Jung on Schizophrenia: An Introductory Survey

Eugen Bleuler is acknowledged by the development of a revolutionary synthesis in the field of the Psychiatry of his time: he elaborated a theory about schizophrenia which, in contrast with the organicist trends prevailing in that period, nowadays could be termed as "organ-dynamic."

Eugen Bleuler is acknowledged by the development of a revolutionary synthesis in the field of the Psychiatry of his time: he elaborated a theory about schizophrenia which, in contrast with the organicist trends prevailing in that period, nowadays could be termed as "organ-dynamic."

In his work of 1911: Dementia praecox. The group of the schizophrenias, Bleuler coined the new term to describe the frightful illness, and he approached a syndromic concept of the same. Bleuler established a fundamental distinction between "primary symptoms" (Disturbances of the thought association, of affectivity, autism and ambivalence) directly produced by an unknown organic process, and the "secondary symptoms," or psychogenic ones, derived from the former. The enlargement of the illness concept and the therapeutical implications of such a new focus gave rise to an intense debate with the Kraepelinian point of view about schizophrenia; this debate turned into a focal point of interest for the psychiatry of this century.

However, to understand the genesis of the Bleuler's work , we have to direct our attention further back. To be exact, we need to consider Moreau of Tours (1845) who was the first to apply the concept "dynamic" in psychiatry. He conceived mental illness as a special world comparable with the oniric one, where the basic fact resided in a modification which entailed the decrease of the intellectual functions and the disproportionate unfolding of vestigial psychic activities. His concepts were expanded to the field of Neurology by H. Jackson in 1874.

It is, however, with the work of Pierre Janet, that the so-called "dynamic theory" reached a first stage of maturity, a starting point for the new psychological trends that would develop across the twentieth century.

In 1889, Janet set up a dual system in which the conscious mind exerted a synthethic function of control over subconscious tendencies that, released from their natural inhibition—as was evident in Neurosis—brought about the so-called "automatisms" (hypnoid states, distractions, obsessions, hallutinations, "fixed ideas," etc.). He discerned two basic types of neurotic disturbances: Hysteria and Psychasthenia, each of them involving "basic symptoms" (the narrowing of the consciousness and the alteration of the"function of reality" respectively) and "contingent symptoms." Contingent symptoms were fundamentally "fixed ideas" of a subconscious character with regard to hysteria, and, on the other hand, ideas that should be conscious in psychasthenia: phobias, obsesions, etc.).

In 1903, Janet expanded his conception of the mind, establishing a hierarchic system based on five levels, from greater to minor complexity. At the top was the "reality function" with its characteristic synthetic operation, "presentification." Below, would be located "disinterested activity"—habitual, indifferent, and automatic actions—and further on , in decreasing complexity, "imagination functions," and finally, the emotional reactions and the muscular movements. The maintenance of a psychic activity as complex as possible required the support of a hierarchical structure of functions with the necessary performance of a "psychological tension" function on the highest level. Janet postulated that the basic phenomenon present in psychasthenia was precisely the decrease of that level of "mental tension." With this decrease the symptomatology reflected the reorganization of psychological functions corresponding to stages of lower complexity.

The system of Pierre Janet was founded mainly on his experiments with hypnosis, and the system constituted a genuine and pioneering psychodynamic theory whose field of application was that of Neurosis.

It can be affirmed after a careful examination that some of the most important ideas of Bleuler with regard to the notion of Schizophrenia are a tributary of the dynamic conception of psychasthenia developed by Pierre Janet (Ellenberger, p. 468).

Evidently, however , there is a great distance in speaking about Neurosis on the one hand and of Psychosis on the other. This move was made by Carl Gustav Jung who in his work of 1907, The Psychology of Dementia Praecox, set up the bridge that would unite the first dynamic conceptions of Janet with the later organo-dynamic theory developed in 1911 by Eugen Bleuler.

As an offspring of intense years of studies with the word-association test, Jung had arrived at the conclusion that the phenomena supporting the apparition of the well-known "automatisms" (Despine, Bernheim, Janet) coincided with the involuntary eruption, in the conscious course of representations, of particular "affects" which usually originated in the vital history of the patient due to traumatic or conflictive events of a different nature. These events had the property of clustering round them, a certain number of thoughts, mental images, and sensations. These ideational contents and affect-constellations were called "Feeling-toned Complexes" (using the term proposed by Ziehen). The "Complexes," which finally would be converted into the foundation of the entire Junguian system, had the following characteristics.

In the first place complexes were firmly rooted in the corporal "inervations," forming a "block" with them, as could be demonstrated by studying the changes in the neurovegetative system that happened concomitantly with its eruption into consciousness. The selfsame "Ego" was considered a Complex, the most firmly rooted complex. The ego complex occupied the highest hierarchic position in the mental life, and its function should include the maintainence of the other complexes under its ascendancy, giving rise to continuity in the conscious process. None the less, it was habitual that the other complexes—whose desirable role would be that of cooperative work together with the voluntary intentionality—would emancipate or separate in a more or less intense way. Such dissociation of the complexes showed that they possessed the capacity of functioning as something like a "secondary psyche," with a strong tendency to reveal themselves as "personified" and with a considerable autonomy. It was even possible to glimpse in them the trails of consciousness (Jung, 1907, 1934, 1935).

Its effects on the word-association test could be described as "complex-reactions" (disturbances in the time of reaction, inadequate responses, etc.).In this way, they were not only a reformulation of the old concept of "automatism", but also ,as Jung thought in 1905, they agreed extensively with the phenomena of repression, substitution and symbolization, described by Sigmund Freud.

In The Psychology of the Dementia Praecox, Jung, in a great synthesis, could demonstrate for the first time a dynamic conception of the illness.

With this purpose, he applied the association test to schizophrenic subjects and saw how the results obtained coincided amazingly with those of other studies performed with normal persons, but in conditions of external distraction (shallowness of association, automatisms, neologisms, stereothypes, perseverations, etc...). This fact led him to postulate, regarding dementia praecox, a factor of internal distraction, which, on the other side , fit well with the concept of "Aperceptive impairment" (Weygandt)—that had been already put forward to explain the illness—and with the other concept of "Abaissement du niveau mental," proposed by Janet as the cause of Psychasthenia. In the way it had been defined, the "Abaissement du niveau mental" bore several characteristics:: the damage of the logical connection of thoughts; loss of the control of whole regions of mental contents with the production of split fragments of the personality; the invasion of the consciousness on the part of contents usually inhibited conscious functioning and, in consequence, caused inadequate or inappropriate emotional reactions.

Jung's findings agreed outstandingly with his experiments of association with neurotic and psychotic patients which revealed abnormally intense ways the presence of the Complexes. His research gave cause for establishing the similarity between certain mechanisms underlying the formation of symptoms in hysteria and the symptoms in dementia praecox (Jung, 1907 pp 62-83).

So then, two parallel phenomena were established with regard to neurosis just like for dementia praecox: On the one hand the existence of "Abaissement du niveau mental" and on the other, the abnormally intense intrusion of "Complexes" into normal consciousness, anintrusion that revealed the dissociation and emancipation of the complexes from the mental hierarchy to be expected in normal subjects.