Prologue:

Sometimes it seems preposterous to me to believe that therapy works at all. (16)

Where individual lives are concerned, there can be no control group. The only meaningful controls exist in our minds and imaginations:
Is this the life I hoped for?
Is this the life I hoped to avoid? (17)

Chapter 1:

There is magic in the first encounter with a patient; you get a slice of everything to come. (24)

I would not have to risk alienating Naomi by trying to disabuse her of any fantasy identity because that identity would simply fade away on its own once she felt better about being herself. (31)

Shame begets shame. It’s like a bad seed that gets passed from one generation to another. (32)

“I started to cry, like always,” Naomi told me. “And I started to scream at him, but suddenly it was like I was watching the whole scene from the ceiling and there was this broken man spitting and sputtering because he was so terribly unhappy and lonely. It was sad, very sad, but it didn’t hurt me anymore because it had nothing to do with me.” (33)

I sometimes think of the ego in physiological terms, a sort of psychic muscle that responds to training with increased strength and durability. (34)

I have always been of the opinion that everyone is entitled to a simple delusion or two–that, say, a man who has gone half bald is permitted to convince himself that he has a full head of hair. No harm done. He is no danger to himself or anyone else. (40)

But if one’s performance is one’s entire waking life, at what point does that willful suspension of disbelief become delusion?
And again, if a delusion, how serious? How dangerous?
There is a murky sea lying between simple delusion and delusionary disorder. As would forever be the case for me, the finely wrought categories of my profession’s diagnostic criteria did not seem to describe my patient adequately. (41)

Dance, my teachers said, is sublimation, a creative stand-in for powerful natural drives. It releases these drives without causing harm. It is what separates us from the beasts; it makes the base sublime. (42)

I often wish I could spy on my patients when they think they are alone and unseen, when they have no reason to project an image of themselves. It is not that I think of this solo self as /truer/ than any of their other selves, but it is a self I rarely get to glimpse, a piece of the puzzle I usually have to infer from my patients’ self-conscious reports. (46)

This, too, is a privilege I wish I could be granted with all of my patients: to view their living spaces, to see the parts of their personalities that decorate the walls. (47)

“I mean, I don’t know about anybody else, but I’ve got lots of selves inside me, all fighting to be the star. And I’ve always got to referee between them, pick the parts that feel right at the time… But isn’t it wonderful? I mean, the way you can be so many people in one lifetime?” (50)

I remember reading Hegel’s philosophy of history when I was a student; the philosopher saw the driving forces of history as going in cycles, from thesis to antithesis to synthesis, spiraling ever upward to higher, more complex levels of being. (55)

How /do/ you determine what a successful posttherapy life is? It’s never happily-ever-after for anyone. (56)

Chapter 2:

That is the drama, the tension between success and failure that keeps us all riveted in our seats. (59)

For all the hundreds of times the broken heart of unrequited love has revealed itself to me in my office, it is always painful to behold. (62)

I certainly did not expect to come up with some comprehensive theory that accounted for why this particular man had become eroticized by a bear. I doubted there was any such theory that I would find acceptable, just as, for example, I am skeptical of theories that purport to explain why this particular person became gay and this one did not. Such theories usually strike me as circular, ultimately citing the effect as proof of the cause. (70)

“I always tell my students that the best performances are pure improvisation.” (87)

“A fascination with masks means you are looking for a way to hide, right? Disguising yourself from the world? Well, here’s another theory… and it’s just the opposite of yours. I think wearing masks is a way of showing who you really are. Like there’s a clown in everybody just aching to get out, but we hold it in with our furrowed brows and stiff upper lips. Those brows and lips–/they/ are the real masks. But paint on a clown face and the real you sees daylight. Those commedia dell’arte masks that I cataloged–they were mirrors of the soul, not disguises.” (89)

I was once again reminded that a fourteen-stitch claw cut was nothing as compared with a broken heart. (90)

“The best things in life go around in circles.” (96)