Jung frankel and the 20th century psychiatry

Jung, Frankl and the 20th century psychiatryCan psychiatry be misused again?

Adonis Sfera, MD

The 20th century through the eyes of Carl Jung and Viktor Frankl The historical events of the 20th century cannot be

separated from the human mind in which they originated. Carl Jung promoted a unitarian idea of reality in which the

matter and the mind are not actualized separately, but form a continuum.

The mind-matter continuum

The outer reality (the collective conscious) is paralleled by an inner reality (the collective unconscious).

We communicate to each other not only in the outer, but also in the inner reality.

The first decade

The first decade of the 20th century was uneventful and idyllic.

Peace and prosperity had prevailed for almost 100 years after the Napoleonic wars enabling unprecedented scientific advances:

1900 Freud's book, "The Interpretation of Dreams"

was released 1900 Planck discovers the quantum nature of

energy 1905 Binet pioneers intelligence testing 1905 Einstein publishes the special theory of

relativity 1909 Ehrlich finds the cure for syphilis

The supremacy of the human intellect

The promises of Enlightenment finally materialized: human intellect appeared supreme and the Universe seemed to abide by human rules.

Men lived twice as long as they had previously

and women no longer died in childbirth.

The art of Europe, the philosophy and the politics, all have taken humanity to a place it has never been before.

To many, it seemed as if they were at the gates of heaven.

The preface of hell

Between 1914 and 1945 roughly 100 million Europeans died from political causes: war, genocide, purges and planned starvation.

By the end of the 31 years, Europe has become a graveyard of ruined cities and shattered lives.

Other civilizations have undergone turmoil, war and savagery, but the unexpectedness, the intensity, the rapidity and the consequences for the entire world were unique.

The limits of reason “Our time has demonstrated what it means

for the gates of the underworld to be opened. Things whose enormity nobody could have imagined in the first decade of the 20th century have happened and have turned our world upside down” (C.G.Jung)

The archetype

The archetype = object + emotion The archetype is both subjective and

objective

The archetype of the nation

Nationalism as the modern religion

“My noble country, you must take the place of God who escapes us, that you may fill within us the immeasurable abyss which extinct Christianity has left there. You owe us the equivalent of the infinite.” Jules Michelet, 1831

The cult of the nation

From modernity to madness

The demise of European Empires

Far-called, our navies melt away;On dune and headland sinks the fire:Lo, all our pomp of yesterdayIs one with Nineveh and Tyre!Judge of the Nations, spare us yet,Lest we forget, lest we forget! Rudyard Kipling “Recessional”

The last European Empire, the Soviet Union, survived until 1991.

Psychiatric genocide The Nazi genocide of psychiatric patients

was the greatest criminal act in the history of psychiatry.

It is estimated that between 220 000 and 269 500 individuals with schizophrenia were sterilized or killed. This represents between 73% and 100% of all individuals with schizophrenia living in Germany between 1939 and 1945.

The aftermath

Soul Searching

The outer recovery In 1947 William Clayton, Under Secretary of

State for Economic Affairs, wrote a memo to Secretary of State George C. Marshall:

“We are in need of a plan based on a European Economic Federation on the order of Belgium-Netherlands-Luxembourg Customs Union. Europe cannot recover from this war and again become independent if her economy continues to be divided into many small watertight compartments as it is today.”

And the innerJung and Frankel: the soul and the meaning

Extracting meaning out of chaos

EnantiodromiaCivilized consciousness has steadily separated itself from the basic instincts. But these instincts have not disappeared. They have merely lost contact with our consciousness and are thus forced to assert themselves in an indirect fashion.

“He who has a WHY to live for can bear almost any HOW” (Nietzsche)

Viktor Frankl “We who lived in concentration camps can

remember the men who walked through the huts comforting others, giving away their last piece of bread. They may have been few in number, but they offer sufficient proof that everything can be taken from a man but one thing: the last of human freedoms - to choose one's attitude in any given set of circumstances - to choose one's own way.”

―Viktor E. Frankl

A quest for meaning

Terrible as it was, Frankl’s experience at Auschwitz, reinforced what was already one of his key ideas: Life is not primarily a quest for pleasure, as Freud believed, or a quest for power, as Adler thought, but a quest for meaning.

Meaning = Freedom

Existential vacuum “If meaning is what we desire, then

meaninglessness is a hole, an emptiness, in our lives. Whenever you have a vacuum, of course, things rush in to fill it” (Frankl).

The future

Modernity in search of a soul Contemporary humanity has

sacrificed introspection and reflection in order to achieve rationality and efficiency, but in this process lost its meaning, soul and wisdom(C.G.Jung).

Psychopharmacology and cognitive psychology

Second half of the 20th century:-1954 discovery of Chlorpromazine-Schizophrenia a “dopamine disorder”-Psychopharmacology

Psychology response:-focus on the cognitive domain (measurable)- abandonment of introspection-abandonment of feeling

Chronic psychosis: a cornerstone or a stumbling block

Being free of hallucinations, delusions or anxiety is important to our patients, but things that matter most to them, such as going to school, work or raising children are out of the reach for the majority in spite of the best available treatments.

Neurodegeneration and prevention

In neurodegenerative disorders such as Parkinson’s disease, Alzheimer’s disease and Huntington’s disease changes in the brain precede changes in behavior , sometimes by more than a decade.

In Parkinson’s disease symptoms only emerge after 80% of dopamine cells have been lost.

Thomas Insel; Rethinking Schizophrenia; Nature vol 468, November 201; doi:10.1038/nature09552

Prevention in medicine Over the past few decades preventive efforts led

to:

60% reduction in mortality due to coronary artery disease (1.1 million death averted each year).

AIDS was declared a chronic disease.

Prevention in chronic psychosis

In utero brain development is affected in chronic psychosis:

-neuronal proliferation-neuronal differentiation -neuronal migration-synapse formation -myelination

A Case for Prevention and Early Detection

Birth cohort studies demonstrate that individuals who develop schizophrenia differ from the general population on a range of developmental indices some of which occur as early as the first year of life.

Joy Welham,2 Matti Isohanni,3 Peter Jones,4 and John McGrath; The Antecedents of Schizophrenia: A Review of Birth Cohort Studies; Schizophr Bull. 2009 May; 35(3): 603–623, . doi: 10.1093/schbul/sbn084

The end of the 20th century

Philosophers and poets have long separated the mind’s purview into three components: information, knowledge and wisdom.

In the information age, search engines are able to handle increasingly complex questions with increasing speed. Yet a surfeit of information may paradoxically inhibit acquisition of knowledge and push wisdom even further than before. In order to be truly useful, information must be placed within a broader context of history and experience to emerge as actual knowledge (Henry Kissinger)

Where is the Life we have lost in living?Where is the wisdom we have lost in knowledge?Where is the knowledge we have lost in information? T. S. Eliot “Choruses from The Rock”

C. G. Jung Institute in Zürich