Jung At Heart Archive November 2007

Invisible in academic psychology

An article in today's New York Times  an article about the disappearance of Freud in academic psychology set me to musing a bit. To Jungians being ignored by psychology, especially in the US, is old news. But until the last 25 years or so, psychoanalysis still had a place at the table in many if not most departments of psychology. 

Alice Eagly, the chairwoman of the psychology department at Northwestern University, explained why: Psychoanalysis is “not the mainstream anymore” and so “we give it less weight.”

The primary reason it became marginalized, Ms. Eagly, said, is that while most disciplines in psychology began putting greater emphasis on testing the validity of their approaches scientifically, “psychoanalysts haven’t developed the same evidence-based grounding.” As a result, most psychology departments don’t pay as much attention to psychoanalysis.

Because you know, it is ever so important for what is being taught to be the latest and greatest thing. But what about expecting psychology students to have a sense of the history of the field? Why shouldn't clinicians be expected to know how the firld developed, how we got from Mesmer to Cognitive Behavioral Therapy? How can they develop a critical eye for the next shiny new thing if they do not have well developed understanding of what went before?

I was an undergraduate 40 years ago -- good grief, my 40th reunion is next spring! -- and even then Jung was mentioned only in passing along with Adler and others from the early days of psychoanalysis. But we did learn the rudiments of psychoanalytic theory. Even then, though, changes were afoot. And when I was in clinical psych. graduate school, Freud was a minor player of historical interest but not seen as of clinical importance. Jung wasn't mentioned at all.

Freud had room in the academy in psychology on the coasts, but not so much in the center of the country. I remember the term "boot strap empiricism" being applied to the behavioral approaches already coming from the Midwest. I wonder if Freud ever had a solid place outside of major centers like New York, Chicago, San Francisco, and Los Angeles? And Jung? Never had a home in the US in psychology. Look for Jung in the religion department or comparative literature or mythology. 

It does worry me that a significant body of knowledge is being lost. The therapeutic frame is important no matter what kind of therapy is practiced. Being able to look at one's own reactions and understand them in relation to a patient is important. The inferiority complex which seems to have gripped psychology, making it seem imperative to be more scientific than any of the hard sciences surely deserves interpretation? So maybe for now, it is the salvation of the depth psychologies that we have retreated to these other departments so we can allow psychology to work through its issues. Because I cannot believe that the insights of Jung and Freud and those who followed them, insights which have informed psychotherapy for 100 years and which today inform us about characters in literature, film and history, will disappear just because psychology needs to be "scientific".


Just for fun

back to the serious tomorrow, but today --

funny-pictures-therapy-cat

from one of my very favorite places, lolcats.





Back to Jung

A few days of focus on the sorry state of things in the world of mental health treatment and I happily return to Jung. As I was looking for something last night, I found this quote which I had saved several years ago and here we are at an intersection between the mind vs the brain people:

"It is generally assumed in medical circles that the examination of the patient should lead to a diagnosis of his illness, so far as this is possible at all, and that with the establishment of the diagnosis an important decision has been arrived at as regards prognosis and therapy. Psychotherapy forms a startling exception to this rule: the diagnosis is a highly irrelevant affair since, apart from afixing a more or less lucky label to a neurotic condition, nothing is gained by it, at least as regards prognosis and therapy...

The content of a neurosis can never be established by a single examination, or even by several. It manifests itself only in the course of treatment. Hence the paradox that the true psychological diagnosis becomes apparent only at the end." (Collected Works, Vol. 16, pp.86-87)

Jung argues that initially one must make an assessment of whether or not organic brain disease is present and I would add that it is important to assess for psychosis. But given that the vast majority of patients who show up for psychotherapy have already prescreened themselves along those lines so that it is rare for a therapist to see either in a new patient, most of the people we see are what Jung called neurotic. And isn't it interesting that despite the fact that psychiatry discarded neurosis with the DSM III, the term persists in common usage?

How different Jung's perspective is from what dominates today -- a fixation on diagnosis. In fact, if one is not assigned, then there is no third party payment. We may have rather hugely increased the number of potential diagnoses, but to think the process is actually precise or scientific is to labor under serious delusion. Following Jung's path takes patient and therapist to meaning of symptoms in the context of that patient's life. 

When I first started out, all the world was divided into 3 parts: psychosis, neurosis, organic brain syndromes. And yes, borderline was in there too along with personality disorders but not as major categories. I can't see that things are better now for having so many more labels. 

Sacred Cows 

I had an interesting experience the other day. After reading CP&P's excellent post on the role of serontonin in depression and the long essay he linked to, I decided to raise  them -- the essay, the post, and the issue -- in discussion in a virtual community I belong to. It's fascinating to me how adamantly intelligent people will defend their sacred cows. And the whole chemical imbalance theory of depression has become one. 

I asked my husband, who is not a mental health professional, if all he knew about depression is what he sees in the drug ads, what would he think was the cause? And of course, he said he would believe it was a purely biological illness. And that just about anything less than happy fell under it.

I found in the community where I posted that what I posted triggered something of a defensive response as if I had said that SSRIs are of no value. Or that there is no biological dimension to depression.  There seemed to be something close to hostility to the notion that depression could be treated with non-medical approaches, this despite articles which have appeared in the popular press about the efficacy of exercise and therapy vs medication alone.

Many of the folks I know who take SSRIs believe they must take them for the rest of their lives, as a diabetic takes insulin. Very few of them have been in other than relatively short term therapy and even fewer were originally prescribed their SSRI by a psychiatrist nor have they ever seen one.

It is impressive to me how deeply effective the advertising for these drugs has been and continues to be. One has to wonder if the battle is indeed lost.

© Cheryl Fuller, 2007. All  rights reserved.