Depression:

Depression is almost invariably caused by the ego trying to block the emergence of unconscious material, often including manifestations of the aggressive instinct.

Two types of depression are usually described, endogenous and reactive. Reactive depression is usually due to some alleged external cause, such as bereavement, unemployment, injury or other setback in life. Endogenous depression has less obvious external triggers, seeming to come from within the person for no immediately apparent reason. Careful investigation will frequently show that endogenous depression is associated with some blockage or interruption to the patient's individuation process, the most classical being the so-called mid-life crisis. During the first half of life we are preoccupied with coming to terms with the outside world, gaining a career, a partner and family, a house and other material things. But in our mid-forties (or slightly earlier, especially for women) we become increasingly impelled to look inside ourselves to see what aspects of our personalities have been neglected and now need to be brought to consciousness.

For many, especially hard-driving business or professional people, this natural tendency causes considerable challenge to their accustomed way of behaving. Typically they hold fast to their habitual ways, and try to ignore the inner call, dismissing it as "silly imagination." Many become even more extreme in their habits, working longer hours, making themselves busier than they had ever been, and ensuring they are always in noisy environments, so introspective thoughts and feelings are blocked out by external stimuli like talk radio. (One woman had radios in every room in her house, so she was never in quiet surroundings.) What such people do not realise is that this change at mid-life is a natural part of human development, and we can no more avoid it than we could have talked our way out of going through puberty. It is simply the brain doing what it always does; establishing hoeostasis, balance. If we have developed our extraverted side to an excessive degree, the brain makes us counterbalance that with compensatory development of our introverted aspects. This particularly applies to extraverted sensation, living in the so-called "real" world, which the majority of western people do to the detriment of their inner intuition. Such people would never dream of driving their car without a service until it broke down, but frequently do it to themselves. The so-called nervous breakdown they suffer is actually a blessing in disguise, because, if handled correctly, it forces them to reestablish balance in their lives, and to tackle their work and life with renewed vigour and flexibility. Tragically there is a prevalent naïve delusion in medical circles that "people can get depressed at any age. If they get depressed in their forties, it's called mid-life crisis." This is tragic, because the unique psychodynamics of this condition go unregognised, more tragic because the patient is often put on antidepressant medication, (which is about as sensible as putting a Band-Aid on a gunshot wound,) and very tragic indeed when, as often happens, the patient ends up committing suicide, usually in a gruesome fashion. One man who failed to have appropriate treatment for this condition burned himself alive with petrol, but also took a lethal dose of insecticide.

Part of the reason for the frequency of suicides in this age group is that the required change in attitude is often depicted as death of the ego as it was, followed by rebirth of a new ego which is more inclusive and adaptable. The problem is that in most people's minds, ego is intimately related to their body. Instead of viewing their dreams and images of death of ego in an appropriate (metaphorical) way, they concretise the impulses into a drive to bring death to their body, which makes rebirth a little bit difficult!

Often the motif of hanging occurs, especially in men. Here the message is shown by the Tarot Major Arcana card, the Hanged Man. This depicts someone hung, not by the neck, but by the foot, usually with the hands bound. Such a person isn't going anywhere without some outside help. That is precisely what the image means: hang about and let the outside forces (outside the ego, that is,) readjust themselves for the next phase of life. There is an often unrecognised detail in this card. The triangular shape of the lead and arms, and the "folfot" cross made by the legs form the alchemical symbol for tin, but upside down. Tin is associated with Jupiter (Zeus) who was hanged by Typhon (unconscious forces perceived as negative,) and had to be freed by Hermes-Mercury. Zeus eventually defeated Typhon and became king of Olympos. A person who lets this process occur is eventually freed and becomes monarch of their own life, instead of a passive or unconscious victim.

Inanna's Descent depicts the process precisely. The dynamic feminine goes through the seven gates into the underworld, is stripped of all her symbols of power and killed. She is hung on a piece of wood for three days before Enki, the Sumerian progenitor of Hermes, sends two small beings down to restore her to life and bring her back into the world.

Although depression may be relieved by medication, this often simply masks the symptom and the patient becomes depressed again as soon as the medication is finished. Jung's approach is to discover what exactly is being blocked from entry into consciousness, then aid its integration. Frequently patients simply need to accept aspects of themselves which have always been there, but have remained under cover. Once integrated, these give the person new more flexible ways of handling their environment.

OCD:

Obsessive and compulsive disorders often appear to act as ritualistic defences against the emergence of unconscious material, particularly inferior intuition in sensate people. We have a natural tendancy to organise material by quartering it. Thus we use the four cardinal compass points to orient ourselves in space, and Descartes' coordinate axes allowed the representation of any shape in terms of mathematical formulae. As with so many useful functions, when this tendency is concretised, it leads to pathology, and many sufferers from OCD need to carry out ritualistic gestures to four points before getting on with their lives.

Similarly, our natural tendency to delineate differences into dark and light, good and bad, high and low etc. can become too literal and patients become obsessed with boundaries, never walking on lines in pavement, and other much more bizarre and incapacitating habits.

Our inclination to secure our houses against intruders is understandable, but when someone returns sixteen times to check their door lock, something else is obviously concerning them. Again it is not actual burglars who would probably get in anyway if they were sufficiently determined. It is rather what those imaginary burglars represent: the intrusion of unwanted material into the ego.

Washing our hands once after using the toilet is sensible. Washing one's hands all day until they become sore has to make us think further. Pontius Pilate's famous hand-washing gives a clue to what directs this behaviour. What we call guilt is in fact a feeling of alienation of the ego from the unconscious. If, rather than addressing the problem by reintegrating the two, we make a ritual of keeping dirt as a symbol of the unconscious, we work in the opposite direction. As in all disorders, looking for the underlying symbolism gives the therapist guidance which can then enable the patient's conflicts to be resolved.

Anxiety:
Like depression, and often associated with it, anxiety is often projected onto external world events. Sometimes this is quite appropriate, as when one is confronted with a savage dog, taxation official, or any other predator! Equally often though, the fear we feel is not proportional to the apparent external cause, and here Jung's methods work well, identifying, then integrating the complex causing the problem.

We can classify anxiety as general or specific, i.e., free-floating or phobic. Anxious people can be tense and nervous about everything, and with such people we usually find they have kept unconscious material down in large quantities. Unfortunately you cannot do that without bits popping up at all sorts of unexpected times, and for a variety of reasons. They do well when we assist them to accept aspects of themselves which they had previously denied or repressed. General anxiety works similarly to phobias. The external triggering situations represent symbols of what the patient is repressing.

Phobias tend to be symbolic representations of a patient's psychic state. For instance clautrophobic people have frequently surrounded themselves with such thick defenses that what they thought was a protective fortress has become a restrictive prison. The Tarot card called the Tower depicts this situation. Only some force outside the person's consciousness can blow the lid off and allow them to live more freely in the world. Similarly, agoraphobia, a fear of going out in public as often associated with fear of coming into contact with those complexes other than the ego. Acrophobia (abnormal fear of heights) often hits people who are too intellectual and need to become more down to earth.

Of particular interest is ailurophobia, a fear of animals, especially cats. Given that we now recognise that the dynamic feminine archetype is associated with feline symbols, we can assist the person to come to terms with this aspect of her Self, thus improving many aspects of her life and not just those times when she meets these delightful creatures.

Many phobic states reveal an underlying intelligence in the patient's mind which appears to be pointing them in a more sensible direction. One man had a fear of flying and a fear of travelling in a car with someone else driving. Unfortunately for him, he had business dealings in Victoria and Queensland, so had to drive himself between the two. His problem showed a fear of losing control. He treated all the women in his life with contempt, but when made to see that anima was there to help rather than consume him, he improved radically, and saved himself considerable travelling time!

Hypochondriacal symptoms and fear of dirt or disease often give clues to a patient's fear of an inferior function, most frequently intuition in a sensate person. Emerging intuition is usually perceived as dirty or dangerous, and because these people have no language to express their state of mind, describe it in symptoms, or fears of some form of contamination or disease. The trick here is to differentiate between genuine symptoms and those being used by the patient to express the inexpressable. It would be extremely embarrassing to delude oneself that one was treating a hypochondriac, only to find that their complaints pointed to an organic disorder! However, too much testing and specialist referral can often encourage the patient in their perceived problem while ignoring the real one. A balance is difficult but necessary to accomplish.

Paranoid states:

These fascinating delusional conditions can also be divided into four.
Delusions of grandeur cause people to believe that they are a prominent historical figure, or have a unique relationship with a famous person, present or past, or even a deity.
Delusions of reference cause a person to experience events as having immediate personal significance, unjustified by any objective measure. A group of people chatting in a street are seen as talking about the patient. A scrap of newspaper blowing acroos the road might be interpreted as containing slanderous remarks about the person.
Delusions of interference tend towards the more bizarre end of the scale, where a patient is convinced that their thoughts are being spied on or manipulated by an external organisation, often the CIA.
Delusions of persecution involve fixed ideas that the patient is the victim of anything from Jews to government agencies to Martians.

In all forms of delusion, the person has literalised something as an expression of the relationship between ego and unconscious. Usually the ego boundaries are less resilient than they ought to be, so the major archetypes of anima, animus and Self are experienced as uncomfortably close. Grandeur expresses a confusion between ego and Self, the latter being seen in projected form on the prominent person or deity. Reference indicates an inability to discriminate between external impersonal events and internal subjective dynamics. Interference and persecution delusions concretise what is psychologically quite true, metaphorically. Our thoughts are partly influenced by unconscious intrusions. We should hope they are. Otherwise we could not call on the brain as a whole to help us solve problems.

However, when these unconscious influences are projected onto specific outside people or agencies, the situation becomes pathological. We now know that the anterior cingulate gyrus, a small part of the frontal lobe, is defective in such patients, and that it comes to function normally as the delusions recede.

Schizophrenia:

Schizophrenia shares with paranoia a tendency to project inner dynamic material onto the outside world, but in a much more bizarre manner. In addition, raw unconscious material breaks into the ego with varying degrees of disruption, and the patient may have hallucinations, usually auditory. (Visual and other hallucinations tend to be associated more often with epilepsy and chemically caused disorders.) There tends to be a complete breakdown of the normal feedback relationship between feeling and thinking functions, which can result in the person having no emotion and motivation, or even emotional reactions which are completely inappropriate. While the fear and suffering such people experience most certainly justifies major tranquiliser therapy while the disease is active, much more can be done using psychotherapy during remissions.

Jung's interest in alchemy was in part motivated by his recognition that many alchemical symbols were described by patients suffering from schizophrenia. Thus a therapist with reasonable familiarity with alchemical material can often help a patient to make more sense of the initially strange phenomena which erupt from the collective stratum of the unconscious. This by itself can help allay the patient's fears and help them feel that someone at least partially understands their distress. Given that withdrawal and isolation are frequent problems in schizophrenia, this can be quite therapeutic. In the Enheduanna section, she describes events whose more or less cosmic dimensions suggest that the Self broke through to her in a manner quite analogous to a psychotic crisis. Fortunately Enheduanna's genius allowed her to integrate the influx and indicate how others could cope with a similar potential catastrophe.

"I don't know what's wrong with me, but I'm just stuck."

Despite Jung's psychology being a powerful primary or ancillary method for treating a variety of serious nervous disorders, most people who present to Jungian analysts in Melbourne (and probably throughout the world,) do so because of feeling stuck, feeling that they have come to an impasse in their lives. They need not have critical symptoms. They may be coping well enough with work, but something seems to be missing. Their lives no longer have meaning or fulfilment.

Such people are very rewarding to treat, not only because they are highly motivated to work on their own psyches, but also because they have considerable potential to contribute substantially to their families, community and professions once their psychic logjams are released.