desires or fears—what are the consequences for his already inadequate self-esteem? What specific self-doubts are
his neurotic defenses designed to protect? How does this view and estimate of himself relate to his values and goals
in the spheres of work and human relationships? How does it affect his sexual psychology? The detailed working
out, with the patient, of the answers to such questions, is basic to the process of effective psychotherapy.
Consider the case of a man who enters psychotherapy with the following dual complaint: he is unhappy and
frustrated in his work and he is unhappy and frustrated in his marriage; he does not know why. Investigation
reveals that the patient is a social metaphysician; that he selected his particular career under the pressure of his
parents' urging, without any first-hand interest or desire on his own part; and that he selected the girl who was to
become his wife by an essentially similar process: she was generally regarded as the most attractive and desirable
girl among his circle of friends and acquaintances, so that winning her was perceived by him as a great personal
triumph. Twice during his marriage, as a blind attempt at self-assertiveness, he has deceived his wife in affairs with
other women; the women meant nothing to him and the net effect of the experiences was to raise the level of his
anxiety. He feels increasingly haunted by a sense of inner emptiness and futility, the sense of attaining nothing,
enjoying nothing, being nothing.
In the treatment of such a patient, one of the therapist's chief tasks is to make the patient aware of the psycho-
epistemological processes by which his values and goals were chosen: the reliance on the terms, expectations,
beliefs, standards of his "significant others," the substitution of the minds of those others for his own, the craving
for approval and status as the regulator of his "thinking" (which means: the destruction of thinking); the fear of
independence that lay behind the early surrender of his intellectual autonomy; and the devastating consequences for
his self-esteem, not only of his initial surrender, but of its implementation across the years, via his attempts to deal
with reality second-hand, i.e., by means of the minds of others. The patient has to be led to understand in what way
his initial default on the responsibility of independence generated the sense of insecurity that pushed him into the
position of a psycho-epistemological dependent; the process by which each new act of surrender to the minds of
others carried him