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though only two people are actually in the room, the number of
more or less imaginary people that get themselves involved in
this two-group is sometimes really hair-raising. In fact, two or
three times in the course of an hour, or more, whole new sets of
these imaginary others may also be present in the field. Of that,
more later when I discuss what I call parataxic distortion.
The Two-Group
To return to my definition of the interview, the next point
is that this communication is in a two-group, and in that sugges
tion there certainly is a faint measure of irony. While it is prac
tically impossible to explore most of the significant areas of per
sonality with a third person present. it is also true that even
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what in the way -of some sort of evil, fateful entity that is
tied to them or built into them. They don't think of their
troubles, as they call them, as important, but not especially
distinguished, parts of their general performance of living in a
civilized world with other people. Many problems are so
thoroughly removed from any connection with other people-
when they are reported by the patient-that the young psy
chiatrist would, I think, feel rather timid about suggesting to
the patient that perhaps he did not experience these problems
in his relations with everybody, but only with some particular
people; and I think that even the very experienced psychia
trist would scarcely wish to expose the patient to such un
necessary stress. But one can always ask when the trouble oc
curs-in what setting it is most likely to be seen. Remarkably
often one of these patients who has an "organic" or "heredi
tary" neurosis that has nothing to do with other people can
produce instances of his neurosis in which five or six different
people have been involved--and for the life of him can't think
of any other settings in which it has been demonstrated. It is
only when he has come to this point that the psychiatrist can
say, "In other words, you don't have this difficulty, so far as
you know, with your wife and her maiden sister, and so on and
so forth?" The patient stops, and thinks, and quite honestly
says, "No, I don't believe I ever do." Only then is he on the
verge of realizing that perhaps the other fellow does have some
thing to do with the difficulty; only after being led around to
making that discovery from his own data can he begin to re
alize that it is the interpersonal context that calls out many
troubles.
I am not attempting to say here that there is nothing that
makes living difficult except other people and one's inadequate
preparation for dealing with them. There are a vast number
of things, such as blindness in one or both eyes, and harelip,
and poor education, which make difficulties in living. But the
psychiatric interview is primarily designed to discover obscure
difficulties in living which the patient does not clearly under
stand: in other words, that which for cultural reasons-reasons
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harm. To repeat, that the person will leave with some measure
of increased clarity about himself and his living with other
people is an essential goal of the psychiatric interview.
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of three things: he decides it is too much for him and leaves it,
he handles it satisfactorily, or he calls in adequate help to handle
it. And that's all there is to it.
When people find themselves recurrently in obscute situa
tions which they feel they should understand and actually
don't, and in which they feel that their prestige requires them
to take adequate action (a somewhat hypothetical entity, since
they do not know what the situation is), they are clearly in
need of psychiatric assistance. That asSistance is by way of the
participant observation of the psychiatrist and the patient, in
which the psychiatrist attempts to discover what is happening
to the patient. A great many questions may be asked and an
swered in the psychiatric interview before the patient sees much
of what the psychiatrist is exploring; but, in the process, the
patient will have experienced many beginning clarifications of
matters which will subsequently take on considerable personal
significance.
As an example of such an obscure situation which seemed to
demand action, I would like to mention a patient whom I saw
for a brief interview a number of years ago in New York. She
was 11 young lady of forty-three or so who presented, as her
trouble in life, the fact that at night her breasts were frightfully
tampered with by her sister who lived in Oklahoma. Now, such
a statement is a reasonable sign of something being a little the
matter with the mind. It also developed that the pastor of one
of the more important New York churches gave the only help
that she had ever been able to obtain in this cursed nuisance
perpetrated by her sister. Since I always appreciate any help
that anybody can get, particularly from somebody besides me,
I was pleased to learn this and wondered why she had sought
me out.
At this I learned that there were other difficulties. She was
coming to suspect that a woman who worked in her office had
been employed by her sister to spy on her-this nice psychotic
lady, like many others, was earning a living. I said, "Aha!
Now we are getting somewhere! Tell me all about that."
Whereupon she bridled, realizing that it was risky to admit
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parataxic distortion.