THE GOLDEN RULE AND THE CYCLE OF LIFE
Erik H. Erikson
***
The Golden Rule
“It does not say: “Here is the rule; go, and act accordingly.” It says: “Go, and learn it.” Here lies our challenge”
By the bequest of the late Dr. George W. Gay the “advanced or graduating classes” of Harvard Medical School are to hear each year a lecture “Upon Medical Ethics.”1 The bequest specifies, with increasing concreteness: “. . . and upon wise and proper methods of conducting the business of physicians as relates to fees, collections, investments etc.” Over the years, however, Gay Lecturers seem to have found in and between those lines a sanction for ranging over a widening area, from economic prudence to professional propriety and from medical wisdom to the ethics of human and international relations. I take advantage of such leeway by offering a few insights coming from the study of life histories—a field of study first inspired by a series of physicians (from Sigmund Freud to William James and Henry A. Murray) who became psychologists and who created out of the study of cases the study of lives. The insights to be advanced will, it is hoped, prove to be relevant to “wise and proper conduct” even though the only kind of ethical investment to be recommended is that of one generation in the next.
THE GOLDEN RULE
My base line is the Golden Rule, which advocates that one should do (or not do) to another what one wishes another to do (or not do) to him. A pretty battered base line it is, and obscured with the grime of hypocrisy. No wonder that systematic students of ethics often indicate a certain disdain for this all too primitive ancestor of loftier and more logical principles. Yet, for generation after generation this rule has marked a mysterious meeting ground between ancient peoples separated by oceans and eras, a theme hidden in the sayings of great thinkers.
- The present essay was the George W. Gay Lecture Upon Medical Ethics, presented at Harvard Medical School on May 4, 1962.
I would like to take the Talmudic version of the Golden Rule for my opening: “What is hateful to yourself, do not to your fellow-man,” the Talmud says, adding, “That is the whole of the Torah and the rest is but commentary. Go and learn it.” The rule in this form, as critics have never tired of pointing out, is the rock bottom of moral prudence. But then, the rule was so stated by Rabbi Hillel in answer to an unbeliever’s challenge that he be told the whole of the Torah while he stood on one foot. Pressed for brevity, the great rabbi put basic things first. If he added that the rest was but commentary, nobody acquainted with the Jewish way of life would mistake “but commentary” for “merely commentary,” for surely sometimes the ongoing commentary is the very life of a rule.
The Golden Rule obviously concerns itself with one of the very basic paradoxes of human existence. Each man calls his own a separate body, a self-conscious individuality, and a personal awareness of the cosmos; and yet he shares this world as a reality also perceived and judged by others and as an actuality within which he must commit himself to ceaseless interaction. To identify self-interest and the interest of other selves, the rule alternately employs the method of warning, “Do not as you would not be done by,” and of exhortation, “Do as you would be done by.” For psychological appeal, some versions rely on the minimum of egotistic prudence, while others demand a maximum of altruistic sympathy: it must be admitted that the formula, “Do not to others what if done to you would cause you pain,” does not presuppose much more than the mental level of the small child who desists from pinching when he gets pinched in return. On the other hand, mature insight and more are assumed in the saying, “No one is a believer until he loves for his brother what he loves for himself.” Of all the versions, however, none commits us so unconditionally as “Love thy neighbor as thyself”: it even suggests a true love of ourselves.
I will not (I could not) involve us in comparative religion by tracing the versions of the rule to various religions; no doubt in translation all of them have become somewhat assimilated to our biblical versions. Yet, the basic formula seems to be universal, and it reappears in an astonishing number of the most revered sayings of our civilization, from St. Francis’ prayer to Kant’s moral imperative and to Lincoln’s simple political creed: “As I would not be slave, I would not be master.”
The variations of the rule have, of course, provided material for many discussions of ethics weighing the soundness of the logic implied and measuring the degree of ethical nobility reached in each. My field of inquiry, the study of life histories, suggests that I desist from arguing relative logical merit or spiritual worth and instead relate some variations in moral and ethical sensitivity to successive stages in the development of human conscience. In the framework of the cycle of life, the The Golden Rule 415 most primitive and the most exalted rules may well prove necessary to each other.
THE DEVELOPMENT OF MORALITY
This lecture is entitled the “Lecture Upon Medical Ethics” and not upon “Medical Morality.” The implication is clear: a man who knows what is legal or illegal and what is moral or immoral has not necessarily yet learned what is ethical. Highly moralistic people can do unethical things; whereas an ethical man’s involvement in immoral doings becomes by inner necessity an occasion for tragedy. The dictionary, our first refuge from ambiguity, in this case only confounds it; morals and ethics are defined as synonyms and antonyms of each other. In other words, they are the same, with a difference—a difference which I intend to emphasize.
I would propose that we consider moral rules of conduct to be based on a fear of threats to be forestalled—outer threats of abandonment, punishment, public exposure; or a threatening inner sense of guilt, shame, or isolation. In contrast, I would consider ethical rules to be based on a love of ideals to be striven for—ideals that hold up to us some highest good, some definition of perfection, and some promise of self-realization. This differentiation is, I think, substantiated by developmental observation, and the developmental principle is the first of those principles which will represent for us the kind of insight which we have gained by the study of life histories.
All that exists layer upon layer in an adult’s mind has developed step by step in the growing child’s, and the major steps in the comprehension of what is considered good behavior in one’s cultural universe are-—for better and for worse—related to different stages in individual maturation. The response to a moral tone of voice develops early. The small child, so limited to the intensity of the moment, somehow must learn the boundaries marked by “don’t’s.” Here cultures have a certain leeway in underscoring the goodness of one who does not transgress or the evilness of one who does. But the conclusion is unavoidable that children can be made to feel evil and that adults continue to project evil on one another and on their children, far beyond the call of rational judgment.
Before discussing this early moral sense in more detail, let me mention the later steps which I will differentiate from it: they are the development of an ideological sense in adolescence, and of an ethical sense in young adulthood. The imagery of steps, of course, is useful only where it is to be suggested that one item precedes another in such a way that the earlier one is necessary to the later ones and that each later one is of a higher order. But development is more complex, especially since all manner of step formations take place simultaneously and in not too obvious synchronization.
To return to the moral sense, psychoanalytic observation first established in a systematic fashion what certain Eastern thinkers have always known, namely that the radical division into good and bad can be the sickness of the mind. It has traced the moral scruples and excesses of the adult to the childhood stages in which guilt and shame are ready to be aroused and are easily exploited. It has named and studied the superego, which hovers over the ego as the inner perpetuation of the child’s subordination to the restraining will of his elders. Although the voice of the superego is not always cruel and derisive, it is ready to become so whenever the precarious balance which we call a good conscience is upset. At those times the secret weapons of this inner governor are revealed: the brand of shame and the bite of conscience. Are these “caused” or merely accentuated by the pressure of parental and communal methods, by the threat of loss of affection, of corporal punishment, of public shame? Or are they by now a proclivity for self-alienation which has become a part—and, to some extent, a necessary part—of man’s evolutionary heritage? All we know for sure is that the moral proclivity in man does not develop without the establishment of some chronic self-doubt and some truly terrible, even if mostly submerged, rage against anybody and anything that reinforces such doubt. The “lowest” in man thus is apt to reappear in the guise of the “highest”: irrational and prerational combinations of goodness, doubt, and rage can re-emerge in the adult in those malignant forms of righteousness and prejudice which we may call moralism. In the name of high moral principles it can employ all the vindictiveness of derision, of torture, and of mass-extinction. One surely must come to the conclusion that the Golden Rule was meant to protect man not only against his enemy’s open attacks but also against his friends’ righteous encroachments.
THE EVOLUTIONARY PRINCIPLE
Lest this view, in spite of the evidence of history, seem too “clinical,” we turn to the science of evolution, which in the last few decades has joined psychoanalysis in recognizing the superego as an evolutionary fact—and danger. The developmental principle is thus joined by an evolutionary one. Waddington even goes so far as to say that superego rigidity may be an overspecialization in the human race, like the excessive body armor of the late dinosaurs. In a less grandiose comparison he likens the superego to “the finicky adaptation of certain parasites which fits them to live only on one host animal.”2 In recommending his book, The Ethical Animal (in addition to the works of J. Huxley and G. G. Simpson), I must admit that his terminology contradicts mine.
- H. Waddington, The Ethical Animal (London: Allen and Unwin, 1960).
He calls the awakening of morality in childhood a proclivity for “ethi- cizing,” whereas I would prefer to call it moralizing. As many animal psychologists do, he dwells on analogies between the very young child and the young animal, instead of comparing, as I think we must, the young animal with the pre-adult human, including the adolescent.
I cannot dwell here on the new insights into the cognitive and emotional gains of adolescence which enable the young—often only after a severe bout with moralistic regression—to envisage more universal principles of a highest human good. The adolescent learns to grasp the flux of time, to anticipate the future in a coherent way, to perceive ideas and to assent to ideals, to take—in short—an ideological position for which the younger child is cognitively not prepared. In adolescence, then, an ethical view is approximated, but it remains susceptible to an alternation of impulsive judgment and odd rationalization. It is, then, as true for adolescence as it is for childhood, that man’s way stations to maturity can become fixed, can become premature end stations or stations for future regression—in one person or in masses of individuals.
The moral sense, in its perfections and its perversions, has been an intrinsic part of man’s evolution, whereas the sense of ideological rejuvenation has pervaded his revolutions, both with prophetic idealism and with destructive fanaticism. Adolescent man, in all his sensitivity to the ideal, is easily exploited by promises of counterfeit millennia, easily taken in by the promise of a new and arrogantly exclusive identity.
The true ethical sense of the young adult, at its best, encompasses moral restraint and ideal vision, while insisting on concrete commitments to those intimate relationships and work associations by which man can hope to share a lifetime of productivity and competence. But young adulthood engenders its own dangers. It adds to the moralist’s righteousness and to the ideologist’s repudiation of all “otherness” the territorial defensiveness of one who has appropriated and staked out his earthly claim and seeks eternal security in the superidentity of organizations. Thus, what the Golden Rule at its highest has attempted to make all- inclusive, tribes and nations, castes and classes, moralities and ideologies have consistently made exclusive again—proudly, superstitiously, and viciously denying the status of reciprocal ethics to those “outside.”
If, so far, I have underscored the malignant potentials of man’s slow maturation, I have not done so in order to dwell on a kind of dogmatic pessimism which can emerge all too easily from clinical preoccupation, often leading only to new moralistic avoidances. I know that man’s moral, ideological, and ethical propensities can find and have found on occasion a sublime integration, in individuals and in groups, who are
both tolerant and firm, flexible and strong, wise and obedient. Above all, men have always shown a dim knowledge of their better potentialities by paying homage to those purest leaders who taught the simplest and most inclusive rules for an undivided mankind. But men have also persistently betrayed them, on what passed for moral or ideological grounds, even as they are now preparing a potential betrayal of all of human heritage in the name of science and technology, that is, in the name of what must surely be good merely because it can be made to work—no matter where it leads.
We now see where it may lead. But only in our time, in our generation, have we come to view with a start the obvious fact that throughout history the rule, in whatever form, has comfortably coexisted with warfare. A warrior, armored, spiked and set to do to another what he fully expected the other to be ready to do to him, saw no ethical contradiction between the rule and his military ideology: he could, in fact, grant to his adversary a respect which he hoped to earn in return. This tenuous co-existence of ethics and warfare may outlive itself in our time; the military mind may well come to fear for its historical identity when technical mass annihilation replaces tactical warfare. The Golden Rule of the nuclear age, which is “Do not unto others unless you are sure you can do them in as totally as they can do you in,” creates not only an international deadlock but a profoundly ethical one as well.
One wonders, however, whether this deadlock can be broken by even the most courageous protest, the most incisive interpretation, or the most prophetic warning—a warning of catastrophe of such immensity that most men must ignore it, as they ignore certain death and have learned to ignore the monotonous prediction of hell. It seems, instead, that only an ethical orientation, a direction for vigorous co-operation, can free today’s energies from their bondage in armed defensiveness. We live at a time in which—for all the species-wide destruction possible—we can think for the first time of a species-wide identity, of a truly universal ethics, such as has been prepared in the world religions, in humanism, and by philosophers. Ethics can not be fabricated; it can only emerge from an informed and inspired search for a more inclusive human identity, which a new technology and a new world image make possible as well as mandatory.
Man’s sociogenetic evolution is about to reach a crisis in the full sense of the word: a crossroads offering one path to fatality and one to recovery and further growth. Artful perverter of joy and keen exploiter of strength, man has learned to survive “in a fashion,” to multiply without food for the multitudes, to grow up healthily without reaching
personal maturity, to live well but without purpose, to invent ingeniously without aim, and to kill grandiosely without need. But the processes of sociogenetic evolution also seem to promise a new humanism, the acceptance by man—as an evolved product as well as a producer and as a self-conscious tool of further evolution—of the obligation to be guided in his planned actions and his chosen self-restraints by his knowledge and his insights. In this endeavor, then, it may be of a certain importance to learn to understand and to master the differences between infantile morality, adolescent ideology, and adult ethics: each necessary to the next, but each effective only if they eventually combine in that wisdom which, as Waddington puts it, “fulfills sufficiently the function of mediating evolutionary advance.”
At the point when one is about to end an argument with a global injunction of what we must do, it is good to remember Blake’s admonition that the common good readily becomes the topic of “the scoundrel, the hypocrite, and the flatterer”; and that anyone who would do some good must do so in “minute particulars.” And indeed, I have so far spoken only of the developmental and evolutionary principle, according to which the propensity for ethics grows in the individual as part of an adaptation roughly laid down by evolution. Yet, to grow in the individual, ethics must be generated and regenerated in and by the sequence of generations. This generational principle we must now make more explicit.
THE GENERATIONAL PRINCIPLE
Let me make an altogether new start here; let us look at scientific man in his dealings with animals. Harry Harlow’s studies on the development of affection in monkeys are well known. He did some outstanding experimental and photographic work attempting, in the life of laboratory monkeys, to “control the mother variable.” He took monkeys from their mothers within a few hours after birth, isolated them, and left them with “mothers” made out of wire, metal, wood, and terry cloth. A rubber nipple somewhere in the middle emitted piped-in milk, and the whole contraption was wired for body warmth. All the “variables” of this mother situation were controlled: the amount of rocking, the degree of “body warmth,” and the exact incline of the maternal body necessary to make a scared monkey feel safe and comfortable. Years ago, when this method was presented as a study of the development of affection in monkeys, the clinician could not help wondering whether the object of study was monkey affection or a fetishist addiction to inanimate objects. And, indeed, while these laboratory reared monkeys became healthier and healthier and much more trainable in technical know-how than the
inferior monkeys brought up by mere monkey mothers, they became at the end what Harlow calls “psychotics.”3 They sit passively, they stare vacantly, and some do something terrifying: when poked they bite themselves and tear at their own flesh until the blood flows. They have not learned to experience “the other,” either as a mother, a mate, a child —or enemy. Only a tiny minority of the females produced offspring, and only one of those made an attempt to nurse hers. But science remains a wonderful thing. Now that we have succeeded in producing “psychotic” monkeys experimentally, we can convince ourselves that we have at last given scientific support to severely disturbed mother-child relationships as causative factors in human psychosis.
It speaks for Harry Harlow’s methods that what they demonstrate is unforgettable. At the same time, they lead us to that border line where we recognize that the scientific approach toward living beings must be with concepts and methods adequate to the study of ongoing life, not of selective extinction. I have put it this way: one can study the nature of things by doing something to them, but one can really learn something about the essential nature of beings only by doing something with them or for them. This, of course, is the principle of clinical science. It does not deny that one can learn by dissecting the dead or that animal or man can be motivated to lend circumscribed parts of their beings to an experimental procedure. But for the study of those central transactions which are the carriers of sociogenetic evolution and for which we must take responsibility in the future, the chosen unit of observation must be the generation, not the individual. Whether an animal or a human being partook of the stuff of life can be tested only by the kind of observation which discerns his ability to transmit life—in some essential form—to the next generation.
In contrast, one remembers the work of Konrad Lorenz, and the kind of “interliving” research which he and others have developed, making—in principle—the life cycle of certain selected animals part of the same environment in which the observer lives, studying his own role in it as well as theirs, and taking his chances with what his ingenuity can discern in a setting of sophisticated naturalist inquiry. One remembers also Elsa the Lioness, a foundling who was brought up in the Adamsons’ household in Kenya. There, the mother variable was not controlled; it was in control. Mrs. Adamson and her husband even felt responsible for putting grown-up Elsa back among the lions and succeeded in sending her back to the bush, where she mated and had cubs, and yet came back from time to time (accompanied by her cubs) to visit her human foster parents. In our context, we cannot fail to wonder about the
- Harry F. Harlow and Margaret K. Harlow, “A Study of Animal Affection,” The Journal of the American Museum of Natural History, LXX (1961), No. 10.
built-in “moral” sense that made Elsa respond—and respond in very critical situations, indeed—to the words: “No, Elsa, no,” if the words came from human beings she trusted. Yet, even with this built-in “moral” response and with a lasting trust in her foster parents (which she transmitted to her wild cubs), she was able to live as wild lions do. Her mate, however, never appeared; he apparently was not curious about her folks.
The point of this and similar stories is that our habitual relationship to what we call beasts in nature and (“instinctive” or “instinctual”) beastliness in ourselves may be highly distorted by thousands of years of superstition and that there may be resources for peace even in our “animal nature” if we will only learn to nurture nature, as well as to master her. Today we can teach a monkey, in the very words of the Bible, to “eat the flesh of his own arm,” even as we can permit “erring leaders” to make of all mankind the “fuel of the fire.” Yet, it seems equally plausible that we can let our children grow up to lead “the calf and the young lion and the fatling together”—in nature and in their own nature.
MUTUALITY
To recognize one of man’s prime resources, however, we must trace back his individual development to his premoral days, his infancy, marked by basic trust—an over-all attitude integrating those things in the newborn organism that reach out to its caretakers and establish with them what we will now discuss as mutuality. The failure of basic trust and of mutuality has been recognized in psychiatry as the most far-reaching developmental failure, undercutting all development.
I would call mutuality a relationship in which partners depend on each other for the development of their respective strengths. A baby’s first responses can be seen as part of an actuality consisting of many details of mutual arousal and response. When the baby initially smiles at a mere configuration resembling the human face, the adult cannot help smiling back, filled with expectations of a “recognition” which he needs to secure from the new being as surely as it needs him. The fact is that the mutuality of adult and baby is the original source of the basic ingredient of all effective as well as ethical human action: hope. As far back as 1895, Freud, in his first outline of a “Psychology for Neurologists,” counterpoints to the “helpless” newborn a “helprich” (hilfreich’) adult and postulates that their mutual understanding is “the primal source of all moral motives.”4 Should we, then, equip the Golden Rule
- Marie Bonaparte, Anna Freud, and Ernst Kris, eds., The Origins of Psychoanalysis, “Letters to Wilhelm Fliess, Drafts and Notes: 1887-1902” (London: Imago, 1954; New York; Basic Books, 1954).
with a principle of mutuality, replacing the reciprocity of prudence and sympathy?
A parent dealing with a child will be strengthened in his vitality, in his sense of identity, and in his readiness for ethical action by the very ministrations by which he secures to the child his vitality, his future sense of identity, and his eventual readiness for ethical action. On this mutuality, then, all ethical potentialities are built—and we know how tragic and deeply pathogenic its absence can be in children and parents who cannot arouse and cannot respond.
But we should avoid making a new Utopia out of the “mother-child relationship.” The paradise of early childhood must be abandoned—a fact which man has as yet not learned to accept. The earliest mutuality is only a beginning and leads to more complicated encounters, as both the child and his interaction with a widening cast of persons grow more complicated. I need only point out that the second basic set of vital strengths in childhood (following trust and hope) is autonomy and will, and it must be clear that a situation in which the child’s willfulness faces the adult’s will is a different proposition from that of the mutuality of instilling hope. Yet any adult who has managed to train a child’s will must admit that he has learned much about himself and about will that he never knew before, something that cannot be learned in any other way. Thus each growing individual’s developing strength “dovetails” with the strengths of an increasing number of persons arranged about him in the social orders of family, school, community, and society. These orders, in turn, safeguard themselves by formalizing the Golden Rule in a hierarchy of institutions. But all orders and rules are kept alive by those “virtues” of which Shakespeare says (in what appears to me to be his passionate version of the rule) that they, “shining upon others heat them and they retort that heat again to the first giver.”
With such high encouragement I will try to formulate my amendment to the Golden Rule. I have been reluctant to come to this point; it has taken thousands of years and much linguistic acrobatics to translate this rule from one era to another and from one language into another, and at best one can only confound it again, in a somewhat different way.
It would, at any rate, seem irrelevant to formulate any new or better “do’s” or “don’t’s” than the rule already implies in its classical forms. Rather, I would advocate a general orientation not too narrowly hemmed in by scruples and avoidances and not too exclusively guided by high promises and rewards. This orientation has its center in whatever activity or activities give man the feeling, as William James put it, of being “most deeply and intensely active and alive.” In this, so James promises, each one will find his “real me”; but, I would now add, he will also acquire a conviction that truly ethical acts enhance a mutuality between the doer and the other—a mutuality that strengthens the doer even as he strengthens the other. Thus the “doer” and “the other” are one deed. Developmentally, this means that the doer is activated in whatever strength is appropriate to his age, stage, and condition, even as he activates in the other the strength appropriate to his age, stage, and condition.
THE PRINCIPLE OF ACTIVE CHOICE
Our next step is to demonstrate that the inequality of parent and child, or better, the uniqueness of their respective positions which has served as our model so far, has significant analogies in other situations in which uniqueness depends on a divided function. Here, eventually, we may come closer to an application of our amendment of the rule to medical ethics as well.
But there is one more principle which must be added to the developmental one, to mutuality and to the generational principle. I would call it the principle of active choice. It is, I think, most venerably expressed in St. Francis’ prayer: “Grant that I may not so much seek to be consoled as to console; to be understood, as to understand; to be loved as to love; for it is in giving that we receive.” Such commitment to a decisive initiative in love is, of course, contained in the admonition to “love thy neighbor.” It is not in our domain, however, to discuss that religious frontier of existence where man expects to derive his most decisive ethical initiative from a highest grace. Yet I think that we can recognize in these exalted words a psychological verity that only he who approaches an encounter in a (consciously and unconsciously) active and giving attitude, rather than in a demanding and dependent one, will be able to make of that encounter what it can become.
To return to particulars, I will attempt to apply my amendment to the diversity of function in the two sexes. I have not dwelled so far on this most usual subject of a psychoanalytic discourse, sexuality. So much of this otherwise absorbing part of life has, in recent years, become stereotyped; and not the least among the terminological culprits to be blamed for this sorry fact is the psychoanalytic term “love object.” For this word object in Freud’s theory has been taken too literally by many of his friends and by most of his enemies. (Moralistic critics delight in misrepresenting a man’s transitory findings as his ultimate “values.”) The fact is that Freud, on purely conceptual grounds and on the basis of his scientific • training, pointed out that drives have objects; but he never said, and he certainly never advocated, that men or women should treat one another as objects on which to live out their sexual desires. Instead, his central theory of a mutuality of orgasm which com-
bines strivings of sexuality and of love points, in fact, to one of those basic mutualities in which a partner’s potency and potentialities are activated even as he activates the other’s potency and potentialities. Freud’s theory implies that a man will be more a man to the extent to which he makes a woman more a woman—and vice versa—because only two uniquely different beings can enhance their respective uniqueness for one another. A “genital” person in Freud’s sense thus is more likely to act in accordance with Kant’s version of the Golden Rule, namely, that one should so act as to treat humanity (whether in his person or in another) “always as an end, and never as only a means.” What Freud added, however, is a methodology which opens to our inquiry and to our influence the powerhouse of inner forces which provide the shining heat for our strength—and the smoldering smoke of our weaknesses.
I cannot leave the subject of the two sexes without a word on the uniqueness of women. One may well question whether the oldest versions of the rule meant to acknowledge women as partners in the golden deal; and today’s study of lives still leaves obscure the place of women in what is most relevant to men. True, women are being granted equality of political rights and the recognition of a certain sameness in mental and moral equipment. But what they have not begun to earn, partially because they have not cared to ask for it, is the equal right to be effectively unique and to use hard-won rights in the service of what they uniquely represent in human evolution. One senses today the emergence of a new feminism as part of a more inclusive humanism. This coincides with a growing conviction—highly ambivalent, to be sure—that the future of mankind cannot depend on men alone and may well depend on the fate of a mother variable uncontrolled by technological man. The resistance to such a consideration always comes from men and women who are mortally afraid that by emphasizing what is unique, one may tend to re-emphasize what is unequal. The study of life histories certainly confirms a far-reaching sameness in men and women insofar as they express the mathematical architecture of the universe, the organization of logical thought, and the structure of language. But such study also suggests that while men and women can think, act, and talk alike, they naturally do not experience their bodies (and thus the world) alike. One could illustrate this by pointing to sex differences in the struc- turalization of space in the play of children. But I assume here that a uniqueness of either sex will be granted without proof, and that the difference acclaimed by the much-quoted Frenchman is not considered a mere matter of anatomical appointments for mutual sexual enjoyment, but a psychobiological difference central to two great modes of life, the paternal and the maternal modes.
The study of creative men reveals that only a vital struggle makes it possible for them to reconcile in themselves the paternal and the maternal dimensions of all mental productivity. It may well be that there is something in woman’s specific creativity which has only waited for a clarification of her relation to masculinity (including her own) in order to assume her share of leadership in human affairs, which so far have been left entirely in the hands of gifted and driven men and often of men whose creativity eventually has yielded to ruthless self-aggrandizement. Mankind now obviously depends on new kinds of social inventions and on institutions which guard and cultivate that which nurses and nourishes, cares and tolerates, includes and preserves. Mere conquest and invention alone and more expansion and organization will make life more exciting but not more livable. And if my amendment to the rule suggests that one sex enhances the uniqueness of the other, it also implies that each, to be really unique, depends on a mutuality with an equally unique partner: only when women dare to assume the motherhood of man, may men be emboldened to overcome the boyhood of history.
MUTUALITY IN PROFESSIONAL ETHICS
By now, one might well have reached the conclusion that my discursiveness was intended to leave me little time for the problem of medical ethics. However, medical ethics can only be a variation of a universal theme, and it was necessary to establish the general context within which I could hope to give a slightly different emphasis to a subject so rich in tradition.
There is a very real and specific inequality in the relationship of doctor and patient in their roles of knower and known, helper and sufferer, practitioner of life and victim of disease and death; for which reason doctors have their own and unique professional oath and strive to live up to a universal ideal of “the doctor.” Yet the practice of the healing arts permits of extreme types of practitioners, from the absolute authoritarian over homes and clinics to the harassed servant of demanding mankind, from the sadist of mere proficiency to the effusive lover of all (well, almost all) of his patients. Here, too, Freud has thrown intimate and original light on the workings of a unique relationship. His letters to his friend and mentor Fliess illustrate the singular experience which made him recognize in his patients what he called transference—that is, the patient’s wish to exploit sickness and treatment for infantile and regressive ends. But more, Freud recognized a countertransference in the healer’s motivation to exploit the patient’s transference and to dominate or serve, possess or love him to the disadvantage of his true function. He made systematic insight into transference and countertransference part of the training of the psychoanalytic practitioner. I would think that all of the motivations necessarily entering so vast and so intricate a field could be reconciled in a Golden Rule amended to include a mutuality of divided function. Each specialty and each technique in its own way permit the medical man to develop as a practitioner and as a person, even as the patient is cured as a patient and as a person. For a real cure transcends the transitory stage of pa- tienthood; it is a life experience which enables the cured patient to develop and to transmit to home and neighborhood an attitude toward health which is one of the most essential ingredients of an ethical outlook. This variation on the over-all theme of an amended rule is all I can offer you here.
Beyond this, can the healing arts and sciences contribute to a new ethical outlook? This question, which always recurs in psychoanalysis, is usually disposed of with Freud’s answer: The psychoanalyst represents the ethics of scientific truth only and is committed to studying ethics (or morality) in a scientific way. Beyond this, he leaves Weltaiischauungen (ethical world views) to others.
It seems to me, however, that the clinical arts and sciences, although employing the scientific method, are not defined by it or limited by it. The healer is committed to a highest good, the preservation of life, and the furtherance of well-being. He need not prove scientifically that these are, in fact, the highest good; rather, he is precommitted to this basic proposition while investigating what can be verified by scientific means. This, I think, is the meaning of the Hippocratic oath, which subordinates all medical method to a humanist ethics. True, a man can separate his personal, his professional, and his scientific ethics, seeking fulfilment of needs in personal life; the welfare of others in his profession; and in his research, truths independent of personal preference or service. However, there are psychological limits to the multiplicity of values a man can live by; and, in the end, not only the practitioner, but also his patient and his research, depend on a certain unification in him of temperament, intellect, and ethics: this unification clearly characterizes great clinical teachers. Although it is true, then, that as scientists, we must study ethics objectively, we are, as professional people, committed to a unification of personality, training, and conviction which alone will help us to do our work adequately. At the same time, as transient members of the human race we must record the truest meaning of which the fallible methods of our era and the accidental circumstances of our existence have made us aware. In this sense, there is (and always has been) not only an ethics governing clinical work and a clinical approach to the study of ethics but also a contribution to ethics of the healing orientation. The healer, however, has now committed himself to prevention on a large scale, and he cannot evade the question
The Golden Rule 427 as to how to assure ethical vitality to all lives saved from morbidity and early mortality.
MUTUALITY AMONG NATIONS
And now a final word on what is and will be for a long time to come, the sinister horizon of the world in which we all study and work: the international situation. Here, too, we cannot afford to live for long with a division of personal, professional, and political ethics—a division endangering the very life which our professions have vowed to keep intact and thus cutting through the very fiber of our personal existence. But again, I can offer you only another variation of the theme, and propose, in all brevity, that what has been said here about the relationships of parent and child, of man and woman, and of doctor and patient, may have some application to the relationship of nations to each other, nations which by definition are units at different stages of political, technological, and economic transformation. I know that it is all too easy for us to believe that nations thus engaged should treat one another (or, at least, that we should treat others) with a superior educative or clinical attitude. This is not what I mean. The point is, again, not one of underscored inequality, but one of respected uniqueness within historical differences. Insofar as a nation thinks of itself as a collective individual, it may well learn to visualize its task as that of maintaining international relations of mutuality. For the only alternative to armed competition seems to be the effort to activate in the historical partner what will strengthen him in his historical development, even as it strengthens the actor in his own development—toward a common future identity. Only thus can we find a common denominator in the rapid change, the rapid unification of technology and history, and transcend the dangerous imagery of victory and defeat, of subjugation and exploitation, which is the heritage of a fragmented past.
Does this sound utopian? I think, on the contrary, that all of what I have said is already known in many ways, is being expressed in many languages, and is being practiced on many levels. At our historical moment it becomes clear in a most practical way that the doer of the Golden Rule and he who is done by, is the same man, is man.
Men of clinical background, however, must not lose sight of a dimension which I have taken for granted in what I have said. Although the Golden Rule in its classical versions prods man to strive consciously for a highest good and to avoid mutual harm with a sharpened awareness, our insights assume an unconscious substratum of ethical strength and, at the same time, unconscious arsenals of destructive irrationality. The last century traumatically expanded man’s awareness of the existence of motivations stemming from his animal ancestry, from his economic history, and from his inner dividedness; but it also created methods of productive self-scrutiny. It will be the task of the next generation to begin to integrate such new awareness with the minute particulars, not only of advancing proficiency, but also of that ongoing mutuality, by which alone man’s ready rage is neutralized.
It does not seem easy to speak of ethical subjects without indulging in some moralizing and ideologizing. As an antidote I will repeat the final words of the quotation from the Talmud, with which I began. It does not say: “Here is the rule; go, and act accordingly.” It says: “Go, and learn it.” Here lies our challenge.
