Erik Erikson’s book, Insight and Responsibility was a series of previously published essays put together to form a book. The first chapter was an address given by Professor Erikson on the occasion of Freud’s 100th birthday, held jointly by the Universities of Frankfurt and Heidelberg. An important part of the rationale for the celebration was that under Hitler’s National Socialism much of Freud’s contribution to psychology had been erased for a generation of German students. The first chapter emphasizes some of the important reasons that Erikson felt such a deep admiration for his mentor, the figurative Father of psychoanalysis, and how important Freud’s contributions were to Erikson’s life work.
Erikson likened the lonely struggles to advance mankind’s knowledge by Darwin in identifying evolution, and by Freud in discovering the unconscious and its role in health and mental illness. Erikson referred to Freud’s hysterical patients as being a source of insight similar to the role the Galapagos Islands played for Darwin. He compared both men’s doggedness in pursuit of truth and the psychic toll of discovery on both men:
• “He (Freud) became aware of the fact that man, in principle, does not remember or understand much of what is most significant in his childhood, and… that he does not want to. Here a mysterious individual prehistory seemed to loom up, as important for psychology as Darwin’s biological prehistory was for biology.”
• “Before Copernicus, vanity as well as knowledge insisted that the earth must be in the exact nodal center of God’s universe… Before Darwin, man could claim a different origin from the rest of the animal world with whom we share a slim margin of the earth’s crust and atmosphere. Before Freud, man (that is man of the male sex and better class) was convinced that he was fully conscious of all there was to him, and sure of his divine values. Childhood was a mere training ground, in charge of that intermediary race, women”
• “Freud had to relinquish a most important ingredient of the doctor role of the times: the all-knowing father role, which was safely anchored in the whole contemporary cult of the paternal male as the master of every human endeavor except the nursery and the kitchen. This should not be misunderstood. Freud did not, overnight, become a different man… True roles are a matter of a certain ideologic-esthetic unity, not of opinions and appearances. True change is a matter of worthwhile conflict, for it leads through the painful consciousness of one’s position to a new consciousness of that position. As Justice Holmes has said the first step to a truer faith is the recognition that I am not God…Now he (Freud) discarded the practicing neurologist’s prevailing role of dominance and license…. He had to create a new therapeutic role for which there was no ideological niche in the tradition of his profession. He had to create it – or fail.”
• “Knowing what we know today it is obvious that somebody had to come sometime who would decide that it would be better for the sake of the study of human motivation to call too many rather than too few things sexual, and then to modify the hypothesis by careful inquiry. For it would be only too easy to do what had become civilization’s ‘second nature’, that is, in the face of man’s sexual and aggressive drives to beat a hasty retreat into romanticism and religionism, into secrecy, ridicule, and lechery. The patients’ fantasies were sexual, and something sexual must have existed in their early years. Freud later called that psychosexuality, for it encompasses the fantasies as well as the biology in the earliest stages of human sexuality.”
• “Freud’s case studies have given to the study of lives a demonic depth to be found before him only in drama, in fiction, and in the confessions of men endowed with passionate introspection.”
• “This shift in self-awareness… cannot remain confined to professional partnerships such as the observer’s with the observed, or the doctor’s with his patient. It implies a fundamentally new ethical observation of adult man’s relationship to childhood: to his own childhood, now behind and within him, and to every man’s children around him.”
In chapter two, Erikson sets out to answer the question, ‘How does a clinician work?’ With the sentence, “Let me now review the elements making up the core of medical work as the encounter of two people, one in need of help, the other in the possession of professional methods…” Erikson begins a practical summary of clinical work.
Besides this summary of the Doctor-Patient encounter, the following quotes summarize the most important things I have taken away from the second essay:
• “Clinical work is always research in progress.”
• “Scientists may learn about the nature of things by finding out what they can do to them, but the clinician can learn of the true nature only in the attempt to do something for and with him (the patient).”
• “Perhaps there are certain stages in the lifecycle when even seemingly malignant disturbances are more profitably treated as aggravated life crises rather than as diseases subject to routine psychiatric diagnosis.”
In his third essay, Erikson discusses identity from the perspective of emigration and forced migration. He develops the metaphor of establishing human connection or rootedness with the lifecycle challenges of maturing children and adults. He also draws parallels between parent-child, and doctor–patient relationships, as examples of psychosocial conflicts or crises.
In a fourth essay, Erikson reviews some of his lifecycle work, from the perspective of a schedule of virtues. Through the efforts to solve a normative conflict, each of the stages leads to the development of a new strength:
Stage Conflict or crisis Strength or virtue
Infancy Trust vs. Mistrust Hope
Toddler Autonomy vs. Doubt Will
Pre-school Initiative vs. Guilt Purpose
School-age Industry vs. Inferiority Competence
Adolescence Identity vs. Confusion Fidelity
Young adult Intimacy vs. isolation Love
Middle age Generativity vs. stagnation Care
Old age Integrity vs. despair Wisdom
In his fifth essay, Erikson catalogs some of the characteristics of healthy identity formed in the adolescent pursuit of fidelity: veracity; accuracy; authenticity; truthfulness; fairness; genuineness; and reliability.
In the sixth, and final essay, Eriksen examines the Golden Rule, in light of his life’s work with the normal human lifecycle and the stepwise resolutions of successive internal conflicts. This essay was originally a lecture delivered in India, so the author began it with some comparisons between Hindu Vedic concepts and Christian scriptures. The author learned of the Vedic ideas during his intensive study for the writing of Gandhi’s Truth.
Erikson emphasizes the subtle differences between morality, which comes from within, and ethics, which are externally imposed. He strongly opposes the use of threats or punishments to manipulate behavior. He explores the idea of mutuality developed during the healthy, stepwise maturation process, and perspective on the Golden Rule that develops within the maturing ego or personality. As he does throughout this book, Erikson examines both clinical care for patients and clinical research from patient histories as moral endeavors, guided by what the Doctor does for and with, rather than to his/ her patient (mutuality and care).
Erikson quotes another of his favorites, George Bernard Shaw, ‘Don’t do to another what you would like to be done by, because his tastes may differ from yours’, setting up the ending by Rabbi Hillel, who stated, what Nasim Nicholas Taleb has called the Silver Rule: Don’t do to others what you would not have done to you’. Famously, the rabbi reportedly said this admonition encompasses the essence of the Torah so all that remained was for the believer to live it.
Insight and Responsibility is another one of Erikson's scholarly contributions to understanding normal, healthy human psychosocial maturation. it is another of his protean efforts to apply his insights to a range of human behavior. I have found it to be well worth the effort I have needed to try to read it with understanding.