by Phil Goss
Jung’s approach to depression
The angle Jung took towards working with depressed people was rather different from the current emphasis on structured, often short-term therapeutic interventions for depression and anxiety, such as those deployed by a cognitive behavioural approach (Beck and Alford, 2008). Jung wrote about depression in relation to his theory of archetypal opposites and compensatory mechanisms in the psyche. One case from his practice which he described involved a wealthy businessman who had been able to retire early to enjoy all the benefits of his financial situation. However, he discovered that this drove him into a state of hypochondriac anxiety and depression, which did not abate when he decided to start working again. Jung made a link between this apparently regressed psychological state and his need to be attended to by his mother, which inevitably dated back to early life.
Jung tried to help this analysand by getting him to recognize the presence of the opposite to the overflowing riches which he (materially) possessed. This opposite was the neediness of the boy within who had not had his needs met and was now manifesting this through psychosomatic symptoms and a deep despair. Jung characterizes the approach required in terms of the ‘downward gradient’ trapped energy needs in order to be able to flow naturally again (like a stream seeking a downhill route in the landscape):
‘It has become abundantly clear to me that life can flow forward only along the path of the gradient. But there is no energy unless there is a tension of opposites: hence it is necessary to discover the opposite to the attitude of the conscious mind… Seen from the one-sided point of view of the conscious attitude, the shadow is an inferior component of the personality and is consequently repressed through intensive resistance. But the repressed content must be made conscious so as to produce a tension of opposites, without which no forward movement is possible.’
Jung, 1966a, para. 78
In this case, the analysand was not ready to work with his shadow to uncover what lay behind his neurotic and depressed state. Jung reports that the analysis, and likewise the man’s process of healing, was not able to move forward.
Another example that builds on this approach to working with depression is Judith Hubback’s (in Samuels, 1989) discussion of working with people whose depression is intimately linked with early experiences of familial disruption or unhappiness. She demonstrates how the unconscious will split in defence against this and in turn how this can make the archetypal inner coniunctio (or ‘inner marriage’, as described in alchemical terms in Chapter 13) needed for healing, unavailable. Intensive work in the transference–countertransference is needed. The analyst picks up how the analysand is unconsciously fantasizing about the inner life/lives of their parents so these fantasies can be properly processed, to clear the way for the trapped energy in the depression to be released.
A further example of a Jungian approach is provided by David Rosen (2002), who emphasizes the healing potential of working with the unconscious. Individuals experiencing the deepest of depressions, he argues, can gradually transform their misery into creative energy by working with symbols that arise from their suffering. This approach tallies with Jung’s premise that we need to identify and work with repressed shadow contents in the psyche, to release, step by step, the trapped energy which can slowly improve the person’s state of mind.
Addiction: a sickness of the spirit
Jung provided a framework for understanding addiction from an archetypal perspective, which has come to be influential. His proposal that addiction – and in particular alcoholism – has its roots in an absence of spirit, or the spiritual in a general sense, was picked up by the founders of Alcoholics Anonymous (AA), and provided the foundation for the work of that organization (as well as other ‘Anon’ groups such as Narcotics Anonymous). The principle of there being a ‘gap’ in the psyche which alcohol or another drug can fill led to the emphasis in AA on ‘handing over’ the task of giving up alcohol to something with more ‘spiritual power’ than the drink.
As Jung put it (1961) in a letter to Bill Wilson (one of AA’s founders):
‘(the)… craving for alcohol was the equivalent, on a low level, of the spiritual thirst of our being for wholeness, expressed in medieval language: the union with God… “alcohol” in Latin is “spiritus” and you use the same word for the highest religious experience as well as for the most depraving poison. The helpful formula therefore is: spiritus contra spiritum.’
The Latin phrase here translates roughly into ‘spirit against the ravages of spirits’. So, for Jung, the domination of alcoholic spirits (and by implication, other addictive substances) in the life of the addict needs to be replaced by something ‘spiritual’. Jung may have had religious belief in mind for some people. However, like AA’s ‘12 steps’, a Jungian approach emphasizes the individuality of the pursuit of meaning in life. So this could also be a wider or alternative version of spirituality rather than being part of a faith community. Equally, it could be a deeper grasp of life’s existential value and struggle, or a humanistic/atheistic framework.
Whichever form this takes, the key point here is that addiction comes to be seen as an attempt to fill the gap in meaning in someone’s life. This gap may be triggered by trauma or loss, or generated by a more low level, long-lasting sense of unease and emptiness. In this sense, one could describe addiction as a kind of complex, which grips the psyche by the way it perpetuates the sense of lack, that then gets temporarily ‘filled’ by alcohol or other drugs. As well as the AA framework, the principle of ‘filling the gap’ which supposedly stimulates the draw towards drug dependency is a familiar one in some of the literature associated with ‘Recovery’ (e.g. Adams and Greider, 2005). Presentation of addiction in Jungian analysis tends to be viewed through this frame, although other perspectives on treatment of addiction, as well as the specifics of the analysand’s way of presenting with this, will be incorporated properly into the approach taken.
Luis Zoja (2000), a Jungian thinker, has taken this thinking a step further by locating addiction in a collective context. He argues that addiction (whether to drinking, eating, gambling, smoking, sex or shopping) is prevalent in westernized societies because it is a response to an important lack in the Western, consumerist psyche. This lack he associates with the need for initiation:
‘We appear to live under conditions that are, for the most part, desacralized. However, it is enough just to scratch the surface of the situation to rediscover many elements of a real religious state, the survival of which manifests itself indirectly, especially in a need for esoteric and initiatory experiences.’
Zoja, 2000, p. 2
Zoja points out that, in so-called primitive societies, drugs were used in a controlled way as part of initiation rituals. In particular they would play their part in the following sequence, where an adolescent was being initiated into the mysteries and responsibilities of adulthood:
1 Experiencing the transcendence of meaninglessness
2 An initiatory death, involving a kind of renunciation of one’s previous identity and ‘the ordinary world’
3 Initiatory ritual, e.g. through controlled use of drugs
Step three is generally unavailable, as the second step is not provided for in Western societies – there is no established provision for people to refrain from behaviour that is consumer led, other than in some religious or alternative lifestyle communities. What Zoja suggests happens instead is a kind of misguided attempt (partly conscious but mainly unconscious) to ‘arrive’ in a new or ‘other’ state which fulfils an archetypal need for initiation. So the gambler keeps gambling, the drinker keeps drinking, etc., in an attempt to experience a proper sense of initiation. However, the fantasy of reaching the new/adult state via the use of the drug becomes the thing that sustains the addiction. Without the ‘initiatory death’ first, the use of the drug becomes a thing of addiction, not initiation.
WORKING WITH ADDICTION IN ANALYSIS
In the therapeutic context, naming an
d owning the shadow of addiction in a person’s life, then the reflective search for what really matters to them (existential, spiritual, practical or religious), followed by the nurturing and conscious integration of this in their life via concrete steps or inner commitment to what is important, can make a real difference in supporting abstinence or moderation of addictive behaviour, as those who have successfully implemented the ‘12 steps’ of AA can testify. David Schoen (2009) provides an archetypal Jungian critique of why these seem to work more than many other interventions. He suggests that more than personal shadow needs to be overcome – addiction, he says, is a struggle with archetypal shadow (or ‘evil’?). Work with dreams and other unconscious material is needed to tackle the deep roots of addiction, he argues.
However, other writers have stressed the need for a science-based understanding of the nature of addiction and sobriety (e.g. Sheff, 2014), and Jung’s initial formula can seem a little simplistic, relying on his own emphasis on the ‘religious problem’. In this respect, the possibly one-sided solution he proposes needs to be placed in the wider context of what can influence addictive behaviour, such as the way the craving for the addictive substance can get hard-wired into the brain. However, Schoen’s and Zoja’s formulations provide powerful insight into what perpetuates the apparent epidemic of addictive behaviour in Westernized societies.
Addiction: finding the will to stop
Jolanta had been aware for some time that her habit of having a beer and a few glasses of wine just about every night after work, sometimes complemented by smoking cannabis, had got out of hand. Sometimes it would be a whole bottle of wine (or more) and at the weekends there would often be parties with the friends she had made from work, as well as from the gym she worked out at most days of the week.
Curiously (at first glance), it was the gym that alerted Jolanta to the problematic cycle she seemed to have got into. She would go to the gym straight after work and go for the burn – push herself as hard as she could on the running machine and the weights, before showering and then heading home. She was often on a high anyway, with the endorphins kicking in, but she deliberately did not drink any water. When she got home she’d open a cold beer, relishing it as she drank it quickly, and then go on to the wine, as well as smoking cannabis some evenings.
Jolanta knew this cycle was starting to dominate her life; she would be thinking about the high-octane workout–drink–smoke sequence at regular intervals during the day at work, and had got to the point where she was turning down social invitations in order to get her buzz at the end of each day. She sensed an emptiness behind all this and shared this with her analyst. She described a dream where she was standing in an empty classroom in her old school in Poland.
When they explored what this might be about, it became clear how powerful the sense of disconnect between present and past was for Jolanta. She had left so much behind, including some deeply unhappy family dynamics that remained unresolved. She spoke of having come to the UK to escape this but also to ‘grow up’. After a number of sessions around this theme, she resolved to go home in her next holiday – ‘to get back in touch with who I am’. Whatever it was she had tried to escape from, but which she inevitably carried in her shadow, needed to be faced. She also resolved to cut back on her substance use, but was unsure whether she had the will to manage this. But by not renewing her gym membership for a few months, she could change the routine that supported this. She would jog instead, and drink water afterwards, and restrict her weekend drinking to moderate levels.
Jolanta’s emerging awareness of her reliance on the previous routine, which seemed to have an addictive quality, enabled her to recognize the feeling of ‘lack’ behind it. She saw the importance of finding a more meaningful sense of who she was and what really mattered to her (Jung’s ‘spirit’ to counter the ‘ravages of spirits’). She also recognized the need to root her movement into full adulthood, in both a proper recognition of past influences and a conscious effort to control her drug consumption. Here, ego had begun to listen to self: but would Jolanta be able to sustain this?
Trauma: an archetypal approach
An important contribution to clinical work with severe mental health problems has been made by Donald Kalsched (1996). Rather than trying to understand the impact of childhood trauma only in neurobiological or psychodynamic terms (though both of these are crucial), Kalsched proposed that a deeper psychic process is activated by trauma. This is archetypal, in terms of how psyche responds to the overwhelming terror and threat of destruction, inherent in trauma induced by physical or sexual abuse, or some kind of shocking experience of loss or disaster. Kalsched drew on Jung’s pertinent observations on how the consequences of trauma manifest in the psyche:
‘a traumatic complex brings about dissociation of the psyche… it forces itself tyrannically upon the conscious mind… I have frequently observed that the typical traumatic affect is represented in dreams as a wild and dangerous animal – a striking illustration of its autonomous nature when split off from consciousness.’
Jung, 1966b, paras 266–7
Like Jung, Kalsched noticed in his practice how analysands who had been on the receiving end of deeply disturbing traumatic experiences in childhood presented with nightmarish dream material involving not just dangerous animals, but scenes of utter brutality – murder, beheadings and vicious attacks on the dreamer or other figures in dreams.
Kalsched made sense of these phenomena by considering the workings of what he named ‘archetypal defences’. He posited that the psyche has a natural tendency to defend itself in proportion to the scale of the attack it experiences. Where abuse or other trauma involving primary carers occurs, these defences are caught in an impossible position, as the child cannot expel the bad experiences, for they have been created by an intimately loved figure. The energy remains trapped and, instead, the very defences that also hold the child’s brittle psyche intact in the face of devastating assault assume a position where they attack the self, because they cannot attack the external figure which has inflicted the damage. Hence the dissociation occurs, which means the psyche splits into separate domains, causing inner disturbance and conflict. Kalsched argues that this is an archetypal response, manifested in archetypal imaginal figures, to early trauma and loss.
The analyst utilizes the (archetypal) transference to enable the intervening, disrupting defences to slowly transform, as well as taking the empathic stance needed for healing. Dream material is pivotal to noticing where and how the internal ‘figure’ maintains the split, and for any symbolism which might indicate a shift in this. Kalsched gives an example of a black sword held by a monstrous figure which became double-edged with a red tinge, reflecting the alchemical move in the analysand’s unconscious from the darkness of nigredo to the life-bringing rubedo (redness), a move which showed itself in the settling and integrating of psychic elements, as the healing process ensued. Kalsched (2013) more recently deepened his conceptual framework in terms of describing where trauma interrupts not just personal development but also the archetypal level of human experiencing – the level of ‘soul’.
Because of how deeply pervasive these influences are, meaningful work with them takes time. Careful attention to the process of the analysand is needed, from ethical as well as therapeutic standpoints. Likewise, the analyst also needs to attend to their own self-care, as they contend with disturbing material (supervision plays an important role here).
Key idea: Trauma and countertransference
The analyst needs to attend to their countertransference when working with trauma, as with all clinical work. Wilkinson (2003) has elucidated this in terms of a neuroscientific understanding of how important it is for the right-brain of the analyst to connect to the right-brain of the analysand, as this is where the connections to deeper trauma buried in the unconscious can be found. The dissociative defences can be broken down via the transference–countertransference, drawing on dreams and other material, with important s
hifts resulting for the analysand.
Personality disorders and other mental health needs
The Jungian approach can be caricatured as being suitable only for the ‘worried well’ (people who have the time and money to explore their inner processes in analysis). However, analysts are geared up to practise with the full range of mental health difficulties. This is supported through their training (where a placement in a psychiatric setting is usually a prerequisite) and, often, previous experience (many trainees will have worked in the mental health field, or already be qualified psychotherapists or practitioners in this area).
Analysts are required to keep up to date with developments in the mental health field throughout their professional lives, and integrate this into their practice (an example is Wilkinson’s work (2003), above). They will also often take a number of low-fee analysands who cannot afford the full fee but are presenting with significant needs. The work of an analyst also includes situations where decisions need to be taken about referral of those presenting with very significant mental health problems. These can require a more cross-disciplinary approach than pure analysis, to protect the psychological stability, and even the safety, of the person concerned, and those around them.