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 Psychology Revivals

The Practice of Psychotherapy

Freud once humorously remarked that "Anyone who wants to make a living
from the treatment of nervous patients must clearly be able to do something
to help them". It is amazing how frequently this simple precept is ignored
and, when a patient does not get well, how often the failure is attributed to
lack of proper motivation, diminutive ego strength, latent schizophrenia, and
a multitude of assorted resistances. Difficulties that arise during therapy are
not due to a deliberate conspiracy of neglect on the part of the therapist. They
usually come about because of obstructive situations that develop in work
with patients with which the therapist is unprepared to cope.

During his psychiatric career the author, who spent time both teaching and
supervising, collected and collated questions from students and graduate
therapists who had raised concerns about psychotherapy that related to such
obstructive situations. Originally published in 1982, this volume contains
both those questions and his answers.
This page intentionally left blank
The Practice of Psychotherapy
506 questions and answers

Lewis R. Wolberg
First published in 1982
by Brunner/Mazel Inc.
This edition first published in 2014 by Routledge
27 Church Road, Hove BN3 2FA

and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business

Copyright © 1982 by Lewis R. Wolberg

The right of Lewis R. Wolberg to be identified as author of this work has been asserted
by him in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act
1988.
All rights reserved. No part of this book may be reprinted or reproduced or utilised in
any form or by any electronic, mechanical, or other means, now known or hereafter
invented, including photocopying and recording, or in any information storage or
retrieval system, without permission in writing from the publishers.

Publisher’s Note
The publisher has gone to great lengths to ensure the quality of this reprint but points
out that some imperfections in the original copies may be apparent.

Disclaimer
The publisher has made every effort to trace copyright holders and welcomes
correspondence from those they have been unable to contact.

A Library of Congress record exists under ISBN: 0876302908

ISBN: 978-1-138-77860-3 (hbk)

ISBN: 978-1-315-76842-7 (ebk)
 Lewis R. Wolberg, M.D.

THE
PRACTICE
OF
PSYCHOTHERAPY
506 Questions and Answers

BRUNNER/MAZEL, Publishers • New York

 Library of Congress Cataloging in Publication Data

Wolberg, Lewis Robert, 1905-

The practice of psychotherapy.

Bibliography: p.
Includes index.
1. Psychotherapy—E xam inations, questions,
etc. I. Title.
RC343.5.W64 616.89'14 81-21724
ISBN 0-87630-290-8 AACR2

Copyright © 1982 by Lewis R. Wolberg

Published by
BRUNNER/MAZEL, INC.
19 Union Square
New York, New York 10003

All rig h ts reserved. No p a rt of th is book may be reproduced by any process w hatsoever,

w ithout the w ritten perm ission of the copyright owner.

MANUFACTURED IN THE UNITED STATES OF AMERICA

Contents

Preface..................................................................................... v

I. General Aspects of Psychotherapy..................................... 3

II. Psychoanalysis....................................................................... 27
III. Psychoanalytically Oriented (Dynamic) Psychotherapy 43
IV. Behavior Therapy (BehaviorModification)....................... 51
V. Group Therapy ...................................................................... 73
VI. Family T h erap y ..................................................................... 79
VII. M arital (Couples) Therapy .................................................. 89
VIII. Cognitive T herapy................................................................. 107
IX. Hypnosis.................................................................................. 113
X. Somatic Therapy ................................................................... 127
XI. Short-term Therapy .............................................................. 143
XII. Miscellaneous T herapies...................................................... 147
XIII. Emergencies............................................................................ 161
XIV. Psychotherapeutic Practices................................................ 165
XV. Psychotherapy in Special Conditions ................................ 179
A. Depression................................................................. 180
B. Phobias....................................................................... 191

V
vi The Practice of Psychotherapy

C. Anxiety Reactions .............................. 193

D. Alcoholism .......................................... 194
E. Schizophrenia .................................... 198
F. Chronic Mentally III .......................... 232
G. Personality Disorders ........................ 241
H. Miscellaneous Problem s................... 250
XVI. Transference and Countertransference ..... 263
XVII. Theoretical A spects........................................ 277
XVIII. D evelopm ent.................................................... 285
XIX. Psychodynamics.............................................. 297
XX. Prognosis.......................................................... 303
XXI. O utcom e........................................................... 311
XXII. Cost-Effectiveness of Psychotherapy .......... 325
XXIII. Prevention........................................................ 331
XXIV. Conclusion........................................................ 335
References......................................................... 379
Name In d e x ...................................................... 393
Subjectlndex .................................................. 399
Preface

Freud once humorously remarked that "Anyone who wants to make

a living from the treatm ent of nervous patients must clearly be able
to do something to help them ” (S.E. 22:16). It is amazing how frequently
this simple precept is ignored and, when a patient does not get well,
how often the failure is attributed to lack of proper motivation, di­
minutive ego strength, latent schizophrenia, and a multitude of as­
sorted resistances. Difficulties th at arise during therapy are not due
to a deliberate conspiracy of neglect on the part of the therapist. They
usually come about because of obstructive situations th at develop in
work with patients with which the therapist is unprepared to cope.
During the past years of my psychiatric career, a good part of which
has been spent in teaching and supervising, I have come into contact
with many students and graduate therapists who have brought up
concerns about psychotherapy th at relate to such obstructive situa­
tions. Over a period of time, I have collected and collated questions
they have asked, with the eventual object of organizing them and their
answers into a book. The present volume is the result of this effort.
My original idea was a supplementary volume to my The Technique
o f Psychotherapy, which was being used as a standard reference in a
viii The Practice of Psychotherapy

number of training centers. But as the book evolved, it became ap­

parent th a t it could stand on its own as an independent text. The
format, as will be seen, is a main section of several hundred questions
dealing with various topics related to psychotherapy and their answers,
followed by a concluding chapter which treats implications of the ques­
tions for the effective practice of psychotherapy. I have selected for the
most part those questions th at rank highest in frequency. Where ques­
tions were unclear in the original form, I have taken the liberty of
rephrasing them without altering the basic ideas behind the questions.
I have also in some cases expanded the questions to cover broader areas
of more widespread interest. The answers to the questions were gen­
erally taken from cassette recordings in the event recordings were
made. Otherwise I have tried to recall the questions after lectures and
supervisory conferences, and to reconstruct my replies. Where I have
felt my answers might have been expanded, I have amplified them,
again retaining the original ideas as closely as I could. I have also
included references from the literature wherever possible. Obviously,
my replies reflect my own biases and some of the answers may not
accord with what other professionals would consider appropriate.
Where I have been aware of variant answers to a question, I have tried
to include these and even to analyze them, again reflecting my biases.
A m ultitude of the questions deal with the management of the hard-
to-treat patient such as affective disorders, borderline personality,
schizophrenia, and chronic mental illness, topics of contemporary in­
terest and importance. The use of pharmacotherapy and other adjunc­
tive measures and the handling of transference and countertransference
are other issues th at are responsible for a good number of questions.
Many other subjects are broached; indeed, there is scarcely an area
th a t has not been covered in the queries under discussion.
The points of view th at I have advanced are gleaned from 50 years
of experience in the psychiatric field. I started my career in psychiatry
in 1932 as the Assistant Executive Officer at the Boston Psychopathic
Hospital (now the Massachusetts Mental Health Center) under C.
Macfie Campbell as overall Director and Karl Bauman as Medical
Director. One of my functions was admitting new cases, after which
I had an opportunity to follow them as they were being treated by the
residents until their discharge or transfer. Consequent to this I worked
for the next 13 years with inpatients at the Kings Park State Hospital
on Long Island; as Supervising Psychiatrist there I gave lectures to
psychiatric nurses and attendants. I was fortunate in being able to
participate in organizing one of the first insulin therapy and ECT units
in the country. I was also deeply involved in research in hypnosis, out
 Preface ix

of which issued my books, Hypnoanalysis and Medical Hypnosis. Dur­

ing this period, I received my psychoanalytic training, personal anal­
ysis, and "control” analysis in New York City, first at the New York
Psychoanalytic Institute with its brilliant array of teachers like Gre­
gory Zilboorg and Lawrence Kubie, who espoused the classical Freud­
ian viewpoint; and later with the Society for the Advancement of
Psychoanalysis with neofreudians like Karen Horney, Clara Thompson
and Erich Fromm. I became acquainted with other points of view by
contact with innovators like Paul Federn, Sandor Rado and Abram
Kardiner. At this time I was on the staff of Flower-Fifth Avenue Hos­
pital and taught a psychiatric course at the New York Medical College.
My wife Arlene, Chief Psychiatric Social Worker at the Flower-Fifth
Avenue Hospital, and I were responsible for bringing a large group of
analysts to the New York Medical College, where the first postgraduate
psychoanalytic training program connected with a medical school was
founded. I served as a training analyst in this program for a number
of years, engaging in lecturing and "control” analyses (supervision) of
psychoanalytic candidates. Many of the questions today about psycho­
analysis and psychotherapy interestingly are the same as those puz­
zling my trainees then, and these questions are included in this volume.
Coordinate with the above experience, my wife and I founded the
Postgraduate Center for Mental Health in New York City in 1945, an
interdisciplinary postgraduate psychoanalytic training and treatm ent
facility with research and community mental health departments. This
organization rapidly became the largest mental health center of its
kind in the country. As Medical Director and Dean I had an opportunity
to make in-depth contact with the training problems of students from
various disciplines through lectures, supervision, and follow-up stud­
ies. Teaching residents at Bellevue Hospital brought me in touch with
the problems of another group of trainees. Moreover, my interests took
me to different parts of the United States and Europe, where I lectured
on various subjects in the psychiatric field. My work in these different
areas inspired several books, including The Technique of Psychotherapy
and The Handbook of Short-term Psychotherapy.
I have taken the liberty of summarizing my background to explain
whence springs my dynamic orientation with eclectic overtones. The
questions in this present volume are the outcome of this broad spectrum
of experience. I have learned a great deal from my students by their
questions and in answering these I hope to contribute somewhat to a
field th a t continues to intrigue us with its vast problems and possi­
bilities.
Acknowledgment is made to the many students with whom I have
X The Practice of Psychotherapy

worked whose questions inspired this book, to my colleagues from

whose contributions in the field I have drawn liberally, and to the
Postgraduate Center for Mental Health who sponsored and supported
the research and writing of the volume.

L e w is R. W olberg, M.D.
 THE
PRACTICE
OF
PSYCHOTHERAPY
506 Questions and Answers
This page intentionally left blank
I. General Aspects
of Psychotherapy

A puzzling phenomenon th at vexes many students is the continuing

parade of new psychotherapies th at burst into the therapeutic arena
like lions, only to slink out in defeat like lambs. Is the constant influx
of desultory techniques testimony to the sterility of present-day con­
ventional approaches? The facts th at approximately two-thirds of all
patients improve with psychotherapy, irrespective of type, and th at
statistical studies reveal little superiority of any one treatm ent method
have raised the knotty point as to whether techniques are mere epi-
phenomena th at are secondary to more important factors operating in
the therapeutic situation. Many uncertainties confound the clinician
who seeks clarification about amorphous issues that invest psycho­
therapy. Some of these issues are raised in questions contained in this
section. These concern themselves with topics of general interest re­
lated to a number of themes including: the basic ingredients of psy­
chotherapy; factors th at make for therapeutic change; therapist and
patient characteristics that result in good or bad therapy; the utility
of eclecticism in method; modes of enhancing a therapeutic alliance;
the matching of patients and therapists; the impact of cultural factors;
the role of insight; acting-out phenomena; resistance to termination;
the effect of changing therapists; present-day training needs and prob­
lems; working with cotherapists; the use of paraprofessionals and men­
tal health aides; and the difficulties of informed consent.
3
4 The Practice of Psychotherapy

Qls What is the best kind of therapy?

A l: One cannot generalize about what is the best therapy for all people.
Different individuals learn most advantageously by interventions th a t
uniquely interlock with their needs. The therapist’s clinical judgm ent
should be based on the criterion of what interventions are best em­
ployed at a specific time, rather than "shot-gun” methods for all per­
sons. This should not preclude the employment of standard approaches
as a way of getting started, but these should be implemented less with
the expectation th a t they will work with all patients than as a way of
studying the patient’s responses for clues regarding resistances, con­
flicts, and defenses.
W hat is good for the patient, however, must accord with what is good
for the therapist. Definitive research is yet to be done in the area of
selection of the "best” therapy in terms of the therapist, but considering
the many factors th at enter into the psychotherapeutic situation, th a t
therapy is probably best which works best for each individual therapist,
provided, of course, the patient can use it. A behavior therapist will
do better with methods organized around the social-learning paradigm
th an with methods issuing from psychoanalytic theory. A psychoan­
alyst who has little faith in behavioral, family, group, hypnotic, and
other methods will not give these techniques the enthusiastic dedi­
cation required to make them optimally effective. Above all, flexibility
is the key to determining what is "best” in therapy.

Q2: How would you account for the great proliferation of ther­
apies that w e see today?

A2: Professionals develop individual styles of doing psychotherapy, as

artists evolve unique ways of painting. They then become wedded to
these styles, perfect them, find them effective to their satisfaction, and
then sometimes promote them as the "best” of all treatm ents. A general
theory is fabricated sooner or later to provide a rationale which, more
or less, draws from their personal lives and intrapsychic experiences.
If they are sufficiently persuasive, they may attract a host of followers
who are searching for answers to the dilemmas of treatm ent. And if
they possess an abundance of charisma, they may even initiate a "rev­
olution” in the form of a new school, which lasts for a period until
sufficient failures in therapy accumulate to convince therapists th a t
the psychiatric messiah has not yet arrived. When we distill out the
 General A spects of Psychotherapy 5

im portant essences of all of the existing therapies, the differences are

not as profound as they seem on the surface, although several classes
of therapies do exist with distinctive goals and operational modes (see
Wolberg, 1977, pp. 13-17, 269-281).

Q3: In your opinion, what are the most important ingredients in

psychotherapy?

A3: Briefly put, I would say that first and foremost is establishing a
good working relationship (rapport, therapeutic alliance). This holds
true irrespective of the kind of therapy done. Next, I believe a psy­
chodynamic orientation is an indispensable basis for understanding
what has happened to and what is now going on in the patient, in
relation to both the evolution and continuing perpetuation of the prob­
lem. It is helpful also in tracking the course of therapy and in spotting
resistances th at interfere with it.
The therapist does not have to be a psychoanalyst to apply dynamic
principles. However, he needs to have integrated into his frame of
reference information about personality development and dynamics.
I am not talking so much about metapsychology, which concerns itself
with such speculations as the vicissitudes of drives, instincts, "split­
ting,” structure of the psychic apparatus, and sundry other theoretical
constructs. I refer to an understanding of: how past conditionings fash­
ion needs and defenses th at survive in the present and pollute a re­
alistic adaptation; conflicts th at are relegated to the unconscious and
th a t engender present-day anxiety; defenses and coping measures,
some of which generate symptoms; and transference and other resist­
ances th a t obstruct constructive learning. In short, the therapist needs
to know how these dynamic constituents are influencing the patient's
present problems and how they affect what is being done for the patient
in treatm ent.
As to the treatm ent process itself, flexibility and eclecticism of
method are, in my opinion, of great advantage, the techniques used
being fashioned by the patient’s needs and learning capacities. Irre­
spective of the techniques, many similarities may be found in the proc­
esses through which a patient works out his problems. A number of
nonspecific healing agencies facilitate the therapeutic process. These
include the placebo influence, the impact of the relationship with an
empathic nonjudgmental therapist, emotional catharsis, suggestion,
dyadic group dynamics fostering identification with the therapist, op­
6 The Practice of Psychotherapy

erant conditioning with the reinforcing of adaptive patterns, growing

awareness and understanding of what has produced and is sustaining
one's problems (insight), and the testing of new behavioral patterns
with evolvement of an increasing sense of mastery.
Finally, in all cases the therapist must recognize his own biases and
prejudicial antitherapeutic reactions (countertransference) to avoid
stim ulating the patient into repeating his pathogenic developmental
difficulties.

Q4: Isn’t therapeutic change related to the degree of em pathy

expressed by the therapist?

A4: Empathy is only one of the therapy-enhancing variables and an

im portant one. But the degree of empathy expressed may not be a good
index of predicted therapeutic responsiveness. In schizophrenics or bor­
derline patients, for example, too great empathy at the start may be
regarded as a seduction and may frighten some patients. While em­
pathy is important, it must be titrated against the extent of patient
receptiveness to such empathy. Moreover, there are times during tre a t­
m ent where withdrawal of empathy may be indicated, as when con­
frontation is utilized to accent the undesirability of certain attitudes
or patterns, or where in psychoanalytic therapy one wishes to stir up
negative feelings or tension to expedite transference.

Q5: You have m entioned that concern for, interest in, and caring
about a patient and what happens to him or her is quite
important in the helping process. What happens if you ex­
perience none of these things toward your patient?

A5: You simply can’t hatch an egg in a refrigerator. Unless you are
empathic with your patient and have some notion as to what he is
experiencing, you will not be able to communicate essential concern
or compassion. How you develop empathy is, of course, a key problem.
You can’t turn it on if it isn’t there. Often, putting yourself in the
patient’s position and asking yourself how you would feel if you went
through what he has gone through may enable you to understand the
feelings, thoughts, and motives of the patient and to act accordingly
with sympathy and understanding.
 General A spects of Psychotherapy 7

Q6: H ow can a psychotherapist who is having problems in his

ow n personal adjustment, e.g., marital discord, do good p sy­
chotherapy?

A6: Considering the stresses and pressures of contemporary society,

it is little wonder th at all individuals, including psychotherapists, are
burdened with some neurotic defenses. Even thoroughly "analyzed”
psychoanalysts possess a share of these burdens, which may display
themselves in m arital and other maladjustments. The fact th at some
personal difficulties exist should not prevent a psychotherapist from
doing good psychotherapy. The role he plays in a therapeutic situation
is different from th at assumed in personal relationships. The therapist
is usually more in control and hence more secure with patients than
he may be with his family or with his colleagues. Difficulties will occur,
however, where the therapist’s neurotic problems are quantitatively
too strong and cannot be controlled during therapy, spilling over into
the therapeutic situation in the form of unbridled countertransference.
This is why personal psychotherapy can be so helpful to a psychother­
apist, equipping him to assume greater objectivity in work with pa­
tients.

Q7: Isn’t the psychotherapeutic process also therapeutically

helpful to the therapist?

A7: It can be; in some cases it is even more beneficial for the therapist
than for the patient. We are hopeful, of course, that the therapist is
somewhat less neurotic than the patient! Seriously speaking, psycho­
therapy is a two-way process and each participant (patient and th er­
apist) should benefit from it, at least educationally if not in reconstructive
change.

Q8: I get mixed up by so many different therapies claim ing su­

periority in results. Can one ever use pieces from different
therapies in one’s own system?

A8: This is the essence of methodological eclecticism. No one therapy

covers every aspect of the therapeutic process. Each therapy seems to
have selected a limited zone of pathology and to have focused on this
8 The Practice of Psychotherapy

dimension. In an eclectic approach we may employ techniques from

different therapies at different phases of the treatm ent process; for
example, we may use some of the methods of the client-centered school
during the early stages when we seek to establish a therapeutic alli­
ance; some of the methods of psychoanalysis (dreams, transference,
etc.) when we are probing for conflicts; some of the methods of gestalt
therapy when confrontation is in order; some of the methods ofbehavior
therapy when we are trying to convert insight into action; and some
of the methods of cognitive therapy when we are trying to alter belief
systems. We might also try other modalities for specific reasons like
drug therapy, m arital therapy, sex therapy, family therapy and group
therapy. These methods have to be employed selectively, coordinating
them with the patient’s needs and the objectives we are trying to
achieve. The problem with most psychotherapeutic schools is th a t they
try to approach all phases of the therapeutic process with a limited
tool. It would be like building a house with a hammer alone when a
variety of tools is needed. Naturally, how eclectic methods are used
and the personality of the therapist are crucial for success.

Q9: There are many psychotherapeutic techniques available.

When should a therapist change from one to the next?

A9: This is a personal matter. There is no earthly reason for jumping

around from one method to another if therapy is proceeding satisfac­
torily. Most therapists learn a few techniques thoroughly and do well
with them. It would seem to me th at only where a patient is not re­
sponding to one’s habitual techniques, and the therapist is assured the
failure is not rooted in transference and other resistances, should he
change the interventions. This presupposes th at the therapist has
learned and has available to him supplementary techniques. The fact
th a t a therapist is eclectic in his methods does not mean th a t he cannot
be discriminating in using them.

Q10: Since a therapeutic alliance is fundam ental to doing good

psychotherapy, are there w ays of enhancing the therapeutic
alliance?

A10: Research data exist which endorse certain procedures as facili-

tative of a therapeutic alliance (Goldstein, 1980, Goldstein and Wolpe
 General A spects of Psychotherapy 9

1971). First, preparatory structuring for the patient by the initial

screener of what to expect from the assigned therapist and from therapy
itself, couched in enthusiastic constructive terms, has a beneficial in­
fluence on the patient. After the patient describes the kind of therapist
he would like, assurance th at the therapist to whom he will be assigned
actually possesses the desired qualities appears to promote expectant
trust. The screener, in further describing the assigned therapist, makes
the patient additionally receptive by indicating the latter’s expertise,
w arm th and capacities to help. Where the therapist comes from the
same background as the patient, a statement to th at effect has also
been shown to facilitate the forthcoming relationship. Finally, role
expectancy structuring can be useful in terms of what the patient and
therapist will do and what the patient may expect from therapy. This
helps eliminate surprise, confusion and negative feelings.
A recommended article is th at by Orne and Wender (1968), which
details the words to use in a structuring interview. In my 1977 (pp.
506-519) and 1980 (pp. 41-42) books there are also precise ways of
structuring the therapeutic situation. Sometimes a cassette tape is
given to the patient which contains clarifying instructions of how the
patient and the therapist are to behave with each other. Research
studies show th at modeling or observational learning can add to the
attraction potential the patient has for the therapist. Here an audio-
or videotape th at is played containing an actual or simulated session
which brings out the therapist’s sympathetic and caring qualities in
relation to a patient seems to have an impressive effect on some pa­
tients. According to contemporary studies, the higher the expertise and
status of the therapist in the mind of the patient, the greater the
therapist’s confidence in what he is doing, the stronger the activity
level and degree of demonstrable conviction, the more manifest the
empathy with the patient’s feelings—the more attracted the patient
will be to the therapist and hence the more likely a therapeutic alliance
will develop.

Q ll: How important an accelerating factor is faith in and iden­

tification with the therapist?

A ll: Faith in the therapist and in his techniques expedites the placebo
element and makes the patient more receptive to the ministrations of
the therapist, whether the latter deserves it or not. It also does a great
deal toward neutralizing the initial resistance. The factor of identifi­
10 The Practice of Psychotherapy

cation with the therapist, particularly with his value systems and
modes of managing problems, eventually plays a part in altering some
pathogenic attitudes and behavior. This presupposes th a t the therapist
is a well-balanced individual and reflects values and patterns th a t will
prove to be adaptive for the patient. Therapists reared in cognitive
approaches tend to minimize the effect of this modeling phenomenon
which, an aspect of dyadic group dynamics, nevertheless plays an im­
portant part, consciously or unconsciously, in helping to promote
change.

Q12: D oes the patient’s confidence in the therapist influence his

convictions?

A12: Enormously important—even when the therapist’s ideas of the

etiology or dynamics of the patient’s difficulty are wrong. The patient’s
acceptance of explanations proffered with conviction by a therapist in
whom there is confidence can have a determining influence on him.
They are incorporated into his belief system and sponsor tension re­
duction and restoration of habitual defenses. Through what means this
alchemy takes place is not clearly known, but suggestion, the placebo
effect, and the impact of the protecting relationship offered by the
therapist undoubtedly play a part.

Q13: How important are nonspecific factors in psychotherapy?

A13: Very important and always present. Since they cannot be avoided,
the therapist should graciously (and thankfully?) accept them with
humility, realizing th at such factors as the placebo influence, relief
experienced by emotional catharsis, suggestion, idealization of the
therapist, and dyadic group dynamics may counteract his operative
errors.

Q14: How would you explain the placebo effect?

A 14: Until recently the ranking opinion was th a t a placebo depended

on confidence in the efficacy of a procedure, which psychologically
allayed tension and fear and thus helped the individual achieve his
customary sense of mastery. Exactly how the suggested effect operated
 General A spects of Psychotherapy 11

was not even speculated on. With the discovery of endogenous opiate­
like substances th at reduced pain and substances th at acted like a
tranquilizer, both of which were manufactured in the brain, a new
hypothesis has evolved, namely th at both the placebo effect and the
effect of suggestion are due to the release of endorphin and kindred
chemicals. Whether this hypothesis will hold up with scientific exper­
iment remains to be seen, but so far it is an interesting explanation.
Acupuncture, biofeedback, and hypnosis may also, hypothetically, in
part at least, exploit the same biochemical mechanism.

Q15: How does the therapeutic relationship act to effectuate

change in the patient?

A15: One way is th at while the patient may want to cling to his neurotic
patterns, he may be willing to experiment with different behaviors
solely to please the therapist. Once the patient receives rewards in the
form of approving gestures and words for changes in attitudes and
behavior, such changes may become solidified. Of importance here is
an alteration of the self-image, which contributes to the permanence
of change. Modeling oneself after an idealized therapist is another
change mechanism and may gear the patient toward new constructive
experiences. A relationship with the therapist helps him to tolerate,
explore and accept aspects of himself that have been repudiated and
repressed. The incorporation of a new image of authority as embodied
in the more tolerant, nonjudgmental therapist helps alter a punitive,
intolerant superego. There are undoubtedly other mechanisms oper­
ative, further exploration of which may be found elsewhere (Wolberg,
1977, pp. 44, 47, 641, 648).

Q16: How can you pragm atically assign a proper therapist for
a certain patient?

A16: To date there are no definite studies th at indicate we have an­

swers to this question. The best thing one can do is to see th a t the
problems of any patients are within the training and experiential scope
of the assigned therapists. Thus severe depressions, schizophrenias,
manic states, paranoid conditions and somatic ailments should be han­
dled by medically trained therapists (psychiatrists) who have the
proper experience with psychotropic medications and the management
12 The Practice of Psychotherapy

of emergencies. Where psychotherapy, psychoanalysis, group therapy,

family therapy, couples therapy, biofeedback, hypnosis, behavior th er­
apy and various adjunctive therapies appear indicated, a therapist,
irrespective of discipline, who is trained and skilled in these techniques
should be able to execute them. Matching patient and therapist on the
basis of personality characteristics is still haphazard, even though the
Indiana Matching Project (Bergin, 1977) has indicated th a t the best
pairings are those where patient and therapist characteristics comple­
m ent each other (passive, submissive, inhibited patients doing better
w ith active and dominant therapists and vice versa). Some syndromes
seem to be helped more by therapists skilled in certain techniques,
e.g., phobias by flooding and in vivo desensitization, obsessive-com­
pulsive reactions by paradoxical intention and behavioral methods,
depression by cognitive therapy and antidepressants, schizophrenia by
neuroleptics and milieu therapy, etc. (see also p. 338 in the final chap­
ter).

Q17: Are there specific characteristics that make a patient su s­

ceptible to chosen psychotherapeutic methods?

A 17: A number of attempts have been made to establish criteria for

a patient-method alignment, for example, the symptomatic diagnosis
(like behavior therapy for phobias, an inspirational group such as AA
for alcoholism, neuroleptics for schizophrenia, lithium for mania); the
characterologic diagnosis (like the personality typologies proposed by
Horowitz, 1976, 1977); responses to hypnotic induction (Spiegel and
Spiegel, 1978); and the developmental diagnosis (Burke et al., 1979).
The latter authors believe that therapeutic methods may be selected
th a t coordinate with the period in development where the most offen­
sive conflicts were sustained.
Except for the symptomatic diagnosis where certain syndromes lend
themselves to special interventions, matching patient and method is
haphazard. Matching patients and therapists is even more challenging,
because of the interference of miscellaneous patient, therapist, envi­
ronmental, transferential, countertransferential and resistance vari­
ables. The very choice of a diagnosis and the identification of the m ental
conflict around which the therapeutic plan is organized are subject to
the therapist’s bias, as is the method to which the therapist is dedicated.
This bias will prejudice the patient’s response. A therapist who applies
 General Aspects of Psychotherapy 13

himself to a favored technique with enthusiasm and conviction will

expedite the patient’s progress, whereas the same technique used cas­
ually and unenthusiastically may have a minimal effect on the patient.
The style of some therapists and their investment in their theories will
support or m ilitate against the effective use of any of the methods. In
summary, at the present stage of our knowledge we cannot be sure
th a t a selected method exists for every patient we treat. Our options
m ust rem ain open and we must be willing to change our methods when
a selected technique does not work.

Q18: Are there certain therapist characteristics that facilitate

treatm ent in selected patients?

A 18: Therapists from the same cultural and socioeconomic background,

who are able to communicate in the same language forms, and who
have similar values, political ideas, and world views, more readily
empathize with and establish contact with their patients, and more
easily serve as identification models. They also tend more accurately
to interpret their patients’ unexpressed feelings and attitudes.

Q19: Is acting-out ever caused by arousal of early memories in

therapy?

A19: Acting-out can occur when early repudiated memories threaten

to break out and the patient resists their revelation to the therapist.
Instead of being talked about, they are defensively discharged outside
of the session in action tendencies.

Q20: How is acting-out best handled?

A20: Acting-out is best handled by interpretation; sometimes, espe­

cially where the acting-out behavior is hazardous, this may mean going
a bit beyond the patient’s immediate emotional readiness for such
interpretation. Any untoward reponse to the interpretation will then
have to be handled, but this is better than allowing the patient to
plunge into serious troubles through destructive acting-out.
14 The Practice of Psychotherapy

Q21: Patients often show a stubbornness in moving forward in

treatment. How is this best handled? Are there differences
in the w ay psychoanalysts and behavior therapists deal
with this problem, and is there a good behavioral model one
can follow?

A21: Little has been written on how definitely to solve the paradox of
the patient who seeks help yet resists any external control or guidance
toward change. What would seem to be indicated is a participant model
for therapy in which the patient takes responsibility in treatm ent,
monitoring his own behavior and determining the nature of his en­
vironment and his future plans.
In psychoanalysis, early in treatm ent the patient gathers from the
passivity of the analyst that he has to make his own decisions and
work through his blocks toward utilizing insight in the direction of
change. Interpretation of resistances is the prime modality used and
the analyst hopes th at the patient will in the resolution of these ob­
structions generalize his learnings in therapy toward making new con­
structive adaptations.
In psychoanalytically oriented therapy, the therapist is more active
and employs techniques in addition to interpretation to help the patient
effectuate change. These techniques often draw from many schools and
are more or less eclectic in nature.
In behavior therapy, the therapist is highly active, utilizing when
necessary a rich assortment of devices, including systematic desensi­
tization, operant conditioning, modeling of preferred behaviors, role-
playing, work assignments, and cognitive therapy. These treatm ents
are sometimes blended with counseling.
At the outset it often becomes apparent th at what some patients
w ant from therapy is to overcome suffering without giving up attitudes
and behaviors th a t are responsible for their suffering. W hat is required
before any progress can be made is to work toward motivating the
patient to change and to formulate worthwhile objectives in treatm ent.
In his chapter on self-management methods, Kanfer (1980) describes
a behavioral model drawn from Skinnerian methods and research find­
ings in social and cognitive psychology as well as current clinical prac­
tices. Through various techniques, the patient acquires skills for use
in problem-solving. He is also trained in altering noxious elements of
his environment. Development of constructive repertoires is conducted
through negotiations with the patient. Past experiences are reviewed
only to provide information during behavioral analysis on the circum­
 General Aspects of Psychotherapy 15

stances surrounding the original conditions when the maladaptive be­

havior was developed and to point out the present inappropriateness
of this behavior.
In controlled environments like a hospital or in military organiza­
tions, reinforcement contingencies may be relatively easily applied.
But in one’s ordinary living environment these are not so readily a r­
ranged and it is for this reason th at manipulation of cognitive variables
through cognitive behavior therapy can be valuable in order to help
evolve constructive self-reinforcing attitudes. A good deal of support
will be required from the therapist at the start of treatm ent, but this
will diminish as the patient becomes more skilled in self-management.
A contract is usually negotiated, details of which spell out the required
behavior, the time goal, the reinforcements for fulfillment of obliga­
tions, some aversive consequences of non-fulfillment of the contract,
and the way reviews and evaluations will be conducted. Where required
behaviors occur outside the range of observation of the therapist, self­
monitoring is mandatory and here the patient will benefit from keeping
a careful record of his behaviors. Assignment of tasks expedites self­
observation and hastens the development of new behavioral reper­
toires. Techniques are employed to set up environmental conditions
unfavorable to the undesired behavior, and to establish contingencies
for self-reinforcement. Discussions cover the patient’s experiences in
self-management with the object of helping him transfer his learnings
and skills to situations th at may develop in the future. There are other
models one may follow if one is pursuing a behavioral program, but
the one I have outlined seems to cover the essential points.

Q22: How important is knowledge of cultural factors in treating

patients from another background?

A22: Very important. Cultural factors influence how the patient re­
gards his problem, as well as his attitude toward the treatm ent process
and the therapist. The individual may be under the influence of misbe­
liefs, of primitive notions of disease causation, and superstitious ideas
of witchcraft and sorcery th at can prejudice responses to treatm ent.
Archaic ideas may persist even in educated individuals and among
higher socioeconomic classes. Individuals from a culturally different
background may believe they can respond only to action-oriented m eth­
ods and medications. Interviewing and probings for psychological caus­
ation leave them cold. It may require a good deal of preparation, best
16 The Practice of Psychotherapy

undertaken in a warm empathic relationship, before patients are ready

to move from their established values and ideas to those consonant
w ith our own principles of psychotherapeutic technique. It can be done,
however, if the therapist is forbearing and handles his own prejudices
and countertransferences.

Q23: D oes one alw ays have to have insight before he can exp e­
rience change?

A23: Not necessarily. Behavioral changes can come about purely as

a consequence of conditioning and reinforcement. Interestingly, insight
regarding w hat has been responsible for faulty coping patterns may
follow such behavioral change. On the other hand, we always strive
for some cognitive improvement or change, and often the therapeutic
focus is on bringing the individual to an insightful awareness of what
is behind his difficulties. This awareness (insight) then can act as a
motivating force to inspire the person to take steps to change his p at­
terns.

Q24: Can false insights result in improvement and change?

A24: Yes, if the individual then acts on these to alter his destructive
behavioral patterns. Sometimes spurious insights, by bringing about
freedom from fear, tension, and anxiety, may halt the use of associated
pathological defenses. The individual is then free to pursue behaviors
which are constructive and which through reinforcement may lead to
a healthy adaptation. On the other hand, if the false insight is a bla­
tantly deceptive canard, the individual will eventually see through it,
and he may experience a relapse.

Q25: Is there a difference betw een em otional insight and intel­

lectual insight?

A25: The difference is a subtle and often blurred one. We can regard
an intellectual insight as merely a twinkling of understanding on
which the individual does not act to produce behavioral change. It is
quite likely th a t the individual here is not ready to put his insights
to the test. An emotional insight may be defined as a "gut” feeling th a t
a revelation is correct. This can inspire behavior th a t may lead to
Another random document with
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that Richard was brought almost to death by grief and the
disappointment of his hopes, but that his death was partly caused by
the scantiness of the food supplied to him. The Chronique de la
Traïson tells the story about Piers Exton, which was afterwards
commonly accepted by historians, but this was certainly not current
at the time in England.
462 ff. The epithet ‘pius,’ which Gower attaches to Henry’s name
in this passage, means in his mouth ‘merciful,’ and in the margin the
‘pietas’ of the new king is contrasted with the ‘cruelty’ of Richard, the
vice to which Gower chiefly attributes his fall. There is no doubt that
the execution of Arundel and the murder of Gloucester (or the
popular opinion that he had been murdered) produced a very sinister
impression, and caused a general feeling of insecurity which was
very favourable to Henry’s enterprise. It is true also that Henry
showed himself scrupulously moderate at first in his dealings with
political opponents. Gower expresses the state of things pretty
accurately, when he says below:

‘R. proceres odit et eorum predia rodit,

H. fouet, heredesque suas restaurat in edes;
R. regnum vastat vindex et in omnibus astat,
Mulset terrorem pius H., que reducit amorem.’

486. This is a perilously near approach to the Wycliffite doctrine.

REX CELI Etc. (p. 343)

This piece is here connected by its heading with the Cronica
Tripertita, but it occurs also in the Glasgow MS. independently and in
the Trentham MS. as a sequel to the poem In Praise of Peace, with
the following in place of the present heading, ‘Explicit carmen de
pacis commendacione.... Et nunc sequitur epistola, in qua idem
Iohannes pro statu et salute dicti domini sui apud altissimum
deuocius exorat.’ The poem itself is an adaptation of the original
version of Vox Clamantis, vi. cap. 18: see vol. iii. p. 554.
 H. AQUILE PULLUS Etc. (p. 344)
The word ‘Prophecia’ in the margin seems to be intended to
recall the supposed prophecy of Merlin about the ‘filius (or pullus)
aquilae’ (Archaeol. xx. p. 257, Adam of Usk’s Chronicle, p. 133).
These four lines immediately follow the Cronica Tripertita in the
Glasgow and Hatton MSS., and are themselves followed by two
quotations from the Psalms (lxxxviii. 23, xl. 3):
‘Nichil proficiet inimicus in eo, et filius iniquitatis non apponet
nocere ei.’
‘Dominus conseruet eum, et viuificet eum, et beatum faciat eum
in terra, et non tradat cum in animam inimicorum eius.’
In the Trentham MS. we have the lines ‘H. aquile pullus,’ and the
above quotations, subjoined to the first eight lines of ‘O recolende,’
as part of the dedication of the Cinkante Balades: see vol. i. p. 336.
1. aquile pullus: Henry is called so because his father was named
John and used the eagle as one of his cognisances: cp. Adam of
Usk, p. 24, ‘pullus aquile, quia filius Iohannis.’ The reference is to a
prophecy, one form of which is quoted by the editor of Adam of Usk’s
Chronicle, p. 133. For the use of the eagle by John of Gaunt see
Sandford’s Genealogical History, p. 249.
2. colla. The reading of S may be supported by reference to Vox
Clamantis, vi. 876, where our author in borrowing from the Aurora
substitutes ‘bella’ for ‘corda’ or ‘colla.’
3. aquile ... oleum: this is the oil produced for Henry’s coronation,
which was said to have been miraculously delivered to Thomas à
Becket in a vial enclosed within an eagle of gold, and deposited by
him in the church of St. Gregory at Poitiers. It was said to have been
brought to England by Henry, first duke of Lancaster, and to have
been delivered by him to the Black Prince. Thus it came into the
possession of Richard II, who is said to have worn it constantly about
his neck. He had desired to be re-anointed with this oil, but
archbishop Arundel had refused to perform the ceremony (Annales
Henrici IV, pp. 297-300, Eulog. Hist. contin. iii. 380).
 O RECOLENDE, Etc. (p. 345)
The first eight lines of this appear in the Trentham MS. in
combination with ‘H. aquile pullus’ as part of the dedication of the
Cinkante Balades.
16 ff. For ‘pietas,’ ‘pius,’ see note on Cronica Tripertita, iii. 462.

CARMEN SUPER MULTIPLICI VICIORUM PESTILENCIA (p. 346)

‘Putruerunt et corrupte sunt,’ &c. This is in fact a quotation from
the Psalms, ‘Putruerunt et corruptae sunt cicatrices meae a facie
insipientiae meae,’ xxxvii. 6. (xxxviii. 5).
32. quasi Iouiniani. Already in the Vox Clamantis we have had
reference to the ‘new Jovinian’ who is a sower of heresy (vi. 1267),
and the person meant is no doubt Wycliffe. Jovinian, the opponent of
Jerome on the marriage question, is taken as a type of the
ecclesiastic of lax principles. Milman calls Jovinian and Vigilantius
‘premature Protestants’ (History of Christianity, Bk. III. ch. iv).
36. sub grossa lana: an allusion perhaps to the simple russet
garb of Wycliffe’s poor priests.
52 ff. Cp. Vox Clamantis, ii. 437 ff., whence many of these lines
are taken, e.g. 54-57, 60-77.
54. mortis ymago: that is, the mortal creature.
86. ‘time’ was probably written originally for ‘stude’ in SCH, as
well as in F, but it was perceived perhaps that ‘reuereri,’ which was
required for the rhyme, would not stand as an imperative. Similarly in
line 88 ‘Que fantasias aliter tibi dant’ stood no doubt originally in
SCH, and was altered for grammatical reasons.
181 f. This couplet is repeated from Vox Clamantis, vi. 861 f.
190. quam prius, for ‘prius quam,’ as frequently: cp. ll. 202, 292.
199. This line is from Ovid, Metam. vii. 826, ‘Credula res amor
est,’ &c., and is quite without sense as it stands here: cp. Vox
Clamantis, v. 165.
 203 f. 1 Cor. vi. 18.
246 ff. Cp. Vox Clamantis, vi. 445 ff.
250. semel nisi, i.e. ‘once only’ for ‘non nisi semel’: cp. Vox
Clamantis, iii. 22.
312. bis deno Ricardi regis in anno. The twentieth year of Richard
II is from June 22, 1396 to the same date of 1397. The arrests of
Arundel and Gloucester took place in the first few days of the twenty-
first year.

DE LUCIS SCRUTINIO (p. 355)

The Ecton MS. (E) gives a different form of the marginal notes,
as follows: 6. Nota de luce prelatorum et curatorum. 18. Nota de
luce professorum. 30. Nota de luce regum. 44. Nota de luce
procerum. 51. Nota de luce militum. 58. Nota de luce legistarum
et causidicorum. 67. Nota de luce mercatorum. 79. Nota de luce
vulgari in patria. 89. Nota quod Iohannes Gower auctor huius libri
hic in fine tenebras deplangens pro luce optinenda deum exorat.
25 ff. See Praise of Peace, 225 ff.
64 f. Cp. Vox Clamantis, v. 703.
91 ff. The language is of course figurative: we must not assume
that the author is referring to any physical blindness.

ECCE PATET TENSUS Etc. (p. 358)

This piece is found in the Trentham MS. f. 33 vo, following the
Cinkante Balades. It is probably imperfect at the end, the manuscript
having lost the next leaf.
25. que naturatur, &c., ‘which is irresistibly disposed to that which
is unlawful.’ This seems to be the meaning, but it is awkwardly
expressed.

EST AMOR Etc. (p. 359)

 This piece occurs also in combination with the Traitié: see vol. i.
p. 392. For the substance of it cp. Vox Clamantis, v. 53 ff.

QUIA VNUSQUISQUE Etc. (p. 360)

The form given by G is practically identical with that of the Fairfax
MS. That of the text, as given by SCH, varies from it in the first
paragraph, where it adopts the wording found in the second
recension copies, BTA. See vol. iii. pp. 479 and 550.
10. The word ‘meditantis’ is written over an erasure in G.
11 ff. This paragraph, as finally rewritten, seems intended to
include the Cronica Tripertita as a sequel to the Vox Clamantis: cp.
p. 313, where in the note which connects the two works language is
used very similar to that which we have here. The author in his
retrospective view of Richard’s reign has brought himself to feel that
the earlier calamities were a divine warning, by the neglect of which
the later evils and the final catastrophe had been brought about. It
has already been pointed out (vol. iii. p. 550) that in the Fairfax MS.
this account of the author’s books is completely separated from the
text of the Confessio Amantis and is written in a later hand, the same
in fact which we have here in the All Souls MS.

ENEIDOS BUCOLIS Etc. (p. 361)

These lines, which Gower says were kindly sent to him by ‘a
certain philosopher’ (not ‘quidam Philippus,’ as printed by the
Roxburghe editor) on the completion of his three books, are found
also at the end of the Fairfax MS. The author is probably the same
as that of the four lines ‘Quam cinxere freta,’ &c., appended to the
Confessio Amantis, which are called ‘Epistola super huius opusculi
sui complementum Iohanni Gower a quodam philosopho
transmissa.’ I have ventured on the conjecture that this philosopher
was in fact Ralph Strode, whom Chaucer couples with Gower in the
last stanza of Troilus with the epithet ‘philosophical,’ and of whom we
know by tradition that he wrote elegiac verse.
 O DEUS IMMENSE Etc. (p. 362)
There is no reason why the heading should not be from the hand
of the author, though added of course somewhat later than the date
of composition. The phrase ‘adhuc viuens’ or ‘dum vixit’ does not
seem to be any objection to this. It is used with a view to future
generations, and occurs also in the author’s account of his books (p.
360, l. 4).
2. morosi: opposed here to ‘viciosi’; cp. l. 57 and Epistola (p. 1), l.
33.
7. foret, ‘ought to be.’
19. Isaiah xxxiii. 1.
49. Cp. Traitié, xv. 7, &c.
62. habet speciale, ‘keeps as a secret.’
74. recoletur: apparently meant for subjunctive.

QUICQUID HOMO SCRIBAT, Etc. (p. 365)

Of the three forms given here we must suppose that of the
Trentham MS. to be the earliest. It is decidedly shorter than the
others, it has no prose heading, and it names the first year of Henry
IV in such a manner that we may probably assign it to that year. The
poet’s eyesight had then failed to such an extent that it was difficult
for him any longer to write; but complete blindness probably had not
yet come on, and he does not yet use the word ‘cecus.’ Of the other
two forms it is probable that that given by S is the later, if only
because the precise date is omitted and the very diffuse heading
restrained within reasonable limits. S, it is true, ends with this piece,
while CHG have the later pieces; but these were probably added as
they were composed, and the All Souls book may have been
presented to archbishop Arundel before the last poems were written.
This concluding piece is written in S in the same hand as the
Epistola at the beginning of the book, the heading apparently over
the writing of another hand, some parts as ‘dicitur,’ l. 2, ‘tripertita—
tempore,’ 2, 3, being obviously over erasure. The original hand
remains for ‘est qualiter ab illa Cronica que,’ ‘in Anglia—rerum,’ ‘varia
carmina—quia.’

ORATE PRO ANIMA Etc. (p. 367)

I have no doubt that this exhortation was set down by Gower
himself, who had probably arranged before his death for the
promised indulgence, following the principle laid down in the last
poem of the collection, of being his own executor in such matters.
The verses ‘Armigeri scutum,’ &c., which are appended in the
Glasgow MS. were originally upon his tomb, and they have every
appearance of being his own composition: cp. p. 352, ll. 217 ff.
Berthelette after describing the tomb says, ‘And there by hongeth a
table, wherin appereth that who so euer praith for the soule of John
Gower, he shall, so oft as he so dothe, haue a thousande and fyue
hundred dayes of pardon.’

PRESUL, OUILE REGIS, Etc. (p. 368)

This is evidently addressed to archbishop Arundel. The comet
referred to is no doubt that of March, 1402. The evils complained of
are the conspiracies against the king, and we are told by the
chroniclers that the appearance of this comet in the north was taken
as a presage of the troubles in Wales and in Northumberland: cp.
Walsingham, ii. 248. Adam of Usk, who saw it when on the
Continent, says it was visible by day as well as by night, and that it
probably prefigured the death of the duke of Milan, whose arms were
also seen in the sky (p. 73).

DICUNT SCRIPTURE Etc. (p. 368)

5. The neglect complained of is of prayers for the soul of the
departed. Gower seems to have followed his own precept and made
arrangements for some of the prayers in his lifetime, though others
are provided for by his will. Berthelette in his preface to the
Confessio Amantis (1532) speaks of Gower’s place of burial as
having been prepared by himself in the church of St. Mary Overes,
‘where he hath of his owne foundation a masse dayly songe. And
more ouer he hath an obyte yerely done for hym within the same
churche, on fryday after the feaste of the blessed pope saynte
Gregory.’ St. Gregory’s day is March 12.

FOOTNOTE:
819 Dr. Stubbs says that the earls of Worcester and Wiltshire
were appointed to represent the clergy on this commission, as
on that mentioned Rot. Parl. iii. 360, which consists of the
same persons; but the official record is as given above, and
the commission afterwards acted on its powers without
requiring the presence of either of these two lords (Rot. Parl.
iii. 369).
 GLOSSARY
The Glossary is not intended as a complete record of Gower’s
Latin vocabulary. It is a list of words which are unclassical in form or
usage, or seem to present some difficulty, with select references and
occasional explanations. Regular differences of spelling, such as e
for ae and ci for ti are passed over without notice. The Roman
numbers without letters prefixed indicate books of the Vox
Clamantis, Ep. stands for the Epistola at the beginning of the
volume, C. T. for Cronica Tripertita, V. P. for Carmen super multiplici
Viciorum Pestilencia, L. S. for Tractatus de Lucis Scrutinio, and the
other pieces are represented by their opening words. A few
references only are given, and common usages are illustrated chiefly
from the first book of the Vox Clamantis.

A
abbas, s. iii. 379.
abhominacio, s. C. T. iii. 33.
abhorreo, v. a. i. 1084, shrink from, i. 1020*, be repulsive to;
abhorret as subj. vii. 186.
abinde, adv. C. T. i. 199, iii. 4.
abintus, adv. i. 2056.
abissus, s. i. 345.
abortus, &c. for ‘obortus,’ &c. i. 885.
absto, v. ii. 9, cease to exist.
accidia, s. vii. 817, sloth.
accidiosus, a. iii. 2069, vii. 817 ff., slothful.
Acephalus, iii. 956, iv. 715.
acra, a. f. sing. and n. pl., iii. 1162, C. T. ii. 27.
Actĕon, i. 446.
actrix, s. i. 763.
adhero, v. vii. 1296.
aera, s. nom. sing., iii. 831 (also aer, e.g. iii. 837).
Āgamĕnon, i. 988.
agon, s. i. 1124, C. T. iii. 464, contest, action.
alba, s. iii. 1787, alb.
aliqualis, a. i. 486, (not) any.
aliquis, for ‘quisquam,’ i. 261.
alter (= different) i. 21.
altero, v. a. i. 534, change.
ambassiător, s. C. T. iii. 107.
ammodo (amodo), adv. i. 196, 495, 2146, henceforth, now.
amurca, s. i. 359, scum.
ancer, for ‘anser,’ i. 518.
angelicus, a. iii. 283.
ab ante, adv. i. 1355.
Anthĕnor, i. 963.
antifrasis s. vii. 507, contradiction.
antitodum, s. vi. 828, antidote.
aperculus, s. i. 305.
apex, s. vii. 746, letter, vii. 1076, crown.
āpocapatus, a. iv. 354, cut short.
āpocapē, s. v. 820, cutting short.
apostata, s. iv. 289, 973.
appello, v. C. T. ii. 77 ff., accuse.
approprio (aproprio), v. a. i. 198.
aproprio, see approprio.
aquilonicus, a. C. T. i. 55, northern.
ăra, for ‘hara,’ i. 306, 369.
arătrum, s. i. 249, 283.
archanum, for ‘arcanum,’ V. P. 64.
architesis, s. v. 45, (?).
ardeo, v. a. i. 325.
artes, i. 474, see Notes.
assessus, pp. vi. 425, prepared.
assisa, s. vi. 426, assise.
asto, v. v. 96, 100, vi. 26, be.
Āthenis, abl. pl. v. 1011.
auca, s i. 549, goose.
augo, v. a. C. T. iii. 341 (also augeo, as ‘Rex celi’ &c. 45).
Augustīnensis, a. C. T. ii. 153.

B
Bachus, for ‘Bacchus,’ i. 949.
bāro, s. C. T. 152, băro, ‘O recolende’ &c. 10.
bassus, a. i. 523, C. T. ii. 104, low.
bercarius, s. iii. 1761, shepherd.
biblea, s. V. P. 182 (also biblia, vi. 862).
biceps, a. i. 227, two-edged.
blădum, s. i. 318, corn-crop.
Boētes, for ‘Boōtes,’ i. 139.
bombizo, v. i. 811, buzz.
botrus, s. ii. 219, bunch of grapes.
brauium, s. iv. 847, prize.
bruchus, s. i. 603, caterpillar.

C
Cālĭsia, C. T. ii. 47, Calisie (pl.), C. T. iii. 133, Calais.
Cāmĕlion, s. iv. 826.
camera, s. i. 471, chamber.
cānon, s. iv. 359, rule.
cānonicus, s. iv. 359.
Cāpanĕus, i. 985.
capitale, s. iii. 1801, head-dress.
capitaneus, s. i. 921, captain.
capitatus, a. iv. 839, (?).
capitosus, a. ‘Est amor’ &c. 4, headstrong.
capitulum, s. chapter.
captiuo, v. C. T. ii. 70, arrest.
carecta, i. 285, cart.
caribdis, for ‘Charybdis,’ C. T. iii. 23.
carta, s. C. T. ii. 16, charter.
catallum, s. C. T. i. 144, pl. C. T. i. 22, property.
catasta, s. i. 682, cage.
cathena, for ‘catena,’ i. 400.
cātus, s. C. T. i. 25, cat.
causo, v. i. 1072.
cautela, s. vi. 29, trick.
celsithronus, i. 2068.
celsitonans, i. 26.
ceptrum, for ‘sceptrum,’ iii. 579.
Cerem, for ‘Cererem,’ v. 812.
cerpo, for ‘serpo,’ iii. 1963.
cessit, for ‘cessat,’ Ep. 11.
Chaÿm, i. 1117, Cain.
choruscho, for ‘corusco,’ i. 23.
cicius, adv. i. 846, iv. 207, rather.
ciclus, s. ii. 241, cycle.
Cilla, for ‘Scylla,’ i. 1951.
ciniphes, s. i. 603, (?).
citharistĕus, a. vii. 753, of the harp.
clamo, i. 2, iv. 1330, claim.
clarifico, v. ii. 560, C. T. i. 188.
clata, s. v. 809, pillory (?).
claustralis, s. iv. 273, 828, monk;
a. L. S. 15.
claustrum, s. iii. 379, cloister.
clerus, s. iii. 1.
cognicior, a. comp. i. 1112.
colonis, s. i. 1876, vii. 1261.
comitissa, s. C. T. ii. 203, countess.
comitiua, s. C. T. iii. 139, company.
compacior, v. i. 1330, 1545, iv. 272, sympathize (with).
compotus, s. iii. 1397, account.
concerno, v. v. 127, look at.
concito, adv. i. 1955, quickly.
concomitor, v. vi. 786.
condignum, s. iii. 1564, desert.
condignus, a. iv. 556, suitable.
confero, v. n. i. 360, ii. 311, be of use;
refl. i. 207, suit.
confrater, s. iv. 63, brother in religion.
congaudeo, i. 97, C. T. iii. 148, 245.
congradior, for ‘congredior,’ i. 308.
conroto, v. i. 1194, whirl about.
consiliaris, s. ‘O deus’ &c. 13.
consiliator, s. ‘O deus’ &c. 33.
constellacio, s. i. 141.
construo, iii. 998, 1237.
contemplor, v. pass. Ep. 4.
contritus, a. C. T. iii. 206.
coppa, s. i. 545, hen.
corditer, adv. C. T. iii. 315, heartily.
cordula, s. iv. 509, string (of a musical instrument).
cornuto, v. i. 245, push with horns.
corona, iii. 1763, 2104, tonsure.
corrodium, s. iv. 215, see Notes.
cōtĭdianus, a. ii. 164.
co-vnatus, a. C. T. i. 131, assembled.
crapulus, s. i. 280, see Notes.
crasso, v. iii. 122, iv. 71, fatten.
Cristicola, iii. 310, Christian.
crōnica, s. i. 670, C. T. iii. 489, chronicle, record.
crucifer, s. i. 1087, cross-bearer.
cumque, for ‘cum,’ i. 119, iii. 545, 958, vii. 872.
cupero, v. for ‘recupero,’ v. 214.
cura, s. iii. 1315 ff. cure of souls.
curatus, s. iii. 1322, parish priest.
curo, v. iii. 1344, have a cure of souls.
cy̆ nōmia, s. i. 1603, dog-fly (κυνόμυια) (?).

D
Dauiticus, a. iii. 365, of David.
de, prep. Ep. 35, i. 14, 101, 115, 202, 230, 244, 392, 430, 523,
614, 868, 872, 1240, &c. with, by reason of, for the sake of.
decapito, v. i. 836, C. T. i. 184.
decasus, ii. 30, vii. 1242, fall.
decaudo, v. v. 819, curtail.
dēcimo, v. v. 785, take tithe.
decōro, v. vii. 595.
dedico, v. iii. 943, refuse.
dedignosus, a. ‘Est amor’ &c. 11.
defendo, v. v. 719, forbid.
deforis, adv. i. 63, outside.
deliciosus, a. i. 196.
demon, s. i. 301.
denărius, s. v. 760.
denaturo, v. i. 979, v. 637, degenerate, misbehave.
dentale, s. i. 283, ploughshare.
depenno, v. C. T. ii. 315.
derogo, v. vi. 29, obtain.
desuper, adv. i. 96, vii. 678. &c. on high.
deuiolo, v. iv. 676.
dextrarius, s. i. 639, steed.
a dextris, i. 31.
dieta, s. C. T. i. 58, iii. 157.
digito, v. a. iii. 1004, lay finger to.
disproprio, v. iii. 680, cast aside.
dissoluo, v. vii. 549, spread out.
distancia, s. i. 965, difference.
ditescere, v. a. ii. 607, C. T. iii. 119, enrich.
diuarico, v. a. ii. 612, vii. 474, vary.
diŭturnus, a. i. 219.
doleum, s. for ‘dolium,’ v. 777.
dominati, s. pl. iii. 297, ‘dominions.’
dompnus, s. iv. 34, 323 ff., see Notes.
dorsa, s. i. 409, back.
dubitatus, a. i. 1561, doubtful.
ducatus, s. C. T. iii. 117, dukedom.
ductilis, a. iii. 1091, guiding; cp. i. 930.
dummodo, for ‘dum,’ Ep. 11.
dumque, for ‘dum,’ Ep. 23, i. 165, 806, iii. 366, iv. 266.

E
eccho, for ‘echo,’ i. 376.
ecclĕsia, s. iii. 293, C. T. i. 104.
eclipsis, s. C. T. i. 60.
econtra, adv. i. Prol. 5, on the other hand.
econuerso, adv. ii. 102.
edus, for ‘haedus,’ iv. 693.
elemōsyna, s. iv. 263, alms.
elongo, v. ii. 308, v. 99.
enim, with relat. pron. vi. 740, 1238, cp. vii. 372, indeed.
ephot, s. i. 1080.
esse, inf. as subst. ii. 437, 512, ‘Rex celi’ &c. 7.
Ethna, C. T. ii. 207.
euinco, v. vii. 67, acquire (?).
ex, prep. i. 97, 156, 522, 881, 1334, because of, by means of, by,
away from.
excercitus, for ‘exercitus,’ i. 609.
excetra, ii. Prol. 51, serpent (?).
executor, s. p. 368 marg., executor of the dead.
exemplicor, v. vii. 925, warn by example.
exennia, s. pl. vi. 63, gifts.
exilium, s. i. 455, destruction.
explanto, v. C. T. iii. 255, root out.
expresse, adv. ‘Vnanimes esse’ &c. 2.
exquo, conj. ii. cap. xi. (heading), since.
extasis, s. i. 1470, v. 138.
extenta, iii. 942, (?).
exto, v. i. 421, 433, be.

F
falco, s. i. 521, C. T. ii. 51.
fatatus, pp. C. T. iii. 356, fated.
fāuus, s. ii. Prol. 77 (but făuus, vi. 900).
febricitor, v. iv. 64, be fevered.
fero, v. i. 164, 365, 724, 1200, 1202, find, obtain, experience,
direct.
fīdŭcia, s. vi. 336.
figmentum, s. vii. 1139, formation.
florigeratus, a. vi. 1365, flowery.
forma, s. iii. 1413, dignity.
formalis, a. iii. 1443, dignified.
fortifico, v. ii. Prol. 81.
fortītudo, s. i. 1095.
fossum, s. i. 348, pitfall.
frăgro, v. i. 61.
frendeo, v. i. 337, roar.
fugat, subj. for ‘fuget,’ iii. 1498, vi. 1066.
furiens, for ‘furens,’ i. 777, 843, 1190.
furo, v. a. i. 853, 2106, stir up, infuriate (also v. n. i. 245, &c.).

G
gaiolis, s. (abl. pl.) i. cap. vi. (heading), gaols.
garcio, s. vii. 264, apprentice.
geba, s. iii. 86, see Notes.
gehenna, s. i. 431, 1377, C. T. ii. 2.
genuflexus, a. ‘Rex celi’ &c. 53.
gerarchīa, s. iii. 300, hierarchy.
Gereon, for ‘Geryon,’ i. 447.
gibbosus, a. vii. 1455.
girovago, v. i. 124, wander about.
gladiatus, pp. iii. 366, armed with a sword.
glosa, s. iii. 941, ‘Est amor’ &c. 1, comment, explanation.
graculus, s. i. 681, jay.
grauo, v. n. vii. 1455, be an offence.
grisus, a. v. 797, grey.
grossor, v. perh. for ‘grassor,’ vii. 167.
grossus, a. i. 251, coarse.
guerra, s. i. 2027, ii. 76, war.
gutta, i. 70, gum.

H
habeo, v. vii. 990, 1047, 1148, must, ought.
habundo, v. n. i. 17, increase.
Hănibal, vi. 1289.
Hēlĕnus, Hĕlĕnus, i. 1002, 1153.
Herebus, for ‘Erebus,’ i. 741.
herĕmis, s. ii. 261, desert.
heremita, s. V. P. 300, hermit.
heresis, s. V. P. 32.
hēri, adv. i. 245, yesterday, (hĕri, iii. 1379).
hic, for ‘is’ or ‘ille,’ i. 475, 501, 676.
Hispannia, i. 447.
holocaustum, s. i. 1854, sacrifice.
humerale, s. iii. 1799, vestment worn on the shoulders.

I
Iăsōnis, genit. i. 263.
idipsum, ii. 585.
igniuomus, a. i. 1713.
Ihĕsus, ii. 485, &c.
illiceber, a. vi. cap. xii. (heading), alluring.
illicebrum, s. for ‘illecebra,’ vi. 854, allurement.
illuc, for ‘illic,’ i. 57.
imperialis, a. C. T. iii. 458, royal.
incantatus, pp. iv. 799, C. T. ii. 13, charmed, deluded.
incaustum, s. ii. 1, ink.
inchola, for ‘incola,’ i. 1215.
incircumspectus, a. i. 907, incautious.
ineternum, adv. i. 1756, ‘Rex celi’ &c. 6.
infernus, s. i. 430, 748, hell.
inficio, v. iv. 236, unmake (also taint, pollute, iv. 438, &c.).
infra, prep. C. T. ii. 95 (marg.), iii. 401 (marg.), within:
ab infra, ad infra, i. 2011, v. 167.
ingluuies, s. i. 1907, flow, (?).
inmunis, a. vi. 1307, innocent.
inquiĕto, v. vii. 892.
insulcatus, pp. i. 1649, (?).
interius, comp. n. as subst. i. Prol. 12, 1361.
interuter, a. ii. 188, each in turn (?).