Psychiatric Activities

 

The years at Burgholzli were my years of apprenticeship.

 

Dominating my interests and research was the burning question: “What actually takes place inside the mentally ill?”

 

That was something which I did not understand then, nor had any of my colleagues concerned themselves with such problems.

 

Psychiatry teachers were not interested in what the patient had to say, but rather in how to make a diagnosis or how to describe symptoms and to compile statistics.

 

From the clinical point of view which then prevailed, the human personality of the patient, his individuality, did not matter at all.

 

Rather, the doctor was confronted with Patient X, with a long list of cut-and-dried diagnoses and a detailing of symptoms.

 

Patients were labeled, rubber-stamped with a diagnosis, and, for the most part, that settled the matter.

 

The psychology of the mental patient played no role whatsoever.

 

At this point Freud became vitally important to me, especially because of his fundamental researches into the psychology of hysteria and of dreams.

 

For me his ideas pointed the way to a closer investigation and understanding of individual cases.

 

Freud introduced psychology into psychiatry, although he himself was a neurologist.

 

I still recollect very well a case which greatly interested me at the time.

 

A young woman had been admitted to the hospital, suffering from “melancholia.”

 

The examination was conducted with the usual care: anamnesis, tests, physical check-ups, and so on.

 

The diagnosis was schizophrenia, or “dementia praecox,” in the phrase of those days.

 

The prognosis: poor.

 

This woman happened to be in my section.

 

At first I did not dare to question die diagnosis.

 

I was still a young man then, a beginner, and would not have had the temerity to suggest another one.

 

And yet the case struck me as strange.

 

I had the feeling that it was not a matter of schizophrenia but of ordinary depression, and resolved to apply my own method.

 

At the time I was much occupied with diagnostic association studies, and so I undertook an association experiment with the patient.

 

In addition, I discussed her dreams with her.

 

In this way I succeeded in uncovering her past, which the anamnesis had not clarified.

 

I obtained information directly from the unconscious, and this information revealed a dark and tragic story.

 

Before the woman married she had known a man, the son of a wealthy industrialist, in whom all the girls of the eighborhood

were interested.

 

Since she was very pretty, she thought her chances of catching him were fairly good.

 

But apparently he did not care for her, and so she married another man.

 

Five years later an old friend visited her. They were talking over old times, and he said to her, “When you got married it

was quite a shock to someone your Mr. X” (the wealthy industrialist’s son).

 

That was the moment!

 

Her depression dated from this period, and several weeks later led to a catastrophe.

 

She was bathing her children, first her four-year-old girl and then her two-year-old son.

 

She lived in a country where the water supply was not perfectly hygienic; there was pure spring water for drinking, and tainted water from the river for bathing and washing.

 

While she was bathing the little girl, she saw the child sucking at the sponge, but did not stop her.

 

She even gave her little son a glass of the impure water to drink.

 

Naturally, she did this unconsciously, or only half consciously, for her mind was already under the shadow of the incipient depression.

 

A short time later, after the incubation period had passed, the girl came down with typhoid fever and died.

 

The girl had been her favorite.

 

The boy was not infected.

 

At that moment the depression reached its acute stage, and the woman was sent to the institution.

 

From the association test I had seen that she was a murderess, and I had learned many of the details of her secret.

 

It was at once apparent that this was a sufficient reason for her depression.

 

Essentially it was a psychogenic disturbance and not a case of schizophrenia.

 

Now what could be done in the way of therapy?

 

Up to then the woman had been given narcotics to combat her insomnia and had been under guard to prevent attempts at suicide.

 

But otherwise nothing had been done.

 

Physically, she was in good condition.

 

I was confronted with the problem: Should I speak openly with her or not? Should I undertake the major operation?

 

I was faced with a conflict of duties altogether without precedent in my experience.

 

I had a difficult question of conscience to answer, and had to settle the matter with myself alone.

 

If I had asked my colleagues, they would probably have *warned me, “For heaven’s sake, don’t tell the woman any such thing. That will only make her still crazier.”

 

To my mind, the effect might well be the reverse.

 

In general it may be said that unequivocal rules scarcely exist in psychology, A question can be answered one way or another, depending on whether or not we take the unconscious factors into account.

 

Of course I knew very well the personal risk I was running: if the patient got worse, I would be in the soup too!

 

Nevertheless, I decided to take a chance on a therapy whose outcome was uncertain.

 

I told her everything I had discovered through the association test.

 

It can easily be imagined how difficult it was for me to do this.

 

To accuse a person point-blank of murder is no small matter.

 

And it was tragic for the patient to have to listen to it and accept it.

 

But the result was that in two weeks it proved possible to discharge her, and she was never again institutionalized.

 

There were other reasons that caused me to say nothing to my colleagues about this case.

 

I was afraid of their discussing it and possibly raising legal questions.

 

Nothing could be proved against the patient, of course, and yet such a discussion might have had disastrous consequences for her.

 

Fate had punished her enough!

 

It seemed to me more meaningful that she should return to life in order to atone in life for her crime.

 

When she was discharged, she departed bearing her heavy burden.

 

She had to bear this burden.

 

The loss of the child had been frightful for her, and her expiation had already begun with the depression and her confinement to the institution.

 

In many cases in psychiatry, the patient who comes to us has a story that is not told, and which as a rule no one knows of.

 

To my mind, therapy only really begins after the investigation of that wholly personal story.

 

It is the patient’s secret, the rock against which he is shattered.

 

If I know his secret story, I have a key to the treatment.

 

The doctor’s task is to find out how to gain that knowledge.

 

In most cases exploration of the conscious material is insufficient.

 

Sometimes an association test can open the way; so can the interpretation of dreams, or long and patient human contact with the individual.

 

In therapy the problem is always the whole person, never the symptom alone.

 

We must ask questions which challenge the whole personality.

 

In 1905 I became lecturer in psychiatry at the University of Zurich, and that same year I became senior physician at the Psychiatric Clinic.

 

I held this position for four years.

 

Then in 1909 I had to resign because by this time I was simply over my head in work.

 

In the course of the years I had acquired so large a private practice that I could no longer keep up with my tasks.

 

However, I continued my professorship until the year 1913.

 

I lectured on psychopathology, and, naturally, also on the foundations of Freudian psychoanalysis, as well as on the psychology of primitives.

 

These were my principal subjects.

 

During the first semesters my lectures dealt chiefly with hypnosis, also with Janet and Flournoy.

 

Later the problem of Freudian psychoanalysis moved into the foreground.

 

In my courses on hypnosis I used to inquire into the personal history of the patients whom I presented to the students.

 

One case I still remember very well.

 

A middle-aged woman, apparently with a strong religious bent, appeared one day.

 

She was fifty-eight years old, and came on crutches, led by her maid.

 

For seventeen years she had been suffering from a painful paralysis of the left leg.

 

I placed her in a comfortable chair and asked her for her story.

 

She began to tell it to me, and how terrible it all was the whole long tale of her illness came out with the greatest circumstantiality.

 

Finally I interrupted her and said, “Well now, we have no more time for so much talk. I am now going to hypnotize you.”

 

I had scarcely said the words when she closed her eyes and fell into a profound trance without any hypnosis at all!

 

I wondered at this, but did not disturb her.

 

She went on talking without pause, and related the most remarkable dreams; dreams that represented a fairly deep experience of the unconscious.

 

This, however, I did not understand until years later.

 

At the time I assumed she was in a kind of delirium.

 

The situation was gradually growing rather uncomfortable for me.

 

Here were twenty students present, to whom I was going to demonstrate hypnosis!

 

After half an hour of this, I wanted to awaken the patient again.

 

She would not wake up.

 

I became alarmed; it occurred to me that I might inadvertently have probed into a latent psychosis.

 

It took some ten minutes before I succeeded in waking her.

 

All the while I dared not let the students observe my nervousness.

 

When the woman came to, she was giddy and confused. I said to her, **I am the doctor, and everything is all right.”

 

Whereupon she cried out, “But I am cured!” threw away her crutches, and was able to walk.

 

Flushed with embarrassment, I said to the students, “Now you’ve seen what can be done with hypnosis!”

 

In fact I had not the slightest idea what had happened.

 

That was one of the experiences that prompted me to abandon hypnosis.

 

I could not understand what had really happened, but the woman was in fact cured, and departed in the best of spirits.

 

I asked her to let me hear from her, since I counted on a relapse in twenty-four hours at the latest.

 

But her pains did not recur; in spite of my skepticism, I had to accept the fact of her cure.

 

At the first lecture of the summer semester next year, she reappeared.

 

This time she complained of violent pains in the back which had, she said, begun only recently.

 

Naturally I asked myself whether there was some connection with the resumption of my lectures.

 

Perhaps she had read the announcement of the lecture in the newspaper.

 

I asked her when the pain had started, and what had caused it.

 

She could not recall that anything had happened to her at any specific time nor could she offer the slightest explanation.

 

Finally I elicited the fact that the pains had actually begun on the day and at the very hour she saw the announcement in the newspaper.

 

That confirmed my guess, but I still did not see how the miraculous cure had come about.

 

I hypnotized her once more that is to say, she again fell spontaneously into a trance and afterward the pain was gone.

 

This time I kept her after the lecture in order to find out more about her life.

 

It turned out that she had a feeble-minded son who was in my department in the hospital.

 

I knew nothing about this because she bore her second husband’s name and the son was a child of her first marriage.

 

He was her only child.

 

Naturally, she had hoped for a talented and successful son, and it had been a terrible blow when he became mentally ill at an

early age.

 

At that time I was still a young doctor, and represented everything she had hoped her son might become.

 

Her ambitious longing to be the mother of a hero therefore fastened upon me.

 

She adopted me as her son, and proclaimed her miraculous cure far and wide.

 

In actual fact she was responsible for my local fame as a wizard, and since the story soon got around, I was indebted to her for my first private patients.

 

My psychotherapeutic practice began with a mother’s putting me in the place of her mentally ill son!

 

Naturally I explained the whole matter to her, in all its ramifications.

 

She took it very well, and did not again suffer a relapse.

 

That was my first real therapeutic experience I might say: my first analysis.

 

I distinctly recall my talk with the old lady.

 

She was intelligent, and exceedingly grateful that I had taken her seriously and displayed concern for her fate and that of her

son.

 

This had helped her.

 

In the beginning I employed hypnosis in my private practice also, but I soon gave it up because in using it one is only groping in the dark.

 

One never knows how long an improvement or a cure will last, and I always had compunctions about working in such uncertainty.

 

Nor was I fond of deciding on my own what the patient ought to do.

 

I was much more concerned to learn from the patient himself where his natural bent would lead him.

 

In order to find that out, careful analysis of dreams and of other manifestations of the unconscious was necessary.

 

During the years 1904-5 I set up a laboratory for experimental psychopathology at the Psychiatric Clinic.

 

I had a number of students there with whom I investigated psychic reactions (i.e., associations).

 

Franz Riklin, Sr., was my collaborator.

 

Ludwig Binswanger was currently writing his doctoral dissertation on the association experiment in connection with the psychogalvanic effect,

 

1 and I wrote my paper “On the Psychological Diagnosis of Facts.”

 

There were also a number of Americans among our associates, including Frederick Peterson and Charles Ricksher.

 

Their papers were published in American journals.

 

It was these association studies which later, in 1909, procured me my invitation to Clark University; I was asked to lecture on my work.

 

Simultaneously, and independently of me, Freud was invited.

 

The degree of Doctor of Laws honoris causa was bestowed on both of us.

 

The association experiment and the psychogalvanic experiment were chiefly responsible for my reputation in America.

 

Very soon many patients from that country were coming to me.

 

1 remember well one of the first cases.

 

An American colleague sent me a patient.

 

The accompanying diagnosis read “alcoholic neurasthenia.”

 

The prognosis called him “Incurable.”

 

My colleague had therefore taken the precaution of advising the patient to see also a certain neurological authority in Berlin, for he expected that my attempt at therapy would lead to nothing.

 

The patient came for consultation, and after I had talked a little with him I saw that the man had an ordinary neurosis, of

whose psychic origins he had no inkling.

 

I made an association test and discovered that he was suffering from the effects of a formidable mother complex.

 

He came from a rich and respected family, had a likeable wife and no cares externally speaking.

 

Only he drank too much.

 

The drinking was a desperate attempt to narcotize himself, to forget his oppressive situation.

 

Naturally, it did not help.

 

His mother was the owner of a large company, and the unusually talented son occupied a leading post in the firm.

 

He really should long since have escaped from his oppressive subordination to his mother, but he could not summon up the resolution to throw up his excellent position.

 

Thus he remained chained to his mother, who had installed him in the business.

 

Whenever he was with her, or had to submit to her interference with his work, he would start drinking in order to stupefy or

discharge his emotions.

 

A part of him did not really want to leave the comfortably warm nest, and against his own instincts he was allowing himself to be seduced by wealth and comfort.

 

After brief treatment he stopped drinking, and considered himself cured.

 

But I told him, “I do not guarantee that you will not relapse into the same state if you return to your former situation.”

 

He did not believe me, and returned home to America in fine fettle.

 

As soon as he was back under his mother’s influence, the drinking began again.

 

Thereupon I was called by her to a consultation during her stay in Switzerland.

 

She was an intelligent woman, but was a real “power devil.”

 

I saw what the son had to contend with, and realized that he did not have the strength to resist.

 

Physically, too, he was rather delicate and no match for his mother.

 

I therefore decided upon an act of force majeure.

 

Behind his back I gave his mother a medical certificate to the effect that her son’s alcoholism rendered him incapable of fulfilling the requirements of his job.

 

I recommended his discharge.

 

This advice was followed and the son, of course, was furious with me.

 

Here I had done something which normally would be considered unethical for a medical man.

 

But I knew that for the patient’s sake I had had to take this step.

 

His further development?

 

Separated from his mother, his own personality was able to unfold.

 

He made a brilliant career in spite of, or rather just because of the strong horse pill I had given him.

 

His wife was grateful to me, for her husband had not only overcome his alcoholism, but had also struck out on his own

individual path with the greatest success.

 

Nevertheless, for years I had a guilty conscience about this patient because I had made out that certificate behind his back,

though I was certain that only such an act could free him.

 

And indeed, once his liberation was accomplished, the neurosis disappeared.

 

In my practice I was constantly impressed by the way the human psyche reacts to a crime committed unconsciously.

 

After all, that young woman was initially not aware that she had killed her child.

 

And yet she had fallen into a condition that appeared to be the expression of extreme consciousness of guilt. I once had a similar case which I have never forgotten.

 

A lady came to my office.

 

She refused to give her name, said it did not matter, since she wished to have only the one consultation.

 

It was apparent that she belonged to the upper levels of society.

 

She had been a doctor, she said.

 

What she had to communicate to me was a confession; some twenty years ago she had committed a murder out of jealousy.

 

She had poisoned her best friend because she wanted to marry the friend’s husband.

 

She had thought that if the murder was not discovered, it would not disturb her.

 

She wanted to marry the husband, and the simplest way was to eliminate her friend.

 

Moral considerations were of no importance to her, she thought.

 

The consequences?

 

She had in fact married the man, but he died soon afterward, relatively young.

 

During the following years a number of strange things happened.

 

The daughter of this marriage endeavored to get away from her as soon as she was grown up.

 

She married young and vanished from view, drew farther and farther away, and ultimately the mother lost all contact with her.

 

This lady was a passionate horsewoman and owned several riding horses of which she was extremely fond.

 

One day she discovered that the horses were beginning to grow nervous under her.

 

Even her favorite shied and threw her.

 

Finally she had to give up riding.

 

Thereafter she clung to her dogs.

 

She owned an unusually beautiful wolfhound to which she was greatly attached.

 

As chance would have it, this very dog was stricken with paralysis.

 

With that, her cup was full; she felt that she was morally done for.

 

She had to confess, and for this purpose she came to me.

 

She was a murderess, but on top of that she had also murdered herself.

 

For one who commits such a crime destroys his own soul.

 

The murderer has already passed sentence on himself.

 

If someone has committed a crime and is caught, he suffers judicial punishment.

 

If he has done it secretly, without moral consciousness of it, and remains undiscovered, the punishment can nevertheless be visited upon him, as our case shows.

 

It comes out in the end.

 

Sometimes it seems as if even animals and plants “know” it.

 

As a result of the murder, the woman was plunged into unbearable loneliness.

 

She had even become alienated from animals.

 

And in order to shake off this loneliness, she had made me share her knowledge.

 

She had to have someone who was not a murderer to share the secret,

 

She wanted to find a person who could accept her confession without prejudice, for by so doing she would achieve once more something resembling a relationship to humanity.

 

And the person would have to be a doctor rather than a professional confessor.

 

She would have suspected a priest of listening to her because of his office, and of not accepting the facts for their own sake but for the purpose of moral judgment.

 

She had seen people and animals turn away from her, and had been so struck by this silent verdict that she could not have endured any further condemnation.

 

I never found out who she was, nor do I have any proof that her story was true.

 

Sometimes I have asked myself what might have become of her.

 

For that was by no means the end of her journey.

 

Perhaps she was driven ultimately to suicide.

 

I cannot imagine how she could have gone on living in that utter loneliness.

 

Clinical diagnoses are important, since they give the doctor a certain orientation; but they do not help the patient.

 

The crucial thing is the story.

 

For it alone shows the human background and the human suffering, and only at that point can the doctors therapy begin to operate.

 

A case demonstrated this to me most cogently.

 

The case concerned an old patient in the women’s ward.

 

She was about seventy-five, and had been bedridden for forty years.

 

Almost fifty years ago she had entered the institution, but there was no one left who could recall her admittance; everyone who had been there had since died.

 

Only one head nurse, who had been working at the institution for thirty-five years, still remembered something of the patient’s story.

 

The old woman could not speak, and could only take fluid or semifluid nourishment.

 

She ate with her fingers, letting the food drip off them into her mouth.

 

Sometimes it would take her almost two hours to consume a cup of milk.

 

When not eating, she made curious rhythmic motions with her hands and arms.

 

I did not understand what they meant.

 

I was profoundly impressed by the degree of destruction that can be wrought by mental disease, but saw no possible explanation.

 

At the clinical lectures she used to be presented as a catatonic form of dementia praecox, but that meant nothing to me, for these words did not contribute in the slightest to an understanding of the significance and origin of those curious gestures.

 

The impression this case made upon me typifies my reaction to the psychiatry of the period.

 

When I became an assistant, I had the feeling that I understood nothing whatsoever about what psychiatry purported to be.

 

I felt extremely uncomfortable beside my chief and my colleagues, who assumed such airs of certainty while I was groping perplexedly in the dark.

 

For I regarded the main task of psychiatry as understanding the things that were taking place within the sick mind, and as yet I knew nothing about these things.

 

Here I was engaged in a profession in which I did not know my way about!

 

Late one evening, as I was walking through the ward, I saw the old woman still making her mysterious movements, and again asked myself, ‘Why must this be?” Thereupon I went to our old head nurse and asked whether the patient had always been that way.

 

“Yes,” she replied. “But my predecessor told me she used to make shoes.”

 

I then checked through her yellowing case history once more, and sure enough, there was a note to the effect that she was in the habit of making cobbler’s motions.

 

In the past shoemakers used to hold shoes between their knees and draw the threads through the leather with precisely such movements.

 

(Village cobblers can still be seen doing this today.)

 

When the patient died shortly afterward, her elder brother came to the funeral.

 

“Why did your sister lose her sanity?” I asked him.

 

He told me that she had been in love with a shoemaker who for some reason had not wanted to marry her, land that when he finally rejected her she had “gone off/’

 

The shoemaker movements indicated an identification with her sweetheart which had lasted until her death.

 

That case gave me my first inkling of the psychic origins of dementia praecox.

 

Henceforth I devoted all my attention to the meaningful connections in a psychosis.

 

Another patient’s story revealed to me the psychological background of psychosis and, above all, of the “senseless” delusions.

 

From this case I was able for the first time to understand the language of schizophrenics, which had hitherto been regarded

as meaningless.

 

The patient was Babette S., whose story I have published elsewhere.

 

In 1908 I delivered a lecture on her in the town hall of Zurich.

 

She came out of the Old Town of Zurich, out of narrow, dirty streets where she had been born in poverty-stricken circumstances and had grown up in a mean environment.

 

Her sister was a prostitute, her father a drunkard.

 

At the age of thirty-nine she succumbed to a paranoid form of dementia praecox, with characteristic megalomania.

 

When I saw her, she had been in the institution for twenty years.

 

She had served as an object lesson to hundreds of medical students.

 

In her they had seen the uncanny process of psychic disintegration; she was a classic case.

 

Babette was completely demented and given to saying the craziest things which made no sense at all.

 

I tried with all my might to understand the content of her abstruse utterances.

 

For example, she would say, “I am the Lorelei”; the reason for that was that the doctors, when trying to understand her case, would always say, “Ich weiss nicht, was soil es bedeuten”

 

Or she would wail, “I am Socrates’ deputy.”

 

That, as I discovered, was intended to mean: “I am unjustly accused like Socrates/’ Absurd outbursts like: “I am the double polytechnic irreplaceable,” or,

“I am plum cake on a corn-meal bottom,” “I am Germania and Helvetia of exclusively sweet butter,” “Naples and I must supply the world with noodles,” signified an increase in her self-valuation, that is to say, a compensation for inferiority feelings.

 

My preoccupation with Babette and other such cases convinced me that much of what we had hitherto regarded as senseless was not as crazy as it seemed.

 

More than once I have seen that even with such patients there remains in the background a personality which must be called normal.

 

It stands looking on, so to speak.

 

Occasionally, too, this personality usually by way of voices or dreams can make altogether sensible remarks and objections.

 

It can even, when physical illness ensues, move into the foreground again and make the patient seem almost normal.

 

I once had to treat a schizophrenic old woman who showed me very distinctly the ”normal” personality in the background.

 

This was a case which could not be cured, only cared for.

 

Every physician, after all, has patients whom he cannot hope to cure, for whom he can only smooth the path to death.

 

She heard voices which were distributed throughout her entire body, and a voice in the middle of the thorax was “God’s voice.”

 

*’We must rely on that voice,” I said to her, and was astonished at my own courage.

 

As a rule this voice made very sensible remarks, and with its aid I managed very well with the patient.

 

Once the voice said, “Let him test you on the Bible!”

 

She brought along an old, tattered, much-read Bible, and at each visit I had to assign her a chapter to read.

 

The next time I had to test her on it.

 

I did this for about seven years, once every two weeks.

 

At first I felt very odd in this role, but after a while I realized what the lessons signified. In this way her attention was kept alert, so that she did not sink deeper into the disintegrating dream.

 

The result was that after some six years the voices which had formerly been everywhere had retired to the left half of her body, while the right half was completely free of them.

 

Nor had the intensity of the phenomena been doubled on the left side; it was much the same as in the past.

 

Hence it must be concluded that the patient was cured at least halfway.

 

That was an unexpected success, for I would not have imagined that these memory exercises could have a therapeutic effect.

 

Through my work with the patients I realized that paranoid ideas and hallucinations contain a germ of meaning.

 

A personality, a life history, a pattern of hopes and desires lie behind the psychosis.

 

The fault is ours if we do not understand them.

 

It dawned upon me then for the first time that a general psychology of the personality lies concealed within psychosis, and that even here we come upon the old human conflicts.

 

Although patients may appear dull and apathetic, or totally imbecilic, there is more going on in their minds, and more that is meaningful, than there seems to be.

 

At bottom we discover nothing new and unknown in the mentally ill; rather, we encounter the substratum of our own natures.

 

It was always astounding to me that psychiatry should have taken so long to look into the content of the psychoses.

 

No one concerned himself with the meaning of fantasies, or thought to ask why this patient had one kind of fantasy, another an altogether different one; or what it signified when, for instance, a patient had the fantasy of being persecuted by the Jesuits, or when another imagined that the Jews wanted to poison him, or a third was convinced that the police were after him.

 

Such questions seemed altogether uninteresting to doctors of those days.

 

The fantasies were simply lumped together under some generic name as, for instance, “ideas of persecution.”

 

It seems equally odd to me that my investigations of that time are almost forgotten today.

 

Already at the beginning of the century I treated schizophrenia psychotherapeutically.

 

That method, therefore, is not something that has only just been discovered.

 

It did, howls/ever, take a long time before people began to introduce psychology into psychiatry.

 

While I was still at the clinic, I had to be most circumspect about treating my schizophrenic patients, or I would have been accused of woolgathering.

 

Schizophrenia was considered incurable.

 

If one did achieve some improvement with a case of schizophrenia, the answer was that it had not been real schizophrenia.

 

When Freud visited me in Zurich in 1908, 1 demonstrated the case of Babette to him.

 

Afterward he said to me, “You know, Jung, what you have found out about this patient is certainly interesting.

 

But how in the world were you able to bear spending hours and days with this phenomenally ugly female?”

 

I must have given him a rather dashed look, for this idea had never occurred to me.

 

In a way I regarded the woman as a pleasant old creature because she had such lovely delusions and said such interesting things.

 

And after all, even in her insanity, the human being emerged from a cloud of grotesque nonsense.

 

Therapeutically, nothing was accomplished with Babette; she had been sick for too long.

 

But I have seen other cases in which this kind of attentive entering into the personality of the patient produced a lasting therapeutic effect.

 

Regarding them from the outside, all we see of the mentally ill is their tragic destruction, rarely the life of that side of the

psyche which is turned away from us.

 

Outward appearances are frequently deceptive, as I discovered to my astonishment in the case of a young catatonic patient. She was eighteen years old, and came from a cultivated family.

 

At the age of fifteen she had been seduced by her brother and abused by a schoolmate.

 

From her sixteenth year on, she retreated into isolation.

 

She concealed herself from people, and ultimately the only emotional relationship left to her was one with a vicious watchdog which belonged to another family, and which she tried to win over.

 

She grew steadily odder, and at seventeen was taken to the mental hospital, where she spent a year and a half.

 

She heard voices, refused food, and was completely mutistic ( i.e., no longer spoke).

 

When I first saw her she was in a typical catatonic state.

 

In the course of many weeks I succeeded, very gradually, in persuading her to speak.

 

After overcoming many resistances, she told me that she had lived on the moon.

 

The moon, it seemed, was inhabited, but at first she had seen only men.

 

They had at once taken her with them and deposited her in a sublunar dwelling where their children and wives were kept.

 

For on the high mountains of the moon there lived a vampire who kidnaped and killed the women and children, so that the moon people were threatened with extinction.

 

That was the reason for the sublunar existence of the feminine half of the population.

 

My patient made up her mind to do something for the moon people, and planned to destroy the vampire.

 

After long preparations, she waited for the vampire on the platform of a tower which had been erected for this purpose.

 

After a number of nights she at last saw the monster approaching from afar, winging his way toward her like a great black bird.

 

She took her long sacrificial knife, concealed it in her gown, and waited for the vampire’s arrival.

 

Suddenly he stood before her.

 

He had several pairs of wings.

 

His face and entire figure were covered by them, so that she could see nothing but his feathers.

 

Wonder-struck, she was seized by curiosity to find out what he really looked like.

 

She approached, hand on the knife.

 

Suddenly the wings opened and a man of unearthly beauty stood before her.

 

He enclosed her in his winged arms with an iron grip, so that she could no longer wield the knife.

 

In any case she was so spellbound by the vampire’s look that she would not have been capable of striking.

 

He raised her from the platform and flew off with her.

 

After this revelation she was once again able to speak without inhibition, and now her resistances emerged.

 

It seemed that I had stopped her return to the moon; she could no longer escape from the earth.

 

This world was not beautiful, she said, but the moon was beautiful, and life there was rich in meaning.

 

Sometime later she suffered a relapse into her catatonia, and I had to have her taken to a sanatorium.

 

For a while she was violently insane.

 

When she was discharged after some two months, it was once again possible to talk with her.

 

Gradually she came to see that life on earth was unavoidable.

 

Desperately, she fought against this conclusion and its consequences, and had to be sent back to the sanatorium.

 

Once I visited her in her cell and said to her, “All this won’t do you any good; you cannot return to the moon!”

 

She took this in silence and with an appearance of utter apathy.

 

This time she was released after a short stay and resigned herself to her fate.

 

For a while she took a job as nurse in a sanatorium.

 

There was an assistant doctor there who made a somewhat rash approach to her.

 

She responded with a revolver shot.

 

Luckily, the man was only slightly wounded.

 

But the incident revealed that she went about with a revolver all the time.

 

Once before, she had turned up with a loaded gun.

 

During the last interview, at the end of the treatment, she gave it to me.

 

When I asked in amazement what she was doing with it, she replied, “I would have shot you down if you had failed me!”

 

When the excitement over the shooting had subsided, she returned to her native town.

 

She married, had several children, and survived two world wars in the East, without ever again suffering a relapse.

 

What can be said by way of interpretation of these fantasies?

 

As a result of the incest to which she had been subjected as a girl, she felt humiliated in the eyes of the world, but elevated in

the realm of fantasy.

 

She had been transported into a mythic realm; for incest is traditionally a prerogative of royalty and divinities.

 

The consequence was complete alienation from the world, a state of psychosis.

 

She became “extramundane,” as it were, and lost contact with humanity.

 

She plunged into cosmic distances, into outer space, where she met with the winged demon.

 

As is the rule with such things, she projected his figure onto me during the treatment.

 

Thus I was automatically threatened with death, as was everyone who might have persuaded  her to return to normal human life.

 

By telling me her story she had in a sense betrayed the demon and attached herself to an earthly human being.

 

Hence she was able to return to life and even to marry.

 

Thereafter I regarded the sufferings of the mentally ill in a different light.

 

For I had gained insight into the richness and importance of their inner experience.

 

I am often asked about my psychotherapeutic or analytic method.

 

I cannot reply unequivocally to the question.

 

Therapy is different in every case.

 

When a doctor tells me that he adheres strictly to this or that method, I have my doubts about his therapeutic effect.

 

So much is said in the literature about the resistance of the patient that it would almost seem as if the doctor were trying to put something over on him, whereas the cure ought to grow naturally out of the patient himself.

 

Psychotherapy and analysis are as varied as are human individuals.

 

I treat every patient as individually as possible, because the solution of the problem is always an individual one.

 

Universal rules can be postulated only with a grain of salt.

 

A psychological truth is valid only if it can be reversed.

 

A solution which would be out of the question for me may be just the right one for someone else.

 

Naturally, a doctor must be familiar with the so-called “methods.”

 

But he must guard against falling into any specific, routine approach.

 

In general one must guard against theoretical assumptions.

 

Today they may be valid, tomorrow it may be the turn of other assumptions. In my analyses they play no part.

 

I am unsystematic very much by intention.

 

To my mind, in dealing with individuals, only individual understanding will do.

 

We need a different language for every patient.

 

In one analysis I can be heard talking the Adlerian dialect, in another the Freudian.

 

The crucial point is that I confront the patient as one human being to another.

 

Analysis is a dialogue demanding two partners.

 

Analyst and patient sit facing one another, eye to eye; the doctor has something to say, but so has the patient.

 

Since the essence of psychotherapy is not the application of a method, psychiatric study alone does not suffice.

 

I myself had to work for a very long time before I possessed the equipment for psychotherapy.

 

As early as 1909 I realized that I could not treat latent psychoses if I did not understand their symbolism.

 

It was then that I began to study mythology.

 

With cultivated and intelligent patients the psychiatrist needs more than merely professional knowledge.

 

He must understand, aside from all theoretical assumptions, what really motivates the patient.

 

Otherwise he stirs up unnecessary resistances.

 

What counts, after all, is not whether a theory is corroborated, but whether the patient grasps himself as an individual.

 

This, however, is not possible without reference to the collective views, concerning which the doctor ought to be informed.

 

For that, mere medical training does not suffice, for the horizon of the human psyche embraces infinitely more than the limited purview of the doctor’s consulting room.

 

The psyche is distinctly more complicated and inaccessible than the body.

 

It is, so to speak, the half of the world which comes into existence only when we become conscious of it.

 

For that reason the psyche is not only a personal but a world problem, and the psychiatrist has to deal with an entire world.

 

Nowadays we can see as never before that the peril which threatens all of us comes not from nature, but from man, from the psyches of the individual and the mass.

 

The psychic aberration of man is the danger.

 

Everything depends upon whether or not our psyche functions properly.

 

If certain persons lose their heads nowadays, a hydrogen bomb will go off.

 

The psychotherapist, however, must understand not only the patient; it is equally important that he should understand himself.

 

For that reason the sine qua non is the analysis of the analyst, what is called the training analysis.

 

The patient’s treatment begins with the doctor, so to speak.

 

Only if the doctor knows how to cope with himself and his own problems will he be able to teach the patient to do the same.

 

Only then. 

 

In the training analysis the doctor must learn to know his own psyche and to take it seriously.

 

If he cannot do that, the patient will not learn either.

 

He will lose a portion of his psyche, just as the doctor has lost that portion of his psyche which he has not learned to understand.

 

It is not enough, therefore, for the training analysis to consist in acquiring a system of concepts.

 

The analysand must realize that it concerns himself, that the training analysis is a bit of real life and is not a method which can be learned by rote.

 

The student who does not grasp that fact in his own training analysis will have to pay dearly for the failure later on.

 

Though there is treatment known as “minor psychotherapy/’ in any thoroughgoing analysis the whole personality of both patient and doctor is called into play.

 

There are many cases which the doctor cannot cure without committing himself.

 

When important matters are at stake, it makes all the difference whether the doctor sees himself as a part of the drama, or cloaks himself in his authority.

 

In the great crises of life, in the supreme moments when to be or not to be is the question, little tricks of suggestion do not help.

 

Then the doctor’s whole being is challenged.

 

The therapist must at all times keep watch over himself, over the way he is reacting to his patient.

 

For we do not react only with our consciousness.

 

Also we must always be asking ourselves: How is our unconscious experiencing this situation?

 

We must therefore observe our dreams, pay the closest attention and study ourselves just as carefully as we do the patient.

 

Otherwise the entire treatment may go off the rails.

 

I shall give a single example of this.

 

I once had a patient, a highly intelligent woman, who for various reasons aroused my doubts.

 

At first the analysis went very well, but after a while I began to feel that I was no longer getting at the correct interpretation of her dreams, and I thought

I also noticed an increasing shallowness in our dialogue.

 

I therefore decided to talk with my patient about this, since it had of course not escaped her that something was going wrong.

 

The night before I was to speak with her, I had the following dream.

 

I was walking down a highway through a valley in late-afternoon sunlight.

 

To my right was a steep hill.

 

At its top stood a castle, and on the highest tower there was a woman sitting on a kind of balustrade.

 

In order to see her properly, I had to bend my head far back.

 

I awoke with a crick in the back of my neck.

 

Even in the dream I had recognized the woman as my patient.

 

The interpretation was immediately apparent to me.

 

If in the dream I had to look up at the patient in this fashion, in reality I had probably been looking down on her.

 

Dreams are, after all, compensations for the conscious attitude.

 

I told her of the dream and my interpretation.

 

This produced an immediate change in the situation, and the treatment once more began to move forward.

 

As a doctor I constantly have to ask myself what kind of message the patient is bringing me.

 

What does he mean to me? If he means nothing, I have no point of attack. The doctor is effective only when he himself is affected.

 

“Only the wounded physician heals.”

 

But when the doctor wears his personality like a coat of armor, he has no effect.

 

I take my patients seriously. Perhaps I am confronted with a problem just as much as they.

 

It often happens that the patient is exactly the right plaster for the doctor’s sore spot.

 

Because this is so, difficult situations can arise for the doctor too or rather, especially for the doctor.

 

Every therapist ought to have a control by some third person, so that he remains open to another point of view.

 

Even the pope has a confessor. I always advise analysts: “Have a father confessor, or a mother confessor!”

 

Women are particularly gifted for playing such a part.

 

They often have excellent intuition and a trenchant critical insight, and can see what men have up their sleeves, at times see also into men’s anima intrigues.

 

They see aspects that the man does not see.

 

That is why no woman has ever been convinced that her husband is a superman!

 

It is understandable that a person should undergo analysis if he has a neurosis; but if he feels he is normal, he is under no compulsion to do so.

 

Yet I can assure you, I have had some astonishing experiences with so-called “normality” Once I encountered an entirely “normal” pupil.

 

He was a doctor, and came to me with the best recommendations from an old colleague.

 

He had been his assistant and had later taken over his practice.

 

Now he had a normal practice, normal success, a normal wife, normal children, lived in a normal little house in a normal little town, had a normal income and probably a normal diet.

 

He wanted to be an analyst.

 

I said to him, “Do you know what that means? It means that you must first learn to know yourself. You yourself are the instrument. If you are not right,

how can the patient be made right? If you are not convinced, how can you convince him? You yourself must be the real stuff. If you are not, God help youl Then you will lead patients astray. Therefore you must first accept an analysis of yourself.”

 

That was all right, the man said, but almost at once followed this with: “I have no problems to tell you about.”

 

That should have been a warning to me, I said, “Very well, then we can examine your dreams.”

 

“I have no dreams” he said.

 

“You will soon have some,” I responded.

 

Anyone else would probably have dreamt that very night.

 

But he was unable to recall any dreams.

 

So it went on for about two weeks, and I began to feel rather uneasy about the whole affair.

 

At last an impressive dream turned up.

 

I am going to tell it because it shows how important it is, in practical psychiatry, to understand dreams.

 

He dreamt that he was traveling by railroad.

 

The train had a two-hour stop in a certain city.

 

Since he did not know the city and wanted to see something of it, he set out toward the city center.

 

There he found a medieval building, probably the town hall, and went into it.

 

He wandered down long corridors and came upon handsome rooms, their walls lined with old paintings and fine tapestries.

 

Precious old objects stood about.

 

Suddenly he saw that it had grown darker, and the sun had set.

 

He thought, I must get back to the railroad station.

 

At this moment he discovered that he was lost, and no longer knew where the exit was.

 

He started in alarm, and simultaneously realized that he had not met a single person in this building.

 

He began to feel uneasy, and quickened his pace, hoping to run into someone.

 

But he met no one.

 

Then he came to a large door, and thought with relief:

 

That is the exit.

 

He opened the door and discovered that he had stumbled upon a gigantic room.

 

It was so huge and dark that he could not even see the opposite wall.

 

Profoundly alarmed, the dreamer ran across the great, empty room, hoping to find the exit on the other side.

 

Then he saw precisely in the middle of the room something white on the floor.

 

As he approached he discovered that it was an idiot child of about two years old.

 

It was sitting on a chamber pot and had smeared itself with feces.

 

At that moment he awoke with a cry, in a state of panic.

 

I knew all I needed to know here was a latent psychosis!

 

I must say I sweated as I tried to lead him out of that dream.

 

I had to represent it to him as something quite innocuous, and gloss over all the perilous details.

 

What the dream says is approximately this: the trip on which he sets out is the trip to Zurich.

 

He remains there, however, for only a short time.

 

The child in the center of the room is himself as a two-year-old child.

 

In small children, such uncouth behavior is somewhat unusual, but still possible.

 

They may be intrigued by their feces, which are colored and have an odd smell.

 

Raised in a city environment, and possibly along strict lines, a child might easily be guilty of such a failing.

 

But the dreamer, the doctor, was no child; he was a grown man.

 

And therefore the dream image in the center of the room is a sinister symbol.

 

When he told me the dream, I realized that his normality was a compensation.

 

I had caught him in the nick of time, for the latent psychosis was within a hair’s breadth of breaking out and becoming manifest.

 

This had to be prevented.

 

Finally, with the aid of one of his other dreams, I succeeded in finding an acceptable pretext for ending the training analysis.

 

We were both of us very glad to stop.

 

I had not informed him of my diagnosis, but he had probably become aware that he was on the verge of a fatal panic, for he had a dream in which he was being pursued by a dangerous maniac.

 

Immediately afterward he returned home.

 

He never again stirred up die unconscious.

 

His emphatic normality reflected a personality which would not have been developed but simply shattered by a confrontation with the unconscious.

 

These latent psychoses are the betes noires of psychotherapists, since they are often very difficult to recognize.

 

With this, we come to the question of lay analysis, I am in favor of non-medical men studying psychotherapy and practicing it; but in dealing with latent psychoses there is the risk of their making dangerous mistakes.

 

Therefore I favor laymen working as analysts, but under the guidance of a professional physician.

 

As soon as a lay analyst feels the slightest bit uncertain, he ought to consult his mentor.

 

Even for doctors it is difficult to recognize and treat a latent schizophrenia; all the more so for laymen.

 

But I have repeatedly found that laymen who have practiced psychotherapy for years, and who have themselves been in analysis, are shrewd and capable.

 

Moreover, there are not enough doctors practicing psychotherapy.

 

For such practice, long and thorough training is necessary, and a wide culture which very few possess.

 

The relationship between doctor and patient, especially when a transference on the part of the patient occurs, or a more or less unconscious identification of doctor and patient, can lead to parapsychological phenomena.

 

I have frequently run into this.

 

One such case which was particularly impressive was that of a patient whom I had pulled out of a psychogenic depression.

 

He went back home and married; but I did not care for his wife.

 

The first time I saw her, I had an uneasy feeling.

 

Her husband was grateful to me, and I observed that I was a thorn in her side because of my influence over him.

 

It frequently happens that women who do not really love their husbands are jealous and destroy their friendships.

 

They want the husband to belong entirely to them because they themselves do not belong to him.

 

The kernel of all jealousy is lack of love.

 

The wife’s attitude placed a tremendous burden on the patient which he was incapable of coping with.

 

Under its pressure he relapsed, after a year of marriage, into a new depression.

 

Foreseeing this possibility, I had arranged with him that he was to get in touch with me at once if he observed his spirits sinking.

 

He neglected to do so, partly because of his wife, who scoffed at his moods. I heard not a word from him.

 

At that time I had to deliver a lecture in B.

 

I returned to my hotel around midnight. I sat with some friends for a while after the lecture, then went to bed, but I lay awake for a long time.

 

At about two o’clock I must have just fallen asleep I awoke with a start, and had the feeling that someone had come into the room; I even had the impression that the door had been hastily opened.

 

I instantly turned on the light, but there was nothing. Someone might have mistaken the door, I thought, and I looked into the corridor.

 

But it was still as death. “Odd,” I thought, “someone did come into the room!”

 

Then I tried to recall exactly what had happened, and it occurred to me that I had been awakened by a feeling of dull pain, as though something had struck my forehead and then the back of my skull.

 

The following day I received a telegram saying that my patient had committed suicide.

 

He had shot himself.

 

Later, I learned that the bullet had come to rest in the back wall of the skull.

 

This experience was a genuine synchronistic phenomenon such as is quite often observed in connection with an archetypal situation in this case, death.

 

By means of a relativization of time and space in the unconscious it could well be that I had perceived something which in reality was taking place elsewhere.

 

The collective unconscious is common to all; it is the foundation of what the ancients called the “sympathy of all things.”

 

In this case the unconscious had knowledge of my patient’s condition.

 

All that evening, in fact, I had felt curiously restive and nervous, very much in contrast to my usual mood, I never try to convert a patient to anything, and never exercise any compulsion.

 

What matters most to me is that the patient should reach his own view of things.

 

Under my treatment a pagan becomes a pagan and a Christian a Christian, a Jew a Jew, according to what his destiny prescribes for him.

 

I well recall the case of a Jewish woman who had lost her faith.

 

It began with a dream of mine in which a young girl, unknown to me, came to me as a patient.

 

She outlined her case to me, and while she was talking, I thought, “I don’t understand her at all. I don’t understand what it is all about.”

 

But suddenly it occurred to me that she must have an unusual father complex.

 

That was the dream.

 

For the next day I had down in my appointment book a consultation for four o’clock.

 

A young woman appeared. She was Jewish, daughter of a wealthy banker, pretty, chic, and highly intelligent.

 

She had already undergone an analysis, but the doctor acquired a transference to her and finally begged her not to come to him any more, for if she did, it would mean the destruction of his marriage.

 

The girl had been suffering for years from a severe anxiety neurosis, which this experience naturally worsened.

 

I began witih an anamnesis, but could discover nothing special.

 

She was a well-adapted, Westernized Jewess, enlightened down to her bones.

 

At first I could not understand what her trouble was.

 

Suddenly my dream occurred to me, and I thought, “Good Lord, so this is the little girl of my dream.”

 

Since, however, I could detect not a trace of a father complex in her, I asked her, as I am in the habit of doing in such cases, about her grandfather.

 

For a brief moment she closed her eyes, and I realized at once that here lay the heart of the problem.

 

I therefore asked her to tell me about this grandfather, and learned that he had been a rabbi and had belonged to a Jewish sect. “Do you mean

the Chassidim?” I asked.

 

She said yes. I pursued my questioning.

 

“If he was a rabbi, was he by any chance a Zaddik?”

 

“Yes/’ she replied, “it is said that he was a kind of saint and also possessed second sight. But that is all nonsense. There is no such thing!”

 

With that I had concluded the anamnesis and understood the history of her neurosis.

 

I explained to her, “Now I am going to tell you something that you may not be able to accept. Your grandfather was a zaddik. Your father became an apostate to the Jewish faith. He betrayed the secret and turned his back on God. And you have your neurosis because the fear of God has got into you/’

 

That struck her like a bolt of lightning.

 

The following night I had another dream.

 

A reception was taking place in my house, and behold, this girl was there too.

 

She came up to me and asked, “Haven’t you got an umbrella? It is raining so hard.” I actually found an umbrella, fumbled around with it to open it, and was on the point of giving it to her. But what happened instead? I handed it to her on my knees, as if she were a goddess.

 

I told this dream to her, and in a week the neurosis had vanished.

 

6 The dream had showed me that she was not just a superficial little girl, but that beneath the surface were the makings of a saint.

 

She had no mythological ideas, and therefore the most essential feature of her nature could find no way to express itself.

 

All her conscious activity was directed toward flirtation, clothes, and sex, because she knew of nothing else.

 

She knew only the intellect and lived a meaningless life.

 

In reality she was a child of God whose destiny was to fulfill His secret will.

 

I had to awaken mythological and religious ideas in her, for she belonged to that class of human beings of whom spiritual activity is demanded.

 

Thus her life took on a meaning, and no trace of the neurosis was left.

 

In this case I had applied no “method” but had sensed the presence of the numen.

 

My explaining this to her had accomplished the cure.

 

Method did not matter here; what mattered was. the “fear of God.”

 

I have frequently seen people become neurotic when they content themselves with inadequate or wrong answers to the questions of life.

 

They seek position, marriage, reputation, outward success or money, and remain unhappy and neurotic even when they have attained what they were seeking.

 

Such people are usually confined within too narrow a spiritual horizon.

 

Their life has not sufficient content, sufficient meaning.

 

If they are enabled to develop into more spacious personalities, the neurosis generally disappears.

 

For that reason the idea of development was always of the highest importance to me.

 

The majority of my patients consisted not of believers but of those who had lost their faith,

 

The ones who came to me were the lost sheep.

 

Even in this day and age the believer has the opportunity, in his church, to live the “symbolic life/’

 

We need only think of the experience of the Mass, of baptism, of the imitatio Christi, and many other aspects of religion.

 

But to live and experience symbols presupposes a vital participation on the part of the believer, and only too often this is lacking in people today.

 

In the neurotic it is practically always lacking.

 

In such cases we have to observe whether the unconscious will not spontaneously bring up symbols to replace what is lacking.

 

But then the question remains of whether a person who has symbolic dreams or visions will also be able to understand their meaning and take the consequences upon himself.

 

There is, for example, the case of the theologian which I described in “Archetypes of the Collective Unconscious/’

 

He had a certain dream which was frequently repeated.

 

He dreamt that he was standing on a slope from which he had a beautiful view of a low valley covered with dense woods.

 

In the dream he knew that in the middle of the woods there was a lake, and he also knew that hitherto something had always prevented him from going there.

 

But this time he wanted to carry out his plan.

 

As he approached the lake, the atmosphere grew uncanny, and suddenly a light gust of wind passed over the surface of the water, which rippled darkly.

 

He awoke with a cry of terror.

 

At first this dream seems incomprehensible.

 

But as a theologian the dreamer should have remembered the “pool” whose waters were stirred by a sudden wind, and in which the sick were bathed the pool of Bethesda.

 

An angel descended and touched the water, which thereby acquired curative powers.

 

The light wind is the pneuma which bloweth where it listeth And that terrified the dreamer.

 

An unseen presence is suggested, a numen that lives its own life and in whose presence man shudders.

 

The dreamer was reluctant to accept the association with the pool of Bethesda.

 

He wanted nothing of it, for such things are met with only in the Bible, or at most on Sunday mornings as the subjects of sermons, and have nothing to do

with psychology.

 

All very well to speak of the Holy Ghost on occasions but it is not a phenomenon to be experienced!

 

I knew that the dreamer should have overcome his fright  and, as it were, got over his panic.

 

But I never force the issue if a patient is unwilling to go the way that has been revealed to him and take the consequences.

 

I do not subscribe to the facile assumption that the patient is blocked merely by ordinary resistances.

 

Resistances especially when they are stubborn merit attention, for they are often warnings which must not be overlooked.

 

The cure may be a poison that not everyone can take, or an operation which, when it is contraindicated, can prove fatal.

 

Wherever there is a reaching down into innermost experience, into the nucleus of personality, most people are overcome by fright, and many run away.

 

Such was the case with this theologian.

 

I am of course aware that theologians are in a more difficult situation than others.

 

On the one hand they are closer to religion, but on the other hand they are more bound by church and dogma.

 

The risk of inner experience, the adventure of the spirit, is in any case alien to most human beings.

 

The possibility that such experience might have psychic reality is anathema to them.

 

All very well if it has a supernatural or at least a “historical” foundation.

 

But psychic? Face to face with this question, the patient will often show an unsuspected but profound contempt for the psyche.

 

In contemporary psychotherapy the demand is often made that            the doctor or psychotherapist should “go along” with the patient and his affects.

 

I don’t consider that to be always the right course.

 

Sometimes active intervention on the part of the doctor is required.

 

Once a lady of the aristocracy came to me who was in the habit of slapping her employees including her doctors.

 

She suffered from a compulsion neurosis and had been under treatment in a sanatorium.

 

Naturally, she had soon dispensed the obligatory slap to the head physician.

 

In her eyes, after all, he was only a superior valet de chambre.

 

She was paying the bills, wasn’t she?

 

This doctor sent her on to another institution and there the same scene was repeated.

 

Since the lady was not really insane, but evidently had to be handled with kid gloves, the hapless doctor sent her on to me.

 

She was a very stately and imposing person, six feet tall and there was power behind her slaps, I can tell you!

 

She came, then, and we had a very good talk.

 

Then came the moment when I had to say something unpleasant to her.

 

Furious, she sprang to her feet and threatened to slap me. I, too, jumped up, and said to her, “Very well, you are the lady. You hit first ladies first! But then I hit back!*’ And I meant it.

 

She fell back into her chair and deflated before my eyes. “No one has ever said that to me  before!” she protested.

 

From that moment on, the therapy began to succeed.

 

What this patient needed was a masculine reaction.

 

In this case it would have been entirely wrong to “go along/’

 

That would have been worse than useless.

 

She had a compulsion neurosis because she could not impose moral restraint upon herself.

 

Such people must then have some other form of restraint and along come the compulsive symptoms to serve the purpose.

 

Years ago I once drew up statistics on the results of my treatments.

 

I no longer recall the figures exactly; but, on a conservative estimate, a third of my cases were really cured, a third considerably improved, and a third not essentially influenced.

 

But it is precisely the unimproved cases which are hardest to judge, because many things are not realized and understood by the patients until years afterward, and only then can they take effect.

 

How often former patients have written to me: “I did not realize what it was really all about until ten years after I had been with you.”

 

I have had a few cases who ran out on me; very rarely indeed have I had to send a patient away.

 

But even among them were some who later sent me positive reports.

 

That is why it is often so difficult to draw conclusions as to the success of a treatment.

 

It is obvious that in the course of his practice a doctor will come across people who have a great effect on him too.

 

He meets personalities who, for better or worse, never stir the interest of the public and who nevertheless, or for that very reason, possess unusual

qualities, or whose destiny it is to pass through unprecedented developments and disasters.

 

Sometimes they are persons of extraordinary talents, who might well inspire another to give his life for them; but these talents may be implanted in so

strangely unfavorable a psychic disposition that we cannot tell whether it is a question of genius or of fragmentary development.

 

Frequently, too, in this unlikely soil there flower rare blossoms of the psyche which we would never have thought to find in the flatlands of society.

 

For psychotherapy to be effective a close rapport is needed, so close that the doctor cannot shut his eyes to the heights and depths of human suffering.

 

The rapport consists, after all, in a constant comparison and mutual comprehension, in the dialectical confrontation of two opposing psychic realities.

 

If for some reason these mutual impressions do not impinge on each other, the psychotherapeutic process remains ineffective, and no change is produced.

 

Unless both doctor and patient become a problem to each other, no solution is found.

 

Among the so-called neurotics of our day there are a good many who in other ages would not have been neurotic that is, divided against themselves.

 

If they had lived in a period and in a milieu in which man was still linked by myth with the world of the ancestors, and thus with nature truly experienced

and not merely seen from outside, they would have been spared this division with themselves.

 

I am speaking of those who cannot tolerate the loss of myth and who can neither find a way to a merely exterior world, to the world as seen by science, nor rest satisfied with an intellectual juggling with words, which has nothing whatsoever to do with wisdom.

 

These victims of the psychic dichotomy of our time are merely optional neurotics; their apparent morbidity drops away the moment the gulf between the ego and the unconscious is closed.

 

The doctor who has felt this dichotomy to the depths of his being will also be able to reach a better understanding of the unconscious psychic processes, and will be saved from the danger of inflation to which the psychologist is prone.

 

The doctor who does not know from his own experience the numinosity of the archetypes will scarcely be able to escape their negative effect when he encounters it in his practice.

 

He will tend to over- or underestimate it, since he possesses only an intellectual point of view but no empirical criterion.

 

This is where those perilous aberrations begin, the first of which is the attempt to dominate everything by the intellect.

 

This serves the secret purpose of placing both doctor and patient at a safe distance from the archetypal effect and thus from real experience, and of substituting for psychic reality an apparently secure, artificial, but merely two-dimensional conceptual world in which the reality of life is well covered up by so-called clear concepts.

 

Experience is stripped of its substance, and instead mere names are substituted, which are henceforth put in the place of reality.

 

No one has any obligations to a concept; that is what is so agreeable about conceptuality it promises protection from experience.

 

The spirit does not dwell in concepts, but in deeds and in facts.

 

Words butter no parsnips; nevertheless, this futile procedure is repeated ad infinitum.

 

In my experience, therefore, the most difficult as well as the most ungrateful patients, apart from habitual liars, are the so-called intellectuals.

 

With them, one hand never knows what the other hand is doing.

 

They cultivate a “compartment psychology.”

 

Anything can be settled by an intellect that is not subject to the control of feeling and yet the intellectual still suffers from a neurosis if feeling is undeveloped.

 

From my encounters with patients and with the psychic phenomena which they have paraded before me in an endless stream of images, I have learned an enormous amount not just knowledge, but above all insight into my own nature.

 

And not the least of what I have learned has come from my errors and defeats.

 

I have had mainly women patients, who often entered into the work with extraordinary conscientiousness, understanding, and intelligence.

 

It was essentially because of them that I was able to strike out on new paths in therapy.

 

A number of my patients became my disciples in the original sense of the word, and have carried my ideas out into the world.

 

Among them I have made friendships that have endured decade after decade.

 

My patients brought me so close to the reality of human life that I could not help learning essential things from them.

 

Encounters with people of so many different kinds and on so many different psychological levels have been for me incomparably more important than fragmentary conversations with celebrities.

 

The finest and most significant conversations of my life were anonymous. ~Carl Jung, Memories, Dreams and Reflections, Pages 114-145