We may well point to the idea of psychic reality as the most important achievement of modern psychology, though it is scarcely recognised as such. It seems to me only a question of time for this idea to be generally accepted. It must be accepted, for it alone enables us to do justice to psychic manifestations in all their variety and uniqueness. Without this idea it is unavoidable that we should explain our psychic experiences in a way that does violence to a good half of them, while with it we can give its due to that side of psychic experience which expresses itself in superstition and mythology, religion and philosophy. And this aspect of psychic life is not to be undervalued. Truth that appeals to the testimony of the senses may satisfy reason, but it offers nothing that stirs our feelings and expresses them by giving a meaning to human life. Yet it is most often feeling that is decisive in matters of good and evil, and if feeling does not come to the aid of reason, the latter is usually powerless. Did reason and good intentions save us from the World War, or have they ever saved us from any other catastrophic nonsense? Have any of the great spiritual and social revolutions sprung from reasoning — let us say the transformation of the Græco-Roman world into the age of feudalism, or the explosive spread of Islamic culture?

As a physician I am of course not directly concerned with these world-questions; my duties lie with people who are ill. Medicine has until recently gone on the supposition that illness should be treated and cured by itself; yet voices are now heard which declare this view to be wrong, and demand the treatment of the sick person, and not of the illness. The same demand is forced upon us in the treatment of psychic suffering. More and more we turn our attention from the visible disease and direct it upon the man as a whole. We have come to understand that psychic suffering is not a definitely localised, sharply delimited phenomenon, but rather the symptom of a wrong attitude assumed by the total personality. We can therefore not hope for a thorough cure to result from a treatment restricted to the trouble itself, but only from a treatment of the personality as a whole.

I am reminded of a case which is very instructive in this connection. It concerns a highly intelligent young man who had worked out a detailed analysis of his own neurosis after a serious study of medical literature. He brought me his findings in the form of a precise and well-written monograph fit for publication, and asked me to read the manuscript and to tell him why he was not cured. He should have been according to the verdict of science as he understood it. After reading his monograph I was forced to grant him that, if it were only a question of insight into the causal connections of a neurosis, he should in all truth be cured. Since he was not, I supposed this must be due to the fact that his attitude to life was somehow fundamentally wrong — though I had to admit that his symptoms did not betray it. In reading his account of his life I had noticed that he often spent his winters at St. Moritz or Nice. I therefore asked him who paid for these holidays, and it thereupon came out that a poor school-teacher who loved him had cruelly deprived herself to indulge the young man in these visits to pleasure-resorts. His want of conscience was the cause of his neurosis, and it is not hard to see why scientific understanding failed to help him. His fundamental error lay in his moral attitude. He found my way of looking at the question shockingly unscientific, for morals have nothing to do with science. He supposed that, by invoking scientific thought, he could spirit away the immorality which he himself could not stomach. He would not even admit that a conflict existed, because his mistress gave him the money of her free will.

We can take what scientific position we choose, there remains the fact that the large majority of civilised persons simply cannot tolerate such behaviour. The moral attitude is a real factor in life with which the psychologist must reckon if he is not to commit the gravest errors. The psychologist must also remember that certain religious convictions not founded on reason are a necessity of life for many persons. It is again a matter of psychic realities which can cause and cure diseases. How often have I heard a patient exclaim: “If only I knew that my life had some meaning and purpose, then there would be no silly story about my nerves !" Whether the person in question is rich or poor, has family and social position or not, alters nothing, for outer circumstances are far from giving his life a meaning. It is much more a question of his unreasoned need of what we call a spiritual life, and this he cannot obtain from universities, libraries, or even churches. He cannot accept what these have to offer because it touches only his head, and does not stir his heart. In such cases, the physician's recognition of the spiritual factors in their true light is vitally important, and the patient's unconscious helps him in his need by producing dreams whose contents are undeniably religious. Not to recognise the spiritual source of such contents means faulty treatment and failure.

General conceptions of a spiritual nature are indispensable constituents of psychic life. We can point them out among all peoples whose level of consciousness makes them in some degree articulate. Their relative absence or their denial by a civilised people is therefore to be regarded as a sign of degeneration. Whereas in its development up to the present psychology has dealt chiefly with psychic processes in the light of physical causation, the future task of psychology will be the investigation of their spiritual determinants. But the natural history of the mind is no further advanced today than was natural science in the thirteenth century. We have only begun to take scientific note of our spiritual experiences.

If modern psychology can boast of having removed any of the coverings which concealed the picture of the human psyche, it is only that one which hid from the investigator its biological aspect. We may compare the present situation with the state of medicine in the sixteenth century, when people began to study anatomy but had not as yet even the faintest idea of physiology. The spiritual aspect of the psyche is at present known to us only in a fragmentary way. We have learned that there are spiritually conditioned processes of transformation in the psyche which underlie, for example, the well-known initiation rites of primitive peoples and the states induced by the practice of Hindu yoga. But we have not yet succeeded in determining their particular uniformities or laws. We only know that a large part of the neuroses arise from a disturbance in these processes. Psychological research has not as yet drawn aside all the many veils from the picture of the human psyche; it remains as unapproachable and obscure as all the deep secrets of life. We can speak only of what we have tried to do, and what we hope to do in the future, in the way of attempting a solution of the great riddle.

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