[175] So much is psychotherapy the child of practical improvisation that for a long time it had trouble in thinking out its own intellectual foundations. Empirical psychology relied very much at first on physical and then on physiological ideas, and ventured only with some hesitation on the complex phenomena which constitute its proper field. Similarly, psychotherapy was at first simply an auxiliary method; only gradually did it free itself from the world of ideas represented by medical therapeutics and come to understand that its concern lay not merely with physiological but primarily with psychological principles. In other words, it found itself obliged to raise psychological issues which soon burst the framework of the experimental psychology of that day with its elementary statements. The demands of therapy brought highly complex factors within the purview of this still young science, and its exponents very often lacked the equipment needed to deal with the problems that arose. It is therefore not surprising that a bewildering assortment of ideas, theories, and points of view predominated in all the initial discussions of this new psychology which had been, so to speak, forced into existence by therapeutic experience. An outsider could hardly be blamed if he received an impression of babel. This confusion was inevitable, for sooner or later it was bound to become clear that one cannot treat the psyche without touching on man and life as a whole, including the ultimate and deepest issues, any more than one can treat the sick body without regard to the totality of its functions—or rather, as a few representatives of modern medicine maintain, the totality of the sick man himself.
[176] The more “psychological” a condition is, the greater its complexity and the more it relates to the whole of life. It is true that elementary psychic phenomena are closely allied to physiological processes, and there is not the slightest doubt that the physiological factor forms at least one pole of the psychic cosmos. The instinctive and affective processes, together with all the neurotic symptomatology that arises when these are disturbed, clearly rest on a physiological basis. But, on the other hand, the disturbing factor proves equally clearly that it has the power to turn physiological order into disorder. If the disturbance lies in a repression, then the disturbing factor—that is, the repressive force—belongs to a “higher” psychic order. It is not something elementary and physiologically conditioned, but, as experience shows, a highly complex determinant, as for example certain rational, ethical, aesthetic, religious, or other traditional ideas which cannot be scientifically proved to have any physiological basis. These extremely complex dominants form the other pole of the psyche. Experience likewise shows that this pole possesses an energy many times greater than that of the physiologically conditioned psyche.
[177] With its earliest advances into the field of psychology proper, the new psychotherapy came up against the problem of opposites—a problem that is profoundly characteristic of the psyche. Indeed, the structure of the psyche is so contradictory or contrapuntal that one can scarcely make any psychological assertion or general statement without having immediately to state its opposite.
[178] The problem of opposites offers an eminently suitable and ideal battleground for the most contradictory theories, and above all for partially or wholly unrealized prejudices regarding one’s philosophy of life. With this development psychotherapy stirred up a hornets’ nest of the first magnitude. Let us take as an example the supposedly simple case of a repressed instinct. If the repression is lifted, the instinct is set free. Once freed, it wants to live and function in its own way. But this creates a difficult—sometimes intolerably difficult—situation. The instinct ought therefore to be modified, or “sublimated,” as they say. How this is to be done without creating a new repression nobody can quite explain. The little word “ought” always proves the helplessness of the therapist; it is an admission that he has come to the end of his resources. The final appeal to reason would be very fine if man were by nature a rational animal, but he is not; on the contrary, he is quite as much irrational. Hence reason is often not sufficient to modify the instinct and make it conform to the rational order. Nobody can conceive the moral, ethical, philosophical, and religious conflicts that crop up at this stage of the problem—the facts surpass all imagination. Every conscientious and truth-loving psychotherapist could tell a tale here, though naturally not in public. All the contemporary problems, all the philosophical and religious questionings of our day, are raked up, and unless either the psychotherapist or the patient abandons the attempt in time it is likely to get under both their skins. Each will be driven to a discussion of his philosophy of life, both with himself and with his partner. There are of course forced answers and solutions, but in principle and in the long run they are neither desirable nor satisfying. No Gordian knot can be permanently cut; it has the awkward property of always tying itself again.
[179] This philosophical discussion is a task which psychotherapy necessarily sets itself, though not every patient will come down to basic principles. The question of the measuring rod with which to measure, of the ethical criteria which are to determine our actions, must be answered somehow, for the patient may quite possibly expect us to account for our judgments and decisions. Not all patients allow themselves to be condemned to infantile inferiority because of our refusal to render such an account, quite apart from the fact that a therapeutic blunder of this kind would be sawing off the branch on which we sit. In other words, the art of psychotherapy requires that the therapist be in possession of avowable, credible, and defensible convictions which have proved their viability either by having resolved any neurotic dissociations of his own or by preventing them from arising. A therapist with a neurosis is a contradiction in terms. One cannot help any patient to advance furthe. than one has advanced oneself. On the other hand, the possession of complexes does not in itself signify neurosis, for complexes are the normal foci of psychic happenings, and the fact that they are painful is no proof of pathological disturbance. Suffering is not an illness; it is the normal counterpole to happiness. A complex becomes pathological only when we think we have not got it.
[180] As the most complex of psychic structures, a man’s philosophy of life forms the counterpole to the physiologically conditioned psyche, and, as the highest psychic dominant, it ultimately determines the latter’s fate. It guides the life of the therapist and shapes the spirit of his therapy. Since it is an essentially subjective system despite the most rigorous objectivity, it may and very likely will be shattered time after time on colliding with the truth of the patient, but it rises again, rejuvenated by the experience. Conviction easily turns into self-defence and is seduced into rigidity, and this is inimical to life. The test of a firm conviction is its elasticity and flexibility; like every other exalted truth it thrives best on the admission of its errors.
[181] I can hardly draw a veil over the fact that we psychotherapists ought really to be philosophers or philosophic doctors—or rather that we already are so, though we are unwilling to admit it because of the glaring contrast between our work and what passes for philosophy in the universities. We could also call it religion in statu nascendi, for in the vast confusion that reigns at the roots of life there is no line of division between philosophy and religion. Nor does the unrelieved strain of the psychotherapeutic situation, with its host of impressions and emotional disturbances, leave us much leisure for the systematization of thought. Thus we have no clear exposition of guiding principles drawn from life to offer either to the philosophers or to the theologians.
[182] Our patients suffer from bondage to a neurosis, they are prisoners of the unconscious, and if we attempt to penetrate with understanding into that realm of unconscious forces, we have to defend ourselves against the same influences to which our patients have succumbed. Like doctors who treat epidemic diseases, we expose ourselves to powers that threaten our conscious equilibrium, and we have to take every possible precaution if we want to rescue not only our own humanity but that of the patient from the clutches of the unconscious. Wise self-limitation is not the same thing as text-book philosophy, nor is an ejaculatory prayer in a moment of mortal danger a theological treatise. Both are the outcome of a religious and philosophical attitude that is appropriate to the stark dynamism of life.
[183] The highest dominant always has a religious or a philosophical character. It is by nature extremely primitive, and consequently we find it in full development among primitive peoples. Any difficulty, danger, or critical phase of life immediately calls forth this dominant. It is the most natural reaction to all highly charged emotional situations. But often it remains as obscure as the semiconscious emotional situation which evoked it. Hence it is quite natural that the emotional disturbances of the patient should activate the corresponding religious or philosophical factors in the therapist. Often he is most reluctant to make himself conscious of these primitive contents, and he quite understandably prefers to turn for help to a religion or philosophy which has reached his consciousness from outside. This course does not strike me as being illegitimate in so far as it gives the patient a chance to take his place within the structure of some protective institution existing in the outside world. Such a solution is entirely natural, since there have always and everywhere been totem clans, cults, and creeds whose purpose it is to give an ordered form to the chaotic world of the instincts.
[184] The situation becomes difficult, however, when the patient’s nature resists a collective solution. The question then arises whether the therapist is prepared to risk having his convictions dashed and shattered against the truth of the patient. If he wants to go on treating the patient he must abandon all preconceived notions and, for better or worse, go with him in search of the religious and philosophical ideas that best correspond to the patient’s emotional states. These ideas present themselves in archetypal form, freshly sprung from the maternal soil whence all religious and philosophical systems originally came. But if the therapist is not prepared to have his convictions called in question for the sake of the patient, then there is some reason for doubting the stability of his basic attitude. Perhaps he cannot give way on grounds of self-defence, which threatens him with rigidity. The margin of psychological elasticity varies both individually and collectively, and often it is so narrow that a certain degree of rigidity really does represent the maximum achievement. Ultra posse nemo obligatur.
[185] Instinct is not an isolated thing, nor can it be isolated in practice. It always brings in its train archetypal contents of a spiritual nature, which are at once its foundation and its limitation. In other words, an instinct is always and inevitably coupled with something like a philosophy of life, however archaic, unclear, and hazy this may be. Instinct stimulates thought, and if a man does not think of his own free will, then you get compulsive thinking, for the two poles of the psyche, the physiological and the mental, are indissolubly connected. For this reason instinct cannot be freed without freeing the mind, just as mind divorced from instinct is condemned to futility. Not that the tie between mind and instinct is necessarily a harmonious one. On the contrary it is full of conflict and means suffering. Therefore the principal aim of psychotherapy is not to transport the patient to an impossible state of happiness, but to help him acquire steadfastness and philosophic patience in face of suffering. Life demands for its completion and fulfilment a balance between joy and sorrow. But because suffering is positively disagreeable, people naturally prefer not to ponder how much fear and sorrow fall to the lot of man. So they speak soothingly about progress and the greatest possible happiness, forgetting that happiness is itself poisoned if the measure of suffering has not been fulfilled. Behind a neurosis there is so often concealed all the natural and necessary suffering the patient has been unwilling to bear. We can see this most clearly from hysterical pains, which are relieved in the course of treatment by the corresponding psychic suffering which the patient sought to avoid.
[186] The Christian doctrine of original sin on the one hand, and of the meaning and value of suffering on the other, is therefore of profound therapeutic significance and is undoubtedly far better suited to Western man than Islamic fatalism. Similarly the belief in immortality gives life that untroubled flow into the future so necessary if stoppages and regressions are to be avoided. Although we like to use the word “doctrine” for these—psychologically speaking—extremely important ideas, it would be a great mistake to think that they are just arbitrary intellectual theories. Psychologically regarded, they are emotional experiences whose nature cannot be discussed. If I may permit myself a banal comparison, when I feel well and content nobody can prove to me that I am not. Logical arguments simply bounce off the facts felt and experienced. Original sin, the meaning of suffering, and immortality are emotional facts of this kind. But to experience them is a charisma which no human art can compel. Only unreserved surrender can hope to reach such a goal.
[187] Not everybody is capable of this surrender. There is no “ought” or “must” about it, for the very act of exerting the will inevitably places such an emphasis on my will to surrender that the exact opposite of surrender results. The Titans could not take Olympus by storm, and still less may a Christian take Heaven. The most healing, and psychologically the most necessary, experiences are a “treasure hard to attain,” and its acquisition demands something out of the common from the common man.
[188] As we know, this something out of the common proves, in practical work with the patient, to be an invasion by archetypal contents. If these contents are to be assimilated, it is not enough to make use of the current philosophical or religious ideas, for they simply do not fit the archaic symbolism of the material. We are therefore forced to go back to pre-Christian and non-Christian conceptions and to conclude that Western man does not possess the monopoly of human wisdom and that the white race is not a species of Homo sapiens specially favoured by God. Moreover we cannot do justice to certain contemporary collective phenomena unless we revert to the pre-Christian parallels.
[189] Medieval physicians seem to have realized this, for they practised a philosophy whose roots can be traced back to pre-Christian times and whose nature exactly corresponds to our experiences with patients today. These physicians recognized, besides the light of divine revelation, a lumen naturae as a second, independent source of illumination, to which the doctor could turn if the truth as handed down by the Church should for any reason prove ineffective either for himself or for the patient.
[190] It was eminently practical reasons, and not the mere caperings of a hobby-horse, that prompted me to undertake my historical researches. Neither our modern medical training nor academic psychology and philosophy can equip the doctor with the necessary education, or with the means, to deal effectively and understandingly with the often very urgent demands of his psychotherapeutic practice. It therefore behoves us, unembarrassed by our shortcomings as amateurs of history, to go to school once more with the medical philosophers of a distant past, when body and soul had not yet been wrenched asunder into different faculties. Although we are specialists par excellence, our specialized field, oddly enough, drives us to universalism and to the complete overcoming of the specialist attitude, if the totality of body and soul is not to be just a matter of words. Once we have made up our minds to treat the soul, we can no longer close our eyes to the fact that neurosis is not a thing apart but the whole of the pathologically disturbed psyche. It was Freud’s momentous discovery that the neurosis is not a mere agglomeration of symptoms, but a wrong functioning which affects the whole psyche. The important thing is not the neurosis, but the man who has the neurosis. We have to set to work on the human being, and we must be able to do him justice as a human being.
[191] The conference we are holding today proves that our psychotherapy has recognized its aim, which is to pay equal attention to the physiological and to the spiritual factor. Originating in natural science, it applies the objective, empirical methods of the latter to the phenomenology of the mind. Even if this should remain a mere attempt, the fact that the attempt has been made is of incalculable significance.