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Journal of the History of Ideas.
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BY CHRISTOPHER GILL
Storr to the approach sometimes called 'ego psychology'; see n. 15 below for other
approaches.
307
which is neither passive nor overtly active. The therapist tries to avoid
taking the place of the patient's autonomy (by explicit advice or instruc-
tion), but nonetheless suggests, by questions and implicit guidance, ways
in which the patient may develop his own autonomy. The therapist plays
a role, as a person, in the therapeutic process: he often is, and should
be, the object of 'transference', that is, someone to whom the patient
'transfers' feelings of love and hate which are related to the 'working
through' of his problems. But this is a role he plays not as an individual
but as a therapist; the process is not designed to bind the patient emo-
tionally to the therapist, but to enable him to develop normal relations
outside the therapeutic context.
In summarizing Storr's account of psychotherapy, I do not wish to
suggest that I regard his psychiatric method as necessarily ideal or nor-
mative.3 In fact, I will have occasion to refer to psychiatric methods
which are rather different from Storr's later in this article. But it is useful,
nonetheless, to have a fairly representative statement of what is meant,
in contemporary usage, by 'psychotherapy', as a reference point for com-
parison with what we find in the Ancient World; and it is for that reason
that I have summarized Storr's account.
As well as giving a specific answer to the question whether psy-
chotherapy, in this sense, or anything closely resembling it, did or did
not exist in the Ancient World, I am interested in seeing how discussion
of this question bears on the comparative 'mapping'of ancient and modern
practices. I am also interested in demarcating the various conceptions of
the self that the ancient and modern practices in this area presuppose.4
The question of comparative 'mapping' is one of immediate importance.
For I take it as obvious that there is nothing in the Ancient World exactly
like the psychotherapy Storr describes; there is no class of persons whose
profession corresponds exactly to that of modern psychiatrists and psy-
chotherapists.5 To identify the nearest equivalents to modern psycho-
therapy, we need to look at the borders of certain ancient areas, the
borders of religion and medicine, on the one hand, and of medicine and
philosophy, on the other. I hope the remainder of this article will make
it clear why I think these areas are the most important ones to examine
for this purpose.
3 Storr himself sees the method as best suited for the treatment of neurosis rather
than psychosis (160ff); although the psychotherapeutictreatment of psychosis is advocated
in, e.g., Bertram P. Karon and Gary V. VanDenBos, Psychotherapyof Schizophrenia:
The Treatment of Choice (New York, 1981).
4 I discuss another aspect of this subject in "The Question of Character-Development
in Plutarch and Tacitus," Classical Quarterly, 33 (1983), 469-87.
5 Cf. Walther
Riese, "An Outline of a History of Ideas in Psychotherapy," Bulletin
of the History of Medicine, 25 (1951), 442-56, Bennett Simon, Mind and Madness in
Ancient Greece: The Classical Roots of Modern Psychiatry (Ithaca and London, 1978),
217.
1951), 35-37; G.E.R. Lloyd, Magic, Reason and Experience: Studies in the Origin and
Development of Greek Science (Cambridge, 1979), 40ff., and Robert Parker, Miasma:
Pollution and Purification in early Greek Religion (Oxford, 1983), esp. chaps. 7-8.
them.13 Some of our evidence suggests that people with particular psy-
chological problems were attracted to particular rituals (the irrationally
frightened were drawn to the Corybantic rites, for instance) and found
them satisfying.14 But, in the rites themselves, there does not seem to
have been any overt attempt to explore the individual's problems or to
rebuild his confidence.
In this respect, then, there seems to be rather little in common between
the methods of modern psychotherapy and ancient rituals of the Cory-
bantic type. However, it is worth noting that there are some types of
modern psychotherapy which are much closer to the ancient rituals. In
the United States, in particular, alongside the standard types of psycho-
analysis and psychotherapy, therapeutic methods have been developed
which lay much less emphasis on the verbal exploration of the patient's
psychological state and much more on the discharge of emotion in ex-
pressive physical action.'5In some methods, the use of dialogue is omitted
altogether; and the treatment consists entirely of attempts to find the
kind of physical action (for instance, muscular relaxation, violent gestures,
screaming) that gives the patient emotional release. This type of therapy
is often conducted in groups, and the mutual excitement generated by
the group is an important factor in inducing the patient to relax his
normal constraints and express himself physically.'6This type of therapy
is much closer to ancient rituals of the Corybantic type. Indeed, some
psychotherapists of this type are interested in these ancient practices, as
well as in similar practices in contemporary undeveloped cultures, re-
garding them as prototypes for their own methods.'7However, it is worth
examining precisely how close these parallels are. It is clear that both
ancient and modern methods provide some kind of expressive action
which gives emotional release. However, the personal and psychological
content of the modern practice is much more important and overt than
it was in the ancient rites, as far as we can reconstruct these. The modern
participant is encouraged to find the gestures or movements that help
him relax, to scream out his inmost feelings ('Love me', 'I hate you'), to
'act out' his suppressed urges.'8 Even in treatments where the element
of explicit analysis is very small, the therapeutic context (and the prev-
alence, in American culture at least, of a psychotherapeutic approach to
personal life) predisposesthe participantto think in terms of his individual
13
There were, of course, different roles within the ceremony (e.g. ministrant, initiated
worshipper, candidate for initiation), but the performance of these roles does not seem
to vary in ways that reflect the individual psychology of the participant.
14Cf.
Dodds, op. cit., 78-79.
'5 Michael P. Nichols and Melvin Zax, Catharsisin Psychotherapy(New York, 1977).
16
Nichols and Zax, Chaps. 5 and 7.
17 Nichols and Zax, Chap. 2.
18
Examples from Nichols and Zax, 109ff., 140, 148-9.
has a strongly personal dimension. Apuleius' hero comes to feel that Isis
cares for him, as an individual; for she not only miraculously changes
his bodily shape (restoring him from ass to human), but attaches as a
precondition a complete change in his way of life. He is to transform his
life, previously dominated by curiosity about magic, into one dominated
by religious devotion, and to reject the sexual pleasures that were formerly
important to him and become celibate.24By non-Christian standards, this
is a striking portrayal of religious 'conversion', and one that places an
unusual stress on the impact of the conversion on the life of the initiate.25
It is not so much the moral aspect of the conversion that Apuleius stresses,
but rather the fascination of the initiate with the religious rituals, espe-
cially the initiation into the 'mysteries' of the cult, and the quasi-personal
relationship he feels he has with the goddess. The underlying idea seems
to be that this religious absorption has 'cured' Lucius of his previous
restless curiosity about magic, and at the same time provided a focus for
his whole life, channelling all his desires into his love for Isis.26It is
difficult to say how far we can draw inferences, from this peculiar piece
of fiction, about the kind of 'psychotherapeutic'help an ancient mystery
religion could provide. But one point that emerges very clearly is that
religious rituals may be apparently impersonal (the Isis rituals are the
same for all worshippers, and the initiation ceremony is the same for all
initiates); and yet they can have an intensively personal significance for
a particular person. Not only do the rituals have an intense emotional
power for Lucius, but they make sense for him (because of the distinctive
role the conversion has played in his life) in a way they could not make
sense for anyone else. Thus, this example, together with that of Aelius
Aristides, should partly qualify our generalizationabout the impersonality
of ancient religious rituals, considered as a form of therapy.27
Folk-psychotherapy'in GreekDrama. -I shall turn shortly from the
borders of religion and medicine to medicine proper, and to its borders
with philosophy. But, first I want to consider briefly some of the evidence
we find in Greek drama, especially tragedy, for what one might call 'folk-
psychotherapy', that is, psychotherapy which is not connected with any
specific discipline or practice, such as medicine, philosophy, or religion.
In an article on the Bacchae, Georges Devereux describes the dialogue
24 Apuleius, Metamorphoses,lines 15; cf. lines 6 and 11, 19. See further G. N. Sandy
and J. Gwyn Griffiths in Aspects of Apuleius' Golden Ass, ed. B. L. Hijmans and R. Th.
van der Paardt (Groningen, 1978), 123ff. (esp. 130-04), and 141ff (esp. 156-58).
25
Cf. A. D. Nock, Conversion(Oxford, 1933), Chap. IX, esp. 155; Festugiere, op.
cit., 77-84.
26
Festugiere notes the inexplicabilis voluptas (Metamorphoses, 11, 24) Lucius takes
in prolonged gazing at the cult statue of Isis, op. cit., 80-84; cf. Gwyn Griffiths (n. 24
above), 156-58.
27 See further, on the personal and psychological significance of folk-rituals, Claude
33The two periods are presented in 1165-1258, and 1271-1301 (esp. 1286ff) respec-
tively. Agave's transition to sanity is brought about during 1259-1270.
34 See Sophocles, Ajax, 31 lff; Euripides, Heracles, 1094ff, esp. 1122; cf. Devereux, op.
37 For other components of the comedy of the scene, see Aristophanes, Wasps, ed.
40Cf. Lain Entralgo, op. cit., 169-70, Simon, op. cit., 215ff.
41 See Jackie
Pigeaud, La Maladie de L'Ame: Etude sur la relation de 'ame et du
corps dans le tradition medico-philosophiqueantique (Paris, 1981), 42-45, 95ff., 124ff.,
Lain Entralgo, op. cit., 161-63. (Here and subsequently I renderpsuche in its more familiar
form psyche.)
42 Cf.
Pigeaud, ibid., 71ff., 122ff., and H. Flasher, Melancholie und Melancholiker in
den medizinischen Theorien der Antike (Berlin, 1966).
43
See Pigeaud, ibid., Chap. I, esp. 32ff.
49 For refs. in Caelius and Celsus, see Pigeaud, op. cit., 109-11, 427.
50 Cf. Dodds, op. cit., 79-80, and nn. 9-11 above.
51 Cf.
Pigeaud, op. cit., 109-112.
52 See
Storr, The Art of Psychotherapy,93-94; cf. Chap. 13.
icine. Stoic 'madness', for instance, does not necessarily manifest itself
to the sufferer in the kinds of distress and anxiety that ancient medicine
saw as symptomatic of melancholy and that modern medicine sees as
symptomatic of neurosis. Nor does Stoic madness necessarily manifest
itself to the observer in the kinds of pronounced abnormality of behavior
that ancient medicine saw as symptomatic of phrenitis and that modern
medicine sees as symptomatic of psychosis. This reflects the fact that the
Stoics, like Plato, did not proceed by accepting the notions of madness
and sanity that were current in their society and then attempting to find
a psychologically richer account of these. Instead, they wanted to revise
these notions, in line with their radical and revisionary moral theories.0
Modern psychotherapists, since Freud, have produced revisionary psy-
chological theories, too; but their theoretical work has developed directly
out of clinical experience of people who already seemed to themselves
or their society to be abnormal or distressed.
Are there any areas of overlap between the ancient medical and
philosophical approaches to psychic illness? Did the philosophers ever
set out to cure people who were 'sick' or disturbed in a medical sense?
Pigeaud argues that we can find evidence for certain kinds of overlap,
particularly with respect to what we call 'neurosis'.61He points to Lu-
cretius' description of the ennui and restless anxiety that afflicted Roman
aristocrats, and of the ways in which they felt 'weighed down' by cares
whose origin was unclear to them. Lucretius sees these feelings as the
symptoms of a 'sickness' whose primary cause is an unrecognized fear
of death. He undertakes to cure this sickness by his teaching; and his
poem constitutes a kind of therapeutic dialogue, designed for this pur-
pose.62 Pigeaud also points to the quasi-therapeutic form of Seneca's De
TranquillitateAnimi. At the start of this work, Serenus describes, "as
though to a doctor" (ut medico, 1, 2) his current symptoms: indeterminate
anxiety, dissatisfaction with himself, inability to settle down to any one
course of action. Pigeaud notes that these symptoms are close to some
of the symptoms of melancholy, as described in medical texts. This
suggests that some ancient philosophers, as well as doctors, recognized
what we call 'neurosis' (that is, anxiety and distress which are not ex-
plained by the external circumstances of a person's life), and that the
60 Plato's account of the tyrannical psyche in Republic, Book IX, might seem a counter-
instance: the psyche, 'maddened' by desire (573a-e), behaves in a way that might be seen
as mad in conventional terms (574d-575a). But Plato did not write the account in order
to analyse conventional madness, but to dramatize his revisionary ethical theories.
61
Pigeaud, op. cit., 513-14.
62Lucretius, 3.1051ff., cf. Pigeaud, op. cit., 205ff., and B. Farrington, "Form and
Purpose in the De Rerum Natura," in Lucretius, ed. D. R. Dudley (London, 1965), 19-
34.
65 In modern
psychotherapy, there is considerable dispute about the nature of the
unconscious and the extent of its power. But to allocate some role (often a large one) to
the unconscious in the determination of behaviour has been characteristic of psycho-
therapy since Freud.
66 For recent appraisals of Freud's conceptions, see Philosophical Essays on Freud,
ed. Richard Wollheim and James Hopkins (Cambridge, 1982), and Ilham Dilman, Freud
and the Mind (Oxford, 184).
67
According to Michel Foucault, Madness and Civilization (New York, 1967), this
attempt was rarely made in modern Europe before the Nineteenth Century.
68
C. G. Jung, Modern Man in Search of a Soul (London, 1933), 120ff.
69 Ancient
'mystery' cults, e.g. that of Isis, typically offered the hope of immortality
of the psyche to initiates. For philosophical exhortations to overcome the fear of death,
see Pigeaud, op. cit., 205-08, 349-53.