Chapter IV: Psychiatric Activities

I really enjoyed this chapter. It illuminates Jung's working style and his approach to therapy as determined during his years at Burgholzli. The question he began asking as "What actually takes place inside the mentally ill?" This was not a question that was given much thought during this time. The treatment options were limited and primitive by today's standard. The patient as an individual was not given much concern. Jung believed that a patient comes into therapy with a story that needs to be told. "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."

In the early 1900's, Jung became a lecturer in psychiatry at the University of Zurich. He started to teach courses on hypnosis in addition to other topics. Interestingly enough, he used hypnosis to acquire the personal history of his patients, not as a tool to uncover the unconscious, myth, archetypes or personal symbols. He had a very interesting experience with a woman who identified with Jung in a very specific way. So much so that any time he even talked about hypnosis, she entered into a deep trance. She was highly suggestible to him. She appeared to describe her dreams and unconscious state, but at this time he did not yet understand her disclosure. He had difficulty awakening her from the trance, but when he finally did he spoke authoritatively that he was the doctor and that everything was alright. In response, the woman cried out that she was cured! He didn't understand what had happened and shortly afterwards abandoned hypnosis. I think that is regrettable, for it might have been of major importance in his uncovering the unconscious mind. However, Jung gave it up because he could not quantify the results – experiential analysis was of great importance to him. He did not like to work with uncertainty. The woman came back at another time and a similar experience occurred. Later Jung uncovered that the woman identified him as her desired son (her son was mentally ill). He explained this to her and she no longer suffered any relapse. The story of Jung’s success soon got around his community and consequently his private practice became very large.

Jung was willing to stretch the boundaries of what was considered standard medical treatment, if he believed it was in the patient's best interest. In one situation an alcoholic patient had a domineering mother. He discharged the patient with a medical certificate stating that he could no longer work with his mother. The patient was then able to finally separate from his mother and experience a new and successful career.

Jung contended that while a clinical diagnosis was helpful to the physician, it did not assist the patient. To Jung, the most important factor was the patient's story which detailed the human element of suffering. A personality and life history lies behind any clinical diagnosis. His approach was to work with each patient as one human being to another understanding their motivations.

In 1909 Jung began to understand that he "could not treat latent psychoses if [he] did not understand their symbolism." These discoveries lead to his study of mythology. Jung said that the therapist must first understand him/herself. "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." The therapist, therefore, must keep track of himself - observing his reactions, dreams and unconscious behavior toward the patient. The therapist must look at what the patient brings to him. "The doctor is effective only when he himself is affected."

Jung was an intuitive (hence the "N" component in his INFJ personality type). He tells a story of a patient who committed suicide and how he awoke with a pain in his head at the very time of the occurrence. His dreams also proved to be instructive in the way he tailored his therapy towards individual patients. For example, one woman had a great deal of neurosis. In this instance Jung shared a dream he had of her being a goddess and within a week she was cured. He writes, "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." Many of his patients were people who had lost their faith. They were missing the symbolic life. I wonder how many of us are missing that very component in our lives today.

Jung writes that many neurotics would not have been neurotic in another age, because man today is not part of myth and nature. This causes a division of self. "I am speaking of those who cannot tolerate the loss of myth and she can neither find a way to a merely exterior world, to the world as seen by science, not rest satisfied with an intellectual juggling with words, which has nothing whatsoever to do with wisdom." Further he talks about how people with neurosis may achieve success and position in their lives but still remain neurotic. "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." Although Jung was working within an environment of pathology, his words remain relevant to all of us who are on the journey to individuation through personal and spiritual growth.

And finally, it is during this time period that Jung became interested in the writings of Freud, especially his research into dreams and hysteria. But that is food for another chapter…