Die Welt ist tief! und Tiefer als der Tag gedacht! (Nietzche, Zarathustra) "The world is deep, and deeper than you imagine!" Nietzche's admonition takes us to the core of Young's essay: that the experience of illness and treatment eludes our proud cognitive structures. From Freud we can say even further that our ignorance is based mostly upon what we do not want to know about ourselves -in medicine, most often ourselves as evoked by our patients. While I laud Young's intentions, I must take issue with his premise. Young mistakes the enemy, if one there is: it is not 'Rational Man', but how men everywhere (mis-) appropriate thought for unconscious symbolic ends. Young writes in the very language of the problem he analyzes. One misses the depths to which he alludes.
A psychoanalytic view of thinking or cognition begins with the questions 'What is thought for'? 'What does cognition serve'? and proceeds from there (cf., Spiro 1979). From the viewpoint of a human biology of thought governed by psychic primacy rather than cognitive primacy, one discovers that thought is occupied with matters of cohesiveness and disintegration of body/self, annihilation, boundaries, separation, loss, castration, sexuality, aggression, etc. A psychoanalytic cognition must begin with the body of the infant, since growing awareness of self, object world, and reality are mediated by the infantile body and its modes of experiencing itself and the world, further mediated by mother or maternal surrogate. The oscillation between introjection, projection, reintrojection, the foundation for the child's sense of reality, is based on such organismic functions as oral incorporation (sucking, biting), oral expulsion, anal retention and expulsion, and so forth (Ferenczi 1952). The caretakers' response to the infant, interacting with the infant's stage-specific mode of perceiving its caretaker's response, dictates what subsequent forms of cognition will be available to the child and adult. For the oscillation of projection and introjection can only correct each other as magical thinking declines, that is, as the child feels safe and whole enough to venture tentatively into vexatious reality.
Consider the (pre-operational) post hoc, ergo propter hoc fallacy, common to children, adult neurotics and psychotics alike. This confusion of causality with temporal contiguity is far from a mere 'logical aberration', but is "a fundamental