On Caring in Psychiatry.

Abstract

Otto Allen Will, M.D. has a distinctive voice. When asked to write a commentary on his talk: “On Caring in Psychiatry”(Will, 1979), I found chapters he had written (Will, 1980, 1987), a long interview, actually a counterpoint to this talk (Thompson & Thompson, 1998) and a biographical history of Harry Stack Sullivan and Otto Allen Will, Jr. and their work and ideas (Cornett, 2017). Cornett’s descriptions of Will Jr. and his work, and his voice in talking with colleagues, trainees, patients and analysands fits this talk, and the style of Will Jr’s written work. Cornett (2017) reports that Will Jr. openly said that including autobiographical elements in his writings and lectures helped give him more of a sense of coherence about himself and his life. It is not simple or easy to write a “commentary” on Otto Will Jr.’s ideas. He travels many paths, then diverges in different directions in the forests of his words. Then, onto another path, that ties back to what he said some minutes before, and then sidelong to another one. Themes come forward, some are left hanging, some not to be fully connected, others connected again later. This piece is more symphonic and poetic than didactic. Otto Will’s voice is conversational and without jargon, but this is a serious, but not selfimportant, conversation. His style is one of openness about his own life, and about how he developed as a clinician. He has a basic optimism, but one that is tempered by realism about our world, the complexity of human life and love, and his awareness of the dangers, and particularly, the uncertainties the world presents. His descriptions of the chaotic and frightening political, social and climatological challenges could have been written today. Will Jr. reflects on his life and his life as a therapist, and what he learned about himself, people, the world, attachment, communication, connection, disconnection, failure of communication, loneliness, shame, sorrow, loss and grieving. He communicates his personal experience of the seemingly odd profession in which he has found himself or chosen to wander within: psychotherapist to what he calls “schizophrenia”. Thus, as Will works his way through his ideas about the nature of caring, let alone love, in the psychotherapeutic relationship, the basic underlying idea is that caring means seeing the patient as a whole, real person, with all the complexity that entails; and not romanticizing the patient, the therapist or the therapeutic relationship. As therapists, we tend to think about “caring” in terms of empathy, compassion and dedication to the patient's well-being; the word “love” worries us because of its association with romantic and sexual attachment, and, thus, violation of treatment boundaries. However, these words have many other meanings: one can care for one's shoes; one’s pets; take care to paint the door neatly;