第3章
セラピストと患者は「共に旅する者」
フランスの小説家アンドレ・マルローは、何十年も告解を聞き続けたある田舎の司祭を描写し、人間性について学んだことを次のように要約しました。
「まず第一に、人々は思っているよりもずっと不幸である……そして、大人というものは存在しない。」
この言葉は、セラピストも患者も同様に、人生の高揚感だけでなく、避けられない暗闇も経験せざるを得ないという事実を指摘しています。幻滅、老い、病気、孤独、喪失、無意味、痛みを伴う選択、そして死——これらは誰もが直面する宿命なのです。
このことを、ドイツの哲学者アルトゥール・ショーペンハウアーほど、より厳しく、より陰鬱に語った者はいません。
若き日に、私たちはこれから始まる人生を思い描き、舞台の幕が上がる前の劇場の子供たちのようである。高揚感に包まれ、芝居の始まりを心待ちにしているのだ。だが、これから何が起こるかを知らないのは幸いである。もし予見できたならば、子供たちはまるで死刑囚のように見えるかもしれない——死刑ではなく「生」に処せられた囚人として、そして自らの運命が意味するところをまだ理解していない存在として。
また、彼はこうも言います。
私たちは屠殺人の目の前で戯れる子羊のようなものだ。屠殺人はまず一匹を、次に別の一匹を獲物として選び出す。私たちは幸せな時には、自分たちの運命がもたらすかもしれない災厄——病気、貧困、身体の損傷、視力や理性の喪失——を知る由もないのだ。
ショーペンハウアーの見解は彼自身の個人的な不幸に大きく影響されていますが、それでも自己意識を持つすべての人間が内包する絶望を否定することは難しいでしょう。
私と妻はしばしば、同じような傾向を持つ人々を集めた架空のディナーパーティーを考えて楽しみます。例えば、独占欲の強い人々、極端な自己愛者、巧妙な受動攻撃型の人々などを招待するパーティーを想像するのです。しかし、「幸せな人々」を招待するパーティーだけは、どうしても席を埋めることができません。
最初は陽気な性格の人々を何人かリストに挙げますが、しばらくするとその誰かが重大な人生の試練に見舞われるのです——深刻な病気、あるいは子供や配偶者の病気などに。
この悲劇的でありながら現実的な人生観は、私が助けを求める人々に向き合う態度に大きな影響を与えてきました。
「共に旅する者」
治療関係を表す言葉は数多くあります（患者/セラピスト、クライアント/カウンセラー、被分析者/分析者、ユーザー/提供者など）。しかし、これらの言葉では、私の感覚を正確に表現できません。
私は自分と患者を「共に旅する者（fellow travelers）」と考えています。この言葉は、「苦しむ者」と「癒す者」との間にある区別を取り払います。
私が研修を受けていた頃、完全に分析されたセラピストという考え方に何度も触れました。しかし、人生を歩み、同僚と親密な関係を築き、著名な専門家と出会い、自分のかつてのセラピストを助ける立場に立つにつれ、この考えが神話であることを痛感するようになりました。
誰もがこの旅の途中にいるのです。
セラピストであろうと誰であろうと、人間存在に伴う悲劇から免れることはできません。
ヘルマン・ヘッセの『ガラス玉演戯（Magister Ludi）』に登場する、聖書の時代に生きた二人の著名な治療者、ヨゼフとディオンの物語は、私に深く響きます。
若い治療者ヨゼフは、静かに耳を傾けることで癒しを与えました。彼のもとを訪れる巡礼者は、苦しみや不安がまるで砂漠に吸い込まれるように消え、穏やかな気持ちで帰っていきました。
一方、年配のディオンは、積極的に人々を叱責し、助言を与え、罪を指摘し、苦行を課しました。
二人は長い間ライバルとして別々に活動していましたが、ヨゼフが深い絶望に陥ったとき、彼はディオンに助けを求める旅に出ました。
驚くべきことに、旅の途中で彼を導いた年老いた旅人こそがディオンだったのです。
二人は共に暮らし、互いに助け合いましたが、ディオンが死の床についたとき、彼はヨゼフにある告白をします。
実は、あの時ディオン自身も絶望に陥っており、ヨゼフに助けを求めるための旅に出ていたのです。
この物語は、与えることと受け取ること、正直さと隠し事、そして治療者と患者の関係について、深い洞察を与えてくれます。
より深い、真実のつながり
しかし、私は思うのです。
もしこの告白が20年前に行われていたら、二人はより深く、より本質的な癒しを得られたのではないか、と。
ライナー・マリア・リルケは若き詩人への手紙でこう助言しています。
「未解決の問題に対して辛抱強くありなさい。そしてその問い自体を愛することを学びなさい。」
私はこう付け加えたいと思います。
「問いかける者たちをも愛することを学びなさい。」
Yalom より
CHAPTER 3
Therapist and Patient as ‘Fellow Travelers’
André Malraux, the French novelist, described a country priest who had taken confession for many decades and summed up what he had learned about human nature in this manner: “First of all, people are much more unhappy than one thinks … and there is no such thing as a grown-up person.” Everyone—and that includes therapists as well as patients—is destined to experience not only the exhilaration of life, but also its inevitable darkness: disillusionment, aging, illness, isolation, loss, meaninglessness, painful choices, and death.
No one put things more starkly and more bleakly than the German philosopher Arthur Schopenhauer:
In early youth, as we contemplate our coming life, we are like children in a theater before the curtain is raised, sitting there in high spirits and eagerly waiting for the play to begin. It is a blessing that we do not know what is really going to happen. Could we foresee it, there are times when children might seem like condemned prisoners, condemned, not to death, but to life, and as yet all unconscious of what their sentence means.
Or again:
We are like lambs in the field, disporting themselves under the eyes of the butcher, who picks out one first and then another for his prey. So it is that in our good days we are all unconscious of the evil that Fate may have presently in store for us—sickness, poverty, mutilation, loss of sight or reason.
Though Schopenhauer’s view is colored heavily by his own personal unhappiness, still it is difficult to deny the inbuilt despair in the life of every self-conscious individual. My wife and I have sometimes amused ourselves by planning imaginary dinner parties for groups of people sharing similar propensities—for example, a party for monopolists, or flaming narcissists, or artful passive-aggressives we have known or, conversely, a ‘happy’ party to which we invite only the truly happy people we have encountered. Though we’ve encountered no problems filling all sorts of other whimsical tables, we’ve never been able to populate a full table for our ‘happy people’ party. Each time we identify a few characterologically cheerful people and place them on a waiting list while we continue our search to complete the table, we find that one or another of our happy guests is eventually stricken by some major life adversity—often a severe illness or that of a child or spouse.
This tragic but realistic view of life has long influenced my relationship to those who seek my help. Though there are many phrases for the therapeutic relationship (patient/therapist, client/counselor, analysand/analyst, client/facilitator, and the latest—and, by far, the most repulsive—user/provider), none of these phrases accurately convey my sense of the therapeutic relationship. Instead I prefer to think of my patients and myself as fellow travelers, a term that abolishes distinctions between ‘them’ (the afflicted) and ‘us’ (the healers). During my training I was often exposed to the idea of the fully analyzed therapist, but as I have progressed through life, formed intimate relationships with a good many of my therapist colleagues, met the senior figures in the field, been called upon to render help to my former therapists and teachers, and myself become a teacher and an elder, I have come to realize the mythic nature of this idea. We are all in this together and there is no therapist and no person immune to the inherent tragedies of existence.
One of my favorite tales of healing, found in Hermann Hesse’s Magister Ludi, involves Joseph and Dion, two renowned healers, who lived in biblical times. Though both were highly effective, they worked in different ways. The younger healer, Joseph, healed through quiet, inspired listening. Pilgrims trusted Joseph. Suffering and anxiety poured into his ears vanished like water on the desert sand and penitents left his presence emptied and calmed. On the other hand, Dion, the older healer, actively confronted those who sought his help. He divined their unconfessed sins. He was a great judge, chastiser, scolder, and rectifier, and he healed through active intervention. Treating the penitents as children, he gave advice, punished by assigning penance, ordered pilgrimages and marriages, and compelled enemies to make up.
The two healers never met, and they worked as rivals for many years until Joseph grew spiritually ill, fell into dark despair, and was assailed with ideas of self-destruction. Unable to heal himself with his own therapeutic methods, he set out on a journey to the south to seek help from Dion. On his pilgrimage, Joseph rested one evening at an oasis, where he fell into a conversation with an older traveler. When Joseph described the purpose and destination of his pilgrimage, the traveler offered himself as a guide to assist in the search for Dion. Later, in the midst of their long journey together, the old traveler revealed his identity to Joseph. Mirabile dictu: he himself was Dion—the very man Joseph sought.
Without hesitation, Dion invited his younger, despairing rival into his home, where they lived and worked together for many years. Dion first asked Joseph to be a servant. Later he elevated him to a student and, finally, to full colleagueship. Years later, Dion fell ill and on his deathbed called his young colleague to him in order to hear a confession. He spoke of Joseph’s earlier terrible illness and his journey to old Dion to plead for help. He spoke of how Joseph had felt it was a miracle that his fellow traveler and guide turned out to be Dion himself.
Now that he was dying, the hour had come, Dion told Joseph, to break his silence about that miracle. Dion confessed that at the time it had seemed a miracle to him as well, for he, too, had fallen into despair. He, too, felt empty and spiritually dead and, unable to help himself, had set off on a journey to seek help. On the very night that they had met at the oasis he was on a pilgrimage to a famous healer named Joseph.
HESSE’S TALE HAS always moved me in a preternatural way. It strikes me as a deeply illuminating statement about giving and receiving help, about honesty and duplicity, and about the relationship between healer and patient. The two men received powerful help but in very different ways. The younger healer was nurtured, nursed, taught, mentored, and parented. The older healer, on the other hand, was helped through serving another, through obtaining a disciple from whom he received filial love, respect, and salve for his isolation.
But now, reconsidering the story, I question whether these two wounded healers could not have been of even more service to one another. Perhaps they missed the opportunity for something deeper, more authentic, more powerfully mutative. Perhaps the real therapy occurred at the deathbed scene, when they moved into honesty with the revelation that they were fellow travelers, both simply human, all too human. The twenty years of secrecy, helpful as they were, may have obstructed and prevented a more profound kind of help. What might have happened if Dion’s deathbed confession had occurred twenty years earlier, if healer and seeker had joined together in facing the questions that have no answers?
All of this echoes Rilke’s letters to a young poet in which he advises, ‘Have patience with everything unresolved and try to love the questions themselves.’ I would add: ‘Try to love the questioners as well.’
