A Dream of Undying Fame
How Freud Betrayed His Mentor and Invented Psychoanalysis
Basic Books: 148 pp., $22.95
Psychoanalysis has always been a mixed bag, Louis Breger notes. On the one hand, it has produced valuable insights into topics that were previously obscure or even off-limits. On the other, it has generated grand theories that aim to provide universal explanations of human behavior based on little evidence. Breger thinks that psychoanalysis still has something to offer but that it is plagued by an organizational culture that often sacrifices free discussion for personal loyalty.
Breger's "A Dream of Undying Fame" traces many of the problems of psychoanalysis back to its founder, Sigmund Freud. This is by now a familiar intellectual path. Freud's ambition and close-mindedness, his authoritarian personality and his focus on sexuality all supposedly undermine the viability of psychoanalysis. If only Freud weren't Freud.
But without Freud, what is there to build on in the early years of psychoanalysis? Various writers and therapists have searched for new father figures to replace the cigar-wielding patriarch of the field, and Breger finds his in Josef Breuer. A psychoanalyst himself, Breger wants an anti-Freud, and he finds one right in Vienna. Breuer was a serious thinker and a fine clinician; he even kindly helped Freud get on his feet when he started off as a doctor. What a mensch!
Breuer brought his young colleague the case of Bertha Pappenheim, known in the history of psychoanalysis as Anna O. Pappenheim was diagnosed as a hysteric, which meant doctors (and the patient herself) could not explain why she was suffering from so many symptoms that seemed divorced from any physical ailment. What did she need? Breuer discovered that she needed someone to listen to her stories of sorrow and confusion. By "sweeping out the chimney," by expressing the pain of her past, Pappenheim seemed to find some relief, even if short-lived.
Breuer and Freud were onto something: "Hysterical patients suffer mainly from reminiscences," they wrote. Theories of the time emphasized that you could release the tension or energy left over from past pain, or that you could even wipe away the pain by altering memories through hypnosis. Does something still trouble you? Under hypnosis, we can change your memories! The cases in "Studies on Hysteria," the 1895 book the two men co-wrote, read like short stories. Some patients find relief in telling their stories, and the doctors attempt to understand why.
Breuer emphasized "catharsis" because he thought the neurological system had become blocked or dysfunctional. Talking about the past was a release, a discharge in some form. Why did this occur? Following the French neurologist Jean-Martin Charcot, Breuer emphasized that a traumatic event disrupted the mechanical system that normally allowed us to live with memories. Some traumatic event -- in Pappenheim's case, it was related to the death of her father -- made it impossible for the patient to digest the past. Talk therapy allowed the patient to get back on track.
Freud came out of the same mix of neurology and psychology as Breuer, but he began taking decisive steps away from it in "Studies." Rather than wondering what really happened to patients, he listened to their stories to hear clues about desires that the patients were afraid to face. Instead of asking what traumatic accidents happened, he began to ask what patients were getting out of their symptoms. He began, in other words, to ask questions about deep motivations -- not just to feel empathy for what bad things had happened to them.
Like many psychologists of the 1890s and the 1990s, Breger thinks that trauma (not conflicted desire) is the key to understanding mental illness, and he faults Freud for emphasizing fantasy at the expense of something that really happened. After "Studies," Freud moved on to dreams and the unconscious. He would come to see sex and its repression as keys to psychic life. Breger thinks this was a big mistake. Breger sees the patients in "Studies" as victims; he even sees Freud as a victim of childhood trauma. He seems to think that by acknowledging we are victims, we can begin to "heal" -- Freud, however, was on a different path, and it is true that Breuer didn't want to "go there." When one of Freud's patients told him to stop trying to change her past through hypnosis and listen to her stories, Freud began to develop psychoanalysis for understanding why we care about the past. Rather than just help release the energy of victims in talk therapy, Freud began to see analysis as a way of better understanding our desires in the present.
Breger seeks a kinder, gentler history for psychoanalysis, and he describes Breuer as a familiar, sympathetic precursor for the kind of psychotherapy he himself practices. But working through the past isn't the same as finding a new father figure. In the wake of psychoanalysis, shouldn't we turn to history for more than that?
Roth is the president of Wesleyan University and the author of "The Ironist's Cage: Memory, Trauma, and the Construction of History."Copyright © 2015, Los Angeles Times