Memories, Dreams, Reflections

by C. G. Jung

  Nevertheless, I decided to take a chance on a therapy whose outcome was uncertain. I told her everything I had discovered through the association test. It can easily be imagined how difficult it was for me to do this. To accuse a person point-blank of murder is no small matter. And it was tragic for the patient to have to listen to it and accept it. But the result was that in two weeks it proved possible to discharge her, and she was never again institutionalized.

  There were other reasons that caused me to say nothing to my colleagues about this case. I was afraid of their discussing it and possibly raising legal questions. Nothing could be proved against the patient, of course, and yet such a discussion might have had disastrous consequences for her. Fate had punished her enough! It seemed to me more meaningful that she should return to life in order to atone in life for her crime. When she was discharged, she departed bearing her heavy burden. She had to bear this burden. The loss of the child had been frightful for her, and her expiation had already begun with the depression and her confinement to the institution.

  In many cases in psychiatry, the patient who comes to us has a story that is not told, and which as a rule no one knows of. 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. The doctor’s task is to find out how to gain that knowledge. In most cases exploration of the conscious material is insufficient. Sometimes an association test can open the way; so can the interpretation of dreams, or long and patient human contact with the individual. In therapy the problem is always the whole person, never the symptom alone. We must ask questions which challenge the whole personality.

  In 1905 I became lecturer in psychiatry at the University of Zürich, and that same year I became senior physician at the Psychiatric Clinic. I held this position for four years. Then in 1909 I had to resign because by this time I was simply over my head in work. In the course of the years I had acquired so large a private practice that I could no longer keep up with my tasks. However, I continued my professorship until the year 1913. I lectured on psychopathology, and, naturally, also on the foundations of Freudian psychoanalysis, as well as on the psychology of primitives. These were my principal subjects. During the first semesters my lectures dealt chiefly with hypnosis, also with Janet and Flournoy. Later the problem of Freudian psychoanalysis moved into the foreground.

  In my courses on hypnosis I used to inquire into the personal history of the patients whom I presented to the students. One case I still remember very well.

  A middle-aged woman, apparently with a strong religious bent, appeared one day. She was fifty-eight years old, and came on crutches, led by her maid. For seventeen years she had been suffering from a painful paralysis of the left leg. I placed her in a comfortable chair and asked her for her story. She began to tell it to me, and how terrible it all was—the whole long tale of her illness came out with the greatest circumstantiality. Finally I interrupted her and said, “Well now, we have no more time for so much talk. I am now going to hypnotize you.”

  I had scarcely said the words when she closed her eyes and fell into a profound trance—without any hypnosis at all! I wondered at this, but did not disturb her. She went on talking without pause, and related the most remarkable dreams—dreams that represented a fairly deep experience of the unconscious. This, however, I did not understand until years later. At the time I assumed she was in a kind of delirium. The situation was gradually growing rather uncomfortable for me. Here were twenty students present, to whom I was going to demonstrate hypnosis!

  After half an hour of this, I wanted to awaken the patient again. She would not wake up. I became alarmed; it occurred to me that I might inadvertently have probed into a latent psychosis. It took some ten minutes before I succeeded in waking her. All the while I dared not let the students observe my nervousness. When the woman came to, she was giddy and confused. I said to her, “I am the doctor, and everything is all right.” Whereupon she cried out, “But I am cured!” threw away her crutches, and was able to walk. Flushed with embarrassment, I said to the students, “Now you’ve seen what can be done with hypnosis!” In fact I had not the slightest idea what had happened.

  That was one of the experiences that prompted me to abandon hypnosis. I could not understand what had really happened, but the woman was in fact cured, and departed in the best of spirits. I asked her to let me hear from her, since I counted on a relapse in twenty-four hours at the latest. But her pains did not recur; in spite of my skepticism, I had to accept the fact of her cure.

  At the first lecture of the summer semester next year, she reappeared. This time she complained of violent pains in the back which had, she said, begun only recently. Naturally I asked myself whether there was some connection with the resumption of my lectures. Perhaps she had read the announcement of the lecture in the newspaper. I asked her when the pain had started, and what had caused it. She could not recall that anything had happened to her at any specific time nor could she offer the slightest explanation. Finally I elicited the fact that the pains had actually begun on the day and at the very hour she saw the announcement in the newspaper. That confirmed my guess, but I still did not see how the miraculous cure had come about. I hypnotized her once more—that is to say, she again fell spontaneously into a trance—and afterward the pain was gone.

  This time I kept her after the lecture in order to find out more about her life. It turned out that she had a feeble-minded son who was in my department in the hospital. I knew nothing about this because she bore her second husband’s name and the son was a child of her first marriage. He was her only child. Naturally, she had hoped for a talented and successful son, and it had been a terrible blow when he became mentally ill at an early age. At that time I was still a young doctor, and represented everything she had hoped her son might become. Her ambitious longing to be the mother of a hero therefore fastened upon me. She adopted me as her son, and proclaimed her miraculous cure far and wide.

  In actual fact she was responsible for my local fame as a wizard, and since the story soon got around, I was indebted to her for my first private patients. My psychotherapeutic practice began with a mother’s putting me in the place of her mentally ill son! Naturally I explained the whole matter to her, in all its ramifications. She took it very well, and did not again suffer a relapse.

  That was my first real therapeutic experience—I might say: my first analysis. I distinctly recall my talk with the old lady. She was intelligent, and exceedingly grateful that I had taken her seriously and displayed concern for her fate and that of her son. This had helped her.

  In the beginning I employed hypnosis in my private practice also, but I soon gave it up because in using it one is only groping in the dark. One never knows how long an improvement or a cure will last, and I always had compunctions about working in such uncertainty. Nor was I fond of deciding on my own what the patient ought to do. I was much more concerned to learn from the patient himself where his natural bent would lead him. In order to find that out, careful analysis of dreams and of other manifestations of the unconscious was necessary.

  During the years 1904–5 I set up a laboratory for experimental psychopathology at the Psychiatric Clinic. I had a number of students there with whom I investigated psychic reactions (i.e., associations). Franz Riklin, Sr., was my collaborator. Ludwig Binswanger was currently writing his doctoral dissertation on the association experiment in connection with the psychogalvanic effect,1 and I wrote my paper “On the Psychological Diagnosis of Facts.”2 There were also a number of Americans among our associates, including Frederick Peterson and Charles Ricksher. Their papers were published in American journals. It was these association studies which later, in 1909, procured me my invitation to Clark University; I was asked to lecture on my work. Simultaneously, and independently of me, Freud was invited. The degree of Doctor of Laws honoris causa was bestowed on both of us
.

  The association experiment and the psychogalvanic experiment were chiefly responsible for my reputation in America. Very soon many patients from that country were coming to me. I remember well one of the first cases. An American colleague sent me a patient. The accompanying diagnosis read “alcoholic neurasthenia.” The prognosis called him “incurable.” My colleague had therefore taken the precaution of advising the patient to see also a certain neurological authority in Berlin, for he expected that my attempt at therapy would lead to nothing. The patient came for consultation, and after I had talked a little with him I saw that the man had an ordinary neurosis, of whose psychic origins he had no inkling. I made an association test and discovered that he was suffering from the effects of a formidable mother complex. He came from a rich and respected family, had a likeable wife and no cares—externally speaking. Only he drank too much. The drinking was a desperate attempt to narcotize himself, to forget his oppressive situation. Naturally, it did not help.

  His mother was the owner of a large company, and the unusually talented son occupied a leading post in the firm. He really should long since have escaped from his oppressive subordination to his mother, but he could not summon up the resolution to throw up his excellent position. Thus he remained chained to his mother, who had installed him in the business. Whenever he was with her, or had to submit to her interference with his work, he would start drinking in order to stupefy or discharge his emotions. A part of him did not really want to leave the comfortably warm nest, and against his own instincts he was allowing himself to be seduced by wealth and comfort.

  After brief treatment he stopped drinking, and considered himself cured. But I told him, “I do not guarantee that you will not relapse into the same state if you return to your former situation.” He did not believe me, and returned home to America in fine fettle.

  As soon as he was back under his mother’s influence, the drinking began again. Thereupon I was called by her to a consultation during her stay in Switzerland. She was an intelligent woman, but was a real “power devil.” I saw what the son had to contend with, and realized that he did not have the strength to resist. Physically, too, he was rather delicate and no match for his mother. I therefore decided upon an act of force majeure. Behind his back I gave his mother a medical certificate to the effect that her son’s alcoholism rendered him incapable of fulfilling the requirements of his job. I recommended his discharge. This advice was followed—and the son, of course, was furious with me.

  Here I had done something which normally would be considered unethical for a medical man. But I knew that for the patient’s sake I had had to take this step.

  His further development? Separated from his mother, his own personality was able to unfold. He made a brilliant career—in spite of, or rather just because of the strong horse pill I had given him. His wife was grateful to me, for her husband had not only overcome his alcoholism, but had also struck out on his own individual path with the greatest success.

  Nevertheless, for years I had a guilty conscience about this patient because I had made out that certificate behind his back, though I was certain that only such an act could free him. And indeed, once his liberation was accomplished, the neurosis disappeared.

  In my practice I was constantly impressed by the way the human psyche reacts to a crime committed unconsciously. After all, that young woman was initially not aware that she had killed her child. And yet she had fallen into a condition that appeared to be the expression of extreme consciousness of guilt.

  I once had a similar case which I have never forgotten. A lady came to my office. She refused to give her name, said it did not matter, since she wished to have only the one consultation. It was apparent that she belonged to the upper levels of society. She had been a doctor, she said. What she had to communicate to me was a confession; some twenty years ago she had committed a murder out of jealousy. She had poisoned her best friend because she wanted to marry the friend’s husband. She had thought that if the murder was not discovered, it would not disturb her. She wanted to marry the husband, and the simplest way was to eliminate her friend. Moral considerations were of no importance to her, she thought.

  The consequences? She had in fact married the man, but he died soon afterward, relatively young. During the following years a number of strange things happened. The daughter of this marriage endeavored to get away from her as soon as she was grown up. She married young and vanished from view, drew farther and farther away, and ultimately the mother lost all contact with her.

  This lady was a passionate horsewoman and owned several riding horses of which she was extremely fond. One day she discovered that the horses were beginning to grow nervous under her. Even her favorite shied and threw her. Finally she had to give up riding. Thereafter she clung to her dogs. She owned an unusually beautiful wolfhound to which she was greatly attached. As chance would have it, this very dog was stricken with paralysis. With that, her cup was full; she felt that she was morally done for. She had to confess, and for this purpose she came to me. She was a murderess, but on top of that she had also murdered herself. For one who commits such a crime destroys his own soul. The murderer has already passed sentence on himself. If someone has committed a crime and is caught, he suffers judicial punishment. If he has done it secretly, without moral consciousness of it, and remains undiscovered, the punishment can nevertheless be visited upon him, as our case shows. It comes out in the end. Sometimes it seems as if even animals and plants “know” it.

  As a result of the murder, the woman was plunged into unbearable loneliness. She had even become alienated from animals. And in order to shake off this loneliness, she had made me share her knowledge. She had to have someone who was not a murderer to share the secret. She wanted to find a person who could accept her confession without prejudice, for by so doing she would achieve once more something resembling a relationship to humanity. And the person would have to be a doctor rather than a professional confessor. She would have suspected a priest of listening to her because of his office, and of not accepting the facts for their own sake but for the purpose of moral judgment. She had seen people and animals turn away from her, and had been so struck by this silent verdict that she could not have endured any further condemnation.

  I never found out who she was, nor do I have any proof that her story was true. Sometimes I have asked myself what might have become of her. For that was by no means the end of her journey. Perhaps she was driven ultimately to suicide. I cannot imagine how she could have gone on living in that utter loneliness.

  Clinical diagnoses are important, since they give the doctor a certain orientation; but they do not help the patient. The crucial thing is the story. For it alone shows the human background and the human suffering, and only at that point can the doctor’s therapy begin to operate. A case demonstrated this to me most cogently.3

  The case concerned an old patient in the women’s ward. She was about seventy-five, and had been bedridden for forty years. Almost fifty years ago she had entered the institution, but there was no one left who could recall her admittance; everyone who had been there had since died. Only one head nurse, who had been working at the institution for thirty-five years, still remembered something of the patient’s story. The old woman could not speak, and could only take fluid or semifluid nourishment. She ate with her fingers, letting the food drip off them into her mouth. Sometimes it would take her almost two hours to consume a cup of milk. When not eating, she made curious rhythmic motions with her hands and arms. I did not understand what they meant. I was profoundly impressed by the degree of destruction that can be wrought by mental disease, but saw no possible explanation. At the clinical lectures she used to be presented as a catatonic form of dementia praecox, but that meant nothing to me, for these words did not contribute in the slightest to an understanding of the significance and origin of those curious gestures.

  The impression this case made upon me typifies my reaction to the psychiatry of the per
iod. When I became an assistant, I had the feeling that I understood nothing whatsoever about what psychiatry purported to be. I felt extremely uncomfortable beside my chief and my colleagues, who assumed such airs of certainty while I was groping perplexedly in the dark. For I regarded the main task of psychiatry as understanding the things that were taking place within the sick mind, and as yet I knew nothing about these things. Here I was engaged in a profession in which I did not know my way about!

  Late one evening, as I was walking through the ward, I saw the old woman still making her mysterious movements, and again asked myself, “Why must this be?” Thereupon I went to our old head nurse and asked whether the patient had always been that way. “Yes,” she replied. “But my predecessor told me she used to make shoes.” I then checked through her yellowing case history once more, and sure enough, there was a note to the effect that she was in the habit of making cobbler’s motions. In the past shoemakers used to hold shoes between their knees and draw the threads through the leather with precisely such movements. (Village cobblers can still be seen doing this today.) When the patient died shortly afterward, her elder brother came to the funeral. “Why did your sister lose her sanity?” I asked him. He told me that she had been in love with a shoemaker who for some reason had not wanted to marry her, and that when he finally rejected her she had “gone off.” The shoemaker movements indicated an identification with her sweetheart which had lasted until her death. That case gave me my first inkling of the psychic origins of dementia praecox. Henceforth I devoted all my attention to the meaningful connections in a psychosis.