The Necessity of Pathos to Build a Bridge Between Soul and Medicine

“There is a God behind whatever happens” (Hillman, 1978, p. 152).

***

You are not crazy. There is nothing wrong with you. There is nothing to get rid of. This feeling is supposed to be here. Your experience is a healthy response to unhealthy circumstances. It is not wrong. You are not wrong. Give it space. You are not being punished. You are exactly where you are supposed to be. You want a medical answer — an explanation — but you cannot find it… This is soul-making. This is soul. These are the gods.

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Introduction: My Story

The following is both a personal and archetypal account of the experience of emotional and psychological darkness, also referred to as depression. It is also an account of an attempt to shift my perspective of physical illness and suffering from one of being a victim to it to understanding and living with the soul of it. It is a transition from understanding my physical experience from rational/medical to archetypal. This is my journey with chronic health, the worst of which gravitate around digestive disorders and nourishment. I hesitate to solely use the word depression for what I am speaking about as I feel that it is not enough to express the all-consuming rapture of being swallowed by darkness. This is where physical, emotional, and psychological, meet. This is also where they meet soul. It is an experience, but also a real place, with its own richness and texture. This paper is also an exposition of the detrimental approach of modernity and western medicine on the experience itself. In the second half, I will explore this phenomenon primarily through James Hillman’s four moves of soul-making as well as the work of Alfred Ziegler.

My journey here has been induced by chronic physical ailments and health concerns that have continued to waver in intensity for over a decade, but most prominently problematic over the past year and a half. There has been nowhere to hide. I understand this as an encounter with soul — the need to find soul in the suffering, to track the movements of soul in each symptom, each flare-up, each dreary, thick cloud of a day with its feelings of hopelessness. I tirelessly try to continually remember soul and its movements within the physical disaster, but the symptoms get so loud that it can feel impossible. Furthermore, what is difficult is that there are no medical models or practitioners that can hold my experience in both of these realms, and guide my journey, reminding me that the gods are here too. This integration is also lacking in my culture, in my society, in my context. When there is not a context or place for our experience, it becomes crazy. I lose sight when it gets too painful, and I feel that there is a big problem. Self-pathology. I receive unsolicited and unhelpful advice about how I should just be positive and change my perspective. “It’s all up to you whether you suffer,” they say. “You should learn to love yourself, then you won’t feel bad,” or a more classic “some part of you must be resisting health and happiness.” At that point, I am drowning in more pathology — internal and external. Until the next somatic hit where I feel the gods pulse through me and I remember that there is perfection in this too. The weight of my ancestor’s trauma is sitting in my gut, in my throat. My daemon is in my gut. This is perhaps the most kairotic moment of my life.

This story has been a dance. It is an ongoing dance. At the core of my being, I have known that my suffering and illness are much more than physical and in service to soul. Soul is perhaps the only thing, place, being that has made sense to me since I was a child. It has been the only home that has felt true and trustworthy. Yet, I have been stuck. I have not understood how to reconcile trusting soul and yet simultaneously feel pain and constriction in my body, as though my body is attacking me. I have found myself in this ongoing tension. James Hillman (1975) has spoken about this complex perspective:

It has been said that the peculiar conditions of the soul and the complaints it presents may not be sickness in the medical sense… Slowly we have been led to conclude that perhaps these conditions that we have been calling psychopathologies are not true pathologies in the medical sense. (p. 56)

Do I trust the symptoms? Do I trust the depression? Do I trust the gods and this moment? The result of this dance has been a dark cocoon of intensity, uncertainty, and a living in what has felt like a mostly dark cave. It is this image that contains this experience. This cocoon is also my offering to others. This is my story.

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It is dark in here. The walls are closing in. Suffocation. No hope. Melting. Dissolving. Nothing to do. No energy to do it even if there were something to do. Do I let it take me? Do I fight this? I am dissolving. Dissociating from what I know. Dissociating from feeling. I am depleted from feeling this for so long. The night has swallowed me and chewed me up. Contraction. Constriction. I feel the weight of Saturn in my bones and in my mind — a massive boulder pressing on my chest. Saturn pressing himself onto me with slow, deliberate force. My body hurts. I am exhausted. I can’t eat. I need to eat. Pain. I am in pain. The old patterns and behaviors want to come in. They are the ones that created this in the first place. I can’t bear my thoughts anymore. Anxiety. So much anxiety. I can’t see a way through that this works out. How do I get out of this loop with my body, with my mind? The more I think about it, the darker it becomes. This is a long, dark night. Can anyone hear me? Can anyone see me? This feeling is like death. I wouldn’t wish it on anyone. I am not sure what is worse- being deep in it, or the ability to witness myself deep in it. Can I curl up and disappear? Nothing in my body is functioning. I’m in pain. I feel like my body keeps coming to a halt, and/or trying to burst but cannot. What does that lead to? Implosion.

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I have lived with a gnawing sense of wrongness in my body for as long as I can remember. This wrongness has been housed in both my soma and psyche. I felt it as a child when I would look around and see the neurosis in each of my family members, all pretending that nothing was wrong. I could feel it in their stories. Their lives perpetually cracked and broken by genocide and the incessant compulsion to re-create displacement. To where did I belong? And to whom? I was born into the hands of adolescent immigrant parents a short month after their transition to the United States who themselves were in deep need of parenting. I did not yet know that I would embark on an endless and excruciating quest for belonging which was about much more than finding a physical home, but also belonging in my body and mind, belonging to soul, and a place where they all meet.

I have spent years starving myself. Longing for nourishment, yet enacting anything but that. I may think that I am in a dark cave now, but in fact, this is the opening. I have been in a dark cave for as long as I can remember. Habits, addictions, coping mechanisms all to keep together a system that was built on a shaky foundation and protecting my smallness. I have lived in this cave for too long. It is only now, when I begin to take steps toward the light, that I can truly reckon with the darkness I have been in. It has been my soul guide and I have had to take some significantly tumultuous paths to become who I am meant to be. It has taken many years of pain, fatigue, losing my hair, the inability to eat “normally”, a wrecked digestive system, crippling anxiety, and much more. There must be a purpose behind this, mustn’t there? Hillman (1975) said that “madness teaches the method” and I think that now, I understand what this means (p. 75). There is a common phrase that is thrown around often, trust your gut. Well, that’s exactly what I am attempting to do, but the situation has been set up such that I have had nothing to trust about my gut. Instead, I have felt as if there is a creature living in there, in here, and it is not happy. The daemon is in my gut. How do I learn to listen to it? I have been trying to get rid of it, rather than asking it what it wants, what it needs, and why it’s here. I built the dark cave around it. The very cave I have felt imprisoned by and stuck in.

***

The Darkness speaks: You do not understand me. I am not here to hurt you, though I have that power, and it may seem like I am. What you know about pain is anemic. What you believe about darkness is blinded. It is missing its nutrients. You might believe you feel lifeless because of me, but I am the embodiment of life. I am very alive, coursing through you. You’ve been taught to get rid of me. That I am the problem and I am in the way of your health and happiness. You’ve heard that I am wrong. This experience must be a mistake. You are told that once you get rid of me, you will be better. What if I am your pathway to health and wholeness? What if you need me? What if nothing is wrong? Can you consider the perfection in this? Can you sense the seed of possibility I carry? What if the utter sense of loss comes from the battle with me, from exhausting yourself trying to get rid of me?

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Depression and Psychological Darkness

Depression. What have you heard of it? My guess is that you have heard that it indicates some kind of issue or problem to solve. Perhaps it should be medicated, numbed. It is a nagging feeling that gets in the way of truly living life. Now, I do not underestimate the seriousness of depression in the slightest. I believe it is more serious than I observe my western culture consider it to be. My thesis here is to create an invitation for another perspective. The American Psychiatric Association and the DSM (Diagnostic Statistics Manual) define depression as:

Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities you once enjoyed. It can lead to a variety of emotional and physical problems and can decrease your ability to function at work and at home. (American Psychiatric Association, 2013)

Depression can be induced by physical and chronic health issues. Hopelessness and despair can result from the ongoing discomfort and suffering, and losing sight of possibility. Depression is diagnosed from a number of the following symptoms: ​​sadness, loss of interest in once enjoyed activities, changes in sleep, appetite, energy levels, restlessness or slowing of speech, worthlessness, and guilt, difficulty with thinking and concentration, and suicidal ideation. They use mainly surface level, practical, symptoms to define depression. What about meaninglessness? What about losing color in one’s life? What about a lack of imaginal thinking? What about losing the connection with soul, with the gods, with a greater whole?

But, have you heard depression (or health-induced suffering) described as a living, breathing entity? Or maybe a rich and fertile terrain with creatures, textures, and sounds? I imagine not. “Depressed individuals also present with irritability, brooding, and obsessive rumination, and report anxiety, phobias, excessive worry over physical health, and complains of pain” (American Psychiatric Association, 2013). True as these may be, these are the symptoms of deeper issues cropping up in whatever way they can to get attention. Depression is a type of descent. It takes us down into underworld territory. As Hillman (1989) said, “Underworld fantasies and anxieties are transposed descriptions of psychic existence” (p. 47).

When speaking of the issues with the traditional psychotherapeutic model and its lack of understanding of depression, Hillman (1971) stated “this model fundamentally devalues the existential importance of depression and the descent into dissolution per se. Downward phenomena are good, not in themselves, but rather because they offer hope for resurrection” (p. 203). I find this sentiment pertinent, as implicated in it is the belief that within the descent is the seed for resurrection, transformation, and rebirth. Hillman-influenced soul-activist and psychotherapist, Francis Weller, shared a story of a man who had just experienced a heart attack. The man asked Weller to help him return to the way things were before the heart attack. Weller’s response was “why would you waste a perfectly good heart attack trying to go back?” (Weller, 2018). This example is valuable as it implies a greater purpose and possibility in the physical affliction. It insinuates that there might be wisdom to it, and the need to trust it, perhaps even to engage with it as an entity. We might ask “what do you want from me, heart attack?” or consider its voice, shape, story, and purpose.

Hillman (1975) stated that “pathologized events must necessarily be central to soul and therefore must be essential to any psychology that bases itself upon soul” (p. 55). This statement speaks to the very core of my thesis here; that what is deemed pathology is actually a necessary component in our lives. “Everything matters to soul” (Hillman, 1975, p. 80). Our pain and suffering is, in a sense, a stepping stone in our journey of becoming ourselves. Later, Hillman (1975) expressed that “pathologizing must be met by imaginal thinking rather than clinical thinking” (p. 79). Through an imaginal approach, the former is possible. Our symptoms are asking for curiosity and participation rather than a clinical interpretation and diagnosis. For example, Hillman (1971) spoke about depression in a way that paints the various possibilities to personify (or animate) the phenomenon:

Depression, say, may be led into meaning on the model of Christ and his suffering and resurrection; it may through Saturn gain the depth of melancholy and inspiration, or through Apollo serve to release the blackbird of prophetic insight. From the perspective of Demeter depression may yield awareness of the Mother-Daughter mystery, or, through Dionysos, we may find depression a refuge from the excessive demands of the ruling will. (Hillman, 1971, p. 198)

My sense is that countless individuals would benefit from a medical model which could invite them into this type of inquiry — to personify their symptoms. It is difficult to imagine that such a model would not change the collective perspective of depression and darkness as well.

Pathological Pathologizing

“When we are told what is healthy we are being told what is right to think and feel. When we are told what is mentally ill we are being told what ideas, behavior, and fantasies are wrong” (Hillman, 1975, p. 77).

Through his concept of pathologizing, Hillman (1975) posited that “the psyche’s autonomous ability to create illness, morbidity, disorder, abnormality, and suffering in any aspect of its behavior and to experience and imagine life through this deformed and afflicted perspective” (p. 57). Pathology and archetypes are two sides of the same coin. Behind every pathology lies an entire archetypal world and archetypal phenomenology.

In his book, Archetypal Medicine, Alfred Ziegler put forward an understanding of health, physical illness, suffering, and medicine which turns on its head most of what conventional medicine preaches. Ziegler, influenced by Hillman, took the pathologizing concept even further into specificity. By getting to the heart of the many contradictions and oppositions of human experience, Ziegler uses them to propose an alternate experience to suffering. “Archetypal medicine turns up images that carry the symbolic essence and are accompanied by a perceptible physical resonance” (Ziegler, 2005, p. 1). Ziegler’s entire premise lays on the foundation that the human being is a chimera, “a monstrosity composed of an indeterminable number of contradictions” (Zieglear, 2005, p. 7) and in this chimera-like existence, we skillfully and soulfully come upon ways to enact our own purposeful destruction through illness. “Nature needs disease to maintain her chimerical balance, grasping in her unpretentiousness whatever will serve her purpose… Each of us has his own, unique murderer” (Ziegler, 2005, p. 19). In this sense, we manifest physical symptoms to keep us connected to our morbidity.

All of these ideas beg the question, which Ziegler also raised, when did we decide that health looks a particular way? When did culture decide that illness and suffering were not actually a part of health? Ziegler (2005) expressed “illness is no isolated occurrence. Rather, it is brought about by a particular emphasis on health, an emphasis that serves self-seductively in its compulsive and limiting nature” (p. 11). In a Jungian sense, we might say that these so-called ‘pathological’ conditions and symptoms are manifestations of a cultural shadow — parts of the psyche we deny, avoid, hide, and repress. What if the fact that these experiences (physical, emotional, and psychological symptoms) are pathologized is what breeds more of the symptoms? We end up with an ouroboros of symptoms. In my personal experience, this is devastatingly true. When I feel bad in my body and my mind, I begin to feel shame about feeling this way. The result is feeling even worse than I started because I cannot get myself out of feeling terrible and feeling terrible about feeling terrible. I am caught in a feedback loop that is perpetuated by the world around me, and anyone I seek support from. This is a maddening cocktail. A recipe for psycho-spiritual-social disaster.

So, it seems we are led to another one of depth and archetypal psychology’s paradoxes. How does one hold the tension of feeling bad, feeling pain, not wanting to exist, and knowing that it is perfect, that there is nothing wrong per se about being in this experience? Ziegler (2005) stated “by coming to grips with the perplexities of psychic disorder, symptoms, and suffering, our hope is to gain a new purchase upon the psyche’s pathologizing tendency so as to comprehend it from another angle” (p. 55). This is the work of creating an archetypal medical model. It is an existential riddle, but I believe it is possible. I believe there is an archaic part of us that knows how, we just need to re-member.

A World Afraid of the Dark

It isn’t any wonder why the individual is terrified of the dark when the very culture in which they exist avoids it at all costs. There are countless ways that modernity, with its obsession with progress, denies, oppresses, and represses anything that might threaten its fast pace and forward and upward movements. Depression. Darkness. Melancholia. Grief. Soul. These all carry the quality of descent, and more importantly, a pause. A halt. A reconsideration. Even the word itself and the way it sounds: Depression. Depressed. Deep rest. It asks us to stop, slow down, re-evaluate. Can you imagine a capitalist, consumerism-obsessed culture taking a ‘deep rest?’ The word depression is also used synonymously with ‘decline’ or ‘standstill’ when referring to the trajectory of something like the economy. It also refers to a sunken area on some type of surface, as if something were pressed down onto it. Remember the boulder pressing down on my chest?

I do not need to preach much further to get to the point. Depression, or slowing down in any capacity, threatens the very foundation of modern, industrial, capitalist culture. If you can’t keep up, then something must be wrong with you. If you don’t want to play along, again, something must be wrong with you. If your body is giving you proper cues that this is intolerable, inhumane, mechanical, and draining, shouldn’t that be taken seriously? Instead, we breed shame. Pathology galore. Through Hillman’s practice of psychologizing, we are getting to the heart of the matter. “Psychologizing tries to solve the matter at hand, not by resolving it, but by dissolving the problem into the fantasy that is congealed into a “problem” (Hillman, 1975, p. 135). We find that there are all kinds of cultural norms and expectations, operating systemically at levels far beyond consciousness, which keep this pathology alive. It is a “system which must find illness in order to promote health and which, in order to increase the range of its helping, is obliged to extend the area of sickness” (Hillman, 1975, p. 77). Even the helping professions, the dedicated healers, are playing along. Again, we see clearly here the perpetual feedback loop of pathology.

One could easily study pagan traditions, indigenous cultures, animism, goddess worship, or any belief system or worldview which is/was founded on a connection with the feminine and with the natural world to discover deeper wisdom. We would find a profound appreciation, even worship, of the darkness as it was typically associated with fertility, the womb, transition, and the place of possibility. Even Ziegler alluded to this when he described a more ancient perspective of disease. “Turning away from diseases as entities and toward diseases as images is almost an anachronism, a kind of medical regression to an epoch before rational, scientific research when diseases were spoken of in images” (Ziegler, 2005, p. 22). Additionally, we could conclude that the rise of a patriarchal culture and worldview has had a significant impact on the way the collective understands these dark periods.

Beyond their relationship with the darkness, mental health and depression are understood within an entirely different context in these traditions and cultures. It is significantly more aligned with that of archetypal psychology, and shamanic and mythopoetic purpose behind every part of reality — even the challenging parts. Trauma and addiction specialist, Gabor Maté (2017), has spoken of the perspective of the Lakota people on illness. He explained that in Lakota culture when an individual is sick, the entire village thanks them for carrying something big for their people, and their world. It is considered an intervention from spirit, and that the person is manifesting the grief and trauma of the entire village through their body. It is not tragic. They believe the individual was chosen for this. This is their place and their people hold them in great esteem, with much care.

In Greek mythology, Thanatos is the embodiment of death. He is considered to show up and carry individuals into the underworld during times of darkness. We also have Hades, or Pluto, the lord of the underworld himself, and god of the dead. These two often get confused or combined into one figure. In regards to Hades, Hillman (1989) explained the word death demon etymologically to mean “hider” implying that “Hades hides invisibly in things” (p. 28). In this sense, Hades is in every symptom, like Ziegler’s chimera metaphor. Much like in Hillman’s concept of pathologizing and Ziegler’s Archetypal Medicine, Thanatos and Hades keep us on our toes and serve to remind us of our proximity to death. By doing so, he reflects to us how alive we truly are.

Because his realm was conceived as the final end of each soul, Hades is the final cause, the purpose, the very telos of every soul and every process… All soul processes, everything in the psyche, moves towards Hades. As the finis is Hades, so the telos is Hades. Everything would become deeper, moving from the visible connections to the invisible ones, dying out of life. When we search for the most revelatory meaning in an experience, we get it most starkly by letting it go to Hades, asking what has this to do with ‘my’ death. Then essence stands out. (Hillman, 1989, p. 30)

This, I believe, is one of the most important ideas that emerge from archetypal psychology: every archetype contains its opposite. We will die because we have lived, we are alive because we will die. An archetypal framework allows us to see the multidimensionality of every experience and every thing. There is an opportunity to be stretched by opposition. We might say that Thanatos is the god (or one of them) carrying forth our ills. He is in conversation with us, moving us along, keeping us close to the paradoxes of being alive. In this sense, Thanatos’s purpose is to uncover what Ziegler (2005) has pointed to by stating “the entire wealth of human polarities seems only then to become visible when, in our brooding over riddles of disease, we stumble upon the manifold human qualities that play such an important role in the genesis of malaise” (p. 8).

Further, there is cosmological significance to our pain. It is much more than human. Each physical disease, symptom, ailment also holds the stories of everything we are made of and everything we come from — the entire living universe. The soul of the world is nested in each individual soul, so why would our pain be separate from the pain of our world? Hillman (1982) himself stated:

My practice tells me I can no longer distinguish clearly between neurosis of self and neurosis of world, psychopathology of self and psychopathology of world. Moreover, it tells me that to place neurosis and psychopathology solely in personal reality is a delusional repression of what is actually, realistically, being experienced. (p. 72)

So, what if I told you that the earth, the entire cosmos, needs you to undergo descent when it shows up at your doorstep? What if I told you that all of life depends on it? Would that make it more tolerable? Would you be more willing to endure the discomfort of being dissolved and reorganized? The soul of each human and the soul of the world are inextricably bound.

Much like we need our pathology to be included in our wholeness, the entire living universe needs those descents as well. I believe here that the seed for resurrection, which I mentioned above, is behind this. To be alive means to continually transform and adapt. Most of the time, that gift comes with excruciating pains. De-humanizing is another of Hillman’s moves of soul-making. This is what he said:

Finally, how can we call the soul human when its fantasies, emotions, morality, and death are beyond our human reach. Soul may be lent by our ancestors as we live out their patterns in our genealogy myth; or by the Gods as we enact their pathologically bizarre dramas; or by our dreams, thereby reminding us at the fresh day’s start of the soul’s different and underworld existence; or by something yet to happen that is making its way through us — the Zeitgeist, the evolutionary process, karma the return of all things to their maker — but our lives are on loan to the psyche for a while. During this time we are its caretakers who try to do for it what we can. (Hillman, 1975, p. 180)

Conclusion

This is my story, but this is also where I am being dragged. This intersection — soul and medicine — does not exist in the world at large. As I listen to soul and participate with what occurs, I am continually rearranging my life to forge a path for this work. If we are to find a way through as a species, it must exist. Archetypal psychology provides a framework for how one might approach this. Ziegler’s Archetypal Medicine speaks to the heart of it too. Here, Hillman (1975) articulated this very thought beautifully by means of a phrase from Jung:

“Pathologizing the myth onward” means staying in the mess, while at the same time regarding what is going on from a mythical perspective. We try to follow the soul wherever it leads, trying to learn what the imagination is doing in its madness. By staying with the mess, the morbid, the fantastic, we do not abandon method itself, only its medical model. (p. 74)

My sense is that Hillman was onto the need to bridge soul and medicine, particularly with his concept of pathologizing as one of the necessary modes of soul-making. If we follow his lead, we may discover something big. There is another perspective if we are willing to be shaken by it, or even stopped in our tracks.

What are we left with here? Well, it’s hard to tell. Was this a plea? A protest? A promise? A combination of the three? I think so, and it comes straight from the core of my being. It is the gut-wrenching reality of the tension I straddle and have been straddling for well over a decade, and perhaps my entire life. A chunk of this paper was written from a hospital bed in the emergency room where I visited twice in one week after a worsening of symptoms and surfacing of new ones. I left with no answers, which is a very familiar experience. My story continues to lead me to grok the deepest truth of what I am presenting here, to live it, to embody it. It is not enough to just know it. It must flow through me in every movement and every word. I have been given no other path or possibility to lean into. Again, this is soul, these are the gods. I have spent years struggling with physical pain and symptoms of various chronic illnesses, but nobody can explain to me, medically, what is going on. Within this, I have to continue to remember the perfection of this, to not pathologize it, and lean into an archetypal and imaginal possibility. This is the only way through.

References

Hillman, J. (1971). Psychology: Monotheistic or polytheistic? Spring, 1971,

193–208.

Hillman, J. (1975). Revisioning psychology. Harper.

Hillman, J. (1978). Further notes on images. Spring, 1978, 152–182.

Hillman, J. (1982). Anima mundi: The return of soul to the world. Spring,

1982, 71–93.

Hillman, J. (1989). The Dream and the Underworld. Harper & Row.

Weller, F. (2018). Living a Soulful Life and Why it Matters. Lecture presented in Santa Rosa, CA.

​Ziegler, A. J. (2005). Archetypal Medicine. S.l.: Spring Publications.

What is Depression? (2020). Retrieved December 28, 21, from https://www.psychiatry.org/patients-families/depression/what-is-depression

(2017, May 19). Retrieved April, 2021, from https://www.youtube.com/watch?v=vMstO3U4sVw&feature=youtu.be