Antithesis
. The therapist must first decide whether the game is played innocently and hence should
be allowed to continue for the benefit of the patient until her Adult is sufficiently well-established
to risk countermeasures. If it is not innocent, the countermeasures may be taken at the first
appropriate opportunity, after the patient has been sufficiently well prepared so that she will be able
to understand what happens. The therapist then steadfastly refuses to give advice, and when the
patient begins to protest, he makes it clear that this is not merely "Poker-Faced Psychiatry" but a
well-thought-out policy. In due time his refusals may either enrage the patient or precipitate acute
anxiety symptoms. The next step depends on the malignancy of the patient's condition. If she is too
upset, her acute reactions should be dealt with by appropriate psychiatric or analytic procedures to
re-establish the therapeutic situation. The first goal, in the dissembled form, is to split off the Adult
from the hypocritical Child so that the game can be analyzed.
In social situations, intimate entanglements with innocent GYWM players should be avoided, as
any intelligent actor's agent will impress upon his clients. On the other hand, women who play
dissembled GYWM are sometimes interesting and intelligent if they can be de-GYWMed, and may
turn out to be quite a delightful addition to the family social circle.
5 PSYCHIATRY
Thesis
. Psychiatry as a procedure must be distinguished from "Psychiatry" as a game. According to
the available evidence, presented in proper clinical form in scientific publications, the following
approaches, among others, are of value in treating psychiatric conditions: shock therapy, hypnosis,
drugs, psychoanalysis, orthopsychiatry and group therapy. There are others which are less
commonly used and will not be discussed here. Any of these can be used in the game of
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"Psychiatry," which is based on the position "I am a healer," supported by a diploma: "It says here I
am a healer." It will be noted that in any case this is a constructive, benevolent position, and that
people who play "Psychiatry" can do a great deal of good, providing they are professionally trained.
It is likely, however, that there will be some gain in therapeutic results if therapeutic ardor is
moderated. The antithesis was best expressed long ago by Ambroise Par£, who said in effect: "I
treat them, but God cures them." Every medical student learns about this dictum, along with others
such as primium non nocere, and phrases such as vis medicatrix naturae. Nonmedical therapists,
however, are not likely to be exposed -to these ancient cautions. The position "I am a healer
because it says here that I am a healer" is likely to be an impairment, and may be replaced to
advantage with something like: "I will apply what therapeutic procedures I have learned in the hope
that they will be of some benefit." This avoids the possibility of games based on: "Since I am a
healer, if you don't get better it's your fault" (e.g., "I'm Only Trying To Help You" or "Since you're
a healer, I'll get better for you" (e.g., "Peasant"). All of this, of course, is known in principle to
every conscientious therapist. Certainly every therapist who has ever presented a case at a reputable
clinic has been made aware of it. Conversely, a good clinic may be defined as one which makes its
therapists aware of these things.
On the other side, the game of "Psychiatry" is more apt to crop up with patients who have
previously been treated by less competent therapists. A few patients, for example, carefully pick
weak psychoanalysts, moving from one to another, demonstrating that they cannot be cured and
meanwhile learning to play a sharper and sharper game of "Psychiatry"; eventually it becomes
difficult for even a first-rate clinician to separate the wheat from the chaff. The duplex transaction
on the patient's side is:
Adult: "I am coming to be cured."
Child: "You will never cure me, but you will teach me to be a better neurotic (play a better game of
'Psychiatry')."
"Mental Health" is played similarly; here the Adult statement is, "Everything will get better if I
apply the principles of mental health which I have read and heard about." One patient learned to
play "Psychiatry" from one therapist, "Mental Health" from another, and then as a result of still
another effort began to play a pretty good game of "Transactional Analysis." When this was frankly
discussed with her, she agreed to stop playing "Mental Health," but requested that she be allowed to
continue to play "Psychiatry" because it made her feel comfortable. The transactional psychiatrist
agreed. She continued, therefore, for several months to recite her dreams and her interpretations of
them at weekly intervals. Finally, partly out of plain gratitude, perhaps, she decided that it might be
interesting to find out what was really the matter with her. She became seriously interested in
transactional analysis, with good results.
A variant of "Psychiatry" is "Archaeology" (title by courtesy of Dr. Norman Reider of San
Francisco), in which the patient takes the position that if she can only find out who had the button,
so to speak, everything will suddenly be all right. This results in a continual rumination over
childhood happenings. Sometimes the therapist may he beguiled into a game of "Critique," in
which the patient describes her feelings in various situations and the therapist tells her what is
wrong with them. "Self-Expression," which is a common game in some therapy groups, is based on
the dogma "Feelings are Good." A patient who uses vulgar expletives, for example, may be
applauded or at least implicitly lauded. A sophisticated group, however, will soon spot this as a
game.
Some members of therapy groups become quite adept at picking out games of "Psychiatry," and
will soon let a new patient know if they think he is playing "Psychiatry" or "Transactional
Analysis" instead of using group procedures to obtain legitimate insight. A woman who transferred
from a Self-Expression group in one city to a more sophisticated group in another city told a story
about an incestuous relationship in her childhood. Instead of the awe which she had come to expect
whenever she told this oft-repeated tale, she was greeted with indifference, whereupon she became
enraged. She was astonished to discover that the new group was more interested in her transactional
anger than in her historical incest, and in irate tones she hurled what apparently in her mind was the
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ultimate insult: she accused them of not being Freudian. Freud, himself, of course, took
psychoanalysis more seriously, and avoided making a game of it by saying that he himself was not
a Freudian.
Recently unmasked is a new variant of "Psychiatry" called "Tell Me This," somewhat similar to the
party pastime "Twenty Questions." White relates a dream or an incident, and the other members,
often including die therapist, then attempt to interpret it by asking pertinent questions. As long as
White answers the questions, each member continues his inquiries until he finds a question White
cannot answer. Then Black sits back with a knowing look which says: "Aha! If you could answer
that one, you would certainly get better, so I have done my part." (This is a distant relative of "Why
Don't You—Yes But"). Some therapy groups are based almost entirely on this game, and may go
on for years with only minimal change or progress. "Tell Me This" allows much latitude to White
(the patient) who, for example, can play along with it by feeling ineffectual; or he can counter it by
answering all the questions offered, in which case the anger and dismay of the other players soon
becomes manifest, since he is throwing back at them, "I've answered all your questions and you
haven't cured me, so what does that make you?" "Tell Me This" is also played in schoolrooms,
where the pupils know that the "right" answer to an open-ended question asked by a certain type of
teacher is not to be found by processing the factual data, but by guessing or outguessing which of
several possible answers will make the teacher happy. A pedantic variant occurs in teaching ancient
Greek; the teacher always has the upper hand over the pupil, and can make him look stupid and
prove it in print by pointing to some obscure feature of the text. This is also often played in
teaching Hebrew.
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