Perspectives in Biology and Medicine

THERAPEUTIC USE OF SPONTANEOUS IMAGERY SELMA HYMAN* It will assuredly be a long time before the physiology and pathology of the brain and thepsychology ofthe unconsciousareable tojoin hands. Tillthen they must go their separate ways. But psychiatry, whose concern L· the total man, L·forced by its task ofunderstanding and treating the sick to consider both sides, regardless ofthe gulfthat yawns between the two aspects ofthe psychic phenomenon. Even ifitL· not yet granted to ourpresent insight to discover the bridges that connect the visible and tangible nature ofthe brain with the apparent insubstantiality ofpsychicforms, the unerringcertainty of their presence nevertheless remains. May this certainty safeguard investigatorsfrom the impatient error of neglecting one side infavor of the other, and, still worse, ofwaking to replace the one by the other. Forindeed, nature would not exist without substance, but neither would she existfor us ifshe were not reflected in the psyche. [1] Physicians are not unaware of the importance of psychosocial factors in disease. Our problems in addressing them are due to many factors, some inherent in the delivery system, some inherent in the inability of the scientific paradigm to deal with the nonUnear or associative thinking that is linked with emotions and thereby a whole scale of autonomous behavior of psychological and physiological significance. The scientific paradigm requires an appraisal of cause and effect observed with objectivity and confirmed by reproducibility. This lends itselfto quantification and data processing and gives valuable information about disease but tends to take attention away from the person-patient. In a recent paper [2], McMahon concludes that there is an abundant modern Uterature supporting the premodern beUefthat imagination has an arousal function and thus has a connection with psychophysiologic disorders and reviews some of this literature. Donald Sandner, in his beautiful Navaho Symbols ofHealing, places this in context in the following quotations: The practitioners of scientific medicine work with principles and facts, not beliefs . This is their strengdi and also their limitation because diis type of healing,»Address: 2311 N. W. Northrup, Portland, Oregon 97210.© 1983 by The University of Chicago. All rights reserved. 003 1-5982/83/2602-0328$01 .00 Perspectives in Biology and Mediane, 26, 2 · Winter 1983 \ 219 though often effective, is not enough. Scientific fact can never "prove" human values. It may restore the specific organ (and we are grateful for diat), but it does not satisfy die individual in his quest for harmony widi his surroundings and for peace of mind within. [3, p. 17] . . . die doctor . . . who works widi people in distress . . . learns diat man can accept a tremendous amount of legitimate suffering; what he cannot accept is suffering that has no purpose. To be endured and accepted, suffering must be given a meaning. [3, p. 11] These principles have served the main healing function for the entire human race for a period of time mat can only be measured in millennia. They are archetypal forms and as such function outside die sphere of conscious intent, giving rise in every age to new intuitive adaptations to an ever-changing cultural environment. [3, p. 265] Depth psychology as developed by Jung, a path that pursues this direction , has been useful in our radiation therapy practice, adding a dimension to conventional medical patterns of care. Jung postulated an autonomous ordering principle within the psyche, for the most part unconscious, which strives to fulfill a human potential. The autonomous elements of the psyche as well as the body seem to have enormous homeostatic capacities which our intervention can sometimes encourage or simply welcome. Jung recognized psychic patterns, which he called archetypes, common to the human race, as themes in folklore, mythology, art, reügions, and dreams. Whether this is a provable hypothesis is arguable. But it offers an approach to the patient, who in my practice is always confronted with the prospect of death, pain, or mutilation, in a way that recognizes a universal and dignified dimension to suffering, without condescension or presumption. In a culture whose God is often dead, dream image can bring a source of strength that is unarguably beyond will and yet manifested uniquely within the individual. It is a healing agent, whether that healing is a reversal of...