East of Eden: Clinical and theoretical aspects of the sense of excommunication

This article investigates an organization of personality, centered on a sense of excommunication. What often seems like amoralism or cynicism often hides a moral outrage against the moral and social order the individual experiences as inherently painful, as condemning him or her to unavoidable guilt, or as an identity of deviance or illegitimacy. This constellation is exemplified through elements of Philip Roth's works and Jean Genet. A clinical case study exemplifies the inherent complexity of working with patients whose identities are governed by the protest against social order. It is shown that they are particularly susceptible to experiencing the therapist as representing this order and that the experience of mutuality in the therapeutic relationship most likely is to establish a good working alliance.