As we are getting further from the 20th century many historical facts become clearer and clearer. Looking at the past century in perspective helps us to figure out our way forward. Jung and Frankl urged humanity to assimilate the devastation of the two World Wars by taking personal responsibility, and become aware of our projections, such as nationalism. They insist that reason is not enough to prevent future tragedies. These post-World War issues were never dealt with by humanity, just swept under the rug, as in the second half of the 20th century psychiatry identified with psychopharmacology. Moreover, psychology's self-imposed limitation to the cognitive domain alone, neglecting the study of emotion or introspection is setting the stage for the 21st century repetition of history. The idea is that the current trajectories of both psychiatry and psychology are unsustainable as they direct us towards polarization, thus opening the way for the terrible enantiodromia. The events world-wide such as geographical fragmentation and failure of the nation states are proofs that we, humans have not dealt with our dormant demons.

1. Jung, Frankl
and the 20th
century
psychiatry
Can psychiatry be misused
again?
Adonis Sfera, MD

2. 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.

3. 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.

4. 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

5. 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.

6. 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.

7. 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)

8. The archetype
 The archetype = object + emotion
 The archetype is both subjective and objective

9. The archetype of the nation

10. 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

11. The cult of the nation

12. From modernity to madness

13. The demise of European Empires
Far-called, our navies melt away;
On dune and headland sinks the fire:
Lo, all our pomp of yesterday
Is 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.

14. 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.

15. The aftermath

16. Soul Searching

17. 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.”

18. And the inner
Jung and Frankel: the soul and the meaning

19. Extracting meaning out of chaos

20. Enantiodromia
Civilized
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.

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

23. 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

24. 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.

25. Meaning = Freedom

26. 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).

28. The future

29. 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).

31. 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

32. 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.

33. 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

34. 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.

35. Prevention in chronic psychosis
 In utero brain development is affected in chronic
psychosis:
-neuronal proliferation
-neuronal differentiation
-neuronal migration
-synapse formation
-myelination

36. 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

37. 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”

39. C. G. Jung Institute in Zürich