1.01 - Principles of Practical Psycho therapy

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object:1.01 - Principles of Practical Psycho therapy
book class:The Practice of Psycho therapy
author class:Carl Jung
subject class:Psychology
class:chapter

I - PRINCIPLES OF PRACTICAL PSYCHO THERAPY 1
[1]
Psycho therapy is a domain of the healing art which has developed
and acquired a certain independence only within the last fifty years.
Views in this field have changed and become differentiated in a great
variety of ways, and the mass of experience accumulated has given rise
to all sorts of different interpretations. The reason for this lies in the fact
that psycho therapy is not the simple, straightforward method people at
first believed it to be, but, as has gradually become clear, a kind of
dialectical process, a dialogue or discussion between two persons.
Dialectic was originally the art of conversation among the ancient
philosophers, but very early became the term for the process of creating
new syntheses. A person is a psychic system which, when it affects
another person, enters into reciprocal reaction with another psychic
system. This, perhaps the most modern, formulation of the
psycho therapeutic relation between physician and patient is clearly very
far removed from the original view that psycho therapy was a method
which anybody could apply in stereotyped fashion in order to reach the
desired result. It was not the needs of speculation which prompted this
unsuspected and, I might well say, unwelcome widening of the horizon,
but the hard facts of reality. In the first place, it was probably the fact
that one had to admit the possibility of different interpretations of the
observed material. Hence there grew up various schools with
diametrically opposed views. I would remind you of the Libeault-
Bernheim French method of suggestion therapy, rducation de la
volont; Babinskis persuasion; Dubois rational psychic
orthopedics; Freuds psychoanalysis, with its emphasis on sexuality
and the unconscious; Adlers educational method, with its emphasis on
power-drives and conscious fictions; Schultzs autogenic trainingto
name only the better known methods. Each of them rests on specialpsychological assumptions and produces special psychological results;
comparison between them is difficult and often wellnigh impossible.
Consequently it was quite natural that the champions of any one point of
view should, in order to simplify matters, treat the opinions of the others
as erroneous. Objective appraisal of the facts shows, however, that each
of these methods and theories is justified up to a point, since each can
boast not only of certain successes but of psychological data that largely
prove its particular assumption. Thus we are faced in psycho therapy
with a situation comparable with that in modern physics where, for
instance, there are two contradictory theories of light. And just as
physics does not find this contradiction unbridgeable, so the existence of
many possible standpoints in psychology should not give grounds for
assuming that the contradictions are irreconcilable and the various views
merely subjective and therefore incommensurable. Contradictions in a
department of science merely indicate that its subject displays
characteristics which at present can be grasped only by means of
antinomieswitness the wave theory and the corpuscular theory of
light. Now the psyche is infinitely more complicated than light; hence a
great number of antinomies is required to describe the nature of the
psyche satisfactorily. One of the fundamental antinomies is the
statement that psyche depends on body and body depends on psyche.
There are clear proofs for both sides of this antinomy, so that an
objective judgment cannot give more weight to thesis or to antithesis.
The existence of valid contradictions shows that the object of
investigation presents the inquiring mind with exceptional difficulties, as
a result of which only relatively valid statements can be made, at least
for the time being. That is to say, the statement is valid only in so far as
it indicates what kind of psychic system we are investigating. Hence we
arrive at the dialectical formulation which tells us precisely that psychic
influence is the reciprocal reaction of two psychic systems. Since the
individuality of the psychic system is infinitely variable, there must be
an infinite variety of relatively valid statements. But if individuality
were absolute in its particularity, if one individual were totally different
from every other individual, then psychology would be impossible as a
science, for it would consist in an insoluble chaos of subjective opinions.
Individuality, however, is only relative, the complement of human
conformity or likeness; and therefore it is possible to make statements ofgeneral validity, i.e., scientific statements. These statements relate only
to those parts of the psychic system which do in fact conform, i.e., are
amenable to comparison and statistically measurable; they do not relate
to that part of the system which is individual and unique. The second
fundamental antinomy in psychology therefore runs: the individual
signifies nothing in comparison with the universal, and the universal
signifies nothing in comparison with the individual. There are, as we all
know, no universal elephants, only individual elephants. But if a
generality, a constant plurality, of elephants did not exist, a single
individual elephant would be exceedingly improbable.
[2]
These logical reflections may appear somewhat remote from our
theme. But in so far as they are the outcome of previous psychological
experience, they yield practical conclusions of no little importance.
When, as a psycho therapist, I set myself up as a medical authority over
my patient and on that account claim to know something about his
individuality, or to be able to make valid statements about it, I am only
demonstrating my lack of criticism, for I am in no position to judge the
whole of the personality before me. I cannot say anything valid about
him except in so far as he approximates to the universal man. But
since all life is to be found only in individual form, and I myself can
assert of another individuality only what I find in my own, I am in
constant danger either of doing violence to the other person or of
succumbing to his influence. If I wish to treat another individual
psychologically at all, I must for better or worse give up all pretensions
to superior knowledge, all authority and desire to influence. I must
perforce adopt a dialectical procedure consisting in a comparison of our
mutual findings. But this becomes possible only if I give the other
person a chance to play his hand to the full, unhampered by my
assumptions. In this way his system is geared to mine and acts upon it;
my reaction is the only thing with which I as an individual can
legitimately confront my patient.
[3]
These considerations of principle produce in the psycho therapist a
very definite attitude which, in all cases of individual treatment, seems
to me to be absolutely necessary because it alone is scientifically
responsible. Any deviation from this attitude amounts to therapy by
suggestion, the kind of therapy whose main principle is: The individualsignifies nothing in comparison with the universal. Suggestion therapy
includes all methods that arrogate to themselves, and apply, a
knowledge or an interpretation of other individualities. Equally it
includes all strictly technical methods, because these invariably assume
that all individuals are alike. To the extent that the insignificance of the
individual is a truth, suggestive methods, technical procedures, and
theorems in any shape or form are entirely capable of success and
guarantee results with the universal manas for instance, Christian
Science, mental healing, faith cures, remedial training, medical and
religious techniques, and countless other isms. Even political
movements can, not without justice, claim to be psycho therapy in the
grand manner. The outbreak of war cured many a compulsion neurosis,
and from time immemorial certain miraculous localities have caused
neurotic states to disappear; similarly, popular movements both large
and small can exert a curative influence on the individual.
[4]
This fact finds the simplest and most nearly perfect expression in
the primitive idea of mana. Mana is a universal medicinal or healing
power which renders men, animals, and plants fruitful and endows
chieftain and medicine-man with magical strength. Mana, as Lehmann
has shown, is identified with anything extraordinarily potent, or
simply with anything impressive. On the primitive level anything
impressive is therefore medicine. Since it is notorious that a hundred
intelligent heads massed together make one big fathead, virtues and
endowments are essentially the hallmarks of the individual and not of
the universal man. The masses always incline to herd psychology, hence
they are easily stampeded; and to mob psychology, hence their witless
brutality and hysterical emotionalism. The universal man has the
characteristics of a savage and must therefore be treated with technical
methods. It is in fact bad practice to treat collective man with anything
other than technically correct methods, i.e., those collectively
recognized and believed to be effective. In this sense the old hypnotism
or the still older animal magnetism achieved, in principle, just as much
as a technically irreproachable modern analysis, or for that matter the
amulets of the primitive medicine-man. It all depends on the method the
therapist happens to believe in. His belief is what does the trick. If he
really believes, then he will do his utmost for the sufferer with
seriousness and perseverance, and this freely given effort and devotionwill have a curative effectup to the level of collective mans
mentality. But the limits are fixed by the individual-universal
antinomy.
[5]
This antinomy constitutes a psychological as well as a
philosophical criterion, since there are countless people who are not only
collective in all essentials but are fired by a quite peculiar ambition to be
nothing but collective. This accords with all the current trends in
education which like to regard individuality and lawlessness as
synonymous. On this plane anything individual is rated inferior and is
repressed. In the corresponding neuroses individual contents and
tendencies appear as psychological poisons. There is also, as we know,
an overestimation of individuality based on the rule that the universal
signifies nothing in comparison with the individual. Thus, from the
psychological (not the clinical) point of view, we can divide the
psychoneuroses into two main groups: the one comprising collective
people with underdeveloped individuality, the other individualists with
atrophied collective adaptation. The therapeutic attitude differs
accordingly, for it is abundantly clear that a neurotic individualist can
only be cured by recognizing the collective man in himselfhence the
need for collective adaptation. It is therefore right to bring him down to
the level of collective truth. On the other hand, psycho therapists are
familiar with the collectively adapted person who has everything and
does everything that could reasonably be required as a guarantee of
health, but yet is ill. It would be a bad mistake, which is nevertheless
very often committed, to normalize such a person and try to bring him
down to the collective level. In certain cases all possibility of individual
development is thereby destroyed.
[6]
Since individuality, as we stressed in our introductory argument, is
absolutely unique, unpredictable, and uninterpretable, in these cases the
therapist must abandon all his preconceptions and techniques and
confine himself to a purely dialectical procedure, adopting the attitude
that shuns all methods.
[7]
You will have noticed that I began by presenting the dialectical
procedure as the latest phase of psycho therapeutic development. I must
now correct myself and put this procedure in the right perspective: it is
not so much an elaboration of previous theories and practices as acomplete abandonment of them in favour of the most unbiased attitude
possible. In other words, the therapist is no longer the agent of treatment
but a fellow participant in a process of individual development.
[8]
I would not like it to be supposed that these discoveries dropped
straight into our laps. They too have their history. Although I was the
first to demand that the analyst should himself be analysed, we are
largely indebted to Freud for the invaluable discovery that analysts too
have their complexes and consequently one or two blind spots which act
as so many prejudices. The psycho therapist gained this insight in cases
where it was no longer possible for him to interpret or to guide the
patient from on high or ex cathedra, regardless of his own personality,
but was forced to admit that his personal idiosyncrasies or special
attitude hindered the patients recovery. When one possesses no very
clear idea about something, because one is unwilling to admit it to
oneself, one tries to hide it from the patient as well, obviously to his
very great disadvantage. The demand that the analyst must be analysed
culminates in the idea of a dialectical procedure, where the therapist
enters into relationship with another psychic system both as questioner
and answerer. No longer is he the superior wise man, judge, and
counsellor; he is a fellow participant who finds himself involved in the
dialectical process just as deeply as the so-called patient.
[9]
The dialectical procedure has another source, too, and that is the
multiple significance of symbolic contents. Silberer distinguishes
between the psychoanalytic and the anagogic interpretation, while I
distinguish between the analytical-reductive and the synthetic-
hermeneutic interpretation. I will explain what I mean by instancing the
so-called infantile fixation on the parental imago, one of the richest
sources of symbolic contents. The analytical-reductive view asserts that
interest (libido) streams back regressively to infantile reminiscences
and there fixatesif indeed it has ever freed itself from them. The
synthetic or anagogic view, on the contrary, asserts that certain parts of
the personality which are capable of development are in an infantile
state, as though still in the womb. Both interpretations can be shown to
be correct. We might almost say that they amount virtually to the same
thing. But it makes an enormous difference in practice whether we
interpret something regressively or progressively. It is no easy matter todecide aright in a given case. Generally we feel rather uncertain on this
point. The discovery that there are essential contents of an indubitably
equivocal nature has thrown suspicion on the airy application of theories
and techniques, and thus helped to range the dialectical procedure
alongside the subtler or cruder suggestion methods.
[10]
The depth-dimension which Freud has added to the problems of
psycho therapy must logically lead sooner or later to the conclusion that any
final understanding between doctor and patient is bound to include the
personality of the doctor. The old hypnotists and Bernheim with his
suggestion therapy were well enough aware that the healing effect
depended firstly on the rapportin Freuds terminology,
transference and secondly on the persuasive and penetrative powers of
the doctors personality. In the doctor-patient relationship, as we have said,
two psychic systems interact, and therefore any deeper insight into the
psycho therapeutic process will infallibly reach the conclusion that in the
last analysis, since individuality is a fact not to be ignored, the relationship
must be dialectical.
[11]
It is now perfectly clear that this realization involves a very
considerable shift of standpoint compared with the older forms of
psycho therapy. In order to avoid misunderstandings, let me say at once that
this shift is certainly not meant to condemn the existing methods as
incorrect, superfluous, or obsolete. The more deeply we penetrate the
nature of the psyche, the more the conviction grows upon us that the
diversity, the multidimensionality of human nature requires the greatest
variety of standpoints and methods in order to satisfy the variety of psychic
dispositions. It is therefore pointless to subject a simple soul who lacks
nothing but a dose of common sense to a complicated analysis of his
impulses, much less expose him to the bewildering subtleties of
psychological dialectic. It is equally obvious that with complex and highly
intelligent people we shall get nowhere by employing well-intentioned
advice, suggestions, and other efforts to convert them to some kind of
system. In such cases the best thing the doctor can do is lay aside his whole
apparatus of methods and theories and trust to luck that his personality will
be steadfast enough to act as a signpost for the patient. At the same time he
must give serious consideration to the possibility that in intelligence,
sensibility, range and depth the patients personality is superior to his own.But in all circumstances the prime rule of dialectical procedure is that the
individuality of the sufferer has the same value, the same right to exist, as
that of the doctor, and consequently that every development in the patient is
to be regarded as valid, unless of course it corrects itself of its own accord.
Inasmuch as a man is merely collective, he can be changed by suggestion to
the point of becomingor seeming to becomedifferent from what he
was before. But inasmuch as he is an individual he can only become what
he is and always was. To the extent that cure means turning a sick man
into a healthy one, cure is change. Wherever this is possible, where it does
not demand too great a sacrifice of personality, we should change the sick
man therapeutically. But when a patient realizes that cure through change
would mean too great a sacrifice, then the doctor can, indeed he should,
give up any wish to change or cure. He must either refuse to treat the
patient or risk the dialectical procedure. This is of more frequent
occurrence than one might think. In my own practice I always have a fair
number of highly cultivated and intelligent people of marked individuality
who, on ethical grounds, would vehemently resist any serious attempt to
change them. In all such cases the doctor must leave the individual way to
healing open, and then the cure will bring about no alteration of personality
but will be the process we call individuation, in which the patient
becomes what he really is. If the worst comes to the worst, he will even put
up with his neurosis, once he has understood the meaning of his illness.
More than one patient has admitted to me that he has learned to accept his
neurotic symptoms with gratitude, because, like a barometer, they
invariably told him when and where he was straying from his individual
path, and also whether he had let important things remain unconscious.
[12]
Although the new, highly differentiated methods allow us an
unsuspected glimpse into the endless complications of psychic relationships
and have gone a long way to putting them on a theoretical basis, they
nevertheless confine themselves to the analytical-reductive standpoint, so
that the possibilities of individual development are obscured by being
reduced to some general principle, such as sexuality. This is the prime
reason why the phenomenology of individuation is at present almost virgin
territory. Hence in what follows I must enter into some detail, for I can only
give you an idea of individuation by trying to indicate the workings of the
unconscious as revealed in the observed material itself. For, in the process
of individual development, it is above all the unconscious that is thrust into the forefront of our interest. The deeper reason for this may lie in the fact
that the conscious attitude of the neurotic is unnaturally one-sided and must
be balanced by complementary or compensatory contents deriving from the
unconscious. The unconscious has a special significance in this case as a
corrective to the onesidedness of the conscious mind; hence the need to
observe the points of view and impulses produced in dreams, because these
must take the place once occupied by collective controls, such as the
conventional outlook, habit, prejudices of an intellectual or moral nature.
The road the individual follows is defined by his knowledge of the laws
that are peculiar to himself; otherwise he will get lost in the arbitrary
opinions of the conscious mind and break away from the mother-earth of
individual instinct.
[13]
So far as our present knowledge extends, it would seem that the vital
urge which expresses itself in the structure and individual form of the living
organism produces in the unconscious a process, or is itself such a process,
which on becoming partially conscious depicts itself as a fugue-like
sequence of images. Persons with natural introspective ability are capable
of perceiving fragments of this autonomous or self-activating sequence
without too much difficulty, generally in the form of visual fantasies,
although they often fall into the error of thinking that they have created
these fantasies, whereas in reality the fantasies have merely occurred to
them. Their spontaneous nature can no longer be denied, however, when, as
often happens, some fantasy-fragment becomes an obsession, like a tune
you cannot get out of your head, or a phobia, or a symbolic tic. Closer to
the unconscious sequence of images are the dreams which, if examined
over a long series, reveal the continuity of the unconscious pictorial flood
with surprising clearness. The continuity is shown in the repetition of
motifs. These may deal with people, animals, objects, or situations. Thus
the continuity of the picture sequence finds expression in the recurrence of
some such motif over a long series of dreams.
[14]
In a dream series extending over a period of two months, one of my
patients had the water-motif in twenty-six dreams. In the first dream it
appeared as the surf pounding the beach, then in the second as a view of the
glassy sea. In the third dream the dreamer was on the seashore watching the
rain fall on the water. In the fourth there was an indirect allusion to a
voyage, for he was journeying to a distant country. In the fifth he wastravelling to America; in the sixth, water was poured into a basin; in the
seventh he was gazing over a vast expanse of sea at dawn; in the eighth he
was aboard ship. In the ninth he travelled to a far-off savage land. In the
tenth he was again aboard ship. In the eleventh he went down a river. In the
twelfth he walked beside a brook. In the thirteenth he was on a steamer. In
the fourteenth he heard a voice calling, This is the way to the sea, we must
get to the sea! In the fifteenth he was on a ship going to America. In the
sixteenth, again on a ship. In the seventeenth he drove to the ship in an
automobile. In the eighteenth he made astronomical calculations on a ship.
In the nineteenth he went down the Rhine. In the twentieth he was on an
island, and again in the twenty-first. In the twenty-second he navigated a
river with his mother. In the twenty-third he stood on the seashore. In the
twenty-fourth he looked for sunken treasure. In the twenty-fifth his father
was telling him about the land where the water comes from. And finally in
the twenty-sixth he went down a small river that debouched into a larger
one.
[15]
This example illustrates the continuity of the unconscious theme and
also shows how the motifs can be evaluated statistically. Through
numerous comparisons one can find out to what the water-motif is really
pointing, and the interpretation of motifs follows from a number of similar
dream-series. Thus the sea always signifies a collecting-place where all
psychic life originates, i.e., the collective unconscious. Water in motion
means something like the stream of life or the energy-potential. The ideas
underlying all the motifs are visual representations of an archetypal
character, symbolic primordial images which have served to build up and
differentiate the human mind. These primordial images are difficult to
define; one might even call them hazy. Cramping intellectual formulae rob
them of their natural amplitude. They are not scientific concepts which
must necessarily be clear and unequivocal; they are universal perceptions
of the primitive mind, and they never denote any particular content but are
significant for their wealth of associations. Lvy-Bruhl calls them
collective representations, and Hubert and Mauss call them a priori
categories of the imagination.
[16]
In a longer series of dreams the motifs frequently change places. Thus,
after the last of the above dreams, the water-motif gradually retreated to
make way for a new motif, the unknown woman. In general, dreamsabout women refer to women whom the dreamer knows. But now and then
there are dreams in which a female figure appears who cannot be shown to
be an acquaintance and whom the dream itself distinctly characterizes as
unknown. This motif has an interesting phenomenology which I should like
to illustrate from a dream series extending over a period of three months. In
this series the motif occurred no less than fifty-one times. At the outset it
appeared as a throng of vague female forms, then it assumed the vague
form of a woman sitting on a step. She then appeared veiled, and when she
took off the veil her face shone like the sun. Then she was a naked figure
standing on a globe, seen from behind. After that she dissolved once more
into a throng of dancing nymphs, then into a bevy of syphilitic prostitutes.
A little later the unknown appeared on a ball, and the dreamer gave her
some money. Then she was a syphilitic again. From now on the unknown
becomes associated with the so-called dual motif, a frequent occurrence
in dreams. In this series a savage woman, a Malay perhaps, is doubled. She
has to be taken captive, but she is also the naked blonde who stood on the
globe, or else a young girl with a red cap, a nursemaid, or an old woman.
She is very dangerous, a member of a robberb and and not quite human,
something like an abstract idea. She is a guide, who takes the dreamer up a
high mountain. But she is also like a bird, perhaps a marabou or pelican.
She is a mancatcher. Generally she is fair-haired, a hairdressers daughter,
but has a dark Indian sister. As a fair-haired guide she informs the dreamer
that part of his sisters soul belongs to her. She writes him a love-letter, but
is another mans wife. She neither speaks nor is spoken to. Now she has
black hair, now white. She has peculiar fantasies, unknown to the dreamer.
She may be his fathers unknown wife, but is not his mother. She travels
with him in an airplane, which crashes. She is a voice that changes into a
woman. She tells him that she is a piece of broken pottery, meaning
presumably that she is a part-soul. She has a brother who is prisoner in
Moscow. As the dark figure she is a servant-girl, stupid, and she has to be
watched. Often she appears doubled, as two women who go mountain-
climbing with him. On one occasion the fair-haired guide comes to him in a
vision. She brings him bread, is full of religious ideas, knows the way he
should go, meets him in church, acts as his spiritual guide. She seems to
pop out of a dark chest and can change herself from a dog into a woman.
Once she appears as an ape. The dreamer draws her portrait in a dream, but
what comes out on the paper is an abstract symbolic ideogram containing the trinity, another frequent motif.
[17]
The unknown woman, therefore, has an exceedingly contradictory
character and cannot be related to any normal woman. She represents some
fabulous being, a kind of fairy; and indeed fairies have the most varied
characters. There are wicked fairies and good fairies; they too can change
themselves into animals, they can become invisible, they are of uncertain
age, now young, now old, elfin in nature, with part-souls, alluring,
dangerous, and possessed of superior knowledge. We shall hardly be wrong
in assuming that this motif is identical with the parallel ideas to be found in
mythology, where we come across this elfin creature in a variety of forms
nymph, oread, sylph, undine, nixie, hamadryad, succubus, lamia,
vampire, witch, and what not. Indeed the whole world of myth and fable is
an outgrowth of unconscious fantasy just like the dream. Frequently this
motif replaces the water-motif. Just as water denotes the unconscious in
general, so the figure of the unknown woman is a personification of the
unconscious, which I have called the anima. This figure only occurs in
men, and she emerges clearly only when the unconscious starts to reveal its
problematical nature. In man the unconscious has feminine features, in
woman masculine; hence in man the personification of the unconscious is a
feminine creature of the type we have just described.
[18]
I cannot, within the compass of a lecture, describe all the motifs that
crop up in the process of individuationwhen, that is to say, the material is
no longer reduced to generalities applicable only to the collective man.
There are numerous motifs, and we meet them everywhere in mythology.
Hence we can only say that the psychic development of the individual
produces something that looks very like the archaic world of fable, and that
the individual path looks like a regression to mans prehistory, and that
consequently it seems as if something very untoward were happening
which the therapist ought to arrest. We can in fact observe similar things in
psychotic illnesses, especially in the paranoid forms of schizophrenia,
which often swarm with mythological images. The fear instantly arises that
we are dealing with some misdevelopment leading to a world of chaotic or
morbid fantasy. A development of this kind may be dangerous with a
person whose social personality has not found its feet; moreover any
psycho therapeutic intervention may occasionally run into a latent psychosis
and bring it to full flower. For this reason to dabble in psycho therapy is toplay with fire, against which amateurs should be stringently cautioned. It is
particularly dangerous when the mythological layer of the psyche is
uncovered, for these contents have a fearful fascination for the patient
which explains the tremendous influence mythological ideas have had on
mankind.
[19]
Now, it would seem that the recuperative process mobilizes these
powers for its own ends. Mythological ideas with their extraordinary
symbolism evidently reach far into the human psyche and touch the
historical foundations where reason, will, and good intentions never
penetrate; for these ideas are born of the same depths and speak a language
which strikes an answering chord in the inner man, although our reason
may not understand it. Hence, the process that at first sight looks like an
alarming regression is rather a reculer pour mieux sauter, an amassing and
integration of powers that will develop into a new order.
[20]
A neurosis at this level is an entirely spiritual form of suffering which
cannot he tackled with ordinary rational methods. For this reason there are
not a few psycho therapists who, when all else fails, have recourse to one of
the established religions or creeds. I am far from wishing to ridicule these
efforts. On the contrary, I must emphasize that they are based on an
extremely sound instinct, for our religions contain the still living remains of
a mythological age. Even a political creed may occasionally revert to
mythology, as is proved very clearly by the swastika, the German
Christians, and the German Faith Movement. Not only Christianity with its
symbols of salvation, but all religions, including the primitive with their
magical rituals, are forms of psycho therapy which treat and heal the
suffering of the soul, and the suffering of the body caused by the soul. How
much in modern medicine is still suggestion therapy is not for me to say.
To put it mildly, consideration of the psychological factor in practical
therapeutics is by no means a bad thing. The history of medicine is
exceedingly revealing in this respect.
[21]
Therefore, when certain doctors resort to the mythological ideas of
some religion or other, they are doing something historically justified. But
they can only do this with patients for whom the mythological remains are
still alive. For these patients some kind of rational therapy is indicated until
such time as mythological ideas become a necessity. In treating devout
Catholics, I always refer them to the Churchs confessional and its meansof grace. It is more difficult in the case of Protestants, who must do without
confession and absolution. The more modern type of Protestantism has,
however, the safetyvalve of the Oxford Group movement, which prescribes
lay confession as a substitute, and group experience instead of absolution.
A number of my patients have joined this movement with my entire
approval, just as others have become Catholics, or at least better Catholics
than they were before. In all these cases I refrain from applying the
dialectical procedure, since there is no point in promoting individual
development beyond the needs of the patient. If he can find the meaning of
his life and the cure for his disquiet and disunity within the framework of
an existing credoincluding a political credo that should be enough for
the doctor. After all, the doctors main concern is the sick, not the cured.
[22]
There are, however, very many patients who have either no religious
convictions at all or highly unorthodox ones. Such persons are, on
principle, not open to any conviction. All rational therapy leaves them stuck
where they were, although on the face of it their illness is quite curable. In
these circumstances nothing is left but the dialectical development of the
mythological material which is alive in the sick man himself, regardless of
history and tradition. It is here that we come across those mythological
dreams whose characteristic sequence of images presents the doctor with an
entirely new and unexpected task. He then needs the sort of knowledge for
which his professional studies have not equipped him in the least. For the
human psyche is neither a psychiatric nor a physiological problem; it is not
a biological problem at all butpreciselya psychological one. It is a field
on its own with its own peculiar laws. Its nature cannot be deduced from
the principles of other sciences without doing violence to the idiosyncrasy
of the psyche. It cannot be identified with the brain, or the hormones, or
any known instinct; for better or worse it must be accepted as a
phenomenon unique in kind. The phenomenology of the psyche contains
more than the measurable facts of the natural sciences: it embraces the
problem of mind, the father of all science. The psycho therapist becomes
acutely aware of this when he is driven to penetrate below the level of
accepted opinion. It is often objected that people have practised
psycho therapy before now and did not find it necessary to go into all these
complications. I readily admit that Hippocrates, Galen, and Paracelsus were
excellent doctors, but I do not believe that modern medicine should on that
account give up serum therapy and radiology. It is no doubt difficult,particularly for the layman, to understand the complicated problems of
psycho therapy; but if he will just consider for a moment why certain
situations in life or certain experiences are pathogenic, he will discover that
human opinion often plays a decisive part. Certain things accordingly seem
dangerous, or impossible, or harmful, simply because there are opinions
that cause them to appear in that light. For instance, many people regard
wealth as the supreme happiness and poverty as mans greatest curse,
although in actual fact riches never brought supreme happiness to anybody,
nor is poverty a reason for melancholia. But we have these opinions, and
these opinions are rooted in certain mental preconceptionsin the
Zeitgeist, or in certain religious or antireligious views. These last play an
important part in moral conflicts. As soon as the analysis of a patients
psychic situation impinges on the area of his mental preconceptions, we
have already entered the realm of general ideas. The fact that dozens of
normal people never criticize their mental preconceptionsobviously not,
since they are unconscious of themdoes not prove that these
preconceptions are valid for all men, or indeed unconscious for all men,
any more than it proves that they may not become the source of the severest
moral conflict. Quite the contrary: in our age of revolutionary change,
inherited prejudices of a general nature on the one hand and spiritual and
moral disorientation on the other are very often the deeperlying causes of
far-reaching disturbances in psychic equilibrium. To these patients the
doctor has absolutely nothing to offer but the possibility of individual
development. And for their sake the specialist is compelled to extend his
knowledge over the field of the humane sciences, if he is to do justice to the
symbolism of psychic contents.
[23]
I would make myself guilty of a sin of omission if I were to foster the
impression that specialized therapy needed nothing but a wide knowledge.
Quite as important is the moral differentiation of the doctors personality.
Surgery and obstetrics have long been aware that it is not enough simply to
wash the patient the doctor himself must have clean hands. A neurotic
psycho therapist will invariably treat his own neurosis in the patient. A
therapy independent of the doctors personality is just conceivable in the
sphere of rational techniques, but it is quite inconceivable in a dialectical
procedure where the doctor must emerge from his anonymity and give an
account of himself, just as he expects his patient to do. I do not know which
is the more difficult: to accumulate a wide knowledge or to renounce onesprofessional authority and anonymity. At all events the latter necessity
involves a moral strain that makes the profession of psycho therapist not
exactly an enviable one. Among laymen one frequently meets with the
prejudice that psycho therapy is the easiest thing in the world and consists in
the art of putting something over on people or wheedling money out of
them. But actually it is a tricky and not undangerous calling. Just as all
doctors are exposed to infections and other occupational hazards, so the
psycho therapist runs the risk of psychic infections which are no less
menacing. On the one hand he is often in danger of getting entangled in the
neuroses of his patients; on the other hand if he tries too hard to guard
against their influence, he robs himself of his therapeutic efficacy. Between
this Scylla and this Charybdis lies the peril, but also the healing power.
[24]
Modern psycho therapy is built up of many layers, corresponding to the
diversities of the patients requiring treatment. The simplest cases are those
who just want sound common sense and good advice. With luck they can
be disposed of in a single consultation. This is certainly not to say that
cases which look simple are always as simple as they look; one is apt to
make disagreeable discoveries. Then there are patients for whom a
thorough confession or abreaction is enough. The severer neuroses
usually require a reductive analysis of their symptoms and states. And here
one should not apply this or that method indiscriminately but, according to
the nature of the case, should conduct the analysis more along the lines of
Freud or more along those of Adler. St. Augustine distinguishes two
cardinal sins: concupiscence and conceit (superbia). The first corresponds
to Freuds pleasure principle, the second to Adlers power-drive, the desire
to be on top. There are in fact two categories of people with different needs.
Those whose main characteristic is infantile pleasure-seeking generally
have the satisfaction of incompatible desires and instincts more at heart
than the social role they could play, hence they are often well-to-do or even
successful people who have arrived socially. But those who want to be on
top are mostly people who are either the under-dogs in reality or fancy that
they are not playing the role that is properly due to them. Hence they often
have difficulty in adapting themselves socially and try to cover up their
inferiority with power fictions. One can of course explain all neuroses in
Freudian or Adlerian terms, but in practice it is better to examine the case
carefully beforehand. In the case of educated people the decision is not
difficult: I advise them to read a bit of Freud and a bit of Adler. As a rulethey soon find out which of the two suits them best. So long as one is
moving in the sphere of genuine neurosis one cannot dispense with the
views of either Freud or Adler.
[25]
But when the thing becomes monotonous and you begin to get
repetitions, and your unbiased judgment tells you that a standstill has been
reached, or when mythological or archetypal contents appear, then is the
time to give up the analytical-reductive method and to treat the symbols
anagogically or synthetically, which is equivalent to the dialectical
procedure and the way of individuation.
[26]
All methods of influence, including the analytical, require that the
patient be seen as often as possible. I content myself with a maximum of
four consultations a week. With the beginning of synthetic treatment it is of
advantage to spread out the consultations. I then generally reduce them to
one or two hours a week, for the patient must learn to go his own way. This
consists in his trying to understand his dreams himself, so that the contents
of the unconscious may be progressively articulated with the conscious
mind; for the cause of neurosis is the discrepancy between the conscious
attitude and the trend of the unconscious. This dissociation is bridged by
the assimilation of unconscious contents. Hence the interval between
consultations does not go unused. In this way one saves oneself and the
patient a good deal of time, which is so much money to him; and at the
same time he learns to stand on his own feet instead of clinging to the
doctor.
[27]
The work done by the patient through the progressive assimilation of
unconscious contents leads ultimately to the integration of his personality
and hence to the removal of the neurotic dissociation. To describe the
details of this development would far exceed the limits of a lecture. I must
therefore rest content with having given you at least a general survey of the
principles of practical psycho therapy.

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