Collected Works of C.G. Jung, Volume 3 – Psychogenesis of Mental Disease: The Psychogenesis of Mental Disease: 62 - Hardcover

Jung, C. G.; Adler, Gerhard; Read, Herbert; Hull, R. F.c.

Hardcover

ISBN 10: 0691097690 ISBN 13: 9780691097695

Publisher: Princeton University Press, 1992

Synopsis

The authoritative edition of some of Jung's most important writings on psychiatry

The Psychogenesis of Mental Disease presents some of Jung's most important writings on psychiatry, including "On the Psychology of Dementia Praecox," his landmark early study of what is today called schizophrenia. Also featured here are nine other key papers in psychiatry, the earliest being "The Content of the Psychoses," written in 1908, when Jung was a leading member of the early psychoanalytic movement. The latest are two papers written in 1956 and 1958, which embody Jung's conclusions after many years of experience in the psychotherapy of schizophrenia. These writings reflect the original techniques with which Jung is especially associated.

About this title

From the Back Cover

The importance of this volume of scientific papers for understanding Jung's researchers as a whole can scarcely be overrated, even though most of them are now mainly of historical interest or represent the reflections of his later years on a subject that never ceased to engage his active psychotherapeutic endeavors.

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THE PSYCHOGENESIS OF MENTAL DISEASE

By C. G. JUNG, GERHARD ADLER, R. F. C. HULL

PRINCETON UNIVERSITY PRESS

Copyright © 1960 BOLLINGEN FOUNDATION
All rights reserved.

ISBN: 978-0-691-09769-5

Contents

EDITORIAL NOTE, v, 
I, 
The Psychology of Dementia Praecox, 1, 
II, 
The Content of the Psychoses, 153, 
On Psychological Understanding, 179, 
III, 
A Criticism of Bleuler's Theory of Schizophrenic Negativism, 197, 
On the Importance of the Unconscious in Psychopathology, 203, 
On the Problem of Psychogenesis in Mental Disease, 211, 
Mental Disease and the Psyche, 226, 
IV, 
On the Psychogenesis of Schizophrenia, 233, 
Recent Thoughts on Schizophrenia, 250, 
Schizophrenia, 256, 
APPENDIX: Letter to the Second International Congress of Psychiatry (Symposium on Chemical Concepts of Psychosis), 1957, 272, 
BIBLIOGRAPHY, 275, 
INDEX, 287, 

CHAPTER 1

CRITICAL SURVEY OF THEORETICAL VIEWS ON THE PSYCHOLOGY OF DEMENTIA PRAECOX

1 The literature which treats of the psychological disturbances in dementia praecox is very fragmentary, and although parts of it are quite extensive it nowhere shows any clear co-ordination. The statements of the older authors have only a limited value, because they refer now to this, now to that form of illness, which can be classified only very indefinitely as dementia praecox. Hence one cannot attribute any general validity to them. The first and somewhat more general view concerning the nature of the psychological disturbance in catatonia, so far as I know, was that of Tschisch (1886), who thought that the essential thing was an incapacity for attention. A similar view, somewhat differently formulated, was expressed by Freusberg, who stated that the automatic actions of the catatonic are associated with a weakening of consciousness, which has lost its control over the psychic processes. The motor disturbance is only a symptomatic expression of the degree of psychic tension.

2 For Freusberg, therefore, the motor catatonic symptoms are dependent on corresponding psychological symptoms. The "weakening of consciousness" resembles the quite modern view of Pierre Janet. That there is a disturbance of attention is also confirmed by Kraepelin, Aschaffenburg, Ziehen, and others. In 1894 we encounter for the first time an experimental psychological work on the subject of catatonia: Sommer's "On the Theory of 'Inhibition' of Mental Processes." The author makes the following statements which are of general significance:

1. The process of ideation is slowed down.

2. The patient is so fascinated by pictures shown to him that he can tear himself away from them only with difficulty.

3 The frequent blockings (prolongations of reaction time) are explained by Sommer as visual fixation. The state of distractibility in normal persons occasionally shows similar phenomena; e.g., "amazement" and "staring into space." With this comparison of the catatonic state to normal distractibility Sommer affirms much the same thing as Tschisch and Freusberg, namely that there is a reduction of attention. Another phenomenon closely related to visual fixation, according to Sommer, is catalepsy; he considers it "in all cases a phenomenon of entirely psychic origin." This view of Sommer's conflicts sharply with that of Roller, with whom Clemens Neisser is in entire agreement.

4 Says Roller: "The ideas and sensations that reach perception in the insane person and force themselves into the field of consciousness arise from the morbid state of the subordinate centres, and when active apperception, or attention, comes into play it is fixated by these pathological perceptions."

5 In this connection Neisser remarks: "Wherever we look in insanity we find something different, something strange; processes that cannot be explained on the analogy of normal psychic life. The logical mechanism in insanity is set in motion not by apperceptive or associative conscious activity but by pathological stimuli lying below the threshold of consciousness." Neisser thus agrees with Roller's view, but it seems to me that this view is not quite free from objections. First, it is based on an anatomical conception of psychic processes—a conception that cannot be cautioned against too strongly. What significance "subordinate centres" have in the formation of psychic elements (ideas, sensations, etc.) we do not know at all. An explanation of this kind is merely a matter of words.

6 Second, the RolIer-Neisser view seems to presuppose that outside consciousness the psyche ceases to exist. From the psychology of the French school and from our experiences with hypnotism it is evident that this is not so.

7 Third, if I have understood him correctly, by "pathological stimuli lying below the threshold of consciousness" Neisser must mean cell-processes in the cortex. This hypothesis goes too far. All psychic processes are correlates of cell-processes, according to both the materialistic view and that of psychophysical parallelism. So it is nothing out of the ordinary if the psychic processes in catatonia are correlates of a physical series. We know that the normal psychic series develops under the constant influence of countless psychological constellations of which we are as a rule unconscious. Why should this fundamental psychological law suddenly cease to apply in catatonia? Is it because the ideational content of the catatonic is foreign to his consciousness? But is it not the same in our dreams? Yet no one will assert that dreams originate so to speak directly from the cells without psychological constellations. Anyone who has analysed dreams according to Freud's method knows what an enormous influence these constellations have. The appearance of strange ideas in consciousness which have no demonstrable connection with previous conscious contents is not unheard of either in normal psychology or in hysteria. The "pathological ideas" of catatonics have plenty of analogies in normal as well as in hysterical persons. What we lack is not so much comparative factual material as the key to the psychology of catatonic automatism. For the rest, it always seems to me rather risky to assume something absolutely new and strange in science.

8 In dementia praecox, where as a matter of fact countless normal associations still exist, we must expect that until we get to know the very delicate processes which are really specific of the disease the laws of the normal psyche will long continue to play their part. To the great detriment of psychopathology, where the only thing we are beginning to agree about is the ambiguity of our applied concepts, our knowledge of the normal psyche is unfortunately still on a very primitive level.

9 We are indebted to Sommer for further stimulating studies on the associations of catatonics. In certain cases the associations proceed in a normal way but are suddenly interrupted by an apparently quite disconnected, strangely "mannered" combination of ideas, as the following example will show:

dark green
white brown
black "good day, William"
red brown

10 These "erratic" associations were also observed by Diem, who conceived of them as sudden "whims." Sommer justly considers them an important criterion for catatonia. The "pathological inspirations" described by Breukink, following Ziehen, were observed by these authors in insane patients and were found exclusively in dementia praecox, especially in its paranoid forms, where "inspirations" of every kind play a well-known role. Bonhoeffer's "pathological ideas" probably refer to a similar phenomenon. The question Taised by Sommer's discovery has naturally not been settled; but, until we are better informed, the phenomena observed by different authors and designated with almost the same names must for the present be grouped under one heading. Although it would seem from clinical experience that "pathological ideas" occur only in dementia praecox (we naturally discount the falsifications of memory which often appear suddenly in organic dementia and in Korsakow's syndrome), I would like to point out that in hysteria, especially in cases that never reach the clinic, "pathological ideas" play a large part. The most interesting examples are reported by Flournoy. I have observed similar sudden irruptions of altered psychological activity in a very clear case of hysteria, and recently I was able to confirm it again in a similar case. Finally, as I have shown, the sudden disturbance of association by the irruption of apparently strange combinations of ideas occurs also in normal people. The "erratic" association or "pathological idea" may therefore be a widespread psychological phenomenon which, we may at once agree with Sommer1 appears in its most glaring form in dementia praecox.

11 Furthermore, in examining the associations of catatonics Sommer found numerous clang associations and stereotypies. By "stereotypy" he meant the frequent reappearance of previous reactions. In our association experiments we called this "repetition." The reaction times showed enormous fluctuations.

12 In 1902, Ragnar Vogt again took up the problem of catatonic consciousness. He started from the Müller-Pilzecker investigations by considering mainly their observations on "perseveration." According to Vogt, the persistence of psychic processes or their correlates, even after they have been superseded in consciousness by other ideas, is the normal analogy of catatonic processes of perseveration (verbigeration, catalepsy, etc.). Hence the capacity of the psychophysical functions for perseveration must be especially great in catatonia. But as, according to the Müller-Pilzecker investigations, perseveration becomes very marked only when no new content has impressed itself on consciousness, Vogt assumes that perseveration is possible in catatonia only because no other conscious processes of interest to the patient are taking place. One must therefore assume a certain restriction of consciousness. This would also explain the resemblance between hypnotic and catatonic states. The impulsive actions of catatonics are likewise explained by Vogt on the basis of restriction of consciousness, which prevents inhibitions from intervening. Vogt has evidently been influenced by Pierre Janet, for whom "restriction of consciousness" and "reduction of attention" are the same as "abaissement du niveau mental." So here again, though in a somewhat more modern and more generalized form, we meet the view already mentioned, that in catatonia there is a disturbance of attention, or, to express it more broadly, of the positive psychic performance. Vogt's reference to the analogy with hypnotic states is interesting, but unfortunately he describes it only in outline.

13 Similar views are expressed by Evensen. He draws a skilful parallel between catatonia and distractibility, and maintains that absence of ideas in a restricted field of consciousness is the basis of catalepsy, etc.

14 A painstaking and thorough examination of catatonic psychology is to be found in the thesis of René Masselon. He maintains from the start that its chief characteristic is reduction of attention ("distraction perpétuelle"). As is to be expected from his French training in psychology, he conceives of attention in a very broad and comprehensive sense: "Perception of external objects, awareness of our own personality, judgment, the feeling of rapport, belief, certainty, all disappear when the power of attention disappears."

15 As this quotation shows, a very great deal depends on attention as Masselon conceives it. He concludes that the commonest features of the catatonic state are "apathy, aboulia, loss of intellectual activity." A brief consideration of these three abstractions will show that at bottom they are all trying to say the same thing; indeed, throughout his work, Masselon is constantly endeavouring to find the word or simile that will best express the innermost essence of his correct feeling. However, no concept need be quite so many-sided, just as there is no concept that has not had a one-sided and limited connotation forced upon it by some school or system. Masselon can best tell us what he feels about the essence of dementia praecox if we listen to the wording of some of his statements: "The habitual state is emotional apathy ... these disturbances are intimately connected with disturbances of intelligence: they are of the same nature ... the patients manifest no desires ... all volition is destroyed ... the disappearance of desire is bound up with all the other disturbances of mental activity ... a veritable cramping of cerebral activity ... the elements [of the mind] show a tendency to live an individual life, being no longer systematized by the inactive mind."

16 In Masselon's work we find an assortment of views which he feels all go back to one root, but he cannot find this root without obscuring his work. Yet despite their shortcomings, Masselon's researches contain many useful observations. Thus he finds a striking resemblance to hysteria, marked self-distractibility of the patients to everything, especially to their own symptoms (Sommer's "visual fixation"), fatiguability, and a capricious memory. German critics have reproached him for this last statement, but quite unjustly when we consider that Masselon really means only the capacity for reproduction. If a patient gives a wrong answer to a direct question, it is taken by the German school as an "irrelevant answer," as negativism; in other words, as active resistance. Masselon regards it rather as an inability to reproduce. Looked at from the outside, it can be both; the distinction depends only on the different interpretations we choose to give of the phenomenon. Masselon speaks of a "true obscuration of the memory-image" and regards the disturbance of memory as the "disappearance from consciousness of certain memories, and the inability of the patient to find them again." The contradiction between the two views can be resolved without difficulty if one considers the psychology of hysteria. If an hysterical patient says during the anamnesis, "I don't know, I have forgotten," it simply means, "I cannot or will not say it, for it is something very unpleasant." Very often the "I don't know" is so clumsy that one can immediately discern the reason for not knowing. I have proved by numerous experiments that the faults (failures to react) which occur during the association test have the same psychology. In practice it is often very difficult to decide whether hysterical patients really do not know or whether they simply cannot or will not answer. Anyone who is accustomed to investigating dementia praecox cases will know how much trouble he has to take to obtain the correct information. Sometimes one is certain that the patients know, sometimes there is a "blocking" that gives the impression of being involuntary, and then again there are cases where one is obliged to speak of "amnesia," just as in hysteria, where it is only a step from amnesia to not wanting to talk. Finally, the association test shows us that these phenomena are all present, in the bud, in normal people.

17 For Masselon the disturbance of memory comes from the same source as the disturbance of attention, though what this source may be is not clear. As if in contradiction to this, he finds ideas that obstinately persist. He qualifies them as follows: "Certain memories that once were more intimately connected with the affective personality of the patients tend to reproduce themselves unceasingly and to occupy consciousness continually ... the memories that persist assume a stereotyped form ... thought tends to coagulate (se figer)." Without attempting to produce any further proof Masselon declares that the stereotyped ideas (i.e., the delusions) are associations of the personality complex. It is a pity that he does not dwell longer on this point, for it would have been very interesting to know how far, for instance, a few neologisms or a "word salad" are associations of the personality complex, since these are often the only vestiges that still give us a clue to the existence of ideas. That the mental life of the dementia praecox patient "coagulates" seems to me an excellent simile for the gradual torpidity of the disease; it characterizes most pregnantly the impression that dementia praecox must have made on every attentive observer. Masselon naturally found it quite easy to derive "command automatism" (suggestibilité) from his premises. Concerning the origin of negativism he has only vague conjectures to offer, although the French literature on obsessional states would afford him any number of starting points for analogical explanations. Masselon also tested the associations experimentally, finding numerous repetitions of stimulus words and frequent "whims" of an apparently quite fortuitous nature. The only conclusion he came to from these experiments was that the patients were unable to pay attention. The conclusion is right enough, but Masselon spent too little time on the "whims."

18 From the main results of Masselon's work it can be seen that this author, like his predecessors, is inclined to assume a quite central psychological disturbance, a disturbance that sets in at the vital source of all the mental functions; that is, in the realm of apperception, feeling, and appetition.

(Continues...)

Excerpted from THE PSYCHOGENESIS OF MENTAL DISEASE by C. G. JUNG, GERHARD ADLER, R. F. C. HULL. Copyright © 1960 BOLLINGEN FOUNDATION. Excerpted by permission of PRINCETON UNIVERSITY PRESS.
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Edition details

• Publisher: Princeton University Press
• Publication date: 1992
• ISBN 10: 0691097690
• ISBN 13: 9780691097695
• Binding: Hardcover
• Language: English
• Edition number: 2
• Number of pages: 320