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Clients With Serious Mental Health Issues

Jung began his practice working with seriously mentally ill psychiatric inpatients. Therefore, his theory and the interventions are designed to work well with them. Word association tests, the Rorschach Inkblot Test, and the TAT are projective tests that are frequently used by psychotherapists as part of their assessment and treatment of clients. These instruments are described in detail later in the chapter.

Jung believed that major psychiatric disorders had their roots in brain-based biochemical disorders (Jung, 1909). He believed that psychoanalysis is ineffective without medical intervention. His beliefs were confirmed in the 1950s when Swiss physicians stumbled onto the use of MAOIs (monoamine oxidase inhibitors) as treatment for depression (Satinover, 1995).

Borderline Personality Disorder

People with borderline personality disorder have many characteristics in common. They tend to be emotionally labile, with wide swings of emotions from feeling joyous to feeling intense anxiety and anger. They also show high degrees of impulsivity with potential self- injurious behavior and a strong potential for substance abuse. They have distorted thinking that in extreme cases may be to the point of delusions. This highly unstable pattern of behavior is marked by mercurial shifts in attachments and relationships and changes in career paths, with a negative impact on their financial situations and most areas of their lives (American Psychiatric Association, 2000).

With clients exhibiting these problems, the Jungian analyst would interpret these thoughts, feelings, and behaviors as occurring as a result of dissociation of the clients' conscious and collective unconscious. Some of these characteristics would be interpreted in relation to archetypes that are clamoring to be expressed but are instead repressed. The goal of therapy would be to reintegrate the disowned parts into one functioning personality. The therapist would use case history, word association, analysis of transference and countertransference, assessment of types and attitudes, analysis of dreams, and talk therapy (Sander & Beebe, 1995). Psychiatrists would recommend medication in situations in which medication would relieve some of the problematic behaviors associated with borderline personality disorder (i.e., impulsivity, unstable mood, and/or delusional thoughts; Satinover, 1995).

Psychosis

Clients who are psychotic manifest a lost touch with reality. Jung (1909) believed that psychosis is a biochemical brain disorder. From a Jungian perspective, the therapist would explore the client's belief systems, case history, conscious and unconscious, and transference and countertransference. The therapist would analyze the symbolic meaning of the delusions, hallucinations, fears, and anxieties. The Jungian would also use assessments such as word association tests and the TAT to uncover pervasive complexes. The therapist would also attend to dreams as they relate to the client and analyze them to add more information about what the client is experiencing. The therapist would also encourage the appropriate use of psychotropic medications for the alleviation of psychotic symptoms (Satinover, 1995).

Major Depression

Jungian therapists believe that depression is most likely to occur with perfectionist clients. Therefore, they would investigate complexes relating to inferiority, as well as archetypes that are perfect and heroic beyond mortal capacity. People with depression are also likely to be weighed down. Therefore, special attention would be paid to symbols and metaphors related to weight and mass. People who are depressed also trap their energy and sometimes turn it on themselves. Therefore, the role of the therapist is to discover where this energy is trapped, and then release it so that it is directed away from the individual (Samuels, 1991). Because of the increased risk of suicidal behavior, the therapist must be sensitive to self- injurious threats and communication of symbols of death. Some clients may require hospitalization to protect them from self-harm (Sander & Beebe, 1995). Jungians also advocate for the use of psychotropic medications for the treatment of endogenous major depression. When Swiss physicians discovered that MAOIs treated depression in the 1950s, Jung's belief in brain-based roots for psychiatric disorders was confirmed (Jung, 1909; Satinover, 1995).

 
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