Leaders in Healthcare Conference

This case is called the ferryman. It was published under that name some years ago in the Journal
of center therapy and it concerns a 49 year old man came into the emergency room with a small
bowel obstruction. It had a previous episode and on this occasion we offered him surgery but he
declined and as he wasn't tender in his abdomen, his vital signs are okay, we left him till the next
day when he decided he did want the operation and when we did the operation, we found a tumor
in the cecum and we did a right hemi colectomy. Subsequently, he was seen by the oncologist
who decided to give him a course of chemotherapy at that time and he came to see me in my
rooms to have a look at sampling and perhaps get involved and he did get involved with this at
the time I offered sampler to any patient I had with cancer. I just want to explain to you a
concept of Young's called the Anima and animus which is important in this case. Inside every
man there's an image for him is the perfect woman and inside every woman, there's an image of
the perfect man. Young call these inner energies, the Anima and animus, the male and female
version of that word which is a Latin word for soul and I'm gonna talk from the man's
perspective now. But this Anima in a man is in his unconscious but it's not just his own
unconscious, that's the personal unconscious. It's connected to the collective unconscious and to
the experience of the feminine throughout history. It's also colored by his own experience in his
personal unconscious his own experience of his mother when he's born and as he grows up in
infancy and is exposed to other women as well. So that's the personal aspect of his unconscious
Anima. So, if I then meet someone, I talk about myself now but if I meet someone, who I fall in
love with, they usually have a hook on which I project this image of the perfect woman and the
hook could be a physical attribute, but very often it's a psychological one and through them I
have access to this Anima energy and it's a powerful experience and in Jungian analysis, it's a
very important piece, the masterpiece of analysis they say is integrating the Anima or animus. So
when you lose contact with your partner if they left or died, you're cut off from that energy of
your own and so you suffer and that's part of the story in this case. So this is Shawn's first tray.
I'm calling him Shawn, that wasn't his real name. He says, this is the little place where I lived
and grew up. That was very kind. He couldn't read but he could remember stuff line by line and
my mother often read to him. He gave away a lot. He was 68 when he died. He is still at home in
some way and you can see in this picture in the right side, there's a boat and just beyond the boat
is a structure, which is actually a church, you might be able to see it that clearly. But these are
the two significant pieces and a board is about making a journey and the church will come up at
the very end of a session at the end of his work and that's why I'm drawing your attention to it.
This is a second picture and he says my mother and father were very good to me as a child. We
used to make toboggans and they used to tell ghost stories. We had a snowmobile, it was a happy
time. We had horses and tractors and he describes one of the legs near him and a little river, that
he shows in the picture. He says the trees are not like they used to be children are not like they
used to be. So Shawn is getting comfortable with this mortality and then on this particular trade
which is coming up now. He says he trusted his wife and he felt very betrayed when she left him
and he could never trust another woman again. He walked away from the relationship with a suit
of clothes. In this tray, he says that's how I felt when my wife left. I spent more than one night

crying myself to sleep. I missed the kids and I was very alone. Now this is a very important piece
here. From what I've just said about the Anima, his partner has left and he has no contact with his
Anima and his experience of his Anima is of suffering. And it's well portrayed in that piece and
it takes courage to put that piece into a tray on its own but as I mentioned before the beautiful
thing about symbols is that they can change things and this is an image from the day of death
culture in Mexico where people have parties around all souls day and they go to graveyards and
have parties and graveyards. So it's a symbol actually of resurrection. So having acknowledged
his pain with that picture, the next one, things are improving a bit. He says, I had gotten back
together with my former girlfriend and we had bought a house and I had a new Mercedes, it felt
really good and then he moved on to this trip where he says, I'd like to be fishing and in this one,
this is me and my woman. Where I live, there were 1000s of birds. They were no neighbors for a
year. It was the wilderness and in this tray, he says, I had a dream about a beautiful place where I
was walking. There were lots of flowers. It was almost like a desert but flowers don't grow in a
desert. I was saying to myself that I've been here before but it was never like this. It was full of
birds nests, two nights in a row, I had this dream. The next time I saw him, he was in quite a bit
of pain and we had been talking to the oncologist and done some x-rays, nothing was showing
up. But it seemed likely he was going to need a laparotomy to identify what was causing his pain
and he made this tray. He says if I can get over this pain, I'm going to take a holiday in the
summer and in this one, he says that's as much work as I will do. If I get well enough this
summer, his pain continued and we decided to do a laparotomy and unfortunately his disease had
spread and there was quite a lot of tumor in his abdomen although it hadn't shown up in the CT.
But one good thing about it was that he was almost fully obstructed in one area of a small bowel
and we were able to relieve that with the surgery and it did relieve his pain and he now knows
that he's dying really. I mean, he doesn't really talk about it upfront. But he's been told this
clearly and he comes to do a tray and this is what he does and you can see from the tray that he's
looking out on an MTC and it's you know, the C is the great symbol of the unconscious. So he's
almost confronted with his own unconscious, he's confronted with the void and it's almost as if
well could something happen. Shortly after this tray, maybe a week afterwards, he was brought
into hospital as an emergency and I was called in to see him and I remember the nurse saying to
me, I think you might be dying and I had to agree with her. He looked so warm and so sick but
when we rehydrated him, he recovered quite a bit and this happened to be Easter week and he
wanted to go to the Easter ceremonies. He was feeling quite a bit better on good Friday but the
Easter ceremonies at that time in the Catholic tradition take about three hours and he really was
not a bad fit to do that but he then wanted to do a sand tray and so his friend brought him down
from the hospital to my office and this is what he did. He says, this is myself and my girlfriend
lying in the sand. It's a park in Prince Edward Island, a bull knocked me off the fence when I was
there and I was knocked out and the two he's describing are those two in the sand, there's a close
up and it actually felt on the day like he was saying goodbye. He was very weak and at the end of
the session, he still wanted to go to the church and I agreed to go with him and his friend. At this
stage the ceremonies were over and he went into the church and prayed before the crucifix which

was exposed there on a Good Friday and then we brought him back to his hospital bed and that
was a bit of a relief for all of us I have to say and over the weekend, rehydration, all that he got
so much better and on Sunday, he wanted to go to the services, this was Easter Sunday and it
seemed to be reasonable to let him and again his friend took him and brought him back to the
hospital and on that evening, he wanted to know if he could do another sand tray and I agreed
and as you can see, this slide is not very good, it was damaged at the time. So if reconstructed as
best I can and I draw your attention to the individual standing at the front of the boat and this is
seen as the ferry man, this man is in the dyeing process and he's going to carry himself if you like
across the river sticks. So he projects this in his unconscious, this individual who's going to take
him across and it's a person in a morning suit form of kind of person and this was his next tray
and it's damaged as well. But I couldn't reconstruct it because I didn't really have enough of the
pieces but you can see there's a lot of energy, there are boats there again for this journey and you
can see in this slide, that form a person what we call the ferry man is there again. In this tray,
which is a lovely tray has a lovely feel about it. He says there's a big strip of grassland would
bring the horses and sheep out there in the spring, his boat is still there. So that was a pleasant
place to be and then it's as if he's prepared now for the next slide which shows an island with
several negative people on it and if you remember, when I talked about in looking at the MTC,
kind of almost an expectation [Inaudible word at 11:58] something has happened and we see
this. So in this tray, he says, we're having a picnic, these fellows can't get me and he told me
about a dream he had at this time in which he went to Labrador and made a lot of money. On the
way back the boat sank. I lost all my money but we were rescued by a helicopter and a boat. I
felt great the next day, the boat took the cancer with it, I had a lot of dreams like that. The end
result was I didn't make any money but I got better. Cancer isn't the path of life to strengthen you
up for other things. Cancer has taught me that grandchildren are important. When I think about
the trays it occupies my mind. So if you remember that tray from a few slides back when he was
looking at the MTC sort of an expectation or waiting and now we have this island appears on the
sea and on it there six or seven negative figures two day of death figures, the Wicked Witch of
the West, an angry man, Tin Man and these probably represent complexes that are presenting
themselves to him to be dealt with before he dies and many people in that journey to death deal
with stuff from their life that they haven't looked at before and it can be a very rich time for
people but in this case he's not talking about anything specific but he has these probably material
from the unconscious that are represented by these symbols and we know that one of them is
anima. Now, we'll go on to the next tray here and you can see that there is now a bridge
connecting to the island and he doesn't say anything about this. But you can see that these
individuals are getting nearer now he's still defending himself because there's a centurion and a
ninja warrior on his side of the bridge and in his next tray, he relents. He says these people are
having a party, a woman is going first and then a woman with wine and a fellow is coming from
the band. It's no good to offer the money but you can offer them the band and lots of food and
just to point out here in these series of pictures around this is that the ferryman is there still, all
this food signifies spiritual food and it truly is a rich tray. He's been so creative about the way he

made the band. It was not easy to do this but you can see these little instruments on wires as well
and around about this time one of the times he came to my office I had music playing and it was
a [Inaudible word at 14:57] and he really liked it and I'll play it for you at the end because
there's a lot of music in his trays. At the end we'll have a look at his slides again with that music
but now as we move on to his next tray, you can see that these figures from the island have been
integrated, they've been accepted, be kind to your complex, be kind to the parts of yourself you
don't like and this piece that he's done here is really beautifully illustrates that idea of accepting
the things about ourselves, we don't like, he's brought them to the feast and you can see there that
the wicked witch of the west is actually playing the bass and the straw man or Tin Man is
playing another violin as well and the day of death figures are there too, all the negative figures
are there at the party, they've been accepted and so after this piece we start the last part of his
journey, if you like and in this picture it looks to me like he's going to meet the ancestors there,
these people waiting for him and that he probably is the person with a suitcase and he gets quite
a lot of comfort from this tray. He says you can work so hard for things that you don't need. I
used to see people playing golf and think they were crazy. Now, I think they're right. You should
enjoy the simple things. There isn't anything in this world that comes your way that you aren't
given the strength to deal with and he has just dealt with something very important in all those
negative symbols. So he speaks from the heart here and we move on to his final tray, the picture
he made about a week or 10 days before he died and this is the same church that was present in
his first tray, the church there on the top right and you can see, there's a Woman in white, you
don't know it's a woman but a figure in white heading to the church as if through a row of people
on each side and that's a graduate figure he is used. You can see there's a lot of music, you can
see that the ferryman is there again and it's very interesting that he used to graduate because one
of the things that he missed was that he didn't have an education. He was a car mechanic and in
this journey, he has graduated and this is a really very spiritual piece because we're suggesting
that he has healed his Anima and he's bringing his Anima to the church to God and this idea of a
sacred marriage is a common theme throughout history. You see it a lot in the poems of Rumi
and you see it in Johnathan cross and Jonathan cross; his work was commented on by young as
being part of this thing, bringing your soul the feminine part of yourself to God as soon as of
indication of coming together in yourself. So that's the way we think of this lady who's coming to
the church in this scene and it looks like that Shawn has done a lot of healing of his Anima. So
I'm just going to show you a few of the slides again with the piece of music that he liked and
thank you for your attention [From 18:48 Music starts own wards]

Finally, there are two aspects of Jungian psychology that are applicable to our profession in
healthcare
One of the big contributions that Jung made was the identification that throughout
In this last part of this presentation about Jung I would like to tell you about two point phenomena.
Synchronicity and Mythology
Synchronicity is the phenomenon of there being a connection between things and events that are not
connected in the usual causal way.The usual causal way is it falls off the table because I
inadvertently knocked it with the sleeve of my jacket. But sometimes things can fall with no obvious
cause or the cause is very unusual in itself. Like where did that sudden draught come from. Carl Jung
(slide) and Wolfgang Pauli(slide) discussed this many years ago around the time that Pauli won the
Nobel prise for his work on Quantum Mechanics. And as you probably know the quantum physics
world now knows that matter at its smallest existence as we know it turns into wave a form. You have
all experienced the fact of thinking about someone you haven’t had contact for a long time and then
next day you get phone call from them. I will illustrate a few moments of synchronicity shortly. Another
aspect of our lives that Jung identified was that the myths and fairy tales of all cultures are basically
the same and that they actualize that is going on unconsciously in the process of psychological
development. One example is of Hansel and Gretel going into the woods to meet the wicked witch.
The wicked witch represents the negative mother who would eat them up, psychologically if not
confronted and we all meet this at some point.
Another example is the series of tales concerning King Arthur and the knights of the round table. In
these legends the symbolic meaning is that the Knight represents the Ego in the service of the king,
the self. That I have mentioned already.
A few years ago I went to a hospital in Tanzania for a few weeks to work. There I found a group of
women , some of whom had spent all of their lives there, working as doctors and nurses.They were
MMMs Medical missionaries of Mary I will come back to that is a minute.
On the first day after my arrival I helped the surgeon who was leaving to operate on a 3 month old
baby who had a cyst in his bowel.On the second morning I was there I went on the ward at 9 o'clock
and was presented with a patient who was under a sort of blue brown tent and turned out to have
65% full thickness and partial thickness burns.It was almost like a coffin because he himself chose to
keep his head under it .It was to protect the burned area. I had never seen anything like it and one of
the features I noted was that he did not have much pain. And that indicated full thickness. I was
overwhelmed. What am I going to do. Apart from giving him lots of fluids and debridement but what do
I do with such a massive area for debridement. Transport to another hospital was not an option.
Perhaps I should do nothing. Just one hour later a small plane arrived in a little airstrip at the back of
the hospital an in it was a Dr.Odour, a doctor from Kenya and a plastic surgeon who had come to do
some elective surgeries on children. I could not at first believe it. I would have coped but this was
indeed a gift. We worked together on this man for three days but, not unexpectedly he died. The child
that we operated on earlier was not doing well and I kept monitoring him and pushing for further
surgery.I had some paediatric surgery experience. The surgeon who I was relieving Dr.Chiamwe quite
heroically came in from leave and the three of us re-operated on the child who had a leak from his
large bowel The experience with re-operating on patients who have not responded well to an initial
operation, except in straightforward situations, is that they do not do well and take up a lot of precious
resources that could be used to better effect. However in this case Zohan survived and left the
hospital about a week later. Some time later, back in Ireland I thought about the fact that my presence
there had contributed to that child surviving and that he was meant to survive and I had been part of
something bigger than myself, a sort of numinous experience as described by Jung and many others.
Months later I was playing a short piece of video of a birthday celebration for one of the sisters there
who was over 80. The sisters were singing a song in Swahili called Malaika. My partner Eleanor
Shanley who is a singer thought that she recognized the melody…. And then she knew she did. The
actor Patrick Bergen had translated the song and asked Eleanor to record it with him about 7 years
previously. So there was more synchronicity. But it occurred to me some time later that Zohan and
literally thousands of other babies would not survive if not for the sisters who ran that hospital. I do
mean that. There was a large maternity unit in that hospital doing caesarian sections every day for

people who would die without them. These people and so many others like them, and the doctors and
nurses of `Medicin San Frontier are also leaders in healtcare that we should not forget. And in the
final image of the short video I play for you now you will see that 80 year old lady raise her hand in
celebration and while she is celebrating her birthday she could well be celebrating her life as a Knight
in the service of Medicine.