Foreword to Perry: “The Self in Psychotic Process”

Foreword to Perry: “The Self in Psychotic Process”

As I studied Dr. Perry's manuscript, I could not help recalling the time when I was a young alienist searching vainly for a point of view which would enable me to understand the workings of the diseased mind.

Merely clinical observations—and the subsequent post mortem when one used to stare at a brain which ought to have been out of order yet showed no sign of abnormality—were not particularly enlightening. "Mental diseases are diseases of the brain" was the axiom, and told one just nothing at all.

Within my first months at the Clinic, I realized that the thing I lacked was a real psychopathology, a science which showed what was happening in the mind during a psychosis.

I could never be satisfied with the idea that all that the patients produced, especially the schizophrenics, was nonsense and chaotic gibberish.

On the contrary, I soon convinced myself that their productions meant something which could be understood, if only one were able to find out what it was.

In 1901, I started my association experiments with normal test persons in order to create a normal basis for comparison.

I found then that the experiments were almost regularly disturbed by psychic factors beyond the control of consciousness.

I called them complexes.

No sooner had I established this fact than I applied my discovery to cases of hysteria and schizophrenia.

In both I found an inordinate amount of disturbance, which meant that the unconscious in these conditions is not only opposed to consciousness
but also has an extraordinary energic charge.

While with neurotics the complexes consist of split-off contents, which are systematically arranged, and for this reason are easily understandable,
with schizophrenics the unconscious proves to be not only unmanageable and autonomous, but highly unsystematic, disordered, and even chaotic.

Moreover, it has a peculiar dreamlike quality, with associations and bizarre ideas such as are found in dreams.

In my attempts to understand the contents of schizophrenic psychoses, I was considerably helped by Freud's book on dream interpretation, which had just appeared (1900).

By 1905, I had acquired so much reliable knowledge about the psychology of schizophrenia (then called "dementia praecox") that I was able to write two papers3 about it.

The Psychology of Dementia Praecox (1906) had practically no influence at all, since nobody was interested in pathological psychology except Freud, with whom I had the honour of collaborating for the next seven years.

Dr. Perry, in this book, gives an excellent picture of the psychic contents with which I found myself confronted.

At the beginning, I felt completely at a loss in understanding the association of ideas which I could observe daily with my patients.

I did not know then that all the time I had the key to the mystery in my pocket, inasmuch as I could not help seeing the often striking parallelism between
the patients' delusions and mythological motifs.

But for a long time I did not dare to assume any relationship between mythological formations and individual morbid delusions.

Moreover, my knowledge of folklore, mythology, and primitive psychology was regrettably deficient, so that I was slow in discovering how common
these parallels were.

Our clinical approach to the human mind was only medical, which was about as helpful as the approach of the mineralogist to Chartres Cathedral.

Our training as alienists was much concerned with the anatomy of the brain but not at all with the human psyche.

One could not expect very much more in those days, when even neuroses, with their overflow of psychological material, were a psychological terra incognita.

The main art the students of psychiatry had to learn in those days was how not to listen to their patients.

Well, I had begun to listen, and so had Freud.

He was impressed with certain facts of neurotic psychology, which he even named after a famous mythological model, but I was overwhelmed with "historical" material while studying the psychotic mind.

From 1906 until 1912 I acquired as much knowledge of mythology, primitive psychology, and comparative religion as possible.

This study gave me the key to an understanding of the deeper layers of the psyche and I was thus enabled to write my book with the English title Psychology of the Unconscious.

This title is slightly misleading, for the book represents the analysis of a prodromal schizophrenic condition.

It appeared forty years ago, and last year I published a fourth, revised edition under the title Symbols of Transformation.

One could not say that it had any noticeable influence on psychiatry.

The alienist's lack of psychological interest is by no means peculiar to him.

He shares it with a number of other schools of thought, such as theology, philosophy, political economy, history, and medicine, which all stand in need of psychological understanding and yet allow themselves to be prejudiced against it and remain ignorant of it.

It is only within the last years, for instance, that medicine has recognized "psychosomatics."

Psychiatry has entirely neglected the study of the psychotic mind, in spite of the fact that an investigation of this kind is important not only from a scientific and theoretical standpoint but also from that of practical therapy.

Therefore I welcome Dr. Perry's book as a messenger of a time when the psyche of the mental patient will receive the interest it deserves.

The author gives a fair representation of an average case of schizophrenia, with its peculiar mental structure, and, at the same time, he shows the reader what he should know about general human psychology if he wishes to understand the apparently chaotic distortions and the grotesque "bizarrerie" of the diseased mind.

An adequate understanding often has a remarkable therapeutic effect in milder cases which, of course, do not appear in mental hospitals, but all the more in the consultation hours of the private specialist.

One should not underrate the disastrous shock which patients undergo when they find themselves assailed by the intrusion of strange contents which they are unable to integrate.

The mere fact that they have such ideas isolates them from their fellow men and exposes them to an irresistible panic, which often marks the outbreak of the manifest psychosis.

If, on the other hand, they meet with adequate understanding from their physician, they do not fall into a panic, because they are still understood by a human being and thus preserved from the disastrous shock of complete isolation.

The strange contents which invade consciousness are rarely met with in neurotic cases, least not directly, which is the reason why so many psychotherapists are unfamiliar with the deeper strata of the human psyche.

The alienist, on the other hand, rarely has the time or the necessary scientific equipment to deal with, or even to bother with, his patients' psychology.

In this respect, the author's book fills a yawning gap.

The reader should not be misled by the current prejudice that I produce nothing but theories.

My so-called theories are not figments but facts that can be verified, if one only takes the trouble, as the author has done with so much success, to listen to the patient, to give him the credit—that is humanly so important—of meaning something by what he says, and to encourage him to express himself as much as he possibly can.

As the author has shown, drawing, painting and other methods are sometimes of inestimable value, inasmuch as they complement and amplify verbal expression.

It is of paramount importance that the investigator should be sufficiently acquainted with the history and phenomenology of the mind.

Without such knowledge, he could not understand the symbolic language of the unconscious and so would be unable to help his patient assimilate the irrational ideas that bewilder and confuse his consciousness.

It is not a "peculiar historical interest," a sort of hobby of mine to collect historical curiosities, as has been suggested, but an earnest endeavour to help
the understanding of the diseased mind.

The psyche, like the body, is an extremely historical structure.

I hope that Dr. Perry's book will arouse the psychiatrist's interest in the psychological aspect of his cases.

Psychology belongs as much to his training as anatomy and physiology to that of the surgeon. ~Carl Jung, CW 18, Pages 353-356