LECTURE 6

FREUD

1. DORA

The real name of Freud's Dora was Ida Bauer. She was born in Vienna in 1882, into a family of Bohemian Jewish ancestry. Dora's father, Philip Bauer, was a wealthy textile manufacturer who owned two factories in the provinces and identified politically with the liberalism that had sponsored the emancipation of the Jews. The father was in poor health throughout Dora's childhood, suffering from tuberculosis and syphilis, contracted before his marriage. His wife understandably developed a fetish about cleanliness, which expressed itself in an elaborate washing compulsion, or "housewife's psychosis," as Freud called her condition.

Dora's brother, Otto Bauer, became a leading figure in the Austrian Social Democratic Party, a Marxist theorist who specialized in the question of nationality and nationalism. When Lenin assigned Stalin the task of analyzing the nationalities issue in the Soviet Union, it was Otto Bauer's work that Stalin plagiarized. Otto was a prolific author and a tireless participant in party meetings and parliamentary debates. He sympathized with his sister's misery, but seems to have coped with the family troubles by learning how to avoid them. He identified with his mother's moralizing and tried to become what his father was not–an idealist.

Dora did not have the academic and political options available to her brother. She married in 1903 at the age of twenty-one. Her husband was an unsuccessful composer employed by her father, who once hired an entire orchestra to give his son-in-law the chance to hear his music performed. The marriage was unhappy; Dora loathed her husband and accused him of infidelity. She continued to suffer from a variety of psychosomatic ailments throughout her life. One of her few satisfactions, a later analyst reported, was that she knew herself to be the subject of one of Freud's most famous case histories.

2. PSYCHOANALYSIS

Of an earlier case, that of Fraulein Elisabeth von R., Freud had written: "I have not always been a psychotherapist. Like other neuro-pathologists, I was trained to employ local diagnoses and electro-prognosis, and it still strikes me myself as strange that the case histories I write should read like short stories and that, as one might say, they lack the serious stamp of science. I must console myself with the reflection that the nature of the subject is evidently responsible for this, rather than any preference of my own. The fact is that local diagnosis and electrical reactions lead nowhere in the study of hysteria, whereas a detailed description of mental processes such as we are accustomed to find in the works of imaginative writers enables me, with the use of a few psychological formulas, to obtain at least some kind of insight into the course of that affliction."

In the course of his collaborations during the 1890s with his fellow physicians Josef Breuer and Wilhelm Fliess, Freud had become convinced of the sexual etiology (origin) of hysterical symptoms. This meant moving from a mechanical and materialist model of mental illness, to a more sophisticated model that required the elaborate interpretation of these symptoms. The patient's illness is conceived as a kind of code in need of breaking: listening closely to the patient's pattern of expression–words, gestures, tone, avoidance, meanderings, "free associations"–the analyst could disclose meanings of which the patient was unaware, and thereby translate the patient's symptoms into a form of self-knowledge.

Freud's first hypothesis was that the largest part of our mental lives consists of processes–thoughts, wishes, impulses, ideas, desires, images, associations–that are unconscious. When we examine consciousness, it turns out to be full of discontinuities, inconsistencies, and gaps. The key to a successful treatment is the recovery of blocked memory. In fact the kind of illness with which Freud is concerned can be defined in terms of a selective blockage and leakage of memory. In the course of a person's development, certain forbidden desires and traumatic experiences become sealed off from conscious awareness, but leak through in the form of painful symptoms. Suppressed by the conscious part of the mind, they come back to haunt the body: this is what Freud calls the return of the repressed. "Psychoanalysis is a technique that allows dark meanings and irrational motivations to rise to the surface of conscious awareness. They can then be taken into account; they can be influenced by other considerations; and they become less liable to disrupt human life in violent and incomprehensible ways" (Jonathan Lear).

This is why dreams are so important: in sleep the mind's internal censorship mechanism relaxes, and the unconscious speaks more directly, though still in a kind of symbolic language that needs to be interpreted. Gradually it becomes possible to put the patient's partial and somewhat incoherent version of his or her story into an intelligible and reasonably complete narrative. Tell me your story as best you can, Freud seems to be saying, and I'll cure your amnesia. On the other hand, those who forget the past are condemned to repeat it, or to be oppressed and depressed by it, which is perhaps the same thing.

3. ARCHAEOLOGIST AND DETECTIVE

We can think of Freud as a kind of memory plumber, trying to restore the normal flow of psychic energy after it has been dammed up by neurotic or hysterical symptoms. But Freud's favorite metaphors for his kind of analysis are drawn from archaeology. If you have ever seen any photographs of the famous consulting room, you will have noticed that almost every square foot of space except the famous couch itself is filled with an amazing number of antiquities. He fills up space with objects that remind him of the persistence of things through time, just as he digs or probes into the buried past of the patient to recover the early strata of the personality. This work is painstaking and it relies heavily on inference and conjecture. Every remnant of the past, every clue, every fragment of a dream, every scrap of memory, every seemingly arbitrary association of our thinking, no matter how trivial in appearance, is potentially significant and has to be traced and collated with all of the other data. Every detail is a possible key to the mystery of the patient's suffering. The patient is "an infinitely expressive, though often reluctantly communicative subject" (Philip Rieff).

One of Freud's famous patients, the Wolf Man, reported that Freud was an avid reader of Conan Doyle's Sherlock Holmes stories. Think about the parallels between Freud's case histories and the cases written up by Holmes's faithful friend Dr. Watson: the structure is the same. A patient or client comes to the consulting room in trouble and narrates a bizarre tale of woe: the job of the detective/analyst is to interpret that narrative, make sense of its apparent gaps and inconsistencies, and to use fragmentary and misleading evidence to get back to the hidden origins of the case.

Now think about the hysterical symptoms in the Dora case–the loss of speech, the nervous coughing and labored breathing, the limp–each is, for the analyst, a transcription of the pain of the psyche written in the language of the body. Freud's task is to take the seemingly nonsensical symptoms and tell the story of how they came to be. By translating them back into the narrative of their origin, he hopes to undo them. The symptoms together make up a kind of mute speech. They point to certain compromises that the patient has made in the history of her development, defenses against unacknowledged sexual and aggressive drives–defenses which have become dysfunctional. But once the patient is confronted with the literal truth of her psychosexual life-histories, once it is shown that hysterical symptoms are the expression of her most secret and repressed wishes, then she can be relieved of the pain that is symbolically and deviously expressed those symptoms.

So analysis is not only detective work, but also a kind of exorcism. Freud writes: "No one who, like me, conjures up the most evil of those half-tamed demons that inhabit the human breast, and seeks to wrestle with them, can expect to come through the struggle unscathed." Freud is going down into the depths of the unconscious and rebuking and casting out the demons he finds there. His therapy is squarely in the classical and also the Judeo-Christian traditions of the West: know thyself; the truth shall make you free. His "talking cure" is a kind of catharsis. As a scientist, he belongs in the Enlightenment tradition: his aim is to use reason to diminish the amount of unnecessary suffering in the world. And as a humanist, he falls within the tradition of European Romanticism: the self has depths and secrets that are not easily fathomed.

4. HYSTERIA

Freud made his reputation, and built his science of psychoanalysis, around the treatment of hysteria–a very peculiar psychosomatic disease in which the mind interacts with the body. One of the classic problems associated with fin-de-siècle Vienna is of course why so many of Freud's patients were "hysterical" women. Why was this condition so prevalent in this time and place? The fin-de-siècle has long been considered the golden age of hysteria–not only in Austria, but also in England, America, and France, where the disease seems to have taken off so rapidly that the French Surrealists, in 1928, could designate 1878 as the official "birthdate" of hysteria and call for a semicentennial celebration.

But of course hysteria was not born in 1878. It has a very long history which goes back to the Greeks who gave it its name. Etymologically, the word derives from the Greek for "uterus" and attributes the condition to a pathological wandering of a restless womb out of its normal position in the body; hence the long-standing belief that hysteria was an exclusively feminine malady. According to Plato: "The womb is an animal that longs to generate children. When it remains barren too long, it is distresses and sorely disturbed, and straying about in the body and cutting off the passages of the breath, it impedes respiration and brings the sufferer into the extremist anguish and provokes all manner of diseases." The Hippocratics, the founders of Western medicine, believed that the womb needed continuous irrigation by the male to keep it moist and pregnancy to anchor it in place. Otherwise, they believed, the womb tends to dry up and lose weight, and then to begin a migration upwards, causing various painful symptoms along its route through the body.

This disease, then, has always been associated with a bundle of symptoms, especially convulsions and spasmodic seizures, faintings and swoonings, anesthesias, loss of taste, smell, hearing, or vision, coughing, inability to swallow, feelings of strangulation, paralyses of the extremities, pains in the joints–in short, a hodgepodge of disparate and usually temporary symptoms, which sometimes refused to stay put and migrated, like the wandering womb, from one part of the body to another. The most important student of the subject before Freud was the Frenchman Charcot, who developed an elaborate typology of the stages of the hysterical attack, with heavy emphasis on the theatricality of the patient's gestures. Freud studied with him in 1885 in Paris and translated his work into German.

Freud made the most of one of Charcot's remarks about hysteria: "Mais, dans des cas pareils c'est toujours la chose genitale." As we've seen, Freud redefined the disease in terms of the "somaticization" of repressed sexual wished and fantasies. If he was right, then the social and cultural factors which encouraged and enforced the relegation to unconsciousness of sexual thoughts also encouraged the spread of the disease. The rigid codes of nineteenth-century morality, which prescribed sexual abstinence before marriage and allowed only male deviation from this norm, and which held that a "proper" woman was effortlessly chaste–these taboos were certainly part of the problem.

But in some respects it's beginning to look as though Freud's analysis of hysteria did not go far enough. In recent years, feminist historians have argued that hysterical symptoms were not only due to sexual repression, but were also physical expressions of the anger and assertiveness that nineteenth-century women were not allowed to demonstrate openly. Invalidism provided an acceptable means of nonconformity: if women could not be overtly aggressive or resistant, they could be passively so. Hysteria was the outcome not only of a repressed sexual drive, but of rage. Dora certainly had reason for anger–against her parents, against the man who tried to seduce her, and against Freud himself. In principle, psychoanalysis was not moralistic: it did not judge the hysteric as weak or bad, but saw hysterical symptoms as the products of unconscious conflicts beyond the patient's control. But in Dora's case, Freud did seem to blame the victim.

There is an interesting counterexample to the case of Dora: it's the case of Anna O., which figures as the first case history in Breuer and Freud's Studies on Hysteria in 1895. Anna O., whose real name was Bertha Pappenheim, had at the age of sixteen finished all the schooling available to her as the daughter of a wealthy Jewish family. While her less brilliant younger brother went off to the university, Anna remained at home doing domestic work and nursing her tubercular father. When her father died, hysterical symptoms proliferated: anorexia, paralyses, hallucinations, and an elaborate series of speech disorder culminating in mutism. Breuer concluded that her mutism was a form of psychical inhibition: "she had felt very much offended over something and had determined not to speak about it." When, after hypnosis, her powers of speech returned, she was still unable to speak her native German, and instead spoke and read English, French, and Italian; she was able to produce instantaneous translations of tests in these three languages.

Breuer saw through the unconscious strategy of mutism and invalidism: "Adolescents who are later to become hysterical are for the most part lively, gifted and full of intellectual interests before they fall ill. Their energy of will is often remarkable. They include girls who get out of bed at night secretly so as to carry on some study that their parents have forbidden for fear of their overworking." Unlike Dora, who was overshadowed by her brilliant brother and locked into an unsatisfying marriage, Anna O. found a career as a social worker, reformer, and feminist activist. She translated Mary Wollstonecraft's Vindication of the Rights of Women and wrote a play called Women's Rights. In other words, Anna O. really did find her voice, exchanging the self-enclosed and self-punishing strategy of psychosomatic illness for a public role as a social critic. Ideally, this is what psychoanalysis is supposed to do: to draw people out of their disabling inwardness, to make the fullest possible use of their energies, instead of wasting them or bottling them up in self-defeating and compulsive patterns of behavior. Dora was not so lucky.