Chapter IX: On Some Crucial Points in Psychoanalysis176 (1)

CORRESPONDENCE BETWEEN DR. JUNG AND DR. LOY APPEARING IN
"PSYCHOTHERAPEUTISCHE ZEITFRAGEN." PUBLISHED BY DR. LOY, SANATORIUM
L'ABRI, TERRITET-MONTREUX, SWITZERLAND, 1914.

I

_From Dr. Loÿ._

12th January, 1913.

What you said at our last conversation was extraordinarily stimulating. I was expecting you to throw light upon the interpretation of my own and my patients' dreams from the standpoint of Freud's "Interpretation of Dreams." Instead, you put before me an entirely new conception: the dream as a means of re-establishing the moral equipoise, fashioned in the realm below the threshold of consciousness. That indeed is a fruitful conception. But still more fruitful appears to me your other suggestion. You regard the problems of psychoanalysis as much deeper than I had ever thought: it is no longer merely a question of getting rid of troublesome pathological symptoms; the analysed person gets to understand not his anxiety-experiences alone, but his whole self most completely, and by means of this understanding he can build up and fashion his whole life anew. But he himself must be the builder, the Analyst only furnishes him with the necessary tools.

To begin with, I would ask you to consider what justification there is for the original procedure of Breuer and Freud, now entirely given up both by Freud himself and by you, but practised by Frank, for instance, as his only method: I mean "the abreaction of the inhibited effects under light hypnosis." Why have you given up the cathartic method? More particularly, has light hypnosis in psychocatharsis a different value from suggestion during sleep, long customary in treatment by suggestion? that is, has it only the value which the suggestionist contributes, or does it claim to possess only the value which the patient's belief bestows upon it? Or, again, is suggestion in the waking-state equivalent to suggestion in hypnoidal states? This Bernheim now asserts to be the case, after having used suggestion for many years exclusively in hypnosis. You will tell me we must talk of psychoanalysis, not of suggestion. But I really mean this: is not the _suggestion_, by means of which the psychocatharsis in the hypnoidal state produces therapeutic effects, (modified naturally, by the patients' age, etc.) the main factor in the therapeutic success of the psychocatharsis? Frank, in his "_Affektstörungen_," says: "these partial adjustments of effect, suggestibility and suggestion, are almost altogether omitted in the psychocathartic treatment in light sleep, in so far as the content of the reproduced presentations is concerned." Is that really true? Frank himself adds: "How can meditation upon the dreams of youth in itself lead to the discharge of the stored-up anxiety, whether in hypnoidal states or under any other conditions? Must one not suppose, with much greater probability, that the anxiety-states would become more pronounced through such concentration upon them?" [I have noticed that myself, and much more than I at all liked.] One does indeed say to the patient: "First we must stir up, then afterwards comes peace." And it does come. But does it not come _in spite of the stirring-up process_, because gradually, by means of frequent talks under light hypnosis, the patient gets such confidence in the doctor that he becomes susceptible to direct suggestion, and that produces at first improvement and finally, cure? I go still further: in an analysis _in the waking-state_, is not the patient's belief that the _method employed will cure him_, coupled with his ever-growing trust in the doctor, a main cause of his cure? And I ask even further: in every systematically carried-out therapeutic treatment, is not faith in it, trust in the doctor, a main factor in its success? I will not indeed say the only factor, for one cannot deny that the physical, dietetic and chemical procedures, when properly selected, have a real effect in securing a cure, over and above the obvious effect of their indirect suggestion.

II

_From Dr. Jung._

28th January, 1913.

With regard to your question as to the applicability of the cathartic method, the following is my standpoint: every method is good if it serves its purpose, including every method of suggestion, even Christian Science, Mental Healing, etc. "_A truth is a truth, when it works._" It is quite another question whether a scientific physician can answer for it to his conscience should he sell little bottles of Lourdes-water because that suggestion is at times very useful. Even the so-called highly scientific suggestion-therapy employs the wares of the medicine-man and the exorcising Schaman. And please, why should it not? The public is not even now much more advanced and continues to expect miracles from the doctor. And truly those doctors should be deemed clever--worldly-wise in every respect--who understand the art of investing themselves with the halo of the medicine-man. Not only have they the biggest practices--they have also the best results. This is simply because countless physical maladies (leaving out of count the neuroses) are complicated and burdened with psychic elements to an extent scarcely yet suspected. The medical exorcist's whole behaviour betrays his full valuation of the psychic element when he gives the patient the opportunity of fixing his faith firmly upon the doctor's mysterious personality. Thus does he win the sick man's mind, which henceforth helps him indeed to restore his body also to health. The cure works best when the doctor really believes in his own formulæ, otherwise he may be overcome by scientific doubt and so lose the correct, convincing tone. I, too, for a time practised hypnotic suggestion enthusiastically. But there befell me three dubious incidents which I want you to note:--

1. Once there came to me to be hypnotised for various neurotic troubles a withered peasant-woman of some fifty years old. She was not easy to hypnotise, was very restless, kept opening her eyes--but at last I did succeed. When I waked her after about half an hour she seized my hand and with many words testified to her overflowing gratitude. I said: "But you are by no means cured yet, so keep your thanks till the end of the treatment." She: "I am not thanking you for that, but--(blushing and whispering)--because you have been so _decent_." So she said, looked at me with a sort of tender admiration and departed. I gazed long at the spot where she had stood--and asked myself, confounded, "So decent?"--good heavens! surely she hadn't imagined, somehow or other.... This glimpse made me suspect for the first time that possibly the loose-minded person, by means of that notorious feminine (I should at that time have said "animal") directness of instinct, understood more about the essence of hypnotism than I with all my knowledge of the scientific profundity of the text-books. Therein lay my harmlessness.

2. Next came a pretty, coquettish, seventeen-year-old girl with a harassed, suspicious mother. The young daughter had suffered since early girlhood from _enuresis nocturna_, which, among other difficulties, hindered her from going to a boarding-school abroad.

At once I thought of the old woman and her wisdom. I tried to hypnotise the girl; she laughed affectedly and prevented hypnosis for twenty minutes. Of course I kept quiet and thought: I know why you laugh; you have already fallen in love with me, but I will give you proof of my decency in gratitude for your wasting my time with your challenging laughter. I succeeded in hypnotising her. Success followed at once. The enuresis stopped, and I therefore informed the young lady later that, instead of Wednesday, I would not see her again for hypnosis till the following Saturday. On Saturday she arrived with a cross countenance, presaging failure. The enuresis had come back again. I remembered my wise old woman, and asked: "When did the enuresis return?" She (unsuspecting), "Wednesday night." I thought to myself, There it is again, she wants to show me that I simply must see her on Wednesdays too; not to see me for a whole long week is too much for a tender, loving heart. But I was quite resolved to give no help to such annoying romancing, so I said, "To continue the hypnosis would be quite wrong under these circumstances. We must drop it for quite three weeks, to give the enuresis a chance to stop. Then come again for treatment." In my malicious heart I knew I should then be on my holiday and so the course of hypnotic treatment would come to an end. After the holidays my _locum tenens_ told me the young lady had been there with the news that the enuresis had vanished, but her disappointment at not seeing me was very keen. The old woman was right, thought I.

3. The third case gave my joy in suggestion its death-blow. This was the manner of it. She was a lady of sixty-five who came stumbling into the consulting-room with a crutch. She had suffered from pain in the knee-joint for seventeen years, and this at times kept her in bed for many weeks. No doctor had been able to cure her, and she had tried every possible remedy of present-day medicine. After I had suffered the stream of her narrative to flow over me for some ten minutes, I said, "I will try to hypnotise you, perhaps that will do you good." She, "Oh yes, please do!" leaned her head on one side and fell asleep before ever I said or did anything. She passed into somnambulism and showed every form of hypnosis you could possibly desire. After half an hour I had the greatest difficulty in waking her; when at last she was awake she jumped up: "I am well, I am all right, you have cured me." I tried to make timid objections, but her praises drowned me. She could really walk. Then I blushed and said, embarrassed, to my colleagues: "Look! behold the wondrously successful hypnotic therapy." That day saw the death of my connection with treatment by suggestion; the therapeutic praise won by this case shamed and humiliated me. When, a year later, at the beginning of my hypnotic course, the good old lady returned, this time with the pain in her back, I was already sunk in hopeless cynicism; I saw written on her forehead that she had just read the notice of the re-opening of my clinic in the newspaper, that vexatious romanticism had provided her with a convenient pain in the back so that she might have a pretext for seeing me, and again let herself be cured in the same theatrical fashion. This proved true in every particular.

As you will understand, a man possessed of scientific conscience cannot endure such cases without embarrassment. There ripened in me the resolve to renounce suggestion altogether rather than to allow myself passively to be transformed into a miracle-worker. I wanted to understand what really went on in the souls of people. It suddenly seemed to me incredibly childish to think of dispelling an illness with charms, and that this should be the only result of our scientific endeavours for a psychotherapy. Thus for me the discovery of Breuer and Freud was a veritable deliverance. I took up their method with unalloyed enthusiasm and soon recognised how right Freud was, when at a very early date, indeed so far back as the _Studien ueber Hysterie_, he began to direct a searchlight upon the accompanying circumstances of the so-called trauma. I too soon discovered that certainly some traumata with an obvious etiological tinge are opportunely present. But the greater number appeared highly improbable. So many of them seemed so insignificant, even so normal, that at most one could regard them as just providing the opportunity for the neurosis to appear. But what especially spurred my criticism was the fact that so many traumata were simply inventions of phantasy which had never really existed. This perception was enough to make me sceptical about the whole trauma-theory. (But I have dealt with these matters in detail in my lectures on the theory of psychoanalysis).[177] I could no longer suppose that the hundred and one cathartic experiences of a phantastically puffed-up or entirely invented trauma were anything but the effect of suggestion. It is well enough if it helps. If one only had not a scientific conscience and that impulsion towards the truth! I found in many cases, especially when dealing with more mentally gifted patients, that I must recognise the therapeutic limitations of this method. It is, of course, a definite plan, and convenient for the doctor, since it makes no particular demands upon his intellect for new adaptations. The theory and practice are both of the pleasantest simplicity: "The neurosis is caused by a trauma. The trauma is abreacted." When the abreaction takes place under hypnotism, or with other magical accessories (dark room, peculiar lighting, and the rest), I remember once more the wise old woman, who opened my eyes not merely to the magic influence of the mesmeric gestures, but also to the essential character of hypnotism itself. But what alienated me once for all from this relatively efficacious indirect method of suggestion, based as it is upon an equally efficacious false theory, was the perception I obtained at the same time that, behind the confused deceptive intricacies of neurotic phantasies, there stands a _conflict_, which may be best described as a _moral_ one. With this there began for me a new era of understanding. Research and therapy now coincided in the attempt to discover the causes and the _rational_ solution of this conflict. That is what psychoanalysis meant to me. Whilst I had been getting this insight, Freud had built up his sexual theory of the neurosis, and therewith had brought forward an enormous number of questions for discussion, all of which I thought deserved the profoundest consideration. Thus I have had the good fortune of co-operating with Freud for a long time, and working with him in the investigation of the problem of sexuality in neurosis. You, perhaps, know from some of my earlier work that I was always dubious somewhat concerning the significance of sexuality.[178] This has now become the exact point where I am no longer altogether of Freud's opinion.

I have preferred to answer your questions in rather non-sequent fashion. Whatever is still unanswered, let me now repeat: _light hypnosis_ and _complete hypnosis_ are but varying grades of intensity of unconscious attraction towards the hypnotist. Who can here venture to draw sharp distinctions? To a critical intelligence it is unthinkable that suggestibility and suggestion can be excluded in the cathartic method. They are present everywhere and are universal human attributes, even with Dubois and the psychoanalysts who think they work on purely rational lines. _No technique, no self-deception avails here--the doctor works, nolens volens--and perhaps primarily--by means of his personality, that is by suggestion._ In the cathartic treatment, what is of far more importance to the patient than the conjuring up of old phantasies is the being so often with the doctor, and having confidence and belief in him personally, and in his method. The belief, the self-confidence, perhaps also the devotion with which the doctor does his work, are far more important things to the patient (_imponderabilia_ though they be) than the recalling of old traumata.[179]

Ultimately we shall some day know from the history of medicine everything that has ever been of service; then perhaps at last we may come to the really desirable therapy, to psychotherapy. Did not even the old materia medica of filth have brilliant cures?--cures which only faded away with the belief in it!

Because I recognise that the patient does attempt to lay hold of the doctor's personality, in spite of all possible rational safeguards, I have formulated the demand that the psychotherapeutist shall be held just as responsible for the cleanness of his own hands as is the surgeon. I hold it to be an absolutely indispensable preliminary that the psychoanalyst should himself first undergo an analysis, for his personality is one of the chief factors in the cure.

Patients read the doctor's character intuitively and they should find in him a human being, with faults indeed, but also a man _who has striven at every point_ to _fulfil his own human duties in the fullest sense_. I think that this is the first healing factor. Many times I have had the opportunity of seeing that the analyst is successful with his treatment just in so far as he has succeeded in his own moral development. I think this answer will satisfy your question.

III

_From Dr. Loÿ._

2nd February, 1913.

You answer several of my questions in a decidedly affirmative sense. You take it as proved that in the cures by the cathartic method the main _rôle_ is played by faith in the doctor and in his method, and not by the "abreaction" of real or imaginary traumata. I also. Equally I am at one with your view that the cures of the old materia medica of filth, as well as the Lourdes cures, or those of the Mental Healers, Christian Scientists and Persuasionists, are to be attributed to faith in the miracle-worker, rather than to any of the methods employed.

Now comes the ticklish point: the augur can remain an augur so long as he himself believes the will of the gods is made manifest by the entrails of the sacrificial beast. When he no longer believes, he has to ask himself: Shall I continue to use my augur's authority to further the welfare of the State, or shall I make use of my newer, and (I hope) truer convictions of to-day? Both ways are possible. The first is called opportunism; the second the pursuit of truth, and scientific honour. For a doctor, the first way brings perhaps therapeutic success and fame; the second, reproach: such a man is not taken seriously. What I esteem most highly in Freud and his school is just this passionate desire for truth. But again, it is precisely here that people pronounce a different verdict: "It is impossible for the busy practitioner to keep pace with the development of the views of this investigator and his initiates." (Frank, "Affektstörungen Einleitung.")

One can easily disregard this little quip, but one must take more seriously one's self-criticism. We may have to ask ourselves whether, since science is an undivided, ever-flowing stream, we are justified in relinquishing on conscientious grounds any method or combination of methods by means of which we know cures can be achieved?

Looking more closely at the fundamental grounds of your aversion to the use of hypnosis (or semi-hypnosis, the degree matters nothing) in _treatment by suggestion_, (which as a matter of fact every doctor and every therapeutic method makes use of willy-nilly, no matter what it is called), it is clear that what has disgusted you in hypnotism is at bottom nothing but the so-called "transference" to the doctor, which you, with your unalloyed psychoanalytic treatment, can get rid of as little as any one else, for indeed it plays a chief part in the success of the treatment. Your insistence that the psychoanalyst must be answerable for the cleanness of his own hands--(here I agree with you unreservedly)----is an inevitable conclusion. But, after all, does anything more "augurish" really cling to the use made of hypnosis in psychotherapeutic treatment, than to the quite inevitable use made of the "transference to the doctor" for therapeutic ends? In either case we must perforce "take shares" in faith as a healing agent. As for the feeling which the patient--whether man or woman--entertains for the doctor, is there never anything in the background save conscious or unconscious sexual desire? In many cases your view is most certainly correct; more than one woman has been frank enough to confess that the beginning of hypnosis was accompanied by voluptuous pleasure. But this is not true in all instances--or how would you explain the underlying feeling in the hypnotising of one animal by another, _e.g._ snake and bird? Surely you can say that there the feeling of _fear_ reigns, fear which is an inversion of the libido, such as comes upon the bride in that hypnoidal state before she yields to her husband wherein pure sexual desire rules, though possibly it contains an element of fear. However this may be, from your three cases I cannot draw any ethical distinction between the "unconscious readiness towards the hypnotist" and the "transference to the doctor" which should avail to condemn a combination of hypnotism and psychoanalysis as a method of treatment. You will ask why I cling to the use of hypnotism; or rather of hypnoidal states. Because I think there are cases that can be much more rapidly cured thereby, than through a purely psychoanalytic treatment. For example, in no more than five or six interviews I cured a fifteen-year-old girl who had suffered from _enuresis nocturna_ from infancy, but was otherwise thoroughly healthy, gifted, and pre-eminent at school: she had previously tried all sorts of treatment without any result.

Perhaps I ought to have sought out the psychoanalytic connexion between the enuresis and her psychosexual attitude and explained it to her, etc., but I could not, she had only the short Easter holidays for treatment: so I just hypnotised her and the tiresome trouble vanished. It was a lasting cure.

In psychoanalysis I use hypnosis to help the patient to overcome "resistances."

Further, I use light hypnosis in association with psychoanalysis, to hasten the advance when the "re-education" stage comes.

For example, a patient afflicted with washing-mania was sent to me after a year's psychocathartic treatment by Dr. X. The symbolic meaning of her washing-ceremonial was first made plain to her; she became more and more agitated during the "abreaction" of alleged traumata in childhood, because she had persuaded herself by auto-suggestion that she was too old to be cured, that she saw no "images," etc. So I used hypnosis to help her to diminish the number of her washings, "so that the anxiety-feeling would be banished"; and to train her to throw things on the ground and pick them up again without washing her hands afterwards, etc.

In view of these considerations, if you feel disposed to go further into the matter, I should be grateful if you would furnish me with more convincing reasons why hypnotic treatment must be dispensed with; and explain how to do without it, or with what to replace it in such cases. Were I convinced, I would give it up as you have done, but what convinced you has, so far, not convinced me. _Si duo faciunt idem, non est idem._

Now I want to consider another important matter to which you alluded, but only cursorily, and to put one question: behind the neurotic phantasies there stands, you say, almost always (or always) a moral conflict which belongs to the present moment. That is perfectly clear to me. Research and therapy coincide; their task is to search out the foundations and the rational solution of the conflict. Good. But can the rational solution always be found? "Reasons of expediency" so often bar the way, varying with the type of patient, for instance children, young girls and women from "pious" catholic or protestant families. Again that accursed opportunism! A colleague of mine was perfectly right when he began to give sexual enlightenment to a young French patient, a boy who was indulging in masturbation. Whereupon, like one possessed, in rushed a bigoted grandmother, and a disagreeable sequel ensued. How to act in these and similar cases? What to do in cases where there arises a moral conflict between love and duty (a conflict in married life)?--or in general between instinct and moral duty? What to do in the case of a girl afflicted with hysterical or anxiety symptoms, needing love and having no chance to marry, either because she cannot find a suitable man or because, being "well-connected," she wants to remain chaste? Simply try to get rid of the symptoms by suggestion? But that is wrong as soon as one knows of a better way. How to reconcile these two consciences: that of the man who does not want to confine his fidelity to truth within his own four walls; and that of the doctor who must cure, or if he dare not cure according to his real convictions (owing to opportunist-motives), must at least procure some alleviation? We live in the present, but with the ideas and ideals of the future. That is _our_ conflict. How resolve it?

IV

_From Dr. Jung._

4th February, 1913.

You have put me in some perplexity by the questions in your yesterday's letter. You have rightly grasped the spirit which dictated my last. I am glad you, too, recognise this spirit. There are not very many who can boast of such tolerance. I should deceive myself if I regarded my standpoint as that of a practical physician. First and foremost I am a scientist; naturally that gives me a different outlook upon many problems. In my last letter I certainly left out of count the doctor's practical needs, but chiefly that I might show you on what grounds we might be moved to relinquish hypnotic therapy. To remove the first objection at once, let me say that I did not give up hypnotism because I desired to avoid dealing with the basic motives of the human soul, but rather because I wanted to battle with them _directly_ and _openly_. When once I understood what kind of forces play a part in hypnotism I gave it up, simply to get rid of all the indirect advantages of this method. As we psychoanalysts see regretfully every day--and our patients also--_we do not work with the "transference to the doctor,"_[180] _but against it and in spite of it_. It is just not upon the _faith_ of the sick man that we can build, but upon his _criticism_. So much would I say at the outset upon this delicate question.

As your letter shows, we are at one in regard to the theoretical aspect of treatment by suggestion. So we can now apply ourselves to the further task of coming to mutual understanding about the practical question.

Your remarks on the physician's dilemma--whether to be magician or scientist--bring us to the heart of the discussion. I strive to be no fanatic--although there are not a few who reproach me with fanaticism. I contend not for the application of the psychoanalytic method solely and at all costs, but for the recognition of every method of investigation and treatment. I was a medical practitioner quite long enough to realise that practice obeys, and should obey, other laws than does the search after truth. One might almost say practice must first and foremost submit to the laws of opportunism. The scientist does great injustice to the practitioner if he reproaches him for not using the "one true" scientific method. As I said to you in my last letter: "A truth is a truth, when it works." But on the other hand, the practitioner must not reproach the scientist if in his search for truth and for newer and better methods, he makes trial of unusual ways. After all, it is not the practitioner but the investigator, and the latter's patient, who will have to bear any injury that may arise. The practitioner must certainly use those methods which he knows how to use to greatest advantage, and which give him the best relative results. My tolerance, indeed, extends, as you see, even to Christian Science. But I deem it most uncalled for that Frank, a practising doctor, should depreciate research in which he cannot participate, and particularly the very line of research to which he owes his own method. It is surely time to cease this running down of every new idea. No one asks Frank and all whom he represents to become psychoanalysts; we grant them the right to their existence, why should they always seek to cut ours short?

As my own "cures" show you, I do not doubt the effect of suggestion. Only I had the idea that I could perhaps discover something still better. This hope has been amply justified. Not for ever shall it be said--

"The good attained is oft of fairer still
The enemy, calling it vain illusion, falsehood's snare."

I confess frankly were I doing your work I should often be in difficulties if I relied only on psychoanalysis. I can scarcely imagine a general practice, especially in a sanatorium, with no other means than psychoanalysis. At Dr. Bircher's sanatorium in Zürich the principle of psychoanalysis is adopted completely by several of the assistants, but a whole series of other important educative influences are also brought to bear upon the patients, without which matters would probably go very badly. In my own purely psychoanalytic practice I have often regretted that I could not avail myself of the other methods of re-education that are naturally at hand in an institution--this, of course, only in special cases where one is dealing with extremely uncontrolled, uneducated persons. Which of us has shown any disposition to assert that we have discovered a panacea? There are cases in which psychoanalysis operates less effectively than any other known method. But who has ever claimed psychoanalysis should be employed in every sort of case, and on every occasion? Only a fanatic could maintain such a view. Patients for whom psychoanalysis is suitable have to be selected. I unhesitatingly send cases I think unsuitable to other doctors. As a matter of fact this does not happen often, because patients have a way of sorting themselves out. Those who go to an analyst usually know quite well why they go to him and not to some one else. However, there are very many neurotics well suited for psychoanalysis. In these matters every scheme must be looked at in due perspective. It is never quite wise to try to batter down a stone wall with your head. Whether simple hypnotism, the cathartic treatment, or psychoanalysis shall be used, must be determined by the conditions of the case and the preference of the _particular_ doctor. Every doctor will obtain the best results with the instrument he knows best.

But, barring exceptions, _I must say definitely that for me, and for my patients also, psychoanalysis proves itself better than any other method_. This is not merely a matter of feeling; from manifold experiences I know many cases can indeed be cured by psychoanalysis which are refractory to all other methods of treatment. I have many colleagues whose experience is the same, even men engaged exclusively in practice. It is scarcely to be supposed that a method altogether contemptible would meet with so much support.

When once psychoanalysis has been applied in a suitable case, it is _imperative_ that rational solutions of the conflicts should be found. The objection is at once advanced that many conflicts are intrinsically incapable of solution. That view is sometimes taken because only an external solution is thought of--and that, at bottom, is no real solution at all. If a man cannot get on with his wife he naturally thinks the conflict would be solved if he were to marry some one else. If such marriages are examined they are seen to be no solution whatsoever. The old Adam enters upon the new marriage and bungles it just as badly as he did the earlier one. _A real solution comes only from within, and only then because the patient has been brought to a new standpoint._

Where an external solution is possible no psychoanalysis is necessary; in seeking an internal solution we encounter the peculiar virtues of psychoanalysis. The conflict between "love and duty" must be solved upon that particular plane of character where "love and duty" are no longer in opposition, for indeed they really are not so. The familiar conflict between "instinct and conventional morality" must be solved in such a way that both factors are taken satisfactorily into account, and this is only possible through a change of character. This change psychoanalysis can bring about. In such cases external solutions are worse than none at all. Naturally the particular situation dictates which road the doctor must ultimately follow, and what is then his duty. I regard the conscience-searching question of the doctor's remaining true to his scientific convictions as rather unimportant in comparison with the incomparably weightier question as to how he can best help his patient. The doctor _must_, on occasion, be able to play the augur. _Mundus vult decipi_--but the cure is no deception. It is true that there is a conflict between ideal conviction and concrete possibility. _But we should ill prepare the ground for the seed of the future, were we to forget the tasks of the present, and sought only to cultivate ideals._ That is but idle dreaming. Do not forget that Kepler cast horoscopes for money, and that countless artists have been condemned to work for wages.

V.

_From Dr. Loÿ._

9th February, 1913.

The selfsame passion for truth possesses us both when we think of pure research, and the same desire to cure when we are considering therapy. For the scientist, as for the doctor, we desire the fullest freedom in all directions, fullest freedom to select and use the methods which promise the best fulfilment of their ends at any moment. Here we are at one; but there remains a postulate we must establish to the satisfaction of others if we want recognition for our views.

First and foremost there is a question that must be answered, an old question asked already in the Gospels: _What is Truth?_ I think clear definitions of fundamental ideas are most necessary. How shall we contrive a working definition of the conception "Truth"? Perhaps an allegory may help us.

Imagine a gigantic prism extending in front of the sun, so that its rays are broken up, but suppose man entirely ignorant of this fact. I exclude the invisible, chemical and ultra-violet rays. Men who live in a blue-lit region will say: "The sun sends forth blue light only." They are right and yet they are wrong: from their standpoint they are capable of perceiving only a _fragment_ of truth. And so too with the inhabitants of the red, yellow, and in-between regions. And they will all scourge and slay one another to force _their_ belief in _their_ fragment upon the others--till, grown wiser through travelling in each others' regions, they come to the harmonious agreement that the sun sends out light of varying colours. That comprehends more truth, but it is not yet _the_ Truth. Only when the giant lens shall have recombined the split-up rays, and when the invisible, chemical and heat rays have given proof of their own specific effects, will a view more in accordance with the facts be able to arise, and men will perceive that the sun emits white light which is split up by the prism into differing rays with different peculiarities, which rays can be recombined by the lens into one mass of white light.

This example shows sufficiently well that the road to Truth leads through far-reaching and comparative observations, the results of which must be controlled by the help of freely chosen _experiments_, until well-grounded hypotheses and theories can be put forward; but these hypotheses and theories will fall to the ground as soon as a single new observation or experiment contradicts them.

The way is difficult, and in the end all man ever attains to is _relative_ truth. But such relative truth suffices for the time being, if it serves to explain the most important actual concatenations of the past, to light up present problems, to predict those of the future, so that we are then in a position to achieve adaptation through our knowledge. But _absolute_ truth could be accessible only to omniscience, aware of all possible concatenations and combinations; that is not possible, for the concatenations and their combinations are infinite. Accordingly, we shall never know more than an approximate truth. Should new relationships be discovered, new combinations built up, then the picture changes, and with it the entire possibilities in knowledge and power. To what revolutions in daily life does not every new scientific discovery lead: how absurdly little was the beginning of our first ideas of electricity, how inconceivably great the results! Time and again it is necessary to repeat this commonplace, because one sees how life is always made bitter for the innovators in every scientific field, and now is it being made especially so for the disciples of the psychoanalytic school. Of course, every one admits the truth of this platitude so long as it is a matter of "academic" discussion, but only so long; just as soon as a concrete case has to be considered, sympathies and antipathies rush into the foreground and darken judgment. And therefore the scientist must fight tirelessly, appealing to logic and honour, for freedom of research in every field, and must not permit authority, of no matter what political or religious tinge, to advance reasons of _opportunism_ to destroy or restrict this freedom; opportunist reasons may be and are in place elsewhere, not here. Finally we must completely disavow that maxim of the Middle Ages: "_Philosophia ancilla Theologiæ_," and no less, too, the war-cries of the university class-rooms with their partisanship of one or other religious or political party. All fanaticism is the enemy of science, which must above all things be _independent_.

And when we turn from the search for Truth back once more to therapeutics, we see immediately that here too we are in agreement. In practice expediency _must_ rule: the doctor from the yellow region must adapt himself to the sick in the yellow region, as must the doctor in the blue region, to his patients; both have the same object in view. And the doctor who lives in the white light of the sun must take into consideration the past experiences of his patients from the yellow or blue region, in spite of, or perhaps rather because of, his own wider knowledge. In such cases the way to healing will be long and difficult, may indeed lead more easily into a _cul-de-sac_, than in cases where he has to do with patients who, like himself, have already come to a knowledge of the white sunlight, or, one might say, when his patient-material has "already sorted itself out." With such sorted-out material the psychoanalyst can employ psychoanalysis exclusively; and may deem himself happy in that he need not "play the augur." Now, what are these psychoanalytic methods? If I understand you aright, from beginning to end it is a question of dealing directly and openly with _the basic forces of the human soul_, so that the analysed person, be he sick or sound or in some stage between--for health and sickness flow over by imperceptible degrees into one another--shall gradually have his eyes opened to the drama that is being acted within him. He has to come to an understanding of the development of the hostile automatisms of his personality, and by means of this understanding he must gradually learn to free himself from them; he must learn, too, how to employ and strengthen the favourable automatisms. He must learn to make his self-knowledge real, and of practical use, to control his soul's workings so that a balance may be established between the spheres of emotion and reason. And what share in all this has the physician's _suggestion_? I can scarcely believe that suggestion can be altogether avoided till the patient feels himself really _free_. Such freedom, it goes without saying, is the main thing to strive for, and it must be _active_. The sick man who simply obeys a suggestion, obeys it only just so long as the "transference to the doctor" remains potent.

But if he wishes to be able to adjust himself to all circumstances he must have fortified himself "from within." He should no longer need the crutches of faith, but be capable of encountering all theoretical and practical problems squarely, and of solving them by himself. That is surely your view? Or have I not understood correctly?

I next ask, must not every single case be treated differently, of course _within the limits of the psychoanalytic method_? For if every case is a case by itself, it must indeed demand individual treatment.

"Il n'y a pas de maladies, il n'y a que des malades," said a French doctor whose name escapes me. But _on broad lines_, what course, from a technical point of view, does analysis take, and what deviations occur most frequently? That I would gladly learn from you. I take for granted that all "augurs' tricks," darkened rooms, masquerading, chloroform, are out of the question.

Psychoanalysis--purged so far as is humanly possible from suggestive influence--appears to have an essential difference from Dubois' psychotherapy. With Dubois, from the beginning conversation about the past is forbidden, and "the moral reasons for recovery" placed in the forefront; whilst psychoanalysis uses the subconscious material from the patient's past as well as present, for present self-understanding. Another difference lies in the conception of morality: morals are above all "_relative_." But what essential forms shall they assume at those moments when one can hardly avoid suggestion? You will say, the occasion must decide. Agreed, as regards older people, or adults, who have to live in an unenlightened _milieu_. But if one is dealing with children, the seed of the future, is it not a sacred duty to enlighten them as to the shaky foundations of the so-called "moral" conceptions of the past, which have only a dogmatic basis; is it not a duty to educate them into full freedom by courageously unveiling Truth? I ask this not so much with regard to the analysing doctor as to the teacher. May not the creation of _free schools_ be looked for as one task for the psychoanalyst?

VI.

_From Dr. Jung._

11th February, 1913.

The idea of the relativity of "Truth" has been current for ages, but whether true or not, it does not stand in the way of anything save the beliefs of dogma and authority.

You ask me, or indeed tell me--what psychoanalysis is. Before considering your views, permit me first to try and mark out the territory and definition of psychoanalysis. Psychoanalysis is primarily just a method--but a method complying with all the rigorous demands insisted upon to-day by the conception "method." Let it be made plain at once that psychoanalysis is not an _anamnesis_, as those who know everything without learning are pleased to believe. It is essentially a method for the exploration of the unconscious associations, into which no question of the conscious self enters. Again, it is not a _kind_ of _examination_ of the nature of an intelligence test, though this mistake is common in certain circles. It is no _cathartic method_, abreacting real and phantastic "traumata," with or without hypnosis. _Psychoanalysis is a method which makes possible the analytic reduction of the psychic content to its simplest expression, and the discovery of the line of least resistance in the development of a harmonious personality._ In neurosis, straightforward direction of life's energies is lacking, because opposing tendencies traverse and hinder psychological adaptation. Psychoanalysis, so far as our present knowledge of it goes, thus appears to be simply a rational nerve-therapy.

For the technical application of psychoanalysis no programme can be formulated. There are only general principles, and, for the individual case, working rules. (Here let me refer you to Freud's work in volume I. of the _Internationale Zeitschrift für Ärztliche Psychoanalyse_.) My one working rule is to conduct the analysis as a perfectly ordinary, sensible conversation, and to avoid all appearance of medical magic.

The leading principle of the psychoanalytic technique is to analyse the _psychic material which offers itself then and there_. Every interference on the part of the analyst, with the object of inducing the analysis to follow some systematic course, is a gross mistake in technique. _So-called chance is the law and the order of psychoanalysis._

Naturally in the beginning of the analysis the anamnesis and the diagnosis come first. The subsequent analytic process develops quite differently in every case. To give rules is well-nigh impossible. All one can say is that very frequently, quite at the beginning, a series of resistances have to be overcome, resistances against both method and man. Patients having no idea of psychoanalysis must first be given some understanding of the method. In those who already know something of it there are very often many misconceptions to set right, and frequently one has to deal also with many reproaches cast by scientific criticism. In either case the misconceptions rest upon arbitrary interpretations, superficiality, or complete ignorance of the facts.

If the patient is himself a doctor his special knowledge may prove extremely tiresome. To intelligent colleagues it is best to give a complete theoretic exposition. With foolish and limited persons you begin quietly with analysis. In the unconscious of such folk there is a confederate that never refuses help. From the analysis of the very earliest dreams the emptiness of the criticism is obvious; and ultimately of the whole beautiful edifice of supposedly scientific scepticism nothing remains, save a little heap of personal vanity. I have had amusing experiences here.

It is best to let the patient talk freely and to confine oneself to pointing out connexions here and there. When the conscious material is exhausted we come to the dreams, which furnish us with the subliminal material. If people have no dreams, as they allege, or if they forget them, there is usually still some conscious material that ought to be produced and discussed, but is kept back owing to resistances. When the conscious is emptied then come the dreams, which are indeed, as you know, the chief material of the analysis.

How the "Analysis" is to be made and what is to be said to patients depends, firstly, upon the material to be dealt with; secondly, on the doctor's skill; and, thirdly, on the patient's capacity. I must insist that no one ought to undertake analysis except on the basis of a sound knowledge of the subject; that necessitates an intimate understanding of the existing literature. Without this, the work may be bungled.

I do not know what else to tell you beforehand. I must wait for further questions. In regard to questions of morality and education let me say that these belong to the later stages of the analysis, wherein they find--or should find--solutions for themselves. _You cannot compile recipes out of psychoanalysis._

VII

_From Dr. Loÿ._

10th February, 1913.

You write that a solid knowledge of the psychoanalytic literature is necessary for initiation into psychoanalysis. I should agree, but with a certain reservation: the more one reads, the more one notices how many contradictions there are among the different writers, and less and less does one know--until one has had sufficient personal experience--to which view to give adherence, since quite frequently assertions are made without any proof. For example, I had thought (strengthened in the view by my own experience of suggestion-therapy) that the transference to the doctor might be an essential condition in the patient's cure. But you write: "We psychoanalysts do not build upon the patient's faith, rather do we have to deal with his criticism." And Stekel writes, on the other hand (_Zentralblatt für Psychoanalyse_, 3rd year, vol. IV., p. 176, "Ausgänge der psychoanalytischen Kuren"): "Love for the doctor can become a power essential to recovery. Neurotics never get well for love of themselves. They recover out of love for the doctor. They give him that pleasure." Here again, surely, stress is laid on the power of suggestion? And yet Stekel too thinks he is a psychoanalyst pure and simple. On the other hand, you say in your letter of Jan. 20th that "the doctor's personality is one of the main factors in the cure." Should not this expression be translated: "When the doctor inspires respect in the patient and is worthy of his love, the patient will gladly follow his example and endeavour to recover from his neurosis and fulfil his human duties in the widest sense"? I think one can only emerge from all this uncertainty by means of much personal experience, which will indicate also which way best suits one's own personality and brings the greatest therapeutic success. This is a further reason for undergoing analysis oneself, to recognise fully what one is. I was decidedly in agreement with your definition of psychoanalysis in its first (negative) portion: psychoanalysis is neither an _anamnesis_ nor a _method of examination_ after the fashion of a test for intelligence, nor yet a _psychocatharsis_. In your second (positive) part, however, your definition: "Psychoanalysis is a method of discovering the line of least resistance to the harmonious development of the whole personality," seems to me valid for the patient's inertia, but not for the releasing of the sublimated libido with a view to the new direction of life. You consider that the neurosis causes a lack of singleness of aim in life, because opposing tendencies hinder psychic adaptation. True, but will not this psychic adaptation eventuate quite differently according as the patient, when well, directs his life either to the avoidance of pain merely (line of least resistance) or to the achievement of the greatest pleasure?--In the first case he would be more passive, he would merely reconcile himself "to the emptiness of reality" (Stekel, _loc. cit._, p. 187). In the second he would be "filled with enthusiasm" for something or other or some person or other. But what will determine this choice of his as to whether he will be passive rather than active in his "second life"? In your view, will the determining factor manifest itself spontaneously in the course of the analysis, and must the doctor carefully avoid swaying the balance to one side or other by his influence? Or must he, if he does _not_ renounce the right to canalise the patient's libido in some particular direction, renounce the right to be called a psychoanalyst, and is he to be regarded as "moderate" or altogether as "wild"?[181] (Cf. Furtmüller, "Wandlungen in der Freudschen Schule," _Zentralblatt für Psychoanalyse_, vols. IV., V., 3rd year, p. 191.) But I think you have already answered this question, since in your last letter you write: "Every interference on the part of the analyst is a gross mistake in technique. So-called chance is the law and the order of psychoanalysis." But, torn from its context, perhaps this does not quite give your whole meaning. With regard to detailed explanation of the psychoanalytic method before the beginning of the analysis, I think you agree with Freud and Stekel: give too little rather than too much. For the knowledge _instilled into_ a patient remains more or less half-knowledge, and half-knowledge engenders "the desire to know better" (than the analyst), which only impedes progress. So, after brief explanation, first "let the patient talk," then and there point out connexions, then after the exhaustion of the conscious material, take dreams.

But there another difficulty confronts me which I have already pointed out in our talks: you find the patient adapting himself to the doctor's tone, language, jargon, whether from conscious imitation, transference, or even resistance, when he can fight the analyst with his own weapons; how then can you possibly prevent his beginning to produce all manner of phantasies as supposedly real traumata of early childhood, and _dreams_ supposedly spontaneous which are in reality, though not designedly, directly or indirectly _suggested_? I then told you that Forel ("Der Hypnotismus") made his patients dream just what he wanted, and I have myself easily repeated the experiment. But if the analyst desires to _suggest nothing_, should he remain silent for the most part and let the patient speak--except that in interpreting dreams he may lay before the patient his own interpretation?

VIII

_From Dr. Jung._

18th February, 1913.