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IGAP Paper: The History of Neurosis. Dec. 15, 2006.

Luisetta Mudie

Spirits and magic are almost the sole causes of illness among primitives. The autonomous contents
are projected by the primitive upon these supernatural beings. Our world, on the other hand, is
freed of demons to the last trace, but the autonomous contents and their demands have remained.
They express themselves partly in religion, but he more the religion is rationalized and watered
down...the more intricate and mysterious become the ways by which the contents of the
unconscious contrive to reach us. One of the commonest ways is neurosis.i
Jung, CW8.712

The neurosis of history

The term 'neurosis' can be seen as a response to a complex of psychological, somatic and
cultural phenomena which first began to be described among patients in a post-
Enlightenment, rapidly industrialising Europe. Advances in medicine and technology had
produced a deepening of the divide between subject and object. Mind, if separated from
matter through repeatable and verifiable experiment, could achieve great things,
including social reform, the eradication of major diseases, and a new culture of Industry
and Progress. It could even objectify, and therefore study, itself.

The term 'neurosis' was coined by a Scottish doctor, William Cullen, in 1769 to refer to
"disorders of sense and motion" caused by a "general affection of the nervous system".
Cullen needed a term that would describe problems which had no physiological cause.ii
The non-biological basis of neurosis was maintained with Sigmund Freud and the
beginning of the psychoanalytic movement. It moved away from attempts to describe the
somatised experiences of patients in terms of putative organic disorders, for example, the
'wandering womb', and opened up the field of psychology as a legitimate object of
enquiry for the scientifically minded, while at the same time differentiating it from
medicine.

The Enlightenment shift also moved away from the holistic approach to mind, body and
soul characterised by Renaissance thinkers, for whom the gods and astrology were still a
proper part of scientific enquiry. It is that attitude which Jung develops and revives in a
form appropriate to his time and social milieu: analytical psychology.

By the mid-19th century, across Europe, intellectuals were deserting the old systems of
meaning, once the preserve of the Church. Ernest Renan's secular appraisal of Christ, La
Vie de Jesus, was emblematic of the positivist rush to believe in the power of human
reason. And while the newly-empowered rationality redefined itself against the backdrop
of an increasingly watered-down religious life, the irrational, troublesome and fascinating
parts of the psyche not adequately addressed by post-Enlightenment thinking were
thrown into sharp relief: both in individuals seeking help for neurotic suffering; and
collectively, in mass movements and war.

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Early approaches

Henri Ellenberger dates the beginnings of what he terms 'dynamic psychiatry' from 1775,
when the physician Franz Anton Mesmer superseded the work of the highly respected
exorcist Gassner.iii Mesmer's theory of animal magnetism was based on the concept of an
energetic fluid, and his philosophy—which his disciple Puységur later summarised as
believe and wantiv—fully recognized the effects of clinical intent on his patients. The late
18th century and entire 19th centuries were dominated by a psychiatric focus on the
'magnetic diseases'. Most common in the care of such practitioners were patients
suffering from spontaneous somnambulism, lethargy, catalepsy, multiple personality,
and, later, hysteria.

Theories of invisible fluids began to be replaced by notions of psychic energy1, an


heuristic concept which informed much of Jung's psychological theoryv. The chief
clinical technique throughout much of this time was hypnotism, which had its roots in the
Renaissance concept of imaginatio, which placed a great emphasis on the power of
suggestion.

Such techniques were used to great theatrical effect by the Paris-based neurologist Jean-
Martin Charcot (1825-93) during his tenure as clinical professor of the nervous system at
the Pitié-Salpêtrière hospital. Nicknamed "the Napoleon of the neuroses", Charcot was
most famous for staging demonstrations of technique and symptoms using his most
prominent and interesting hysterical patients. But the mainstay of Charcot's work was his
concern with a diagnostic classification of key neurological disorders; his 'nosography'.
Charcot's work has proved fertile ground for later critiques of the phenomena of hysteria
as owing more to gender politics and the socioeconomic circumstances of the day than to
classifiable and treatable illness.vi

One of Charcot's students, Pierre Janet (1859-1947), was to influence Jung's work
profoundly. A summary of Janet's theory of psychic energy is included as an end-note to
this paper.vii

Haunted minds: Jung's roots

While the practice of hypnosis gained momentum throughout the 19th century, it wasn't
taken up by medically trained practitioners until the 1880s. By then, the plethora of
minds turning their attention to the hypnotic method had begun to show up its
weaknesses, which included the difficulty of knowing whether people were truly
1
According to Ellenberger, one of the earliest theories put forward by the mesmerists was that there existed
a universal 'fluid'. Illness could be caused by disturbances in the fluid, by faulty fluid, or by insufficient
fluid. Puységur's emphasis on will, an essentially psychological explanation, ran concurrently with fluidic
theory throughout the 19th century. In the second half of the century, the two ideas appeared to find some
synthesis in increasing references among academic physicians to a deficiency of 'nervous energy' as a
cause for illness. One of these was George Beard, known for his description of neurasthenia in the United
States. Beard said some people were 'millionaires of nervous force', while a neurasthenic had overdrawn his
nervous force to the point of 'nervous bankruptcy'. Pierre Janet's theories of psychic energies drew both on
Beard's, and on the experiences of the earlier magnetisers. William James' work, The Energies of Man, was
also influential at that time.

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hypnotised or simply pretending to be in order to maintain social acceptability. In the
language of the age, it became difficult to separate the phenomena of the hypnotic
movement into observable facts free of the influence of the social contexts in which they
occurred.

Related phenomena that began to emerge in the drawing rooms of mediums and
spiritualistic practitioners were later to inspire Jung's doctoral thesis, in which he also
noted their inseparability from social and psychological contexts. Jung's interest in such
phenomena as a member of the medical profession, which via psychiatry was already
beginning to emphasise organic and physical causes for mental disorders, is remarkable.
It can be seen as a significant step towards reintegration of the subject-object split, so
necessary for scientific enquiry, and towards a fuller experience of the neurosis of history
which resulted from it.

Jung's deep conviction that what the insane said or experienced was not separable from
human experience, that is, that meaning was inherent in the fantasies of even his most
psychotic patients at the Burghölzli hospital, led him to delve more deeply into the
contexts in which such phenomena as spiritualism, hysteria, hypnosis and madness were
embedded. Using a philological analogy which took the fantasies of the insane as texts in
an unknown language, Jung found parallels for these fantasies in little-known theological
texts, alchemical manuscripts and folk tales, myth and legend.

His development of the concept of the collective unconscious sprang from a profound
experience both of his own neurosis, and of that of the age in which he lived.

Freud and repression

Since I could not alter the psychic state of most of my patients at my wish, I directed my efforts to
working with them in their normal state. This seems at first sight to be a particularly senseless and
aimless undertaking. The problem was this: to find out something from the patient that the doctor
did not know and the patient himself did not know.viii

Hypnotism had enjoyed a brief honeymoon period of intense interest from the medical
profession before lapsing into relative obscurity. One of its legacies, which it had
inherited from mesmerists, Gassner, and even the ancients, was a practice which placed
strong emphasis on precipitating a crisis, or 'bringing out' the symptom, in order that it
might be cured, a principle Freud redefined as the cathartic method, although he was soon
to reject hypnosis.

This way of working arose at about the same time as the idea that psychic energy or
contents might be 'located' somewhere not immediately obvious, creating a distinction
between the apparent state of the patient and their latent, unseen energies or symptoms.

From here, it was a short step to the distinction between conscious and unconscious
psychic activity, which began increasingly to be made and became the hallmark of the
psychoanalytic movement. These foundations were laid, of course, by Freud.

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...The forgotten memories were not lost. They were in the possession of the patient, ready to
emerge and form associations with his other mental content, but hindered from becoming
conscious, and forced to remain in the unconscious by some sort of a force. The existence of this
force could be assumed with certainty, for in attempting to drag up the unconscious memories into
the consciousness of the patient, in opposition to this force, one got the sensation of his own
personal effort striving to overcome it. One could get an idea of this force, which maintained the
pathological situation, from the resistance of the patient.ix

The theory of resistance leads Freud to the theory of repression in the very next
paragraph.

These same forces, which in the present situation as resistances opposed the emergence of the
forgotten ideas into consciousness, must themselves have caused the forgetting, and repressed
from consciousness the pathogenic experiences. I called this hypothetical process "repression"
(Verdrängung), and considered that it was proved by the undeniable existence of resistance.x

Jung, writing in the early part of the 20th century, picks up on the theory of psychic
energy and its implication of the existence of the unconscious psyche afresh, using it to
underpin his view of neurosis. In his essay on psychic energy, he uses the laws of
thermodynamics as a metaphor for his psychodynamics, and concluding that if a packet
(quantum) of life energy, or libido, has disappeared as a conscious value, it is not lost.
The conviction that it is no longer detectable, but yet has not been lost, presupposes an
Other, hidden location, in which 'it' may now reside. Jung attributes much of the
development of this principle to Freud, and the theory of repression:

Nowhere can we see more clearly than in the relation of sexuality to the total psyche how the
disappearance of a given quantum of libido is followed by the appearance of an equivalent value
in another form...Anyone who reads Freud's works with attention will see what an important role
the equivalence principle plays in the structure of his theories. This can be seen particularly clearly
in his investigations of case material, where he gives an account of repressions and their substitute
formations. Anyone who has had practical experience of this field knows that the equivalence
principle is of great heuristic value in the treatment of neurosis.xi

But Jung, while acknowledging his debt to Freud, was soon to diverge from the path
taken by the Viennese school of psychoanalysis. Neurosis is also conceived by Jung in
social terms as a crisis of meaning: to borrow his shamanic metaphor, a loss of soul in
modern life. At a personal level, it is 'the avoidance of legitimate suffering'; a refusal to
entertain one's demons, to give them house-room.

The concept of soul loss took Jung into a direct encounter, both personally and as a
scholar, with what Freud labelled "the black mud tide of occultism" and into a much
broader definition of libido as psychic energy, which sought expression in increasingly
complex forms in human life, including religion. For the individual, Jung described libido
as residing in personal complexes, which consisted of affect (strong emotion) against
which neurotic behaviours often defended, but also of images which were capable of
symbolising and containing the experience, which had their roots in the collective
unconscious, the home of the archetypes, and of a human experience of the numinous and
the sacred.

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Most importantly, meanings could be made from any or several of the archetypal
metaphors inherent in humankind, and were no longer confined to infantile wish-dramas
and the Oedipal myth; while Jung never denied the importance of the latter, he added to it
a large array of myths and images found in his clinical practice and in his research into
alchemy, Gnosticism, anthropology and folk tales. For Jung, the healing of the neurosis
lay in the very images its suffering produced. This suffering would initially be
experienced in the external world, he wrote, 'as Fate', but through analysis could be
approached and transformed through dreams, artwork, fantasy and active imagination.

But Jung's view of neurosis was also defined against the Freudian view of neurosis as the
result of the repression of 'disagreeable memories and tendencies',xii or wishes that were
incompatible with the neurotic's other desires.xiii Instead, Jung argued for the existence of
a positive unconscious, something with its own existence independent of the ego, and not
merely a dustbin for repressed ego wishes.

[The] positive function of the unconscious is, in the main, merely disturbed by repressions, and
this disturbance of its natural activity is perhaps the most important source of the so-called
psychogenic illnesses...Like bile seeping into the blood, the repressed content infiltrates into other
psychic and physiological spheres. In hysteria it is chiefly the physiological functions that are
disturbed; in other neuroses, such as phobias, obsessions, and compulsion neuroses, it is chiefly
the psychic functions, including dreams.

For Jung, neurotic symptoms like these were an attempt on the part of the unconscious to
compensate for a one-sided attitude in the conscious mind which had not allowed them
full expression in the life of the person who suffered them. The key difference between
his early patients at the Burghölzli clinic and his later analysands was in the former's
inability to maintain the tension of the opposites necessary to psychological development
in their waking life; their ego. Here again, there are resonances with Janet*.

The repressed feminine

In social terms, the neurosis of history and the collective return of the repressed was often
carried by women patients, themselves subjected to social repression in a male-dominated
society. Feminist studies of psychoanalytic history have critiqued the role of psychiatry
and psychoanalysis as a purely diagnostic and curative set of practices, highlighting
instead the (unconscious) use of psychiatric labels and coercion as a political weapon in
the social struggle for gender equality.

For example, women whose gifts and abilities were underdeveloped because they were
considered unfeminine were seen as attempting to kick back against the patriarchal
system, and simply labelled 'nervous' or 'hysterical' when they continued to rebel.

"During an era when patriarchal culture felt itself to be under attack by its rebellious
daughters, one obvious defense was to label women campaigning for access to the
universities, the professions, and the vote as mentally disturbed," writes Elaine
Showalter.xiv She cites Freud and Breuer's studies in hysteria, in which they refute Janet's
view of hysteria as the result of a congenital psychical weakness:

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Adolescents who later become hysterical are for the most part lively, talented and full of
intellectual interests until they fall ill; they often have a remarkably energetic will. This category
includes girls who get up during the night to pursue in secret some kind of study that their parents
have forbidden them for fear of over-exertion.xv

In men, the repressed feminine in the form of the maternal unconscious, or in dreamlike
anima representations, manifested itself in such diagnoses as neurasthenia, which was
characterised by a lack of desire or motivation. Jung repeatedly linked tales of vampires
which suck a man's energy to a failure to get to grips with the anima. Many others who
came under the care of the psychiatric profession, male or female, saw themselves as
victims of social discrimination and repression, rather than as sick.

"Throughout the writings of the insane runs a wail of protest," writes Roy Porter, in
Madness: A Brief History. Citing the account of Clifford Beers, Porter describes Beers'
committal to a mental institution following relatively mild symptoms, which later
developed into a set of paranoid beliefs about his family. Beers, looking back, concludes
that his sense of persecution was relatively sane, given his arbitrary incarceration and
subjection to procedures very much resembling torture.xvi

In authoritarian or totalitarian states, psychology is under the aegis of a monistic


government, which arrogates all meaning-making to itself or to its ideological system.
Psychological appraisal, if it exists at all, is frequently used forensically, to lock up those
who are crazy enough to disagree with the all-powerful State. In such extreme
environments, biological causes for mental health problems tend to be disregarded by the
general population, who prefer to blame the regime for sending people mad. Behaviours
which in a liberal culture would be considered paranoid are the norm; only normal human
feeling is pathologised.xvii

Meaning, neurosis, and the body

The ambiguities and questions surrounding psychiatric diagnosis have called many others
to question the purpose of the psychiatric profession, the most notable of these being
Thomas Szasz, who suggested that psychiatry as practised is a disguised form of social
control and behaviour modification, rather than a genuine branch of medicine with
knowable diseases and cures.xviii

This has ramifications for the concept of neurosis, and therefore for the work done by
psychotherapists working with non-psychotic disturbances. Even given the strong
evidence for organic aspects to certain psychiatric disorders—for example the
relationship between dopamine and behaviours grouped under the diagnosis
'schizophrenia'—mental health groups are now campaigning for the abolition of the term
schizophrenia from diagnostic manuals on the grounds that it spells social and economic
disaster for anyone labelled with it.xix

Current diagnostic manuals have already dispensed with the term 'neurosis', leaving
Jungian practitioners working with a vast spectrum of problems not acutely and floridly

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psychotic. Given the manifold suffering reported by disempowered people as a result of
the fixities of meaning and conduct applied to them by powerful practitioners, perhaps a
degree of fluidity is the best guarantee we can offer our clients and the experiences they
bring to the consulting room.

From another point of view, however, a certain degree of firm conceptualisation can be
helpful. One analysand, the client of a senior Jungian analyst, said she appreciated the
effort to find a psychological explanation, rather than a biological quick fix, to recent
difficulties. "A mediocre shrink would have put me back on drugs last week," she said.

"A final thought on definitions and terminology...one way that they're useful to the
patient is in defining what you're not. [My analyst] can say to me, no you're not bipolar,
you have a complex. If he said to me, no you're not bipolar, you're just a unique
individual with a unique problem, I might feel actually more trapped," she wrote in
personal correspondence on the subject of neurosis.

The concept of neurosis has undergone many challenges, including changing attitudes to
the relationship between body and psyche. Advances in neuropsychiatry have shown that
brain changes take place as a result of key emotional events, that brain development is
essentially a relational processxx, and that words literally matter, in that they can affect
our physiology. How the body affects the psyche, or interpenetrates it, is also beginning
to be considered, as non-Western philosophies (e.g. Chinese, Ayurvedic, Tantric) become
entwined in our pluralistic cultures.

Such resonance – never before possible – between the nitty gritty of psychological work
and the detectable activity and development (even in adult life) of the brain, has given
Jung's psychology a new legitimacy, in the sense that his theory of complexes has a firm
basis in observable biology. Some writers have suggested that the entire basis of brain
function is essentially metaphorical: that the brain, even in rabbits, communicates with
itself in terms of not-quite-closed meaning systems which reside in associative clusters to
produce memory.xxi Image, and therefore even our continuity of identity, is constantly
being retranscribed through metaphor, which some have described as an emergent
property of matter itself.

But the concept of neurosis as employed in analytical psychology—and Jung's theory of


complex and archetype—may not ultimately need this legitimacy. Indeed, the enduring
value of the term may be rooted in the fact that it risks—in today's high-tech world—a
purely human meaning for suffering, and therefore for the psychotherapeutic work which
attends it.

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i
References

Jung, C.G., "Analytical Psychology and 'Weltanschauung'", CW8.712


ii
Wikipedia contributors, 2006. "Neurosis". Wikipedia, The Free Encyclopedia. Retrieved Nov. 20, 2006, from
http://en.wikipedia.org/w/index.php?title=Neurosis&oldid=88850627
iii
Ellenberger, H, 1970. The Discovery of the Unconscious, Basic Books, New York. p110
iv
Ibid. p72
v
Jung, C.G., 1948. "On Psychic Energy", CW8.26
vi
Szasz, T, 1974. The Myth of Mental Illness. HarperCollins, New York.
vii

viii
Freud, S, 1910. "The Origin and Development of Psychoanalysis", first published in American Journal of Psychology, 21,
181-218. Retrieved Nov. 1, 2006, from http://psychclassics.yorku.ca/Freud/Origin/origin2.htm
ix
Ibid.
x
Ibid.
xi
Jung, C.G., 1948. "On Psychic Energy", CW8.35
xii
Jung, C.G., "Analytical Psychology and 'Weltanschauung'", CW8.702
xiii
Freud, S, 1910. "The Origin and Development of Psychoanalysis", first published in American Journal of Psychology, 21,
181-218. Retrieved Nov. 1, 2006, from http://psychclassics.yorku.ca/Freud/Origin/origin2.htm
xiv
Showalter, E, 1985. The Female Malady, Virago, New York. p145
xv
Freud, S and Breuer, J, 1893. Studies in Hysteria
xvi
Porter, R, 2002. Madness: A Brief History. OUP, Oxford. p167
xvii
Bai, F and Mudie, L, 2006. "East Asia's Mental Health", Healthcare Today. Retrieved Nov. 20, 2006 from
http://www.hc2d.co.uk/content.php?contentId=912
xviii
Szasz, T, 1974. The Myth of Mental Illness. HarperCollins, New York.
xix
Bosely, S, 2006. "Call to wipe out schizophrenia as catch-all tag'. Guardian Unlimited, Oct. 10, 2006. Retrieved Nov. 18,
2006 from http://www.guardian.co.uk/medicine/story/0,,1891740,00.html#article_continue
xx
Carroll, R, 2001. "Interview with Allan Schore, 'the American Bowlby'". Thinkbody.co.uk. Retrieved Nov. 20, 2006 from
http://www.thinkbody.co.uk/papers/interview-with-allan-s.htm
xxi
Modell, AH, 1996. "The interface of psychoanalysis and neurobiology". Paper given to the Boston Colloquium for
Philosophy of Science, Dec. 18, 1996. Retrieved Nov. 20, 2006 from
http://www.psychomedia.it/pm/science/psybyo/modell.htm

*Janet and psychic energy

The psychological analysis of Pierre Janet described a system of psychic energies held in tension
between hierarchies of mental activity. At the bottom of the tree, psychic energy was confined to the
expression of reflexive tendencies like attraction, repulsion, incorporation or excretion. These actions
might be simple or more complex, but the energy would be used until the chain of events was
complete, and therefore not available for other modes of functioning. He describes epileptic seizure as
a regressive return to this level of activity. The next stage of functioning, 'perceptive-suspensive',
requires the ability to suspend action during a chain of events, suggesting a basic capacity to play a
game, even if that game is the game of life itself. At the social level of functioning, two channels of
action become apparent; the diversion of energy towards others in the social group, and its diversion
towards one's own body. Janet also observed close interactions between the two systems, and saw them
as having a strong effect on the emotional life of the individual. His observations have been borne out
by attachment theory and still more recent neurobiological understanding of the relational basis of brain
development and affect regulation. The 'middle' functions occupied a great deal of Janet's attention,
especially the level he termed 'elementary intellectual tendencies'. This staged is concerned with double
signals (often of form and function) contained in things, but also in the capacity to represent things in
language. The capacity both to participate and to observe is important at this stage of psychic
organisation, and to switch between the two. Moreno's work on psychodrama can be seen as a journey
to recover this capacity, as the tension between observatory and participatory modes gets harder to hold
as mental functioning becomes 'higher'; that is, more rational and objective. The first level of Janet's
higher functions describes further complexities, as the ability of language to detach itself from the
world is experienced. One of the characteristics of this stage is the ability, as Tolkien would say, to say
'green sun'. Janet calls this inconsistent language. He shows how language exacerbates the difference
between the individual's experience of themselves and their interaction with the world. He also
describes a difference between the ease of saying something ('talk is cheap'), and the act of affirming it
to oneself, or in bringing it to action in the world. This stage is called 'immediate actions and assertive
beliefs' and is linked closely to the development of will and thought. It is also the point at which
psychological life exists through persona roles and projections onto others, in Jungian terms. The
rational-ergetic stage is the level where the human world becomes truly separate from the animal, with
organisational structures and logic which are carried through often for no other reason than that they
exist. Real world experience is reintegrated with the emergence of scientific enquiry at the next,
'experimental', stage, while the best a human being can be begins with the emergence of a reflective
capacity.
At this level, many of the themes of the earlier levels are recapitulated, like the ability to stand more
than one viewpoint. Except that, this time, different levels of psychological reality are held in tension
and synthesised. He describes the 'complete real' the synthesis of which requires the affirmation,
through reflection, of the existence of corporeal and non-corporeal bodies. The former are endowed
with material form; the latter with intentionality. In the 'almost real' mode, the individual is making use
of a sensitive feedback mechanism, in a state of constant adaptation. Janet calls this process 'self-
reporting'. And in the 'semi-real', abstract ideas, fantasies, recent memory and predictions for the near
future are brought into play. This most complex stage of psychological development Janet called
'progressive tendencies', and linked it to the refinement of consciousness.

Janet saw psychological problems in terms of the individual's ability both to draw upon a supply of
psychic energy, and to maintain it at levels of ever-increasing complexity, without losing the force
necessary to contain the raw energy, or without the supply being insufficient to stay at the level already
achieved. He describes an evolutionary, bottom-up and adaptive process of ever-increasing complexity,
which is open-ended and sensitive to its environment. Janet also emphasised the dissociative capacity
of a psyche in which the supply of energy was out of keeping with the level of tension needed to give it
form. Many of his themes were taken up by Jung, who developed them further throughout his long
elaboration of the principle of the tension of opposites. They would be recognisable to many who work
with notions of complex, emergent and ecological systems across a number of disciplines today.