Therapeutic goals and ideals of health

Abstract

A therapist has the task of healing illness. Illness may be defined as serious deviation from some ideal. The ideal will be variously described by different people: their descriptions will help define any illness that deviates from the ideal and direct their efforts toward healing. I am writ ing chiefly of the psychotherapist, but what I say will apply to many kinds of healing or counseling. Without a clear conception of the well person, the therapist risks a vagueness of clinical aim and technique in treating the sick one. There is, perhaps, less agreement on the matter than appears when we talk of mental health or maturity. It is easier to speak of character defect or neu rotic personality than to agree about what makes up a character without defect or a neurosis-free personality. Whenever one tries to help another, he has in mind some such criteria of health, which may be subtle or obvious, latent or openly acknowl edged. He may defer to the one he is helping in the setting of ideals, but this deference is based upon the belief that help is best given by thus deferring. If one chooses relative inactivity in therapy, he in no way negates his ideal of health. It is more often vague than clear, but it tends to dominate the treatment from beginning to end. The ideal of health holds the same relationship to limited goals of therapy as the pole star holds to a trip northward. It defines the direc tion of our effort, although we do not expect, in a practical way, to attain it. The terms "ideal" and "goal" will be used more or less inter changeably in this essay. I believe ultimate views of human health actu ally operate, usually unrecognized, in the therapist's daily techniques.