From Dr. Loy 12 January 1913
What you said at our last interview was extraordinarily stimulating.
I was expecting you to throw light on the interpretation of my own and my patients’ dreams from the standpoint of Freud’s dream interpretation.
Instead, you put before me an entirely new conception: the dream as a means, produced by the subconscious, of restoring the moral balance.
That is certainly a fruitful thought.
But still more fruitful, it seems to me, is your other suggestion.
You conceive the tasks of psychoanalysis to be much deeper than I had ever imagined: it is no longer a question of getting rid of troublesome pathological symptoms, but of the analysand learning to know himself completely—not just his anxiety experiences—and on the basis of this knowledge building up and shaping his life anew.
But he himself must be the builder; the analyst only furnishes him with the necessary tools.
To begin with, I would ask you to consider what justification there is for the original procedure of Breuer and Freud, now entirely given up both by Freud himself and by you, but practised by Frank, for instance, as his only method: the “abreaction of inhibited affects under light hypnosis.”
Why did you give up the cathartic method? Please explain.
More particularly, has light hypnosis in psycho-catharsis a different value from suggestion during sleep, long practised in suggestion therapy?
That is, has it only the value which the doctor attributes, or says he attributes to it, the value which the patient’s faith gives it?
In other words, is suggestion in the waking state equivalent to suggestion in the hypnoid state, as Bernheim now asserts, after having used suggestion for many years in hypnosis?
You will tell me that we must talk of psychoanalysis, not of suggestion.
What I really mean is this: is not the suggestion that psychocatharsis in the hypnoid state will produce a therapeutic effect (with limitations, naturally, the age of the patient, etc.) the main factor in the therapeutic effects of psychocatharsis?
Frank says in his Affektstorungen: “These one-sided attitudes, suggestibility and suggestion, are almost entirely in abeyance in psychocatharsis under light sleep, so far as the content of the ideas reproduced is concerned.” Is that really true?
Frank himself adds: “How can ruminating on the dreams of youth in itself lead to discharge of the stored-up anxiety, whether in the hypnoid state or any other?
Must we not rather suppose that ruminating on them would make the anxiety states even greater?” (I have noticed this myself, far more than I liked.)
Of course one says to the patient, “First we must stir up, then afterwards comes peace.” And it does come.
But does it not come in spite of the stirring-up process, because gradually, by means of frequent talks apart from light hypnosis, the patient gains such confidence in the analyst that he becomes susceptible to the direct suggestion that an improvement and then a cure will follow?
I go still further: in an analysis in the waking state, is not the patient’s faith that the method employed will cure him, coupled with his growing confidence in the analyst, a main cause of his cure?
And I go still further: in every therapeutic method systematically carried out is not faith in it, confidence in the doctor, a main cause of its success?
I won’t say the only cause, for one cannot deny that physical, dietetic, and chemical procedures, when properly selected, have their own effect in bringing about a cure, over and above the striking effects produced by indirect suggestion.
From Dr. Jung 28 January 1913
With regard to your question concerning the applicability of the cathartic procedure, I can say that I adopt the following standpoint: every procedure is good if it helps.
I therefore acknowledge every method of suggestion including Christian Science, mental healing, etc. “A truth is a truth, when it works.”
It is another question, though, whether a scientifically trained doctor can square it with his conscience to sell little bottles of Lourdes water because this suggestion is at times very helpful.
Even the so-called highly scientific suggestion therapy employs the wares of the medicine-man and the exorcising shaman.
And why not?
The public is not much more advanced either and continues to expect miraculous cures from the doctor.
And indeed, we must rate those doctors wise—worldly-wise in every sense—who know how to surround themselves with the aura of a medicine-man.
They have not only the biggest practices but also get the best results.
This is because, apart from the neuroses, countless physical illnesses are tainted and complicated with psychic material to an unsuspected degree.
The medical exorcist betrays by his whole demeanour his full appreciation of that psychic component when he gives the patient the opportunity of fixing his faith firmly on the mysterious personality of the doctor.
In this way he wins the sick man’s mind, which from then on helps him to restore his body to health.
The cure works best when the doctor himself believes in his own formulae, otherwise he may be overcome by scientific doubt and so lose the proper convincing tone.
I myself practised hypnotic suggestion therapy for a time with enthusiasm.
But then there befell me three dubious incidents which I would like to bring to your attention.
One day a withered old peasant woman of about 56 came to me to be hypnotized for various neurotic troubles.
She was not easy to hypnotize, was very restless, and kept opening her eyes —but at last I did succeed.
When I woke her up again after about half an hour she seized my hand and with many words testified to her overflowing gratitude.
I told her, “You are by no means cured yet, so keep your thanks till the end of the treatment.”
“I’m not thanking you for that,” she whispered, blushing, “but because you were so decent.” She looked at me with a sort of tender admiration and departed.
I gazed for a long time at the spot where she had stood. So decent?
I asked myself, flabbergasted—good heavens, surely she hadn’t imagined . . . ?
This glimpse made me suspect for the first time that possibly the old reprobate, with the atrocious directness of feminine (at the time I called it “animal”) instinct, understood more about the essence of hypnosis than I did with all my knowledge of the scientific profundity of the text-books.
My innocence was gone. Next came a pretty, coquettish, seventeen-year-old girl with a very harassed-looking mama.
She had suffered since early childhood from enuresis nocturna (which she used, among other things, to stop herself being sent to a finishing school in Italy).
At once I thought of the old woman and her wisdom.
I tried to hypnotize the girl; she went into fits of laughter and held up the hypnosis for twenty minutes.
I kept my temper and thought: I know why you laugh, you have already fallen in love with me, but I will give you proof of my decency as a reward for wasting my time with your provocative laughter.
At last I put her under. The effect was immediate.
The enuresis stopped, and I thereupon informed the young lady that, instead of Wednesday, I would not see her again for hypnosis till the following Saturday.
On Saturday she arrived with a cross face, boding disaster. The enuresis had come back again.
I thought of my wise old woman and asked, “When did it come back?” She (unsuspecting): “Wednesday night.”
I thought to myself: There we have it, she wants to prove to me that I absolutely must see her on Wednesdays too; not to see me for a whole long week is too much for a tender loving heart.
But I did not intend to pander to this annoying romance, so I said, “It would be quite wrong to continue the treatment under these circumstances.
We must drop it altogether for three weeks, to give the enuresis a chance to stop.
Then come again for treatment.”
In my malicious heart I knew that I would be away on holiday and the course for hypnotic treatment would be finished.
After the holiday my locum tenens told me that the young lady had been there with the news that the enuresis had vanished, but her disappointment at not seeing me was very keen.
The old woman was right, I thought.
The third case gave my joy in suggestion therapy its deathblow.
This case really was the limit.
A 65-year-old lady came hobbling into the consulting-room on a crutch.
She had suffered from pain in the knee-joint for seventeen years, and this at times kept her chained to her bed for many weeks.
No doctor had been able to cure her, and she had run through all the cures of present-day medicine.
After letting the stream of her narrative pour over me for ten minutes, I said, “I will try to hypnotize you, perhaps that will do you good.”
“Oh yes, please do!” she said, then leaned her head to one side and fell asleep before ever I said or did a thing.
She passed into somnambulism and showed every form of hypnosis you could possibly desire.
After half an hour I had the greatest difficulty in waking her; when at last she was awake she jumped up: “I am well, I am all right, you have cured me!”
I tried to raise timid objections, but her praises drowned me.
She could really walk. I blushed, and said embarrassed to my colleagues: “Behold the marvels of hypnotic therapy!”
That day saw the death of my connection with therapy by suggestion; the notoriety aroused by this case shamed and depressed me.
When, a year later, the good old lady returned, this time with a pain in her back, I was already sunk in hopeless cynicism; I saw written on her brow that she had just read in the paper the notice of the reopening of my course on hypnotism.
That tiresome romanticism had provided her with a convenient pain in the back so that she might have a pretext for seeing me, and again let herself be cured in the same spectacular fashion.
This proved true in every particular.
As you will understand, a man possessed of a scientific conscience cannot digest such cases with impunity.
I was resolved to abandon suggestion altogether rather than allow myself to be passively transformed into a miracle-worker.
I wanted to understand what really goes on in people’s minds.
It suddenly seemed to me incredibly childish to think of dispelling an illness with magical incantations, and that this should be the sole result of our efforts to create a psychotherapy.
Thus the discovery of Breuer and Freud came as a veritable life-saver.
I took up their method with unalloyed enthusiasm and soon recognized how right Freud was when, at a very early date, indeed as far back as Studies on Hysteria, he began to direct a searchlight on the circumstances of the so-called trauma.
I soon discovered that, though traumata of clearly aetiological significance were occasionally present, the majority of them appeared very improbable.
Many traumata were so unimportant, even so normal, that they could be regarded at most as a pretext for the neurosis.
But what especially aroused my criticism was the fact that not a few traumata were simply inventions of fantasy and had never happened at all.
This realization was enough to make me skeptical about the whole trauma theory. (I have discussed these matters in detail in my lectures on the theory of psychoanalysis.)
I could no longer imagine that repeated experiences of a fantastically exaggerated or entirely fictitious trauma had a different therapeutic value from a suggestion procedure.
It is good if it helps.
If only one did not have a scientific conscience and that hankering after the truth!
I recognized in many cases, particularly with intelligent patients, the therapeutic limitations of this method.
It is merely a rule of thumb, convenient for the analyst because it makes no particular demands on his intellect or his capacity to adapt.
The theory and practice are delightfully simple: “The neurosis comes from a trauma. The trauma is abreacted.”
If the abreacting takes place under hypnotism or with other magical accessories (dark room, special lighting, etc.), I think at once of my clever old woman, who opened my eyes not only to the magical influence of the mesmeric passes but to the nature of hypnotism itself.
What alienated me once and for all from this comparatively effective, indirect method of suggestion, based as it is on an equally effective false theory, was the simultaneous recognition that behind the bewildering and deceptive maze of neurotic fantasies there is a conflict which may best be described as a moral one.
With this there began for me a new era of understanding.
Research and therapy now joined hands in the effort to discover the causes and the rational solution of the conflict.
For me this meant psychoanalysis.
While I was arriving at this insight, Freud had built up his sexual theory of neurosis, thus posing a mass of questions for discussion, all of which seemed worthy of the deepest consideration.
I had the good fortune to collaborate with Freud for a long time, and to work with him on the problem of sexuality in neurosis.
You know perhaps from some of my earlier works that I was always rather dubious about the significance of sexuality.
This has now become the point on which I am no longer altogether of Freud’s opinion.
I have preferred to answer your questions in a somewhat inconsequential fashion.
I will now catch up on the rest: light hypnosis and total hypnosis are simply varying degrees of intensity of unconscious susceptibility to the hypnotist.
Who can draw sharp distinctions here?
To a critical intelligence it is unthinkable that suggestibility and suggestion can be avoided in the cathartic method.
They are present everywhere as general human attributes, even with Dubois and the psychoanalysts, who all think they are working on purely rational lines.
No technique and no self-effacement avails here; the analyst works willy-nilly, and perhaps most of all, through his personality, i.e., through suggestion.
In the cathartic method, what is of far more importance to the patient than the conjuring up of old fantasies is the experience of being together so often with the analyst, his trust and belief in him personally and in his method.
The belief, the self-confidence, perhaps also the devotion with which the analyst does his work, are far more important to the patient (imponderabilia though they may be) than the rehearsing of old traumata.
It is time we learnt from the history of medicine everything that has ever been of help, then perhaps we shall discover the really necessary therapy—that is, psychotherapy.
Did not even the old apothecaries’ messes achieve brilliant cures, cures which faded only with the belief in their efficacy?!
Because I know that, despite all rational safeguards, the patient does attempt to assimilate the analyst’s personality, I have laid it down as a requirement that the psychotherapist must be just as responsible for the cleanness of his hands as the surgeon.
I even hold it to be an indispensable prerequisite that the psychoanalyst should first submit himself to the analytical process, as his personality is one of the main factors in the cure.
Patents read the analyst’s character intuitively, and they should find in him a man with failings, admittedly, but also a man who strives at every point to fulfil his human duties in the fullest sense.
Many times I have had the opportunity of seeing that the analyst is successful with his treatment just so far as he has succeeded in his own moral development.
I think this answer will satisfy your question. ~Loy/Jung Letters, CW 4, Pages 253-260