Sue Mehrtens is the author of this and all the other blog essays on this site. The opinions expressed in these essays are her own and do not necessarily reflect the views or opinions of other Jungian Center faculty or Board members. Honesty, as well as professional courtesy require that you give proper attribution to the author if you post this essay elsewhere.
Jung on Doctors
“Your medical man is a stupid shitbag who ought to become a psychiatrist so that he can get better acquainted with X., whose sister I saved from the madhouse. There is too much of this sorry medical rabble running around Switzerland judging me without knowing me.” Jung (1929)[1]
“Doctors in general not only have a repugnance to reading voluminous books, they also have a regular horror of thinking, for which they have ceased to be trained ever since their high-school days. It therefore remains uncommonly difficult for them; so difficult, indeed, that they can read the simplest of my books only with beads of sweat on their brows, if at all. In the end, of course, psychology is only an outlying frontier of medicine, but in its practical aspects it is so important that at least the psychiatric side of medicine will not be able to avoid acquiring some knowledge of the nature of the psyche, which after all is the essence of bodily life.”
Jung (1948)[2]
“The doctor knows—or at least he should know—that he did not choose this career by chance; and the psychotherapist in particular should clearly understand that psychic infections, however superfluous they seem to him, are in fact the predestined concomitants of his work, and thus fully in accord with the instinctive disposition of his own life. This realization also gives him the right attitude to his patient. The patient then means something to him personally, and this provides the most favorable basis for treatment.”
Jung (1946)[3]
“Psychotherapy is at bottom a dialectical relationship between doctor and patient. It is an encounter, a discussion between two psychic wholes, in which knowledge is used only as a tool. The goal is transformation—not one that is predetermined, but rather an indeterminable change, the only criterion of which is the disappearance of egohood. No efforts on the part of the doctor can compel this experience. The most he can do is to smooth the path for the patient and help him to attain an attitude which offers the least resistance to the decisive experience.”
Jung (1939)[4]
As the above quotes indicate Jung could be quite crude and caustic in his criticism of his fellow physicians, or at least those who had no interest in broadening their outlook to include the new discoveries in science, and especially in psychology. Jung was aware of the essentially conservative attitude of medical professionals,[5] and it gave him no end of frustration. In this essay we will examine Jung’s opinions—both negative and positive—of doctors, and then note the traits he felt made a person a good doctor. I will also include some of the key features of the training of a doctor in the Jungian form of psychotherapy.
Jung on the Negative Doctor
Jung was himself an M.D.,[6] so he knew what the typical training of a physician was like, and he was not impressed. He felt doctors were not trained to think, didn’t enjoy reading “voluminous books”[7] (e.g. like those Jung wrote), and tended to lag behind in adopting new methods and integrating new discoveries into their practices. He noted that “… it is just the doctors who are the greatest hindrance to our endeavors. The professional spirit is always inimical even to the most useful innovation.”[8] and then Jung recalls the obstinacy on the part of the medical profession to adopt the simple practice of washing hands when delivering babies, and their pilloring of Ignaz Semmelweis, who suggested it.[9]
Jung recognized that he was unpopular with both theologians and doctors.[10] He felt “The medical chaps have no intelligence,… They work too much from the outside,…” and were reluctant “to face themselves, and the shadow. It’s their chance to realize the self….”[11] and Jung saw this as a great opportunity, but most of his fellow physicians were less than enthused with the idea.
Another negative quality Jung saw in his fellow professionals was lack of honesty.[12] Most doctors hesitate to admit ignorance. Jung knew that when a patient comes to a doctor “he assumes that the doctor will know a way. If the doctor is honest, he recognizes that he also does not know the way.”[13] Given the breadth and depth of the psyche, who could possibly claim to know the way??? Jung did not hesitate to admit he did not know, did not have the answers for his patients.[14] But he recognized that some doctors are not honest: they get hung up on “prestige”[15] and “power” and claim they know what’s going on, what is best for the patient, and what the psyche intends.
Some doctors—the “somatically oriented”[16] ones—found the new discoveries in psychology to be unfamiliar, and chose to stick with their “familiar clinical pictures.”[17] Jung found this attitude full of “the most stubborn prejudices.”[18] He also got frustrated at physicians’ recoiling from the “religious problem,” when Jung knew from his own years of experience that many problems of psychoneurosis “often required the doctors to look at the religious problem.”[19]
The above complaints Jung had reflect his time—an interval in the history of medicine when the mind-body connection had not yet been well worked out in terms of hard science. Sixty years of research, and the development of the discipline of psychneuroimmunology (PNI) has proven the validity of Jung’s contention that the single-minded focus on soma without psyche is faulty practice.[20] But Jung’s complaint is still too true:
“… even psychologically trained doctors have the greatest difficulty in following my reflections, if they follow them at all. They have habituated themselves to handing out prescriptions and mechanically applying methods which they have not thought out themselves. This tendency is the most unsuitable that can be imagined for the practice of medical psychology, for it clings to the skirts of authoritarian theories and techniques and hinders the development of independent thought. I have found that even elementary distinctions, such as those between subjective level and objective level, ego and self, sign and symbol, causality and finality, etc., which are of the utmost importance in practical treatment, overtax their thinking capacities. This may explain their obstinate adherence to views that are out of date and have long been in need of revision. That this is not merely my own subjective opinion is evident from the fanatical one-sidedness and sectarian exclusiveness of certain psychoanalytical groups.” [21]
Especially in the United States, with a health care system that now regards itself as an “industry,” dominated by insurance companies which require diagnoses that then determine how many minutes a physician can spend with a patient, the treatment of neuroses and other forms of mental illness generally consists of what Jung notes: “handing out prescriptions and mechanically applying methods.”[22]
Jung also found many doctors full of themselves, believing they know better.[23] When Jung had occasion to treat physicians, he relied on analysis of their dreams, which would quickly puncture their pride and reduce their criticism to “a little heap of personal vanity.” Jung added that “I have had very amusing experiences in this respect.”[24]
The Positive Doctor à la Jung
If Jung had multiple complaints about many doctors it was perhaps because he had such a high sense of the physician’s calling. In his view, the physician holds a “divine office,”[25] and his work is not some mundane job, but a vocation taken up as the result of
“…a fateful disposition which originally inclined him to the medical profession. The more one sees of human fate and the more one examines its secret springs of action, the more one is impressed by the strength of unconscious motives and by the limitations of free choice. The doctor knows—or at least he should know—that he did not choose this career by chance; and the psychotherapist in particular should clearly understand that psychic infections, however superfluous they seem to him, are in fact the predestined concomitants of his work, and thus fully in accord with the instinctive disposition of his own life. This realization also gives him the right attitude to his patient. The patient then means something to him personally, and this provides the most favorable basis for treatment.”[26]
The sense that the healing profession is his/her destiny gives the doctor the stamina and willingness to face the “psychic infections”[27] patients bring into the consulting room.
Jung regarded good psychotherapeutic medical practice to be as much a spiritual undertaking as it is physical. In this he found constant frustration in the lack of support—even the lack of comprehension—from the clergy.[28] Jung knew that religious leaders “will have to make sacrifices”[29] if they attempt to help people with psychological problems, and not all were willing to do so. The result was that “The doctor and the clergyman … clash head-on in analytical psychology….”[30] Jung felt the two professions should work together.
In Jung’s vision of the good doctor, the physician brought his/her whole self to the work. He quoted an old alchemical adage: “Ars requirit totum hominem.”[31] The art (of soul healing) requires the whole person. Wholeness, an integrated personality in touch with its woundedness,[32] was a key feature of the good doctor. Let’s examine some of the other features of Jung’s good psychiatrist.
The Personality, Attitudes and Actions of the Good Psychiatrist
Integration—that time, energy and effort that had been invested to get one’s act together—was one key feature of the good doctor.[33] Others were keen instinct, intuition and the capacity to learn from experience.[34] Jung himself was extremely intuitive, in his “number 2” personality that verged on the psychic.[35] Intuition is that “irrational” function that allows us to know without knowing how we know,[36] and this is a very useful personality trait for the physician who would venture into the realm of the psyche, where so often logic and intellect come up short.
The good psychotherapist also should be both persuasive[37] and susceptible to influence, i.e. willing to be influenced by the patient.[38] Jung knew there was no point in working in this field if one sought to shield him/herself from the patient and his/her “irrationalities.”[39] Understanding and sympathy[40] on the part of the doctor were essential if there was to be a “rapport”[41] between the two persons.
Rapport was a key to a successful therapeutic experience. The personality of the analyst had to resonate with that of the patient. If a shift in typology was required to foster this rapport, Jung felt that it was incumbent on the analyst to make this shift, i.e. to access his/her inferior function so as to help the patient heal.[42]
The good psychotherapist would also have a “finger for nuance.”[43] Jung took this phrase from Nietzsche. By it he meant that a good healer of souls would be able to read/hear/sense between the lines/words of the patient’s dreams and discussions to grasp meaning at multiple levels. Sometimes this required a “moral strain that makes the profession of psychotherapist not exactly an enviable one…”[44] Jung admitted that “it is a tricky and not undangerous calling.”[45]
It also requires humility—the ability to hold the patient’s projections of savior, god, lover, father, mother, magician,[46] wise old man,[47] etc., without getting inflated. The analyst should come across to the patient as a “normal person,”[48] rather than as a superior. Humility is also essential for the regular practice of self-criticism[49] that Jung stressed, and it requires humility to admit ignorance, in the face of the wisdom of the psyche, to acknowledge that both—oneself and one’s patient—are doing the work together, both coming to the task with woundedness.
Humility is one key attitude in the good physician. Jung felt it was also important for the doctor to be flexible in his/her aim.[50] No one knows the intention of the soul, so it is essential for the doctor to be adaptable as the psyche takes the lead in the work of healing. The doctor also has to be willing to “go on relearning endlessly,”[51] and never sit back in smug self-satisfaction that he/she has everything figured out. In fact, “figuring it out” rarely works in this business. Jung knew that far more important than head trips is the willingness to “follow nature as a guide,”[52] drawing truth “from the light of nature.”[53]
Patience is also essential, for the psyche has its own timetable (almost always different from that of the ego mind), and the analyst has to be able to “advise the patient to wait and see”[54] when things seem stuck. “Conflicts of duty”[55] often produce such situations, and the proper approach to handling these times, Jung felt, was to wait for the psyche to produce the tertium non datur—the “third thing” that would resolve the tension of opposites.[56] In my experience, this can be one of the most difficult aspects of analytical work.
Elements of the Training of a Jungian Psychiatrist
Jung had very firm ideas about the training likely to produce a good psychotherapist. First on his list of requirements was a personal analysis,[57] for only by personal immersion in one’s own unconscious, and personal experience of the process, could a person qualify to lead others into the depths of the unconscious. This requirement served also to bring up the physician’s own complexes and wounds, so he/she might heal, in the recognition that the healer can take the patient only as far as he/she has healed. Jung was explicit:
“… it… has been confirmed over and over again by experience, that what the doctor fails to see in himself he either will not see at all, or will see grossly exaggerated, in his patient;… one ought to insist with especial emphasis that the psychotherapist be prepared at all times to exercise adequate self-criticism, …”[58]
and self-criticism[59]—the ability to look objectively at oneself—is fostered by a personal analysis. By undergoing analysis, the doctor gets clued into his own issues, foibles, shadow, anima/animus, and hence is more likely later on to understand the experiences of patients.
A second key element in Jung’s scheme of training is a “dialectical” interaction between doctor and patient:
“… any final understanding between doctor and patient is bound to include the personality of the doctor…. the healing effect depended firstly on the ‘rapport’—in Freud’s terminology, ‘transference’—and secondly on the persuasive and penetrative powers of the doctor’s personality. In the doctor-patient relationship, as we have said, two psychic systems interact, and therefore any deeper insight into the psychotherapeutic process will infallibly reach the conclusion that in the last analysis, since individuality is a fact not to be ignored, the relationship must be dialectical.”[60]
The interaction of the two psyches is fostered, Jung felt, by the equality that exists between doctor and patient. Jung recognized that this flies in the face of the training of most physicians: “I do not know which is the more difficult: to accumulate a wide knowledge or to renounce one’s professional authority and anonymity.”[61] But both doctor and patient are “partners” in the process and
“… the therapeutic effect comes from the doctor’s efforts to enter into the psyche of his patient, thus establishing a psychologically adapted relationship. For the patient is suffering precisely from the absence of such a relationship. Freud himself has long recognized that the transference is the alpha and omega of psychoanalysis. The transference is the patient’s attempt to get into psychological rapport with the doctor. He needs this relationship if he is to overcome the dissociation. The feebler the rapport, i.e. the less the doctor and patient understand one another, the more intensely will the transference be fostered and the more sexual will be its form.”[62]
A transference “provides the energy [libido] with an outlet relatively free from conflict,”[63] and Jung felt that “… if the libido is allowed to run its natural course, it will find its own way to the destined object….”[64]
Jung was insistent that the doctor not make suggestions about what the patient needs or how to get out of difficulties.[65] The reason for this is that, with such suggestions from the doctor, the patient is apt to get off track, and start living out what the doctor thinks, rather than what is his/her own way:
“…If the doctor tells him what he thinks the trouble may be, he follows the doctor’s suggestions and does not experience himself. Suggestions may work for a time, but when he is away the patient collapses because he has no contact with himself and is living not his own way but the doctor’s way. Then he has to return to the doctor for new suggestions, and after a while this becomes disgusting to both. It is important that the doctor admits he does not know; then both are ready to accept the impartial facts of nature, scientific realities. Personal opinions are more or less arbitrary judgments and may be all wrong; we are never sure of being right. Therefore we should seek the facts provided by dreams. Dreams are objective facts….”[66]
The patient’s dreams provided Jung with insights into how the healing was unfolding, where the psychic energy wanted to go, and what the soul’s intentions were.
Because the doctor and patient are partners[67] in the work, both immersed in the realm of the unconscious, mixing the two personalities results in the transformation of both, and in Jung’s system, the doctor must be willing to be changed.
“For two personalities to meet is like mixing two different chemical substances: if there is any combination at all, both are transformed. In any effective psychological treatment the doctor is bound to influence the patient; but this influence can only take place if the patient has a reciprocal influence on the doctor. You can exert no influence if you are not susceptible to influence. It is futile for the doctor to shield himself from the influence of the patient and to surround himself with a smoke-screen of fatherly and professional authority. By so doing he only denies himself the use of a highly important organ of information….”[68]
When my analyst speaks of this process, she calls it “being in the soup” together.
A final feature of Jung’s system is his valuation and use of symbols. Jung may have gotten the idea of the importance and usefulness from his immersion in alchemy, for the medieval alchemists understood that “… for those who have the symbol the passage is easy,…”.[69] Symbols are very helpful, Jung felt: “All this [work in the unconscious] passes off smoothly and without difficulty provided that his [the patient’s] consciousness contains certain ideas of a symbolic nature…”.[70] So Jung had his students study archetypes, art, myths, legends, fairy tales and other aspects of culture that contain symbols, for the psychotherapeutic value they have.
Conclusion
Jung was blunt, even to the point of being crude, in his exasperation with mainstream physicians who failed to appreciate the value of psychology in their healing work. As vigorously as he championed therapy, analysis, and self-examination, he worked to develop a training program that would equip doctors open to his ideas to undertake the soul healing that he felt is so essential in the modern world.[71] Given the materialism of our culture and the industrialization of medicine nowadays, Jung’s approach is all the more essential now, and his criticisms of the medical profession are still all too valid.
Bibliography
Bair, Deirdre (2003), Jung: A Biography. New York: Little, Brown & Co.
Jung, C.G. (1961), “Freud and Psychoanalysis,” Collected Works, 4. Princeton: Princeton University Press.
________ (1956) “Symbols of Transformation,” Collected Works, 5, 2nd ed. Princeton: Princeton University Press.
________ (1971), “Psychological Types,” Collected Works, 6. Princeton: Princeton University Press
________ (1966), “Two Essays on Analytical Psychology,” CW 7. Princeton: Princeton University Press.
________ (1960), ”The Structure and Dynamics of the Psyche,” CW 8. Princeton: Princeton University Press.
________ (1959), ”The Archetypes and the Collective Unconscious,” CW 9i. Princeton: Princeton University Press.
________ (1970), “Civilization in Transition,” CW 10. Princeton: Princeton University Press.
________ (1969), “Psychology and Religion: West and East,” CW 11. Princeton: Princeton University Press.
________ (1953), “Psychology and Alchemy,” CW 12. Princeton: Princeton University Press.
________ (1967), “Alchemical Studies,” CW 13. Princeton: Princeton University Press.
________ (1963), “Mysterium Coniunctionis,” CW 14. Princeton: Princeton University Press.
________ (1966), “The Spirit in Man, Art, and Literature,” CW 15. Princeton: Princeton University Press.
________ (1954), “The Practice of Psychotherapy,” CW 16, 2nd ed. Princeton: Princeton ________ (1975), Letters, ed. Gerhard Adler & Aniela Jaffé. 2 vols. Princeton: Princeton University Press.
________ (1977), C.G. Jung Speaking: Interviews and Encounters, ed. William McGuire & R.F.C. Hull. Princeton: Princeton University Press.
________ (1965), Memories, Dreams, Reflections. New York: Vintage Books.
________ (1984), Seminar on Dream Analysis. Princeton: Princeton University Press.
Lipton, Bruce (2008), The Biology of Belief. Carlsbad CA: Hay House.
Pert, Candace (1997), Molecules of Emotion. New York: Scribners.
[1] “Letter to Walter Robert Corti,” 30 April 1929; Letters I, 65.
[2] “Letter to Albert Jung,” 10 November 1948; Letters I, 512.
[3] Collected Works 16, ¶365. Hereafter Collected Works will be abbreviated CW.
[4] CW 11, ¶904.
[5] “Letter to Edmund Kaufmann,” January 1950; Letters I, 543-4.
[6] He passed his medical boards in December 1900; Bair (2003), 55.
[7] “Letter to Albert Jung,” 10 November 1948; Letters I, 512.
[8] “Letter to Edmund Kaufmann,” January 1950; Letters I, 543-4.
[9] Ibid.
[10] “Interview with Kenneth Lambert,” Jung (1977), 160.
[11] Ibid.
[12] Jung (1984), 3.
[13] Ibid.
[14] CW 11, ¶515.
[15] “Letter to Edmund Kaufmann,” January 1950; Letters I, 543; and CW 10, ¶339.
[16] CW 11, ¶466.
[17] Ibid.
[18] Ibid.
[19] Ibid., ¶738.
[20] On psychoneuroimmunology, cf. Pert (1997) and Lipton (2008).
[21] CW 8, ¶526.
[22] Ibid.
[23] CW 4, ¶627.
[24] Ibid.
[25] CW 13, ¶151.
[26] CW 16, ¶365.
[27] Ibid.
[28] “Interview with Kenneth Lambert,” Jung (1977), 160.
[29] “Letter to Pastor Damour,” 15 August 1932; Letters I, 97-8.
[30] CW 11, ¶548.
[31] CW 16, ¶198.
[32] Ibid., ¶s 239 & 367.
[33] CW 15, ¶41.
[34] Ibid. and “Letter to Pastor Damour,” 15 August 1932; Letters I, 97-8.
[35] Jung (1965), 50.
[36] CW 6, ¶770.
[37] CW 16, ¶10.
[38] Ibid., ¶163.
[39] Ibid., ¶82.
[40] Ibid., ¶270.
[41] Ibid., ¶10.
[42] Ibid., ¶170.
[43] CW 7, ¶65.
[44] CW 16, ¶23.
[45] Ibid.
[46] CW 7, ¶s97-8.
[47] CW 9i, ¶398.
[48] CW 10, ¶881.
[49] CW 16, ¶237.
[50] Ibid., ¶81.
[51] “Letter to Pastor Damour,” 15 August 1932; Letters I, 97-8.
[52] CW 16, ¶82.
[53] CW 15, ¶41.
[54] CW 11, ¶738.
[55] Ibid.
[56] Ibid.
[57] CW 16, ¶165.
[58] Ibid., ¶237.
[59] Ibid.
[60] Ibid., ¶10.
[61] Ibid., ¶23.
[62] Ibid., ¶276.
[63] CW 7, ¶95.
[64] Ibid.
[65] Jung (1984), 3.
[66] Ibid.
[67] CW 10, ¶532.
[68] CW 16, ¶163.
[69] CW 5, ¶683.
[70] Ibid.
[71] “Letter to Edmund Kaufmann,” January 1950; Letters I, 543-4.
