Superman and His Shrink : WHEN NIETZSCHE WEPT: A Novel of Obsession, <i> By Irvin D. Yalom (Basic Books: $20; 306 pp.)</i>

The facts behind this fascinating “novel of obsession” are these: Friedrich Wilhelm Nietzsche was born in 1844, the grandson of Lutheran ministers. His father died of “softening of the brain” when Friedrich was 5, and he was forced into a company of grandmother, mother, sister and aunts that he finally found alienating. After studying first theology and then classical philology, Nietzsche turned to philosophy and was so impressive a student that he won both a doctorate and a professorship at the University of Basel without having completed a dissertation.

His first book, “The Birth of Tragedy,” was followed by “The Gay Science” and the highly aphoristic “Human, All Too Human,” but Nietzsche found neither readers nor respect. Hating the imprisonment of his job, and hated by his faculty colleagues, the stern and imperious “philosopher of culture” left the university after a few years for a hard and simple life of furious writing, bleak isolation and sexual asceticism.

In 1882, however, his friend Paul Ree introduced him to 22-year-old Lou Andreas Salome, a brilliant, beautiful and boldly unconventional feminist and future psychoanalyst. There developed a galling “Pythagorean relationship” in which both men were equally smitten by Lou and were so flirtatiously teased but chastely turned away that Nietzsche finally referred to her as “a predator clothed as a house pet” and left for Italy in such despair that his friends feared suicide.

Dr. Josef Breuer was then just 40, two years older than Nietzsche, but he was already the father of five children, an eminent physician and physiologist in Vienna, a foremost authority on equilibrium and respiration, a friend and mentor to a 26-year-old intern named Sigmund Freud and a forerunner in the field of psychoanalysis.

Earlier, Breuer had treated the hysteria of Bertha Pappenheim--the famous “Anna O.” of psychoanalytic history--by a kind of “talk therapy” in which he forced her to recall troubling experiences under hypnosis and found that her neurotic symptoms disappeared when unconscious processes were exposed to consciousness. While he treated no other patients by psychotherapy, Breuer fully discussed his technique and conclusions with Freud and finally collaborated with him on “Studies in Hysteria” in 1895.

The “what if?” and fictional premise of “When Nietzsche Wept” is that Lou Salome heard of Anna O.’s cure, hunted down Breuer on his vacation in Venice, hinted at her menage a trois with Ree and Nietzsche, and hectored him into a consultation by saying she was afraid her friend would soon kill himself and that “the future of German philosophy hangs in the balance.”

She tells him that a host of clinical symptoms--headaches, nausea, blindness, insomnia, dizziness--accompany Nietzsche’s depression. Twenty-four of Europe’s best physicians have failed to offer him any relief, for he’s an unusually skeptical and difficult patient: “Nietzsche is extraordinarily sensitive to issues of power. He would refuse to engage in any process that he perceives as surrendering his power to another. He is attracted in his philosophy to the pre-Socratic Greeks, especially to their concept of Agonis--the belief that one develops one’s natural gifts only through contest--and he is deeply distrustful of the motives of anyone who forgoes contest and claims to be altruistic. His mentor in these matters is Schopenhauer. No one desires, he believes, to help another; instead, people wish only to dominate and increase their own power. The few times when he surrendered his power to another, he’s ended up feeling devastated and enraged. It happened with Richard Wagner. I believe it is happening now with me.”

Dr. Breuer’s ingenious solution is to hospitalize Nietzsche in the Lauzon Clinic under the name Eckhardt Muller, alleviate his migraine headaches with ergotamine, and intrigue him into frequent conversations in which the philosopher would try to heal the internist of his own despair, for, Breuer confesses, “I am invaded and assaulted by alien and sordid thoughts. As a result, I feel self-contempt, and I doubt my integrity. Though I care for my wife and children, I don’t love them! In fact, I resent being imprisoned by them. I lack courage: the courage either to change my life or to continue living it. I have lost sight of why I live--the point of it all. I am preoccupied with aging. Though every day I grow closer to death, I am terrified of it. Even so, suicide sometimes enters my mind.”

What he does not immediately admit is that there is a further parallel with Nietzsche’s condition: He is tortured by a hopeless passion for his voluptuous former patient, Bertha Pappenheim, whose first name was his mother’s, who’d so often held him for balance, fallen asleep with her head in his lap, called him “my dear little father” and otherwise inspired a hundred fantasies of heightened life and sexual fulfillment.

At first, Nietzsche treats the Austrian with variations on his own favorite sentences: “Become he who you are” and “Whatever does not kill me makes me stronger.” And then he tries more unorthodox, and wryly comic, measures. “Nietzsche instructed him to compose a list of ten insults and to imagine hurling them at Bertha. Next, Nietzsche encouraged him to imagine living with Bertha and then to visualize a series of scenes: sitting across the breakfast table and watching her with legs and arms in spasm, cross-eyed, mute, wry-necked, hallucinating, stuttering. Nietzsche then suggested even more unpleasant images: Bertha vomiting, sitting on the toilet; Bertha with the labor pains of pseudocyesis. But none of these experiments succeeded in bleaching the magic out of Bertha’s image.

“Nietzsche calculated that (Breuer) spent approximately one hundred minutes a day on his obsession, over five hundred hours a year. This meant, he said, that in the next twenty years, Breuer would devote over six hundred precious waking days to the same boring, unimaginative fantasies. Breuer groaned at the prospect. And kept on obsessing.”

The friendship that gradually develops between Breuer and Nietzsche finally leads both men into healing and redemption as they learn how to become fully who they are, to differentiate the pursuit of the desired one from the pursuit of desire itself, and to first “will that which is necessary and then to love that which is willed.”

“When Nietzsche Wept” is the first novel from Irvin D. Yalom, a professor of psychiatry at Stanford University Medical School and the author of the first important text in group psychotherapy, as well as “Existential Psychotherapy,” “Every Day Gets a Little Closer” (with Ginny Elkin) and “Love’s Executioner,” a book of factual narratives about Yalom’s patients and himself. Like this last book, “When Nietzsche Wept” is fascinating for its friendly portrait of the chess match that is psychoanalysis at work, but there is a further attraction in its harvest of Friedrich Nietzsche’s ideas on the four great dilemmas of human existence: death, freedom, loneliness and the problem of finding meaning in life.

While Nietzsche is here just as “arrogant, abrasive, and exasperating” as he was in biography, he is also, in Yalom’s hands, sympathetic, compelling, and peculiarly charming. Even Yalom’s sketches of Sigmund Freud and Mathilde Breuer and European domestic life have the feel of historical reality, but he makes it clear that his greatest interest lies in page after page of often forced but fiercely original argument.

At one point, Yalom has Nietzsche say, “ ‘You have looked at my books. You understand that my writing succeeds not because I am intelligent or scholarly. No, it’s because I have the daring, the willingness, to detach myself from the comfort of the herd and to face strong and evil inclinations. . . . Do you know what the real question for a thinker is?’ He did not pause for an answer. ‘The real question is: How much truth can I stand?’ ”

Yalom’s own shrewd intellectual thriller succeeds because of his informed insights into existential thought and the birth of psychoanalysis, and because he had the good novelist’s instinct to let his brilliant characters be who they are, and talk.