits). But after you
have chosen you lose your freedom of inclination and are bound
by the restraint of obligation. Bill assumed the marital obligation
to share but retained his individual inclination to lead
an independent life. The needs, tastes and feelings of the person
he had tied himself to were neglected, ignored or shocked.

He insisted on practicing contradictory and incompatible modes
of living at one and the same time: self-centeredness and groupcenteredness,
independence and restraint, refusing and sharing,
drive and will, individualism and companionship, inclination
and obligation.
You remember I asked whether Bill meant to be rude, whether
he meant to rob Bernice of her due share of matrimonial life.
This term "to mean" refers to that singular capacity of the
human Will to toy and trifle with some activities and to "mean
business" with others. A Will which makes group-centeredness
its business means the group and not the self. It is then unqualifiedly
group-minded and ceases to be self-minded. If it
oscillates and alternates between self and group, then, it toys
and trifles with one or with both tendencies. It does not
mean business. Bill was a good provider. At heart, he was
deeply concerned about his wife's welfare. When Bernice was
ill he went out of his way to help her. In a sense, he meant
to be a companion and to maintain the marital group. But he
permitted his personal inclinations to interfere with and frustrate
his group obligations. His Will was divided, serving partly
the group, partly the self. He was both group-minded and selfminded.
Meaning both members of a team of opposites he did
not "mean business" with either. Perhaps he did not mean to
be rude. Perhaps he meant to share. But whether meaning
or not meaning, at all events, he did not "mean business.'*
Now a word about Bernice. When she felt mortified and
decided not to work herself up over it; when she burnt with
indignation and concluded that "there is no right or wrong in
domestic life;" when she was crushed by humiliation and refused
"to make an issue of it," when she did all of this she
exhibited a degree of self-control that is truly touching in its
gentleness and nobility. In a savage assault on her feelings she
used her Will and conquered emotion. She was thoroughly
group-minded and self-oblivious, devoted to obligation and forgetful
of inclination, in short, the flower and consummation of
Recovery's self-help spirit. She had the Will to companionship
and the Will to health and meant both.

Annette, on the Saturday panel, recalled an episode from
the days when she was ill already but had not yet joined
Recovery. The incident referred to an experience in her
pre-marital life when expecting a Valentine gift from her
present husband, Clem, her expectations were disappointed.
"Valentine's day came," she said, "but there was no gift or
card or any sort of a token of attention. I got angry and
tense and had a pain in my side and had no appetite for
supper. When I made an effort to push down the food,
forcing myself to eat, there was a tight feeling in my abdomen.
I went to bed, and cried and felt I had been let
down. In the middle of the night I awoke and had a strange
sensation in the abdomen. I felt nauseated, went to the
bathroom but couldn't vomit. Then I began to tremble all
over. I felt wretched all the time, I boiled inside and was
furious at Clem and worked myself up into a panic . . .
About two years after this miserable night Valentine's Day
came around again. By that time I had my Recovery training
and knew the difference between important things and
matters that are trivial. And after dinner I asked Clem
calmly, did you forget today is Valentine's Day? He said,
no,' and went to his coat and pulled out a box of caady.
At that moment I realized how I had changed . . . ."
Annette failed to receive a box of <-andy (Valentine gift), and
as a consequence worked herself up to such a degree of excitement
that she developed an agonizing night of pain, tightness
in the abdomen, nausea, tremors and a "boiling fury" at her
boy friend and later husband, Clem. In other words, she disturbed
the peace of her inner organs and the harmony of her
marital life because of a box of candy. At the time of the in

cident, Annette assures us, she had not yet gone through the
process of Recovery training and did not know the "difference
between important things and matters that are trivial." Some
years later she had a similar experience but behaved in accord
with Recovery principles, controlling temper and refusing to
sacrifice inner and outer peace to a box of candy. "At that
moment,*' Annette commented, "I realized how I had changed."
But does it take the cumbrous machinery of Recovery training
to make a person recognize the difference between trivial matters
and important values? Between the relative insignificance
of a Valentine gift and the supreme relevance of individual
well-being and marital happiness? To make this distinction
requires nothing more than a modicum of intelligence. From
what we know about Annette today she must have had a generous
amount of that commodity even before she joined Recovery.
And if she insists that she has changed the change cannot
refer to her intellectual powers but rather to her sense of
values. What Annette learned in Recovery and what all my
patients are expected to learn there is to approach things with
a proper set of valuations. It is your table of valuations which
tells you what is important or trivial, what is essential and what
insignificant. In her pre-Recovery days, Annette's table of valuations
was in a muddle, contradictory, jumbled, confused. Today
it is solid, stable, balanced. And if this is so, Annette must
have changed, indeed.
You may object to my manner of simplifying and distorting
the story of the Valentine gift. The meaning of that gift is by
no means exhausted by calling it a box of candy. As a Valentine
gift it was meant to be a token of affection and attention. As
such it represented a value, and if Annette felt hurt and provoked
because that valuable object was denied her is it fair
to charge her with a poor sense of values? Another question
may be properly asked: two years after the first incident another
Valentine came around and Annette's husband, Clem, arrived
home without offering a gift. On that occasion Annette raised
no fuss about Clem's seeming lack of attention and affection.
Due to her Recovery training, she claims, she now realized that

a box of candy was a triviality. But attention and affection can
hardly be called trivialities. Was Annette's sense of values now
blunted? Was it blunted precisely by that much vaunted thing
we call Recovery training? You see here that it is by no means
easy to manipulate the sense of values.
Briefly, a thing is valuable if it promotes inner peace leading
to contentment, well-being and self-respect; or, if it advances
the cause of outer peace resulting in adjustment to family,
friends, neighbors, co-workers. If your main aim is to secure
peace you are a realist. Then, the attainment of inner and outer
peace is your supreme value. Unfortunately, if life is nothing
but peaceful it is apt to acquire a note of drabness and monotony,
a quality of dull routine with a conspicuous lack of variety and
novelty. People are likely to be bored by an existence that is
gently flowing along in its unruffled course with little change
and newness. Many people crave activities which are flavored
and spiced. They want a measure of excitement, stimulation,
adventure. They prefer the thrill of "dangerous living" to a
peaceful, well settled and thoroughly ordered daily round. To
them, mere peace is deadening, flat, colorless and lifeless while
excitement, thrill and adventure are vitalizing, sparkling and
energizing. To many men and women, the supreme value is
that which is interesting, agitating, stirring. If they are romantic
they want to be stirred by emotion; if they are intellectualists
they prefer the thrill of bold views and daring thoughts. Summing
up: The realist strives for peace, the romanto-intellectualist
for thrill and excitement. Peace, order and balance are the
supreme values of the one; thrilling excitement, variety and adventure
those of the other. Unfortunately, many persons prefer
romanto-intellectualist excitement to realistic peace.
I shall admit that excitement, producing thrills, is the spice of
life. But it is not life. It is merely its spice. If spices are added
to food they contribute nothing to its value as nourishment.
They merely make the food more tasty and palatable, more
appetizing and desirable. But mark here that taste and palatability,
appetite and desirability are highly personal and subjective.
What is tasty to me may not at all suit your taste;

what whets my appetite may blunt yours. My palate may be
tempted by what yours is repelled; my desires may run to
things which yours shun. Food is in a different class. You may
dispense with spices altogether but you cannot eliminate food
from your life any more than I can. In other words: food is
an objective need, spices are subjective wants. Returning to our
original subject we may conclude that peace is the food of life,
a value and objective need while excitement is merely the spice
and thrill of life, a desirability (not a value) and nothing but
a subjective want.
I said that peace is a supreme value. This implies the existence
of lesser and lower values. Such lower values are affection
and attention; conversation and conviviality; joy and entertainment.
They go by the name of mental comforts. Another series
of lower values is concerned with the various desires for physical
recreation, with the stimulation of food and drinks, with
the effort to ease the exactions of the daily routine, and with the
craving for attractiveness in point of personal appearance and
personal property. These go by the name of physical comforts.
Both the thrills of excitement and the comforts of the lower
values are legitimate pursuits if cultivated in moderation. However,
if they clash with the aims and needs of the supreme value
of peace they must be suppressed or checked or controlled. To
know which thrills to tolerate and which comforts to admit
within one's scheme of life requires a delicately balanced sense
of values. The sense of values is not born with you; it must
be acquired through training. The one to train you is your
leader. It may be parents, teachers, ministers or anyone who
knows the distinction between values, on the one hand, and
thrills and comforts on the other. For the nervous patient, the
proper source for leadership is his physician.
My role as a leader of nervous patients is difficult and, in a
sense, embarrassing. My patients suffer agonies of discomfort
and torture. Hence, they desire quick or immediate relief.
This is their subjective want. It is legitimate and should be
granted if possible. Unfortunately, a quic\ relief, even if it could
be secured, is not a lasting cure. As your physician I must in

sist on the final cure because it alone will restore your health.
Relief is mere comfort while health is a value. Health returns
you to a useful and valuable life in family and community. Relief
does nothing of the kind. I should like to relieve your
discomfort but my main endeavor is to regain for you the value
of sustained mental health. There is another disturbing element
in my function as a leader to my patients. Handicapped by the
torments of suffering they are barred from an active social and
occupational life. Their existence is, therefore, deprived of the
excitements and thrills of stimulating experience, of accomplishment
and self-respect. Their daily round is carried on in an
emotional void, in an atmosphere of drabness and boredom.
In order to fill the void and to escape the boredom they want
excitement. And if they cannot secure it in routine channels
they hunt for it in devious paths, in endless complaints, in all
kinds of devices for attention-getting, in tantrums and tempers.
That these excitements are wants and not needs is obvious.
Even these excitements might sometimes have a proper claim
to toleration. But as your leader I have the embarrassing obligation
to emphasize needs in preference to wants.
We shall now be in a better position to understand the meaning
of the incident in which Annette disturbed her inner peace
through symptoms and her outer peace through a clash with
her fiance. The missing Valentine gift meant to her a token
of affection (mental comfort) and the anticipation of a surprise
(thrill). When the expected comfort and thrill were denied her,
Annette threw a tantrum and jeopardized the values of health
and marriage. With this she displayed a tendency to favor
subjective wants in preference to objective needs. But endowed
with a good native intellect it should have been easy for Annette
to reason that needs are more important than wants and that
peace is more essential than thrills and comforts. Why did her
intellect fail her? The answer is that a person's reasoning is
powerfully influenced by the values cultivated in his group.
And our contemporary group has placed a preposterous valuation
on romanto-intellectual wants to the detriment of realistic
needs. This statement does not require detailed exposition. All

you have to do is to inspect the system of education as practiced
in our schools and colleges and you will realize that present-day
teaching has the almost exclusive ambition to cater to the student's
want o mental and physical comfort, and to pay far
less attention to his need for training and discipline. That the
modern home has abandoned the effort to train and discipline
children is too well known to call for special mention. The
average parent of today, encouraged by popular philosophies
and psychologies, gives his youngsters ample freedom to express
their individualistic wants and to ignore the needs for group
control and group discipline. If I add that the newspaper headlines,
comic strips, radio, movies and television fairly vie with
one another in their sordid occupations to cater to the comforts
and thrills of their readers, listeners and viewers I have about
completed the circle of the sinister influences which today pervert
the tastes and corrupt the valuations of children and adults
alike. Our modern media of "education" extol, knowingly or
unwittingly, the superiority of wants over needs and the priority
of thrills and comforts over discipline and values. Annette, in
her pre-Recovery days, could not possibly escape the overpowering
pressure of these organs of public opinion and from them
imbibed the pernicious contemporary philosophy which favors
subjective wants and scorns the value of objective needs. This
modern philosophy was largely responsible for her ailment and
her torturing symptoms and might have wrecked her marriage
had not Recovery intervened and made her revise her faulty
sense of values.

The panel discussed the subject of "Helplessness Is Not
Hopelessness," taken from the October 1946 issue of the
Recovery Journal. Caroline mentioned a recent experience
in a department store. Approaching the elevator she was
preoccupied with her inner difficulties, and instead of pressing
the elevator button she pulled a light switch. The store
section went dark. "I immediately realized my mistake, felt
tense and trembled. But then I applied the spotting technique
and knew that average people make mistakes of this
kind and if I didn't have the courage to make mistakes in
trivial matters I did not consider myself a person of average
but as one of exceptional inefficiency. After the spotting I
was calm ... In former days I would have become hysterical,
would have thought that surely something was wrong
with my mind. I would have suffered awful sensations and
would have rushed to the phone telling my husband that
was again proof I couldn't get well and trying to convince
him that I was hopeless."
Caroline described in graphic detail the striking contrast between
her present and her past behavior. In the past, prior to
receiving her Recovery training, she felt helpless and hopeless
when a minor mishap occurred. Now she feels helpless for a
moment; the idea of hopelessness presents itself in a flash but
she spots it instantly and commands her muscles not to respond
to her silly feelings. This is all in accord with the basic principles
of Recovery's self-help system and requires little comment.
By now it ought to be a commonplace that our patients are
trained in Recovery to deny muscular expression to their feelings
of fear and anger and to control their temper through the
process of spotting.

There was one phrase in Caroline's account that arrested my
attention. In the past, she said, she would have rushed to the
phone trying to convince her husband that she was hopeless. A
statement of this sort has a weird and uncanny note. It seems
to me that were I faced with a hopeless situation I might either
resign myself to my fate; or I might make a desperate effort to
force the issue, or I might pray for deliverance; or I might yell
for help. But the last thought that could conceivably enter my
mind would be to want to convince somebody that, really and
truly, I am actually helpless and hopeless. Yet, Caroline, in a
condition of seeming despondency, had no other thought but
to be convincing.
If Caroline's ambition was to convince her husband she must
have assumed that he needed convincing, that he doubted her
stories of suffering and agony, at the very least, that he thought
them exaggerated or colored or twisted. Her stories were what
we call "complaints." And if Caroline's case is somehow representative
of nervous patients in general we must conclude that
the leading fear in the minds of our patients is that their complaints
are doubted, that their sincerity is questioned, in short,
that they are not convincing. No wonder they make heroic
efforts to compel conviction.
What the patient wants his listener to be convinced of is
that he is a helpless victim of his symptoms; that he tries everything
within his power to be calm but does not succeed; that
he is trapped by his handicap and cannot escape its grip. His
tantrums, his bursts of dizziness, his weakness and fatigue, his
tremors and palpitations, he thinks, are all of one cast: they are
beyond endurance and beyond control. These complaints lack
conviction because they are grossly contradicted by the facts of
daily observation. The tantrums have a peculiar quality of
being enacted at home only, perhaps also in the physician's
office, but never at a concert or at a social gathering. The fatigue,
unendurable in the forenoon, disappears miraculously in the
late afternoon and in the evening. The headache, "splitting"
or "killing," follows immediately upon a domestic squabble
and vanishes conveniently when a welcome guest arrives on

the scene. Several of my patients were unable to stop a jerk in
the arm whenever they were at home but kept it under perfect
control when they went shopping in the morning or visiting
in the evening. Some had vomiting spells in restaurants but
never at home or vice versa. I have seen patients whose throat
"locked" exactly at 1 :00 PM every day. I have seen others who
scratched away furiously at an "uncontrollable" itch at home
but controlled it perfectly in the presence of friends and strangers.
There is the patient who experiences his "unbearable"
fatigue on Sundays and holidays only. On weekdays, in the
office or factory, he is alert and chipper; or, the girl who vomits
in the morning only and at home only, never after 9 AM and
never outside the home; or, the woman who is nauseated in
the afternoon only after the husband returns from work. On
Sundays the nausea persists all day, the husband being home
all day. Most suspect of insincerity and most damaging to the
patient's reputation is his incurable fondness for monstrously
exaggerating the intenseness of his symptoms. If month after
month and year after year he clamors that he "simply can't
stand it," that "if something isn't done immediately" he is
"surely going to end it all"; that he "can't take it any longer";
and that today he is "positively at the end of his rope"; if these
hackneyed phrases are repeated monotonously spell after spell
and tantrum after tantrum the relatives cannot fail to realize
how well the patient "can stand it," how little he is inclined to
"end it all," and how the rope has a mysterious way of lengthening
without reaching its end. The threats are then ignored and
the alarms treated with contemptuous indifference. There is
no point mulitplying these examples although it would be easy
for me to cull additional hundreds or thousands from my records.
They all tell the same story: the nervous symptom is not convincing,
and if the nervous patient wants to be believed he
must make it his supreme goal to compel conviction. That's
what Caroline did. In a panic which seemed to shake her with
elemental force she did not cry for help but thought of one
thing only: to convince her husband that her plight was beyond

That the patient's complaint sounds unconvincing to the
relatives is a calamity. But that calamity turns into outright
tragedy if the patient is unable to convince himself. And conviction
is denied him irrevocably. The complaint may be a
frequency of urination which "forces" him to run to the bathroom
every five minutes. "That surely is something I cannot
stop," he exclaims or thinks. Then he sits through a show or
card game for solid three or four hours without even a passing
thought to his otherwise "uncontrollable" bladder trouble. How
can he possibly believe his own doctrine of helplessness if a mere
card game helps him check his trouble? Another complaint
may be that of "unbearable" pressure in the head. "Clearly, that
is out of my control," the patient insists. When questioned he
admits that the pressure is absent when he is in his office, "but
once I step out I have it." Or take the case of the mother who
yells at her own children incessantly because they are "intolerably"
noisy. With the neighbor's children she is a paragon of
charm and sweetness in spite of their equally "intolerable" loud
and boisterous behavior. That mother cannot by any twist of
logic make herself believe that her temper is out of control. The
ease with which she controls it with the neighbor's children
stamps her complaint as insincere and renders it unconvincing.
Experiences of this kind admit of one conclusion only: the patient
has good control but fails to practice it under certain conditions.
Fully aware of his ability to help himself he is unable
to believe his own protestations of helplessness. And trying to
convince his relatives his efforts are stymied by his own lack of
If a person is unable to believe himself he loses or weakens
his self-respect. If he is unable to make others believe him he
loses or weakens their respect for him, that is, he ruins or impairs
his reputation. It is difficult to live without proper selfrespect.
But life becomes an almost unbearable affliction if both
self-respect and reputation are wanting or markedly defective.
From this vantage point it is easy to understand the tragic plight
of the long-term nervous patient. After years of futile and ludicrous
complaining his self-respect is in tatters and his reputation

torn to shreds. He could restore both should he decide resolutely
to give up his plaints and lamentations. If he fails to do that he
is doomed to lead a life of indignity and self-contempt, a life
of stigmatization and social isolation. An existence of this kind
is possible only if somehow, by hook or by crook, the illusion of
uncontrollability is maintained and fortified against all evidence
to the contrary. The doctrine of helplessness and hopelessness
must then be hammered unceasingly and unrelentingly into the
patient's own head (to save his self-respect) and into the heads
of the relatives (to save his reputation). Hence, the imperative
urge to carry on a veritable crusade of convincing, that is, complaining.
The proudest achievement which Recovery can claim
is the thoroughness with which it has purged its members of
their pernicious habits of wailing and lamenting. Trained in
the techniques of spotting and commanding their muscles our
patients have ceased complaining and are now convincing.

Loraine reported her recent setback. She had been well
for the past several months but suddenly got back her fears
of riding alone on elevator trains and subways. She suffered
the "most awful" palpitations, sweats and panics when she
took rides. Before long she employed the Recovery techniques
of spotting fears and using muscles and controlled
her symptoms, manipulating rides without difficulty. But
in spite of all her pluck and determination she was unable
to relax. She was tense and restless and thoroughly disgusted
with herself. She then decided that what was really wrong
with her was that she was not sufficiently busy. So she increased
her average quota of shows, bowling, swimming and
sundry other recreational activities. "I needed something
stimulating," she said, "so I wouldn't think of myself all
the time . . , ."
Loraine wanted stimulation which indicates that she was
bored. Being bored she was disgusted with her Self. And in
order to escape boredom and Self-disgust she decided she had
to avoid thinking of her Self "all the time." But it seems to
me that to think of one's Self ought to be a most stimulating
occupation. Why was it irritating and disgusting to Loraine?
To be bored means to be disinterested. You cannot experience
boredom while you read an interesting story or attend an interesting
show or take part in an interesting conversation. In all
these instances, your interest is held, engaged, attracted. If the
interest deepens you are absorbed, engrossed, fascinated, perhaps
enraptured. In a situation of this kind, most or all of your
attention is directed toward the object which interests or fascinates
you. But once the interest wanes or the fascination lifts
your attention reverts to your Self and is no longer diverted

from it. Now you are alone with your Self, not distracted from
it but attracted to it. And whether your Self bores or interests
you depends on the view you take of it. Clearly, Loraine viewed
her Self as something that could not engross her interest, as
something that bored her, as something devoid of fascination
and stimulation, perhaps as something odious, repelling and
loathsome. Beholding that Self which she thought of as detestable
and hateful she became "tense and restless and thoroughly
disgusted." No wonder she "needed something stimulating."
Her own Self was "disgusting" and irritating,
I know Loraine; I know her husband, mother and sister; I
know her home life and her social activities, her character and
tastes. With all this intimate knowledge of her conduct, history
and circumstances I cannot share even a fraction of the disastrous
view she takes of her Self. To my view, her Self is of
good or fair average; to her own view, it is of the poorest quality,
not fit to be looked at, not suitable to be left alone with.
What precisely makes our views clash so radically ?
If you look at an object, let me say a table, you place yourself
at a certain point and take your view from there. This is your
point of view or your view-point. If the point from which you
observe the table is too distant you will miss many details. Your
viewpoint will then furnish you with a general view only. If
the point on which you take your stand is too close you will
miss the general features of outline, shape and style. Your viewpoint
will then provide you with a particular view only. The
correct view is the one which combines both the particular and
general views. This is the total view. Whether your view of
an object is more particular or more general, in either case, it
is a partial view only. The total view must combine both particular
and general views.
The object which Loraine viewed was her Self. She noticed
her tenseness and restlessness and concluded that her Self was
"disgusting." She knew what was "really wrong" with it; it
"needed stimulation." With this, she diagnosed the condition
and prescribed the cure. If so, her view-point was that she
(her Self) was a competent diagnostician and efficient healer.

She claimed expert knowledge and made a show o authority,
that is, she paraded her Self as important, highly informed and
superior. You, my patients, know that dais is what I call the
romanto-intellectualist attitude.
If Loraine held the view that her Self had the qualities of excellence
and superiority how could she at the same time subscribe
to the very opposite view that it was disgusting? This
is clearly a contradiction which you will not understand unless
you consider what I told you about the difference between particular
and general view-points. If you look into yourself you
will discover within you many features which are excellent,
superior and exceptional. At times you displayed unusual courage,
at other times there was an act of singular loyalty, or a performance
of superior skill, or an exhibit of extraordinary wisdom.
If you merely view these isolated instances of your behavior
(particular viewpoint) you can easily form the opinion that
yours is an exceptional Self. But if you review the broad lines
of your past development you are likely to find a great deal
of misdirected effort, of goals missed and purposes frustrated.
Judged in the light of this general view-point, your record may
appear as one of mediocrity and incapacity in which the instances
of failure crowd out those of accomplishment. Your particular
view-point, focusing the gaze on scattered triumphs, gives you
the impression of an exalted and superior Self; but the general
viewpoint, surveying the larger field of your past endeavor,
offers you the picture of failure and futility and may make you
feel "disgusted."
I told you that my view of Loraine's life was decidedly more
favorable than was her own. I knew many details of her life.
I knew particular occasions when her conduct had been anything
but a credit to her, I was acquainted with her tantrums,
her temperamental explosions, her craving for attention, her
stubbornness and vanity. This was the particular view I had
taken of her behavior. Aside from this, I had studied the various
aspects of her past history, and my verdict was that it represented
a crazy-quilt of good intentions and poor execution,
of lofty aspirations and petty performance. This was the general

viewpoint I had of her. But in reviewing her record, I judged
her neither by the particular nor by the general viewpoint. Instead,
I applied the total view. And surveying the totality of
her experience I reached the conclusion that it had the average
quality of a fumbling, erring and straying existence. But no
matter how deplorable was her fumbling, how distressing her
erring and how disconcerting her straying, it was all average.
Having drawn this conclusion I formed the average viewpoint
which is based on common sense and ought to be the common
viewpoint held by everybody. In order to gain a full understanding
of this average viewpoint you will have to realize that the
life of the average person is punctuated by precisely the features
which were characteristic of Loraine's Self: temper, attentionhunting,
stubbornness and vanity. Being average, these features
cannot, by the wildest stretch of the imagination, be called degrading
or disgraceful or "disgusting." If Loraine applied precisely
these terms to her Self I conclude that her philosophy
was that of exceptionality. She had not yet absorbed the Recovery
philosophy of averageness and condemned when she
could have condoned, accused when she might have excused.
You see here that the total view is closely associated with the
average view. With the average view to guide you, you will
be able to behold the deficiencies of your Self and will judge
them as average failings; they will not strike you with terror,
hence, you will not be tense; being reconciled to them, you
will not try frantically to run away from your Self; hence, you
will not be restless. And losing your tenseness and restlessness,
you will be relaxed and will enjoy your Self instead of being
"disgusted" with it and bored by it. The average view will
teach you to tolerate your Self. Moreover, viewing your own
Self as average and acceptable, you will give the same rating to
the Selves of others; hence, you will practice tolerance toward
them- And being tolerant of the actions of others, you will
not become angry at or provoked by them, hence, you will have
little or no temper. No doubt, the average viewpoint which
is essentially the total view of life has much to recommend it.
If my patients could be induced to adopt it energetically and

wholeheartedly, temper, restlessness, tenseness and Self-disgust
would be reduced to average levels, and symptoms would not
develop into panics and vicious cycles. You will now understand
why I stress so persistently the importance of thinking and feeling
in terms of averageness. What I have in mind is not a highsounding
philosophy but such down-to-earth matters as symptoms,
afflictions and torture.
My patients have the exasperating habit of looking at their
symptoms with the partial viewpoint mainly or exclusively.
They notice a fatigue sensation and rush to the particular view
that their body is exhausted and ready to collapse. They notice
that their attention wanders, that their concentration lags, or
that on a particular occasion their memory fails them and infer
that their mind is unhinged. In all these instances, they observe
particulars and base on them a particular viewpoint of doom
and disaster. At times they resort to a generalizing viewpoint.
They survey the general features of their painful existence, roam
across the years of suffering, across their record of frustration and
disappointment and exclaim, "What's the use? After these
many years, how can I get well?" They shy away, persistently
and doggedly, from the total view that their symptoms are of
the average variety although more persistent in duration and
more resistant to management. True enough, the resistance and
intensity of the symptoms are such that the patient can no longer
control them with his own meager resources. But a total view
of life could easily tell them that, generally speaking, certain
performances of the daily round can be conveniently mastered
by the average person while others, more complicated, more intractable,
require the services of an expert. If my patients could
be made to accept the total viewpoint; moreover, if they were
ready to cultivate the common sense of the average viewpoint,
suffering and discomfort would be held to a minimum.
Unfortunately, the general trend of modern development has
been to disregard, systematically and dogmatically, the total
viewpoint. If you listen to our modern forums you will find
there groups of persons discussing issues, presumably in order
to settle them. However, what they discussed are their particular

views, their own pet notions, their own "true" opinions. The
theme moves from one particular argument to another or loses
itself in a sea of wild generalizations. This has perhaps always
been the case and may not be peculiar to our age. But what is
decidedly peculiar to our age is the advent of popular psychologies.
The exponents of these psychological doctrines seldom if
ever touch on the total experience of the average individual.
Instead, they prefer to give absurd prominence to particular
stirrings and strivings trying to convince you that this particular
trend of yours or that isolated disposition is solely and unqualifiedly
at the roots of all your ills. With some of these clever
coiners of striking and appealing phrases it is the sex instinct
which causes your maladjustment, with others it a mysterious
thing which they call collective consciousness, with still others
it is a shallow conception termed "inferiority complex." With
all of them it is invariably one thing, one trend, one particular
item of your total experience which is supposed to disturb or
wreck your total existence.
Loraine, noticing her tenseness and restlessness, jumped to
the conclusion that these distressing but innocent items of her
experience needed instant and thorough treatment. Had she
taken a total view of her past life she would have realized that
tenseness and restlessness had been frequent occurrences in the
scheme of her existence and were nothing but average psychological
events. But exposed to the defeatist influence of popular
philosophies presented to her on screen and stage, in newspaper
columns and magazine articles, in lectures and books on popular
psychology, she conceived the vague idea that an instinct was
running wild, or that a "complex" went beserk, or that a "conflict"
ran amock having broken through the barriers of a socalled
repression. All these pretentious and bloated terms are
the confused stock in trade preached by modern psychologies.
They are based on particular, narrow and one-sided views of
life and should have no place in the lives of my patients who, in
Recovery, are trained to view events and experiences from the
total viewpoint of average experience.

Lela, on the Saturday panel, spoke of her habit, noticed
since early childhood, of correcting mistakes made by people.
"We lived in the country and salesmen came by and stopped
at our house. One of them spoke of a certain town and
said it was in Wisconsin. I knew this was wrong and ran
for the map and showed the man it was Minnesota and
not Wisconsin. My father laughed and thought it was cute
and did not say a word of disapproval to me. This habit
of correcting people gave me plenty of trouble. It made
me unpopular, worse yet, it made me feel irritated if I
could not correct people when they made remarks which I
thought were wrong. Today I know, of course, that this
desire to prove that people are wrong is temper. It means
I am right. In Recovery I have learned to spot the habit,
and I think I have it under pretty good control. The other
day I stood with a neighbor in front of a yard, and we saw
a weed. I asked, 'What is it?' She said, 'Why, it is a ragweed.'
I grew up in the country and know ragweeds, and
this did not look like any I know. I was about to say, *It is
not a ragweed' but stopped and said, *Is it?' I was' proud
of having controlled my impulse and was grateful to Recovery
for having trained me to check my temper.'*
Lela had the habit of correcting people. She loved to show
them up as ignorant and to present herself as possessing superior
intelligence. This is what you know as the intellectualist
variety of temper. You to whom Lela is no stranger will not
hesitate to call her a kindly person, gentle in disposition, eager
to be helpful and anxious to give no offense. If she was endowed
with an amiable disposition, why did she at the same time display
a tendency to be aggressive, to trip up people, to expose

them as stupid, uninformed, intellectually inferior? Clearly,
the two trends are mutually exclusive, the one cancelling the
other, both working at cross-purpose. Lela's friendly disposition
created good-will, but the good-will thus produced was weakened
or dissipated by her disposition to be critical, fault-finding
and antagonistic. Which was the "real" Lela? Which was her
"real" purpose in life? Was it to win people over with courtesy?
Or, was it to repel them with an uncouth manner? The answer
is: ordinarily, and as a rule, Lela made it her business to make
friends. But sometimes, and as an exception, she practiced the
game of shocking and antagonizing people, thus making enemies.
Lela claims that the game of shocking people caused her "plenty
of trouble," making her unpopular and giving her a lot of irritation.
If so, why did she continue the game? Why did she
insist on toying with life instead of strictly tending to its (and
her) business?
Life is a business. There is or ought to be time in everybody's
routine to play and toy, to amuse himself with games and to
divert his attention from the serious aspects of the business of
living. Nevertheless, life is not a game; it is a business which
must be toiled at and attended to. Its business is to create and
maintain values (family, community, education, religion, sociability).
The trouble is that values are tender and delicate
and easily disturbed. They are likely to be disturbed through
destructive forces arising in inner environment (symptoms and
temper), or from commotions and convulsions affecting outer
environment (strife and dissension between persons and groups) .
Since strife and dissension usually are the result of temper
we may safely assume that the peace of persons, families or
communities is threatened by two elements mainly: symptoms
which interfere with inner peace, and temper which obstructs
both inner and outer peace. To sum up: life needs inner and
outer peace for producing and maintaining values. The factors
which endanger peace are symptoms and temper. Life's principal
business is, therefore, to reduce both symptoms and temper to
a minimum.
If anyone deserves the title of a conscientious, serious-minded

person it is Lela. She is dependable and generous, has firm
convictions and a sturdy quality of character. From what I
know of her background there can be no doubt that even in
early childhood she was thoughtful and considerate, courteous
and tactful, treating people with respect and careful not to hurt
their feelings. With all these features to her credit she must
have taken seriously the business of her life. Why did she at
the same time trifle and gamble with that same business? The
answer is that even people as lovely and desirable as Lela have
a tendency, at times, to be serious about games and playful
about business. They are particularly apt to be so if"the game
they are engaged in is that of romanto-intellectualist temper.
Ordinarily, Lela is a realist taking the business of her life seriously.
But at times she feels (or used to feel) the itch of romanto-
intellectualism indulging the game of playing with the
business of life. And to play with the business of life means
to gamble.
If you start a game you are not obliged to continue it. You
may drop it because you don't like it, or because it bores you;
or because luck is against you; or because you have as trivial
a thing as a headache. Conversely, if you engage in business
(job, marriage, the rearing of children, helping a friend, civic
activities, club work) you are under obligation to continue it,
to see it through, to finish what you have started. Headaches,
boredom, dislike, strain are no justification for shirking the
duty you have assumed or the commission you have accepted.
Games are personal inclinations; business is group obligation.
Games are pleasures, business is a tas^. A task may be pleasing
which means that pleasure and task can be combined. But if a
game, no matter how pleasurable, interferes with the serious task
of a business the thing to do is to stop the game and to continue
the business. Tasks must have unquestioned priority over
games. Lela, going through months of Recovery training, imbibed
this supreme principle of Recovery philosophy that in
the business of life tasks must invariably take precedence over
pleasures. In life, even a plain conversation with a neighbor
acquires the character of a task. It imposes the obligation to be

courteous, to be friendly, to show humility, to create good will,
to avoid criticism and intellectual snobbishness (the desire to
show superiority).
In commercial business, there is one goal only: to produce
income. But business men are human, endowed with human
desires, whims and inclinations. There is the inclination to
take it easy, to go off on a trip, to over-expand, to run up debts
because of hastily conceived plans. These inclinations are human
stirrings and human strivings and as such the direct offsprings
of "human nature." It is human and natural to crave an easy
life or to long for the amenities of a trip, or to take chances
with indebtedness. But no matter how human and natural these
desires are, they turn into a wild gamble if they clash with the
one and only business aim: to produce income.
Getting well is a business. It is emphatically not a game, certainly
not a wild gamble. Unfortunately, my patients have the
tendency to play and gamble with their health. They give unthinking
and wanton precedence to the stirrings of their "human
nature" to the detriment of their only legitimate goal: to get
well. It is human and natural to want quick relief, to be impatient
with the irksome obligation to wait for the final cure;
it is understandable and natural to hate the discomfort of laborious
and untiring practice, to want to give way to temper, to
play for attention, to crave sympathy and to indulge in self-pity,
to complain and to work oneself up. But all of this is gambling
with the business of getting well. It is the game of giving in to
human nature, not the business of health. The one and only
goal of the patient must be to regain his mental health. In order
to achieve it the goals and whims and wishes of "human nature"
must be held down with ruthless determination.
Games provide relief from strain; they provide diversion, entertainment
and relaxation. All of this means: comfort. Business
is in a different category. At times, it may be conducive to
relaxation, diversion and entertainment. But ordinarily it requires
toil and strain, patient application and ceaseless exertion.
All of this means: effort. Games are conducted with the Will
to Comfort; business is executed with the Will to Effort. Time

was when the Will to Effort was systematically cultivated in
homes and schools, on farms, in stores and factories. Men and
women were trained routinely to expect of life a great deal of
effort and a small fraction only of comfort. In the process,
they developed a rugged disposition which means: the Will to
Bear Discomfort. Unfortunately, the accent is today on comfort,
on fun and entertainment, on making things easy and pleasant.
With the Will to Comfort scoring heavily over the Will to Effort
people are no longer prepared to endure strain and anxieties and
suffering. And when suffering strikes, especially the excruciating
suffering of nervous ailments, they expect the cure to be
effected with the proverbial ease of a child's play and perhaps
in as brief a space of time as the average game may last. This
means playing with the illness and converting the business of
getting well into a game of trying to secure effortless comfort.
In Recovery, you are taught to approach the business of getting
well in the spirit of performing a task and meaning business.
The business calls, first and foremost, for labor and exertion
and self-control, in other words, for the Will to Effort. A good
portion of the effort must be directed toward the business of
curbing the romanto-intellectual temper. As you know, it is
temper primarily which creates and maintains tenseness, and
it is tenseness which creates and maintains nervous symptoms.
Lela, having learned in Recovery that temper interferes with
the business of getting well, decided to take seriously the principles
of Recovery training, to keep a vigilant eye on her temper
and to consider health as the supreme task to be accomplished
by a patient. She is not well yet but is certain to obtain her
final cure if she continues as doggedly as she has done to pursue
the serious business of realistic health and to avoid the frisky
game of romanto-intellectualist comfort. With the Will to
Effort effectively curbing her Will to Comfort she is bound to
attain her ultimate goal: to get well.

Ada recalled the agonies she suffered for many years when
at times her throat suddenly "locked." "The locking happened,"
she said, "when I became irritated, when my
feelings were hurt, or when I became temperamental. I
was sure I had a growth in the throat because how could
an irritation or upset produce that awful pressure I felt
in that spot? When the locking took place I would jump
from my seat, my heart would pound and I broke into a
cold sweat and I shook with tremors and I was sure I was
choking to death. My brother lives with us and when he
was present he would grab me and pound me and hit me
on the back as one would revive somebody who is choking.
If that didn't help as it usually didn't he would drag me
on the back porch and continued the pounding there and
I made a terrible noise and the neighbors would rush out
of their apartments to help. Because of these panics I developed
all kind of fears. For instance, I was afraid to take
orange juice because the pulp might stick in my throat. I
was of course afraid of being alone at home because I might
get a spell and nobody around to help me. I was also afraid
to go out on the street or visit people because I might be seen
in a spell. After I joined Recovery the spells got less and
less but sometimes I have them yet. Not so long ago I
was sitting at the table reading a newspaper when I picked
up an apple and took a bite. Suddenly the throat locked. I
got scared and felt like smothering. My brother ran over
to pound me but I motioned him not to. I spotted the spell
as a sensation and knew it was distress but no danger. So
I got up and walked to the kitchen, and when my brother
reached me and saw that I had gotten my breath he said,

'Why, I can't believe it. How did you manage to stop the
choking? I swear it did not last more than thirty seconds.'
I tried to explain and said something about spotting but he
did not seem to understand. Finally he said, *I don't understand
what you folks talk about in Recovery. But it certainly
Ada stated explicitly that her throat "locked" when she was
irritated or when her feelings were hurt or when she was in
temper. This can have one meaning only, namely, that the locking
was caused by emotions, frustrations and mental upsets.
Receiving this information I was certain that Ada considered
her trouble as nervous and psychological and not as organic and
physical. If this is so, you will realize how amazed I was to hear
Ada continue: "I was sure I had a growth in the throat because
how could an irritation or upset produce that awful pressure I
felt in that spot?" In the first pronouncement the condition
was declared to be psychological and nothing else; in the second,
it was said to be physical and nothing else. How is it that
Ada, usually possessed of clear thinking and precise expression,
launched out today into such a flagrant contradiction ? Did her
customary logic fail her? Did her mind "lock?"
What Ada actually did was this: She noticed or thought that
her throat tightened. The tightening was experienced or felt
by her as a choking which stifled speech and impaired breathing.
What she thus thought and felt produced a panic which
gave rise to distressing sensations (palpitations, tremors, sweats)
and produced the impulse to run for life ("I jumped from my
seat") . All of this means that when the locking happened, Ada
made, in a flash, sundry observations about her inner experiences
cataloguing them in her mind as a varied assortment of
thoughts, feelings, sensations and impulses. She noticed further
that whenever the locking occurred it was preceded by irritations,
frustrations and temper. From this series of observations she
drew two conclusions: (1) the cause was psychological, (2) the
cause was physical. This process of drawing two contradictory
conclusions from one and the same set of observations we call

When Ada, with her throat "locked," made observations and
drew conclusions she practiced what is called the process o
thinking. This process is an art based on a technique and governed
by rules. The technique is that of dependable observation;
the rules are those of valid conclusion. When my patients get
ready to employ their thinking process for reporting or studying
their symptoms they almost invariably bungle the observations
and jumble the conclusions. That happened in Ada's case when
she observed a tightening and concluded that it was a "locking."
The throat is a tube which serves the purpose of letting the
food pass through the esophagus and the air through the larynx.
Nervous patients experience frequently a tightening in this
locality. But it is merely a tightening, perhaps not even a narrowing
of the passageway, certainly not a complete closing or
"locking." Had Ada, in her pre-Recovery days, been trained in
the technique of making pertinent observations she could have
noticed that air circulated freely and food traveled unhampered
through the tube even if the throat was "locked." She never
had an opportunity to observe an actual stoppage or occlusion
or obstruction. What she reported on the panel demonstrates
conclusively that she suffered no such thing as a "locked" throat.
On her own accounting, when her brother dragged her out on
the porch she "made a terrible noise, and the neighbors rushed
out of their apartments to help." That "terrible noise" assuredly
required a great deal of air. How did Ada manage to push
through her "locked" throat a quantity of air sufficient to produce
a "terrible noise?" Clearly, her thinking process had acquired
the habit of rushing into hasty observations and jumping
to shaky conclusions.
If observations are made and conclusions drawn with regard
to symptoms the process is called the art of making a diagnosis.
That this art is difficult, utterly complex and reserved for
thoroughly trained persons only is generally accepted. But my
patients ignore what everybody knows and when they observe
a symptom they promptly rush to supply a diagnosis of their
own. They notice a pain in the chest and conclude it means a
weak heart. They feel a pressure in the head and "know'* it is a

tumor. A nervous bladder drives them into endless journeys to the
bathroom, and "what else can that be but a kidney disease?"
Some of my patients discovered that on some days they had
two evacuations instead of one, soft but not at all "running,"
and on the basis of that flimsy observation they concluded it
was a "running bowel," or a "diarrhea" or a "colitis." Experiencing
a pulling sensation in the neck my patients are apt to
conclude that the pulling "must be done" by a growth, at the
very least, by a swollen gland. Many of them delight in the
practice of "observing" themselves in an obliging mirror. The
mirror invariably tells them that their features are drawn and
haggard, that the eyes have no luster, that the tongue is coated.
The diagnostic inference is that "there must be something wrong
somewhere. Don't you think so?" They paw over the entire
expanse of their bodies, find a swelling in the leg, flabbiness in
the arms, glands in the neck, a quickened pulse in the wrist
and forthwith indulge in a riot of grisly diagnoses. Their theory
is that anybody who is not an outright moron knows how to
use the thinking process and that for a person of "normal" intelligence
it is "no trick" to make reliable observations and draw
valid conclusions. In this, they display an enormous contempt
for the complexity of the techniques and rules of solid
thinking. Putting it differently, my patients approach their
symptoms with the philosophy of shallow intellectuaHsm, rushing
headlong into uncritical observations and jumping recklessly
to immature conclusions. It is the particular mark of the petty
intellectual that he has a boundless disrespect for the pitfalls
which beset the utterly complicated process of correct thinking.
He is smart, and his intellect, he is convinced, has a native
sharpness and quickness. So why bother about clumsy techniques
and cumbersome rules.
Observations are of two kinds. You observe either the world
outside you (with your senses) or the world within you (through
introspection). The one furnishes outer experience, the other
inner experience. Suppose you meet a man on the street and
observe through your senses that he is walking at a leisurely
pace, carrying a briefcase and looking straight in front of him.

You advance toward him, offer a friendly greeting, and he
responds with a smile and the assurance that he is glad to see
you. There is hardly any possibility of bungling this series of
outer observations. Everybody whose eyes and ears are not
damaged by disease or injury is qualified to make them without
previous training in technique and rules. The difficulty begins,
however, the moment you go beyond the domain of observation
and pass into the area of interpretation. After observing the
smile on the man's face you may ask yourself, for instance,
what precisely that smile means. It may mean warmth of feeling
and joy of seeing you. The proper interpretation, then,
would be: fellowship, friendship, good will. Or, it may mean
nothing more than conventional politeness. That would be:
indifference. If the smile is associated with strained features the
proper interpretation might be: annoyance or resentment of
your intruding. And finally, the smile may have an expression
of irony or sarcasm. In that case, the proper label would be:
haughtiness, disrespect and perhaps hostility. This simple example
indicates that the pitfalls of thinking reside in interpretation
rather than observation. The trouble is that once you have
made an observation you feel an imperative urge to interpret it.
And if interpretation is difficult even in outer observations, the attempt
to apply it to inner experiences increases the obstacles to
such an extent that only a mind trained in the techniques and
rules of the thinking process can be expected to conquer them.
When Ada experienced the tightening in her throat her observation
played on an inner experience. Had she merely stated
that she felt a tightness, hers would have been a plain observation
secured through introspection. Like everybody, Ada was
in a position to make such introspective observations. But when
she interpreted the sensation as one which "locked" her throat
and stopped the free flow of air, she lacked the qualification to
employ this very difficult part of the thinking process. After
reaching her dismal interpretation she had no choice but to
conclude that something terrible had happened and that a grave
emergency was set going. The result was a panic with the

attendant vicious cycle and the unavoidable commotion and
While doing her disastrous piece of interpreting and concluding
Ada was not aware of the fact that in doing so she
had the temerity to engage in the subtle art of diagnosis. To
her untutored perception, this was merely the innocent act of
"thinking about" her symptoms. And Ada, being a child of
this most modern of all ages, had on many occasions been exposed
to the contemporary slogan that a grownup person has not
only the right but the solemn duty to "do her own thinking."
But I am not at all interested in the philosophical profundities
of this so horribly advanced age of ours, and whether my patients
have the right or duty to "think for themselves" is a question
which concerns me not in the least. My supreme and only
duty is to relieve my patients of their agonies. And if their
panics and vicious cycles result from their faulty use of the
thinking process I shall advise them to throw overboard the
rubbish of modern slogans and let me do their thinking in the
matter of interpreting and concluding with regard to symptoms.
My thinking process has had the benefit of many years of
thorough training and disciplining and my thinking about
symptoms is not likely to rush into interpretations and jump to
conclusions. What you, my patients, have to do is to let me,
your physician, teach you how to exercise your thinking process
when you attempt to apply it to your symptoms. This is what
I have described as "spotting.'* Spotting means for you to be
perpetually on guard against your inveterate tendency to "do
your own thinking" when observing a symptom and its accompanying
temperamental reaction. It means a ruthless determination
to eliminate self-diagnosing and thus to do away with
panics, vicious cycles and endless horrors of agony. Ada reported
an instance in which the resort to spotting was almost
inhumanly difficult. It was of such stupendous difficulty that
her brother refused to believe that it could be done. But even
that skeptical brother had to admit that "it certainly works."

In a recent panel discussion on Imagination, Temper and
Symptoms, taken from the December 1946 issue of the Recovery
Journal, Kenneth made the significant statement:
"I was always troubled with self-consciousness, and down at
work about four months ago some of the girls at the office
were laughing and joking and for some reason I decided
they were laughing at me. I got very tense about it and
my eyes got blurred and my throat got choked and the first
thing I decided was that Recovery was no good and it did
not help me and I was going to drop it ... I was so disturbed
that I decided it would be better to join the army
again. I had no symptoms there . . . ."
Listening to the panel discussion I was struck by Kenneth's
remark and attempting a hurried analysis I noticed three main
points in his utterance: (1) Kenneth traced his self-consciousness,
and I may add, his symptoms, back to early childhood;
(2) his self-consciousness has made him so sensitive that the
innocent giggling of bantering girls was likely to exasperate
him; (3) while he was in the army he lost his self-consciousness
and with it his morbid sensitiveness and his symptoms.
Let me first tell you that many of my patients, concealing
their past record of a nervous or mental ailment, enlisted in
the armed services. They all seem ready to subscribe to Kenneth's
thesis that life in the army provided a mysterious tonic
for jaded nerves and that the supposedly peaceful routine of
civilian existence meant constant grating and grinding for the
same nerves that relaxed so beautifully in barracks, dugouts,
under air bombardments and artillery barrages. While in the
army, close to four years in the Pacific theatre, Kenneth had
his due share of privation: jungle, insects, heat, humidity, mon

otony, worry about an uncertain future, threat to life aplenty
and menace of dreadful disease galore. But he felt relaxed and
secure all the time. There was incessant danger to his physical
person. But his social personality was protected and sheltered.
What was it that secured this protection for the personality
of the soldier while he was in the army? Which was that
factor in military life that made the nervous patient feel that
he was basically sheltered?
The answer is this: in the army there is fellowship and leadership.
The fellows make for contentment and relaxation; the
leaders supply certainty and assurance. A person who is accepted
as a fellow in his group and enjoys the leadership of men endowed
with stability of character and steadfastness of purpose
feels secure and loses his sensitiveness. If he is a nervous patient
he also loses his symptoms.
If this is true, it will be important to know why the singular
benefits of fellowship and leadership are so stubbornly denied
our group of nervous patients. What is a fellow? What is a
A fellow is a person who shares your activities, habits, tastes.
He may also share your views and beliefs. If he does not he
respects them. A leader does not have to share your life. His
part is to tell you what to do and how to do it. He gives you
plans, instructions and directions. They are based on principles,
standards and values. Suppose the set of habits and tastes
which you shared with your fellow comprised in the main such
joint activities as visiting one another, going to shows together,
bowling and swimming. All of a sudden the fellow conceives
a dislike for sports and shows, preferring races, card games
and taverns. Unless you follow suit and adopt the same interests
and tastes fellowship will be disrupted. We conclude that fellowship
rests on stability of habits.
Consider now the matter of leadership. A leader guides your
conduct by means of the principles, standards and values which
he imparts to you. He gives you the policies and patterns for
your daily activities and sets the goals for you to aim at. Suppose
now that the men to whom you look for leadership change

their principles, standards and values as it may suit them, a
few or many times in succession; the policies which guided
you and the goals you aimed at will become shifting, capricious
and whimsical. And without stable principles, firm policies and
steady goals there is no leadership. We conclude that leadership
rests on stability of principle and policy.
Let me be brief now. In the army habits and tastes hardly
change, and principle and policy remain almost unvarying.
Fellowship and leadership are there founded on the rock of
stability. Caprice, whim, passion for frequent changes have
little or no place in its rules and patterns. The physical person
of the soldier is perpetually confronted with novel and perilous
situations, with incessant shifts and changes. But his personality
is thoroughly stabilized by the twin influences of the fellow's
adherence to stable habits and the leader's commitment to
firm policies. In such a moral climate the nervous patient finds
security and relaxation. His person is in continuous danger,
but his personality is solidly sheltered.
It is the curse of our modern life that stability of habits has
become impossible. Everything around us is in constant flux.
We have drifted into a mode of life in which change, under
the guise of "progress," has been turned into an ideal. Home
life is continually changing. Moving from one district to the
other has become a mania. Furniture that served its purpose
last year is no longer wanted the coming year. Automobiles are
traded in although they may be in working condition, just
because a "new" model is wanted. We have adopted the pernicious
philosophy that the "new" is desirable and the "old"
obnoxious. Stable tastes and habits are impossible under a
system of this kind which glorifies everything that has no other
distinction than its novelty and scorns the value of things for
no other reason than that they are no longer modern. Fellowship
is dying or withering under the impact of a system which
idolizes novelty and modernity.
If we "moderns" contented ourselves with merely changing
furniture, homes and automobiles the threat to our personalities
would be serious enough because novelty hunting interferes

with fellowship. Far more fatal, however, is our modern craving
for scrapping time-honored principles and exchanging them for
recent "advanced" and "progressive" patterns of life. What I
refer to here is our tendency to discard with a callous ruthlessness
well established systems of education, to rush at "reforms"
with unholy haste~, to display a contemptuous attitude and outright
ridicule for ancestral standards, to condemn the past as
"Victorian" and to extol present-day endeavors as the inspiration
of "advanced thought." All of this digs the grave for principle
and values and standards. It casts stability of policy into
discard and establishes the prerogative of caprice, whim and
erratic impulsiveness. And with caprice, whim and impulsiveness
to guide our action there can be no firm policy. And
without settled policy there can be no leadership. And without
leadership the nervous patient is bound to be victimized by the
sense of insecurity, tenseness, self-consciousness and symptoms.
No wonder Kenneth felt at home in the army and helpless
and lonesome after he returned to his home community. In
the army he had fellows and leaders. At home he was thrust
into a stream of life whose stabilizing influence had yielded to
the disintegrating effect of novelty and modernity.
Kenneth, noticing the reappearance of symptoms, felt desperate
and despaired even of Recovery. But he is here among
us today, and his mere presence, apart from his participation
in the panel, testifies to his abiding faith in the Recovery system.
He knows that in Recovery there is stability of habits,
hence, fellowship, and stability of principle, hence, leadership.

Gertrude, during a Saturday panel, spoke of her condition
prior to joining Recovery. "My main symptom/' she said,
"was the fear of death. I had palpitations and felt weak and
could hardly eat and lost weight and I was sure I was just
dying away. Dr. Low asked me whether I was afraid of
riding in an automobile and I told him it didn't mean anything
to me to race 60 or 70 miles an hour, and he said,
'Well, one thing is sure, you are not afraid of death in an
automobile accident/ That reminded me that I did other
things which were dangerous but I didn't fear them. I
wasn't scared at all when I went on high rides in Riverview
Park. And where I live I have to pass three cemeteries every
day to get to where I work. And in the evening, coming
back from work, I pass the three cemeteries again, frequently
late at night. That doesn't frighten me a bit. When
I told Dr. Low all of these things he said, 'What you are
afraid of are your own thoughts and impulses and sensations.
You don't fear physical death.* That was hard for me to
understand and I don't know whether I understand it much
better today. But one thing is sure: I have learned to spot
my fear as distressing but not dangerous and since I don't
attach the idea of danger to my palpitations they bother
me only once in a while and when I have them they go
as fast as they come."
Gertrude was given an explanation about the nature of her
fear and did not understand. Then she was given instructions
about spotting her inner experiences and she promptly learned
to practice a rule and to dispose of symptoms. My theoretical
explanations failed, but my practical directions succeeded. When
I offered explanations I was a teacher; when I gave directions

I functioned as a leader. Gertrude reacted poorly to my teaching
but responded magnificently to my leadership.
What I tried to teach Gertrude was the simple fact that what
appears to be an outer danger may be an inner threat. There
is nothing mysterious or obscure about a statement of this kind.
It is plain and simple and ought to be grasped without difficulty.
Why was Gertrude unable to understand this obvious and not
at all complex explanation? As I see it, the substance of my
teaching was clear in language and transparent in meaning. It
certainly had greater clarity than the rather complex directions
I gave her when I acted as leader. As such I told her to employ
our spotting techniques. Assuredly, the principles of spotting
are far more difficult to manipulate than a simple sentence
about inner and outer dangers. And if Gertrude is still unable,
even today, to understand my teaching but ready to accept my
leadership I suspect that it is not so much a matter of understanding
but rather one of preference. Whether she knows it
or not, the fact is she prefers dynamic leadership to pale and
dry teaching.
I wish that all my patients shared Gertrude's preference for
leadership^ Then, I could tell them what to do in order to
control their temperamental leanings, how to curb their romanticisms
and intellectualisms, how to check their sabotaging
trends and how to eliminate their fondness for self-diagnosing.
If that came to pass, suffering would be reduced to a minimum,
and Improvements might rise to an optimum. But unlike
Gertrude, the general run of my patients have an absurd hankering
for explanations and probings, for discussions and arguments.
At the time they consult rne they are in a state o confusion.
For Gertrude this confusion was a source of untold
agonies. In the morning she felt exhausted and "beaten up"
and had the desire to stay in bed but knew that it was her
duty to prepare breakfast for her husband. Duty conflicted with
desire. Should she tend to what she conceived as her health?
Or should she discharge what was clearly her marital duty?
The dilemma confused her. To the physical torture of the
symptoms was added the mental torture of not knowing what

was right and what wrong. Life appeared to her as an unbroken
series of confusions. When she was petrified by the
fear of death and dreaded being alone, she rushed out of the
house, hurrying in a senseless haste to her mother or sister
seeking comfort and assistance. But, on arriving, the panic was
gone and what was left was a crushing sense of shame for acting
like a baby and causing distress to those she loved. Was that
proper? Was this not evidence of inconsiderateness, even of
cruelty? It was all so puzzling, so perplexing. At times her
husband reprimanded her in harsh terms, insisting on her using
her will-power. To her this appeared to be a lack of understanding.
She was resentful and felt ugly impulses rising within
her. Was she getting irresponsible? Could she no longer trust
her impulses? How confusing! Then the racing of thoughts,
the inability to concentrate, the difficulty of following her own
trend of thought or of "taking in" what others told her. Did
that perchance mean that her mind was slipping? Confusion
was with her all the time, in every place, on all occasions. If
she only knew what it all meant. If she could only understand.
This was her state of mind when I first saw her. Every fiber
in her ached to get understanding, to be shown what was right
and what wrong, to escape her doubts, to relieve her ignorance.
And doubts can be cured, she thought, by explanations, ignorance
through knowledge. That called obviously for teaching,
discussion, exploration and talk. In this, Gertrude acted the
part of the intellectual. It is the intellectual's way of thinking
that problems, issues and perplexities are the result of ignorance,
and the proper remedy is education which he calls enlightenment.
Confusion, reasons the intellectual, is created by darkness,
and darkness is dispelled by light, and once the individual
"sees the light" impulses become docile and sensations turn
reasonable. The scheme, I admit, is easy to understand; it represents
the purest logic and the most attractive reasoning. But
does it work? Is it successful?
It is possible that I lack the astuteness and logical skill of an
intellectual. Perhaps I am deficient in the art of devising snappy
formulas and trim slogans. And so it happened that when I

offered Gertrude what I considered solid explanations about
sensations and impulses she was not at all relieved and her
confusion was not lifted. "That was hard for me to understand"
was her way of indicating that my attempt at re-educating
her had miscarried. Plainly, she was not impressed with
the quality of my teaching. This is the verdict of the majority
of my patients. Few of them take kindly to my explanations.
Most of them "find it hard to understand" what I tell them.
Yet, I am certain that what I tell them is about as substantial
and lucid as explanations can reasonably be expected to be. It
is not true that my teaching is "hard to understand." The truth
is that patients cannot be taught by teaching alone. What they
need is teaching supplemented by leading. Gertrude failed to
understand what I taught her, but when I added leadership to
instructorship her confusion gave way to clear vision and her
puzzlement to firm grasp.
Nervous patients suffer from fears and must learn how to
conquer them. Learning suggests education, but education is
by no means identical with teaching. What teaching does is to
give you information. Many things can be adequately acquired
through information. If you wish to gain knowledge in history
and geography or in languages and literature mere information
will or may fill the need. The teacher in geography or literature
need not be a leader. This is different if you want to learn a
trade. The foreman who teaches you must supply leadership
besides technical information. He will have to make you translate
into practice what he taught you through information. To
make a person practice what he is learning is the essence of
leadership. In making you practice the leader will insist on
patience, perseverance, self-discipline. While you practice your
attention will frequently wander, your effort will lag, your
courage will ebb. The leader will then, through precept and
example, revive attention, redirect effort and restore courage.
He will watch your performance and correct mistakes. He will
demand numerous repetitions of part acts until the total act will
be mastered. You will understand now why I say that to lead
means to make one practice. In Recovery, my patients receive

a prodigious amount of information, in meetings and home
gatherings and in the profuse literature which I have provided
for them. In this, I am their teacher who dispenses information.
But when I make them practice, unremittingly and untiringly,
the information which I gave them I am their leader who
supervises the practical training. Like all my patients, Gertrude
secured for herself the benefit of both information and leadership.
And since she succeeded in conquering her symptoms
leadership must have been effective and information helpful.
Why, then, did she conclude that what I told her was hard to
understand? Why was -she doubtful whether she even understood
it "much better today?" Apparently, my brand of information,
although thouroughly elective, did not appeal to
her and does not appeal "much better today."
I know that what I teach my patients lacks appeal. They do
not relish the thought that they suffer "just" from inner
threats. They insist that what they fear are outer dangers,
"nothing less.'* They do not take kindly to the dictum that their
symptoms are "merely" distressing but not dangerous. They
resent emphatically my instructions to step out boldly when their
muscles feel exhausted or to lie quietly in bed when they cannot
sleep because their body is rocked by tenseness and shaken
with agony. These items of information and principles of
leadership do not suit their fancies. They sound too simple,
even childish. They lack the glamor of sophistication, subtlety
and complexity. In their unadorned and naive phrasing my instructions
are a positive insult to the intellect. And when my
patients come for their first interview they are intellectualists,
and judged by the standard of intellectualism, my information
and my leadership must be found wanting. What Gertrude
found difficult to understand was my temerity to offer simple
information for a suffering so singularly deep and so exquisitely
complex. She had not yet gone through her training in Recovery,
and steeped in the philosophy of intellectualism, was
shocked by this rude insult to her intelligence.
I told you repeatedly that the romanto-intellectualist tendencies
of my patients are fostered by contemporary thought.

And our age is hopelessly addicted to the worship of sheer
information. Present-day men and women receive the bulk of
their education through the channels of information, especially
after they have reached adolescence or adulthood and are eligible
for what is called "adult education." Then they are given the
doubtful benefit of lectures and forums, book reviews, popular
expositions on science and psychology, advice in child rearing
and family management, instruction on how to make friends
and influence people. The implication is that correct information
is the surest way to correct action and that all a person
needs for improving his habits is to be told how to do it. Training,
practice, leadership have been radically, and perhaps joyfully,
discarded in this weird scheme of life in which grownup
persons are expected to repose childlike faith in the magical
power of theoretical knowledge. The scheme has produced such
absurdities as the quixotic plan to reform criminals through
psychology, to prevent delinquency by spreading the information
that "crime does not pay," to convert races and nations to
democracy by teaching them the advantages of the democratic
way. The notion that by some trick information can change
action and direct impulses has gripped the imagination of the
age. We in Recovery refuse to believe in magic, and if we want
to change our action we devise proper counter-action, and if
our impulses need controlling we provide for adequate means
of checking them. Our method is that of patient practice supervised
by a leader. In our old-fashioned scheme, information is
merely the preliminary to training and practice, not a substitute
for leadership. Gertrude demonstrated the effectiveness of the
system. As long as her mind was focused on the questionable
blessings of information she paid dearly in terms of tenseness
and symptoms. After she decided to accept leadership she -was
rewarded with relaxation and freedom from suffering.

Margaret, taking part in the Saturday panel, reported an
experience which she had while attending an auction in one
of the Loop galleries. "I was tense," she said, "the auctioneer
was handling things too fast for me. There was noise; the
people were talking and laughing. I intended to bid but
was afraid I might do it at the wrong time. But I made
myself sit it out and when some cocktail forks were offered
I put in my bid. A girl came to collect the deposit for a
three dollar bid. I was confused and felt a tightening in
my chest. Finally I got up the courage to ask the girl how
much of a deposit was required but she did not answer.
Maybe I didn't hear her. I became more confused and the
tightening in the chest got worse. I fumbled in my pocketbook
and took out a five dollar bill. The girl said she did
not have the change. I looked for a dollar bill but in my
confusion pulled out a ten dollar bill. Realizing what I had
done I put it back only to pull out another ten. By this
time the confusion got worse and I could hardly see. I was
doing what Dr. Low calls processing and realized that I
was busy working myself up to panics and vicious cycles.
So I collected my wits so to speak and made up my mind
to look calmly for a one dollar bill and if it wasn't enough
the girl would tell me. Several months ago before I had my
Recovery training I would have been sure I was losing my
mind. My confusion would have grown worse and that
would have made it surer that my mind was going . *
Margaret, fumbling in her pocketbook for a one dollar bill,
pulled out five and ten dollar notes in three successive attempts.
Noting the three times repeated error she drifted into a confusion
which was so intense that it made her head swim with
dizziness, threw her muscles into tremors and created a vicious

cycle which threatened to precipitate a panic. In former days,
she said, "Before I had my Recovery training I would have
been sure I was losing my mind." But errors are the most
common occurrence in everybody's experience. Indeed, there
would be no sound and tested experience unless errors were
made, and made repeatedly and then corrected. It is precisely
the correction of errors which gives correct experience. If this
is so, then, errors are a necessary and desirable and wholesome
part of life even if they are repeated three times and dozens of
times and hundreds of times. What made Margaret think that
the commission of errors is an indication of a mind crumbling?
Margaret has the record of many years of faithful and efficient
service in a government office. She is married, has friends, belongs
to a church and holds membership in various civic groups.
In all these spheres she has witnessed numbers of mistakes
made by multitudes of people. Yet, it never occurred to her to
suspect this blundering humanity to suffer from mental deterioration
because of the innumerable errors chargeable to it.
Whenever she was faced with an "erring soul'* she knew that
"to err is human" and viewed errors, failures, neglects and
oversights as what they are: an acceptable and unavoidable
"part of life." Why did she assume that erring must not be
permitted to be part of her own life? Why did she practice
gentle tolerance with others and was preposterously intolerant
with herself? To put it differently: when Margaret observed
occasional slips in other peoples' mental activities she did not
conclude that their minds were slipping beyond repair. But
when she noticed a similar temporary weakness in her own
mental function she instantly jumped to the conclusion that
her mind was going or gone. She has an abiding trust in the
mental constitution of others but an abysmal distrust in her own
mental capacity. This attitude of wholesale self-distrust is a
common feature among nervous patients who as a group are
afflicted with the PASSION FOR SELF-DISTRUST.
My daily life is crowded with occasions in which I fumble
and falter. While walking on the street I sometimes stumble
or bump into another person. Occasionally I slip or fall on the

wet or icy sidewalk. At times I actually hurt myself. Nevertheless,
I do not conceive a violent distrust of my Self but
consider the misstep or mishap as part of my life. The same
holds true for numerous other experiences of my daily round.
It happens frequently that I talk to people and fear I said too
much. Or, I feel I did not say enough or said the wrong thing.
Or, I fall into the trap of a slick salesman who, taking advantage
of my preoccupation, tricks me into an ill-considered purchase.
In all these instances my Self, physical or social, fails
me but I do not lose trust in it.
My patients are of a different cast. They spill water and
conclude their coordination is badly damaged. If misplacing
an object they have difficulty retrieving it they are "certain"
their memory is gone. While reading a magazine their attention
may wander and they are "sure" they lost the power of
concentration. They may make a wrong decision in some
paltry endeavor and it is "clear" to them that their judgment
is unreliable. There is the matter of forgetting a name, the
inability to recall an event, the difficulty of collecting their
thoughts for the purpose of writing a letter, or the sudden
"freezing up" when called upon to voice an opinion at a club
meeting. In all these situations, and in a thousand others, they
are "certain" and "sure" and "positive" that their functions,
physical and mental, are disintegrating and cannot be trusted.
If I try to persuade them that their errors and failures are
sheer trivialities, trite and meaningless, they launch into a
fierce argument laboring heavily to convince me that it is
"clear" and "plain" and "obvious" (and "how can anyone doubt
it?") that their mental and physical capacities are utterly beyond
redemption and that their Selves cannot be trusted. It
is this insistence on the "clear evidence" and "certain indication"
and "positive proof" that stamps their attitude as the "PASSION
To have trust in one's organs and functions is to be spontaneous.
Spontaneity means many things. It means, for instance,
that you have an intention and your muscles carry it out,
promptly, without hesitation, with precision and determination.

This happens in the ordinary performances o your daily routine.
You decide to go shopping. This involves a running series of
part acts: dressing, walking to the next street car stop, boarding
the coach, paying the fare, entering a store, giving orders to
the sales person, riding back home. Take the item of the street
car ride. You enter, pay the fare, take your seat, chat with the
neighbor until you finally arrive at your destination. During
this time you performed hundreds of movements and spoke
thousands of words. Your muscles acted and spoke without
your active intervention. No coaxing, prodding or urging was
needed. You passed your intention on to the muscles and they
went ahead and implemented it. This gave you the feeling of
vitality and accomplishment; it gave you the sense of "I can"
There was no doubt in your mind that the muscles were competent
to perform the task. The absence of doubt made for
self-confidence. Since no watching or checking was required
you drifted into a state of relaxation. The relaxation caused an
absence of tenseness. With no tenseness to irritate your nerves
the activity gave you enjoyment. You felt like an active, living,
dynamic personality. Life was pleasure, perhaps bliss and
My patients have gone through months or years of torture
and in the process developed sustained tenseness and symptoms
attending it. Their weariness, their pains, fatigues, pressures
and spasms have made them self-conscious in the extreme.
Hence, they lack the feeling of vitality and accomplishment;
they have lost their self-confidence, are unable to relax or enjoy
things. Required to formulate plans and intentions they are
instantly gripped with the fear that their muscles will fail
them, that they will not be ready to carry out what they are
asked to do. Being the victims of an unrelenting self-consciousness
they question their capacities, watch and check every one of
their moves and perform with hesitation and anxiety. Their
attitude is that of an abiding pessimism; they feel whipped and
defeated; their guiding philosophy of defeatism has hardened
into a settled conviction. They are "sure" and "certain" and
that acting is impossible, that their muscles will defy

orders, that their power to get things done is lost, that their
personality functions are doomed. Their philosophy of "I can't"
has assumed the status of a dogma; it is implicitly believed, hotly
defended and fondly sheltered.
The calamity is that the relatives and friends do not share
the patient's defeatism and refuse to subscribe to the cult of
"I can't." They look at the sufferer and notice a blooming complexion,
a strong voice, a lively facial expression. They observe
the patient in a fit of his frequent tantrums and witness a display
of force and energy which belies the claim to invalidism.
Their conclusion is that the patient could but would not do
the things which are to be done. The idea is forced on them
that he is unwilling instead of unable to perform his function.
They upbraid him, urge him to make an honest effort and
with this they accuse him of shamming disease, of playing a
game, of practicing deception. They indict his character, his
honesty; they charge him with deliberate neglect of duties and
obligations and fasten the label of irresponsibility on him. This
strikes at the root of his self-respect, of his personal value and
social position. This savage assault must be repelled. The
patient feels he must bend every ounce of his energy to the
vital task of convincing the others that he "really" can't, that
he is "truly" incapable of acting, that he is "positively" helpless.
The patient is now a crusader for the philosophy of "I can't."
He concentrates on the effort to win over the others to his
dogma of defeatism, to make converts, to spread the gospel of
his incurability. In order to convince those about him, including
the physician, he must engage in a veritable campaign of
complaining, wailing, lamenting. In his interminable moaning
and groaning he is compelled to overemphasize the utter unreliability
of his organs and functions. His body is forever
about to crumble, his mind is constantly ready to disintegrate.
As he continues on this career of self-denunciation he fairly
gorges himself with the idea of distrust and in the end develops
crusading for the philosophy of "I can't" has netted him one
faithful and unswerving convert: himself.

Mildred reported on the Saturday panel that all her life
she had a perfectionist attitude. "I set a standard for myself
that an Olympic champion could not approach. I work
at top speed and try to do everything at once and drive myself
to finish my job in half the time it would take an expert
to accomplish it. But then I get tremors, pressure in the
head, a feeling of falling apart as though my arms and legs
don't belong to me and some sort of sensation in which
space has become a solid wall and I must push my way
through it every time I move. When this happens I become
panicky and feel sure I am losing my mind. The other day
I was in the basement washing clothes. I had meat cooking
upstairs on the first floor, the vacuum connected on the
second floor ready to use, and the washing machine in the
basement. As if this were not enough I went out into the
yard starting to untangle a hopelessly gnarled clothesline,
blaming myself all the time for messing up my work and
accomplishing nothing. I had hardly untangled the clothesline
when it began to rain. I became confused and frightened
and felt I couldn't move across the yard because the solid
wall was there instead of space. Suddenly I remembered
my Recovery training and spotted my frustration as an attitude
of perfectionism. I realized that my rushing from one
job to another was the desire to do more than an average
person can do and that my confusion was the sense of disappointment
at not being able to do the exceptional job. So
I stopped the rush, calmed down deliberately and made up
my mind to do one job after the other. In an instant the
confusion went and the fear of losing my mind stopped.
Before my Recovery training I would have kept on working

fast and would have gotten into the vicious cycle o fear,
self-blame and the depression that went with it. The vicious
cycle used to last for months and at one time lasted three
Mildred, in a confusion which threatened to unhinge her
mind, "calmed down deliberately" and decided to give up
ambition to do the perfect job. "In an instant," she says, "the
confusion went and the fear of losing my mind stopped." But
if a mere decision is sufficient to put an abrupt end to a longstanding
confusion my patients ought to have no difficulty getting
rid of their perplexities, vicious cycles and tortures. What
Mildred did all of them ought to be able to do.
What was it that troubled and confused Mildred? There
was cooking to be done on one floor, cleaning on another floor
and washing in the basement. A fourth job was waiting to be
finished in the yard: tending to the "hopelessly gnarled clothesline."
The issue was: should all four jobs be carried out at
once or one after another? If the tasks were done coincidently
Mildred would have the sense of pride, of outstanding accomplishment,
of perfection and excellence. If they were done singly
and successively the job would be of average quality, lacking
the glamor of top performance and peak achievement. Reduced
to these simple terms the choice and decision which Mildred
was to make was between two discrete philosophies: to be average
or exceptional.
I spoke to you about philosophies on several occasions. It is
precisely your philosophy (of life) which tells you which decisions
are correct and which acts are acceptable. You will remember
I mentioned three main philosophies which are current
among human beings: realism, intellectualism and romanticism.
The intellectualist claims superior powers of reasoning
while the romanticist boasts of his exquisite capacity for vigorous
feelings, interesting sensations and strong impulses. The
one strives to be recognized as being distinct from the "ignorant
mob"; the other as being apart from the "vulgar crowd." Their
philosophy is decidedly that of exceptionality. They fear or hate
to be rated as "just average." The realist, on the other hand,

does not view the members of his group as mob or crowd. To
him they are average persons, not perfect by any means, not
exceptional on any count, but worthy people of average efficiency
and average solidity. Their averageness may be o good, plain
or poor quality but essentially they are average in the entire
sweep of their daily existence. And so is he, the realist. He
is average in thought, feeling and action. He claims no glory
or glamor, no excellence or exceptionality.
Mildred subscribed to the philosophy of exceptionality. This
is nothing uncommon. There are very few people who do not
think of themselves as being of a superior breed, as ranking
above the "common herd," that is, as being exceptional. With
most of them it is merely a dream, an ambition and aspiration.
They hope to be exceptional but know they are "nothing but
average." In their dreams and fancies they are romanto-intellectuals
but in actual practice they behave as realists. Their
sense of exceptionality is properly controlled by their knowledge
of being average. If you keep this in mind you will realize
that most if not all people embrace both the philosophy of exceptionality
and that of averageness. The average person adjusts
and balances the two philosophies in such a manner that the
one (averageness) is leading and controlling, the other (exceptionality)
is led and controlled. If this is done, then, decisions
and actions are balanced and adjusted on a practical level while
dreams and fancies are given free play on an imaginative level.
Mildred had no leading philosophy of realistic averageness to tell
her which of her decisions were correct, which of her actions
were feasible. In her mind, the two philosophies were not
held apart, they were not properly distinguished the one from
the other; they were permitted to merge and fuse. The free
fusion of the two philosophies produced a confusion of the mind.
What directed her behavior were her dreams and hopes, her
wild aspirations and vague ambitions. With these unrealistic
leads to guide her reactions her decisions became fantastic (to
act at one and the same time on four separate jobs in four separate
places). As a result, her actions became tangled, involved
and as "hopelessly gnarled" as was her clothesline. In the end,

she despaired o ever reaching the correct decision and became
lost in a sea of confusion.
The daily round of the average individual consists in the
main of such trivial performances as reading, conversing, working
on a job, cooking, washing, cleaning, telephoning, shopping.
The person with a settled sense of averageness does these routine
chores with hardly any thought wasted on them, without hurry,
without anxiety, without the harrowing fear of possible failure.
Considering them as routine he knows they involve no danger
and is happily at ease, poised and spontaneous while engaged
in his work. It is only on those relatively rare occasions when
highly important or emergency reactions must be faced that the
person possessed of a sense of averageness may become tense
and may suffer a decrease in his spontaneity. Spontaneity means
that you are not self-conscious, that you are not on your guard
for fear of making mistakes. Spontaneity means the COURAGE
TO MAKE MISTAKES. In trivial or routine activities no
calamity arises if perchance a mistake occurs. This is the reason
why realists, that is, men and women of average aspirations go
about their daily tasks with due caution and circumspection,
it is true, but without any marked fear of making a mistake.
Mistakes made in trivial performances are trivial themselves
and their possible consequences are just as trivial and not to be
feared. With the fear of mistakes largely removed from the
mind of the realist his decisions are reached with ease and his
actions initiated without undue hesitation. All of this is the
result of spontaneity and, in turn, favors its development.
This is altogether different in the instance of the perfectionist
or the person consumed with the desire to achieve exceptionality.
To him every puny endeavor, each trivial enterprise is a challenge
to prove and to maintain his exceptional stature. His life is
a perennial test of his singularity and distinction. For him there
are no trivialities, no routine performances. He is forever on
trial, before his own inner seat of judgement, for his excellence
and exceptional ability. He cannot achieve poise, relaxation,
spontaneity. He cannot afford to have the COURAGE TO
MAKE MISTAKES. A mistake might wipe out his pretense
of being superior, important, exceptional. With no margin

left for mistakes he is perpetually haunted by the fear of making
them. The fear paralyzes decision, hampers actions and confounds
plans. Striving for indiscriminate peak performance and
confronted with his pitiful record of jobs undone, unfinished
and hopelessly bungled he is horrified by his cumulative inefficiency
and becomes confused.
Mildred, a confirmed exceptionalist, turned realist embracing
averageness as her leading philosophy. She did that after she
joined Recovery. There she learned that romanto-intellectualist
dreams and fancies must not be permitted to express themselves
recklessly but must be led and controlled by an average
and humble attitude. She also learned that this must be done
through a system of persistent spotting, thorough self-control
and relentless self-discipline. It was not easy for Mildred to accept
and absorb the idea of control and discipline. She is a
product of our modern age and as such was subjected all her
life to the contemporary doctrine of unrestrained expression of
feelings and impulses. Impulses and feelings are precisely those
elements in our experience which balk at being rated as average.
They are singularly private and intimate and personal and give
you the impression that through them you are set off and distinguished
from the others. And if you think of yourself as
different from others you are inclined to consider the others
as common and ordinary and average and yourself as distinct and
exceptional. With nervous patients this tendency to set themselves
off from the others is apt to assume ridiculous proportions.
If you emphasize your feelings, their importance, and intensity;
if you are forever suspicious that they are not properly understood;
if you constantly fear and complain that they are deliberately
ignored and cruelly hurt; if you pamper and coddle them
and, thereby, work yourself up to a hysterical pitch, then, your
emotionalism and impulsiveness may easily reach such a fury
that they impress you as exceptional, indeed. You will now
understand that our modern tendency to favor unrestrained
expresssion of feelings and impulses overemphasizes individual
differences and personal distinctions and thus promotes the
sense of exceptionality.
Modern education is only one of the factors which promote

the philosophy of exceptionality. Another factor is modern
machine technique. A machine leaves little or no room for
average performance. A machine loses its usefulness if it fails
to work at top speed and record efficiency. It must be perfect
within the sphere of its application. The numerous gadgets introduced
these days in kitchen, shop and office are worthless
unless they conform to the "highest standard" of performance.
Their work must be faultlessly smooth, perfectly safe and of top
flight productivity. In our mechanized existence the machine
has become the symbol of perfection. Mistakes are no longer
tolerated in this modern scheme of mechanical excellence. If
mistakes happen as, for instance, in an airplane or railroad accident
the engineering tribe loses no time shifting the blame from
the "flawless" machine and placing it where it "properly" belongs:
the "human element.
51 The machine can do no wrong.
It is always "perfect." It is man, that miserable, as yet unmechanized,
backward and bungling creature who is at fault.
Man and human nature have become an anachronism, a relic of
that unspeakably imperfect "horse and buggy age" which to the
modern mind is the epitome of clumsiness and ineptitude. In
spite of the "marvelous" advance of technique man is still in a
deplorable state of imperfection. It is he who has failed to
measure up to the matchless efficiency of the machine. We of
Recovery have no use for a system which preaches perfection
as an ideal to be achieved through the blessings of a machineregulated
existence. If our mortal state of imperfection can only
redeemed through the "faultless operation" of lifeless machines,
well, we are old-fashioned enough to renounce the machine
and enjoy our averageness and spontaneity. Mildred,
trained in the philosophy of Recovery, learned to scorn faultless
operations and perfect performances. In the process, she acquired
poise and relaxation and is now in the happy position of doing
jobs efficiently (not perfectly, not faultlessly) by the simple
procedure of practicing the COURAGE TO MAKE MISTAKES
in the trivial affairs of her daily round.

In a panel discussion on "The Illusion of Superiority"
Alice made the following comment: "Some day last week
I was waxing the kitchen floor and my husband sat by the
phone watching me. Suddenly he said, 'Honey, that chair
I painted in the basement must be dry. Will you bring it
upstairs and then get Charlie on the phone for me?* Automatically
I started for the basement and then stopped. *He
is bossing me/ I thought, 'and then he is almost twice my
size and can get that heavy chair himself. Besides he is right
by the phone and can get Charlie himself, and anyway I
am busy.' I felt hurt and was good and angry and in former
days I would have given him a piece of my mind. But
this time I spotted my resentment as temper and said to myself
that my feelings are not so important and I laughed and
said, Til help you carry the chair, and you can make the
phone call yourself/ I expected an outburst on his part and
was already prepared to hold down my temper if that should
happen but he merely said, 'O.K., it's a deal.* After that I
felt proud of myself and there was no temper and so I had
no tremors and pressures or nausea, and on top of it I felt
fine because I had asserted myself without temper."
What Alice reported was an incident in which Edward, her
husband, took the position that he was the boss, and the wife
took the contrary position that she was not going to be ordered
about. But if two partners to a joint enterprise take opposite
positions the result will be that temper will thwart action. In the
present instance, Alice turned her Recovery training to good
account taking the final position that temper is something ridiculous
and a healthy compromise the only way to establish peace

and cooperation in married life. You see here that whether a
partnership is marred by temper or aided by a workable compromise
depends on the nature of the positions habitually taken
by the partners.
It will be important for you to know that every act of yours,
no matter how trivial, is preceded by a position. Before you
take a swallow of your soup you have already decided, that is,
taken the position that the food is not poisoned, that it will cause
no indigestion, that it is the proper kind of nourishment to take.
You may not be, and usually are not, aware of having taken
that position but you took it nevertheless; you took it intuitively
and unreflectively. Positions of this kind are taken in advance
of every move you make and every sentence you speak. No
person in his right mind makes a motion or voices a phrase
unless he has first determined or taken the position that the
coming action is devoid of danger and the planned statement
free from risk. You will understand now that every act of behavior
is preceded by a position. What kind of positions you will
cultivate depends on whether you are sentimental or realistic.
If you are sentimental your positions will prepare you for emotional
excitements; if you are realistic they will favor peace and
Another thing you will have to learn: a position is invariably
preceded by a disposition. If your present disposition is belligerent
it will give rise to a series of fighting positions and your
subsequent behavior will be aggressive, threatening, provocative.
If it is peaceful your positions will be favorable to a courteous,
conciliatory and compromising attitude. Alice and Edward
were belligerent in disposition and when issues arose in their
marital relations their positions were likely to be those of the
angry temper: sharp, antagonistic, unyielding. After months of
Recovery training Alice changed her dispositions, shelved her
temper and tended to take realistic and compromising positions.
Her action was calm and peaceful, and the change in her behavior
laid the groundwork for a workable and satisfactory
marital union.
How did Alice manage to alter her dispositions? Which

method did she use to bring about the change? Is such a
method available? On first thought it would seem hardly
thinkable that a method of this kind could exist. Just reflect
for a moment what the word disposition implies. You enjoy
a thing because you are inclined or disposed to like it. You
hate a person because you are inclined or disposed to hate him.
If you swim, eat, walk, speak, rest, work all of this is done
only if you happen to be moved by a corresponding inclination
or disposition. Leaving aside purely automatic behavior, there is
no act that could conceivably be released without proceeding from
an appropriate disposition. And if every act of yours requires
its proper dispositional preparation it must be clear that disposition
is the very breath of your life. It is the basis of your existence,
your fate and destiny, indeed, your nature. Can nature
be changed?
I do not presume to know whether physical nature can be
changed. I hope it cannot because I love nature just as it is.
I shudder to think that the modern magicians of atomic energy
may yet succeed in their ruthless attempt to tamper with the
grandeur and majesty of physical nature. I fervently hope that
even the frightful inventions of modern technology will find
physical nature unchangeable. But what I know for certain is
that human nature, that is, human dispositions, can be changed
at will and with ease whenever it is convenient, desirable or
mandatory. When you are at home, almie with your family
and no outsiders present, your nature may be that of an ugly
disposition, cantankerous, quarrelsome, demanding and domineering.
Suddenly you decide to go to the corner drug store
to buy the evening paper. No sooner have you reached the
street than your nature undergoes a miraculous transformation.
Your disposition is now that of affability, good will, grace and
courtesy. You meet the policeman on his beat or the delivery
clerk from the nearest grocery store, and the grouch with which
you left your home is gone; your disposition is fairly oozing
sympathy and geniality; your nature has changed from domination
to service. It did that in a fraction of a second, prompted by
no more dramatic an event than the decision to step outside

the house. You can observe the ready changeability of human
dispositions in your daily experience where you will notice that
abrupt transitions from one natural trend to another are carried
out with ease, moreover, without reflection or formal decision.
The subject has been treated in great detail in the various chapters
of volume 3 of the "Self-Help System" dealing with the
temperamental disposition.
Out on the street or at a social function or in the company
of your co-workers, you are well-behaved all the time and your
temper is under rigid control under all circumstances provided
you are a person of manners and not a boor. The man near
you disturbs you with unnecessary questions or unwelcome interruptions.
You are irritated but retain your courteous disposition.
Another man slams the door and you feel provoked by the lack
of consideration but your disposition remains calm. You see,
outside the home your dispositions are even, always controlled,
unconditionally checked. Conversely, at home your dispositions
may be at any time uneven, temperamental, ill-controlled. This
is due to the fact that dispositions are governed by predispositions.
Arriving at home you are likely to assume the predisposition to
domination with the result that henceforth all or most of your
dispositions will be of a domineering nature. On the other
hand, once you step out into the street or join a group anywhere
you will instantly summon your predisposition to service and will
be disposed forthwith to mold your behavior in the spirit of
accommodation. The change from one predisposition to the
other takes place in a fraction of a second which means that
human nature can be changed with lightning-like rapidity,
without conscious effort, without deliberate decision, "quite
Alice shifted her predispositions by means of conscious resolution.
In Recovery she had learned to spot the nature and
quality of her reactions. Spotting the meaning of her positions
she always knew which set of dispositions were about to take
command of her muscles. If they pointed to a temperamental
predisposition she knew that a shift to a realistic predisposition
was in order. She effected the predispositiond shift and her

"nature" changed instantly from temper to controlled behavior.
As I mentioned, the ordinary person produces similar shifts
routinely without benefit of special training. But what he
does is done spontaneously, hence, fumblingly and unsystematically.
What Alice did was done with a systematic effort of
will, hence, consistently and methodically. What the man in
the street does with the aid of vague intuition Alice was trained
to accomplish with conscious determination. Learning to spot
her positions and to stop her dispositions her Recovery-trained
will scored over her "natural" impulses.
What precisely Alice learned in Recovery is this: Human
beings are always members of a group. They are wives, husbands,
friends, neighbors, citizens, co-workers, schoolmates,
executives, employes. If the members of a group are predisposed
to realistic cooperation they act as partners. The spirit is then
that of partnership. If they are predisposed to temperamental
explosions they act as partisans and the resulting spirit is that of
partisanship. Partnership promotes the purpose of the group,
partisanship disrupts it. When Alice and Edward joined hands
for the purpose of a marital union their aim was a close partnership.
But temper intervened and turned marital life into a
sharp partisanship. Their marriage was clearly headed for
the rocks but was saved from disintegration when Alice, racked
by nervous strain and tortured by symptoms, joined Recovery.
There she was made to realize that temperamental positions can
be tracked down by spotting and that the predisposition to
partisanship can be checkmated at will, with ease and with the
promise of unqualified success. Recovery had cured a patient
and saved a marriage.


The concept of sabotage is basic to the philosophy of Recovery.
The nervous patient sabotages his own health, his social adjustment,
his efficiency and equilibrium and most pernicious form
of sabotage the physician's authority. The trouble is that the
patient, engaged in a systematic effort of obstruction, plies his
trade in such a subtle and almost underhanded manner that he
is not aware of his own plottings and machinations. In former
days the author believed that the patient weaves his obstructionist
plots from the depths of subconscious motivations. This
absolved him of all suspicion of deliberate conspiracy. Gradually,
however, it became increasingly obvious that a good deal
of conscious contrivance was at work. The patient asks the innocent-
sounding question, "Don't you think my condition could
be the result of a glandular trouble?" That this is a diagnostic
statement and therefore an attempt at sabotage is clear to the
physician. But is it equally clear to the patient? Is he conscious
of the fact that his question challenged the physician's diagnosis?
It is safe to say that at the precise moment when the inquiry is
made the thought of antagonism or obstruction may be absent
from the questioner's mind. But if we survey the patient's
mental activities beyond the immediate scene and trace his meditations
no farther back than to the bus trip which he made to
the doctor's office the picture changes radically. While on the
bus he was preoccupied with the diagnosis given him on the
occasion of his previous visit. He was told then that his condition
was of a nervous nature, that it implied no danger, that
the combination of office treatment and group management
would eliminate his complaints. Now, on the bus, he views the
physician's pronouncements with a critical eye. It seems preposterous
to him that his "unbearable" fatigue should be labelled
"just nervous," i.e., innocent and harmless.

Why then was he asked by other physicians to take a rest,
to stop working? True enough, his present physician is competent,
highly recommended and undoubtedly successful. But
Drs. J. and F. were no numskulls, either, and the one diagnosed
a mild anemic condition, and the other blamed the fatigue on
a low blood pressure. And the doctor who writes the health
column in the morning paper suggested yesterday that fatigue
states are frequently caused by a lowered metabolism which, in
many instances, can be traced to a glandular deficiency. Why
should all these possibilities be ignored? The ruminations continue
in this vein until the train of thought is interrupted by
some incident that diverts the patient's attention. The sabotaging
activity is no longer pursued. Leaving the bus, the patient
enters a restaurant to take his lunch. He reads the paper, gives
some fleeting thought to all kinds of topics and observations,
and the subjects of complaints and diagnosis sink to a lower
level of consciousness. When he faces the physician his diagnostic
doubts may still be removed from the upper strata of his conscious
awareness. But are they buried in the subconscious?
They were mulled over and rehearsed just half an hour ago
and are quite active and fresh in memory although not in the
forefront of conscious meditation. They wait merely for the
proper occasion to be revived. When the physician opens up
with the introductory question, "How are you today?"" the patient's
slumbering antagonism is quickly aroused, and the
thoughts recently rehearsed during the bus ride are promptly
sprung on the physician. That antagonism may not at the
present moment be glaringly conscious. But it was in the limelight
of awareness a short while ago. It did not have the
time to sink down to the subconscious level. We may safely call
it half-conscious or quasi-conscious.
Clearly, if sabotage is to be controlled and eliminated it must
be stopped at its source and origin. It originates at times and in
places outside the physician's office, in the bus, at home, on the
street, in the workshop. In the presence of the physician the
sabotaging thoughts burst forth spontaneously with little reflection
and hardly any deliberation. But in the absence of the

physician the sabotaging is done reflectively and deliberately.
If a person is spontaneous, his utterances are blurted out and
poured forth impulsively. Usually there is neither time nor
incentive to revise the spontaneous performance. On the other
hand, when the patient sabotages in clear reflection he has the
time and occasion for correction provided he has also the incentive
to correct. Recovery, with its untiring insistence on a
total effort, supplies the patient with the needed incentive. But
the patient's endeavor is bound to be vague, groping and ineffectual
unless he is supplied with adequate insight into the
devious ways in which his own sabotaging tricks operate.
Armed with both incentive and insight he will be properly
equipped for the long-drawn-out and gruelling battle against
his sabotaging propensities, the ENEMY NUMBER ONE of
mental health. Of the many disguises behind which sabotage
hides the most important ones will be mentioned in the present
volume. As may be expected, the most common form is one
which is frequently encountered in ordinary conversation: Literalness.
Essentially, this device makes use of the technique of
rejecting a statement made by the speaker without opposing
it openly.
Example 1. The patient reported that at a card game his
mother corrected him every few minutes. He was provoked,
threw the cards on the table and precipitated a violent argument.
He slept poorly that night and awoke in the morning all
exhausted. He was told to avoid drawing the temperamental
conclusion that he is right and mother wrong. His reply was,
"I think that mother is wrong but not that I am right." It was
not easy to make the patient see the obvious truth that the question
raised in an argument is who is right and who is wrong;
that if the one party to the controversy is declared to be in
the wrong it follows inevitably that the other party must be
right; that if he thought the mother was wrong it was obvious
that he felt he was right. "Can't I think the one thought and
not the other?" the disputant continued. "Not any more/* he
was told, "than you can think of light without darkness, good
without bad, love without hate. Once the one pair of the

team of opposites is thought of the other pair is called up automatically."
The patient was then shown that he could have
used his own common sense to realize that he was literal and
listened to the letter instead of to the meaning of the physician's
statements. If he had done that he would have demonstrated
a will to conquer his temper. Instead, he distorted common
sense and debauched logic and sabotaged the will to get well.
Example 2. A lady exclaimed in utter frustration, "I can't
plan. I get flustered when I begin and then I do not know what
to do next." The physician remarked, "Of course, if you say
you cannot plan . . ." but was unable to continue because the
lady interrupted him sharply, "I don't mean to say that I
cannot plan. It is merely difficult for me to make a decision
because I have no determination." She was told bluntly that
her manner of reasoning was devoid of logic; that the sharp
distinction which she chose to make between planning, making
decisions, and having determination was superficial sophistry, a
literal differentiation meant to confuse the issue instead of
clarifying it. Being a college graduate and possessed of such
keen logic as to be an artist at word juggling, she ought to employ
her logical capacities to analyze her own statements in terms
of sabotage. Her aim ought to be to get well, not to stage a
senseless and futile debate with her physician. The result
was that she produced a new literalistic perversion of logic.
She shouted, "I do not mean to debate with you, I merely wish
to make you understand my point of view." Whereupon she
was told politely but firmly, "Whether I understand or misunderstand
you is of no significance. The thing that counts
is that you make every effort to understand me."
Example 3. A patient turned in an urgent message of distress
over the telephone. He complained in a voice quivering with
excitement that his tenseness was "simply unbearable." "What
can you suggest for my relief?" he inquired. He was asked to
come to the office that same evening. "But I don't see how I
can stand it that long," he replied. He was assured that there
was not the slightest danger in a tenseness of this kind and
there was no reason for being alarmed. "I am not alarmed,

doctor," he shouted, "but I feel something is going to happen
if I don't get help. Can't you let me come to the office right
now?" The man is a government official of considerable rank
and could easily see the identity of meaning between "alarm"
and "feeling that something is going to happen." He had
been given a number of private interviews but resented being
considered a psychoneurotic person. He protested forever that
his distress was physical in origin and was annoyed by the
physician's insistence that it was emotional in nature. The
words "fear" and "alarm" were tabu to him. Taking them in
their literal sense he wiped them out of existence by using a
phrase with a slightly different connotation.
Example 4. A patient suffered from an itch on the scalp for
over five years. In the course of time he developed a marked
self-consciousness and tenseness which interfered with his general
well-being and his occupation as a drummer in an orchestra.
For the past two years drumming had become an obsession with
him. He was compelled to drum incessantly on the table
at which he sat, on the outer aspect of his legs when he stood,
and on the walls of houses when he passed them. The members
of his family claimed they "went almost crazy" because of the
perpetual drumming. After several months of private and class
treatment the itch was under good control, and the tenseness
and self-consciousness had given way to a satisfactory measure
of relaxation. But the drumming persisted. The patient was
asked, "Why don't you stop that drumming? You got rid of
the itch by learning to ignore the discomfort and by controlling
the muscles of the hands when they 'itched* to scratch. You
can control the drumming by exactly the same procedure.
Whenever you feel the 'overwhelming* impulse to drum you can
check the impulse and can command your muscles not to carry
out the drumming movements." The patient replied, "Drumming
is music to me, and I like music/* He was promptly
reprimanded for daring to offer a nonsensical explanation of
this sort. "You know as well as I do," the physician said, "that
you do not maintain the drumming for its musical value. You
know, it is nothing but noise." "It is rhythm, though," the patient

replied. After some sparring he finally admitted that his attempt
to identify compulsory finger movements with music
and rhythm was nothing more than sabotage made possible by
a literal misinterpretation of the physician's words.
Example 5. A patient who had lost many of her symptoms
continued to complain of blurred vision which had been declared
frequently by the physician to be of nervous origin. "The
blur still bothers me," the patient said, "I don't see things clearly."
The physician renewed his assurance that the symptom was
of a nervous nature and nothing to worry about. "I don't worry,"
insisted the patient. "I merely thought you might want to
examine me again." The eyes were re-examined and the patient
told that there was no evidence of any defect. The patient persisted,
"Don't you think an occulist ought to look at them?"
"I do not object to examinations," the physician replied, "but
your solicitude indicates that you worry about your vision."
The patifent then exclaimed with obvious irritation, "But doctor,
I assure you I don't worry about my eyes. But, of course, I
wouldn't like them to get worse. After all, a person may go
blind." The literalistic quality and sabotaging character of this
kind of word juggling requires no comment.
Brief examples: A woman patient reported in astonishing
frankness about her wild temper outbursts. She related a
series of uncalled-for acts of spite and vengefulness, interlarding
the recital with comments as, "Of course, I know it's my fault
... I am just a nag . . . What I need is a good licking, I
guess . .
" When the examiner warned her not to indulge
in an orgy of self-blame she burst forth, "I don't blame myself;
I am just telling my story." A patient was told not to get sore at herself because that
was her main form of temper. She replied, "Doctor, I don't
get sore at myself. I am just disgusted with myself." Another
patient was warned not to be irritable whereupon she rejoined,
"I am not irritable. I am just upset by what my daughter says."
A patient remarked, "I have been coming here several weeks,
and I don't see any results." Examiner: "You must not be discouraged."
Patient: "I am not discouraged. But of course if

one does not see progress . . . ." This patient could have easily
told himself that "not seeing results" and "not seeing progress"
is identical or synonymous with "being discouraged."
Patient: "When I go shopping I wait and wait and have
trouble making the purchase." Examiner: "So, you are still
having difficulty making a decision?" Patient: *TSFo, I merely
cannot get myself to pick the merchandise I want to buy." The
identical meaning of the phrases "having trouble making the
purchase," "having difficulty making a decision," and inability
"to pick the merchandise I want" ought to be obvious, but
nothing is obvious to a person bent on perverting meanings
through literal distortion.
Examiner: "I hope I did not hurt your feelings when I said
that." Patient: "No, I just don't agree with you, and, frankly,
I don't think you have a right to tell me that. It just makes
me mad if everybody jumps at me."
The patient developed a mild depression consequent on the
mother's death. Examiner: "You must avoid guilt feelings."
Patient: "I don't feel guilty. I didn't do anything wrong." Examiner:
"You blame yourself for not having done enough for
your mother." Patient: "This I do." Examiner: "Doesn't this
mean feeling guilty?" Patient: "I thought guilt is crime." This
literalism is rather naive but variations of the theme are frequently
encountered with patients steeped in the practice of
Patient: *Tfesterday I had something like a daze." Examiner:
"You don't have to be afraid of that." Patient: "I am not
afraid. The only thing, I wouldn't like to have to go to the
hospital again." She feared "to have to go to the hospital again"
but was not "afraid!"
In all the situations quoted in the examples the patients display
a tendency to block the physician's effort, to combat his
views, to reject his suggestions by means of a literal misinterpretation
of the words he uses. Once the patient's attention has
been called to his favorite methods of sabotaging he is in a
position to correct his habits. In Recovery, corrections of this
kind are made frequently and effectively.

Ignoring or Discrediting the Initial Improvement
Sabotage is the attempt of an individual to thwart the purpose
o a group, usually that of his own group. In this sense,,
the child sabotages the educational purpose of the parental
group when he opposes the effort to make him eat, wash or
go to bed. Sabotage is also practiced by the soldier who reports
for sick call when, in fact, he is merely lonesome or discouraged
or disgruntled. That soldier sabotages the national purpose.
There is no end to the multitude of occasions which lend themselves
to sabotaging practices. The member of a parliament
who offers needless amendments to legislative proposals, the
employe who absents himself without good cause, the member
of a club who stalls on an assignment, they all sabotage the
purpose of the group to which they belong and to which they
owe allegiance. The purpose that is most commonly and most
consistently sabotaged is that of the family. This type of sabotage
takes the form of domestic temper and was amply discussed
in the "Techniques of Self-Help," volume 3.*)
The child is, as a rule, a frank and forthright saboteur. There
is little or no equivocation, duplicity or deceit to his sabotaging
performance. In most instances, he opposes an order and rejects
the parental purpose in candid rebellion. Children, provided
they are not sophisticated, do not affect loyalty to the group
purpose of good manners and self-discipline. They simply refuse
to accept the educational purpose. If they sabotage it they do
not thwart their own purpose. They do not practice self-sabotage.
In all other instances which were cited the sabotage is directed
*Thc Techniques of Self-Help in Psychiatric After-Care, 3 vols. Chicago,
1943, Recovery, Inc.

against a group purpose which is solemnly accepted and perhaps
cherished and worshipped by the sabotaging person. The soldier,
the parliamentarian, the employe, the club member and the
quarrelling relative level their sabotaging activities against purposes
with which they identify themselves. They sabotage endeavors
which they endorse and approve. The purpose which
they obstruct is their own, accepted and valued by them. Theirs
is self-sabotage.
That the patient who opposes the freely selected physician
sabotages a self-chosen purpose needs no explanation. He has
adopted and accepted the purpose of health and has appointed
his physician to help him reaEze the purpose. If he obstructs
the physician's efforts he frustrates his own purpose and, by
this token, is a self-saboteur.
The situation is clear and transparent in the instance of
infantile sabotage. For some reason, the child has no inclination
to adopt the group purpose of self-discipline. Carrying
out rules and obeying standards is obnoxious to him. It gives
him discomfort to have to wash; going to bed in due time is
reacted to as an odious imposition; eating spinach may be unmitigated
torture. If the group purpose makes the child perform
these offensive practices he logically tries to foil that purpose.
What prompts him to resort to his sabotaging behavior is his
desire to preserve his personal and individualistic comfort. His
own purpose of individualism revolts against the foreign purpose
of group standards. The individualistic craving for comfort
locks horns with the group purpose of self-control. As a general
rule, the chikTs struggle against "the tyranny" of group standards
is plain, transparent, straightforward and aboveboard.
The adult saboteur proceeds differently. Take the case of
the disgruntled soldier reporting for sick call. He complains
of dizziness or "sick headache.'* The army physician, as the
representative of the national group purpose, examines him and
declares him well. But the soldier feels keenly his distress. His
individualistic purpose is directed toward relieving the personal
discomfort. Hence, he pleads for a day of rest and exemption
from fighting or drilling. The group purpose, on the other hand,

insists on continued discharge o duty. If the soldier now engages
in arguments, contending against the physician's opinion
that he is sick and disabled, he fights against the group purpose
which he himself has adopted and accepted. This he can do
only if he fortifies himself with "good reasons." He must justify
the inroads into the approved group purpose in a manner that
will satisfy his own conscience. Since there are no such "good
reasons" he is compelled to manufacture them. The manufactured
reasons are rationalizations. They are a weird compound
of half-lies, truth-twistings, forced excuses and tortured
evasions. The struggle of the adult saboteur against group
standards is anything but plain, transparent, straightforward
and aboveboard. It is a mixture of self-trickery and self-degradation.
The case of the nervous and former mental patient is similar to
that of the complaining soldier. He has "enlisted" in the physician's
group of patients and has by implication obligated himself
to pursue the health aim of this group with the vigor of a
total effort. The patient accepts at first this group obligation
and incorporates the purpose into his own set of values. Then
he pleads the case of his own personal comfort and claims exemption
from health exercises and health drill. He argues and
quibbles with the physician, opposes his individualistic purpose
of physical comfort to the physician's insistence on self-discipline.
His procedure is characterized by the same disreputable
resort to twists, distortions and evasions as practiced by the battleweary
The reasons why the patient sabotages his physician are many.
Some of them will be mentioned in due course. Surpassing
all in importance is the sense of being stigmatized. The patient
resents having his complaint considered "nervous" or "emotional."
He feels his character is indicted as weak by the diagnosis.
If all he needs is insight or assurance, then he is declared
to be lacking qualities which everybody else possesses. He resents
the implications of intellectual and moral inadequacy and embarks
on a process of sabotage. His aim is to convince the physician
and others that his trouble is of a physical nature.

In order to get well It is imperative that a patient upholds
his courage or morale. The prospect of getting and keeping
well is directly proportional to the vigor with which morale is
maintained. But the sabotaging patient is not at all interested
in getting well if the only way to health is that of psychological
explanations and moral education. Since his main concern is
to convince his physician and others that, in fact, he is suffering
from a physical ailment, the self-help system of regaining
his health is not at all pleasing to him. Should he recover
through the methods of will-training and self-discipline the
charge that for years he neglected his will-power and practiced
self-indulgence would be unanswerable. To get well would
be an admission that his relatives and friends were correct when
they attributed his complaints to a weak will and lack of selfcontrol.
He senses keenly the danger to his self-respect should
he get cured through will-training and morale-building. The
topic of morale is repulsive to him. What he wants is vitaminmedication,
administration of hormones, perhaps a minor operation,
but no morale-lifting. In Recovery he is, nevertheless,
caught up in an atmosphere of high morale, reassurance and
encouragement and responds instinctively to the new influence.
He improves; the symptoms get milder; the prospect of getting
well increases. This gives him a subtle scare. He has visions
of accusing fingers pointed at him, of a sneering voice bellowing
self-righteously, "I told you it was all up to you.'* Morale is
now his enemy. He will have none of it. And if the present
state of improvement is an index to a final cure, well, he is
going to see to it that the process of improving does not proceed
too fast nor too far. Perhaps he cannot stop the process, but at
the very least he can ignore or deny it. The saboteur is now
thoroughly committed to a well-conceived plan of ignoring or
discrediting the initial improvement. Examples of this type
of sabotaging activities will now be cited.
Example L A lady's main complaint was a marked anxiety
which at times assumed the proportions of a terrifying panic.
She slept poorly, had no desire for food and was troubled with
a severe headache. The condition had persisted for several

years, but in the past six months it had become "almost unbearable."
She was unable to attend concerts and shows because
o an "irresistible" impulse to stampede out of the theatre the
moment the lights were turned off. She was also afraid to be
alone and to drive her car. After four weeks of private and
class interviews her panics and headaches were gone, sleep and
appetite were satisfactory, and the fear of automobiling and attending
shows had all but disappeared. When at this point
she was asked about her condition she disclaimed any noticeable
improvement. "I am tense all the time," she said, "I can't
stand the slightest irritation, and sleep hasn't been at all good
for the past three nights." On inquiry she admitted that even
on these three occasions sleep "wasn't as bad as it used to be.
She also agreed that she no longer suffered from panics and
that the fear of driving the car and sitting through a show were
under control. "But doctor," she hastened to add, "that tenseness
and irritability just drive me mad. There must be something
radically wrong with me." She was told, "When you
first consulted me you were just as tense and irritable as now,
perhaps more so. But the main source of your agony at that
time were your panics and fears. Since they are gone you ought
to be happy beyond description. You ought to derive a new
courage from the realization that most of your symptoms cause
you no more trouble. Instead, you are despondent because of
some remaining minor afflictions. Suppose you had suffered from
a gastric ulcer for several years. Therapy was ineffective until
a new treatment was instituted. After a few weeks you notice
that the pain decreases considerably, the bleeding stops entirely,
the anemia is checked, weight increases. But some gastric distress
is still present and the tenseness and irritability that were
caused during years of suffering are still producing difficulty of
sleeping and poor relaxation. You would, then, in spite of the
remaining tenseness and irritability, take courage in the thought
that your vital wish to get well is on its way toward fulfillment.
Your morale would improve and would leave no room for
despondency. A patient who shows no appreciation for the
quick relief from year-long suffering indicates plainly that the

relief was not the object of dreams, hopes and desires. A patient
of this kind has no genuine will to regain health and is what
I call a saboteur."
Example 2. A woman patient had suffered for the past nine
years from "intolerable" tenseness, restlessness and irritability,
pressure in the head, difficulty of falling asleep, extreme fatigue
and gagging when eating. She had consulted numerous physicians
and cultists and was emphatic that no treatment ever
helped her. She had spent several periods of weeks and months
in hospitals, rest homes and sanitariums without obtaining anything
but fleeting relief. When a course of electroshock treatment
was instituted she lost practically all her symptoms in a
surprisingly short time. The formerly extensive list of her
complaints was now reduced to an insignificant headache which
she considered quite tolerable. When the question was asked,
"Are you not glad you came to the hospital and received the
treatment?" she replied, "But doctor, that head pressure is still
there and as bad as ever. I wonder whether I'll ever feel just
myself." When reprimanded the patient promptly realized the
unreasonableness of the complaint and admitted freely that
she did not quite relish the thought of improving. "If I were
sure I am going to be cured it would be glorious," she remarked,
"but a mere improvement frightens me. I always remember
how I got worse after improvements." This explanation is
frequently given by patients who realize that their reaction to
the initial improvement is the outcome of sabotage. They have
gone through the ordeal of the "setback" and dread it. To avoid
the thought of the setback they try to ignore the early signs of
the beginning cure.
Example 3. A former college student who contracted a mental
ailment in his sophomore year was seen two years after leaving
the hospital. He presented an inexhaustible list of residual symptoms.
The most outstanding complaint was fatigue, procrastination,
tendency to remain in bed till afternoon, lack of spontaneity
which made him carry out with extreme effort even trifling performances;
a constant feeling of hopelessness, tenseness and irritability;
difficulty of sleeping; dizziness; annoying habits of

twitching and grimacing; forgetfulness; self-consciousness, etc.
After obtaining a well nigh startling improvement in the course
of a few months of private and Recovery training he stated,
"I have a vague fear that I am doomed. Recovery cannot help
me. I may be carrying on for six months but I'll never get
well." After he recognized the sabotaging character of his statements
he volunteered a plausible explanation. He said, "Should
I get well this year or in five years I'll have the thought before
me that all these years were wasted." Translated into the
language of the stigma this means he feared improvement because
it would make him feel stigmatized before his own conscience.
Example 4. A woman patient had the common garden variety
of neurotic complaints; poor appetite, difficulty of sleeping, palpitations,
crying spells and air-hunger. Crawling sensations, numbness,
contractions of the throat, nausea were less regular but
equally distressing when present. The complaints dated back
some fifteen years when a high school boy friend had taken indecent
liberties with her. Although she knew nothing had happened,
nevertheless, she could not shake off the thought of having
been "contaminated." In the past year she had been tortured
by the fear she might do harm to the baby. Coupled with
the other complaints this made her suffering "unbearable." After
about six weeks of combined office and class treatment she reported
that the thought of "contamination" had practically
disappeared, that the fear of harming the baby was no longer
of any consequence, and that the sensations were "much milder."
The physician remarked at this point, "So, you made a nice
improvement." "Do you really think I have?" she replied, "I
am still tense and have quite a bit of trouble in concentrating,
and I want you to know, doctor, that I still have the sensations."
It was explained to her that her refusal to admit improvement
in the face of positive evidence of good progress meant that she
discouraged herself and lowered her morale. She then conceded
that the amelioration of most of her symptoms was a sign of
good improvement but continued, "Why can't I get rid of the
sensations? I can't help thinking that is more than just nerves."

She was one of those patients who resented being stigmatized
as being "just a nervous case." She was unhappy over the initial
improvement because it seemed to clinch the diagnosis of a
psychoneurotic condition. And that diagnosis she considered
a blot on her character.
Brief examples: A lady suffered from a depression of mood.
She did everything with great effort, sleep and appetite were
poor, interests were at a low ebb. A good improvement took
place after three weeks. When seen at the office she denied
feeling better. The following conversation developed: Patient:
"I don't feel a bit better." Examiner: "How is your sleep?"
Patient: "I must admit sleep has been better." Examiner: "Do
you still do everything with effort?" Patient: "I have to drive
myself quite frequently. But yesterday I felt the desire to go
to the movie for the first time in six months." Examiner: "Do
you do your cooking and shopping with more zest?" Patient:
"Yes, but I can't get myself to take care of the baby." She knew
she had improved but brazenly denied the fact of improvement
ignoring and discrediting the evidence.
A patient exclaimed, "I had a bad week again." He was
asked, "How is your fatigue?" The reply was: "I walked close
to twenty blocks today. It really was a surprise to me. But
last Sunday I was awfully tired all day." When questioned
about his fullness in the head he said, "It does not start right
in the morning any more as it used to, but I am always afraid
it will be worse in the afternoon." And this record of good
initial improvement was summed up in the phrase, "I had a
bad week again." In Recovery, patients of this description go
by the name of "but-knockers." Their stock phrases of selfknocking
choose the verbal pattern of "My headache is better,
but . . /' The improvement is affirmed in the first statement but
speedily denied in the second.
Another "but-knocker" stated, "I had a couple of good days
last week, but this morning I felt nauseated again ... I had a
good day, but, of course, I kept busy, and that helped me . . .
My palpitations are better, but I don't understand why my appetite
is still so poor . . .**

Disparaging the Competence or Method of the Physician
If sabotage is directed against a purpose it will be useful
to the sabotaging patient to know something about the manner
in which purposes operate.
In common language the purpose of a house is to give shelter,
comfort, and privacy, the purpose of a garden is to supply vegetables
or flowers, the purpose of an automobile to provide transportation.
In this loose sense, the house, garden and automobile
are conceived as having or being endowed with purposes of
their own. This is not correct. The house, garden and automobile
merely serve the purpose of their owners. The owner
has or is endowed with the capacity for craving, wanting, needing
shelter, comfort, privacy, vegetables, flowers, transportation.
These various purposes are served by house, garden and automobile.
An object that serves a purpose is a means toward achieving
it. Objects, having neither needs nor wants, cannot have
purposes of their own; they are means through which purposes
are realized or accomplished.
A workman, wanting or needing wages for subsistence, works
for the purpose of sustaining himself and his family. The
maintenance of a family is his purpose, the particular kind of
work he performs is the means serving the purpose. The purpose
is set; the means may be subject to change. For some reason
the workman may decide that cessation of work (strike)
may serve his purpose better than continuation of his activities.
Means may change according to circumstances, expediency or
policy. Purposes are set, either for a limited time or for life.
The industrialist for whom the worker toils has essentially
the same purpose as his employe. He maintains his establishment
primarily for the purpose of providing for his own needs

and those of his family. For both the purposes are set and stabilized
by the needs and wants of their families. This is the reason
why the institution of the family is credited with exercising a
stabilizing influence. It sets the purpose for the individual, makes
for constancy of purpose and counteracts flightiness of endeavor.
Unlike the worker, the owner of the factory cannot change
at will the means that serve his purpose. Closing the plant may
at times be necessary due to circumstances, but it will hardly
ever be beneficial to the family purpose. If the manufacturer
wishes to maintain his family he will not be permitted to shut
down his establishment for a long period of time. For him
both purpose and means are set and stabilized.
There is also a marked difference between worker and owner
with regard to the work done in the factory. The worker may
tend to the commodity to be manufactured. But the stock room
and heating plant are not his concern. To the manufacturer,
on the other hand, every part of the factory is important and
essential. His concern extends over all buildings, all departments,
all activities. If the owner is to accomplish his purpose
he must exert a total effort; the worker may attain his purpose
(weekly paycheck) by engaging in a part-effort only.
Another significant feature of a purpose must be mentioned.
The owner of the factory may be sincerely devoted to his family.
But suppose he is addicted to gambling and fritters away his
fortune. He is then divided between two purposes and not
unified. The division is between an individualistic purpose
(gambling) and a group purpose (family). Everybody is the
seat and repository of individualistic and group purposes. In the
adult person who has achieved maturity one group purpose,
usually that of the family, is expected to tat(e the lead over all
other purposes and to guide action towards unified behavior.
The dominant group purpose supplies leadership. Every purpose
which conflicts with the leading group purpose must be
checked and prevented from exerting itself. In this manner the
natural conflict of purposes is controlled. If leadership is not
established two antagonistic purposes act against one another
producing the condition known as cross-purpose or dual purpose.

An individual possessed of a unified purpose is said to represent
an integrated personality. He is endowed with the qualities of
The patient suffering from a nervous ailment may be and
frequently is an integrated personality with regard to the purposes
of family, citizenship and vocation. But with regard to
his own body he has lost leadership. His impulses, sensations,
feelings and thoughts embark on action independent of his dominant
purpose. The purpose of fellowship may suggest a visit
of condolence or his presence at a wedding, but his heart sets
up palpitations suggesting to him the fear of impending collapse.
The group impulse to exercise the obligations and sentiments
of friendship or neighborliness is thwarted by the individualistic
impulse to cater to sensations and fears. The inner functions
of the body are no longer under control. They are discharged
suddenly and unpredictably without relation to the dominant
purpose of the personality. Leadership is utterly lost because
no leadership is possible under conditions of fears, panics and
vicious cycles. The patient may make a half-hearted attempt to
help himself. But that attempt is in the nature of a muddled
and confused part-effort guided by the dual purpose of endorsing
the group impulse toward self-discipline and catering to his
symptoms at die same time. Rocked by a conflict of purposes
he is no longer wholly unified and lacks the qualities of a fully
integrated personality. Having lost control over the functions
of the nervous system the patient consults the physician asking
him to supply the leadership that he himself can no longer provide.
Physician and patient are now forming a partnership in
which a unified purpose is set and defined by the physician and
accepted by the patient. In this partnership the physician represents
the group purpose of mental health and self-discipline.
The patient accepts it and pledges himself to employ all the
necessary means to attain the end. But before long a setback
is experienced. The rebellious sensations, impulses and fears
reappear making their individualistic demands and insisting on
compliance. The resulting panics induce the patient to ignore
and neglect the physician's instructions. The patient demands

instant relief, and the physician points to the necessity of selfdiscipline.
The unified purpose of the partnership is now disrupted.
Should the partnership be dissolved? Or should it be
continued? The decision is not easy. Changing physicians
would not be difficult. However, if for some reason the patient
continues his visits to the office he demonstrates clearly that he
considers the physician competent, that he thinks his knowledge
expert and his instructions pertinent. But if the one partner
is well qualified the failure of the common endeavor disqualifies
the other partner. If the patient is to retain his self-respect
he must find a way to disqualify his physician. How can he
do that if he continues his visits? The fact of the continued
visits emphasizes the physician's qualification. How then can
he be disqualified?
The task is not easy. The patient must prove to himself
that his physician is qualified and unqualified, expert and inept,
proficient and unskilled at the same time. This requires subtle
twists, half-truths, shams and sophistry. The dilemma is solved
by a simple trick: the physician's competence is asserted explicitly
but solidly denied by implication. The patient's conscience
is now saved. Continuing his visits he demonstrates explicitly
that he trusts his physician. But using phrases with
disparaging implications he denies the physician's ability to cure
him. Tactics of this kind permit the patient to maintain the
illusion of accepting the physician's leadership while at the same
time disputing and opposing it. The partnership is then officially
maintained but rendered ineffective by crafty maneuvering. The
precise manner in which this sabotaging technique operates will
now be described.
Example 1. A woman patient had been in and out of hospitals
for the past thirteen years. Her case was diagnosed as dementia
praecox. She was dreaming, untidy, given to explosive outbursts
of violence. The mental contents showed numerous delusions
and hallucinations. On the occasion of her fifth period of hospitalization
she was given a combined course of insulin and
electro-shock treatment which resulted in a fair degree of improvement
with satisfactory insight. She admitted feeling

better but added, "Of course, when the weather is more friendly
I always feel better." She then continued, "What I really need
is to go to work. I should take up my painting. A trip to the
country would do me good, too." These statements were too
obviously calculated to disparage the physician's method to require
comment. The patient refrained from asserting bluntly
that the treatment was ineffective. Instead she pointed out by
implication that other methods were superior to those employed
by the physician.
Example 2. The patient was in the grip of a deep depression
for close to two years. She complained of lack of interest, deficient
sleep and inability to do things except with the utmost
effort. She thought her inner organs were rotting. She disclaimed
experiencing any feelings. The brain was a blank, the
abdomen felt like an empty container. Eating was done mechanically
and the bowels "would not move." She accused herself
of having "committed the unpardonable sin." A course of electro-
shock treatment produced prompt improvement. At this
stage she was asked, "Don't you think it was a good idea to
bring you to the hospital?" The patient replied, "Of course, the
rest and being away from home and child . . ." The physician's
efforts were disparaged, and credit was given to events and
circumstances uncorrelated with technical treatment.
Example 3. The patient, ill for six years, had consulted numbers
of physicians without obtaining sustained relief. When first
seen she suffered from various phobias and compulsions. She
was afraid of fainting in the street and had to be accompanied
by her husband whenever she ventured out of the house. When
performing a task she was unable to stop and had to repeat
the manipulation endless times. Making beds thus consumed
hours because the tucking and straightening seemed never done
to satisfaction. Thoughts "repeated themselves" interminably in
the brain. If she asked a question it had to be repeated over
and again till finally she felt she had found the correct formuladon.
There were other disturbances: procrastination before
retiring and after arising, fatigue, twitches, poor appetite. After
several months of combined private and class treatment

the major symptoms were gone. She was now able to do things
without hardly any repetition, took care of her home work
without much waste of time and manipulated long walks without
fear. Finally she even mustered the courage to move to a
large home confident that she would be equal to the task of
tending to a considerably increased schedule of work. She was
sufficiently improved to do all the cooking and cleaning without
undue repetition. When she was then asked, "Don't you think
that is a good improvement?" she countered with the remark, "Of
course, I improved because the new house keeps me busy."
The physician's effort was disparaged.
Example 4. A patient suffering from a depression of mood
for upward of three years had been the beneficiary of all manner
of treatment with no success. She received three electro-shock
treatments and attended classes thereafter. Before long she regained
her spontaneity and was able to do her work without
having to drive herself. Sleep and appetite improved and the
mood became balanced. The improvement had set in during
the first month and had continued progressively during the subsequent
four months. She had a vacation coming but hesitated
to make use of it because in the past three years she had suffered
agonies whenever she spent time in resort places. When she
finally went to the country it was done mainly at the physician's
insistence. After she returned she was asked how she felt and
said, "I feel so much better. Of course, the vacation picked me
up." The physician's part in her improvement was flatly denied,
Recovery's share was ignored, and the influence of class instruction
was "forgotten."
At times a patient will employ less subtle means of expressing
his disapproval of the physician's competence. He will then
indicate plainly and directly that a different therapeutic approach
is better suited to the exigencies of his case. The instance of
the patient was mentioned who inquired whether glandular
treatment was not preferable to attendance of classes and Recovery
meetings. The same patient suggested on different occasions
that what he needed was psychoanalysis, shock treatment,
change of occupation and scenery. He once exclaimed "I think

I ought to get married. Nothing else will help me." When he
was told there was no objection to his choosing a mate he remarked,
"How can I get married if I am not cured?" The
thought of marriage was obviously meant to sabotage the physician.
It was no settled plan, it was no thought at all; it was
merely a fling at the physician, intended to disparage his method.
Another patient who had been experiencing night terrors for
many years said, "My trouble goes back to childhood. Don't
we have to dig in my past?" She was told that her past had
been dug up so thoroughly both by her present and former physicians
that few patches of ground were left untilled. She
snapped back, "You ask us to get well through self-help. But
it seems that a patient should be helped by the physician."
Subtlety was here thoroughly discarded in favor of a bouncing
slam at the physician's system in its entirety.
One patient, assiduously active in Recovery and indisputably
loyal to the physician, was asked what she thought most instrumental
in bringing about her recovery. She remarked, "I spoke
to Annette and Rosalie. Of course, the classes helped me a lot.
But Annette and Rosalie more. They have experience because
they went through the same trouble." The physician inquired,
"Does that mean that I have no experience?" The patient,
noticing her blunder, corrected with more fumbling, "Oh no,
but they are sincere." The physician pressed the argument, "Do
you think I am not sincere?" The patient explained, "Well,
one never knows whether the doctor is going to tell the truth.
He may hesitate to tell me he can't help me."

Challenging the Physician's Diagnosis:
Outright Insistence on Change of Diagnosis
A student may speak of the examination for which he is preparing
himself as being either his present purpose or his goal
or his aim. Similarly, a housewife on a shopping tour, may
claim that the purchase of vegetables is the purpose, goal or aim
of her present endeavor. In all of this, the terms purpose, goal
and aim are treated as having identical meanings. Much of
the confusion attending plain conversation or important debates
can be traced to this careless manner of using the three discrete
words and juggling their underlying concepts.
The nervous patient must not permit himself the luxury of
employing a confusing terminology. To him it must be clear
that the PURPOSE AIMS AT ITS GOAL. He must then
be shown with unquestioned clarity which is the purpose that
moves him, which the goal he has set for himself and what
is the degree of determination with which he must aim at the
The nervous patient here spoken of is an average individual.
His purpose is that of the average person, i.e., the establishing
and maintaining of a family. There are confirmed bachelors
and spinsters, isolated trappers and roaming hoboes whose
activities are not centered on the family purpose. There are individuals
who devote their lives to religious, scientific or artistic
pursuits escaping or actively avoiding family ties. All these
groups, no matter how numerous they may be, do not fall
within the scope of average existence. Their lives are fashioned
on exceptional patterns, and the purposes which move them are
not pertinent to the present discussion. Within the limits of the
present discussion the central purpose of the average person is

focused on the family. It is fixed by average constitution, anchored
in original predisposition and favored by nature. That
purpose is given, not chosen. It is stable, practically unchanging,
and hardly subject to deliberate manipulation, provided it is
embraced and not ignored or rejected as in the instances quoted.
The purpose, itself largely unchanging, chooses or sets its
goals. They are the means toward accomplishing the purpose.
One person may think a profession is the best means of caring
for his future or present family, another may choose a business
career, a third politics or agriculture or military service. Once
the goal has been set (profession, business, politics, etc.) all
significant action must be so contrived that it aims at the chosen
goal. The aiming must be effective, i.e., straight, direct, sustained,
determined, energetic. It must not be wavering, ambiguous,
capricious, hesitating, irresolute.
The student working for the examination aims at a degree,
let us say, the medical diploma. This is an intermediate goal.
The fin al goal is to attain efficiency or prominence in the field
of his chosen medical profession. A great number of intermediate
goals must be aimed at after the successful passing of the examination:
internship, residency, renting of an office, purchase
of equipment, marriage, education of the children. By means
of these intermediate goals the central purpose (of the family)
aims at the final and supreme goal.
While aiming, the individual, must be able to analyze the
nature of his intermediate goals in order to be certain that they
really and actually lead toward the final goal. Otherwise, the
aim deviates from its target. Campaigning for an electoral contest,
for instance, would be good aiming for the final goal of
the politician. The conferences with election workers, the addressing
of the public, the canvas^.g of neighbors and friends
are intermediate goals that aim straight and undeviatingly at
the final goal of victory at the polls. But if the physician should
choose electioneering activities as his intermediate goals he may
frustrate his final goal of establishing a solid practice in his
community. Aiming must be direct and undeviating, and in
order to keep the aim straight the individual must be in a posi

rion to analyze and diagnose the nature of his intermediate
goals. Faulty diagnosis of intermediate goals leads to defective
aiming at the final goal.
If a physician starting out in medical practice engages in
politics, the chances are he is guided by a fondness for the limelight.
His action is based on or influenced by personal inclination,
emotional craving, ill-controlled impulses, unreasonable
desires, in short, by subjective feelings. In order to prevent
the aim from deviating in improper directions an individual
must train himself to base his action on sane premises, sound
conclusions, cool reasoning and good common sense, in short,
on objective thought. Subjective feelings divert the aim from
its proper target; objective thought tends to keep the aim straight
in the line of the target.
The nervous patient vitiates his purpose by allowing himself
to be deflected in the direction of improper intermediate goals.
The physician diagnoses the condition as one of emotional imbalance
and prescribes the sustained practice of self-discipline
as the final goal to be aimed at. But the subjective feelings of
tenseness, distress and panics intervene to suggest that instant
relief is needed and that patience and self-discipline are futile
remedies in an emergency. If the sufferer yields to the dictates
of his feelings his aim will be deflected from the objective goal
of self-restraint to the subjective goal of self-indulgence. The
deflection is occasioned by the fact that the patient disregards the
physician's diagnosis of an emotional imbalance and substitutes
his own diagnosis of a physical emergency situation. An emotional
imbalance calls for self-restraint as the goal to be aimed at.
An acute emergency may require self-indulgence as the proper
The difficulty would not be serious if the patient limited his
faulty aiming to the occasions when he finds himself in a panic.
Unfortunately, the regrettable practice tends to persist after the
panic has passed. When the patient challenges the diagnostic
ability of the physician during the acute distress of the selfdiagnosed
"emergency" the results carry over into the more
quiescent periods when the symptoms cause merely mild dis

comfort. When, during the panic, he discards the diagnosis of
an emotional imbalance the physician's authority receives in the
patient's mind a severe blow from which it does not recover easily.
His diagnostic ability stands challenged and the propensity for
challenging it gains momentum with each succeeding setback. The
final result is a policy of consistent aiming in the direction of selfindulgence
by insisting that the condition is one of a physical
ailment and not, as the physician puts it, one of an emotional
imbalance. The policy sabotages the physician's authority and
prevents effective cooperation. In the process of pursuing their
sabotage efforts some patients do not hesitate to voice their
challenge with outspoken frankness while others employ more
subtle and indirect methods. The precise manner in which
these forms of sabotage are practiced will be demonstrated in
the following illustrations.
Example 1. A young woman had been suffering from innumerable
frightening sensations for over six years. She complained
of a crawly feeling over the head, a numbness of the
limbs as if they were paralyzed. The eyes felt as if they were
being pulled in. She felt a pressure on the nose as if a ton
was weighing on it. She had spells of air-hunger in which
she felt she was going to suffocate. There were all kinds of
pains, pressures, dizziness and dimness of vision, and many
bizarre sensations. One day she reported that "out of a clear
sky I felt that something blew up in my head. I thought I was
gone." On another day she had a burning in the muscles as
if "electric wires passed through them." Her head seemed to
be falling forward, the body felt as if it were "floating in space."
She knew that the symptoms were precipitated by emotional
upsets and disappeared in response to emotional relaxation. One
day she volunteered the statement that "of course, it's all
nerves. I know that. But that does not help me." She was a
loyal member of Recovery indicating that she considered her
condition subject to treatment through self-help and self-discipline.
Nevertheless, she frequently protested that suffering
of this severity could "not possibly be o a nervous nature."
Once she said, "If I turn my head it cracks in the neck. Then

the pain shoots right up to my hip. How can this be nerves?"
On another occasion she remarked, "I get that pain when I
do the simplest thing. All I have to do is to peel an orange,
and the pain is there. How can nerves do that? ... I am so
weak I cannot cut an apple. That weakness must be physical."
She craved medication. She was willing to submit to an operation.
Her aim was directed toward the intermediate goals of
physical therapy and was deflected from those of self-discipline.
Example 2. A woman whose main symptoms consisted of
pressure in the chest with "awful palpitations" was obsessed
with the fear of sudden collapse. The condition had been progressing
for fully 17 years before she was seen at the office.
After a brief period of combined class and individual treatment
she experienced a considerable improvement and had sequences
of good days and even good weeks "the first time in years.
5 * She
was an untiring Recovery worker and seemed to relish the idea
of self-help. But whenever she appeared at the office shortly
after going through setbacks the thought of a physical ailment
reasserted itself. One of her numerous symptoms was heaviness
of the eyelids. "Couldn't that be astigmatism?" she asked.
She also suffered from severe abdominal spasms. "Why couldn't
that be an ulcer?" she asked. The aiming was deflected from
the intermediate goals of self-discipline toward those of selfindulgence.
What she aimed at were prescriptions, diets, operations,
bed rest, eyeglasses.
Example 3. A male patient had been maladjusted all his
life as far as he could remember. He was always fatigued,
pepless and devoid of ambition. At home he was explosive in
temper, on the outside meek and timid. He suffered from a
profound sense of inadequacy, felt flustered in the presence
of people and blushed easily. Having attained expertness as
a mechanical engineer, he was unable to capitalize on his professional
competence because of his abiding self-consciousness.
In social contacts he was clumsy and awkward. When addressed
he had difficulty formulating a proper sentence and
felt choked when he made an effort to speak. In the presence
of girls he was particularly bashful. He had been engaged for

over three years to a young lady whom he loved dearly but
could not muster the courage to get married. After several
months of treatment, his self-consciousness improved considerably,
but his explosiveness persisted. Finally he decided to go
through with his marriage plans. He established a home and
felt happy. Unfortunately, his periodic temperamental bursts
marred an otherwise compatible marital life. He realized that
his temper could only be cured by self-discipline. He had
studied the volumes of Recovery's Self-Help System and attended
classes regularly. He knew the distinction between
subjective feelings and objective thought, was well aware of
his tendency to sabotage the physician's authority. Nevertheless,
whenever he was seen after a domestic temper outburst
he advanced alternative explanations for his inability to control
temper. "If I am argumentative," he said, "I am sure it
is because of my high blood pressure." The blood pressure
was on the upper level of the norm, not significantly elevated.
One day he asked, "Couldn't my excitability be due to a thyroid
condition?" He was currently deflected from his final
goal of self-discipline in the direction of intermediate goals
of self-indulgence.
Example 4. A male patient had gone through alternating
spells of depressions and elations of mood for the past thirty
years. In the intervals between the attacks he was well enough
to make a moderate living but was haunted by the sense of
being stigmatized. He was unable to throw off the feeling
that he was essentially incurable. During the last spell he was
given a course of electro-shock therapy, and the hospital treatment
was to be followed up with a well prepared program of
participation in Recovery activities. Like so many manic-depressive
patients he did not relish a system that places the main
emphasis on self-help and self-discipline. He cooperated grudgingly
and mainly on the energetic insistence of his wife. For
several weeks after leaving the hospital he complained of a number
of residual symptoms. He still suspected that people watched
him, felt fatigued most of the day and slept poorly. Before
long he learned to ignore the fatigue sensations and to reject

the suspicions about people watching him. Finally he mastered
the difficulty of sleeping by imbibing the principle that the socalled
"insomnia" is no danger to health. At this stage he felt
grateful to Recovery and joined the activities with a better
spirit of cooperation. Nevertheless, he still resented having his
residual symptoms termed "nervous." "My sensations feel real,**
he insisted, "they are physical, not nervous." Soon thereafter
he decided to quit Recovery for a while. "I think it would
do me a world of good to spend several weeks without talking
about my symptoms." The physician's diagnosis was challenged
and his method of treatment disparaged. Aiming was deflected
toward intermediate goals that ran counter to the final goal of
overcoming the sense of stigmatization.
Brief examples. A woman patient who had attended classes
for many months had lost most of the sensations she had complained
of originally. After a setback she said, "I went through
an awful ordeal ... I still have a pain in the right foot. How
is it it does not disappear? That has certainly nothing to do
with nerves."
A lady suffered from all kinds of disturbing sensations, foremost
among them a "sick headache." She improved and seemed
to appreciate the desirability of practicing the self-help methods
she had learned in classes. After a setback she reverted to her
previous practice of suggesting physical methods of therapy as
the proper means for relief. "I am still troubled by these sick
headaches," she said, "don't you think I should have my glasses
Another lady had received a course of insulin treatment for
a mental ailment. She recovered and was given after-care in
Recovery. She "just loved" classes and meetings and boasted
of practicing self-help "just as the doctor wants it." After a
setback she asked, "I still have that headache. Is that nervous,
too? And I have pains in the legs. Is that anything to worry
A woman who was being treated for a psychoneurosis of
long standing suffered a setback which was characterized by
all manner of disturbing sensations. She was in a marked state

of anxiety which she insisted on calling "confusion." Because
of a difficulty of concentrating she anticipated a mental collapse.
She knew about sabotage and admitted practicing it. "But,
doctor," she exclaimed with a show of emotion, "that panic
I had yesterday was just awful. You can't call that nervous.
It looked the nearest to a mental collapse."

Challenging the Physician's Diagnosis: Implied Insistence on
Change of Diagnosis
Once the physician has made the diagnosis of a nervous ailment
a goal is set for the patient to aim at. The patient is
given detailed instructions how to manipulate the aiming. He
is told by word of mouth and through books and pamphlets
that the object is to ignore his disturbing inner experiences, his
threatening sensations, his overpowering impulses, his obsessing
thoughts or deranged feelings. Above all, he is directed to command
his muscles not to do the bidding of the temperamental
lingo and the symptomatic idiom. The instructions are clear.
The patient is perfectly able to understand them. Moreover,
they are endlessly repeated and currently illustrated with telling
examples in classes and meetings. There can be no doubt that
the patient fully grasps the nature of the goal, and the proper
means of aiming at it. Why, then, does his aim stray so persistently
from the goal set by the physician?
The goal is that of self-discipline. What must be disciplined is
the patient's behavior, particularly his behavior toward his inner
experiences. His heart sets up frightening palpitations, and if they
are to be controlled thought and muscles must be trained not
to respond to the threat of the symptom. But in past years the
patient has developed the habits of indulging himself. He has
for many years yielded to the impulse to call for instant relief,
to summon the physician, insisting that he cannot "stand it
one minute longer." He has for years made use of his panics
for the purpose of alerting the house, clamoring for emergency
measures, making everybody jump and rush, turning the home
into a madhouse, keeping all relatives in a frenzy of suspense
and excitement. These reactions have hardened into stubborn
habits of self-indulgence. And if the patient is asked to ex

change his present set of habits for those prescribed by his physician;
i he is told to discard self-indulgence and to replace it
with self-discipline the task seems to be exacting indeed. The
goal scares him, and there is no possibility of a steady, energetic,
fearless aiming if the very target inspires fear, weakens the
energy and shakes steadiness into quivering agitation. If thus
affected, the patient will be inclined to cling to his old habits
of self-indulgence. The goal set for him by the physician will
strike him as unrealistic, impossible of achievement; he will
question its value, will view it with skepticism if not with outright
If the patient is skeptical that means he is not disposed to
accept the goal Yet he accepts it in a sense. The fact that he
does not change physicians indicates that he subscribes to the
diagnosis of a nervous ailment and pledges himself to practice
what he is told to do. But the pledge is given with reservations
which find their expression in the statement, "I'll try my best."
The "best" to which the patient commits himself is nothing
but a weak half-effort, a lukewarm cooperation, a disposition
to give up should the first trial prove unsuccessful. Essentially
it means the goal is accepted partially only. It is neither fully
rejected not wholly accepted. But without full acceptance of
the goal there can be no thorough aiming.
In the foregoing chapter an account was given of defective
aiming on the part of the patient who challenges the diagnosis.
The examples quoted there referred to outright rejection of
the physician's opinion. The patients there described actually
substituted a diagnosis of their own. They asked, "How can
nerves do that? How can this be nerves? That weakness
must be physical." This is about the nearest a patient will
come to an outright rejection of the physician's authority if
he continues to patronize him at all. This type of sabotage
was characterized as "Outright Insistence on Change of Diagnosis"
which meant an unqualified challenge of the diagnosis.
In the present chapter the case of the patient will be discussed
who, avoiding open defiance, rejects the diagnosis by implication
rather than straight denial.

Examples: A woman had been suffering from fatigue, poor
sleep, headaches, dizziness, chest pressure and all kinds of
other threatening sensations. Most annoying was a sensation
felt in the abdomen of a churning and tremulousness which was
present all day every day. The churning became almost unbearable
immediately after taking a meal. As a result, eating
became a continued and dreaded torture. In time, the patient
almost loathed food. She was seen by a number of physicians,
was hospitalized several times with no effort spared to arrive
at a diagnosis. All tests were negative, and the diagnosis was
invariably that of a nervous condition. She was seen in the
fourth year of her invalidism and made considerable headway
in response to private interviews and class treatment. Nevertheless,
she insisted that the constant churning must have a
"cause." This term "cause" is frequently mentioned by patients
who resent having their disturbance classified as nervous. Nervousness,
to them, means a condition for which there is no
"cause*" It means a trouble which has to do with lack of willpower,
self-pampering, refusal to get well, in short, poor morale
and weak character. The "cause," if found, would instantly
redeem the moral status of the patient, and the stigma of low
morale would fall to the ground. The patient in question was
untiring in her assertion that her symptoms must have a "cause."
"I always have diarrhea. There must surely be a cause for that."
When questioned about the character of her evacuation she
gave the information that she had two movements, sometimes
three on the days in which the diarrhea was present. When
asked whether the stool was solid, soft or liquid she said, "Today
it was solid in the forenoon and soft in the afternoon."
And this was called a "diarrhea" which "surely must have a
cause." In this instance, the physician's diagnosis was rejected
by implication. It was implied, not mentioned explicitly, that
in labelling the ailment as nervous the physician had neglected
to look for the "real and true" cause. The diagnosis was challenged
by an implied insistence on physical ailment.
Frequently these patients will quote other physicians whom
they consulted in previous years reciting some diagnostic state

ment which may be reproduced correctly or incorrectly. "Dr.
H.," a patient said, "warned me that vomiting of the kind I
have may be due to a beginning cancer." Another patient
quoted or misquoted a previous consultant as stating that he
found a "thickening of the folds of the sigmoid. He put me
on a rigid diet and warned me to keep my bowels regulated.
He must have had some reason for doing that."
Another patient exclaimed, "I have an awful pressure in the
head. There must be a cause for that." He was told that this
was a quest for a change in the diagnosis and meant sabotage.
Whereupon he replied, "Dr. C. said, 'You are on the borderline.
You go to the hospital and rest your mind.'" This man was
one of those patients who insist that theirs is a mental and not
a nervous ailment. This insistence on the diagnosis of a mental
condition seems to have gained currency since the introduction
of shock treatments. To some patients the prospect of
shock treatment is more promising than mere psychotherapy.
It holds out the promise of quick relief. One patient had her
hopes pinned on electro-shock therapy because she knew it had
given quick aid to many sufferers she met in Recovery. She
was told that her condition was of such a nature that shock
therapy would not be successful. This did not discourage her.
She replied, "But I am afraid I am a mental case and I need
shock treatment. Dr. S. told me people develop bad habits
and 'they stay with them." And this flimsy statement was made
the warrant for a change in diagnosis and for the choice of a
treatment which entails a great deal of hardship and may even
have serious consequences. Some patients, inspired by the desire
for quick relief, go even to the length of pleading for the
diagnosis of a brain tumor. Any diagnosis seems to them more
hopeful than that of a nervous ailment. A brain tumor they
view as a possibility for an operation and a rapid deliverance
from suffering.
A rather common attempt to reject the diagnosis of a nervous
ailment is the recourse to heredity. A nervous ailment,
the patient thinks, means lowered morale. This label cannot
possibly be attached to a condition which is due to a hereditary

pre-disposition. The patient cannot on any account be held
responsible for a difficulty inherited from his ancestors. One
patient, immediately on being told that her complaint was undoubtedly
due to a nervous disturbance replied, "I hope my
son will not get this condition. My mother had exactly the
same complaints I have." Another patient said, "My mother
was like me. Is that hereditary?" There is certainly no glory
in a hereditary ailment. There can be scant consolation in the
thought that one's ancestors were "tainted." But anything
sounds more hopeful and more comforting than the bleak
prospect of having to undergo training in self-discipline. Even
brain tumors, mental ailments and hereditary "taints" are preferable
to that dreadful indictment as being a weak character and
needing training in self-control.

Goals are of two kinds: short range and long range. The
process of bringing up and educating children extends over
twenty to twenty-five years. It takes the greater part of a man's
adult life to establish a reputation, to acquire unquestioned
mastery of a profession, to build up a smooth-running business
enterprise. Such long range goals, requiring prodigious amounts
of time for their development and ripening, tax the patience,
endurance and determination of the individual. Short range
goals are less or not at all exacting. The purchase of a garment,
the writing of a letter, the trimming of the lawn or the visit
to a friends' home are goals of this description. They call for
a minimum of patience, endurance and determination. They
are usually accomplished in little time, with scant effort and
with negligible risk of failure.
Long range goals, as a rule, carry considerable responsibilities.
If you neglect the cutting of your lawn you will not be likely
to suffer the tortures of self-reproach. But let the thought obsess
you that you neglected the education of your children, and
your peace of mind will be gravely affected. You will suffer
pangs of conscience and bitter despair. Short range goals permit
leisurely, relaxed aiming. But long range goals demand
steady concentration and strained attention. They leave little
room for relaxation and diversion.
If your goal is of the short range variety you will be able to
aim at it correctly if you make use of the proper tool and command
the requisite skill and technique for using it. You will
do a good job at cutting the grass in front of your home if
you employ a suitable lawnmower with moderate skill and a
smattering of knowledge about its technical construction. This
is entirely different if your aim is directed at a long range goal.
Tools, skills and techniques alone will be of little significance

if your ambition is to secure a good education for your children.
A goal of this kind demands patient application, sustained
effort, unflagging determination, and above all an unshakeable
sense of duty and responsibility. To be brief: short range goals
must be aimed at with skills and techniques, long range goals
with character and will power.
The fact that you set yourself a given long range goal indicates
that you prefer that goal to another. You might have
chosen a business career but you decided on a medical education
in preference to trading or manufacturing. The preference
placed a valuation on your choice. You value your activities
as student or practitioner of medicine. Your aim Is now
directed at a value.
A physician may value a multitude of things and activities.
Hunting, traveling and golfing may be valuable for his recreation.
Card games, radio and movies may be of value to him
in point of relaxation and diversion. To be expensively dressed,
to own a high priced automobile and to acquire membership
in an exclusive club may be of value to his reputation or to
his vanity. He may, of course, value material possessions, and
if in the pursuit of wealth he engages in stock market or real
estate speculation be certain that the thrill or the mere prospect
of amassing a fortune will be valuable to him. But clearly, the
faithful devotion to a noble profession and the greedy scramble
for money cannot possibly have the same value. Obviously,
valuations must be of two kinds. How are they to be differentiated?
An overcoat is of value as protection against rain and cold.
If keeping dry and warm is your present goal the overcoat
will be a suitable means with which to aim at the goal. Generally
speaking, every means or tool which enables you to aim
at your goal is of value for this particular goal. If your goal
right now is to escape the summer heat a swim will be of value.
If your goal is to still your hunger a hamburger or frankfurter
will be objects of value. Since everything may at times become
the suitable means of aiming at a goal the possible range of
values is limitless. The question is not, however, whether a

given means or tool is of value to a given goal. The more
important question is whether the goal itself is one of value.
A goal may be of value to the individual or to the group.
Whether an overcoat satisfies your desire for protection against
the weather and whether a dish of meat relieves your hunger
is of no direct interest to the group. These goals serve your
personal comfort and are individualistic in nature. They are
individualistic values. On the other hand, if you bend your
energies to educating your children the group will recognize
your endeaver as being valuable to the community and will
class it as a group value. Needless to say that when we speak
of values we mean group values only.
In order to guide the conduct of the individuals belonging
to it the group has set up a table of valuations. All group values,
that is, all valued or preferred group goals are there ranged in
proportion to the importance they bear to the group purpose.
The individualistic goals of personal comfort, vanity, emotional
and temperamental dispositions and competitive ambitions are
reasonably tolerated within the framework of the table of valuations
but are not included in it. To put it otherwise, the
group permits a moderate degree of indulgence in gambling,
drinking, frolicking. It sanctions certain emotional drives and
temperamental leanings. It may even grant a modicum of
license to greed, unwise speculation and sharp competition. But
all these activities are strictly classed as individualistic and are
denied a rating in terms of valuations.
A group strives for stability first and foremost. Short range
goals could never guarantee stability. They are pursued for a
short time until mood, caprice, disposition suggest other more
convenient goals. If stability is to be maintained the group must
insist on reserving its table of valuations for long range goals
only. As was mentioned, aiming at long range goals calls for
steadfastness, determination, patience and sustained effort. In
other words, it calls for character. Character is opposed or indifferent
to mood, caprice, disposition. Everything that is purely
individualistic and personal is outside the sphere of character.
A person endowed with character aims at his long range

group goals (values) either with rigid, unyielding principles
or with elastic but firm policies. Principles admit of no exception,
policies do. It is unprincipled behavior to steal or cheat
even once. But it may be good policy to relax discipline frequently
in dealing with children or employes. Principles call
for relentlessness, severity, perhaps even for fanaticism; policies
call for a flexible strategy, for maneuver aad careful adjustment
to the requirements o the just prevailing situation. But no
matter how fundamentally different they are with regard to
rigidity and flexibility both principle and policy defeat their
purpose unless they are acted on with steadfastness, determination,
patience and sustained effort.
Health, it would seem, does not figure in the average table
of valuations. The group holds its members responsible for
their character and, for instance, frowns on dishonesty and lack
of responsibility. But it does not set up a code that obliges the
individual to tend to his health. There are other important
functions which though they represent undoubtedly long range
group goals are not included in the table of valuations. Parenthood
is one of them, sociability another. The group unquestionably
values them but refrains from regulating or supervising
them. The reason presumably is that the vast majority
of people can be depended on to take adequate care of health,
children and social contacts without any prompting on the
part of the group. Be that as it may, the fact is that heakh
does not seem to be considered a value in its own right. The
other fact, however, is that without health there can be no
proper aiming at long range goals and their corresponding
values. The functions of loyal service, religious devotion, patriotic
duty, parenthood, friendship, sociability, civi<>mindediiess
cannot be accomplished if the individual is crippled, bed ridden
or otherwise seriously handicapped. That functions of tins order
cannot be properly discharged if they are continuously frustrated
by frightening sensations, panics, and anxieties needs no
comment. Mental health particularly is not only a value. It
is a necessary prerequisite for the unhampered functioning ot
all the values represented in the table of valuations.

Failure to Practice Spot Diagnosis
Whether or not health is part of the general table of valuations,
to the patient it cannot be anything but a value. As such
it must be aimed at either with rigid principle or with a firm
policy. A principle is not permitted ever to deviate from its
goal. A policy may at times, but if it is to remain firm the deviations
must be held to an unavoidable minimum.
A physician treating a confirmed drinker will have to insist on
principle. He must instruct the patient never to imbibe even a
single drop of liquor. Should the drinker deviate even once
from the goal of total abstinence the deviations are certain to
be continued. For the nervous patient such a rigid adherence
to principle is not necessary. If suffering from "nervous fatigue"
he is directed to take brisk walks in defiance of his physical discomfort
he may at times weaken and stray from the goal of
self-discipline. In other words, he is permitted to sabotage his
goal occasionally. His health practice must be persistent but
not continuous. In his case, a performance based on rigid principle
can be dispensed with. A firm policy will finally accomplish
the end.
In order to hold down the deviations, that is, the acts of
sabotage, to a minimum the patient will have to know the
nature of the diagnosis and the acts which constitute sabotage.
The diagnosis of a nervous condition establishes that the patient
suffers from disturbing sensations, feelings, impulses and
thoughts. These symptoms may occur numbers of times every
hour of every day. Each time any of the symptoms appear the
patient must have in mind the diagnosis given him after the
initial examination. At that time the physician surveyed the
broad field of the patient's reactions. His final diagnosis covered

the^sum total of the symptoms, the various circumstances in
which they may occur, the domestic, social or vocational influences
that may precipitate them, the emotional background,
the time most favorable for their release. Covering the entire
field of their operation the diagnosis was a field diagnosis. This
field diagnosis the patient must now apply to every occasion
and every spot where the symptoms may be noticed. His part
in the diagnostic scheme is to practice spot diagnosis. In order
to perform the diagnostic function assigned to him he will
have to acquire skill in spotting each symptom as it arises and
each sabotaging trend as it emerges. The symptoms will have
to be spotted in their initial stage before they reach their peak
of intensity. At the moment the "fatigue'* begins to stir in the
morning the spot diagnosis of a harmless nervous disturbance
must be made instantly. Likewise, if worry or alarm supervene
the spot diagnosis of sabotage must immediately dominate the
patient's mind. If the spotting is done promptly both the symptom
and the sabotage will spend themselves without leading to
a vicious cycle. In the beginning the spotting will have to be
done consciously and laboriously, but with continued practice
and experience the process will become relatively automatic and
The spotting practice is not easy. The chief difficulty is that
symptoms frequently acquire the tendency to shoot forth with
the rapidity of a trigger reaction. The palpitation or air-hunger
are there before the patient "even had time to think about them."
The trigger symptom is not only abrupt in its appearance, it
is also extremely intense, overwhelming, threatening, terrifying.
Once its terror grips the patient he will be thrown into a panic
and will be caught in a relentless vicious cycle. The terror will
instantly suggest that these are "the worst palpitations I ever
had," and that "if I don't get my breath quickly this is sure
to be my last gasp." The trigger symptom has now set in
motion a whole train of sabotaging thoughts, the thoughts of
a heart disease, of a tumor in the chest, the fear of impending
collapse. The sabotage sweeps aside the physician's field diagnosis
and aborts the patient's spot diagnosis.

Clearly, the trigger symptom must be spotted before it has
an opportunity to generate the panic and the vicious cycle. This
is possible only if the spot diagnosis is established in the splitsecond
when the trigger reaction is born. Stating it otherwise,
it means that the spot diagnosis must acquire a trigger quality.
The thought "this is nervous and nothing else'* must shoot into
the patient's mind precisely at the moment when his body fires
off its palpitations. Trigger-spotting must coincide with or follow
immediately on the eruption of the trigger symptom. That
spotting of this kind calls for a firm policy needs no emphasis.
Some symptoms have undoubted trigger quality. But most
of them are preceded by ordinary tenseness and irritability and
gain momentum only because of the temperamental attitude
taken by the patient. He becomes provoked at himself or others,
indulges in an orgy of self-pity or attention-demanding, and
it is this process of "working-himself-up" that finally leads to
panicky reactions. This situation which is by far more common
than the "out-of-a-blue-sky" reaction demands a firm policy of
temper control, that means, temper spotting. Contrary to what
might be expected, the average patient encounters greater difficulty
spotting his temperamental reaction than he does in the
process of spotting the symptom. Even the trigger reaction is
more amenable to spot control than is temper. The reason ought
to be clear : the symptom scares and creates distress. It is experienced
as painful, unendurable. Its capacity for creating severe suffering
carries with it the powerful incentive to eliminate it. Temper
is neither terrifying nor painful nor unendurable. Instead, it
is stimulating, vital, energizing. If it provides any incentive it is
for prolonging the stimulation and pleasure it affords. It is temper
mainly that resists the diagnostic spotting necessary to avoid
panics and vicious cycles. Temper spotting calls for an extremely
firm policy. In a sense, it might require rigid principle to
curb it successfully.
The suddenness with which nervous symptoms are apt to
strike is frightening, of course. Anything that occurs suddenly
and unexpectedly has this tendency to scare. You strike against
an innocent object in the dark and you get scared. A dog

jumps at you and instantly your heart palpitates and your knees
shake. Let anybody tap you on the shoulder from behind and
you will start. The scare caused by the suddenly erupting symptom
fits into this common pattern. Anyone would be frightened
if his eyes suddenly went dim or when his legs were stricken
with a sudden limpness. But the patient must learn to deal
with the abruptly emerging symptom as he does when a dog
jumps at him unexpectedly. In the case of the dog he gets
scared but immediately realizes that, after all, it was nothing
but a dog. In this instance, the momentary scare is followed
immediately by the correct spot diagnosis. The latter establishes
the fact that the scare was produced by an innocent,
harmless event. After the spot diagnosis is made the fright
disappears. Why is correct spot diagnosis done after ordinary
scares but not after the scare produced by a symptom? The
answer is that correct spotting is easy in the examples quoted
but extremely difficult in the instance of nervous symptoms.
If a dog is correctly spotted as the cause of an upset there is
nothing to contradict the fact that it was the dog who caused
the damage. The thought of another possibility can hardly
arise. But after a symptom has made its appearance the patient's
thought processes swing into action. Thinking about a symptom
means to appraise it, to assess its significance, its danger, its
likelihood to recur, and all of this means making a diagnosis.
If at that moment the patient makes the physician's diagnosis
the symptom will be spotted as merely nervous. Unfortunately, the
diagnosis is usually taken from the patient's previous knowledge,
and that knowledge was gathered in years past either from his own
misconceptions about how symptoms operate or from misinterpreted
statements of other physicians or from popular notions current
in the community. No sooner has the symptom struck than the
patient recalls in a flash the wild diagnoses that have come to
him from sources other than his physician. He now indulges
in a veritable orgy of self-diagnosing, preventing the correct
spot diagnosis, and precipitating a flood of self-scaring reflections.
The diagnosis gathered from foreign sources sweeps aside the
spot diagnosis recommended by his physician, and the self

scaring ruminations give rise to that variety of temper which,
leading to defeatist auto-suggestions, is nothing but plain hysteria.
The patient now finds that the present dizziness is "worse
than ever." He has "never before" experienced such a furious
bout of dizziness. How can the doctor call a dizziness of this
kind nervous if it "just drives me mad?" Or, a patient notices
that the room swings around him. "I never had that before.
It's something new. And the doctor made his diagnosis without
knowing about this symptom." Or, the patient experiences
that "awful head pressure," and "this time it is real, it is not
merely a sensation." Or, the patient is the victim of palpitations
and air-hunger. Suddenly he recalls a recent newspaper
notice that an acquaintance of his collapsed on the street and
died from a heart ailment that had not been diagnosed by the
physician. And so the hysteria runs on, releasing a veritable
hurricane of defeatist thoughts, sabotaging the field diagnosis
handed down by the physician and frustrating any attempt at
applying the spot diagnosis. The vicious cycle dominates the
scene, multiplying symptoms and pyramiding temperamental
Examples: A woman patient complained of a soreness in one
of her lower teeth. The condition had been in existence for
over ten years alternately affecting different teeth or some part
of the gums or cheeks. Most of her teeth had been extracted in
deference to her urgent demand to have something done to
eliminate "that unbearable pain." She was certain that an
abscess or tumor was causing the soreness. She demanded incessantly
to be placed in the hospital "for a checkup," insisted
on X-Ray studies, tooth extractions, surgery. When she described
her pain, she hardly ever missed remarking "This is the worst
pain I ever felt. It just drives me crazy. There is a pressure
against the root and I am sure it is a tumor." Patients of this
kind are given the following explanation: you compare the
present pain with a previous pain which you had weeks or
months ago. Then you conclude that today's pain is the worst
ever. But you must realize that the present pain is actually
experienced right now while the pain which you had weeks

ago is merely remembered. Of course, a pain felt right now is
always worse than one that is merely remembered. Every experience
fades in memory. The pain is remembered but its intensity
is softened and mellowed in recollection as everything
softens and mellows if viewed in the perspective of time. As a
matter of fact, if your present pain were the "mildest ever" it
would figure in your mind as the "worst ever" even if you
compared it to the most excruciating experience you had in the
past. An experience, no matter how mild, is always more intense
than a recollection, no matter how severe.
The "worst ever" theme has its variations. Some patients do
not merely refer to one single symptom that is felt as having
"now" reached its worst intensity; they experience their total
condition as being "most" deteriorated today. A patient who
had numerous periods of severe depressions to his record was
seen on a day when he suffered from a mild condition that only
remotely resembled his previous episodes. He u
felt blue," but
appetite, sleep and initiative were hardly affected. He admitted
that he had no difficulty eating and sleeping. He agreed also
that he did not have to drive himself as he knew he had to in
his severe spells. Nevertheless, he wound up his account with
the statement, "I don't see what sleeping and eating have to
do with this. I don't think I've ever been that bad."
Another variation of the "worst ever" complaint was furnished
by a lady who had for years experienced a sort of tenseness in
the abdomen. She called it variously "tremor," "dancing" or
"shaking." One day she declared that the shaking was now
"worse than ever. It has never been as continuous as these
past weeks." Continuity was substituted for intensity in point
of being "the worst ever."
Once a patient confers the epithet "worst ever" to a symptom
it is no longer spotted as nervous. It is conceived of as something
new in intensity, as something that the physician has not
considered when he arrived at his field diagnosis. One part of
the field had not been sufficiently covered. The patient then
supplies the deficiency arriving at the diagnostic conclusion, that
"if it is that bad how can it be nervous ?

Some patients content themselves with pointing to the newness
o a symptom without touching1 on its "worse" or "worst"
quality. A male sufferer who listed a bewildering host of complaints
in his repertory exclaimed, "Yesterday, out of a blue sky,
I suddenly felt an electric current through my chest. I never
had that before." The patient was an "old-timer" with numerous
office visits to his record. The examiner fetched the patient's
folder from the files and had no difficulty pointing to several
notations concerning electric currents in various parts of the
body. The patient was far from convinced. His comment was:
"Maybe I had currents before, but that was the most awful
experience I ever had."
Patients frequently emphasize the "first" occurrence of a
symptom. If it is a complaint which they "never had before,"
they hasten to add, "Can that be nerves, too?" In many instances,
the experience is by no means new and "first," as was
easily demonstrated in the case of the patient with the "new"
electric current. But new symptoms are, of course, common in
psychoneurotic conditions. If they occur they offer the patient
a welcome opportunity to engage in his favorite game of sabotaging^
the physician's field diagnosis. Whether the symptom
is the "worst ever" or the "first ever" it is invariably seized upon
for the purpose of avoiding the correct spot diagnosis.

Failure to Spot Emotionalism
If the patient is to spot his temperamental reactions lie will
have to know those of his acts and statements which give expression
to his temper. The coarse varieties of his temperamental
expressions ought to be known to him if he took the
trouble to read the various chapters of the "Techniques of
Self-Help"* which deal voluminously with the subdivisions of
the fearful and angry temper. The descriptions there given
were concerned with the temperamental behavior which precedes
and precipitates symptoms. If a patient develops a spell
of choking and dizziness immediately following a heated
squabble it is hardly necessary to remind him that his symptoms
are the result of his temper. The relation between the two
elements is here patent, obvious, self-evident. All that is required
to understand occurrences of this kind is plain common
sense. The precise meaning of both temper and symptom reveals
itself to anybody's native and untutored intelligence and calls
for no detailed instruction. This is different with the temperamental
behavior which the patient releases after a symptom has
set in. The symptom may have appeared spontaneously, out of
nowhere, without provocation, perhaps at the very moment the
patient awoke in the morning. No commotion of any kind
preceded it. No sooner were the eyes opened than a heavy
pressure settled on the chest and air-hunger produced gasping
and choking. The patient is now scared. The scare is originally
nothing but a startle, exactly as in the case of a dog suddenly
leaping at a man. The startle would spend itself in a
*Low, A. A., The Techniques of Sdf-Hclp in Psychiatric After-
Care, Chicago, 1943, Recovery, Inc, 3 vols.

few seconds if the patient had the determination to spot the
symptom as what it is: the harmless expression of a nervous
imbalance. If the symptom is left unspotted the scare may
persist, and the likelihood is the patient will now drift into a
process of "working-himself-up." Essentially this is a procedure
in which the patient talks or thinks himself into a mixture of
fear and anger which may be prolonged indefinitely just as
long as the sufferer cares to maintain his favorite pastime of
self-torture. Since the "working-up" process follows the symptom
it properly goes by the name of "post-symptomatic temper."
Its counterpart is the situation in which temperamental behavior
precedes and precipitates the symptom. Preceding it, it
is called
prc-symptomatic temper!' The latter is patent and
obvious and needs no or little spotting. The former is subtle
and elusive and calls for a consummate art of spotting skill.
The practice of "working-oneself-up" follows well defined
patterns. The patient may give himself up to a paroxysm of fear
or anger. Then he emotionalizes his predicament. He anticipates
endless torture; he is certain he is utterly incapable of coping
with this "frightful" pressure and visualizes disaster, fatal
consequences or outright collapse. After hours of whipping himself
up he may realize that nothing fatal or disastrous has happened
or is likely to happen. Then he concentrates on the element
of suffering and rages either against himself and his own
helplessness or against his relatives and their indifference in
the face of his agony. All of it is emotionalism, a crazy quilt
of senselessly exaggerated fears and angers, either overlapping or
following one another. AJ:ter a while, the emotional raving may
cease, and another reaction may take its place in the form of
scntimentdism. If this takes the lead, then, the patient releases
an outburst of self-blame or self-pity, deploring his fate which
makes him a coward, a burden to his family, a social outcast
and professional incompetent. He laments the fact, tearfully
and dramatically, that he is deprived of the privilege of discharging
his duties and responsibilities, sets himself down as a pernicious
example for the children and a disgrace to himself and his
relatives. He indicts his moral weakness which robs him of his

will power, and his defective intellect which prevents him from
understanding the physician's instructions. Frequently, emotionalism
goes hand in hand with sentimentalism, the one providing
relief through angry explosions, the other furnishing exoneration
by putting the blame on fate and destiny or on one's weak constitution.
Both employ subtle and indirect reasoning which requires
prompt spotting if symptom and suffering are not to be
prolonged indefinitely.*)
What is here described represents an extreme expression of
the emotional and sentimental character of the "working-oneselfup"
process. Even in this extreme development it is common
enough. More common, however, and far more damaging to
nervous health are its more moderate versions which, keeping
this side of outspoken hysteria, follow the line of specious reasoning
and transparent sophistry. The patient tries to convince
himself or others that he does his best to get well but he "simply
does not know" why he cannot throw off his obsession. He
claims he makes an honest effort to ignore danger but the sensations
persist. What can he do about it? It is his fate to be
suffering and to make others suffer. Along with it go pious
protestations that it breaks his heart to see the poor wife distressed,
the children not properly provided for and the standard
of family life declining. The emotionalism is voiced in soft,
timid phrases, the sentimentalism couched in suave, tepid language.
No excitement, commotion or hysteria, rather calculation,
shrewd strategy, and a good measure of cunning. It is these
subtle and devious manifestations of combined emotionalism and
sentimentalism that call for a maximum of skill in temper spotting-
Examples: A patient gave an account of the ordeal she went
through the day preceding the visit to the office. "I was terribly
nauseated . . . Then I felt a heat wave . . . When these
heat waves get me I feel very, very hot. It gets so bad I can't
stand it any longer and have to call my husband . . .** This is
a moderate degree of emotionalism. The language is undoubtcd-
*For a more precise formulation of the concepts of emotionalism
and sentimentalism see the following chapter.

ly defeatist, exaggerating the intensity of the experience ("terribly
nauseated," "very, very hot") and overstressing its paralyzing
effect ("cannot stand it," "have to call").
Another patient delivered herself of a report which, in point
of urgency and dramatization, pushed to distinctly dizzier
heights on the scale of emotionalism. "This pain," she panted,
"just drives me crazy. It's really a pain, it's a sickly feeling'
really, it's not my imagination ... My hands are so clammy.
They feel like ice. The fingers and toes are real cold. I shake
like a leaf . . ."
The following description is in a similar vein of forceful
dramatization: "I had a chill. My feet got blue. They were
almost black. I couldn't even feel them. I had it at least for
five hours. And when I got up I felt so weak I could not move.
I am still awfully weak. I can hardly eat. Even warm milk
hurts my stomach. Couldn't that be a tumor?" One patient
exclaimed with flashing eyes and tremulous voice. "That pain
is just unbearable ... I was almost out of my mind . . . Honestly,
I don't see how I can go through this again ... I am sure
if that happens again it will be the end ... If my husband
hadn't come home in time I don't know whether I wouldn't
have done something to myself."
That this emotionalizing language fortifies defeatism, that
defeatism intensifies and perpetuates symptoms and that the
protracted fury of the "working-oneself-up" process leads to
panics and vicious cycles has been explained so frequently in
these pages that a renewed discussion of the topic would be
tedious. What must be emphasized, however, is that patients
of this kind are in the habit of supplementing their verbal
emotionalism by equally emotional muscular behavior. They
"notice" the "gas pushing against the heart" and clutch the
throat and chest, and feel the pulse. They rush to the mirror
and scan their features. Then they discover that the eyes have
lost their lustre, that a dark shadow skirts the lower lid, that
die cheeks are hollow and the face looks wan. One patient said,
"My eyes are bloodshot, my tongue is coated. I look in the
mirror, and the eyes look weary and beaten down." Many of

the tribe continually touch and paw their skin and muscles
and promptly discover what they are looking for: hardened
glands, flabby tissues, swellings, dryness, moistness and what not.
At times the emotionalism is callously made use of for the
purpose of keeping the members of the family in a state of
commotion. One such example was furnished by a patient who
stated, "I am disgusted with myself. I can't control my temper.
The other day it was so bad that I cried out *I am sick and
tired of living.' Of course, they were alarmed. I knew they
would be."

Failure to Spot Sentimentalism
If a patient is to spot his emotionalisms and sentimentalisms
he will have to acquire a working knowledge of what are emotions,
sentiments and feelings. The first thing he will have to
know is that these three varieties of inner experiences are particularly
likely to affect the functions of the body. Any of them
may cause the muscle of the heart to speed its action and to
produce palpitations. They may throw the digestive organs
into a state of excitement and give rise to vomiting, nausea,
belching or gas formation. The muscles of the bronchi may
be affected and air-hunger and chest pressure may be the result.
They may affect the muscles of the extremities and cause weariness
and heaviness, that is, "nervous fatigue." Affecting the
functions of the body, emotions, feelings and sentiments have
been properly called affections or affects.
Everybody has feelings and sentiments every moment pf his
life. What he feels can be expressed in two terms: a sense of
security or insecurity. If you feel secure you are vigorous, cheerful,
happy, enthusiastic, enterprising, self-confident. All of this
can be summed up in the word "joy" or its finer shades of
satisfaction, contentment, serenity. The reverse of joy is grief.
The latter is the result of a feeling of insecurity. If you feel
insecure you lose your vigor; you lack your customary enthusiasm,
happiness and initiative, and are deficient in courage and
self-confidence. Grief may shade off into sorrow, gloom, concern,
misgiving. All these feelings affect the physical and psychological
person. If the affection spreads to the social personality
we speak of sentiments. Sentiments are exercised in a group,
feelings can be experienced apart from the group. Animals
and babies can feel happy or grieved. But the sentiments of

sympathy, companionship and fellowship, of duty accomplished
and responsibility discharged can be operative in adult or adolescent
members of a group only. If a person is commonly
affected by these sentiments, practicing them systematically, he
lives up to the standards set down by the group and by this
token acquires the title of a mature personality.
Feelings of security give the person a sense of efficiency and
adequacy. They are exciting, stirring, stimulating. They make
the person feel vital and dynamic. The converse is true of the
feelings of insecurity. They produce a sense of weakness, helplessness
and inadequacy. If they predominate the person lacks
the sense of vitality and dynamism. This is different with sentiments.
If you are moved or affected by sympathy or by the
spirit of fellowship you will hardly experience the flush of vitality
or the push of dynamism. You will merely acknowledge that
you did a good turn or that you conformed to the group standards
of duty and responsibility, that you did the right thing and lived
up to your principles. This will give you a sense of rightthinking
and right-acting. Your behavior was in accord with
established values; it was valid but not necessarily vital. Feelings
express vitality or the lack of it; sentiments stand for
validity or the lack of it, A person driven on by his feelings
is vital, perhaps also colorful and forceful; a personality guided
by group-approved sentiments is valid, perhaps also colorless
and dull.
The daily life of the average man is so arranged that his
feelings and sentiments are held in a fair state of equilibrium.
You feel distressed at a rebuff suffered in your place of employment
but returning home in the evening you enjoy the comfort
and peace of your home, the loyalty of your wife and the loveliness
of your children. The grief experienced on the job is
neatly balanced and perhaps cancelled out by the joy accorded
you in the domestic sphere. Or, you are worried by tie thought
of having defaulted on some duty but your sense of failure is
soon counter-balanced by the evidence of an accomplishment that
raises your morale. Today you have misgivings about your
standing among neighbors and friends; tomorrow you will have

proof positive that you are well thought of. Grief is balanced
by joy, failure by accomplishment. In this manner, both your
vitality and your validity are kept in a satisfactory state of adjustment.
This serene, happy and complacent life may be interrupted
suddenly by a blow dealt you by fate. Your child is
stricken with an incurable disease. He is or may be crippled
for life. Now you are seized with a grief which is deeper and
far more intense than that caused by the pinpricks, failures and
rebuffs encountered in the daily round. The mild feelings of
routine existence, coming and going, causing only transient
disequilibrium, have now been replaced by a feeling of extraordinary
depth and duration. This is still a feeling, deeper
and more intense than the average variety but a feeling, nevertheless.
The question is: Will you "process" or "work-up" this
deep feeling into a fierce, turbulent emotion? Will you, for
instance, permit yourself to think and exclaim that life is now
unbearable, that all is lost, that no joy can henceforth enter your
existence? Will you rave against fate that has betrayed you?
Against medical science that has failed you? Against Divinity
that has forsaken you? Will you go into rages and explosions
against yourself and others? If so, your deep feeling has changed
into an emotion that is loud, boisterous and furious but lacks
the depth of genuine inner experiences. You are now the victim
of emotionalism, and your affect is one of emotional hysteria.
There is another possibility. Instead of venting your wrath on
fate, humanity and Divinity you may turn it against yourself
mainly or solely. You will then embark on a wild crusade
against your own deficiencies. Why did you wait before you
called the physician? If you had summoned him immediately
the calamity might have been averted. What kind of a father
are you? How depraved, how devoid of the most primitive
sense of duty and responsibility? If your child is doomed to lifelong
suffering it is you who wrought his doom. You charge
yourself with carelessness, neglect and indifference to the welfare
of your family and set yourself down as a man without morals,
without character, without judgment. You doubt whether
you are possessed of the ordinary sentiments expected of a

father. You give yourself over to a paroxysm of self-accusations
and self-torture. If that happens your ordinarily deep or average
sentiments have degenerated into a disordered, unbalanced, frenzied
sentimentalism. Your affect is now one of sentimental
In the instance of the child stricken with an incurable disease
the father had ample opportunity to display genuine feelings of
grief and pertinent sentiments of devotion. A combination of
this kind would have led to plans and actions meant to remedy
or mitigate the affliction. The grief would have inspired a mood
of resignation and might have prompted a reappraisal of previous
valuations and ambitions. The father might have realized that
in the past he spent too much time and energy on vocational
and social pursuits, that as a consequence home life was neglected,
that the domestic scene suffered from a deficiency of
affection and intimacy. Considerations of this kind would have
suggested settled plans to rearrange time schedules and work
habits. As a result, the needs of the family would henceforth
have taken their rightful place side by side with the demands of
social and business obligations. The genuine feelings would
have produced a reorientation of goals and aims. In a similar
fashion, the sentiments of sympathy and parental devotion
would have led to decisions to do everything to shape and prepare
the future of the handicapped child. There was the issue
of how to substitute home training for school education, how
to implement projects for medical supervision, recreation, group
life, play, travel. The father might have given thought to a
suitable though limited career for the boy, perhaps even to the
possibility of married life in spite of the handicap* In all of
this, the father would have thought of the boy and the family
first and of himself last. Instead, he gave himself up to a burst
of emotionalism and sentimentalism, and now he thought of
himself first and the boy last. He lamented his own fate, the
frightful loss which he suffered. His wails and moans centered
on the sorrowful reflection how he would be able to bear up
under the strain of anguish and despair. His feelings and sentiments
were primarily focused on his own self, on his poor ego,

secondarily only on son and family. The difference is clear;
genuine feelings and sentiments tend to produce plans and
actions designed to manipulate or remedy a situation outside
the person who experiences the affects. Emotionalism and
sentimentalism have the opposite effect. They turn the attention of
the affected person inside, to his own inner experiences, to his
own woes, anxieties and anticipations. The difference is one
between fellowship and individualism. Genuine affects make
for fellowship and group-centered interests; emotionalism and
sentimentalism produce stark individualism and self-centered
The tendency today, in daily life, literature, art, and popular
scientific pursuits, is to emphasize emotions (fear and anger)
to the neglect of genuine feelings and sentiments. Unfortunately,
this trend has served to put the stamp of approval on the emotional
and sentimental hysteria practiced by the nervous patient.
Experiencing disturbing sensations or thoughts the patient's
first impulse is to concentrate his attention on his dear self and
his poor ego. He expatiates in unending tirades on the nature,
quality and intensity of his inner perceptions. He picks them
apart, goes into details of analysis and explanation, insists that his
feelings and sentiments are real, not imaginary, that his
sensations are excruciating and unbearable, that instant relief is
imperative. Otherwise how is he going to "stand them?" He ap*
peals for sympathy and attention, demands understanding and
above all a "friendly hearing," an opportunity to pour forth a
stream of complaints, an occasion for "processing" his feelings and
sentiments into wild orgies of hysteria. This patient is interested
first and foremost in coddling and pampering his inner experiences.
He "works them up" or "processes" them into excitements,
frenzies and panics. The preoccupation with his
experiences inside him keeps him from taking adequate courses
of action outside him for the purpose of remedying the situation.
Moreover, if such a course of action is suggested by his physician
he counters with reactions of sabotage sensing keenly
that outside action is bound to divert his attention from the
painful delights of inside analysis and self-observation. This

patient is a confirmed individualist, self-centered and thoroughly
egotistical with reference to his symptoms, oblivious to
his own realistic needs and indifferent to the demands of fellowship.
His endless complaints disrupt group life and aggravate
his own hysteria and suffering. If this deplorable situation
is to be rectified the nervous patient will have to learn that
emotionalism and sentimentalism are the enemies of his own
welfare and a blight on the group he lives in. In order to do
that efficiently he will have to train himself to spot his inner
experiences and to prevent his originally mild and innocent feelings
and sentiments from being processed into emotional and
sentimental hysterias by means of the "working-onesclf-up
The technique for spotting emotionalism was described
in the preceding chapter. Instructions for spotting sentimentalism
are offered in the following examples.
Examples: A woman who had been suffering from numerous
disturbing sensations, obsessions and compulsions released
a veritable torrent of moans, sobs and complaints whenever
she found somebody willing to listen to her. She had been
given instructions in classes and in private conferences to the
effect that moaning, sobbing and complaining are done through
the medium of speech muscles and that muscles can be controlled
at will. The precise technique of practicing this type of musde
control had been discussed with her repeatedly. There was no
doubt but she understood the procedure. She also understood
that restraining muscles meant to produce increased tenseness
in the restrained muscles but that the tenseness disappears in a
few minutes or seconds if the "command to the muscles*' is maintained
resolutely. She understood but failed to practice control.
Instead she bewailed her fate. "I know I am a drag on my
family. I hate to torture them but I cannot help It. Honestly,
I don't understand how they stand up under the strain. I know
Fll be their ruin." She loved to pamper her inner sentimentalisins
and refused to control her muscles for purposes of inner control
or for proper outer action.
Another patient with a similar bent for incessant complaining
l am afraid I ruin my family.*' The following con

vcrsation developed between patient and physician: Physician:
"The best way to stop ruining your family is to stop working
yourself up. You can do that easily if you control your speech
muscles." Patient: "I try but I can't. Maybe I don't understand
you." Physician: "Don't work yourself up over your inability
to understand. Stop making an issue of it." Patient: "How
can I avoid making an issue of the health of my family. I certainly
can't stop worrying about that." Physician: "Don't make
an issue of your worries." Patient: "And I can't stop this
daydreaming." Physician: "Daydream but make no issue of it.
Don't work yourself up over it." Patient: "And why can't I
shake o5 these ugly thoughts?" Physician: "Have the thoughts
and wait till they disappear. But, above all, make no issue
of your having thoughts." Patient: "But, doctor, you don't listen
to me." Physician: "The most important thing is that you
listen to what I tell you. You told me of your inner experiences
and your sentimentalisms so many times that I know them by
heart. You should stop talking about your worries and issues
and start controlling them by using your muscles."
A male patient had difficulty controlling his temper. But
instead of making an honest effort to "command his muscles"
he relished indulging in sentimental self-accusations. "I strike
my children," he exclaimed, "Is that human?" He was told,
"Control the muscles of your arms and command them not to
strike. But above all, don't become emotional and sentimental
after you have struck your children. Avoid working yourself
up." The patient replied, "Maybe I haven't got the mental
capacity to do that." Physician: "I asked you to use your muscles
for control, not your brain." Patient: "But how can I carry
out your orders if I don't think?" Physician: "You do an excellent
piece of thinking right now arguing with me. The
trouble is you think too much and too well when it is a matter
of convincing yourself that you cannot do what I ask you to do."
Like so many other patients, this man made use of sentimental
self-condemnations in order to prove to himself and the physician
that he is desirous but incapable of improving.
One articulate patient expressed the relationship between

sentimentalism and the will to sabotage in the following words:
"I like to think of myself as a lost soul. I feel I am irretrievable,
If I went with as much enthusiasm about the job of getting well
as I go about moping and feeling sorry for myself I'd be well in no
time." Another patient expressed a similar thought when she
said, "I am getting more tired in the morning thinking about
what is to be done than doing it." These patients love to pamper
their sentiments but hate to control their muscles.

Failure to Practice Muscle Control
Recovery stands for simplicity. Its systems of instruction and
training are meant to enable the plain, humble and untutored
patient to practice self-help. An objective o this kind cannot
be achieved by means of involved explanations and complex
techniques. Self-help in psychiatric after-care calls for simple
methods of interpreting and manipulating symptoms. It is for
this reason that Recovery offers to its members plain common
sense instead of intricate philosophies and artless techniques of
training in place of elaborate procedures.
Whatever else a disturbing nervous symptom may mean, its
main effect is that it interferes with the adjustment of the
patient. And adjustment is effected through action, and action
is carried on through muscles, including the muscles of speech.
The patient says he suffers from fatigue. The fact is, however,
that he thinks his muscles are exhausted and fears or neglects
to use them for the purposes of walking or working. "Fatigue,"
then, thwarts proper muscular behavior. With the thought of
exhaustion in his brain the patient is doomed to inactivity and
incapacity. The conclusion is plain: convince the patient that
his muscles are neither weak nor damaged, and he will regain
the courage and determination to use them for his daily activities.
Adjustment will be restored and action reinstated.
Nothing is more convincing than muscular performance. A
letter is waiting to be written. The message which you are to
deliver is embarrassing or difficult to present in proper language.
You doubt whether you can choose the right phrasing
to express it without being too sharp or overcourteous, or too
dull. Finally you decide to proceed with the irksome task and
find to your surprise that in the end your communication is

little short of a fine accomplishment In wording, style and composition.
You are proud of your product and have gained considerably
in self-confidence. The action of your muscles conquered
and convinced the anxieties of your brain. Instances of
this kind are too common to need amplification. The underlying
principle is of universal application and finds its pertinent
formulation in the proper prescription: try and you will find
out. To a mind reared in the tradition of intellectual pomposity
such a naive method may appear to be too simple to deserve the
name of a technique. But self-help is based and predicated on
simplicity, and simple rules only will serve the mass of nervous
and former mental patients who, in the mass, are composed
of simple folk.
Nobody will doubt that a patient can convince his brain
through the muscles that he can walk on in spite of his "exhaustion"
without incurring the danger of collapse. All he has
to do is to step out in forceful movement and if he fails to "keel
over" or to "cave in" he has given incontrovertible evidence
that his muscles are anything but exhausted and that the menace
of collapsing is a myth. Nor will anybody dispute the fact
that a temperamental person can cut short his emotionalism
by commanding his speech muscles to stop arguing or his skeletal
muscles to stop fighting. Temper of this kind creates an impulse
to strike or shout, and since the shouting or striking must be
done by the muscles they can be stopped by an order to the
same muscles to refrain from striking or shouting. The same
transparent relationship obtains in the case of many disturbing
sensations. An itch mobilizes the impulse to scratch and it is
well known how difficult it is for most persons to resist the temptation.
Nevertheless, in company or on the street, intuitively or
reflectively, the itch is successfully controlled, that is, the
muscles have been commanded to refrain from scratching. Similar
examples of effective blocking of symptomatic reactions
through control of muscles could be quoted from experiences
with other disturbances, for instance, the control of restlessness
and agitation through determined motionless sitting, the conquest
of "sleeplessness" through persistent lying in bed without

turning and twisting. But these illustrations refer to sensations
that have or seem to have their seat in the skin or the muscles
of trunk and extremities. How about sensations which are produced
in inner organs? How about experiences other than sensations,
for instance, fears, obsessions, preoccupations? Can
muscle training stop a lump in the throat, pressure in the head
and churning in the abdomen? Can muscles do away with the
thought that the body is expanding or that people are looking
at you?
An intelligent approach to these questions will have to consider
the nature and character of both sensations and obsessions.
Sensations are notorious for their transient and ephemeral existence.
They come and go. All you have to do is to observe
yourself for a few minutes' time and you will have no difficulty
spotting numerous mild sensations rising to consciousness and
instantly falling back into unawareness. You can then notice
in quick succession a warm feeling in the lobe of the ear,
some tenseness in the neck, a tickle in the throat, a momentary
heartburn in the region of the sternum, a pulling in the shoulder,
an itch somewhere and a pressure somewhere else. Some sensations,
if mild, are pleasing, like the warmth, the tickle and the
itch; others are displeasing, like the heart-burn, the pulling and
the pressure. In this manner, stimulation and irritation alternate.
The one set of sensations are relaxing; the others are tensing.
This continuous ebbing and flowing, appearing and disappearing
has been likened to the systolic and diastolic phases of the
action of the heart and has been called the "sensation pulse."
How is it, one may ask, that the sensations felt by nervous patients
come but do not go? What causes them to lose their
transient character and to acquire the quality of sustained duration?
To express it differently, why do the sensations experienced
by nervous patients tend to lose their pulse?
The same consideration may be applied to the obsessions which
plague nervous patients. An obsession is a thought, usually a
suspicion. The suspicion may be directed at others as in jealousy,
or at one's self as in the case of the obsessive thought that one's
body is changing or that people stare at you. Of thoughts it is

just as axiomatic as o sensations (and feelings) that they are
of transient durations flitting through the brain, coming and
going, unless they are concentrated on. Just give yourself over
to a few moments of revery or day-dreaming and you will realize
how your thoughts wander across the field of experience,
now reaching out into the future, then roaming through the past
with a motley assortment of ideas, opinions, plans and dreams
crowding in on one another, the ones just entering your brain,
the others leaving. This ceaseless hustle and bustle of an up
and down flowing mentation has been called the "stream of
thought." The question is again permitted: How is it that
with nervous patients the ordinarily fading and floating thought
elements harden and crystallize into perennial and unending
suspicions and obsessions? Why does their stream of thought
cease streaming? Obviously, some factor operating in nervous
patients upsets the pulse of their sensations and interrupts the
stream of their thoughts. That factor is an abiding sense of
insecurity producing, through concentrated preoccupation, sustained
tenseness and preventing the nervous system from relaxing.
If the patient could gain the unquestioned assurance that his
condition is "just nerves," distressing but not dangerous, he
would have no difficulty relaxing his organs and reinstating the
pulse of sensations and the stream of thought. Unfortunately,
the assurance given the patient by his physician is verbal, mainly
or exclusively, and words do not necessarily carry conviction.
Usually the patient is an "experienced complainer," has made
the round of physicians and clinics, and numerous past attempts
at reassuring him met with failure* He is now skeptical, listens
but is not convinced. The physician's "sales talk'* strikes against
the patient's "sales resistance." Verbal explanations, no matter
how skillful, usually fail to reach the "expert sufferer." The
thing that will convince him is his own performance. Make
him walk ten blocks and the action of his own muscles will
demonstrate to him that he did not collapse in spite of his feeling
of exhaustion. The myth of exhaustion is then reduced to
absurdity by the patient's own muscular movements. Or, to

give another illustration: the patient is tense, restless, in constant
motion. He is unable to sit through a theatre performance.
Hence, in a show, he chooses a seat near the aisle so he can
make a hasty escape if the tenseness becomes "unendurable."
Patients of this sort are gripped with fear that unless they rush
instantly out of the door into the fresh air they will faint or
burst. Train them to force the muscles to sit through the ordeal
of tenseness which is "extremely distressing but utterly harmless,"
and the first trial, as a rule, will convince them that the
"intolerable" tenseness can be tolerated and that the burst or
faint do not materialize. If the patients have been exposed to
group psychotherapy classes and Recovery meetings, the example
of other patients who "have done it" prepares the new practitioner
for the first trial In classes and meetings he has obtained
the conviction that others have conquered fears by the muscular
route. Later his own practice reinforces the assurance gained
from the reports of the others. After a few more trials the fears
disappear, the tenseness recedes and relaxation re-establishes
itself. And under conditions of relaxation, the suspended pulse
of sensations regains its balance, and the disordered stream of
thought restores the regularity of its flow. The following illustrations
will demonstrate the details of technique which patients
are taught to employ in order to conquer disturbing
sensations and obsessive thoughts by the simple means of
"commanding the muscles to do what you fear to do." That most
patients bungle the method in the beginning ought to be
understood. Many patients not only bungle but also sabotage
the method.
Example 1. A woman patient had been suffering from numerous
anxieties, obsessions and compulsions for upward of three
years before she was assigned to classes and Recovery membership.
She feared going out unaccompanied, anticipating fainting
spells although she had never experienced any. Her most distressing
difficulty was the compulsion to "repeat." Whatever she
did had to be done over numbers of times, sometimes for hours
on end. Making beds was a never ending procession. After
the sheet was tucked in it had to be pulled out and smoothed

and stretched and tucked in again. Then the pulling out and
smoothing and stretching had to be done again, undone, redone.
In this manner, every task took hours to perform and seemed
never finished. Washing the hands, cleaning the bathtub, locking
the door required the same protracted ceremonial. No matter
how well the original act was performed it had to be done
over in interminable repetitions. Particularly agonizing was the
compulsion to repeat sentences and questions. It was hazardous
for the patient to engage in any kind of conversation because
each statement made by her had to be reiterated until it finally
"sounded just right." If a statement was made by another
person the patient had to ask question after question to make
sure that she had actually understood what was meant. If the
ritual of repeating was interrupted because a visitor appeared
on the scene or the door bell rang the patient experienced an
"unbearable" tenseness, tremors and tightening of the throat
The repetitions had to be resumed instantly after the visitor
was disposed of or the telephone message was received. The
patient learned soon that what she feared was not rumpled bedsheets
and dirty bathtubs, misphrased sentences and misunderstood
questions but rather the "intolerable" tenseness, tremor
and tightness which resulted from the fears. "I know that,
doctor," she replied, "but the knowledge doesn't help me." She
was then trained to do with the muscles what her brain feared
to do; to command her speech muscles not to repeat statements
and questions; to order the muscles of the arms to interrupt
the movements of washing, scrubbing and straightening after a
reasonable amount of time had been spent on these activities.
Above all she was asked to be prepared to stand the tenseness
resulting from a frustrated impulse and to know that it was
"distressing but not dangerous." With the example and other
patients she practiced encouragement of other patients she
practiced but with partial success only. One day she remarked,
"I can now stop the repeating with regard to bedmaking, dusting,
locking the door, and I no longer repeat statements and
questions as much as I used to do. But with washing the hands
and cleaning the tub I have had no luck/' It was not easy to
persuade her that the

tenseness was the same in both series of tasks and that if she
was able to brave it in one type of activity and not in the other
the reason for this senseless discrimination was her tendency
to sabotage. Prior to joining classes and Recovery she had been
treated with methods of verbal assurance and found the technique
of muscle training tedious, absurd and "not suited to
my case." Many patients offer this negative reaction. They
resent simple methods of this kind as an insult to their intelligence.
The procedure is likely to appear insulting and, indeed,
humiliating because if excruciating tortures of years' duration
can be disposed of with such simple means why were the pains
and pressures and dizziness made the object of years of wailing,
temper tantrums, neglect of duty and financial sacrifice? The
question is unanswerable but is rated as sabotage in Recovery
and countered with the alternative question: Is the fact that you
suffered needlessly in the past sufficient excuse to continue the
suffering into the future just because the mode of treatment
fails to impress you as intricate or dignified? In the present
case, the sabotage against the "indignity" of being treated with
a too simple method was overcome after months of therapeutic
effort and the patient has done well for the past seven years.
When her husband was called into service in 1944 the wife had
no difficulty taking over his business and conducting it till
months after Armistice day.
Example 2. A young woman had been afflicted with a most
distressing condition for upward of four years prior to being
assigned to classes. On walking along the street the sidewalks
seemed to heave up against her and the buildings appeared to
bend toward her. This caused dizziness, tightening of the abdomen
and, of course, panicky fear. After due explanations
concerning the utter absence of any danger that she might be
caught and crushed by the collapsing buildings or by the uprising
pavement she was trained to walk on in spite of the threat of
the sensations. She soon learned to step out fearlessly into the
street and acquired mastery in ignoring the "symptomatic idiom"
of her sensations. But after a while she complained that although
she had conquered successfully the fear of being swal

lowed up by pavement and buildings she still had the tightening
of the abdomen, the dizziness and tenseness. "How can
I get rid of this by practicing muscle control?" she asked. She
was told: "When the abdomen tightens up command your
muscles to continue the meal regardless of the pains and spasms
in your stomach. Discipline your body by means of your musdes,
always keeping in mind that no danger whatever is involved.
If sensing the tightness of the stomach you refrain from eating
you incidentally tell yourself that the condition of your stomach
is one of a crippling disease. This intensifies your tenseness,
and the tenseness keeps your stomach from relaxing. The abdominal
spasms and pains are thus perpetuated. They will
disappear only if you relax, and you will relax only if you are
fully convinced that no danger threatens. This conviction you
can gain if you continue to eat, demonstrating to yourself that
nothing happens if you do continue. After a few performances
of this kind your confidence will return, and your conviction
will be established. Then your body will relax and the stomach
will follow suit and the dizziness will subside because there will
be little tenseness left to sustain it." After a short period of
bungling trials and attendant sabotaging thoughts she manipulated
walking and eating with the aid of muscle control and
has been comfortable for the past six years.
Example 3. A woman patient complained of an itch in the
rectum. The itch had been with her off and on for over twenty
years. It was experienced for weeks and months uninterruptedly
during the day, never at night. At times it disappeared for a
few days or weeks spontaneously. She had done well with regard
to a number of other nervous symptoms but was unable
to get rid of the itch. "It just drives me crazy," the patient said,
"How can I control that?" She was asked, "Do you scratch
when you are in the street car?" "Isn't that strange," she replied,
"Now that you ask me I remember I never scratch when
I am in the street car. I don't even have the itch there. I don't
have it anywhere riding or driving." She was then told, "You
sat in my waiting room for over an hour today. Did you scratch
there?" "Why," she said, "I didn't have to scratch. I didn't

itch. Isn't that funny?" "That is not at all funny," the physician
remarked, "When you are among people you give the order
to your muscles intuitively and instinctively not to scratch and
muscles always carry out orders that are "meant" orders which
are resolutely passed on to them. After you have given that
order you know by experience that it will be obeyed implicitly
and don't give a thought to the itch any more. Removing your
thought from the itch you are without preoccupation, and there
is neither itch nor scratch. But once you approach your home
you know that there scratching is permitted or at least possible.
Now your mind is preoccupied with the itch which is trouble
and pleasure at the same time. Again intuitively and instinctively
you decide that now at last you will be able to indulge
the pastime of scratching." The patient, a member of Recovery,
soon learned to command the muscles discursively and reflectively
and got rid of the itch in a short time.
Brief examples: A patient was obsessed with the fear of dying.
As a consequence, he dreaded reading the word "death," shied
away from funeral parlors and gave up reading newspapers
from fear of encountering reports of killings or sudden deaths.
After proper explanations in classes and during office interviews
he was trained to command his muscles to stand in front of
funeral parlors and to practice reading newspapers deliberately
and assiduously. He had little difficulty shedding his fears.
Patients with fears of crossing streets, riding in elevators,
looking down from high places are currently treated by the
method of "commanding the muscles to do what you fear to
do." Success is almost always prompt and lasting.
Of particular interest are patients who suffer from outright
delusions subsequent to discharge from the hospital as improved
but not fully recovered. One patient still complained that the
neighbors were knocking at the walls, another that automobile
lights were again flashing their headlights signalling threatening
messages. In these and other instances, it is sufficient to
train the patients to first spot the experience as a "nervous
symptom, distressing and annoying but not at all dangerous,"
second, to exhort them to ignore the symptom and not to act

on it. If the patient commands his muscles not to shout at the
neighbors who "knock at the wall" and not to knock back at
them, or to ignore the flashing of lights, not to draw the curtains
or retire to another room, then he avoids the process of "working
himself up." And with no hysteria engendered the symptom
disappears. It "comes and goes." The sensation and thought
pulses re-establish themselves even with such pathological
experiences. An experience reported by an observant relative of a
patient threw light on the mode of operation of some delusions. The
patient complained of being stared at by people. Her cousin
stated that when she was in a restaurant with her, nobody did
any staring during the first few minutes. But then the patient,
suspicious that she may be stared at, began looking at people,
turning her gaze in all directions, staring at everybody and
anybody, thus attracting the attention of the diners at various
tables who actually began staring at her. In this manner, the
suspicion of being stared at had produced the staring.


Evelyn had been irritable, restless and tense for the past ten
years. Sleep was poor. Appetite had declined to the point
of making a meal an ordeal. There was a constant tightness
of the throat, pressure in the head, palpitations and gastric discomfort.
Overshadowing all complaints in importance and intensity
was "an awful fatigue, an exhaustion that starts right
when I get up in the morning and continues without letup
till late afternoon. Then it eases up and in the evening I feel
almost well."
In spite of this sustained suffering, "without letup/' Evelyn
managed to keep her job for years, supplementing her husband's
income. It was only in the past two years that the fatigue and
exhaustion became "unbearable." She resigned her position and
tended to her household and her young son. "But in taking care
of my home I have to drag myself all morning and the greater
part of the afternoon. I am exhausted most of the day.**
E Examiner
P Patient
E: You have attended classes for several months. Has your
condition improved during these months?
P: It has. I sleep well, and my appetite is much better. The
pressure in the head has hardly bothered me lately, and the
pain in the abdomen is getting less and less. But I am still
fatigued. In the morning I have to drag myself and can hardly
keep on my feet. Then I take lunch, and right after I have finished
eating I am all exhausted, my eyes droop and I have to
lie down for an hour or so.
E: You say that you are "all exhausted/' May I ask you what
precisely you mean when you use the word "exhaustion?"

P: Why, I am all in. I have no pep and must force myself
to do the simplest thing.
E: Look here, Evelyn, an exhaustion that has lasted for years,
day after day, even hour after hour, ought to have finally reduced
you to a physical wreck. Your muscles should have
shrunk, your face should by now look gaunt and haggard.
Instead, you maintained your weight, your complexion is blooming,
and your capacity for working is equal to the task of taking
care of house, family and social activities. Several months ago
when sleep was poor and appetite scant your claim to be exhausted
might have been logical. But with a good appetite
and sound sleep it is difficult to think that you are suffering
from a state of exhaustion.
P: I don't understand it myself, but it is a fact that I feel
tired and weary all the time, except in late afternoon and evening.
E: You say you "feel tired and weary all the time." I do not
deny that. You alone are competent to state how you feel. What
interests rne is whether your so-called fatigue is a mere subjective
feeling or an actual and objective condition, whether you
merely feel tired or actually are tired. You seem to be puzzled
by the sharp distinction and I shall try to be more specific.
You understand that if somebody says he feels guilty that does
not necessarily mean he is guilty. And if somebody feels feverish
that does by no means establish the objective fact that he
has fever. These examples will prove to you that a subjective
feeling does not necessarily point to an objective condition. And
if you say you "feel tired and weary all the time," I shall ask
you whether you consider your tiredness a subjective feeling or
an objective condition?
P: All I know is I am miserable all day. I wake up in the
morning, and the fatigue is there the moment I open my eyes.
E: You told me, Evelyn, that for the past few months your
sleep has been good. Suppose you awoke this morning after a
good night's rest. Would you nevertheless have felt fatigued
immediately after awakening?

P: I feel fatigued immediately after I wake up in the morning
regardless of whether sleep was good or poor.
E: If this is true then it is established that you suffer from
the subjective feeling of tiredness and weariness, and not from
the objective condition of fatigue. I shall tell you why I can afford
to be so positive about my statement. You see, Evelyn,
soldiers after a long march, athletes after an exhausting race,
laborers after a strenuous effort, may sometimes be too tired to
fall asleep. But once they lapse into a sound sleep they invariably
and inevitably feel refreshed after awakening. These are examples
of extreme fatigue. Even in these utmost exertions sleep
eliminates fatigue with unquestioned certainty. In minor exertions,
mere rest without sleep will have the same effect. The
only exception to this rule is physical ailment, like an anemia or
tuberculosis. In these conditions, even a sound sleep may not do
away with fatigue. But with physically healthy persons, sleep
never fails to remove fatigue. If it is true that for several
months past you have enjoyed good sleep you have no reason
for being tired in the morning. To sleep means to rest the
muscles. How can your muscles be fatigued if they are rested?
P: I don't know what to say. The fact is that I am all in
no matter how well I slept. If you call that a subjective feeling
you must think it is mental. But I didn't even have time to
think about it. It is there the moment I wake up.
E: I do not know what precisely you mean when you use the
word "mental." Presumably you refer to the possibility that
you may have the thought of fatigue in your mind and instantly
feel the fatigue in your muscles* This instantaneous response
of the muscles to a thought seems to puzzle you. I do not see
why it should. You have certainly gone through similar experiences
hundreds of times. Remember the occasion, for instance,
when you were at a meeting and were called upon to make a
speech. Instantly, your heart began to palpitate, your face reddened,
your abdomen trembled and the knees shook. To use
your own words, you "didn't even have time to think" of the
speech; you merely heard your name called, and the muscles of

your heart, abdomen and legs were thrown into violent tremors
"in no time." In the instance which I quoted the thought in
your mind which caused your muscles to shake was the fear of
not being able to deliver a well constructed address. It was a
fear, or you may call it a fear idea, or the idea of danger. Do
you understand now that if an idea strikes or occupies your
mind the muscles may respond with a violent reaction in a
fraction of a second?
P: I understand that. But when I get up in the morning
there is no idea of danger in my head.
E: The question is what you mean by danger. If you wish to
indicate that, in the morning, you are not trembling with the
fear of being killed or trapped or burned I shall fully agree
with you that no such idea may occupy your brain immediately
after awakening. But there are subtler forms of fears and
dangers. These subtle anxieties and apprehensions go by the
name of preoccupations. I happen to know from your own
account how readily you fall victim to such preoccupations. Let
me remind you, for instance, of the anguish you experience
whenever you expect visitors for the afternoon or the evening.
You fret and worry days in advance, anticipating some bungling
or clumsiness while performing the part of the hostess. You
know that when finally the much dreaded day arrives you feel
troubled and helpless "the very minute" you awaken. The day
stares you in the face as a threat, as an event fraught with
heavy responsibilities. You are without pep or zest. Your vitality
is at a low ebb. A heaviness seems to descend on your
limbs. Everything is done with effort. You have to drag yourself,
feel "all in," exhausted, lifeless, fatigued. Do you understand
that all of this is caused by your preoccupation, and that
the preoccupation is based on the idea of danger ?
P: It is true I am worrying my head off when I expect
guests. People are critical, and it is not easy to please them and
make them feel at home. But we don't have visitors every day,
and there is not a day when I feel relaxed. I am always tired.
E: I mentioned your preoccupation with your guests as an example
only. The example will demonstrate to you that a pre

occupation of this kind is apt to produce, in a split second, a
condition in which you feel "all in," dragging, exhausted and listless.
Being a nervous patient you are always preoccupied with
your disability. This preoccupation is a kind of worry which
hardly ever leaves you. You are always on guard against something
untoward happening in some part of your body. Looking
back on your unhappy experiences of the past ten years you can
recall numerous instances in which you planned a social engagement,
a card game, a show, a trip and were stricken with
a severe head pressure or palpitations or abdominal pain or
numbness. The card game had to be interrupted, or you managed
painfully to go through with it in wretched agony. You
remember the frequent occasions when dinner parties had to
be cancelled because your throat suddenly "locked," and you
were afraid you might not be able to swallow or speak; or the
dances that had to be called off because a heaviness settled on
your legs so that you could hardly walk. It was observations
of this character that in time suggested to you that it was no use
planning. The unpredictable suddenness with which your symptoms
could make their appearance gave you no guarantee that
if you made a plan you could go through with it. Gradually the
inability to plan spread to the trivial chores of everyday life. You
set out to prepare a meal, and your eyes blurred. Or you decided
to darn your husband's socks, and the hands trembled. The
symptoms came without warning. They shot through your
body without cause, without provocation. To use your own
words, you "didn't even have time to think about them." I
may tell you that symptoms which shoot up so unexpectedly,
in a mere fraction of a second, are called "trigger symptoms."
They shoot forth with the rapidity of a bullet after the trigger
has been pulled. Their trigger character makes them appear
weird, mysterious, threatening. In essence, they suggest to you
that you have utterly lost control of your primitive bodily functions.
Having noticed time and again that your organs may go
on a rampage without warning you feel you cannot trust your
body. You must always be on the alert for some sudden disturbance.
You cannot plan with any assurance of carrying out

your decisions. But if you are deprived of the power to plan,
your day is carried on without accomplishment. Moreover, without
planning, you miss that singular joy of looking ahead to
accomplishments. The joyous trembling of watchful anticipation is
taken from your daily routine. Life becomes a never-ending
drabness and drudgery. It is this type of life that you look forward
to when you awaken in the morning. In a flash, before
you had "time to think about it," the dismal dreariness of your
existence stares at you. Again one of those empty days with
no plans, no decisions, no accomplishments. You become
discouraged, disgusted with the dead monotony that is in store
for you, and it is the self-disgust that robs your tissues of their
vitality. There is no vigor, zest or incentive with which to
start out on the daily routine. Your body is devoid of stimulation;
it feels uninspired, flabby, limp. This feeling of limpness
you call "fatigue." You will now understand why towards
evening your vitality returns and why, after supper, you "feel
almost well." There is nothing left for planning after supper,
no drabness to be anticipated, no drudgery to be performed in
self-disgust. The dreadful day is gone or going. Nothing is
expected of you any more. You breathe freely now, and your
vitality returns. Do you realize now that what you call "fatigue"
is nothing but a psychological reaction to the anticipated and
dreaded boredom of daily existence? Do you understand that
the tiredness of which you complain is not in your muscles but
in your mind?
P: You are right, doctor. I realize now that everything you
say is exactly as I feel it. My mornings are dreadful. I have
nothing to look forward to. I can't plan; I am afraid to plan.
You are right, doctor, but why was I never told what is wrong
with me? I have seen all kinds of physicians, and the one
told me I was suffering from nervous exhaustion, another said
my energy was running down, and I should take it easy. One
blamed it on my thyroid gland; another told me I had a poor
constitution and he couldn't do anything about it. I was warned
not to overwork, was told to take long periods of rest, to go on
trips and vacations. If you say that my trouble is nothing but

boredom and disgust why did nobody tell me that before?
It would have spared me ten years suffering, and I could have
saved thousands of dollars spent on cures, sanitariums and trips.
E: It is painful for me to answer this question. I do not
like to be critical of what other men think or believe. Unfortunately,
there are superstitions that refuse to die. One of them,
very preposterous and pernicious, is the myth of nervous fatigue
or nervous exhaustion. All I can tell you is that, in 1880, a New
York physician formulated the absurd theory that a group
of patients whom he called "neurasthenics" suffered from a state
of nervous exhaustion.* How uncritical this man was is evident
from the fact that he did not hesitate to make unwarranted and
extravagant claims, for instance, that the "disease runs in families,"
that it is due to inheritance, that it has its origin in the
spine, that it is typically American and, hence, proposed to call
it "American Nervousness." Somehow this fanciful idea spread
all over the globe and is still widely accepted today as a message
of scientific truth. I cannot tell why a theory of this kind has
been permitted to figure in textbooks and to be practiced on
hapless sufferers. All I can state is that superstitions are born
easily but die with difficulty. I do not blame you for feeling
resentful of the unnecessary hardship that was imposed on you
during ten long years of anguish. But resentment will not help
you. It will only serve to whip up your emotions and throw
an additional load on your nervous system. What you need is
re-education. You must learn to reject as untrue all the silly
notions that were crammed into your head and to accept the
explanation which I gave you. Up to now, with the thought of
exhaustion in your brain, you were afraid to move, to work,
to tax your "weak" muscles. I take it for granted that henceforth
you will throw to the winds all this drivel about nerve
exhaustion and will not hesitate to tax your muscles to your
heart's delight.
P: You told me that before, and I made every effort to accept
your view. On many mornings I jumped out of bed with-
*George M. Beard, A Practical Treatise on Nervous Exhaustion
(Neurasthenia), New York, 1880, William Wood.

out paying attention to my fears. I ignored the heaviness in my
muscles and did my work, but it was certainly difficult. Your
assurance that the fatigue is in the brain and not in the muscles
helps me at times. But after I continue with my work for
awhile the thought strikes me that maybe the other doctors
were right when they warned me not to strain my muscles.
After ten years it seems not easy to shake off the fears.
E: You said you made every effort to accept my views about
fatigue. This is, of course, an exaggerated claim. I do not
expect anybody to make "every" effort in any endeavor. What
you mean is that you tried hard but did not succeed. But remember,
Evelyn, I never asked you to "accept my views." I
asked you to practice them. My view with regard to "nervous
fatigue" is that you can safely ignore it, that it is a bugaboo
and not a real danger. This view cannot be "accepted" and,
as it were, placed in your brain there to preside over your
actions. In order to make a view direct your action it must
be acquired, digested and absorbed through patient practice.
This is true of every sphere of life in which you wish to plant
views into the thoughts and brains of a person. In bringing
up your children you did not merely present them with lovely
notions and lofty principles, asking them to accept them. These
views had to be practiced, again and again, till finally they
were incorporated and lived and experienced and acted out
spontaneously. When you intended to make your boy adopt
the view of group responsibility you did not tell him to accept
your principle of group behavior. Instead, you told him not
to make noise in the presence of people. You urged him to
say "thank you" and "please." This you did for months and
years until finally the new habits took root. After ceaseless
practice your boy finally incorporated the view in his system,
made it part of his organism. The practice made the view
"sink in" and take its firm place in the brain from where it
then directed action. In this process of child training you influenced
your boy's muscles and through them established a
firm structure of habits. It was these good habits that represented
your view. You understand now that I asked you to

practice my view, not merely to accept it. The continued practice
would have brought acceptance in its train. You will perhaps
remember what precisely I asked you to do. I told you
to jump out of bed and to go about your work, fatigue or no
fatigue. But I also warned you to avoid all actions that embody
the view of danger, I specifically instructed you not to look in
the mirror to watch your so-called fatigue in your anxious
features. I asked you to avoid the practice of touching the
muscles of your arms and legs to investigate the degree of
their flabbiness. I cautioned you not to sit down after a few
steps or a few manipulations. Most important, I enjoined you
not to complain about your fatigue, not to moan or sob, not
to ask for help or sympathy. If you had complied with these
instructions you would have established a new set of habits
of how to deal with this legendary thought of nervous fatigue.
The old habits of fear would have been crowded out of your
mind, and a new set of constructive trends would have settled
down or sunk into your brain. My view would then have
occupied and taken possession of your brain without any effort
on your part to accept or adopt it. If you say that "after ten
years it is not easy to shake off the fears" I shall advise you
that you had no business assuming that it might be easy. Mere
acceptance of a view is easy, but practicing it means sustained
application with endless trials and endless failures till finally
you score the ultimate success. You thought of merely accepting
a view. That would have been easy but ineffectual. What
I wanted you to do was to practice, i.e., to direct your muscles
to carry out my view. I presume that after tonight's interview
you will no longer entertain the unrealistic notion that mere
lip-service to a principle -will reestablish a new set of habits.
Practice alone will do that.

Bill complained of episodes occurring every few weeks in
which he experienced intense fatigue and numbness in both
legs from the knees down. On these days he felt choked and
had difficulty breathing. The condition lasted upward of eighteen
years but improved greatly after he attended classes. The
spells no longer interfered with his work. "In the past," he
said, "I was out of circulation because of these spells. The
choked feeling and numbness and weakness were with me
for several days on a stretch. Then they became milder but
would start again after another few days. I was in bad shape
even on the good days. On a Wednesday I might want to
buy tickets for the coming Saturday. But I was afraid I might
go through a spell on Saturday and dropped the plan. Gradually
I stopped going out with people, except that I kept associating
with one boyhood friend."
When questioned concerning the degree of improvement since
attending classes he stated that the spells were milder now and
the intervals between them longer. "But I am still having
trouble with sleeping. It takes me a long time to fall asleep,
and the slightest noise gets me awake again. The other night
I couldn't get to sleep till after 4 A.M., and when I got up in
the morning I was worn out and felt I hadn't slept a wink."
E Examiner
P Patient
E: You say you could not fall asleep till after 4 A.M. Suppose
you retired at 11 P.M. What did you do while you lay in bed
between 11 P.M. and 4 A.M.?
P: (Bill) I retire late, usually after midnight. I hate to go
to bed early and lie there fighting for sleep.
E: If you retire at 1 A.M. and fall asleep at 4 A.M., what do

you do between 1 and 4? Do you lie in bed? Or do you get
up walking, smoking, reading?
P: I may lie in bed for a while. Then I become tense and
feel I have to get up. I take a book and read, or I go to the
kitchen for a drink of water, or get myself a bite from the ice
box. After that I may return to bed and lie down for a while,
but the trouble starts all over and I get up again.
Ethel Is AsJ(ed to Join the Interview
E: Ethel, several months ago, when I first saw you, you
also complained you were unable to fall asleep. Is that still
the case?
P: (Ethel) I have no trouble now. I sleep like a rock.
E: How do you do that?
P: I used to go to bed fearing that another one of those
dreadful sleepless nights was in store for me. Now I know it
was this fear that kept me awake. Ever since I stopped fearing
the sleepless nights I don't have any.
E: To put it differently, the fear of not sleeping made you
tense, and the tenseness kept you awake. After you eliminated
the fear you were no longer tense and had no difficulty sleeping.
But tell me, Ethel, how did you manage to eliminate the
fear of not sleeping?
P: I did what you told me to do.
E: What was it I told you?
P: You said there is no such thing as lack of sleep except in
acute diseases. If a person is not suffering from an acute ailment
he may have trouble falling asleep, or his sleep may be
broken and interrupted. But he will get a good deal of sleep
if he keeps lying in bed. You also said a person may not get
sufficient sleep in one particular night but will get enough of
it the next following night to compensate for what he missed
the night before. I remember you saying that difficulty of sleeping
deprives one of comfort but does not interfere with health.*
After I grasped that, I no longer worried about sleep.
*This does not, of course, apply to growing children whose health,
may suffer from insufficient sleep.

Bill Rejoins the Interview
E: Bill, having attended classes for many months, you certainly
know the rules mentioned by Ethel. How is it you do
not practice them?
P: (Bill) I know the rules and practice them night after
night. But I can't sleep. I know you will call that sabotage.
If it is I am not aware of sabotaging. I go to bed keeping in
mind that sleep is nothing to worry about; nevertheless, I feel
tense the minute I stretch out. Is this sabotage?
E: It could hardly be anything else. You say you practice
the rules for sleeping but cannot sleep. How is it that Ethel,
practicing the same rules, applies them successfully? Obviously,
Ethel's practicing is done with determination, yours without.
She carries out my orders resolutely, you half-heartedly. The
half-hearted practice is sabotage. If you were determined to
carry out my instructions you would not wait till after midnight
before you retire. You say you are without worry or
fear about sleep. Why, then, do you wait for hours hesitating
to retire? Hesitation is fear and the reverse of determination.
Do you understand now why I call your effort undetermined
and half-hearted?
P: I admit it must be fear that keeps me from going to bed
in time. But I don't see why it is sabotage if I can't get rid
of my fears. I certainly try my best.
E: That is all you do. You try your best which is the halfhearted
practice I mentioned. Every sabotaging patient offers
the excuse that he tries his best. What you try is a method, the
method of initiating and maintaining sleep. You described your
method. It may be your best. However, my instructions do
not call for your method, poor, good or best. They demand
that you employ that method which I have outlined here repeatedly.
You sabotaged that method first when you delayed
the process of retiring by hours, second when after retiring at
a late hour you failed to lie quietly, but instead kept jumping
out of bed, reading, walking, or rummaging for a drink and
food. Both sequences of sabotaging acts were carried out through
the medium of your muscles. You may have difficulty con

trolling fears and worries. But muscles can be controlled "at
will." Everybody has it within his power to command his
muscles to effect an act or to refrain from effecting it. That is
all my instructions require you to do. They direct you to order
your muscles to walk toward your bed at a given early hour, to lie
down and to maintain the recumbent position until you fall
asleep. If you permitted your muscles to do otherwise you may
have tried your best, but you failed to carry out my instructions.
Of course, it is difficult to forbid the muscles to stir when you
are tense and feel the imperative urge to move. The muscles
become more tense and press with greater vehemence for relief
through motion. But you heard me state repeatedly that no
matter how agonizing muscular tenseness may be it disappears
after a few minutes if you refuse resolutely to move the muscles.
A resoluteness of this sort requires that you are ready to pass
for a few minutes through the torture of lying quietly when
every fiber of yours is aching for motion.
P: In the beginning I frequently did what you asked me to
do. I went to bed early and stayed in bed without leaving it.
At times I kept that up for hours. Finally I got so tense I
couldn't stand it. I don't think you can call that sabotage or
half-hearted practice.
E: I must challenge your statement that you couldn't sleep
although you stayed in bed for hours. That may happen occasionally
and does happen with great regularity in the instance
of persons suffering from acute distressing ailments. Otherwise,
to lie in bed for hours means to sleep fart of the hours.
The sleep may be of poor quality and may proceed in fitful
snatches. After each snatch you awaken having the feeling that
you "did not sleep a wink." Nevertheless, you slept a considerable
portion of the time which you spent in bed.
P: I know I don't sleep. I am aware all the time of everything
that goes on. I hear every little noise and am wide
awake all the time.
E: What you said right now is nothing but an act of sabotage.
After I explained that everybody who lies in bed for
hours sleeps part of these hours you exclaim,
I know I don't

sleep/* With this, you contradict my statement. Apparently,
you intend to engage me in an argument. After months of
attending classes you ought to know that I do not permit
patients to question my statements. If you do that you set your
own immature knowledge against my seasoned experience. Indeed,
you challenge rny authority. You know that this is one
form of sabotage, perhaps its worst form.
P: I don't understand why you speak of arguing. Am I not
supposed to tell my side of the story ?
E: The trouble is that you consider this a story of which
you take one side, and I the other. Why should we take sides?
If you think we should, you conceive of an interview as an
argument or debate with "two sides to the story." While interviewing
a patient I do not engage in story telling, not even in
story listening. An interview deals with an account of symptoms,
not with the telling of a story. Your sleeplessness is a
symptom, not a topic of conversation. In a conversation you
are permitted, even desired, to state "your side of the story"
which is based on your common knowledge. But in a discussion
of symptoms you cannot rely on common knowledge. In order to
understand the nature and action of symptoms you are required to
possess special and authoritative knowledge. Where and when
did you acquire authoritative knowledge about sleep and sleep
disturbances? All you were ever able to observe were your
own difficulties of sleeping. What you observed was one single
case which is a slender basis for any kind of knowledge. I shall
ignore the fact that your manner of observing was naive and
amateurish. You are of course not trained in making valid
and expert observations. This I will ignore. But tell me, Bill,
would you apply to me for help if you knew that I had experience
with only one case like yours? You would not consider
me an expert with authoritative knowledge unless you
were certain I observed and studied hundreds and perhaps
thousands of cases. You see, Bill, when you said,
I know I
don't sleep" you referred to your own haphazard and hazy
knowledge which you obtained by means of untrained observation
and inexpert interpretation. In relying on your own

irrelevant knowledge you rejected my authoritative opinion.
You told "y ur side of the story" and "took sides" against me.
Do you realize that this is sabotage?
P: I cannot get it into my head that I should not be able
to know whether I am awake or asleep. That doesn't seem to
require expert knowledge.
E: I grant that you know when you are awake. But after
you awaken from a brief snatch of sleep you do not have to
know at all that you have slept. I have heard it stated a hundred
and perhaps a thousand times from patients and non-patients
that last night they "didn't sleep a wink." Some people
go to absurd extremes claiming they "did not sleep a wink"
for solid weeks or months. I told you that to lie in bed for
hours means to sleep part of those hours. I added that the
quality of this kind of sleep may be poor, proceeding in snatches.
The snatches may last ten minutes or half an hour or an hour
or longer. The sleep being light and superficial it is easily
interrupted by every sound, by a mild muscular pain, by a moderate
irritation of one's bladder or a slight spasm of the intestines.
Awakening from this superficial slumber the sleeper is
not aware of having slept. Added together the successive
snatches may have amounted to a sizeable total, let me say,
five or six hours in the aggregate. During these five or six
hours the muscles rested, and conscious attention was relaxed.
This is all that sleep is required to do for purposes of health.
For purposes of comfort it is desirable to enjoy deep sleep from
which one awakens refreshed with new vigor. But I do not
cater to your comfort; I tend to your health. And health is
adequately served by the brief snatches of light and superficial
sleep. You will now realize that you have a fitful, broken and
superficial sleep. It serves your health but does not give you
the subjective feeling of having slept. Lacking this subjective
feeling you think you have been awake and express this conclusion
in the wholly unwarranted exclamation, "I know I did
not sleep." By making this statement or thinking this thought
you oppose your common sense observation to my expert knowledge,
and this is sabotage.

Lester Joins the Interview
P: (Lester) Doctor, is a question in order?
E: If it is to the point.
P: I think it is. I frequently read health articles and listen to
health broadcasts in which sleep is said to be essential to health.
I know you are our only authority in matters of health, and
I know it is sabotage to accept other opinions. And if you say
that sleep has little to do with health that settles it for me. But
I hear plenty about the importance of sleep from friends and
relatives, and I should like to know how to answer their arguments.
E: Your point is well taken, and I shall be glad to oblige
you. Since I am supposed to be your only authority on health,
as every physician ought to be to his patients, you are entitled
to know the sources of my authoritative knowledge. They are,
first, my own experiences; second, the studies of leading men
of science who are unquestioned authorities in this field.
I shall first tell you of my own experiences. They are manifold
and concern observations on patients mainly, but also observations
on my own sleep performance. I am of course not
immune to "sleepless nights," which means that I pass occasionally
through nights in which my sleep is fitful and superficial.
When this happens I also awake in the morning with
the subjective feeling that I "did not sleep a wink." On one
such night, years ago, I noticed that precisely at a moment
when I felt distressed at my wakefulness I still had in mind
the tail-end of a dream that had just occupied my brain. At
that moment there was no doubt that I had slept. Otherwise,
how could I have dreamt? I then decided to look out for these
dream fragments, and the method seldom fails me. Whenever
I feel wretched because I seem to waste futile hours trying to
fall asleep I instantly recall the last dream fragment that I can
bring to consciousness. Then I know I have been sleeping and
dismiss anxiety and apprehensiveness. You will be well advised
to hunt for these dream portions of the past few seconds or
minutes whenever you are obsessed with the idea that you have
"not slept a wink." Do you understand, Bill, that if you know
you had a dream you must have been sleeping?

Bill Rejoins the Interview
P: (Bill) I shall certainly look out for these dreams when
I can't fall asleep. I hope I'll catch them.
E: If you say, "I hope 111 catch them" you indicate that you
are by no means certain about succeeding. With this you express
doubt whether you will be able to convince yourself that
lying in bed for hours means sleeping part of the hours. Perhaps
I shall be able to furnish you with more conclusive evidence.
Since you have not gone through a mental disease but
suffer from a so-called psychoneurosis I shall quote observations
from psychoneurotic patients first. On numerous occasions I
witnessed patients of this description sleeping and snoring but
when awakened they protested they "didn't sleep a wink."
Other patients of this kind were observed by my nurses, internes
and resident physicians who reported that the patients who
complained of utter inability to fall asleep either snored or
failed to respond when their names were called, when they
were sprinkled with water or pricked with a pin. Does that
prove to you that to lie in bed means to sleep?
P: I am making every effort to take in what you say. Nevertheless,
it seems to me I don't sleep. Couldn't there be an exception
to the rule?
E: I am sure you are not the exception. But I agree there
are exceptions. I told you that patients with acute physical
distress may actually fail to sleep although they lie in bed all
night. This is true also of acutely suffering mental (psychotic)
patients. It is weU known that so-called depressed patients
may go without sleep or with a minimum of it for nights and
even weeks in succession. Nevertheless, after they get well, not
a trace of evidence can be found that the prolonged vigils have
caused any damage to their health. If any proof is needed that
sleep has little bearing on health these patients provide it. More
convincing evidence yet is furnished by the so-called manic
patients. In the days when we had no shock treatment many
of these wretches spent weeks and months on the wards raving
day and night with scarcely any interruption. They hardly skjpt
or rested. Day after day and night after night they were in
almost continuous motion, talking incessantly, jumping, run

ning, fighting. In this manner, their well nigh complete sleeplessness
was combined with a terrific expenditure of energy.
If prolonged wakefulness is supposed to drain a person's strength
and to undermine his health these manic patients should have
emerged from their spells as irreparable physical wrecks. Nothing
of this kind, however, was observed. After they recovered
their state of health they gave no indication of having suffered
as a result of the ordeal. Do you think, Bill, I have
finally demonstrated to you that lack of sleep (1) is a myth
as concerns persons not afflicted with acute physical or mental
illness, (2) leaves no permanent damage if it actually does
occur as, for instance, in the mental ailments which I mentioned?
P: You certainly proved your point. I am now convinced
that to lie in bed means to sleep. But will I be convinced tonight
when I lie down and my brain begins to rattle?
E: When your brain rattles you must let it go on rattling,
but you must remain calm. Your look of surprise indicates
that you do not think it possible for anyone to be calm when
his brain is in uproar. Many patients have told me about this
rattling. They call it variously "brainstorm," "chasing of
thought," "racing." What it actually means is that the brain
has difficulty relaxing. The thoughts are in a welter of confusion.
The "stream of thought," ordinarily calm and well
ordered, becomes stormy and feverish. Such disorder is frequently
found in other organs. The heart may be thrown into
sudden palpitations, the muscles into tenseness, rigidity and
tremors. Every organ may begin to "rattle" at any time, to
use your expression. This "rattling" is nothing but our old
standby tenseness. After attending classes for months you
ought to know how to deal with tenseness. An organ that becomes
tense is thrown into a storm of activity. A storm rises,
but it also subsides after it has run its course. How is it that
your storm of tenseness keeps up its fury for hours without
subsiding? Tenseness is a sensation ordinarily produced by
fear. I told you repeatedly that sensations and feelings rise
and fall provided you do not attach the idea of danger at the

moment the curve reaches its peak. How is it that your fearful
feelings and sensations rise but do not fall?
P: I know what you are driving at. I create a vicious cycle.
E: Correct. And I shall describe the precise manner in which
your vicious cycle operates. When you merely think of going
to bed you are seized with an apprehensiveness, a not yet marked
fear that you are again headed for one of those dreadful
sleepless nights. Now you postpone the ordeal. You wait and
hesitate and keep yourself busy with chores. Soon you notice
that you have difficulty concentrating on the chores with which
you busy yourself. The less you are able to concentrate the
stronger grows your tenseness; the greater the tenseness the
worse the concentration. You are already in the throes of a
minor vicious cycle. After hours of tinkering you finally retire,
apprehensive, anxious, disheartened. You said, "I feel tense the
very minute I stretch out." I presume you meant to suggest
that the very act of contacting the bed makes you tense. Fear,
you mean to say, has nothing to do with it. Rather it is some
mysterious habit which makes the muscles tense when they
merely touch the bedsheet. But from what I just told you it
ought to be clear to you that you are choked with fear long
before you "stretch out." The vicious cycle was set going hours
before you touched the bed. Feeling tense you have difficulty
lying still. You twist, turn, throw yourself from side to side,
thereby increasing your tenseness many times its original intensity.
You say you "hate to lie there fighting for sleep."
There is nobody and nothing to fight, and be certain you do
nothing of the kind. What you do is to work yourself up to
a paroxysm of rage and fury. Against whom do you rage?
Presumably against yourself. Or, it is nothing but a blind
anger directed against nobody in particular. At any rate, to
the original fear of not sleeping is now added this senseless
anger that merely serves to accelerate the vicious cycle and to
fan the tenseness to an intolerable pitch. Then the brain begins
to "rattle." Do you understand that all of this is the result of
fear? Fear can be remedied only by the certain knowledge

that no danger threatens. You cannot gain this knowledge
from your own experience which is amateurish and limited to
the acquaintance with one single case. What must guide you
is my authoritative knowledge which is based on solid study
and expert observation. This alone can give you the conviction
that no danger whatever attends a night spent in bed even
i you feel you "haven't slept a wink."*
*The reader will notice that the author who set out originally to
buttress his argument both with his own experience and "the studies
of leading men of science who are unquestioned authorities in this
field" failed to quote scientific evidence. Omissions of this kind are
unavoidable in interviews. They are due either to oversight or pressure
of time. For the benefit of those interested in the subject it may be
pointed out that the experimental evidence that prolonged periods of
sleeplessness cause little or no harm is fully dealt with in a study by
Nathaniel Kleitman, entitled "Sleep and Sleeplessness/* University of
Chicago Press, 1939.

Nancy had been apprehensive and self-conscious all her life.
After she married and had children the responsibilities of caring
for the family weighed heavily on her tender conscience. One
day, about twelve years ago, she became panicky, with palpitations,
dizziness, dry throat, and body tremor dominating the
picture. She was so scared that she feared she was losing her
mind. She recovered from the first scare but the fear of mental
collapse persisted. Her sleep was poor. She watched herself
continuously magnifying minor observations. When she discovered
that her memory or concentration failed her on some
occasion she considered this as incontrovertible evidence that
her mind was slipping. In time she developed other well defined
fears. The main fear was to be confined in a closed space.
She suffered agonies of dizziness, sweats, churning of the
stomach, sinking feelings, faints and palpitations whenever she
ventured to take a ride in an automobile, street car, elevated or
railroad train. Rides in an elevator were less disturbing if they
were short stops but if the point of destination was a high upper
floor the performance was a nightmare. Since the physician's
suite was situated on the 17th floor of a downtown building a
visit to his office was looked forward to with great apprehension
and required a companion to reassure her. As the years
passed Nancy's fears expanded. She grew to fear her impulses.
She dreaded the thought of being alone with her daughters
or with her husband for fear she might do harm to those she
loved. "My impulses," she said, "become confused. I feel the
urge to be helpful, but once I have done a good turn I instantly
resent it and feel a hatred against the person to whom I was
friendly a minute ago. Isn't that proof that I am going insane?"

She attended classes and Recovery meetings and begged to be
interviewed after merely four weeks of participation in the
self-help program before she had a reasonable opportunity to
stage an initial improvement. Such early requests for class
interviews are generally considered a good sign of cooperation.
E Examiner
P Patient
E: You have been in classes for only four weeks and I do
not expect you to have improved a great deal Are you still
afraid of closed rooms and high places?
P: Right now I feel awfully weak and exhausted after a
thirty minute ride on the I. C. (Illinois Central.)
E: If that is so I presume that your other fears have not improved,
either, and that you are still obsessed with the thought
that you will lose your mind and that you might do harm to
the members of your family.
P: I have not noticed any change, except that I am now
more hopeful.
E: Let me ask you, Nancy, what precisely do you fear when
you enter an automobile or train coach or an elevator? Are
you afraid of an accident?
P: I was in three major accidents and was not a bit scared.
As a matter of fact, I was the calmest person in the crowd,
perhaps because I don't care if I die. Another thing: I am
afraid to be in an automobile even if it stands in the garage.
E: I understand, Nancy, that if you notice a weakness of
memory and attention you think of a possible mental ailment.
I also understand that if you have frightening impulses you
fear you might some day carry them out. These fears are
exaggerated but they are not absurd or ridiculous. But if you
state that you fear being in an automobile even when it is
not moving, well, that is absurd. You cannot possibly think
of danger under these circumstances, and your fear is without
rhyme or reason. Can't you tell me what makes you quiver
with fear in situations that neither you nor anybody else considers

P: I get so worked up when I step into a car or an elevator
that I fear I am going to collapse the next minute.
E: People get "worked up" on many occasions but do not
fear they will collapse. Why do you?
P: I get those awful palpitations and the sinking feeling in
my stomach, and I go into a cold sweat and I feel so faint that
I think that's my last moment. Right now when I merely
speak of these things I have my palpitations.
E: Now I know what you are afraid of. You don't fear cars
and elevators or closed spaces and high places. What you fear
is your sensations that are called forth by these closed or high
P: You may be right but it does not matter to me whether
it is the sensations or the places that frighten me. I simply
feel that I am going to pass out.
E: The distinction which I made may matter little to you.
But to me it is a fundamental difference whether your fears
are caused by sensations within you or by objects without. If
your fears are the result of frightening sensations and overpowering
impulses I ought to be able to teach you how to
control them, but I am unable to give you directions how to
exercise control over automobiles and elevators. I do not mean
to be facetious if I mention in the same breath such disparate
things as automobiles and sensations, elevators and impulses.
But it is about time that patients should know that the only
things they are afraid of are their own inner experiences, their
thoughts, feelings, sensations and impulses. I do not deny, of
course, that some fears stem from objects outside you. There
are holdups and burglaries and drownings and killings. But
these objective dangers, as a general rule, hold little terror for
nervous patients. What they are mostly afraid of are terrifying
sensations, threatening impulses, obsessing thoughts and
depressing feelings, that is, their own inner experiences. You
gave an excellent example of your indifference to realistic, objective
dangers when you stated that in three separate automobile
accidents you were "the calmest person in the crowd."
This is a common rule with nervous patients. In situations of

grave realistic and objective danger they may be calm and fearless.
But let them be confronted with disturbing inner experiences
and they become panicky and hysterical. Do you realize
now that what you fear is not automobiles, street cars and
elevators but your own inner storms and excitements that are
aroused when you approach or enter these objects?
P: I understand. But will that stop my palpitations and sinking
E: Why do you question that? Common sense ought to tell
you that you cannot conquer a fear unless you first know what
it is that you are afraid of. And if I succeeded in demonstrating
to you the true object of your fears you ought to have
gained some relief already. You ought to feel more confident
now because at last you know what it is that scares you. The
fact that you do not feel relief proves that you did not accept
my explanation. You still doubt and question it. If this is so
I shall have to give you other and perhaps more convincing
examples. You know, Nancy, that many people hesitate to
admit trivial misdemeanors, for instance, children to their parents.
They hesitate even if the parents have seldom inflicted
bodily punishment on them. What they are afraid of is that
after confessing they will have the tortured feelings of shame,
embarrassment and loss of face. They do not fear anything
realistic like being spanked; what they fear is their own inner
feelings. You have also heard of mature men who fear asking
their employer for an increase in salary. They fear to advance
their request even if they know for certain that the boss is a
kindly person and by no means bossy. In most instances, this
fear of approaching another person with an otherwise well
justified request is due to the fact that on previous occasions
the making of requests was followed by a sense of embarrassment
and sensations of tenseness, stammering, flushing and
perhaps palpitations and faintness. That man who trembles
at the thought of approaching his superior may try to analyze
the nature of his fear. In all likelihood, he will then advance
inconsequential reasons. He will say that what he fears is

that his "boldness" may cost him the job or that, after all,
his services are not worth more than he earns. In all of this
he will ignore or evade the real explanation that what he fears
is the possibility of arousing unpleasant inner experiences. Do
you think you understand better now what I am driving at?
P: You mean to say that I am afraid of my sensations when
I fear rides in automobiles and elevators. I think I know that
now. But will the knowledge help me get rid of the fears?
E: Knowledge alone will not help. But once you know
what you are afraid of you can devise plans for eliminating
fear. You will agree that if you fear something you think of
that something as a danger. You will also admit that in order
to fear a danger you must believe it is real and not imaginary.
In other words, you must take the danger seriously and be
convinced of its reality. All you have to do to dispose of a
fear is to refuse to believe that there is danger. Then you will
ignore it or laugh it out of existence. If you laugh at a thing
and ridicule it you cannot possibly fear it. That is the reason
why a sense of humor is such a strong antidote against fear.
You see, Nancy, if at the moment you are gripped with the
fear of your sensations, if at that moment you could reach
the conviction that the danger is unreal, imaginary or not serious
you could laugh at it and make it disappear in an instant.
Unfortunately the many scares you have gone through in the
past ten or twelve years have cowed you into such an abysmal
fright that you have lost every trace of a sense of humor with
reference to that fear. Your only salvation is to gain the unquestioned
conviction that the danger you think of is not existent.
I have tried to convince you of that; I pointed out to
you the reasons why a fear of this kind cannot possibly be
based on a realistic danger. But it seems you are not convinced
yet. Why do you still listen to the language of your body instead
of accepting what your
physician tells you?
P; I have tried my best to accept what you told me. I have
read many times what you said about the symptomatic idom
and the temperamental lingo. I have listened to what the
patients told me and I have studied the interview with Ruth

on the "Vicious Cycle of Panic."* I am convinced that you
are right. And if I do not happen to be cooped up in a street
car or in an elevator I can reason with myself and realize that
your authoritative knowledge is superior to my personal experience.
I know all of that. But when I enter an automobile my
knowledge is gone. What can I do about that?
E: What you can do is to gain conviction. You have acquired
knowledge but you do not possess conviction. You say
that your conviction fades the moment you enter an automobile.
What happens is that the moment you reach the car
your heart begins to palpitate, your stomach churns, your
throat contracts. To put it otherwise, your inner organs are
"scared." That scare communicates itself to the muscles of
your arms and legs. They feel tense and heavy and refuse to
move. In a sense, they feel paralyzed. Having read the interview
with Ruth you will know that this is the proper setting
for a vicious cycle. The panic "marches," as it were, from the
inner organs to the outer muscles and to the brain. The greater
the commotion of the organs the more intense is the "paralysis"
of the muscles, and the more threatening the paralysis
of the muscles the more terrifying is the fear in the brain.
You ask what you can do. Well, you cannot dictate to the
heart to stop the palpitations, or to the stomach to cease churning.
But you can command your muscles to move, paralysis
or no paralysis. And once you make the muscles move in spite
of their apparent paralysis the brain will instantly be convinced
that at least one of the dread dangers it feared is without
foundation and nothing to be taken seriously. That may not
do away with the commotion of the inner organs. The palpitations
and other sensations may continue. But a breach has
been made in the solid rampart of the panic, and the implicit
belief in the reality of the danger is shaken. When on the
next occasion you enter the car the organs may again be thrown
into a violent turmoil but you will no longer be scared by the
"paralysis" of the muscles. Assurance and conviction will now
*The interview with Ruth on the "Vicious Cycle of Panic" was published
ia volume 2 of the 'Techniques of Self-Help," page 31.

be more assuring and more convincing with the result that
the brain will be more calm, and with a calm brain there is
no possibility of a sustained panic. With the panic petering
out in consequence of reassurance the organs will soon quiet
down, and this time conviction will be strengthened. On the
occasion of a third or fourth or a dozen other trials you are
certain to cut short the panic in its very beginning. Then conviction
will score the final triumph and you will be cured of
your fear and incapacity. Do you realize that the way to shed
your fears is to give the proper directions to your muscles?
P: Frankly, that sounds a bit too easy. It doesn't just seem
possible that I should cure my fears by moving my muscles.
It should take more than that.
E: It will be difficult for you to convince me that it is "a bit
too easy" for persons to command their muscles to move if
they feel paralyzed by the fear of making another step. You
did not mean to say that my suggestion sounds too easy; you
thought it sounds too simple. I shall not enter into a detailed
discussion of this very important distinction. I shall merely
tell you that I do not want my patients to believe that cures
and remedies must necessarily be complex, involved and
timeconsuming. It is easy to sit in a chair and to be given lengthy
and interesting explanations about how fears arise and develop.
That is complex but easy. But if a boy is afraid of swimming or
diving it is not at all easy to make him move his muscles for
the purpose of a resolute jump. That jump is simple but difficult.
Do you realize that you expect to be cured of your fears by
means of complex but easy and sometimes glib explanations instead
of by means of simple but exacting directions? You want to
be studied and analyzed and discussed but you do not want to be
told what to do and how to act. What will the most lucid explanations
profit you if you are seized with a deep anxiety or a
paralyzing panic? In a condition of this kind you are utterly
unable to make use of the ingenious and fascinating explanations
you may have been given. If in a panic you try to remember
what you learned and to reason out what is the sensible thing
to do your mind will fail you disastrously. The panic weakens

your memory and blots out your reasoning power. All you
will be able to do in a commotion of this sort is to apply simple
rules. Their very simplicity renders them capable of being employed
in a situation in which complex thought is impossible.
P: I do not mean to be contrary, doctor. But it seems to
me that when I get into a panic I will not be able to carry
out even simple rules.
E: That may be correct for the first and second trial. But if
you continue to practice you become ever more proficient in the
application of these simple rules. Moreover, you have ample
opportunity to practice in situations that are less disturbing or
threatening. You mentioned that you are obsessed by the fear
of doing harm to your husband and your daughters. This fear
does not throw you into a panic. It is with you all the time
and being strung out over endless hours and days it is milder,
less vehement, less acute. This fear can be handled with a
method that is not only simple but also easy. You know that
in consequence of the fear you avoid touching knives or any
sharp objects. Well, should you practice the simple method
of deliberately touching sharp objects in the presence of those
that you fear to harm you would have no difficulty convincing
yourself that your impulse to do harm is not dangerous. You
would soon refuse to take that impulse seriously and would
learn thereby that at least some of your fears are ridiculous
and can be laughed at. Once you have succeeded in discarding
one of your fears by the simple method of commanding your
muscles to act against them you will have learned the general
principle that fears can be checked by a command to the muscles
to counteract the suggestions of danger. The lesson that you
have learned with minor fears will then carry over to the region
of the major fears. As with most patients, your fears are many
in numbers. Some of them are strong, some are mild. You
may say that the fears form a chain with strong and weak links.
If you wish to break a chain you must attempt to pry it open
at its weakest spot, not where the links are strongest. This
is the Method of Attack on the Weakest Point which I have
mentioned in interviews repeatedly.

P: I have tried so often to touch knives. I wish I could, but
I can't.
E: What happened when you stretched out your arm toward
the knife?
P: Well, I felt I couldn't do it.
E: Don't tell me that you couldn't do it Tell me what
happened. Tell me whether you had a panic when you advanced
your arm in the direction of the knife. Did you feel like fainting?
Did you have violent palpitations, sweats and weakness and
churning ?
P: No, I simply couldn't move my arm.
E: Do you see the difference between entering the car and
picking up a knife ? In both instances you are afraid, that means,
you have the idea of danger in your brain. But in the case of
the automobile the idea of danger is attended by threatening
sensations, while in the case of the knife it is nothing but a
thought. You will now understand why I call this fear of touching
a knife a weak link in the chain of your fears. All you have
to do to get rid of your fear of the knife is to convince yourself
that your thought of danger is absurd. And the best means of
reducing an idea of danger to its absurdity is to act against it.
The moment you touch the knife and notice that nothing happens,
not even a palpitation, certainly no fainting or any other
sign of a panic, once you notice that the thought of danger is
immediately proved absurd. Although you are a newcomer
to this group, nevertheless, I am certain you heard the members
of Recovery mention in their panel discussions how they learned
to conquer their fears through their muscles. Many of my
patients were afraid to be on their feet because they thought
their muscles were exhausted by nervous fatigue. When they
decided to walk on in defiance of their fears they became convinced
in an instant that their idea of danger was absurd. With
some, success came on the first or second trial, with others after
a period of extended trials. But whether success comes quickly
or slowly the underlying principle is the same: attack the chain
of your fears at their weakest point and convince your brain
through your muscles that its ideas of danger are absurd.

Virginia's health broke when she was 20. Her previous
history was that of an average girl with a good record of school,
job and social adjustment. But after she passed her twentieth
year she suffered an attack of depression. She lost weight, ate and
slept poorly. Her interests weakened. She neglected her job
and her appearance. She felt tired all the time and had to make
an extreme effort to perform the trifling tasks of her daily
routine. Dressing, speaking, walking required an excessive
amount of energy. Her mood was down. She experienced the
desire "to make an end of it" but lacked the courage to do so.
Due to her dejected spirit she blamed herself for past mistakes
and petty misdemeanors. Finally she had to be taken to the
hospital. She returned after six months and felt well for four
years. Then she drifted again into a mood of depression. This
time she received a course of electro-shock treatment and regained
her health after only five weeks of hospitalization. She
resumed her activities, secured a position with a real estate firm
but continued to be tired, restless and irritable. It was at this
point that her mother heard of Recovery. Virginia joined the
organization practicing the system of self-help and conquering
fatigue, irritability and restlessness. But in spite of her patient
application she was unable to shake off a sense of shyness which
made her feel miserable and helpless when she was to meet
people singly or in social groups. She volunteered for a class
interview in the spring of 1947 stating that a previous interview
two years ago had given her much relief.
E Examiner
P Patient
E: How are you, Virginia?

P: I feel all right. But I am so self-conscious. I shut up like
a clam when I am among people. When I want to say something
I can't find a thought. It seems my brain freezes and I
can't think. It is all a fog and blank. If somebody asks a
question my throat tightens and I can't speak a word.
E: Have you been working all the time?
P: I have worked continuously since shortly after I left the
E: That makes it close to four years of continuous work. Did
you change jobs during this time?
P: No, I am still holding the same job that I got four years
E: Do you think your employer is satisfied with your work?
P: I got three raises and my boss leaves the running of the
office practically to me.
E: I consider this a neat accomplishment and a very creditable
comeback after what you went through. You ought to
be proud of yourself. Instead, you shrink and almost swoon
when you are asked to do nothing more than open your mouth
and formulate a simple sentence. You say your brain freezes
and you cannot think, your throat tightens and you cannot
speak. How is it you do a good piece of speaking and thinking
right now? How is it your brain thaws up and your throat
unlocks during this interview? You are certainly among people
here. More than that, this is an audience and you the star performer
tonight. You are in the limelight, watched by everybody
in this hall. Many people with strong nerves and no
record of a past breakdown wilt when they are asked to make
a speech before a public gathering of this size. And, remember,
what you say here is a tale of weakness, a recital of your shortcomings,
a confession of personal inadequacy, while in a social
group the conversation turns around more or less impersonal
and indifferent topics. You show courage here in a highly embarrassing
situation in which your failures and inefficiencies are
laid bare, and exhibit fear in a social setting where courtesy
and etiquette banish all possibility of being exposed. Can you
explain this strange behavior?

P: I am relaxed here. But when I meet people on the outside
I am tense.
E: I am frequently tense myself. But that does not cause
my brain to freeze and my throat to tighten. No matter how
tense I sometimes am I get my brain to think and my speech
muscles to produce words and sentences. How is it you cannot
think and speak when you are tense?
P : I don't know how to explain it. I simply don't get thoughts
and the words don't come.
E: I shall try to give the explanation. You will grant, Virginia,
that to speak means to produce movements of the muscles
of speech. To put it differently: speaking is a muscular act. I
take it you know that muscles will act only if they are stimulated
and will refuse action if they are frustrated. From this
you may conclude that your muscles of speech are stimulated
here tonight but would be frustrated if you were to repeat
this performance elsewhere. What stimulates muscles is courage
and self-confidence, that means, the sense of security. What
frustrates them is fear and self-distrust, that is, the sense of
insecurity. Do you understand now, Virginia, that when you
have the thought of insecurity in your brain it will frustrate
and tighten your muscles and keep them from acting and
P : It seems to me I have no views or thoughts in my brain when
my speech stops. My head feels like a blank and no thoughts
come, not even the thought of insecurity.
E: If you say you have no thoughts in your brain you seem
to believe you know how your brain works. In this, you presume
a trifle too much. Right now you sit on this chair. Moreover,
you keep sitting. You do not jump up or run away. How
could you maintain your seat unless you were certain that the
is solid and you are in no danger of falling? Yet, you
may insist the thought of security was not in your brain while
you kept up your sitting activity. Do you realize that you could
never sit down or continue sitting unless your brain told you
that the act of sitting is safe and secure? The same consideration
holds good for every variety of acting, for eating, stand

ing, walking, speaking. You would never dare voice a sentence
unless your brain told you that the statement you are about to
release will not endanger your social, moral or ethical security;
that the remark you intend to make is neither offensive nor
compromising. This rule applies to every act, no matter how
simple or how insignificant. You could never make a step unless
you were sure you would not fall and fracture your leg.
You could never ask even the most innocent question unless
you were reasonably certain it would not be resented. These
examples which could be multiplied indefinitely will tell you
that ordinarily no act of yours will be released unless the brain
first takes the view that no danger is involved. After the brain
has, in the flash of a momentary decision, reached the conclusion
that the situation is one of security it stimulates the muscles
to release the appropriate act. The conclusion that the planned
act is safe is formed without your conscious knowledge. We
say it is arrived at intuitively and not discursively. When you
came here tonight you had already formed the conclusion in
your brain that the situation of this interview is one of security.
Hence, your thoughts did not freeze and your throat did not
lock. Why is there freezing and locking when you attend a
social gathering?
P: I guess because there my brain forms the conclusion of
E: Correct. But how is it that this conclusion of insecurity
keeps occupying your brain all the time you attend the gathering?
Why is there no letup, no change of conclusions?
P: I think I know what you have in mind. I produce a
vicious cycle.
E: That is correct if you specify what kind of vicous cycle
you have in mind. The most common varieties of vicious cycles
are those of fear and anger. But fear and anger are part of
life, indeed, a most significant part of life; and if they run in
vicious cycles their action represents a very stormy, an almost
tempestuous sort of life. However, when your thoughts freeze
and go blank they can hardly be said to be stirring with life.
In a sense, they are dead. Their life pulse has gone out of

them. If you speak of freezing, of fogs and blanks, of shutting
up like a clam, that means that you pass into something like a
state of lifelessness. Your vicious cycle affects the pulse of
your responses and reactions. You know what a pulse means.
It means something that rises and falls, something that begins,
matures and finally fades away. This is true of muscular movement,
of glandular activity, of nerve impulses, of thoughts, sensations
and feelings. All of them have their life history of
being born, of maturing into full action and of passing out of
activity. For the sake of simplicity I shall limit the discussion
and consider the pulse cycle of thought only. You know that
if you now happen to think of the weather that thought will
not occupy your brain for a great length of time. Your attention
will soon wander from the topic of the weather to that of your
office or home or mother. It will then turn to the book you
are just reading, then to the friend who phoned you yesterday,
then to the subject of the atomic bomb which was discussed in
the morning paper. In order to make the mind hop and skip
in this rather careless manner you must be reasonably carefree.
That means, you must have a reasonable sense of security. If
you feel insecure your thoughts will be focused on the object
that threatens and your attention will be riveted on the topic
of danger. The one thought of danger will preoccupy your
brain and will prevent it from occupying itself with other
thoughts. The thinking pulse will then be interrupted by
your preoccupation. The preoccupation will make one single
thought dominate the brain with the result that the remaining
thoughts will no longer rise and fall, the thought pulse will be
suspended and life will seem abolished. The brain will then
feel as if in a fog, dense, blank, lifeless, pulseless. How is it,
I shall ask, that your thought pulse shows life and vigor during
this interview and loses its vitality in other groups?
P:I still think it is the vicious cycle that does that.
E: I told you I am ready to accept the explanation. But it
will have to be qualified. There are many types and degrees of
vicious cycles. One of them is that of fear, another of anger.
These are the most common varieties. If yours were that of

fear the vicious cycle would fan it into a panic. If it were that
of anger it would be raised to the pitch of rage. I have observed
you in the company of other people and you gave no evidence
of being rocked by either panic or rage. Your face was smooth,
perhaps even blank, and its muscles gave little evidence o
lively expression. You sat motionless, staring into space. You
give this a different wording when you say that your brain
does not think and your speech muscles do not move. They
are not lifeless by any means, but you feel that life has gone
out of them. The brain feels unable to think, and the muscles
unable to act. The more helpless the brain the more limp are
the muscles; the more limp the muscles the more helpless is
the brain. This is the vicious cycle of helplessness. How is it,
I shall ask again, that you are able to shake off this sense of
helplessness when you are interviewed here in front of a large
P: I don't know exactly but the nearest I can think of as
an explanation is that I don't feel cramped here as I feel in
groups on the outside.
E: That does not explain a great deal. It seems to me I
shall have to do the explaining. We spoke of a vicious cycle.
That means that some sort of circular movement is set up
between the brain cells and the muscles. In this cycle the
brain acts on the muscles, and the muscles act on the brain.
The two influence one another. The cycle begins its destructive
work before you arrive at the particular gathering. For
hours and perhaps for days you have anticipated that your
brain will be paralyzed and helpless. On the way to the social
function which you are to attend the "freezing" process begins
and when you reach your destination it has deepened into
what you call a blank. The brain feels lifeless and dispatches
impulses to the muscles not to stir, not to move. In this manner,
the helplessness of the brain communicates itself to the muscles
and the vicious cycle is set afoot. I told you that brain and
muscles influence one another in this cycle or circular movement.
Since they interact or act on one another it ought to
be clear to you that if you cause the one to move the other

will follow suit. To state it differently: make the one move
and the other will perforce join the movement. You may not
be able to get the brain moving. But you certainly can do
that with muscles. Command your speech muscles to act, and
the brain will instantly realize that its theory of helplessness
is a myth, a fiction, an untruth. The more vigorously your
muscles will move, the less will the brain be able to believe
that it is helpless. That this can be done you demonstrated here
with your perfect speech performance during the present interview.
You remember the first occasion when you were interviewed
about two years ago. You stammered, hemmed and
hawed and had extreme difficulty squeezing a few words out
of your throat. The first sentences leaped out of your mouth
explosively. I had to proceed slowly and cautiously, giving you
ample time to warm up to the task until finally you took heart
and gained courage and gave an excellent account of yourself.
At that time you experienced the vicious cycle of helplessness
at the beginning of the interview. During this cycle your brain
was devitalized and deprived your speech muscles of their
vitality. But once you commanded your speech muscles to
move the very action of the muscles had a vitalizing effect on
the brain. The movement of the muscles convinced the brain
that speaking is possible. And when the brain witnessed the
living, vital performance of the muscles it acquired a new
vitality itself and lost its lifelessness. The more forceful was
the action of the muscles the more vitalized became the brain;
the more vital the brain the more forceful the muscles. By
commanding your muscles to move you had thus transformed
the vicious cycle of helplessness into the vitalizing cycle of
selfconfidence. As the interview drew to its close it was
explained to Virginia that her energetic performance during
the interview could be duplicated and multiplied on numerous
other occasions inside Recovery and outside. What she had to do
was to practice commanding her speech muscles to initiate the
vitalizing cycle of self-confidence whenever she had an opportunity
to do so. It developed that Virginia had neglected this practice by

reframing from joining the panel discussions at family gatherings.
She realized that this was her golden opportunity and
felt that having gained revealing information about the nature
and operation of the vitalizing cycle she was now in a position
to practice with understanding. Reports reaching the writer
indicate that Virginia is making a good effort at participating
in panel discussions and is ready to transfer to social engagements
outside Recovery the experience she is gaining in the
family gatherings of the ex-patients.

Roy was 35 years of age when he was first seen in the physician's
office. He was married, had two children, loved his
home and was well liked by friends and neighbors. His employment
record was good. He had held his present position
for fifteen consecutive years advancing to the rank of a foreman.
All in all he had done well until three years ago when
suddenly, "out of a blue sky," his right arm and right leg went
numb. The numbness had come on at the moment when he
entered the plant to start on the afternoon shift. It disappeared
as fast as it had come lasting a few minutes only. But Roy
was frightened into a senseless fear that he was headed for a
stroke. Ordinarily stolid and unemotional, he was now pale,
trembling, restless. His fellow workers noticed the change and
drove him home. The family physician ordered Roy to stay
home for a week and to rest. The following week an electrocardiogram
was taken and the doctor was heard to say that
something in the graph was "flat instead of round." After that
Roy developed violent palpitations, headaches, dizziness, fatigue,
air-hunger, difficulty of sleeping, fears of physical collapse and
mental breakdown. He saw specks floating in front of his eyes
and once "nearly went blind" for a couple of minutes. Some
of his sensations were bizarre and intensified his fear of a
mental breakdown. Looking at his hands he saw them in a
yellow tinge. He felt pains which settled in narrowly confined
places, in the left wrist or in the space above the right knee.
His teeth began to hurt. There was a pain around the heart.
He lifted his little son and instantly felt a pain around his right
ear. He lay on the left side and something clicked in the right
flank. The fingers of the right hand might hurt and suddenly

the pain shifted to the back of the head. He felt pressure of
the throat, had night sweats which roused the fear of tuberculosis,
pain in the chest, difficulty of sleeping, trouble in concentration
and "confusion all the time." A combined course
of office and group treatment produced a good improvement. He
returned to work and was able to attend to his job in spite
of the fact that some of his sensations persisted as weak "reminders."
He had learned in Recovery to ignore the threat
of symptoms and turned his new knowledge to good account
There were minor setbacks but he handled them well until
after about six months of successful self-management a major
setback occurred which he was unable to shake off. When he
was interviewed in class he stated that the present setback had
lasted upward of four weeks already.
E Examiner
E: What is it that has troubled you most in these past four
weeks ?
P: My eyes feel blurry, my memory is poor, and I have an
awful fatigue and the legs feel heavy and numb. And I have
these headaches again and the pain around the heart.
E: You have been ill for three years before I saw you. Is
that correct?
P: It was not quite three years but almost that long.
E: And during these three years your trouble got worse
and worse?
P: Well, I had some good days.
E: Your symptoms changed. They kept coming and going.
P: I can't say that. Some stayed on.
E: Some of your pains shifted from one part of the body
to the other?
P: No, I didn't have that,
E: So far you have denied or corrected or rejected about
every statement which I made. When I mentioned that I saw
you for three years you set me right by stating that "it was
not quite three years but almost that long." You will under

stand that the difference between "three years" and "almost
three years" is so insignificant that you could safely ignore it.
Instead you stress and emphasize this trifling distinction, underscore
it pointedly and make an issue of things that have no
importance. You pick flaws in my argument and turn this
interview into an occasion for verbal fencing, sparring and
skirmishing. This proves that you came here tonight in a
fighting mood which is merely another way of saying that you
are in the grip of tenseness. You say that the tenseness has
been in evidence for fully four weeks without letup. Does that
mean that it was with you all day and every day during these
four weeks?
P: It was easier the first few days and the first week. I could
relax at a card game or at a show. I guess my mind was taken
off my troubles when I had some diversion. But in the past
three weeks it got worse and worse. Even a show or a card
game didn't help me. I got so tense that everything irritated
me, even my little girl and my wife at home. Maybe you are
right, I am in a fighting mood. It makes me mad because I
like to get along with people. I simply cannot understand it.
E: Perhaps I can make you understand it. Look here, Roy,
tenseness is a sensation. Having attended classes for close to a
year you heard me state repeatedly that sensations rise and
fall. How is it that your tenseness has risen but did not fall?
P: I think I know what you mean. I attached the idea of
danger to the sensation.
E: Correct. But what does it mean to attach an idea to a
sensation? Can ideas be made to change places, to wander
from one spot to another? In other words, can ideas be shifted
and shoved and pushed around just as you may please?
P: Yes, you said that a person can choose to think of whatever
he wishes. And I think that is right.
E: How about sensations? Can they be manipulated at will?
If you have the idea of this table in your mind, can you now
"attach tenseness" to the thought of the table?
P: I don't think so.

E: If you deny that, then, you obviously believe that thoughts
or ideas can be handled, directed and manipulated
at will but
sensations cannot. You are right. You cannot say, "I am going
to be tense from now on" and actually produce the tenseness
by sheer wanting it. But you can say, "I am going to think
of this table now" and the thought of the table will be in your
mind and stay there as long as you choose to entertain it. If
that is so we may state it as a general rule that thoughts and
ideas are subject to the action of will but sensations kre not.
But why speak of sensations only? There are feelings and
impulses. You know that when your eyes blur, when your
head aches and the legs are numb you do not merely experience
these sensations; you also feel alarm about them. They
depress your mood, they strike you with despair, with discouragement
and the sense of helplessness. Think of the anguish
and anxiety that go with the listlessness and fatigue that descend
upon you in the morning. Think of the anger and resentment
that you feel rising within you when you notice your pains
and aches and work yourself up to a pitch of excitement. All
of these are feelings added to the sensations. Do you think you
can cut them short or bid them to disappear and make place
for other more comfortable feelings? Of course, you cannot
do that. Feelings cannot be redirected or rearranged at the
bidding of your will. Neither can impulses. When you are in
agony over your disturbing sensations instantly there is the
impulse to call off an engagement or to summon the physician
or to turn with fury upon your wife or child because of some
innocent remark they may make. These impulses are just as
spontaneous and passive as your sensations and feelings. They
appear and you know of their presence only after they have
emerged. You cannot manage them as you can your thoughts.
You cannot command them to come or to go. They come
upon the scene spontaneously and passively. If they are to
depart the process is again passive and spontaneous. Do you
understand now that thoughts are active and deliberate while
sensations, feelings and impulses are passive and spontaneous?

Do you also understand then that while you cannot drop your
sensations, feelings and impulses by a command of will you
can do that with your thoughts?
P: I understand that and I know you are right. But somehow
I haven't been able to get rid of the thought of danger.
I've tried many times to think of what you tell us about sabotage
and that we are not permitted to make our own diagnosis. I
know that when you say there is no danger there isn't any.
But the idea sticks to me and I cannot get rid pf it.
E: Several months ago it was just as difficult for you to shake
off the idea of danger. But you did it and got well. There
is no earthly reason why you should not be able to repeat that
performance. But in order to succeed you will have to practice
as hard as you did months ago. That practice calls for a method.
Do you remember which method you were asked to use at
that time?
P: I came to classes and meetings and I accepted your authoritative
E: Of course, you have to accept my authority and must
attend classes and meetings. But that is not what I meant by
method. What you mention is the person who taught you the
method and the occasions and places where you were supposed
to learn it. You may have some opportunity to practice that
method in classes and in my office. But the bulk of practicing
will have to be done at home, in the shop, on the street1 and
in all kinds of places and situations where there is no physician
and no Recovery to help you along. What you did was to
learn theoretically how the method works. But you failed to
apply it systematically. You do not even seem to know which
method I refer to. What I want you to learn is to throw out
of your brain one thought and to replace it with another. The
thought that I want discarded is the idea of danger, and the
thought which I want to take its place is the idea of security.
You know that the thought of danger is forced upon you by
your sensations. You may, for instance, experience a numbness
in the legs. The likelihood is then that the sensation
will suggest that you are in danger of a physical collapse or

a permanent handicap. I want you instead to think of the
numbness as a harmless though distressing bodily feeling.
Should you effect this change in thought the sensation would
fall soon after it has risen. Similarly, I want you to view
your chest pressure and blurred vision as implying no danger
to life or to mental and physical health. This requires the
proper application of the method I taught you. Now, if somebody
wishes to master a method he will have to begin his
practice where application is easiest. Suppose you wish to become
an airplane pilot. You will first work on prints and models,
then on parts, then on machines of simple design and only in
the last stages of your apprenticeship will you venture to manipulate
the more powerful engines. This gradual progression
from relatively simple to increasingly more complex tasks is the
system by means of which every method is learned. Do you
think you have applied this procedure? You have not. Most
likely you do not even know the name of the method I have in
P : I don't think I know it.
E: I mentioned it frequently in past interviews. It is the
Method of Attack on the Weakest Point. I shall refresh your
memory by quoting examples. If a patient suffers from an
explosive temper it will be easier for him to control it where
the temperamental deadlock is mild than where it is in full
blaze. At home with his wife and children whom he loves
the deadlock is milder than with the boss whom he may hate.
Should he check his explosions more or less regularly whenever
his little daughter irritates him he would attack the chain of
his temperamental flares at their weakest point. He might then
transfer this practice to his wife, then to his friends and lastly
to his boss who represents the strongest link in the chain. You
may be inclined to doubt whether a method which works well
with temper will also be effective with symptoms. Well, if
you have read my books you will know that temper, exactly
like symptoms, is initiated by an irritation or annoyance, that
is, by sensations. To these sensations the temperamental person
adds the ideas of either, "he is wrong" (angry temper) or the

thought of "I am wrong" (fearful temper). You see here that
in temper as in symptoms a thought is always linked to a
sensation. Clearly the same method can be applied to both
I shall give another example. You know that many of my
patients suffer agonies because of their self-consciousness. They
hesitate to address people, to offer opinions or to take part in
conversations because they fear they might say the wrong
thing or they may display a clumsy and awkward manner in
speech, movement or carriage. Most of them are haunted by
suspicions of being misunderstood or of being considered below
par. Obviously, there is here again a linkage between disturbing
sensations and thoughts of insecurity. The sensations are
those of discomfort on meeting peoples and the thought is that
of the danger of compromising oneself. In order to check the
idea of insecurity the first step to be taken by the self-conscious
person will have to be to practice in an environment in which
the chances of being misunderstood or underrated are at their
lowest. This is one of the reasons, as you know, why I insist
that my patients associate with their fellow-sufferers in Recovery.
There they have an opportunity to attack their fears and suspicions
where they are weakest. I hope you realize now that
if you wish to get rid of your troubles you will have to adopt
this well tried method which means that you will have to
attack those of your symptoms first which form the weakest
links in the chain of your ill-balanced sensations, feelings and
P: It seems to me my symptoms are all pretty strong. It
would be quite a job to find weak sensations among them.
E: I cannot agree with you on this point. You said your
main difficulties are now (1) blurring of vision, (2) poor memory,
(3) headaches, (4) pain around the heart, (5) fatigue with
heaviness and numbness in the legs. It might be difficult for
you to persuade yourself that the first four symptoms are without
danger. The moment you experience the pain in the region
of the heart the thought of a stroke or sudden collapse shoots
into your brain, and it will not be easy to shut it out by means

of a simple procedure or formula. You may also find It difficult
to believe that your blurred vision, your poor memory and
your headaches are harmless and devoid of danger. But this
is altogether different with your fatigue. You think that your
muscles are in danger of exhaustion should you continue to
tax their fading strength. This thought of danger can be thrown
out of your brain instantly if, accepting my authoritative knowledge,
you conclude that yours is a psychological feeling of
tiredness and not a physiological condition of exhaustion. If
you do that you can decide to step out vigorously and to walk
on for dozens of blocks. The sheer act of brisk and steadfast
walking will give you the conviction that your muscles can
easily perform a good sized piece of labor without withering
or caving in. If you continue the walking practice day after
day the conviction will gain strength and become unshakeable.
The thought of muscular weakness and physical infirmity will
give way to the idea of health, vigor and resistance; or the
thought of security will replace the idea of insecurity. After
you will have broken the link of fatigue in the chain of
your symptoms you will know that when your body spoke of
danger in connection with the fatigue it lied to you. Why
should you believe the other symptoms if they voice threats
and sound alarms? It seems to me that if the one symptom
has been exposed as a liar the other symptoms can no longer
escape the same kind of exposure.
I shall make one more point: what you call nervous fatigue
is a condition that has its highest intensity in the morning,
dwindling in strength in the afternoon and disappearing in the
evening. You know that this is the case with your own socalled
fatigue. Now if your muscles were weak to the point
of exhaustion why should they regain their strength after a
day's exertion? This alone ought to convince you that your
fatigue is a feeling and nothing else. Moreover, this feature
of the afternoon decline gives you an added opportunity to
practice replacing the thought of insecurity with the idea of
security. If after a day's work you set out on an energetic
evening walk of about one or two miles you can easily per

suade yourself that fatigued muscles which are capable of
doing strenuous exercise after a day's hard labor cannot possibly
have been exhausted in the morning and early afternoon.
If you carry on your practice in the evening your performance
will not only be convincing but it will have the additional advantage
of being easy of execution.

Peter told the story of his seven years of suffering. It began
when one night he awoke and could not catch his breath. He
rushed to the window, tried to draw in the fresh winter air
but the "air-hunger" persisted for what appeared to him hours
of never-ending torture. He fell asleep again but in the morning
belched incessantly. Although the breath-holding spell did
not recur he still shuddered when he remembered the ghastly
experience of the preceding night. He was certain he had a
heart ailment. His physician reassured him with the result
that except for recurring belching reactions he managed to
maintain a precarious adjustment for five years. Then the
belching increased in intensity and became associated with a
pain about the heart region. This time the physician's assurance
that his condition was harmless failed to convince Peter.
One day, while working in his shop, he jumped up and
"couldn't breathe." Now he was sure he was in danger of a
physical collapse. He became panicky and intractable and was
taken to the hospital. He was given electro-shock treatment
which added the suggestion of mental ailment to the fear of
physical collapse. After discharge from the hospital he returned
to work. He was now obsessed with all kinds of fears and
tormented with suddenly rising violent impulses. The fears
centered about lungs and heart, and the impulses were in the
nature of indiscriminate aggressions, for instance, "to punch
somebody in the face." The impulses were controlled but the
fears spread. He became afraid of swallowing because eating
might lead to belching. If he occasionally exploded in a temper
outburst he felt wretched. If he controlled temper he "felt
like a rat." Trigger symptoms made their appearance. He

thought of getting a spell of air-hunger, "and presto I got it."
His concentration suffered. At times he stammered. All of
this made him feel confused, self-conscious, miserable. It was
at this stage that he was seen in the office and assigned to
classes. He made a fair improvement, got the belching, airhunger
and fear of swallowing under tolerable control but
what disturbed him most was his lack of self-confidence and
the inability to check his temper.
E Examiner
P Patient
E: What seems to trouble you most is the fact that your
self-confidence is reduced to a level in which you are no longer
as cocky, argumentative, conceited and intellectually snobbish
as you used to be. If my sharp wording displeases you I shall
remind you of the pertness with which you used to voice your
political opinions, the intolerance you used to display in your
tiffs with friends, wife and co-workers, of the delight you took
in out-arguing anybody who might engage in an exchange of
views with you. As I see it, you do not suffer from any lack
of self-confidence. You merely resent the fact that your former
vanity and inflated sense of importance are now gone. You
consider that a loss, thinking you have become a dish rag; I
regard it as a gain, thinking you are on the way to develop
a measure of humility. What interests me is your failure to
curb your temper sufficiently. As long as you continue to indulge
your temperamental habits your symptoms will persist.
Eliminate your temper and you will do away with your symptoms,
P: I have tried the hardest to get rid of my temper and it
seems to me I accomplished a good deal. At home I have few
arguments, and in the shop I keep quiet most of the time. But
of course I fly off the handle once in a while. And, good Lord,
once I let myself go there are the palpitations and the confusion
and some air-hunger and belching. Can't I ever be natural
and human like others?
E: I am not at all concerned with your being natural and

human. My sole objective is to rid you o your symptoms.
You seem to think it is your natural and human privilege to
exercise your temper. It is just as natural and human to eat
steak. But if a man is suffering from a gastric upset he'd
better relinquish his "natural and human right" to steak dinners.
Are you willing to give up your temper for the sake
of your health?
P: I guess I am willing. But this thing got me licked. I
try to be calm and I do pretty well most of the time. But if
the boss is unreasonable and rides me the worst way I cannot
hold back and tell him where to get off.
E: Give me an example of the manner in which the boss
is unreasonable. Tell me what he does to "ride you the worst
P : The other day when I came to the shop a tool was missing.
I asked the boss whether he had seen it and he said, "You
lost it and you will have to find it." That just burned me up.
I came back with a saucy remark and he laughed out loud.
That dirty laugh made me boil. I let loose and gave him a
mouthful. It didn't take a minute and I had my belching and
it took me hours to get rid of it.
E: From what I know about you it seems to me that this
example is representative. It represents your customary habit
of reacting to minor frustrations. You asked a question, and
the boss returned a gruff answer. Instantly you became irritated
to the point of "burning up." The next link in the
chain of events was that you came back with a "saucy" remark.
The boss, refusing to become temperamental, laughed
and made your blood "boil." The final result was that you
belched for hours. You will realize that what "burned" and
"boiled" was your temper. You know, however, that temper
will neither burn nor boil unless you form the idea that you
have been wronged. From this we conclude that prior to
releasing your temper you thought or decided that the boss
was wrong and you were right. It was this temperamental
thought in your brain that touched off the temperamental
commotion in your body. This again led to the "saucy" re

mark and ultimately to the sustained fit of belching. Let me
repeat: there was (1) the temperamental thought, (2) the temperamental
commotion, (3) the "saucy" remark, (4) the
belching. You will understand that the thought "he is wrong and I am
right" can be rejected, suppressed or dropped. You will also
understand that your "saucy" remark could have been checked.
In other words in this fourfold series of incidents, two lent
themselves readily for control. You could have rejected the
thought of being wronged by the boss and could have prevented
your muscles of speech from voicing the "saucy" remark.
Do we agree on this point?
P: Of course. I heard you say that many times and I know
that ideas can be rejected and that muscles can be commanded
not to move. I know that but it doesn't seem to help me.
That thing gets me and I explode.
E: What you say means that control of thought and muscles
is theoretically possible as a general principle but practically
impossible in your particular case. Which means that you
are an exception. But I do not recognize exceptions, and what
one patient can do another can likewise. We shall take it
for granted then that you could have controlled the temperamental
thought in your brain and the temperamental utterance
of your speech muscles. How about the temperamental
commotion ("boiling") and the belching? Do you think you
could have stopped that?
P: I can only say what you told us in previous interviews.
Temper runs its course and symptoms do the same.
E: Correct. Both temper and symptom run their course,
and you cannot stop them by an effort of the will as you can
do with thoughts and muscular action. And if you say that
temper and symptoms run on of their own momentum that
means that once they are set going they continue on, rising
and falling passively without any possibility of arresting their
progress until they exhaust themselves. For this reason they
have been termed the passive responses of the body to a disturbing
event. They are called passive because they cannot be
actively influenced by the intervention of will. This is differ

ent with thought and muscular action. Your will can play
on them as it chooses. If you now think that your boss emitted
a "dirty laugh" you can in a second change your view and
admit that the laugh was perhaps not so dirty after all. If
the thought strikes you that his remark about the tools was
provocative and offensive there is nothing to prevent you from
surmising that a more sympathetic explanation may be just
as acceptable. And as concerns your muscles, well, that muscles
can be -restrained from moving is a commonplace fact that
need not be stressed. And when you had the impulse to "let
loose" and "tell the boss a mouthful" you could have decided
to hold your tongue and to prevent your speech muscles from
moving. Muscles and thoughts can be manipulated actively
and for this reason are called the active reactions in contradistinction
to the passive responses of temper and symptoms.
If you really wanted to get rid of the belching all you had to
do was to stop your speech muscles from voicing the "saucy"
remark and to reject the absurd idea that you are the judge
as to who is right and who is wrong. Had you done that your
temper would have been reduced to a flicker of an inner stir
and the belching would have been aborted. Do you understand
now that your belching cannot be cured unless you control
your temper and that the latter can only be checked if
the brakes are applied to thought and muscles?
P: I understand that when I listen to you. But at the moment
my temper gets me I forget what you told me.
E: Which means that in your opinion your temper is an
overwhelming power that has you in its grip and leaves you
helpless when it seizes you. But the grip is so tight only because
you do not make the proper effort to loosen it. The time
to make this effort is not when you are face to face with the
boss. There a deadlock has developed between you and him,
and the mere sight of the boss makes your temper flare. In
order to get a hold on your temper you must practice control
under circumstances which do not produce the situation of the
deadlock. You must practice at home with your mother and
wife and child. There is no deadlock at home, or if there is

one it is mild and can be handled with ease. With the members
of your family your temper rises slowly and perhaps
never reaches excessive heights. There ought to be no difficulty
rejecting the thought of "I am right and she is wrong" when
your little girl irritates you with her childish pestering or
when mother and wife ask annoying questions. These trifling
impositions give you an opportunity for practicing temper control
dozens of times each day. From your own account and
from reports that come to me from other sources I know that
you "let yourself go" in the morning before you leave for work
and in the evening after you return from the shop. You permit
yourself the expensive luxury of releasing wild thought
and speech reactions. Once these active reactions are set of! the
passive responses of temper and symptom follow promptly in
their wake. When you arrive at the shop in the morning you
are already primed for the responses of temper and symptom
because you failed to practice control of thought and speech
reactions the evening before. On entering the shop you are
disposed to explode and belch because you pre-disposed yourself
to flare-ups in the paltry domestic squabbles of the previous
day. Your temperamental disposition at the shop in the
morning is the result of the temperamental predisposition cultivated
in the evening at home. If you wish to get rid of your
belching you will have to realize that the place to practice
temper control is at home and not in the shop, and that the
elements which have to be controlled are the active reactions
of thought and muscles, not the passive responses of explosion and symptom.

E Examiner
P Patient
Lester had an accident five years ago in which he suffered a
skull fracture. He recovered but was left with a persistent
headache, spells of dizziness, and difficulty of remembering.
In the course of the interview he made the following statement:
P: (Lester) After I returned to the office I expected the
people I worked with to be understanding and considerate. Instead
they did everything to irritate me and to make me feel
E: What precisely did your co-workers do that showed they
had no consideration?
P: Why, they slammed the doors and knocked against my
chair and laughed and yelled when I was busy concentrating
on my work. One fellow particularly made it a practice to
brush against me whenever he passed me. When I told him
to stop he made a sassy remark and then kept moving his chair
and dropping objects and scratching the table with his pencil
Anybody could see that this chap just wanted to provoke me.
That sort of thing went on all day. Do you wonder why I
lose my temper?
E: Indeed, I wonder. Since you have persistent headaches,
the best thing for you to do is to control your temper. The
surest means of producing or aggravating your headache is to
lose your temper. Why don't you make every effort to control
P: If anybody does something to irritate me, it gets my
goat and I explode. I wish I could hold my temper, but I can't.
E: Have you been working in the same office all these five

P: I was transferred to another room but had quite a few
battles there, too.
E: How are you at home?
P: I lose my temper at home, too. My mother pesters me,
and my brother and sister wouldn't do a thing for me when
I am suffering.
E: I know also that you have hardly any friends, because
they did not give you the sympathy you expected and you
threw tantrums whenever you did not have your way.
P:I think I am entitled to consideration. Can I help it if
the headache drives me frantic and I explode?
Rhoda Joins the Interview
E: Rhoda, do you think Lester is unable to control his temper?
P: (Rhoda) You told us there is no uncontrollable temper;
his temper is uncontrolled, but not uncontrollable.
E: What you tell me, Rhoda, is what you heard in previous
interviews in which we reached the conclusion that tempers
are frequently uncontrolled but never uncontrollable. But tell
me, Rhoda, why does Lester leave his temper without control?
P: That's difficult for me to say.
E: Now, Rhoda, you remember the examples which Lester
quoted. He becomes enraged when the man near him scratches
the table with the pencil, or when somebody closes the door
with more noise than Lester thinks proper, or when somebody
else brushes inadvertently against his chair. You know that
people do not, as a rule, "fly off the handle" because of such
trivial irritations. Ordinarily, a person will go into a rage only
if he is injured or insulted. I might be provoked and react with
a violent emotion if I were addressed in rude language, or
pushed off my chair with brute force. In an instance of this
kind I would feel outraged because my right to peaceful living
was infringed upon willfully and intentionally. Let me tell
you, Rhoda, that nobody loses his temper unless he is or feels
he is wronged or insulted intentionally. Your temper does not
flare up if you hurt your foot against a stone. The pain and
irritation which you experience may be just as intense as if

somebody throws the stone on your foot deliberately. But in
the one case the hurt was inflicted by accident and you do not
feel insulted; in the other case, the hurt was caused by intention,
and that makes you feel insulted and arouses your anger
or your temper. If you understand that, you will realize that
when the man near Lester scratched the table with the pencil,
he did so by accident and not by intention; and if somebody
slammed the door or brushed against Lester, the "irritating"
act of behavior was again the result of an accidental happening
and not of a deliberate intention to cause offense. Why, then,
did Lester go into a huff because of such accidental trivialities?
P: I guess he thinks they are intentional and not accidental.
E: That's it. Lester thinks of intentions where there are
only accidents. And since accidents may happen every time
and in every place, he is provoked everywhere and on every
occasion. Did you listen, Lester, and do you agree with what
I said about your temper?
Lester Rejoins the Interview
P: (Lester) I listened and tried to understand what you said,
but I am sure I don't think of intentions when I am irritated.
I simply go off and don't think at all. The explosion comes
before I have time to think.
E: In a sense, you are right, Lester. But in one sense only.
The word "thinking" has two meanings, and I wish to explain
to you the difference between the two kinds of thinking.
Suppose I tell a story and in the process say, "A man approached
me; he walked slow." Be certain I shall instantly catch
my error and correct swiftly, saying, "I meant to say he walked
slowly." Do you think I did a great deal of thinking when I
offered the correction? Did I stop and reflect and deliberate
whether the adverb "slowly" is better grammar than the adjective
"slow?" Presumably I did not do any reflecting but noticed
the error intuitively and felt likewise intuitively that my
statement needed correction. But while doing this intuitive job
of noticing and correcting the error I drew two discrete conclusions:
I concluded (1) that "slow" was the wrong use, (2) that

I had to correct to "slowly." In all of this I did not debate within
myself and did not reflect on the words "correct" and "incorrect"
or on the words "adjective" and "adverb." Had I done
so, I would have discoursed (within myself) about the issue
of the grammatical error, and my type of thinking would have
been discursive. Instead, I drew the conclusions by way of
intuition. Hence, my type of thinking was intuitive. I want
you to understand this distinction between discursive and intuitive
thinking. You see, children correct themselves frequently.
At a certain stage of their development they may
say, "I will go to kindergarten yesterday," and correct instantly
to "tomorrow." We grownups could discourse in such an instance
that the word "yesterday" connotes the past and clashes
with the phrase "I will go" which connotes the future. If we
do that our conclusions are drawn discursively. The child has
not yet learned how to engage in discursive thinking of this
sort. He must draw the same conclusions by a process of intuitive
thought. I could perhaps tell you how we come to
acquire discursive thought. It is done through school instruction
mainly. How intuitive thought is achieved I am unable
to tell It is one of the mysteries of life which I, at any rate,
am unable to explain.
I hope you will now understand, Lester, that in order to
draw conclusions about the meaning of a situation, one does
not have to reflect or to do an act of discursive thinking. One
may reach the same conclusion by means of imaginative or
intuitive thinking. That's what you do when your coworker
scratches the table with his pencil. Intuitively you draw the
conclusion (without having time to think by reflection) that
he intends to irritate you. Once you reach this conclusion you
interpret the situation as one in which an enemy attacks or
provokes you, and instantly your anger (or temper) is aroused.
You will now realize that the common variety of temper is a
condition in which one person draws the intuitive conclusion
that another person intends to offend him. The explosion and
anger are merely the result of this preceding intuitive conclusion.
Far less common is that variety of temper in which
discursive conclusions are acted upon.

It was explained to Lester and the class that in order to gain
control over his temper a person must learn through continuous
practice to avoid the intuitive conclusion of a deliberate
insult which precedes the temperamental outburst. Several more
examples were given to illustrate the difference between discursive
and intuitive thought. Finally the examiner asked:
E: Now, Lester, suppose your coworker will scratch the
table with his pencil tomorrow; what will you do then?
P: (Lester) I will try not to draw the conclusion that he does
that intentionally.
E: That would be fine. But I have reason to doubt whether
you will be able to do that. You see, Lester, your temper has
been with you for many, many years, indeed, since your childhood.
True, it has become intensified and almost crystallized
since your accident. But as such it has been with you practically
all your life. Do you think you can change such a life habit
just by making up your mind to drop it?
P: Of course, I'll have to practice.
E: That's it. You'll have to practice, and to practice hard.
Can you tell me how you will carry out your practicing?
P: I will think of what you told me and will stop arguing.
E: I doubt whether that will be successful. You see, Lester,
a temperamental outburst runs in stages. First, you explode
and go into a rage. In a given instance, you may rave on for
two or five minutes. During this time you are "out of your
senses" and will not be likely to exercise a great deal of thought.
You will certainly not stop to consult your memory recalling
what I told you about control of temper. So I take it that
during this initial stage of your explosion you will not think
of the instruction I gave you. You will simply rave on until
your anger will subside. I shall call this initial stage of your
temper the "immediate effect of the temper outburst." I hope
you realize that when I want you to practice avoiding intuitive
conclusions, I do not ask you to do that during this stage of
the immediate effect. But after the immediate effect is over,
you enter a "cooling off" process which may last some ten
or fifteen minutes. This is the temperamental after-effect. Once
the after-effect sets in you begin to think, perhaps not very

clearly, but sufficiently so to be able to remember what I told
you. Whatever thinking you do during the immediate effect
is intuitive, vague and dim. But in the after-effect your thought
becomes discursive again. You can then reflect and meditate.
The question is whether your type of reflection will be rational
or emotional. If it is emotional you will contine to fume, will
brood over the outrage of which you were the "innocent victim.'*
Burning with righteous indignation, you will justify
the explosion which you released during the immediate effect
and will give it your endorsement. Once you endorse your
outburst as justified, you are primed for another explosion; you
fairly itch to
pay that fellow back" and thus keep your temper
boiling in anticipation of another bout. This is the last stage
of the uncontrolled temperamental cycle which we shall call
the stage of anticipation. It is called the stage of anticipation because
in this third phase of the temper outburst you anticipate
a renewed squabble in which you expect to come out on top.
You anticipate a victory which will wipe out the "disgrace"
of the present defeat. You will understand now that the socalled
temperamental cycle if left to itself without an attempt
to control it consists of three discrete stages; (1) the immediate
effect, (2) the after-effect, (3) the anticipation of a renewed
outburst. Can you tell me now which stage of this cycle you
must make use of for the purpose of remembering what I told
you in matters of control?
P: You said it can't be done in the immediate effect. So I
think it will have to be done after that.
E: That's correct. You will have to make use of the aftereffect.
Of course, I do not expect you to succeed the first time,
nor do I expect full success the fourth, fifth and sixth time.
Instead, I presume you will become emotional in the first few
beginnings of your practice and your after-effects will be spent
in spells of fussing and fretting, with the result that the temperamental
cycle will be run unchecked through its immediate effect,
after-effect and the anticipation of the next temperamenal
"comeback." I hope, however, that after repeated practice you
will finally manage to stop short at the end of the immediate

effect and that henceforth the after-effect will be given over
to a sane, rational appraisal of the situation in which you will
refrain from endorsing your explosion, thus avoiding the anticipation
of and preparation for the next outburst. This will
come to pass if, after a few initial failures, you will not permit
yourself to be discouraged and will continue practicing with
solid determination. You will do that if you have the genuine
will to remedy and check your temperamental habits. Do you
think you will make the effort?
P: I sure will. After all, my temper didn't do me a lot of
E: What harm did it do you?
P: Why, I have lost all my friends, and I know I am a pest
at home.
E: That is correct. Your temper made you lose your friends
and has destroyed what peace and happiness was left in your
home. But let me tell you, Lester, I am not so much interested
in friendship and home life. My main interest is to get my
patients to lose their symptoms. It is important, of course, to
have friends, and to have peace in the home is a desirable
aim, indeed. But the patient's first obligation is to get rid of
his symptoms. I do not think you will make a strenuous effort
to curb your temper if you merely have your eye on the damage
it does to friendships and home life. This ought to be a strong
incentive. But experience teaches it is not. The only thing
that will make you bend all your energies toward conquering
your temper is the realization that you cannot get well unless
your temper is prevented from creating emotional upheavals
in your body and producing an incessant train of symptoms.
Mark this, Lester, I am not primarily interested in temper as
a disturbance of social relations. I am interested in it mainly
because it maintains and intensifies nervous symptoms. This
is the reason why I insist that my patients cannot get well
unless they learn to control their temperamental cycles.

Herbert had been in good health until four years ago, when
waiting for a street car, he suddenly felt a "light-headedness"
and was seized with the fear of "keeling over." The sensations
passed quickly, and Herbert paid scant attention to the
incident. But when three weeks later the sensations recurred
in exactly the same fashion, again while waiting for a street
car, the otherwise stolid man became alarmed. He feared he
was suffering from a fatal illness. Henceforth, he was afraid
of boarding street cars and experienced sweats and palpitations
when in the morning he prepared to leave the house. The
"lightheadedness" and "keeling-over" sensations became more
frequent. He noticed they occurred in open places only. At
home he was free from them. He also observed that he was
never subject to spells on the street if he was in the company
of another person. When first seen at the office he stated that
for the past three years he has not left his home unaccompanied.
He was compelled to give up his position, and his wife had
to secure employment to provide for the family needs.
Two months after joining classes and acquiring membership
in Recovery Herbert was able to take long walks without
a companion. His "lightheadedness" did not disappear altogether,
but he learned to dismiss the idea of danger and
to ignore the symptom. Numerous disturbing sensations
which had established themselves in the course of his ailment
palpitations, sweats, crawling and numbness in the arms,
fatigue and blurred vision were on the point of fading away.
At the end of the third month he returned to work resuming
his position as the breadwinner of the family.
He continued classes and stated in an interview, "I have

been swell for the past six weeks. I worked and didn't have
any of these symptoms, except that I felt some of the sensations
for a short time occasionally. And they were very mild.
I think you'd call them 'reminders.' But a couple of days
ago I had a severe spell of light-headedness again. That sure
scared me. And some of the other sensations came back, too.
I tried to ignore them but it's not easy."
E Examiner
P Patient
E: When did you start on your new job, Herbert?
P: Six weeks ago.
E: Two months ago you told me that you were taking walks
of three and four miles all by yourself. Have you done that
lately ?
P: No. I work hard and feel tired when I quit the job In
the afternoon. I still walk the five or six blocks to the street
car. But then I am all in.
E: How many hours per day do you work?
P: On some days it is four hours, on some seven.
E: I told you to take long walks every day. You did that
until recently. Why did you not continue the practice? With
an average of five to six hours of daily work you had ample
time to take your walks. If you failed to do that you sabotaged
my instructions.
P: I am on my feet all the time when I am at work, and
it's always a rush. When I leave the shop I can hardly drag
E: What you said is an excuse. You justify your failure to
take long walks on the grounds of hard work, rush and fatigue.
On this score you do not only practice sabotage; worse yet, you
claim you were justified in practicing it. If this is so you will
go on excusing and justifying, and the final result will be that
the walks will cease and you will slip back into your condition
of fear and helplessness. Is that what you want? Don't you
want to get well?
P: Of course, I want to get well I keep going to the shop

and coming to classes. Would I do that if I didn't want to get
E: In a sense, you may be correct in stating that you want
to get well. But I am just as correct if I say you do not want
to get well. You see, Herbert, if a man who is out of work
says he wants a job you will hardly deny that he really wants
it. But then you observe that after he obtains the position he
complains about the hard work and the poor pay. He loafs
and stalls and makes excuses and finally absents himself frequently.
Will you say that this man wants the job in the sense
that he wants to do a good day's work?
P: But I do a good day's work and don't gripe.
E: I did not mean you when I spoke of the man who loafs
on the job. And if you asumed that my remarks were aimed
at you it merely shows that your conscience bothers you. That
is a good sign and indicates that you are by no means happy
about your backsliding. But to return to the man with die
job: he wanted it, no doubt. He looked for it, took it when
it was offered and kept it although he didn't like it. What
better proof do you need to conclude that he wanted it? But
what precisely did the man want? He wanted the job, but
he resented the things that had to be done on the job. In
other words, he wanted the end but did not want the means
that lead toward the end. Do you realize that the word "wanting"
has at least two meanings? In the one sense it means
that you wish to obtain an end; in the other sense, it means,
you are ready to take every step to reach that end. In the first
sense, you were correct when you said you want to get well.
In the second sense, I was right when I objected that you did
not want to get well. What I tried to make clear to you was
that you wanted health as a shadowy, nebulous end but refused
to employ the concrete means of hard application to
accomplish that end.
P: I don't think I refused to work, and I certainly applied
myself. If you ask my boss he will tell you that I was on the
job all the time.
E: I told you that "wanting" can be used in two different

senses. That applies with equal force to what you said about
your being on the job. What you have in mind is the work
on the premises only. In order to get to the premises where
you work you must be able to take long walks; you must be
able also to perform your task without being handicapped by
"light-headedness," or fatigue, or palpitations, sweats and numbness.
Obviously, if you do not manage to get rid of your sensations
you will have to quit the job. If you want the job
you must at the same time want to be in good enough health
to carry on with your job. You will understand now that your
health is a means toward the end of securing and maintaining
the job. You want the job but not the means necessary to
accomplish it.
P: Can I help it if the "light-headedness" comes back and I
get those frightful palpitations and the sweats and the numbness?
E: I told you frequently that sensations come of their own
account, not at your bidding. You are not responsible for their
coming, but you are responsible for their persistence if you
fail to handle them in accordance with my instructions. Every
nervous sensation disappears after a short while if you refuse
to get alarmed about it. If you permit yourself to become
alarmed about the sensation you establish a vicious cycle. The
more you fear the palpitations the worse they grow. The
worse they grow the greater is your alarm. This vicious cycle
can be cut through instantly if you refuse to think of the sensation
as dangerous.
P: I know that and I have tried to be calm. I told myself
that sensations are distressing but not dangerous but it didn't
help me. The palpitations went on and the numbness got worse
instead of better.
E: You repeated my formula but did not practice it. When
your sensations started their rumble you should not merely
have thought they were harmless; you should have demonstrated
that to yourself. You should have demonstrated your indifference
to the danger. This you could have done by walking on
unhesitatingly in spite of the palpitations. You know numbers
of patients who have conquered their sensations by die simple

expedient o acting on them, with indifference. The indifferent
act demonstrates that there is no danger. Here is Jane,
sitting two seats from you. You know that while walking on
the street she had the frightful sensation that the pavement
moved up toward her and the buildings were toppling over
her. I take it you remember that several weeks ago when Jane
was interviewed she told her method of dealing with these
sensations. Do you recall what she did?
P: She walked on and disregarded the sensations.
E: Jane practiced the rules of fearlessness and got results.
After three years of avoiding walks she now has no trouble
and moves about as if she had never been sick. Had you
practiced the rules instead of merely remembering or repeating
them you would be well by now. You say you tried but
did not succeed. Do you understand that what you tried was
to achieve the goal without practicing the means? Jane had
not only the goal in view but also the means that lead to it.
If you really want to get well you will have to consider the
practical means and not only the theoretical goal. Will you
do that?
P: I shall certainly try.
E: That's not enough. You must want and not merely try.
The interview was then devoted to a discussion of the terms
"trying" and "wanting.'* Herbert tried to walk long distances
but relinquished his effort after an initial failure. The first
failure discouraged him and he gave up. Jane, on the other
hand, experienced the same initial failure but kept practicing
until she succeeded. She showed will and determination, which
means to want the end but also the arduous means that lead
to its achievement.

E Examiner
P Patient
E: How are you, Helen?
P: I have been well for more than six weeks but last week
I had a setback. It was during a card game. I didn't get my
paralysis, but it was bad enough. I had a panic and couldn't
shake it off for two days. Today I am much better, but I am
still shaky.
E: You speak of paralysis. Can you tell the class what you
mean by that? You are a young woman, and why should
you have a paralysis at your age? Tell your story briefly and
try to explain what you mean by "paralysis."
P: I have always been restless. After I got married I couldn't
stand being alone at home in the evening, not even with my
husband. We had to be in the company of people all the
time. We either had people visit at our home, or we went
out visiting. Usually we played cards. One day, three years
ago, while playing a game of bridge, my hands suddenly went
limp. I tried to move them and couldn't. Of course, that
scared the wits out of me. I pretended to have a headache and
excused myself. The moment I left the table my arms moved
again. That was the first time I had that paralysis.
E: Did the condition return?
P: It did not for about three weeks. In between I played
cards repeatedly and had no trouble moving the arms. I actually
forgot the whole thing. But one evening I played
again and the arms gave out. This time, I was so scared I
didn't have the presence of mind to fish for an excuse but
just ran out of die room. My husband called a doctor who

said he couldn't find anything wrong with me. But I felt like
in a daze, although I knew I could move the arms again. After
that I could not get myself to play cards when I was out of
the house. I was in terror when I thought that the arms would
stop moving again.
E: Were you able to play cards at home?
P : Yes. I played without trouble at home, even when visitors
were present. I was also able to visit people but I did not touch
a card when I visited. I gave excuses, said I had a headache
or felt dizzy and couldn't concentrate. That helped for a while
but one evening the hostess was insistent and wouldn't take
an excuse. I gave in and, sure enough, there was the paralysis.
After that, I refused to accept invitations. I still had visitors
at rny home but they gradually petered out because I did not
E: Did the "paralysis" ever appear when you played cards
at home, with only relatives present?
P: This didn't happen for a long time until, one evening,
it finally happened. After that, there was no more card playing
with anybody except my husband and my parents. With
them, I never had the paralysis.
E: Did you have any other trouble aside from this "paralysis?"
P: For many months the paralysis was the only trouble.
But then all kinds of other trouble came. The greatest trouble
was meeting people. I hated their questioning me about my
condition. I had to explain why I kept away from them, and
it wasn't easy to find excuses. Finally I kept out of everybody's
way, that means, I avoided going out as far as I could.
E: Did you continue seeing your relatives?
P; I did. But they became bothersome, too. When they
came to the house the first thing they told me was, "Why,
you are not sick; you just look the picture of health. You
must be feeling fine." When I told them I still had my
fears they said, "Oh, it's all in your mind." Or they told me
to snap out of it, to use my will power. I knew they were

right and the doctors had told me the same thing. But I hated
their way of talking, perhaps because they were right.
E: That was an excellent description. I need not tell you,
Helen, that what you just described was a very severe nervous
condition. Had you continued avoiding people and shutting
yourself up in your home your life would have been that of
a helpless cripple, doomed to lead a useless and miserable
existence. If this is so why don't you make an effort to get well?
P: If I had a setback does that mean I don't make an effort
to get well? You told us so many times that setbacks are
E: That is correct. But I also told you that you must learn
how to handle the setback. Do you think you handled it in
accordance with my instructions?
P: I got over it in two days. Is that so bad?
E: It is bad enough. You said you were panicky and couldn't
shake off the panic for two days. Then you added that you
are still shaky today. Had you done what I asked you to
do the setback would not have developed into a panic and
would have lasted minutes or hours and not days. What did
you do when you noticed the setback?
P: I remembered what you told me. I knew that sensations
are distressing but not dangerous. Wasn't that what I was
supposed to do ?
E: You did very little. You merely "remembered" and
"knew" something that I said. That's not what I call "doing."
I shall ask you: Did you attend the Recovery meetings? Did
you go to family gatherings?
P: No. I didn't. I was so fine the past six weeks that I was
sure I was well and didn't need the meetings.
E: You spent three years in utter agony. Then you got well
but were warned that the condition was likely to return unless
you took part in classes and Recovery activities for at least six
months. You attended my classes but neglected going to Recovery
meetings. That means you made a half-effort. Why
did you not make a total effort?

P: I did what I could. I had to come to your office twice
a week. That took up two afternoons. The class took up an
evening. Then I had to take care of the house and the children,
and my husband is entitled to some of my time, I think. And
you told me I should go and visit people which I did. All of
this took plently of my time.
E: You mentioned the home and the children and social
activities. They are all very important. I do not deny that.
You may call them the domestic, social and marital purposes.
You took care of them and deserve all the credit that is due
for -the accomplishing of purposes, especially if they are as
worthy as the ones you mentioned. You might have added that
you had to attend a church meeting or meetings of a civic club.
These would be the purposes of citizenship, community and
church interest. All worthy and commendable purposes. But
when you are ill your main and all-absorbing purpose must be
the will to get well. All other purposes, no matter how inspiring
and exalted, must be subordinated to the one leading and supreme
purpose of getting well and keeping well. Unless you
regain and maintain your mental health all other purposes
will be frustrated. Only if you keep well will you be able to
discharge your duties as mother, wife, friend, church and club
member. I do not mean to say that health is more important
than motherhood or religion. I merely say that motherhood,
religion, citizenship and fellowship cannot function unless health
is made to function first. To a patient his health must have
unquestioned priority over all other purposes. Health must
be the supreme aim to him, all other aims must be subordinated
to the demands of health. You spent your effort on subordinated
purposes and neglected that aim that ought to be
supreme now. Instead of concentrating all your strength on
the main issue, you frittered away your energies on a number
of side issues. Why are you so careless of your welfare? Don't
you want to keep well?
P: Of course, I want to keep well. I just shudder if I think
of my suffering in the past.
E: You say you want to keep well. In a sense you are right

You would like nothing better than to have done with the
"paralysis" and the awful difficulties into which it got you.
That merely means that you wish to have your health. It does
not mean that you have the will to health. I shall not enter
into a comprehensive discussion of what is the difference between
a loose wish and a determined will. This much I will
say: A wish does not commit you to exercise all your energies
toward attaining it. You wish to make a trip to a distant
country. You may say you want the trip. But you don't want
it hard enough to sacrifice other aims in its favor. You will
not sacrifice your life savings or the welfare of your family for
the sake of that wish. That wish is not directed toward a supreme
aim. You do not give it priority over the family purpose.
Should you for some foolish reason make that trip a
supreme aim .you might perhaps sacrifice all other purposes
to it. Then you would pursue your aim with the force of a
total effort. The trip would no longer be backed by a loose
wish but would be insisted on with the vigor of a determined
will. I hope that you understand now the difference between
a supreme and subordinate purpose. Health was to you a subordinate
aim, a loose wish, something that you thought you
might be able to attain at the cost of a half-effort. You know
better now. You know that health must take precedence over
all other purposes and must be attended to with the energy
of a total effort. If you keep that in mind you will not have
to worry about your setbacks. You will be prepared for them
and will shake them off in minutes instead of hours or days.
The examiner then pointed out that the real reason for
Helen's failure to attend Recovery meetings was her sense of
shame. Helen, he commented, is still harassed by the idea that
her nervous ailment is a disgrace to her and her family. She
still suffers from the pressure of stigmatization. To feel stigmatized
means to be tense. The tenseness creates pressure on
the nervous system and may produce or revive symptoms. As
long as Helen continues to feel stigmatized she will be in danger
of becoming "paralyzed" again. If she wants to prevent a return
of the symptoms she will have to learn how to shake oft

embarrassment and stigmatization. One of the purposes of
Recovery gatherings is to rid the patient of his feeling of being
stigmatized. If Helen continues to shy away from the meetings
she will have demonstrated that her will to avoid embarrassment
is stronger than her will to get well. That will is a
mere wish, not a solid determination.

Irene, a woman of 30 and mother of two children, developed
a depression of mood which persisted for five years with only
brief intervals of fair health. When she was first seen by the
examiner she complained of a "complete absence of interest,"
difficulty of sleeping, lack of appetite, fatigue. She claimed
she had no zest, pep or initiative. She could not plan, make
up her mind, decide or get things started. In the morning it
took her literally hours to get dressed, to choose the proper
attire, to get started with cooking, dusting and cleaning. When
she finally began to do her work she had to drag herself. Everything
was done with extreme effort. Even such simple acts
as turning on the faucet or lighting the gas range required her
to use all of her strength. She could only do things if she
forced herself to do them. A simple conversation was "hard
labor/' walking was an ordeal. On the other hand, sitting or
lying down was intolerable because it made her restless. Because
speaking and walking called for extreme effort she
avoided going out and meeting 'people. After several weeks
of combined office and group treatment she recovered her
health and staged a comeback that surprised both her and the
members of the family. When interviewed in class she reported
that all her symptoms were gone and that she was as well
"as anyone might wish to be."
E Examiner
P Patient
E: I have observed you closely for the past two months, and
there can be no doubt that you have regained your health.
But tell me, Irene, what do you plan to do for the purpose
of maintaining your health?

P: I shall attend classes and Recovery meetings and I will
study your books and the Recovery Journal. Isn't that what
you want me to do?
E: Of course, I want you to do that. But the maintenance
of health is a lifelong task and I do not expect you to attend
classes all your life. And whether you will continue membership
in Recovery forever is questionable. So, what is your
program for keeping well aside from your present activities
in classes and meetings?
P: I certainly intend to take part in Recovery for good. I
know that many members feel the way I do. They think they
are in Recovery for keeps.
E: I like your spirit. But you cannot depend on Recovery
exclusively. Suppose your husband will be transferred to an
out of town branch of his concern. Then you will be separated
from Recovery and will be thrown on your own resources.
Are you prepared for a development of this kind? Are you
ready to practice self-help?
P : I never thought of that. But it seems 111 be able to manage.
E: Look here, Irene, you have suffered for almost five years
and have only been well some two months. In these two
months you have heard me state repeatedly that every patient
must be prepared for setbacks. You have listened to several
interviews in which patients reported that they drifted into
setbacks after months and years of good health. Last week
you had an opportunity to listen to the interview with Emily
who had enjoyed good health for three years in succession and
then developed a severe spell that landed her in the hospital.
You remember that when I criticized Emily for neglecting
her participation in our after-care project she gave the excuse
that three years ago she felt sure she was able to manage herself
without the aid of classes or meetings. Emily paid dearly for
her false sense of security. Now you also say you think you'll
be "able to manage." Are you going to repeat Emily's mistake?
P: I don't know what more I can do than come to classes
and work in Recovery.

E: Be certain I appreciate your loyalty to Recovery. But I
must repeat what I mentioned before. Suppose some day you
will be deprived of Recovery support. Are you prepared to
practice self-help? Do you know how to go about it? Do
you know which method to employ? You wish to keep well.
That means you want to prevent a recurrence of your ailment.
But prevention must be practiced correctly, methodically and
systematically. Do you think you know the method which
will help you maintain your health?
P: I don't know what to say.
E: You see, Irene, you told me that when you were ill you
had no interest, zest or initiative. You could not plan or decide.
Making up your mind and getting things started was
difficult or impossible. Simple tasks which are ordinarily done
without hesitation, required extreme effort. All of this can
be summed up in the statement that you lost your spontaneity.
Do you understand now that if you are to keep well you will
have to know (1) what is the nature of spontaneity, (2) what
you can do to strengthen and preserve it? I shall try to tell
you something about that. While I am speaking here before
the class I have in mind a plan, or intention. My intention is
to express certain ideas and to make this class accept them.
This intention must be carried out by my muscles. The muscles
of my lips, tongue and cheeks must pronounce my sentences,
the muscles of the throat must provide the proper intonation.
The face muscles will have to mold and fashion my features
in such a manner that they give adequate expression to everything
voiced by my lips. Add the gestures of my arms, the
carriage of my frame, all of them must fall in line with the
central intention conveyed by my spoken word. In the space
of one hour I shall have to set in motion hundreds of muscles
in thousands of combinations and all the movements they will
perform will be required to give expression to one intention,
one plan, one idea. Let me tell you that what I described here
is the pattern for every act of every description no matter what
may be its meaning. You may say that every act expresses one
single intention through a multiplicity of muscular movements.

Suppose now that when I arrived tonight I felt tired, discouraged
and dispirited, the reason perhaps being that I experienced
a grave disappointment in the afternoon. If this is so, then, my
intention may still be to plant certain ideas in your brains.
But that intention will now be coupled with another intention:
to go home and rest, to get this class out of the way, to be
finished with it in record time. My mind will no longer be
"made up" or determined by one single intention. Instead it
will be torn between two intentions. The intention to continue
this address will grapple with the opposite intention to go home
and relax. The result will be that two sets of antagonistic
impulses will reach my muscles of speech, intonation, facial
expression and gestures, and the muscles will sometimes express
the one group of impulses (to make a good and effective speech)
and sometimes the other group (to be done with that speech
that keeps me from taking a rest). The dual intention will
distract my attention and will involve me in contradictions.
Before long I will notice that I stray from the theme and
that I do not hold the interest of the audience. The observation
will scare me. I will lose my assurance and will be self-conscious.
And once I become self-conscious I am not spontaneous.
You will understand now that spontaneity is interfered with
or destroyed by self-consciousness. You will also realize that
self-consciousness is produced by the fact that two contradictory
intentions endeavor to make the muscles express two different
ideas at the same time. The muscles are thrown into disorder
expressing portions of the one idea and fragments of the other
with the result that the speech loses clarity and gives the impression
of confusion. Do you understand, Irene, that when
you lacked spontaneity your mind was the seat of two contradictory
basic intentions and was not "made up" in favor of
one single plan?
P: I know I was always self-conscious when I was ill. But
when you speak of contradictory intentions I don't know whether
that was so. I know I wanted to do something and felt I
couldn't. I had to drag myself and when I forced myself to
cook or clean I did it with great effort.

E: You say you wanted to cook but had to force yourself to
do it. That means your intention or plan to cook met with
resistance. You know that at present if you intend to cook
you simply send an impulse down to your muscles and they
perform the act. They do that with ease, without effort. You
no longer drag yourself which means that strain is eliminated;
you hardly think of and certainly do not reflect strenuously
on what your muscles are doing which means that you are
no longer self-conscious about your actions. Since your cooking
proceeds without effort and without self-consciousness you
can say that you are now spontaneous. Your spontaneity has
reestablished itself because your impulse to cook is no longer
resisted and thwarted by the contrary impulse not to cook.
You will understand this situation better if you consider another
example in which resistance hampers prompt and effortless
action. I shall quote the act of buying necessities or conveniences.
Should you want to buy a loaf of bread all you
would have to do would be to have the proper intention and
to impart the corresponding impulse to your muscles to walk
out of the home, to cross the street, to enter the bakery shop,
to pick up the bread and to pay for it. All these* actions would
be executed promptly, and without effort and without selfconscious
hesitation. You would act spontaneously. In the
afternoon of the same day you might want to purchase a coat.
The question will be: cloth or fur? Now you will no longer
just dispatch an impulse to your muscles, fetch a seal coat, pay
for it and stroll home. Now there will be stalling, hesitation,
plenty of thought and an abundance of reflection. You may
want that sealskin very insistently but the intention to buy it
will be crossed by the contrary intention to save the money.
Your spontaneity will be gone because two antagonistic impulses
will impinge on your muscles. I shall try to tell you
what is at stake in situations of this sort. You see when it
was a matter of securing a loaf of bread you were sure you
needed it, you were certain that your intention was proper,
reasonable, harmless. You knew with absolute assurance that
after the purchase of the bread there will be no self-blame, no

compunction, no threat to your moral ego. In other words,
you felt secure with regard to carrying out the impulse once
you conceived it. This sense of security was absent in the instance
of your intention to buy a coat. You had the intention
to acquire the cloth coat but it was not sufficiently dressy. Then
the seal caught your eye and now you were uncertain whether
you could afford it. The impulse to buy engaged in a running
fight with the impulse not to buy, and the result was a sense of
insecurity, strain and tenseness (effort) and stalling and hesitation
(self-consciousness). In the end, you were left without
spontaneity. You will now be in a better position to understand
the factors which tend to do away with your spontaneity: (1)
there is a conflict of intentions and impulses, (2) a sense of
insecurity, (3) effort and self-consciousness, (4) inability to decide,
plan and act. The inability to decide, plan and act is
the outward expression of your defect in spontaneity; the conflict
of impulses, the sense of insecurity and the self-consciousness
are its inner causes.
In the subsequent portions of the interview it was explained
that if Irene meant to preserve and strengthen her spontaneity
she had to cultivate ideas of security and to reduce as far as
possible her thoughts of insecurity. The examiner then demonstrated
with suitable examples that patients can weaken their
sense of insecurity if they learn to adopt the philosophy of
averageness in preference to thinking in terms of exceptionality.
Irene had been brought up as a perfectionist. Her ambition
was to keep her home "perfectly clean"; to do a perfect
job in the education of her children; to attain excellence
as hostess, wife, friend, neighbor. Trivial errors, trifling mistakes
and insignificant failures caused her to sweat and fret,
to wear herself out with vexation and self-reproach. She worried,
felt provoked at her fancied inefficiency, was perpetually
flustered and confused. The confusion multiplied her record
of bungled trivialities and botched irrelevancies. A vicious
cycle developed: The more she was confused the more she
bungled; the more persistently she bungled the more disturbing
became her confusion. In the end, she lost confidence in her

ability to do things "correctly," developed an exaggerated selfconsciousness
and lost her spontaneity. After joining Recovery
she learned to be human and average, to permit herself to be
^like others," to bungle as much or as little as people bungle
"on an average." She rejected the grotesque idea of the "perfect
job*' and the "flawless performance," and imbibed the now
familiar Recovery doctrine to "have the courage to make mistakes
in the trivialities of everyday life." If Irene continued
to practice these Recovery doctrines in her everyday activities,
if she practiced methodically to laugh at the paltry consequences
of her trivial mistakes, she was certain to develop self-assurance
and to rout her self-consciousness. Then her muscles will
not be wedged in between two sets of antagonistic impulses,
her spontaneity will be established on the firm ground of selfconfidence,
and her solid habits o thinking in terms of averageness
will prevent her from becoming discouraged, despondent
and depressed.

An Important Book For The Patient And His Family
Lectures To Relatives of Former Patients
By Abraham A. Low, M.D.
The bulk of Dr. Low's Lectures to families have
been gathered together in this book. It contains
information of great value to patients and
it is indispensible to those who seek to understand
and help those patients.
Cloth, Price $5.00

Continued from Front Flap
It was not until after Dr. Low's death in 1954 that
the real test of Recovery, Inc. as a truly self-help,
lay organization took place. It withstood this test.
The strength and proof of the Recovery panel techniques
are now evident.
Only members who have had thorough training
in the method and have received authorization by
Recovery's Board of Directors may act as panel
leaders. Leaders* qualifications are reviewed annually.
In order to allow total participation, each Recovery
group is limited to approximately thirty members
with the Recovery trained leader responsible for
Physicians, psychiatrists, mental hospitals and
clinics refer patients to Recovery, Inc. for after-care
and self-help. Because it is a lay group, limited to
after-care and self-help , the method does not replace
the physician. Members are at all times expected to
follow the authority of their physicians. Recovery,
Inc. never offers diagnosis, medical treatment or counseling.
Its training deals only with that portion of a
patient's life where he or she is expected to practice
self-leadership under the guidance of a panel leader
trained in the Recovery method.
Recovery, Inc., is non-sectarian, non-political and
has no affiliation with any other organization or individual.
Nevertheless, it has maintained the most
cordial relations wife professional people and clergy
of all faiths and in return these friends have assisted
in securing meeting places for Recovery groups.
It is Recovery's policy to encourage local pdbHcjty
wherever authorized groups are functioning. Contact
with an authorized Recovery group is of the utmost
importance to those wiio wisb to secure the fa!
benefit of Recovery's method as evolved by Dr. Low.
The locations of these authorized groups may be
obtained from National Headquarters.
Recovery, Inc.

Recovery, Inc.
The Association of Nervous
and Former Mental Patients
116 South Michigan Avenue
Chicago, Illinois 60603