Collected Papers on Analytical Psychology

by C. G. Jung

Hitherto we psychiatrists used not to be able to suppress a laugh when we read an artist's attempts to portray a psychosis. These attempts have been generally regarded as quite useless, for the writer introduces into his conception of the psychosis psychological relationships quite foreign to the clinical picture of the disease. But the artist has not simply proceeded to copy a case out of a psychiatric text-book; he knows as a rule better than the psychiatrist.

The case which I have sketched is not unique, it is typical of a whole class for which the artist Spitteler has created a model of universal validity; the model is Imago. I may take for granted that you know his book of that name. The psychological gulf, however, between the creation of the artist and the insane person is great. The world of the artist is one of solved problems; the world of reality, that of unsolved problems. The mental patient is a faithful image of this reality. His solutions are unsatisfying illusions, his cure a temporary giving up of the problem, which yet goes on working in the depths of the unconscious, and at the appointed time again rises to the surface and creates new illusions with new scenery; part of the history of mankind is here seen abridged.

Psychological analysis is far from being able to explain in complete and illuminating fashion all cases of the disease with which we are here concerned. On the contrary, the majority remain obscure and difficult to understand, and chiefly because only a certain proportion of patients recover. Our last patient is noteworthy because his return to a normal state afforded us a survey of the period of his illness. Unfortunately the advantage of this standpoint is not always possible to us, for a great number of persons never find their way back from their dreams. They are lost in the maze of a magic garden where the same old story is repeated again and again in a timeless present. For patients the hands of the clock of the world remain stationary; there is no time, no further development. It makes no difference to them whether they dream for two days or thirty years. I had a patient in my ward who was five years without uttering a word, in bed, and entirely buried in himself. For years I visited him twice daily, and as I reached his bedside I could see at once that there was no change. One day I was just about to leave the room when a voice I did not recognise called out—"Who are you? What do you want here?" I saw with astonishment that it was the dumb patient who had suddenly regained his voice, and obviously his senses also. I told him I was his doctor, whereupon he asked angrily, why was he kept a prisoner here, and why did no one ever speak to him? He said this in an injured voice just like a normal person whom one had neglected for a couple of days. I informed him that he had been in bed quite speechless for five years and had responded to nothing, whereat he looked at me fixedly and without understanding. Naturally I tried to discover what had gone on in him during these five years, but could learn nothing. Another patient with a similar symptom, when asked why he had remained silent for years, maintained, "Because I wanted to spare the German language."[199] These examples show that it is often impossible to lift the veil of the secret, for the patients themselves have neither interest nor pleasure in explaining their strange experiences, in which as a rule they realise nothing peculiar.

Occasionally the symptoms themselves are a sign-post to the understanding of the psychology of the disease.

We had a patient who was for thirty-five years an inmate at Burghölzli. For decades she lay in bed, she never spoke or reacted to anything, her head was always bowed, her back bent and the knees somewhat drawn up. She was always making peculiar rubbing movements with her hands, so as to give rise during the course of years to thick horny patches on her hands. She kept the thumb and index finger of her right hand together as in the movement of sewing. When she died I tried to discover what she had been formerly. Nobody in the asylum recalled ever having seen her out of bed. Only our chief attendant had a memory of having seen her sitting in the same attitude as that she afterwards took up in bed, at which time she was making rapid movements of extension of the arm across the right knee; it was said of her that she was sewing shoes, later that she was polishing shoes. As time went on the movements became more limited till finally there remained but a slight rubbing movement, and only the finger and thumb retained the sewing position. In vain I consulted our old attendant, she knew nothing about the patient's previous history. When the seventy-year-old brother came to the funeral I asked him what had been the cause of his sister's illness; he told me that she had had a love-affair, but for various reasons it had come to nothing. The girl had taken this so to heart that she became low-spirited. In answer to a query about her lover it was found that he was a shoemaker.

Unless you see here some strange play of accident, you must agree that the patient had kept the memory-picture of her lover unaltered in her heart for thirty-five years.

One might easily think that these patients who give an impression of imbecility are only burnt-out ruins of humanity. But such is probably not the case. One can often prove directly that such patients register everything going on around them even with a certain curiosity, and have an excellent memory for it all. This is the reason why many patients become for a time pretty sensible again, and develop mental powers which one believed they had long since lost. Such intervals occur occasionally during serious physical disease, or just before death. We had a patient with whom it was impossible to carry on a sane conversation; he only produced a mad medley of delusions and words. He once fell seriously ill physically, and I expected it would be very difficult to treat him. Not at all. He was quite changed, he became friendly and amiable, and carried out all his doctor's orders patiently and gratefully. His eyes lost their evil darting looks, and shone quietly and understandingly. One morning I came to his room with the usual greeting: "Good morning. How are you getting on?" The patient answered me in the well-known way: "There again comes one of the dog and monkey troupe wanting to play the Saviour." Then I knew his physical trouble was over. From that moment the whole of his reason was as if "blown away" again.

From these observations we see that reason still survives, but is pushed away into some corner by the complete preoccupation of the mind with diseased thoughts.

Why is the mind compelled to exhaust itself in the elaboration of diseased nonsense? On this difficult question our new insight throws considerable light. To-day we can say that the pathological images dominate the interests of the patient so completely, because they are simply derivatives of the most important questions that used to occupy the person when normal—what in insanity is now an incomprehensible maze of symptoms used to be fields of vital interest to the former personality.