The Theory of Psychoanalysis

by C. G. Jung

The Etiological Significance of Phantasy Criticized

The apparent etiological development of neurosis, discovered by psychoanalysis, is in reality only the work of causally connected phantasies, which the patient has created from that libido which at times he did not employ in the biological adaptation. Thus, these apparently etiological phantasies seem to be forms of compensation, disguises, for an unfulfilled adaptation to reality. The vicious circle previously mentioned between the withdrawing in the face of difficulties and the regression into the world of phantasies, is naturally well-suited to give the illusion of an apparent striking causal relationship, so that both the patient and the physician believe in it. In such a development accidental experiences are only “extenuating circumstances.” I feel I must make allowance for those critics who, on reading the history of psychoanalytic patients, get the impression of phantastic elaboration. Only they make the mistake of attributing the phantastic artefacts and far-fetched arbitrary symbolism to the suggestion and to the awful phantasy of the physician, instead of to the unequalled fertility of phantasy on the part of the patient. Of a truth, there is a good deal of artificial elaboration in the phantasies of a psychoanalytic case. There are generally significant signs of the patient’s active imagination. The critics are not so wrong when they say that their neurotic patients have no such phantasies. I have no doubt that patients are unconscious of the greater part of their own phantasies. A phantasy only “really” exists in the unconscious, when it has some notable effect upon the conscious, e. g., in the form of a dream; otherwise, we may say with a clear conscience that it is not real. Every one who overlooks the frequently nearly imperceptible effects of unconscious phantasies upon the conscious, or renounces the fundamental, and technically incontestable analysis of dreams, can easily overlook the phantasies of his patients altogether. We are, therefore, inclined to smile when we hear this repeated objection. But we must admit that there is some truth in it. The regressive tendency of the patient is strengthened by the attention bestowed on it, and directed to the unconscious, that is to say, to the phantasies he discovers and forms during analysis. We might even perhaps go so far as to say that, during the time of analysis, this phantasy-production is greatly increased, as the patient is strengthened in his regressive tendency, by the interest taken by the physician and originates even more phantasies than he did before. Hence, our critics have repeatedly stated that a conscientious therapy of the neurosis should go in exactly the opposite direction to that taken by psychoanalysis; in other words, it has been the chief endeavor of therapy, hitherto, to extricate the patient from his unhealthy phantasies and bring him back again to real life.

CHAPTER IX
The Therapeutical Principles of Psychoanalysis

While the psychoanalyst, of course, knows of this therapeutic tendency to extricate the patient from his unhealthy phantasies, he also knows just how far this mere extricating of neurotic patients from their phantasies goes. As physicians, we should never think of preferring a difficult and complicated method, assailed by all authorities, to a simple, clear and easy one without good reason. I am perfectly well-acquainted with hypnotic suggestion, and with Dubois’ method of persuasion, but I do not use these methods, on account of their relative inadequacy. For the same reason, I do not use the direct “ré-éducation de la volonté” as the psychoanalytic method gives me better results.

In applying psychoanalysis we must grant the regressive phantasies of the patient, for psychoanalysis has a much broader outlook, as regards the valuation of symptoms, than have the above psychotherapeutic methods. These all emanate from the assertion that a neurosis is an absolute morbid formation.

The reigning school of neurology has never thought of considering neurosis as a healing process also, and of attributing to the neurotic formations a quite special teleological meaning. Neurosis, like every other disease, is a compromise between the morbid tendencies, and the normal function. Modern medicine no longer considers fever as the illness itself, but a purposeful reaction of the organism. Psychoanalysis, likewise, no longer conceives a neurosis as eo ipso morbid, but as also having a meaning and a purpose. From this there follows the more reserved and expectant attitude of psychoanalysis towards neurosis. Psychoanalysis does not judge the value of the symptoms, but first tries to understand what tendencies lie beneath these symptoms. If we were able to abolish a neurosis in the same way, for instance, as a cancer is destroyed, then at the same time there would be destroyed a great amount of available energy also. We save this energy, that is, we make it serve the purposes of the instinct for health, as soon as we can trace the meaning of these symptoms; by taking part in the regressive movement of the patient. Those unfamiliar with the essentials of psychoanalysis will have some difficulty in understanding how a therapeutic effect can come to pass when the physician takes part in the pernicious phantasies of the patient. Not only critics, but the patients also, doubt the therapeutic value of such a method, which concentrates attention upon phantasies which the patient rejects as worthless and reprehensible. The patients will often tell you that their former physicians forbade them to occupy themselves with their phantasies, and told them that they must only consider that it is well with them, when they are free, if but momentarily, from their awful torments. So, it seems strange enough that it should be of any use to them, when the treatment brings them back to the very thing from which they have tried constantly to escape. The following answer may be made: all depends upon the position which the patient takes up towards his own phantasies. These phantasies have been hitherto, for the patient, an absolutely passive and involuntary manifestation. As we say, he was lost in his dreams. The patient’s so-called brooding is an involuntary kind of dreaming too. What psychoanalysis demands from a patient is only apparently the same. Only a man who has a very superficial knowledge of psychoanalysis can confuse this passive dreaming with the position taken up in analysis. What psychoanalysis asks from the patient is just the contrary of what the patient has always done. The patient can be compared to a person who, unintentionally, has fallen into the water and sunk, whilst psychoanalysis wants him to dive in, as it was no mere chance which led him to fall in at just that spot. There lies a sunken treasure, and only a diver can raise it.

The patient, judging his phantasies from the standpoint of his reason, regards them as valueless and senseless; but, in reality, the phantasies have their great influence on the patient because they are of great importance. They are old, sunken treasures, which can only be recovered by a diver, that is, the patients, contrary to their wont, must now pay an active attention to their inner life. Where they formerly dreamed, they must now think, consciously and intentionally. This new way of thinking about himself has about as much resemblance to the patient’s former mental condition as a diver has to a drowning man. The earlier joy in indulgence has now become a purpose and an aim—that is, has become work. The patient, assisted by the physician, occupies himself with his phantasies, not to lose himself therein, but to uproot them, piece by piece, and to bring them into daylight. He thus reaches an objective standpoint towards his inner life, and everything he formerly loathed and feared is now considered consciously. This contains the basis of the whole psychoanalytic therapy. In consequence of his illness, the patient stood, partially or totally, outside of real life. Consequently he neglected many of his life’s duties, either in regard to social work or to the ordinary daily tasks. If he wishes to be well, he must return to the fulfilment of his particular obligations. Let me say, by way of caution, that we are not to understand by such “duties,” some general ethical postulates, but duties towards himself. Nor does this mean that they are eo ipso egoistic interests, since we are social beings as well, a matter too easily forgotten by individualists. An ordinary person will feel very much more comfortable sharing a common virtue than possessing an individual vice, even if the latter is a very seductive one. They must be already neurotic, or otherwise extraordinary people who can be deluded by such particular interests. The neurotic fled from his duties and his libido withdrew, at least partly, from the tasks imposed by real life. In consequence, the libido became introverted and directed towards an inner life. The libido followed the path of regression: to a large extent phantasies replaced reality, because the patient refused to overcome certain real difficulties. Unconsciously the neurotic patient prefers—and very often consciously too—his dreams and phantasies to reality. To bring him back to real life and to the fulfilment of its necessary duties, the analysis proceeds along the same false path of regression which has been taken by his libido; so that the beginning of psychoanalysis looks as if it were supporting the morbid tendencies of the patient. But psychoanalysis follows these phantasies, these wrong paths, in order to restore the libido, which is the valuable part of the phantasies, to the conscious self and to the duties of the moment. This can only be done by bringing the phantasies into the light of day, and along with them the libido bound up with them. We might leave these unconscious phantasies to their shadowy existence, if no libido were attached to them. It is unavoidable that the patient, feeling himself at the beginning of analysis confirmed in his regressive tendencies, leads his analytical interest, amid increasing resistances, down to the depths of the shadowy world. We can easily understand that any physician who is a normal person experiences the greatest resistance towards the thoroughly morbid, regressive tendency of the patient, since he feels quite certain that this tendency is pathological. And this all the more because, as physician, he believes he is right in refusing to give heed to his patient’s phantasies. It is quite conceivable that the physician feels a repulsion towards this tendency; it is undoubtedly repugnant to see how a person is completely given up to such phantasies, finding only himself of any importance and never ceasing to admire or despise himself. The esthetic sense of normal people has, as a rule, little pleasure in neurotic phantasies, even if it does not find them absolutely repulsive. The psychoanalyst must put aside such esthetic judgment, just as every physician must, who really tries to help his patients. He may not fear any dirty work. Of course there are a great many patients physically ill, who, without undergoing an exact examination or local treatment, do recover by the use of general physical, dietetic, or suggestive means. Severe cases can, however, only be helped by a more exact examination and therapy, based on a profound knowledge of the illness. Our psychotherapeutic methods hitherto have been like these general measures. In slight cases they did no harm; on the contrary, they were often of great service. But for a great many patients these measures have proved inadequate. If they really can be helped, it will be by psychoanalysis, which is not to say that psychoanalysis is a universal panacea. Such a sneer proceeds only from ill-natured criticism. We know very well that psychoanalysis fails in many cases. As everybody knows, we shall never be able to cure all illnesses.

This “diving” work of analysis brings dirty matter piecemeal out of the slime, which must then be cleansed before we can tell its value. The dirty phantasies are valueless and are thrown aside, but the libido actuating them is of value and this, after cleansing, becomes serviceable again. To the psychoanalyst, as to every specialist, it will sometimes seem that the phantasies have also a value of their own, and not only by reason of the libido linked with them. But their value is not, in the first instance, for the patient. For the physician, these phantasies have a scientific value, just as if is of special interest to the surgeon to know whether the pus contained staphylococci or streptococci. To the patient it is all the same, and for him, it is better that the doctor conceal his scientific interest, in order not to tempt him to have greater pleasure than necessary in his phantasies. The etiological importance which is attached to these phantasies, incorrectly, to my mind, explains why so much room is given up in psychoanalytic literature to the extensive discussion of the various sexual phantasies. Once if is known that absolutely nothing is impossible in the sphere of sexual phantasy, the former estimate of these phantasies will disappear, and therewith the endeavor to discover in them an etiological import. Nor will the most extended discussion of these cases ever be able to exhaust this sphere.

Every case is theoretically inexhaustible. But in general the production of phantasies ceases after a time. Naturally, we must not conclude from this that the possibility of creating phantasies is exhausted, but the cessation in their production only means that there is then no more libido on the path of regression. The end of the regressive movement is reached as soon as the libido takes hold of the present real duties of life, and is used to solve those problems. But there are cases, and these not a few, where the patient continues longer than usual to produce endless phantastic manifestations, either from his own pleasure in them or from certain false expectations on the part of the doctor. Such a mistake is especially easy for beginners, since, blinded by the present psychoanalytical discussion, they keep their interest fixed on these phantasies, because they seem to possess etiological significance. They are therefore constantly at pains to fish up phantasies of early childhood, vainly hoping to find thus the solution of the neurotic difficulties. They do not see that the solution lies in action, and in the fulfilment of certain necessary duties of life. It will be objected that the neurosis is entirely due to the incapacity of the patient to carry out these very demands of life, and that therapy by the analysis of the unconscious ought to enable him to do so, or at least, give him means to do so. The objection put in this way is perfectly valid, but we have to add that it is only so when the patient is really conscious of the duties he has to fulfil, not only academically, in their general theoretical outlines but in their most minute details. It is characteristic for neurotic people to be wanting in this knowledge, although, because of their intelligence, they are well aware of the general duties of life, and struggle, perhaps only too hard, to fulfil the prescriptions of current morality. But the much more important duties which he ought to fulfil towards himself are to a great extent unknown to the neurotic; sometimes even they are not known at all. It is not enough, therefore, to follow the patient blindfold on the path of regression, and to push him by an inopportune etiological interest back into his infantile phantasies. I have often heard from patients, with whom the psychoanalytic treatment has come to a standstill: “The doctor believes I must have somewhere some infantile trauma, or an infantile phantasy which I am still repressing.” Apart from the cases where this supposition was really true, I have seen cases in which the stoppage was caused by the fact that the libido, hauled up by the analysis, sank back into the depths again for want of employment. This was due to the physician’s attention being directed entirely to the infantile phantasies, and his failing therefore to see what duties of the moment the patient had to fulfil. The consequence was that the libido brought forth by analysis always sank back again, as no opportunity for further activity was found.

There are many patients who, on their own account, discover their life-tasks and abandon the production of regressive phantasies pretty soon, because they prefer to live in reality, rather than in their phantasies. It is a pity that this cannot be said of all patients. A good many of them forsake for a long time, or even forever, the fulfilment of their life-tasks, and prefer their idle neurotic dreaming. I must again emphasize that we do not understand by “dreaming” always a conscious phenomenon.

In accordance with these facts and these views, the character of psychoanalysis has changed during the course of time. If the first stage of psychoanalysis was perhaps a kind of surgery, which would remove from the mind of the patient the foreign body, the “blocked” affect, the later form has been a kind of historical method, which tries to investigate carefully the genesis of the neurosis, down to its smallest details, and to reduce it to its earliest origins.