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Notes on the Psychology of Hope

W. W. M E I S S N E R ,

S.J.

The psychopathology of hope I t was Nietzsche, in his c o n s u m m a t e cynicism, w h o r e m a r k e d that " H o p e is the worst of all evils, for it p r o l o n g s the t o r m e n t of m a n . " But as any psychiatrist k n o w s well, m a n ' s h o p e f u l n e s s is n o t his torment; it is rather his loss or failure to h o p e that torments his soul. M a n loses h o p e and becomes hopeless by w a y of defect; he w i t h d r a w s from h o p e by a failure to wish, to desire, to a m b i t i o n , or to plan. H e also becomes hopeless by way of excess, by c l i n g i n g to excessive expectations b e y o n d the limits of w h a t is realistically possible. It is the b u r d e n of m a n ' s o m n i p o t e n t expectations that p r o l o n g s his torment. T h e sense o f hopelessness that pervades so m a n y forms of p s y c h o p a thology is p e r m e a t e d by a sense o f the impossible. T h e hopeless person feels that he is c a u g h t in a prison f r o m w h i c h there is n o exit. W e can recognize the loss of a radical form of h o p e in the depressed, w i t h d r a w n , a n d apathetic states of seriously d i s t u r b e d patients and, at less intense levels, of neurotic patients. We can recognize a failure or distortion of the ThE REv. W. W. MEISSNER,s.J., M.D.,a member of the Boston Psychoanalytic Institute, is Instructor in Psychiatry at the Harvard Medical School and Staff Psychiatrist at the Massachusetts Mental Health Center. This is the second part of a two-part article. The first part appeared in the January issue.

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capacity for spontaneous willing and willingness in the compulsive behaviors of the obsessional, as well as the loss of purposeful restraint in narcissistic and impulse disorders. Hopelessness embraces a sense of futility, a sense of the unattainability of goals and purposes regardless of activity. What needs to be done seems to stand beyond one's capacity to perform or achieve. T h e patient is trapped and checkmated. His watchword is "I can't!" His perspective of the world and of himself is immersed in impossibility. In his hopelessness, the patient makes a basic presumption that he possesses no inner resources to bring to bear on the solution of problems or the fulfillment of wishes--or at least that his inner resources are completely inadequate. In his feelings of frustration and inadequacy, he may expect or demand that others do things for him. He may be unwilling to try, but at the same time may be angered and resentful that others do not respond to or satisfy his wishes. In his sense of frustrated entitlement, he may blame others for their failures and become enraged at their inability to satisfy his expectations. T h e shifting of blame and responsibility away from oneself and onto others is often accompanied by projections of malignant and evil intent on others, a process that can become frankly paranoid. Basic to this position of hopelessness is the perception of oneself as unworthy, inadequate, unacceptable, valueless. This perception is based on a fantasy that provides an inner core of self-perception. It reflects the underlying function of a persistent and resistant introj ect derived from the internalization of the punitive and hostilely aggressive parent. This internalization gives the child a sense of inner evil and destructiveness and subsumes the inner instinctually derived impulses of hateful destructiveness and infantile wishes to hurt and damage. This internalized destructiveness builds a negative sense of self that permeates the rest of the individual's life and experience and activity. It colors all the rest and remains stubbornly resistant to any alteration by the influence of reality factors. One often sees clinically depressed patients w h o persistently maintain this view of themselves as worthless and devalued in the face not only

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of a lack of confirming evidence, but not infrequently in the face of overwhelming evidence to the contrary. T h e sense of inner conviction of worthlessness carries on independently of any influence of reality. The inner sense of evil means that the individual cannot perform good acts, cannot set useful goals, has no right to hope or strive, for what it produces must bear the stamp of its origin: worthlessness and evil. This pattern of internal organization has been described in psychoanalytic terms by the functioning of a primitive and punitive superego. The superego functions in a harsh, critical, and devaluing manner and is conceived as the agency of internal self-deprecation. By way of the superego, the infantile sadism and hostile destructiveness are directed against the self so that depression, guilt, and self-devaluation are the result. This may affect the individual's behavior as well, so that the internal dictates of the superego are lived out in a variety of forms of self-defeating and selfdestructive activity. It is as though the superego's claim that the person is worthless and evil serves as a mandate, which is then acted o u t - - a selffulfilling prophecy of self-defeat and self-degradation. This process is an operative mechanism in m a n y forms of mental disturbance and mental illness. The severity of the self-destructive wishes may reach the point of suicidal wishes and action. In seriously sick and psychotic patients, the power and destructiveness of these instinctually derived forces are often overwhelming. T h e activity of the superego is at the root of what L y n c h has called the absolutizing instinct. 1 T h e absolutizing instinct arises in the developmental failure to achieve a capacity to tolerate and resolve ambivalence. In the course of development, one of the important tasks that the child must accomplish is the resolution of ambivalence toward the important figures upon whom he is dependent. He must be able to accept the feelings of hateful anger and destructive wishes toward the important figures w h o m he also loves. T h e primary figures for the child are the powerful parents. If he were to express and give vent to his angry and hateful feelings, he would r u n the risk of loss of love and a b a n d o n m e n t or rejection, and even punitive retaliation. These issues are resolved in the separation-individua-

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tion process. T h e parents must help the child to tolerate and resolve his hostile and destructive wishes and help h i m grow to realize that his aggressive impulses and wishes are not intolerable or evil. Where this resolution does not take place, the child learns to absolutize, to cling to simple and simplistic ways of thinking and feeling in his relations with other people. If he loves, he can find no room for negative feelings; if he is angered, he can find no room for love. He treats these feelings as though they were absolute and exclusive. Since, in fact, there is no h u m a n relation that perdures over a significant period a n d has any real significance that is without ambivalence, the absolutizing tendency works considerable havoc and i m p a i r m e n t in interpersonal relations. The inability to tolerate negative affects is dealt with by the internalization of aggression, as I have suggested. T h e outcome is an increase of the severity and destructiveness of the superego and the intensification of self-punitive. and self-devaluating processes. Positive and loving feelings toward the significant objects are preserved at the cost of p u n i s h i n g and devaluing oneself. T h e splitting of the two sides of the ambivalence and the absolutizing process was described by Freud in his M o u r n i n g and Melancholia. 2 In his considerations of the dealing with ambivalence toward a lost love object, Freud uncovered the introjective mechanisms that led to his understanding of the superego. When the loved person dies, for example, the mourner may feel a sense of guilt or worthlessness in addition to his grief. T h e negative feelings toward the dead person are submerged and the good aspects of the dead person and positive feelings toward h i m are p u t in the ascendancy. N i l de rnortuis nisi b o n u m . Negative and hostile feelings, particularly any angry and destructive wishes for the person's death, are out of place. T h e absolutizing conscience demands this, but it is impossible. So the m o u r n i n g may continue for months and years in an attempt to deny, avoid, repress the negative aspects of the ambivalence. T h e m o u r n e r continues to punish himself for the anger and destructive wishes that he cannot tolerate or accept in himself. Hopelessness is related to the individual's subjective estimate of the

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probability of achieving certain goals. ~ Plans and goals seem to be out of joint. Goals may be sought a n d striven for long after any realistic expectation of their fulfillment is past. Plans may be restricted merely to immediate short-term goals to the exclusion of any long-term purposes. T h e expectation of hope is that plans of action will reach a n d achieve anticipated goals. Hopelessness expects failure; p l a n n i n g is futile and meaningless. T h e disjunction of plans a n d goals a n d the feeling of hopelessness are most characteristically f o u n d in depressed patients. T h e y form the central and basic theme of depression. T h e patients are overwhelmed with a sense of purposelessness a n d futility. T h e depressive patient is afflicted with a sense of hopelessness a n d helplessness. He believes that his skills and capacities are inadequate to achieve the goals he has proposed for himself, that his failure is due to his own inner inadequacy and incompetence, and that his previous attainments or accomplishments are meaningless a n d w i t h o u t value. He has a sense of helplessness, of dependency on others for any attainment or gratification, and of being foredoomed to futility in any exercise of his o w n resources. His incentive is lost; he sees no recourse but to give up. T h e depressive patient does n o t surrender his goals, particularly the continuing and long-range ones. He despairs because of the disparity between aspirations a n d achievements a n d because of his sense of the unattainability of his goals. T h e experience of frustration a n d the sense of impossibility do not extinguish such long-term goals a n d aspirations. T h e depressive patient, in this view, clings to a future that is thwarted a n d frustrated. His belief is that his o w n capacities a n d skills are the source of any possibility of attaining such goals, but that his resources are too meager and do not measure u p to the task. T h e picture in the sociopath is s o m e w h a t different. T h e sociopath believes that his o w n capacities a n d plans have little to do with his attainm e n t of future goals. He sees others as interfering with any attempt of his to reach goals, and thus as being to blame for his frustrated lot. Any attempt to set goals that w o u l d be p e r d u r i n g or long-range is foredoomed to

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failure. The sociopath thus finds himself in a chronic state of hopelessness that permits little future orientation. He escapes this feeling of futility by seeking his rewards and gratification i n the present, with little regard for the future. T h e more distant and future any given goal, the less realizable does it seem to him. He sees his future as out of his own hands and in the control of others. These others are basically hostile and not to be trusted, so that a n y p l a n n i n g or setting of hopes for the future are doomed to failure. While the depressive patient takes the responsibility for setting and attaining goals, he devalues and undercuts his own inner resources to achieve them. But the sociopath does not accept this responsibility. He places the responsibility elsewhere and satisfies his feelings of entitlement by taking his gratification from the present without regard to long-term effects or consequences. A similar shift is seen in paranoid patients who blame the hostility of others for their own failure or inadequacy. A particular manifestation and expression of hopelessness is boredom. Boredom carries within it a sense of purposelessness, of the meaninglessness of things, of a lack of interest, of apathy and general disinterestedness. It is the death of wishing. It may mask itself in forms of hyperactivity and hypomanic flourishes--forms of pseudowishfulness and pseudohopefulness. But it is substantially a withdrawal of cathexis from things and objects in the environment. T h e withdrawal and the cessation of wishing are essentially narcissistic. Boredom is an expression of the sense of entitlement that places the responsibility for stimulation, interest, attraction, and involvement on other agents besides oneself. It is a disappointment with the world, a reaction to the denial of expectations, a falling out of love with reality. In its basic disappointment, the reaction of boredom is hostile. It represents a hostile, narcissistic withdrawal. Its withdrawal of interest and involvement covers an implicit hostility expressed in a devaluing disregard for what lies beyond the boundaries of one's self. Boredom is an expression of the deeper resentment that the world has not done for me what I can only do for myself. In an excellent phrase, Marcel calls this a "narcissism of nothingness."

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The psychotherapy of hopelessness Our discussion of the functions and the dysfunctions of hoping and hopefulness come to a particularly real and vital focus in the psychotherapeutic process. It has been my experience, along with that of others who engage themselves with the inner worlds of psychologically impaired patients, that the achievement of a hopeful attitude is a central ingredient in any therapeutic success. I have found this to be verifiable even in healthier analytic patients. I would like to focus at this ~point-on some of the specifics of the h u m a n process of psychotherapy in order to lend some clarity and depth to the synthetic views we have been discussing. We can observe, to begin with, that the psycho~herapeutic situation is geared to the generation of hope. Hope is not possible in a vacuum. It takes place within and derives from a meaningful i n t e g r a t i o n of the individual in a context of real h u m a n relationships. Man develops hope in other men even as he derives help from other men. T h e initial roots of hopefulness are laid down in the interchange and mutual regulation and responsiveness of the child and his mother. T h e generation of hope requires the trusting dependence on another h u m a n being. T h e therapeutic context requires and intends such a real contact of man and man. Patients find countless ways to avoid the reality of the therapist, but the therapeutic action and the genesis of hope rest on the basis of a real relationship between therapist and patient. In the analytic model, the process requires a therapeutic alliance as a central constituent of the analytic situation in order to make the work of the analysis possible. It is likewise the basis of hope. T h e therapeutic process takes place through the medium of language, the expression of inner thoughts, feelings, associations, observations. T h e patient's engagement and c o m m i t m e n t to this process within the doctorpatient relationship is an engagement in a time-limited process that works itself out step-by-step in a slow, gradual exploration of the patient's inner life and experience. At each step of the process the patient must commit himself to and engage in the reality of the next step and in the reality of

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the process. T h i s gradual reality-limited process runs c o u n t e r to the implicit expectation that underlies his hopelessness a n d u n d e r m i n e s his capacity to hope. H i s sense of frustration a n d futility is based on an allor-none expectation that says implicitly: " If w h a t I need to a c c o m p l i s h cannot be a c c o m p l i s h e d all at o n c e - - a n d n o w - - i t c a n n o t be a c c o m p l i s h e d at all! So what's the use?" T h e patient's hopelessness can offer m a n y objections to the efficacy or utility of the process, b u t e n g a g e m e n t in it sets the stage for a process of i m m e r s i o n in reality, w h i c h is never all-orn o t h i n g a n d w h i c h engenders the frustration of w o r k i n g t h r o u g h of m a n y c o m p l e x elements piece-by-piece. T h e therapeutic process b o t h builds a n d requires a capacity to tolerate delay a n d the p o s t p o n e m e n t of effective a n d satisfying results. Hopelessness does n o t w a n t to take a limited next step and to keep on taking next steps; it wishes to leap to the final result. T h e r e i n lies its impossibility. O n l y in taking the next step does the p a t i e n t find a n d achieve a sense of the possible. This sense of the possible is central to the process. Patients m u s t g a i n a sense of w h a t is possible a n d w h a t is not. H e a l t h y a n d m a t u r e persons learn this discrimination, a n d they learn to live w i t h i n its limits. M a n has legs, b u t n o wings. Man can walk, b u t he c a n n o t fly. T h e hopeless p a t i e n t does n o t accept that discrimination; he has n o t learned to live in terms of it. One of m y patients was a very intelligent a n d gifted y o u n g m a n w h o c o n t i n u e d to live his y o u n g adult life in terms of his inner adolescent dreams of glory. H i s academic career was strikingly successful, b u t w h e n he began to experience d i s a p p o i n t m e n t s a n d was n o l o n g e r able to meet his o w n idealistic expectations, b o t h in his w o r k a n d in his w o r k i n g o u t of a m e a n i n g f u l heterosexual relationship, he became intensely a n d suicidally depressed. As his narcissism a n d his elaborate expectations became clearer, we b o t h began to realize that he w o u l d have to m o d i f y or surrender some of this excessive expectation in a m o r e realistic direction. I commented o n e day, " Y o u k n o w , y o u seem to w a n t to fly; most of us have to content ourselves with w a l k i n g . " "I k n o w , " he replied, " b u t the t r o u b l e is, G o d d a m n it, that part of me still insists o n flying!" T h i s y o u n g man, for all his capacities a n d real a t t a i n m e n t s in a c a d e m i c

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life, had allowed himself to become paralyzed and suspended in a state of diffuse equilibrium and lack of c o m m i t m e n t to adult roles and functions. He could not determine on a career--nor could he settle on a satisfactory mate--even though there were many available candidates. On the instinctual side, he was trapped in incestuous ties of dependency on his mother and frightened by oedipal concerns over aggressive competition with his rather authoritarian father in assuming adult roles and functions. As he neared the end of his schooling and the necessity for decision, these inner conflicts were intensified. T o avoid them, he clung to his infantile narcissism and omnipotence; but in so d o i n g found himself unable to satisfy these excessive demands and expectations and responded with intense feelings of hopelessness and helplessness. T h e r a p y for this y o u n g m a n was a process of self-discovery, of discovering his own real power and limits, his capacities and incapacities, as a child begins to discover himself in his increasing ability to separate from his mother. For this young man, as for so m a n y others, the learning to recognize and tolerate ambivalence was a central part of the therapeutic process. In his idealism, for example, he had set himself the ideal of a pure and sexless love with a w o m a n of great beauty and noble aspirations and intelligence. When his love objects failed to meet this high standard, he could not tolerate his anger and disappointment with them. Instead of anger at these women, he experienced his depression. In his altruism, as well, he expected everyone he worked with to be high minded and selfless, as he tried to be himself. His expectations were continually being disappointed and frustrated, and again he could not manage the inner sense of disappointed rage. It issued in a vague sense of resentment and alienation from the society in which people behaved in their own interest, in utopian wishes for an idealized social and political order, and in a wish to withdraw from any participation in the real world that surrounded him. Clinically, he presented the picture of what Erikson has described in terms of "identity diffusion."4 T h e toleration of ambivalence and the capacity to resolve it are one of the essential tasks of healthy development. T h e tendency to abolutize and

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idealize reflects an u n d e r l y i n g intolerance of ambivalence a n d a loss of hope. Love a n d hate, however, are part of the staples of h u m a n life a n d experience; they inhere in any m e a n i n g f u l h u m a n relation. T h e therapist can help the patient come to recognize a n d accept these aspects of himself where the patient cannot accept his hate or his love. Often these feelings are worked out within the relation to the therapist, the p h e n o m e n o n of transference thus becomes central for the w o r k i n g t h r o u g h of ambivalence. T h e patient then has an o p p o r t u n i t y to work t h r o u g h the developmental achievement that he could not resolve with his real parents. W h e n this is achieved, the patient can begin to live with a certain degree of uncertainty, he is not compelled to perceive a n d r e s p o n d to life in terms of absolutes, and the role of magical expectations a n d demands begins to diminish. Reality is uncertain a n d real relations are ambivalent; with increasing tolerance for ambivalence, the patient gains an increasing tolerance for a n d contact with reality. T h e reality in and t h r o u g h which this resolution is immediately attained is the real relation with the therapist. In a t t a i n i n g a m e a n i n g f u l contact with the therapist, the patient begins to turn from sickness toward health, from alienation toward social involvement, from narcissism toward realism, from hopelessness toward hope. T h e achievement is n o t always easy or accomplished w i t h o u t considerable effort. One of m y analytic patients came to analysis with an inner conviction that his entering into treatment was a hopeless gesture that w o u l d only conclusively prove his inadequacy a n d the impossibility of any m e a n i n g f u l help for his anxiety and depression. From the first m o m e n t s of our involvement, he responded to me as a critical, controlling, p u n i s h i n g , a n d j u d g i n g authority figure. His response was fear, severe anxiety, a feeling of helplessness and hopelessness, and wishes to fight back in an angry, rebellious, a n d recalcitrant manner. It took m a n y m o n t h s of careful clarification a n d interpretation and repeated o p p o r t u n i t i e s to test o u t his fearful a n d hostile anticipations w i t h i n the therapeutic relation b e f o r e h e could sufficiently set aside his subjectively determined perceptions to begin to recognize the reality of my person and of his relation to me. Only w h e n he was able to

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appreciate the transference elements in his r e s p o n s e - - d e r i v e d from an insecure, controlling, overly possessive a n d intrusive m o t h e r - - c o u l d he begin to see that the fears a n d expectations h a d been generated from w i t h i n a n d that these a n t i c i p a t i o n s distorted his perception of his relation to me, b u t also distorted m a n y other relations a n d situations in his life. O n l y w h e n the fantasies derived from an infantile level of experience were clarified a n d separated o u t could this otherwise intelligent a n d capable y o u n g m a n begin to deal w i t h the reality. T h e contact w i t h reality started a process that gave h i m renewed h o p e a n d a sense of the possibility of things a n d of himself. Father L y n c h has described this process admirably: To put the matter as simply as possible: The patient begins to feel, after the travail of work and of grace, that the doctor is on his side. Until that moment the doctor has been a judge, a punisher, hostile, a threatening giant, an enemy with whom to contend. He is the law in all its objectivity and exteriority. He is the symbol of all the exterior and interior giants before whom we seem helpless. He is omnipotent with an omnipotence that forbids interior growth, action and equality. The agonies of the sick before such images are incalculable and without hope. . . . The first insights into the possibility of mutuality are remarkable in their effects. This transfiguration is the object of all the hopes of the sick and the well. Now that one point of reality is transformed, the whole of reality is transformed with it. The doctor, who was the enemy, is now seen in his actual role of a helper: as a result half of the pain vanishes, because t h e pain had been a construct of hopelessness. The patient had felt the constant need to be alert; but now he enters a new and creative passivity that acts almost without acting, because it now wishes with and not against, and is felt to be wished with by another. ~ In therapy, the p a t i e n t m u s t not o n l y find a basis i n the reality of his relation with the therapist, but he m u s t find sufficient trust in the therapist a n d in the process to enable h i m to delay his wish a n d to c o n t i n u e to work toward therapeutic goals. Patients often c o m e to the treatment process w i t h magical expectations of cure or w i t h p e r e m p t o r y d e m a n d s for instant relief from their anxiety or depression. T h e b e g i n n i n g of h o p e for them is s y n o n y m o u s w i t h the willingness to wait, to tolerate the u n a v o i d a b l e delay, a n d to set their sights o n distant goals for w h i c h they are w i l l i n g to work. In accepting these limits of the reality a n d possibility o f the thera-

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peutic process, they are beginning to surrender mere wishfulness and willfulness and becoming more attuned to and accepting of reality: the reality of themselves, of the limitations of the treatment situation, and perhaps most significantly of the limitations and lack of omnipotence of the therapist. One of the formulae that Freud originated for describing the therapeutic process was that of m a k i n g the unconscious conscious. H e thus underlined one of the essential aspects of the therapeutic process that contribute to the evolution of hope. T h e neurotic symptoms with which patients are afflictedmdepressions, anxieties, phobias, etc.--are unconsciously derived and consequently overwhelm the patient. He cannot understand what is h a p p e n i n g to him. He feels that he is being afflicted by alien forces over which he has no control. One y o u n g w o m a n came to treatment with desperate feelings of depression and anxiety. She felt worthless and frustrated--unhappy with her work and with her heterosexual relations. She felt helpless, unable to see any reason for these desperate and depressed feelings. It did not take very long for us to discover in her history a most malignant and devaluing relation with a hostile and probably schizophrenic mother and a rather distant and u n c a r i n g father. When she became aware of the nature of this relation and her c o n t i n u i n g rage at her mother, it became possible for her to look at what she was experiencing in realistic terms of anger directed toward a frustrating and hostile mother. It then became possible for her to deal with that anger and to do something about it. T h e bringing of such pathogenic unconscious material to consciousness has important consequences for the Patient. It means that what he is experiencing is not an affliction by nameless and uncontrollable forces. It has meaning, it has an identifiable source, it serves specific purposes, and it relates to specific contexts, objects, and behaviors. But even more significantly, beyond the real context in which the problem becomes located, the patient comes to realize that what he is dealing with is his own thoughts and feelings and that these are after all within his capacity to control and direct. He is not a helpless victim. He is capable of determin-

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i n g h o w he wishes to evaluate a n d respond to the distressing a n d difficult situations that confront him. His s y m p t o m s have m e a n i n g as unconsciously determined ways of dealing with painful conflicts, but he has available to h i m other o p t i o n s a n d more effective ways of dealing with these conflicts, if he so chooses. B r i n g i n g unconscious elements into the light of awareness brings them into contact with reality a n d draws t h e m into the orbit of real possibility. T h i s opens the way from unconsciously determined hopelessness to hopefulness based on the awareness of real possibility. While the therapeutic process serves to induce even as it builds on hope, the patient is often n o t willing to surrender his hopelessness. Patients may repudiate hope a n d m a i n t a i n considerable conflict about allowing themselves the luxury of hoping. As French observed, the r e p u d i a t i o n of hope may be a central a n d highly significant resistance. 6 T h e emergence of h o p e brings with it a revitalizing of the traumatic experiences that u n d e r m i n e d h o p e in the past. W h e n the patient begins to h o p e a n d to take his hopes seriously as really possible, he m u s t assume the responsibility for d o i n g s o m e t h i n g about them. Often the associated t r a u m a relates to the fears of separation, loss, a n d a b a n d o n m e n t that were aroused in the child, s early attempts to separate and function m o r e independently of his protective and supportive parents. T h e hopeful anticipation of the possibility of f u n c t i o n i n g on one's o w n makes the essential developmental separation from the maternal matrix possible, but the failure to resolve ambivalence can impede the process. T h e same p r o b l e m can arise in therapy where the patient's incipient hopefulness can be overridden by his unresolved ambivalence. Moreover, certain patients may cling to a regressive a n d narcissistic position that a more hopeful a n d realistic stance w o u l d require them to surrender. In any n u m b e r of relatively depressed patients, one sees a persistent c l i n g i n g to the inner conviction of specialness. T h e y o u n g m a n m e n t i o n e d above c l u n g quite stubbornly to the conviction that he was so u n u s u a l a n d special a case that even psychoanalysis c o u l d n o t cure h i m . There is a special inner gratification that is overlayed by feelings of depression a n d worthlessness in c l i n g i n g to a hopeless a n d helpless posi-

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tion. This narcissistic entrenchment can provide a powerful resistance and challenge the limits of therapeutic skill and possibility. T h e patient must come to see that he is clinging to an infantile position and that he can find a better and more effective way. He must also see that he has it in his power to choose between these courses. T h u s the psychotherapy of hopelessness is a slow and painful process of coming to grips with reality--both the reality outside oneself and the reality within oneself. As Lynch has remarked: " . . . the fact is that reality is healing for those who are without hope, and it is the separation from reality that causes despair. It is all the forms of separation that cause all the degrees of hopelessness. It is all the degrees of contact that give us t h e degrees of hope. ''7 T h e therapeutic process seeks its objectives by exploring and resolving the pain a n d rage of separation and by bringing to bear all the forms of contact with the real: contact with the reality of self in inner unconscious feelings and thoughts, contact with inner fantasies and instinctually colored imaginings, contact with the therapist with all its inherent feelings of love and inner rage, contact with the reality of one's own limited capacity and potentiality, contact with the reality of one's meaningful relations with other h u m a n beings with all the pain a n d satisfaction they entail. Only to the extent that therapy achieves these contacts and resolves their latent uncertainties and ambivalences does it engender hope that sustains and perdures. In r o u n d i n g off these comments on the psychotherapy of hopelessness, I would like to quote a passage from Marcel's H o m o Viator. As Marcel saw so well, it is the essence of m a n to be a viator, to be on the way toward a goal beyond himself, and the essence of that is hope. T o hope, to be able to hope, to be able to accept the limits of self and reality, to be able to look to the future with realistic anticipation and purposeful striving-this is what it means to be h u m a n . Marcel comments: To sum up, I should say that the mode of thought of which I have tried today to analyze two particularly significant manifestations (rentanciation of hope), can be conceived either as a perverse but fascinating game, or at a deeper level and more truly, as the end of a process of auto-destruction which is going on within a

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doomed society, within a humanity which has broken, or thinks it has broken, its ontological moorings. However this may be, it is nothing but a pure and simple imposture to claim to hold up as some unheard-of metaphysical promotion or as a triumph of pure lucidity the really blinding gesture by which all that humanity has ever acquired is swept away and we are thrust headlong into the dungeon, itself a sham, of a Narcissism of nothingness, where we are left with no other resource but to wonder tirelessly at our courage, our pride and our stubbornness in denying both God and the being full of weakness and hope which in spite of everything and for ever--we are. 8 T o the degree that we offer o u r patients the possibility of b e c o m i n g truly h u m a n , we offer them the r u d i m e n t s of h o p e - - t h e sense of real and h u m a n possibility.

Integration My effort here has been to draw together the strands of an u n d e r s t a n d i n g of h o p e that derive from c o n t e m p o r a r y theological perspectives as well as from the u n d e r s t a n d i n g of psychological process as e m b o d i e d in the course of d e v e l o p m e n t a n d in the concrete experience of achieving hopefulness in the clinical therapeutic encounter. T h e parallels between the more c o n t e m p o r a r y theological f o r m u l a t i o n s a n d p s y c h o d y n a m i c understandings are ready a n d e a s y - - s o m u c h so that the u n d e r s t a n d i n g of the basis of Christian h o p e in a creative eschatology focused a n d e m b e d d e d in the real world of h u m a n life a n d experience finds its i m m e d i a t e counterparts in the therapeutic concerns for reality testing a n d the achievement of real h u m a n relatedness. In these terms, one c o u l d personalize the theological f o r m u l a t i o n s and thus translate them into perfectly lapplicable psychological terms, or o n e c o u l d theologize the psychological formulations a n d readily a p p l y them to eschatological concerns. T h e parallels a n d the areas of potential overlap, however, d o n o t violate the essential distinction a n d differential focus of the respective areas of discourse. T o b r i n g these a p p r o a c h e s to a focus, the c o n c e p t of h u m a n i z a t i o n or " h o m i n i z a t i o n " serves rather well. It was T e i l h a r d de C h a r d i n w h o first enunciated the themes of the sanctification of h u m a n endeavor a n d the

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h u m a n i z a t i o n of Christian endeavor as r u d i m e n t a r y to Christian spirituality. T h e " m a k i n g h u m a n " is the i n t e n t a n d objective of C h r i s t i a n theology a n d spirituality as well as the i m p l i c i t goal a n d p u r p o s e of therapeutic endeavors. T o make h u m a n is to give h o p e a n d a sense of h u m a n reality a n d possibility. S p e a k i n g from an eschatological perspective, Metz has given this p u r p o s e f u l intent expression: Must it [faith] not first accept the hominized world as part of its own historical development and in accepting it overcome it? No other way is open to it today. The hominized world still lies more before us than behind us. Man is changing more and more from an observer of the world to its shaper. His view of the world is its transformation. . . . The hominization of the world must not be left to the ideologies, it must be taken hold of in hope as a burden and a task. Everything we have tried to say was concerned to show that faith is able to do this task, In the hominized world, which ultimately Christian faith itself will have made historically possible, man moves in an incomparable way into the center of the world. This anthropocentricity does not mean that man's experience of God is radically obscured, but that ultimately a greater immediacy is given to the experience of the numinous: we encounter God as the transcendent mystery of the unity and richness of human life, which is constantly lost in the pluralism of its areas of experience; as the uncontrollable future of human freedom impinging on the world itself; finally, as the God whose nearness seeks to reveal itself in our encounter with our brother. Thus faith has a genuine future in the hominized world--less obvious, it is true, less apparent, but more inescapable than ever) T h e r e is a n i n n e r link, a m u t u a l reciprocity a n d r e i n f o r c e m e n t that flow between religious h o p e a n d faith a n d the roots of basically h u m a n hopefulness. We have seen that d e v e l o p m e n t a l l y h o p e in its i n c e p t i o n is rooted in the basic sense of trust that evolves in the m u t u a l r e g u l a t i o n a n d acceptance between m o t h e r a n d child. T h e confidence that accrues to the child in virtue of the supportive protectiveness of that r e l a t i o n s h i p allows h i m to respond to the e n l a r g i n g possibility of his awareness of h i m s e l f a n d his capacities. It is a basic sense of the possible that allows h i m to separate himself from the m a t e r n a l m a t r i x w i t h o u t o v e r w h e l m i n g fears of loss or a b a n d o n m e n t . T h i s i n c i p i e n t h o p e leads to u n a v o i d a b l e conflicts of will between the child's e m e r g i n g self-will a n d the i m p o s e d will of

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parents a n d adults. H o p e gives rise to p u r p o s e f u l i n t e n t i o n a n d the capacity to will. T h e conflict is o n e of willingness a n d willfulness, of the capacity to shape ends a n d p u r p o s e s in c o n j u n c t i o n with or, if need be, in the face of other ends a n d purposes. T h e conflict of grace a n d G o d ' s predestining will vis-a-vis m a n ' s free will was at its p s y c h o l o g i c a l r o o t an expression of such an inner h u m a n conflict. Implicitly it tended to envision w i l l i n g as willfulness rather than as willingness, as t h o u g h the expression of individual will were s o m e h o w inevitably placed in o p p o s i t i o n to an o m n i p o t e n t paternal will. Yet, as Erikson has observed, if religious belief in its lesser m o m e n t s trades off of infantile fears a n d d o u b t s a n d wishes, it also performs in its better m o m e n t s an invaluable, if n o t essential, f u n c t i o n in h u m a n life a n d adaptation. It gives concerted expression to m a n ' s m a t u r e need to offer a m e a n i n g f u l context of belief that can sustain h u m a n hopes a n d vitalize h u m a n existence. I n d i v i d u a l h o p e is sustained a n d the meaningfulness of h u m a n life a n d activity is confirmed by the c o m m u n a l h o p e that is embedded a n d solidified by institutionalized religion. T h i s function is served by all forms of religious creed a n d practice, by o r t h o d o x y a n d o r t h o p r a x y in all their h u m a n forms. In an a n a l o g o u s sense, the religious c o m m u n i t y provides a s u s t a i n i n g a n d h o p e - e m b o d y i n g matrix w i t h i n w h i c h the individual can find confirmation of his o w n inner h o p e a n d meaning, even as the infant finds the s u p p o r t a n d confirmation of his o w n i n n e r possibility a n d m e a n i n g in a maternal matrix. It is n o accident that churches are " m o t h e r s " a n d u n d e r t a k e to sustain the h o p e of their children. I w o u l d like to cite a brief passage f r o m a previous reflection o n faith, for it seems to say s o m e t h i n g relevant to the matter of hope. Faith, whether individual or communal, is a dynamic, integrative and, therefore, positively adaptive force in the psychic economy. It is not enough to think of it in merely defensive or restitutive terms. There is no question that the process of faith draws its dynamic power of change from fundamental instinctual energies. These basic energies are operative within faith, but the question must be whether they are adequate to serve all the functions of faith we have considered. The cycle of loss and restitution and the derivation of faith from narcissistic sources of energy serve the defensive and restitutive aspects of psychic functioning involved in

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faith. But faith requires in addition creative energies that serve the creative and integrative capacities of the ego as it reaches beyond the limits of defense and restitution and adaptation through the veil of infinite resignation into the darkness of the absurd.10 T h e creative energies that are required to sustain faith a n d give it purposeful existence pertain to the operation of hope. It is h o p e that sustains faith a n d gives it life. It is m y view, then, that h o p e is the creative a n d sustaining expression of the operation of grace in the h u m a n psyche. H u m a n h o p e is to that extent grace-derived a n d g r a c e - d e p e n d e n c Grace thereby serves psychologically as an i n n e r source of energic potential that enables the f u n c t i o n i n g ego to direct its capacities to realistic and adaptive goals. I a m not concerned in m a k i n g this f o r m u l a t i o n with the priorities of grace a n d nature. I see them as correlative a n d not opposed--gratia perficit naturam. If the ontology of s u p e r n a t u r a l reality requires supernatural specificity--so be it. My concern here is w i t h a n u n d e r s t a n d i n g of the workings a n d function of grace w i t h i n the h u m a n psychic apparatus. T h e effects of grace can sustain m a n ' s hopefulness or even, one m a y hope, bring it to life, a n d m a n ' s i n n a t e hopefulness offers a g r o u n d for the receptivity to the sustaining p o w e r of grace, la Psychologically, grace a n d n a t u r e become indistinguishable. W h e n we t h i n k of this process in ontological terms, there is a t e n d e n c y - - h i s t o r i c a l l y e m b e d d e d - - t o t h i n k of grace as divine action a n d n a t u r e as receptive potency. I w o u l d rather t h i n k of it in m o r e p e r s o n a l - - i f p s y c h o l o g i c a l - terms. T h e m o r e radically I a m able to accept love f r o m a n o t h e r person, the more fully do I come into possession a n d awareness of m y o w n individuality a n d identity. So it is with grace: the m o r e fully receptive m a n is to the action of grace, the m o r e fully is he capable of the free realization a n d expression of his o w n inner reality a n d capacity. T h e effect of grace, t h e n , m u s t be seen in terms of its capacity to m a k e free and to m a k e h u m a n . Metz has written: But grace is freedom, it bestows upon things the scarcely measured depths of their own being. It calls things out of their sinful alienation into their own. It calls the

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world into its perfect worldliness. Gratia perficit naturarn--this is true also of the "consecration of the world" by grace. It seals the world within its deepest worldliness, it gives, in a supreme way, the world to itself, bestowing on it an unex-

pectedly rich existence of its own. Grace perfects the true worldliness of the world. ~z T h e w o r l d is hardly the w o r l d of things, a l t h o u g h the effect of G o d ' s creative action is to b r i n g into its o w n b e i n g a w o r l d of things. T h e world is m a n himself, a n d his worldliness is his h u m a n n e s s . T h u s grace s u m m o n s a n d enables m a n to hope, to b e c o m e the active creator a n d s h a p e r of his o w n r e a l i t y - - b o t h the reality of his inner w o r l d a n d by extension the external, s u r r o u n d i n g w o r l d in w h i c h he moves a n d breathes. T h u s h o p e is an elemental strength a n d capacity of the h u m a n e g o that derives its strength from m a n y sources. It derives from a n d integrates basic sources that c o m e from infantile experience a n d residues w i t h i n the mature personality. It is sustained a n d sustains c o m m o n hopes that are embedded in systems a n d institutions of b e l i e f - - u n i q u e l y a n d particularly in religious beliefs a n d in religious institutions. A n d it remains o p e n to the influence of a s u s t a i n i n g a n d s t r e n g t h e n i n g potential g r o w i n g o u t of the effects of grace based on a loving a n d s u p p o r t i v e divine initiative. T h e creative a n d sustaining potential of grace is seen n o w h e r e m o r e clearly than in man's capacity to hope, for it u n i q u e l y embraces m a n ' s capacity to wish, to mobilize energies from instinctively based resources, a n d the ego's basic capacity to will the future. And this, after all, is w h a t is u n i q u e l y h u m a n - - t o look into the future a n d to will it. T o be a homo viator is the essence of m a n ' s h u m a n i t y as well as the essence of his belief,

References 1. Lynch, S. J., W. F., Images oJ Hope. Baltimore, Helicon Press, 1965. 2. Freud, S., "Mourning and Melancholia." In The Standard Edition of the Complete Psychological Works of Sigrnund Freud, Vol. 14. London, Hogarth Press, 1957. 3. Melges, F. Y., and Bowlby, J., "Types of Hopelessness in Psychopathological Process," Arch. Gen. Psychiatry, 1969, 20, 690-699. 4. Erikson, E. H., Identit~ and the Life C~cle. New York, International Universities Press, 1959. 5. Lynch, op. czt., p. 170.

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6. French, T. M., " H o p e and Repudiation of H o p e in Psycho-analytic Therapy," Internat. J. Psychoanalysis, 1963, 44, 304-316. 7. Lynch, op. cit., p. 191. 8. Marcel, G., Homo Viator: Introduction to a Metaphysics of Hope. New York, Harper and Row, 1962, p. 153. 9. Metz, J. B., Theology of the World. New York, Herder and Herder, 1969, pp. 76-77. 10. Meissner, S. J., W. W., "Notes on the Psychology of Faith," J. Religion and Health, 1969, 8, 47-75. 11. , "Prolegomena to a Psychology of Grace," J. Religion and Health, 1964, 3, 209-240. 12. Metz, op. cit., p. 49.