II
From Dr. Jung.
28th January, 1913.
With regard to your question as to the applicability of the cathartic method, the following is my standpoint: every method is good if it serves its purpose, including every method of suggestion, even Christian Science, Mental Healing, etc. "A truth is a truth, when it works." It is quite another question whether a scientific physician can answer for it to his conscience should he sell little bottles of Lourdes-water because that suggestion is at times very useful. Even the so-called highly scientific suggestion-therapy employs the wares of the medicine-man and the exorcising Schaman. And please, why should it not? The public is not even now much more advanced and continues to expect miracles from the doctor. And truly those doctors should be deemed clever—worldly-wise in every respect—who understand the art of investing themselves with the halo of the medicine-man. Not only have they the biggest practices—they have also the best results. This is simply because countless physical maladies (leaving out of count the neuroses) are complicated and burdened with psychic elements to an extent scarcely yet suspected. The medical exorcist's whole behaviour betrays his full valuation of the psychic element when he gives the patient the opportunity of fixing his faith firmly upon the doctor's mysterious personality. Thus does he win the sick man's mind, which henceforth helps him indeed to restore his body also to health. The cure works best when the doctor really believes in his own formulæ, otherwise he may be overcome by scientific doubt and so lose the correct, convincing tone. I, too, for a time practised hypnotic suggestion enthusiastically. But there befell me three dubious incidents which I want you to note:—
1. Once there came to me to be hypnotised for various neurotic troubles a withered peasant-woman of some fifty years old. She was not easy to hypnotise, was very restless, kept opening her eyes—but at last I did succeed. When I waked her after about half an hour she seized my hand and with many words testified to her overflowing gratitude. I said: "But you are by no means cured yet, so keep your thanks till the end of the treatment." She: "I am not thanking you for that, but—(blushing and whispering)—because you have been so decent." So she said, looked at me with a sort of tender admiration and departed. I gazed long at the spot where she had stood—and asked myself, confounded, "So decent?"—good heavens! surely she hadn't imagined, somehow or other.... This glimpse made me suspect for the first time that possibly the loose-minded person, by means of that notorious feminine (I should at that time have said "animal") directness of instinct, understood more about the essence of hypnotism than I with all my knowledge of the scientific profundity of the text-books. Therein lay my harmlessness.
2. Next came a pretty, coquettish, seventeen-year-old girl with a harassed, suspicious mother. The young daughter had suffered since early girlhood from enuresis nocturna, which, among other difficulties, hindered her from going to a boarding-school abroad.
At once I thought of the old woman and her wisdom. I tried to hypnotise the girl; she laughed affectedly and prevented hypnosis for twenty minutes. Of course I kept quiet and thought: I know why you laugh; you have already fallen in love with me, but I will give you proof of my decency in gratitude for your wasting my time with your challenging laughter. I succeeded in hypnotising her. Success followed at once. The enuresis stopped, and I therefore informed the young lady later that, instead of Wednesday, I would not see her again for hypnosis till the following Saturday. On Saturday she arrived with a cross countenance, presaging failure. The enuresis had come back again. I remembered my wise old woman, and asked: "When did the enuresis return?" She (unsuspecting), "Wednesday night." I thought to myself, There it is again, she wants to show me that I simply 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 was quite resolved to give no help to such annoying romancing, so I said, "To continue the hypnosis would be quite wrong under these circumstances. We must drop it for quite three weeks, to give the enuresis a chance to stop. Then come again for treatment." In my malicious heart I knew I should then be on my holiday and so the course of hypnotic treatment would come to an end. After the holidays my locum tenens told me 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, thought I.
3. The third case gave my joy in suggestion its death-blow. This was the manner of it. She was a lady of sixty-five who came stumbling into the consulting-room with a crutch. She had suffered from pain in the knee-joint for seventeen years, and this at times kept her in bed for many weeks. No doctor had been able to cure her, and she had tried every possible remedy of present-day medicine. After I had suffered the stream of her narrative to flow over me for some ten minutes, I said, "I will try to hypnotise you, perhaps that will do you good." She, "Oh yes, please do!" leaned her head on one side and fell asleep before ever I said or did anything. 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 make timid objections, but her praises drowned me. She could really walk. Then I blushed and said, embarrassed, to my colleagues: "Look! behold the wondrously successful hypnotic therapy." That day saw the death of my connection with treatment by suggestion; the therapeutic praise won by this case shamed and humiliated me. When, a year later, at the beginning of my hypnotic course, the good old lady returned, this time with the pain in her back, I was already sunk in hopeless cynicism; I saw written on her forehead that she had just read the notice of the re-opening of my clinic in the newspaper, that vexatious 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 theatrical fashion. This proved true in every particular.
As you will understand, a man possessed of scientific conscience cannot endure such cases without embarrassment. There ripened in me the resolve to renounce suggestion altogether rather than to allow myself passively to be transformed into a miracle-worker. I wanted to understand what really went on in the souls of people. It suddenly seemed to me incredibly childish to think of dispelling an illness with charms, and that this should be the only result of our scientific endeavours for a psychotherapy. Thus for me the discovery of Breuer and Freud was a veritable deliverance. I took up their method with unalloyed enthusiasm and soon recognised how right Freud was, when at a very early date, indeed so far back as the Studien ueber Hysterie, he began to direct a searchlight upon the accompanying circumstances of the so-called trauma. I too soon discovered that certainly some traumata with an obvious etiological tinge are opportunely present. But the greater number appeared highly improbable. So many of them seemed so insignificant, even so normal, that at most one could regard them as just providing the opportunity for the neurosis to appear. But what especially spurred my criticism was the fact that so many traumata were simply inventions of phantasy which had never really existed. This perception was enough to make me sceptical about the whole trauma-theory. (But I have dealt with these matters in detail in my lectures on the theory of psychoanalysis).[177] I could no longer suppose that the hundred and one cathartic experiences of a phantastically puffed-up or entirely invented trauma were anything but the effect of suggestion. It is well enough if it helps. If one only had not a scientific conscience and that impulsion towards the truth! I found in many cases, especially when dealing with more mentally gifted patients, that I must recognise the therapeutic limitations of this method. It is, of course, a definite plan, and convenient for the doctor, since it makes no particular demands upon his intellect for new adaptations. The theory and practice are both of the pleasantest simplicity: "The neurosis is caused by a trauma. The trauma is abreacted." When the abreaction takes place under hypnotism, or with other magical accessories (dark room, peculiar lighting, and the rest), I remember once more the wise old woman, who opened my eyes not merely to the magic influence of the mesmeric gestures, but also to the essential character of hypnotism itself. But what alienated me once for all from this relatively efficacious indirect method of suggestion, based as it is upon an equally efficacious false theory, was the perception I obtained at the same time that, behind the confused deceptive intricacies of neurotic phantasies, there stands a conflict, which may be best described as a moral one. With this there began for me a new era of understanding. Research and therapy now coincided in the attempt to discover the causes and the rational solution of this conflict. That is what psychoanalysis meant to me. Whilst I had been getting this insight, Freud had built up his sexual theory of the neurosis, and therewith had brought forward an enormous number of questions for discussion, all of which I thought deserved the profoundest consideration. Thus I have had the good fortune of co-operating with Freud for a long time, and working with him in the investigation of the problem of sexuality in neurosis. You, perhaps, know from some of my earlier work that I was always dubious somewhat concerning the significance of sexuality.[178] This has now become the exact point where I am no longer altogether of Freud's opinion.
I have preferred to answer your questions in rather non-sequent fashion. Whatever is still unanswered, let me now repeat: light hypnosis and complete hypnosis are but varying grades of intensity of unconscious attraction towards the hypnotist. Who can here venture to draw sharp distinctions? To a critical intelligence it is unthinkable that suggestibility and suggestion can be excluded in the cathartic method. They are present everywhere and are universal human attributes, even with Dubois and the psychoanalysts who think they work on purely rational lines. No technique, no self-deception avails here—the doctor works, nolens volens—and perhaps primarily—by means of his personality, that is by suggestion. In the cathartic treatment, what is of far more importance to the patient than the conjuring up of old phantasies is the being so often with the doctor, and having confidence and belief in him personally, and in his method. The belief, the self-confidence, perhaps also the devotion with which the doctor does his work, are far more important things to the patient (imponderabilia though they be) than the recalling of old traumata.[179]
Ultimately we shall some day know from the history of medicine everything that has ever been of service; then perhaps at last we may come to the really desirable therapy, to psychotherapy. Did not even the old materia medica of filth have brilliant cures?—cures which only faded away with the belief in it!
Because I recognise that the patient does attempt to lay hold of the doctor's personality, in spite of all possible rational safeguards, I have formulated the demand that the psychotherapeutist shall be held just as responsible for the cleanness of his own hands as is the surgeon. I hold it to be an absolutely indispensable preliminary that the psychoanalyst should himself first undergo an analysis, for his personality is one of the chief factors in the cure.
Patients read the doctor's character intuitively and they should find in him a human being, with faults indeed, but also a man who has striven at every point to fulfil his own human duties in the fullest sense. I think that this is the first healing factor. Many times I have had the opportunity of seeing that the analyst is successful with his treatment just in so far as he has succeeded in his own moral development. I think this answer will satisfy your question.