Dear Professor:

I am a 17-year-old student, and I recently ran across your book, The Abyss of Madness. I don’t know much about psychology, but I was able to read and understand your writing. I feel a calling to follow in your footsteps.

I know the road to a career working with severe mental illness is a difficult one, and there has already been discouragement from my family and my teachers about this idea. What people seem unable to understand though is that this work, as you say in your book, opens a window into human existence. As far as I am concerned, no vocation could be more interesting.

I would so appreciate it if you could share any advice you think might be useful for me to keep in mind. I thank you in advance.



My young friend Adam:

I just received your letter, although I see that you sent it some time ago. I am difficult to reach at this point in my life, on most days preferring solitude. Your note unexpectedly moved me: you remind me of myself more than fifty years ago.

I understand that you are dreaming of a career as a psychotherapist. I see as well that you are looking toward using this work as a way of uncovering the secrets of the human condition. I am letting your request for advice flow over my mind like a waterfall, and will share the thoughts that arise. Here are some of the things you are likely to face in this journey.

Expect opposition that will be fierce and sustained. Are you aware that one of the great difficulties encountered in pursuing the sort of career you are envisioning is the terror of madness itself, something that is everywhere present in our society? Anyone who devotes his life to exploring the inner world of so-called mental illness opens up a territory that most people want to remain closed, for fear of being engulfed by it. We want to believe that sanity rests upon a solid and secure foundation, but looking into the face of madness makes us recognize that this is not the case. The fear of insanity is the primary reason, as far as I have been able to understand it, for the bad treatment and the bad science that have haunted this realm for hundreds of years, down to and including our own time. A deep and enduring line is drawn separating madness from health, “them” from “us.” So anyone exploring madness in search of what makes us all human is a threat from the outset, crossing that all important line and blurring the distinction between the sane and the insane. I recall my own father’s reactions, now so long ago, when I told him of my early interests in this connection:

“Why waste your time on that, George? Those people have something wrong with them. Their DNA is twisted and knotted, and there’s not anything you can do. Go into something useful, like chemistry or physics.”

I am guessing you are hearing something similar from the older generation in your family, and my advice on such discouragement is just this: don’t listen to them. They don’t know what they are talking about, and they are also afraid. My father embraced a completely materialistic philosophy and ascribed the depressive moods that haunted his life to “too many enchiladas,” or “too many beers last night.” His depressions, which sometimes took on a variety of unpleasant masked forms, were about his young wife’s death, my mother, and about the profound helplessness he also felt as a childhood victim of polio. I don’t know if it would be correct to say he feared madness; but I know he fled from recognizing the sources of his emotional suffering and his materialism helped him in that flight. 

Don’t bother fighting with those who oppose your career choice – that would be a battle destined to be lost. Instead stand by your interests and convictions, and let nothing hold you back.

Here is a second set of thoughts perhaps worthy of bearing in mind. A serious encounter with people suffering with extreme psychological disturbances inevitably confronts us with ourselves, with our own traumatic histories and all their legacies. It is not possible to journey into the truths of our patients’ lives without being drawn into the truths of our own. I have no knowledge of your personal background, Adam, but I have never known anyone with deep interests in this field who was not a survivor of significant trauma. So whatever your story is, prepare yourself for confronting it in all of its depth and complexity.

Imagine, my young friend, traveling into dark territories of the human soul, places of abuse, of abandonment, of personal annihilation. Visualize the impact of witnessing unbearable conflict and helplessness, of profound decisions to commit suicide, of commitments to starve to death rather than live. Try to picture also though participating in journeys of recovery, wherein life-threatening crises are made to recede and seemingly fatal wounds to the heart are helped to heal. The experience of the clinician who is open to such phenomena is such as to open him or her up as never before, and there is a flooding that then occurs as wave after wave of one’s own personal tragedies come flowing in. The best kept secret of my field is that the healing journey of psychotherapy inevitably and always embraces both participants. If the analyst or therapist is closed off from the possibilities of personal transformation, the challenge of meeting the patient in the space wherein his or her life has foundered will awaken hatred and fear, and the so-called therapy will devolve into a process that freezes rather than liberates. 

Imagine also though the fulfillment and joy when one has made a difference that is healing to someone. There is no experience in our professional lives that can compare to this one.

These are my thoughts for today. Write again if the spirit moves you to do so.

George Atwood

About the Author

George Atwood, Ph.D.

George Atwood, Ph.D., is a professor of psychology at Rutgers. He is the author of The Abyss of Madness, which examines therapeutic approaches to psychotic states.

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