To the Editors:
In the New York Review issue of November 18, F. Crews (“The Unknown Freud”) makes a reference (p. 61) to an article of mine. In this article I showed that Freud’s later accounts of his “seduction theory” (“all my female patients told me they had been seduced by their father”) does not fit with the way he presented his theory and data originally in 1896.
An examination of Freud’s texts of 1896 suggests that the early sexual trauma was not based directly on the patients’ recovered memories but was reconstructed by Freud, by interpreting a variety of data in the light of his theoretical assumptions. This is not a startling or damming conclusion, since a few years later Freud readily admitted that many of the crucial experiences of childhood were never directly remembered but only inferred and reconstructed by the analyst, through the interpretation of dreams, fantasies, transference, etc.
I believe my findings have been taken out of context and misused by Crews and Esterson. To conclude from my arguments that Freud made up all the sexual material he got from his patients, and that his theories were dominated by “dishonesty and cowardice,” is arbitrary, farfetched, and remote from my intent. I want hereby to dissociate myself completely from such indiscriminate and ill informed Freud bashing.
Department of Psychology
New York University
New York City
To the Editors:
In “The Unknown Freud” Frederick Crews puts forward a new interpretation of Freud’s “seduction theory” of neurosis, and the events surrounding it, based on a number of recent studies by Cioffi, Schimek, Schatzman, Israels, and others (see his footnote 18). Thus Crews writes
even when [Freud] felt secure enough to admit his seduction mistake, he continued to adulterate the facts. In 1896 the alleged seducers of infants were said to have been governesses, teachers, servants, strangers, and siblings, but in later descriptions Freud retroactively changed most of them to fathers so that a properly oedipal spin could be placed on the recycled material. At every stage earlier acts of equivocation and fakery were compounded by fresh ones.
To assess this claim it is necessary to compare it with the historical data, which include both Freud’s published work and his private correspondence from the time with this friend Wilhelm Fliess, to which Crews refers in his footnote 2. As Crews says, in 1896 Freud put forward the view that neurosis was caused by childhood seduction (or abuse), and that the seducers included governesses, teachers, and so forth. Also, as Crews stresses, these papers show Freud employing a technique which might well be supposed to have contaminated his observations by suggestion.
During 1897, however, as his letters to Fliess make clear, Freud framed a different theory, according to which the principal abuser in the case of women was the father; and he also tried to take account of the role of suggestion, in relation to the data upon which this theory was based. Thus on January 3, 1897, Freud exclaims “Habemus papam!” in reference to what he takes to be a clear case of paternal abuse; and on February 11 he records his belief that his own father’s perversion is responsible for hysterical symptoms in his brother and several younger sisters remarking that “the frequency of this circumstance often makes me wonder.” On April 28 he speaks explicitly of “a fresh confirmation of paternal etiology,” describing a dialogue with a young woman whose “supposedly otherwise noble and respectable father regularly took her to bed when she was from eight to twelve years old and misused her without penetrating (‘made her wet,’ nocturnal visits),” to which he appends “QED.”
As this indicates, the data upon Freud’s theories were based included his patients’ recollections of “sexual scenes” or “seduction stories”; and it seems clear that the 1897 paternal seduction theory had the same basis, for Freud wrote on December 17, 1897 that his “confidence in paternal etiology” had risen greatly, because
[Emma] Eckstein deliberately treated her patient in such a way as not to give her the slightest hint of what would emerge from the unconscious and in the process obtained from her, among other things, the identical scenes with the father.
Here Freud was apparently using one of Mill’s methods of causal enquiry, in order to see whether his data—evidently recollected scenes, involving the father—might be due to some influence of his own. Since the same scenes arose also in the case of a different therapist, of a different sex, who gave not “the slightest hint” as to what would be forthcoming, Freud evidently concluded that they were a relatively robust phenomenon, and not to be accounted for by suggestion on his part.
Although Freud clearly held this theory in 1897, he abandoned it without publishing it. He cited some related therapeutic and scientific reasons for this in his letter to Fliess of September 21, 1897. These included
The continual disappointment in my efforts to bring a single analysis to a real conclusion; the running away of people who for a period had been most gripped [by analysis]; the absence of the complete success on which I had counted; the possibility of explaining to myself the partial successes in other ways, in the usual fashion…Then the surprise that in all cases, the father, not excluding my own, had to be accused of being perverse—the realisation of the unexpected frequency of hysteria, with precisely the same conditions prevailing in each, whereas surely such widespread perversions against children are not very probable…Then, third, the certain insight that there are no indications of reality in the unconscious, so that one cannot distinguish between truth and fiction that has been cathected with affect. (Accordingly, there would remain the solution that the sexual phantasy invariably seizes upon the theme of the parents.)
As is well known, Freud was to adopt the alternative hypothesis indicated in the last quoted sentence. The next letters contain the first specific formulations of the theory of the Oedipus Complex, applied in his own case, as well as that of his patients.
This material makes quite clear that Crews’ claim in the paragraph quoted above is false. Freud’s writing in 1897 of “paternal etiology,” “perversion against children,” the fact that “in every case” the father had to be accused, etc., make clear that during 1897 he held a theory of paternal abuse. His continual references to scenes or stories of seduction, and in particular that to Eckstein above, show that the theory was in part based on scenes or stories produced by his patients, which scenes were liable to arise without suggestion. Since Freud’s descriptions in 1897 were written in private correspondence which Freud himself did not see again, there can be no question of their having been “retroactively changed” in any manner for any purpose. In particular there can be no question of retroactive “oedipal spin,” since Freud’s letter formulating some of the main ideas of the Oedipus Complex simply follows that about abandoning the paternal abuse theory quoted above. And since Freud’s later accounts of the seduction episode are in close correspondence with the material in his letters from the time, there is no reason to suppose that they involve fakery, etc. either.
It seems from what he writes that Crews has made two related mistakes (1) he has conflated Freud’s unpublished paternal seduction theory of 1897 with the earlier and less specific theory published in 1896, and (2) he has supposed that Freud’s later accounts of the seduction episode are meant to be accounts of the material in his 1896 publications, rather than accounts of the work which he did in 1897, and did not publish, but wrote about to Fliess. It is easy to see why the two theories might be confused, since the later developed out of the earlier in 1896-1897. Still the differences are fairly clearly indicated, for example in Freud’s remarks about confirmation. Thus in the “Habemus Papam” letter of January 3 Freud also records how a past male patient “travelled to his hometown in order to ascertain the reality of the things he remembered, and that he received full confirmation from his seducer, who is alive (his nurse, now an old woman). He is said to be doing very well.” This is confirmation and follow-up relating to the earlier theory. By contrast, when Freud speaks in April of “a fresh confirmation of paternal “etiology” that is, a further (fresh) confirmation of a theory which he has already previously taken as confirmed—he is concerned with the later theory. Although Freud had been given accounts of paternal seduction from as early as the case of “Catherine” in Studies in Hysteria (1895), he seems to have concentrated on “scenes involving the father,” and to have tried to control for effects of suggestion on these, only in 1897; and these are points relevant to Crews’ charges.
Now of course if you mistake which theory a man is talking about, then even if what he says is true you are liable to think that he is speaking falsely or even incoherently. Since Crews is apparently taking Freud’s later descriptions of his unpublished theory of paternal seduction as descriptions of something quite different, published work containing a distinct theory, he naturally thinks that what Freud says is false or worse. In this Crews is not alone. The same mistake, apparently stemming from the work of Frank Cioffi, is clearly also to be found in the article by Israels and Schatzman which Crews cites (and, if Crews’ account is correct, also in the work of Esterson under review). In each case, it seems, the authors take Freud’s descriptions of his unpublished work and theory of 1897 as intended accounts of the material in his papers of 1896, and so assume that Freud was somehow deeply engaged in the incoherent project of misrepresenting published work about hypothesized seduction by governesses (or nursemaids) and others as a theory about the role of fathers. Hence, of course, they find Freud’s work on this topic highly suspicious, and full of the most astonishing confusions and contradictions. But as Crews’ paragraph illustrates, it remains to be seen how many of these alleged confusions, contradictions, etc., are Freud’s, and how many are due to misinterpretation on the part of these scholars themselves.
In this connection it is worth noting in particular that the letters to Fliess tend to show that, so far from involving fakery, Freud’s practice over this period was in accord with the very methodological canons which Crews cites via the reference to Grünbaum in his first footnote. Thus we saw above that the letters show Freud using Mill’s methods to test the hypothesis of suggestion, they also show Freud finding improvement in his patients with the confirmation of his theories in a way reminiscent of what Grünbaum calls Freud’s “tally argument.”
This can be seen clearly in the case of the patient T, whose symptoms Freud used to illustrate his developing theory on February 19, 1899. On December 21, 1899, Freud reports that this analysis has got to a deep unconscious scene in which “all the puzzles converge” and which is “everything at the same time—sexual, innocent, natural and the rest.” As a result “the fellow is doing outrageously well,” so that Freud can look forward to the conclusion of this analysis as a “happy prospect.” In describing this analysis too Freud apparently speaks of what is unconscious scenes, but by now he is using the term to cover what may be fantasies, as in the paragraph about Eckstein quoted above. Then on April 6, 1900, Freud writes that
I at last concluded his career as a patient by coming to my house to dinner. His riddle is almost completely solved; he is in excellent shape, his personality entirely changed….I shall keep an eye on the man. Since he had to suffer through all my technical and theoretical errors, I actually think that a future case could be solved in half the time. May the Lord now send this next one. L.G. is doing very well. There is no longer any chance of failure.
Plainly this last statement was unduly optimistic, but the sequence of which it is a part provides a clear and detailed illustration of the way in which Freud’s reasoning at this time linked truth with health. When Freud was able to frame a good analytic explanation relating the patient’s symptoms to an unconscious scene recovered in analysis, this was correlated with improvement in the patient’s condition. Since the best explanation of the improvement was that it was due to the recovery and understanding of the scene, the improvement was also a datum which tended to confirm the accuracy of the explanation. This mode of inference also seems to have played a significant role in the transition from the theory of paternal seduction to that of the Oedipus Complex, for Freud evidently began to obtain what he regarded as satisfactory therapeutic results only while working with the latter. (See also the apparent success reported on May 16, 1900.) There are various ways in which this kind of inference might be characterized, but on any account it should be regarded as reasonable.
Department of Philosophy
To the Editors:
Frederick Crews’ article on “The Unknown Freud” deserves some discussion by a clinician working in the field. In this regard it is particularly fortunate that in addition to being a practicing clinical psychiatrist I am a member of a psychoanalytic study group, the Rapaport-Klein Group, that numbers among its members such people as those referred to and whose criticisms of psychoanalysis and Freud are quoted by Professor Crews: the philosopher Adolf Grünbaum, the historian Frank Sulloway, and the psychoanalyst/psychologist Robert Holt.
Over the years our group, including such critical people as Professor Crews has quoted, has repeatedly discussed these same issues, questioning the matter of proof, the validity and usefulness of Freud’s hypotheses, the question of the scientific nature of the enterprise, and so forth. Indeed, many of us would agree with many of the points made in the article, perhaps most of them, certainly those made early in the article, the first page or so.
But as the article goes on an intemperate note enters into the argument, an angry and ad hominem note. A certain cast to the criticism develops that significantly alters the arguments of others. For example: Adolf Grünbaum, while demonstrating that Freud’s methods of proof are not adequate for a truly scientific discipline, does not give up the idea of such proof being possible. He even points out ways to do it. He believes it can be done and should be done, as he has stated in his books. You would not know that from Professor Crews’ article.
The angry note is interesting and, lacking any further information, I cannot account for it. But I know of a similarly angry not in an analogous situation. In my younger days it was the note found in the bitter criticisms of Marxism by former adherents, once devoted, now disillusioned and feeling betrayed. I cannot say that this is the origin of Professor Crews’ point of view but the situation as it appears in a number of cases is similar. Two brilliant men, Marx and Freud, extremely ambitious, even messianic, are not content with merely valuable first order contributions of great importance but must organize a grand, unified synthesis, a universal, all embracing Weltanschauung, explaining everything. They then wrap it in the mantle of science but without the experimental probative factors and the rigorous self-denying quality that true science requires.
Their syntheses are applied and are found often not useful and at times even harmful. In the case of Marx this is self-evident. In the case of Freud psychoanalysis has not been found to be particularly useful in the treatment of the major disorders such as schizophrenia, major affective disorders, addiction, obsessive-compulsive disorder, etc.; indeed, this was noted by Freud himself as regards the former conditions. Furthermore, there were the tendencies of many psychoanalysts to blame others, usually the parents (as in the case of the erroneous concept of the “schizophrenogenic mother”) and to minimize the factors of child abuse and molestation; all this was unfair and incorrect and led to much improperly imposed suffering, although certainly on a lesser scale than Marx’s.
The grand theory in both instances collapsed. One could see multiple competing theories and schools arise in the case of psychoanalysis: classical, ego psychology, object relations, self psychology, Kleinian, systems theory, information theory, etc. These approaches saw things differently; their interventions, in timing and content, were different; and there was no way to prove one and eliminate the others. This has led some toward a radical hermeneutic position that in essence takes all theories as equally true and does not conceive of psychoanalysis as a science with utility and accountability. The picture tends toward, if not chaos, then at least disorder.
Marxism is in no better position, but what must be remembered is that the first order contributions have been taken up, worked over and metabolized into the contiguous major disciplines in both instances: economics, sociology, and history in the case of Marx; psychiatry, psychology, and sociology in the case of Freud. In psychiatry such clinical concepts as unconscious mental activity, the role of early development and the part the past plays in the present, the phenomenon of transference, all are a part of everyday clinical practice even if they are difficult to pin down in a rigorous scientific way; they are nevertheless empirically invaluable to patients and therapists alike.
For example, a young woman who had done well in treatment returns, about to be married. She is very upset because, so she states, her mother does not like her fiancé, and so she is holding off the wedding. I do not understand for I was never aware that her mother’s opinion had such an influence on this somewhat strong willed woman. We go on for a while without any increase in understanding of the matter or change in the situation until she tells me a dream involving her being in a shower, then emerging from the shower, followed by a snake coming through the bathroom wall, and finally her awaking with great anxiety. Based upon my understanding of Freud’s hypotheses I suggest an ambivalence toward the phallus in particular and toward men in general: that aspect/representation of the matter which is clean and good (the shower) is seen positively but is bland, and that aspect/representation which is “wicked,” even “evil” perhaps (the snake), is seen negatively but is highly emotional. I have developed an idea in my mind about this but I do not intrude. I say no more, asking her what she can contribute to our understanding of this.
She says nothing about this subject, speaks about something else, and the session ends. Subsequently she calls to cancel the treatment but returns a month or so later to tell me that there was something she was fully conscious of but guilty about and had not wanted to tell me. In fact she had planned not to until she heard my discussion of the dream and knew that I had guessed her secret. She appreciated my tact and now she had the courage to tell me. The ambivalence that I noted had been carried out in the real world for there was another man, a married man, a secret and “wicked” affair that was most exciting as compared to the bland relationship with the good, clean fiance. Guilty, unable to tell me, she was relieved that I had discovered it in the dream and that it had finally come out in the open. Now we were able to work on it and help resolve it so that she could become “unstuck” and proceed with her life.
In this both my patient and I are indebted to Freud. It is just a small example, an everyday story in practice. It was most useful despite the very serious problem that Freud’s psychoanalysis, now almost a century old, has had in establishing itself as a true science and as an accountable technique in terms of cost and benefit in a sorely pressed health care system. But “grey are all theories and green the golden tree of life,” and we are left, when all is said and done, with the usefulness of such formulations in everyday clinical experience, for which we are grateful to Freud, with all his warts.
Herbert S. Peyser, M.D.
New York City
To the Editors:
The article by Frederick Crews reviewing “revisionist” books about Freud is an interesting one. It seems to have aroused the fear and rage of many psychoanalysts as well as current and former psychoanalytic patients. The review does indeed unleash a broadside against psychoanalysis as the author apparently imagines it is currently practiced. And because it describes some definitely “unscientific” aspects in the history of psychoanalysis, it implies that current practice is still wild, capricious, and self-serving on the part of analysts. It is common for commentators to attack what they think is psychoanalysis, but which is in fact the extremely shaky practices of early pioneers; it is like criticizing modern astrophysics by attacking Newtonian cosmology or by making ad hominem attacks on Isaac Newton.
What is most striking about the article is that it provides all the data for a really interesting conclusion; but, since it is devoted more to polemical detraction, it seems to miss the crucial point entirely.
When reading the article I thought of an acquaintance of mine, a skilled and well-trained surgeon practicing in a medically underserved area in northeastern Canada. At a time when he was the sole physician in a small hospital, he developed appendicitis and, since he was the only surgeon available, did the operation on himself. He had the help of competent nurses; but he injected the local anaesthesia, cut through his layers of skin and fascia, looked around inside with the aid of mirrors, probably nicked a few blood vessels that he shouldn’t have, removed the inflamed appendix, and sutured himself up. The association is of course to Freud’s self-analysis, and his self-supervision in performing the first psychoanalyses ever performed. One can see right away that Freud’s position was much more difficult even than that of the solo surgeon. If the surgeon had not done hundreds of appendectomies (a procedure then perfected over many years), if he was doing the first appendectomy, the first time anyone had ever cut into the abdomen of a live patient, and that patient were himself, then he would be approximating Freud’s position.
Critics of psychoanalysis seldom see that it is a process of dealing with a wildly moving target from a slightly less wildly moving platform. The first person to do it was bound to make mistakes, as was the first person to do an appendectomy. The phenomenon of the erotic transference, in fact of any transference, took the early analysts by surprise. Freud’s early collaborator, Josef Breuer, quit the field in the face of its awesome power. Freud, whose personality did include grandiosity, narcissism, self-delusion, and megalomania, had the imagination, creativity, and recklessness to push on, with no textbooks, maps, or guides. He and his first-generation disciples made some horrendous mistakes. There is no reason to idealize them as anything more than brilliant, dedicated, flawed human doctors. It may well be that Freud was somewhat corrupted by the power that was thrust upon him, and which he no doubt enjoyed. But he did not sleep with his patients, nor found a lucrative ashram. His heart went mostly in a scientific direction, despite the peculiar nature of his instrument.
The nature of that instrument and the nature of psychoanalysis are both missed in the article. Freud had no supervision, no training analysis, other than his “self-analysis”—in his case an oxymoron. One has only to supervise beginning analysts, or in fact to be a beginning analyst oneself, to see the pitfalls beckoning the unwary. One quickly realizes the power of the analytic relationship to evoke the regressed neurotic aspects of both partners. The rigorous training-analysis, and the intensive supervision—in most good institutes lasting five and more years—are for the purpose of organizing and using this power for the good of the patient, preventing it from causing some of the disasters the revisionists are fond of describing.
I do not wish to criticize the valuable work of the more fairminded Freud scholars; in fact they do us a great service. Let’s take a look at the old chestnut, “Is psychoanalysis scientific?” Usually we mean: does it have hypotheses which can be proven or disproven empirically? Also we mean: can we do outcome studies that show the benefit of psychoanalytic techniques? Without belaboring this argument, let us look at the time scale in which there is some empiricism at play. That is the historical timeframe of 100 years in which techniques have been tried and found wanting and improved upon. If such a trial and error method, which is common in the development of surgical techniques, is scientific, then the term applies here also. We have learned that giving financial advice to a patient, or sleeping with a patient, or lying to a patient, are bad techniques which interfere with the analytic process. We have learned, and this only in recent years, that the countertransference-generated urge to commit those errors can be used as valuable information. When used properly, counter-transference has become a valuable lens rather than a destructive nuisance. Another thing we are in the process of learning is the difficulty of evaluating memories; the “false-memory” problem is a serious one. We are at least now sensitive to the danger of suggestibility, and we will have to develop the skills necessary to minimize the potential damage.
The point Professor Crews could have made is that, if we take a historical perspective, we can see that psychoanalysis has moved forward over the graves of bad ideas. In medicine, one remembers radiation therapy for acne, or DES, or Thalidomide. These lessons are not learned by all individuals; there are still unscrupulous and crazy therapists and physicians. But the majority of psychoanalysts attempt to make use of the wisdom learned over the years, and to improve on it. Ironically, we are indebted to Freud, and to the other founders, almost as much for their errors as for their successes. This is an aphorism appropriate in most progressive endeavors.
David D. Olds, M.D.
Associate Clinical Professor of Psychiatry
Center for Psychoanalytic Training and Research
New York City
To the Editors:
Professor Crews’ “The Unknown Freud” misleads readers who are not familiar with critical Freud studies in the psychoanalytic literature. For example, Crews cites Erik Erikson’s 1962 “Reality and Actuality” only to imply that Erikson recommended Freud’s treatment of Dora as a model for the treatment of adolescents and young adults. Nothing could be farther from the truth. In fact, in the paper cited Erikson began one of the most penetrating critiques of Freud and the Dora case yet written; and, making use of the case and Freud’s failure to understand Dora and her needs, he began revolutionary advances that had a salutary effect on psychoanalysis and psychotherapy and paved the way for recent further advances.
Were Crews to divulge the thrust of Erikson’s critique and his substantive clinical contribution he would have undermined his over-riding imperative—to discredit all of Freud’s work and to pronounce all of contemporary psychoanalysis worthless and/or destructive. Therefore, it is worth mentioning some specifics of Erikson’s thinking about Dora and Freud. Erikson protested Freud’s failure to recognize the import of the “traumatic sexual approaches” made to her by a man she expected to be trustworthy (p. 455); and he disputed Freud’s assertions that the past and repressed childhood sexual wishes played a central role in Dora’s disorder. Moreover, Erikson placed the traumatic sexual approaches to her in the wider casual nexus in which they belonged: the “pervading perfidy” with which Dora was treated by her parents and their friends (p. 459); and the family and culture that discouraged an intelligent young woman’s use of her intellect and “did not [give her] a chance” for a future.
Thus Crews fails to even mention that Erikson refuted that Freud and father “know best” about women’s place (Dora, he said, was placed in the “role as an object of erotic barter,” p. 456). In short, in what was to become his encompassing and influential theory of identity, Erikson staked out important “feminist” issues: “A vital identity fragment in [Dora’s] young life…that of the woman intellectual” (p. 459) was nipped in the bud by a convergence of familial and cultural betrayal and lack of encouragement. The deepest significance of Dora’s dream of a house on fire and her hope that her father would save her jewel box was neither sexual nor Oedipal, as Freud insisted. Understood in the light of emerging identity theory, the dream contained the imperative un-conscious need for help from Freud to save herself, her own female self, if you will, and her chances for a future (p. 461).
Crews omits additional insights of Erikson’s that would also undermine his claim that he is revealing the Freud “unknown” to psychoanalysts. Erikson saw clearly that Freud was determined to prove “his kind of truth” (the theory of repressed sexuality); that the need to be right blinded him to Dora’s psychological truth and led to the failure of her treatment; and this repetition of the failure by her adult world had lasting deleterious repercussions. Because of his understanding of transference (one of Freud’s enduring discoveries) Erikson was able to take a step Freud could not take: he realized that Freud’s failure was so important to Dora precisely because she turned to him with her (“transferred”) needs and hopes for fidelity. From Freud, now, she wanted and expected “mutual verification” or her “actuality.” The help she needed was a far cry from making unconscious sexual wishes conscious. Erikson’s Dora needed help to get on with the interrupted tasks of her adolescence and young adulthood: to find value in herself and salvage values to live by when her trust in herself and those most important to her was destroyed.
Intent on “proving his kind of truth” Crews fails to mention that psychoanalysis grows from scholarly Freud studies that do not have an axe to grind. For example, analysts know from Erikson, not from Freud, that many adolescents and young adults of our day are like Dora. They too suffer from what Erikson described as “malignant forms” of frustration of their basic needs for adults’ fidelity; and when they cannot rely on parents, teachers, and others in their wider milieu, they too transfer their needs to therapists and expect understanding and responsiveness from them. Well trained therapists’ understanding of their patients’ quandary is an essential ingredient of their having another chance at a future. (Erikson was neither the first nor the last analyst to dispute Freud’s contentions and to go on ahead of him. Crews fails to acknowledge past and present psychoanalytic work that does not support his thesis.)
In the final analysis, though, Crews is right in at least one respect. Freud’s tendentious arguments to prove his point were extremely harmful to some of his patients and to the field he tried so hard to establish. Nevertheless psychoanalytic scholars continue to study Freud’s theories and case histories as part of the ongoing effort to learn from Freud’s frank histories and his mistakes, to widen knowledge about a still largely “unknown” psychological universe, to further clinical understanding and improve therapeutic efficacy. Perhaps Professor Crews can come to see that his selective omissions of analysts’ critical studies, and what can be learned from them, are in the service of the tendentiousness of his argument, his insistence on his “truth” about psychoanalysis; and that, because these omissions mislead, they actually undermine his argument. If he cannot face this “truth” squarely, his “Unknown Freud” will remain as a classic case of the pot calling the kettle black.
Marian Tolpin, M.D.
Institute for Psychoanalysis
Clinical Professor of Psychiatry
Chicago Medical School
North Chicago, Illinois
To the Editors:
It should not be surprising if psychoanalysts felt impelled to respond to Crews’ missile attack on their profession and its founder.
Perhaps one should start by stating the role of psychoanalysis in the current treatment of mental illness. In their extreme forms, two approaches may be described as follows. The first approach attempts to assess the patient’s illness by an initial interview which is likely to include the use of a questionnaire, a so-called test “instrument,” administered personally or even by computer. The results of this assessment lead the psychiatrist to a code number and diagnosis specified in the current Diagnostic and Statistical Manual. Armed with this information, the psychiatrist then turns to the three volume handbook on Treatments of Psychiatric Disorders. 1 There he will be told how to proceed. Such treatment is usually based primarily upon medication where that is relevant, although other modalities are recommended too. Fortunately this procedure often works out fairly well, especially when the disorder is a circumscribed episode of one of the affective disorders, that is, disorders that lie on the manic depressive spectrum. It is the treatment preferred by third party payers and health maintenance organizations.
Other disorders do not lend themselves to such a mechanical procedure. These include symptom neuroses and personality disorders that impair the individual’s ability to enjoy a loving relation with another person, or to apply himself successfully to any vocation or to escape from a prevailing self-defeating tendency. For these, various psychotherapies are prescribed. Some psychotherapies address themselves to specific symptoms rather than to the patient. They isolate the prominent symptoms of the illness and attempt to suppress them by a kind of conditioning technique. The extraordinary rates of success advertised by the practitioners of such methods, are probably exaggerated, but there is no doubt that the treatment does succeed in many instances.
However for the treatment of other neuroses and the personality disorders, a patient oriented psychotherapy is required. The patient learns about himself, his true desires, and the conflicts that surround them, the salient themes in his life, his major and continuing disabilities. He learns to distinguish between difficulties created by external reality and internal fantasy. For such psychodynamic treatment, an understanding of the basic dynamic mechanisms recognized by Freud are essential; conflict, repression, transference, defense, sublimation, unconscious guilt, Oedipus complex, separation anxiety, the destructive effect of success, to name only a few. In fact, given the current situation in the treatment of mental illness in the United States, the transmission of the understanding of these dynamic mechanisms may be the primary legacy of psychoanalysis to American psychiatry and psychotherapy.
Professor Crews is right. Psychoanalysis has been experiencing a decline in the United States. However one may question his understanding of its cause. As I have watched my practice change over recent years, I see a progressive loss of interest in psychoanalysis for two reasons. First the drug treatments have created a climate of expectation of brief treatment. Second, patients have come to depend more and more on third party—usually insurance company—payments. Insurance companies will not pay for any extended or intensive psychiatric care beyond the bare minimum, except in the case of the most generous policies. Among those segments of the population that can pay for treatment without external supplement, psychoanalysis remains desired. Elsewhere in the world, where economics are different, in Germany for example, and in many countries of South America, for example, psychoanalysis is flourishing.
Having acknowledged in his second sentence that some patients have found psychoanalysis helpful, Crews then feels free to devote the rest of the extended essay to its shortcomings and those of Freud. What are the facts? Establishing the efficacy of any kind of psychotherapy is difficult because personality and individual mental illness, constitutional disposition and temperament, resilience and motivation all differ greatly from one patient to another and it’s difficult to assess these before treatment has started. Moreover it should be obvious that psychoanalysis differ in ability and experience among each other.
In 1979, I reviewed the outcome of 37 former patients, all of my patients who had had at least a minimal amount of psychoanalytic treatment.2 Five of these (14 percent) exhibited dramatic improvement, that is, improvement so striking that friends or relations who hadn’t known that the patients were being treated, commented on the distinct change. Nine others (almost 25 percent) were considered by themselves and their families to have improved impressively as demonstrated by important changes in their ability to function in the several areas of life in which they had previously functioned badly. So these two categories together constituted about 40 percent of the group. Sixteen patients could be said to have achieved limited improvement. They functioned better in one or more areas of life but still far from optimally. In general, these patients and their families were pleased with the outcome but I was less pleased. Seven patients (19 percent) showed no improvement at all. I should add that in almost half of the sample I had used medication along with analysis. However the changes that I looked for in evaluating the treatment, were not the simple changes of mood that drugs produce, but rather alterations in personality function. The distribution of degrees of improvement among patients who had no medication did not differ from those who had medication. Considering the nature of the illness, the duration, and in many cases the constitutional basis, these findings are not at all discouraging. I should imagine that a more recent cohort would do even better.
The reader will note that Crews criticizes only those reports of Freud’s work that were published before 1905, that is, reports of his very earliest psychoanalytic experience, when the discipline was being developed. Crews’ comments did not apply to Freud’s later work nor to psychoanalysis as it is practiced now.
Much has been made in recent years of Freud’s seduction theory versus his subsequent theory that reports of early seduction are fantasy. The perceptive reader who is not looking for polemic, would infer that in some instances actual seduction did take place, while in other instances the seduction took place in fantasy only, and in still others, innocent encounters were interpreted as seduction. In most instances, unless there is outside corroboration, it is difficult or impossible to distinguish among these possibilities. There is no conspiracy here either against children or their parents.
With respect to Freud’s status as a scientist, Crews neglects to inform his readers that before his psychoanalytic work began, Freud had written and published well over 100 papers and monographs on neuroanatomy, neuroembryology, and clinical neurology. At least two of his major monographs, On Aphasia and On Cerebral Palsy, are still considered both authoritative and valid statements.
I shall have nothing to say to Professor Crews’ reports of Freud’s personal behavior. We don’t ordinarily evaluate a discipline by the ethics of its founders but if one thought it necessary to judge Freud’s conduct, it would have been helpful if Professor Crews had made a serious effort to distinguish between established fact on the one hand and gossip, rumor, and speculation on the other. Sigmund Freud never claimed publicly that his personal behavior was exemplary, but those who knew him well, thought that it was.. The Pentateuch demonstrates that the founders of religious monotheism were not above reproach in their personal behavior, but we do not reject monotheistic religion on that account.
Mortimer Ostow, M.D.,P.C.
New York City
To the Editors:
Frederick Crews who wrote the review for you “The Unknown Freud” is clearly a man who reads and writes a lot about psychoanalysis, but there is no evidence that he has knowledge of studies on the comparison of the efficacy of psychoanalysis with other forms of psychotherapy. I have done the studies. I thought the readers would be interested in knowing the facts about the relative efficacy of different forms of psychotherapy including psychoanalysis, because he raised the issue. He says, for example, in his first paragraph in which he reviewed four books about different facts of psychoanalytic history “in the aggregate psychoanalysis has proved to be an indifferently successful and vastly inefficient method of removing neurotic symptoms.”
It is fashionable to make such statements, but in fact Crews should know the facts. His conclusions should have been: (1) there are no adequate studies comparing psychoanalysis with other forms of psychotherapy so there is no proof that it is better or it is worse. (2) It is probably at least as good as other forms of psychotherapy. The evidence for this is that for all treatment comparisons involving different forms of psychotherapy the overwhelming trend is for non-significant differences in benefits received from the different forms of psychotherapy, including psychodynamically oriented psychotherapy (which is a shorter form of psychoanalytic psychotherapy). (3) The evidence is overwhelming, in fact, that these different forms of psychotherapy produce very meaningful benefits for the majority of patients.
For Professor Crews and for the interested audience, which I know is very large, I will cite just a few reviews of comparative psychotherapy studies:
L. Luborsky, L. Diguer, E. Luborsky, B. Singer, D. Dickter (1993). “The efficacy of dynamic psychotherapies. Is it true that everyone has won so all shall have prizes?” In N. Miller et al., Handbook of Dynamic Psychotherapy Research and Practice (New York: Basic Books).
L. Luborsky, N. Miller, J. Barber, J. Docherty (1993). “Where we are and what is next in dynamic therapy research and practice.” In N. Miller et al., Handbook of Dynamic Psychotherapy Research and Practice. (New York: Basic Books, chapter 25).
L. Luborsky, B. Singer, & Lise Luborsky (1975). “Comparative studies of psychotherapies: Is it true that ‘Everyone has won and all must have prizes?”’ Archives of General Psychiatry, 32, pp. 995–1,008.
M. Smith, G. Glass, and T. Miller (1980). The Benefits of Psychotherapy (Baltimore: Johns Hopkins University Press).
I will be glad to send some of these reprints to Professor Crews or any of the readers who write me for them.
Laster Luborsky, Ph.D.
Center for Psychotherapy Research
University of Pennsylvania
3600 Market Street, Room 703
To the Editors:
It was very surprising and disappointing that such a distinguished periodical as The New York Review of Books would publish an article containing gross misunderstandings and scurrilous comments against Freud and psychoanalysis by Professor Frederick Crews. Readers of The Review should expect sober and scholarly appraisal rather than what appears to be a series of emotionally charged statements which deal more with misperceptions and misconceptions than scientific, objective evaluation. It appears that Freud cannot be allowed human frailty, any errors, or lack of present-day knowledge. Even his critics are criticized for not being critical enough. The enduring discoveries of his revolutionary genius are cavalierly dismissed with superficial consideration and supercilious contempt.
At this time, Freud’s initial propositions, first findings, and landmark case reports are no longer vital for the validation of psychoanalytic formulation. Further, as psychoanalysts became popularized, many concepts were distorted and bowdlerized; a tendency which can be discerned in the Crews article.
Freud is part of our culture, our way of comprehending personality development and disorder. All rational psychotherapy is based upon psychoanalytic principles. Psychoanalysis provides a fundamental mode of exploring and understanding art and literature, biography and history, etc. Concepts of repression, regression, denial, projection, and “Freudian slip” have become part of our language. The vulgar idiom “jerk off,” conveys thinly disguised castration anxiety. Lady Macbeth washes her hands because of underlying guilt, not because her hands are literally dirty. Shakespeare intuited ego defenses and can be invoked in “me thinks Dr. Crews doth protest too much.”
Dr. Crews implied that The Sigmund Freud Archives has concealed documents to protect Freud’s reputation. This is contrary to the fact that The Sigmund Freud Archives’ policy has been to derestrict and release Freud correspondence as quickly as legally and ethically possible. Professor Crews cites a document restricted to 2102 when he could have ascertained that this document was already derestricted by The Sigmund Freud Archives. The Archives are now largely derestricted and much of the new Freud documents have become available through The Sigmund Freud Archives.
Finally, the encompassing explanatory reach of psychoanalytic theory and the immense value of psychoanalytic therapy stand on their own merits having endured the test of time and continuing challenge. Psychoanalysis has developed independent of the person, personality, and personal life of its creator. But Freud could have, in the final analysis, ironically observed, “they may attack my theories by day, but they dream of them at night.”
Harold P. Blum, M.D.
The Sigmund Freud Archives, Inc.
Roslyn Estates, New York
Bernard L. Pacella, M.D.
The American Psychoanalytic Association
New York City
Frederick Crews replies:
It does appear that, as the psychoanalyst David Olds reports above, “The Unknown Freud” has caused widespread “fear and rage” within the Freudian community. The result is a deluge of mail such as the New York Review has rarely seen. The letters above constitute only the most civil and temperate of countless protests mailed in by offended Freudians, most of them practicing psychoanalysts.
Those unpublished complaints deserve at least a passing mention here. In the rhetorical tradition perfected by Freud himself, they tend to concentrate not on the substance of my argument but on my allegedly defective personality, the main sign of which is precisely my incapacity to render a “balanced”—i.e., predominantly appreciative—assessment of Freud and his brainchild. The letters thus beg the question of whether, as I argue, Freud’s scientific reputation has been grossly inflated, first through his own promotional efforts and later by self-interested disciples.
The unpublished letters also converge in calling my essay ad hominem, as several of the published letters do as well. I deny the charge. An ad hominem argument is one that ducks substantive issues by vilifying the person or kind of person who takes the position opposite to one’s own. But though the main emphasis of “The Unknown Freud” is biographical, it begins by summarizing the objective grounds for deciding that the “clinical validation” of psychoanalytic ideas is hopelessly circular and that Freud’s theories of personality and neurosis are woolly, strained, and unsupported. And it directs curious readers to sources that establish those judgments in a strictly evidence-based manner3 My essay makes it clear that I object to Freud’s doctrine not because Freud himself displayed certain weaknesses of judgment and character but because his theoretical and therapeutic pretensions have been weighed and found to be hollow.
Although I can hardly expect psychoanalysts to be grateful for my restraint, moreover, I actually steered clear of their founder’s least stable side—his lethal cocaine evangelism, his phobias and psychosomatic fainting spells, his bizarre superstitions, his belief in the magic power of telephone and hotel room numbers, his affinity for ESP, his gnostic ideas about the primal horde and its Lamarckian effect on modern psyches, his paranoid streak, and what even his hagiographer Ernest Jones called his “twilight condition of mind” at the time of his famous self-analysis.4 Both Josef Breuer and Sándor Ferenczi, who knew Freud extremely well, came to regard him as a borderline psychotic, and they were probably right. My essay, however, eschews speculation about the ways in which specific delusions on Freud’s part may have found their way into psychoanalytic theory.
Before answering the pro-Freudian letters that appear above, let me refresh reader’s memories by recapitulating the claims of my essay:
—that Freud’s uniquely psychoanalytic ideas have received no appreciable corroboration, and much discouragement, from independent sources;
—that his method of reaching causal conclusions, even in the idealized form described in his public writings, could not have reliably yielded those conclusions by any imaginable path of inference;
—that his actual method was far worse, namely, turning hunches, borrowed notions, and corollaries of his other beliefs into certainties and then depicting those “findings” as the inescapable results of clinical experience;
—that his idea of corroboration was the fallacious one of heaping up consilient-looking exercises of his interpretative style, without regard for rival lines of possible explanation;
—that his perceptions and diagnoses invariably served his self-interest, always shifting according to the propagandistic or polemical needs of the moment;
—that his therapeutic successes, supposedly the chief warrant that his psychological theory was correct, appear to have been nonexistent, and that he lied about them brazenly and often;
—that his rules of interpretation were so open-ended as to permit him to twist any presented feature to a predetermined emphasis;
—that he brushed aside as trivial the main threat to the integrity of psychoanalytic knowledge, namely, the contaminating effect of the therapist’s suggestion;
—that, as a result, he failed to maintain even a minimal demarcation between his own obsessions and those of his patients;
—that the “stories” figuring crucially in the official version of his transit from the seduction theory to psychoanalysis proper were his own inventions, misascribed at first to his patients’ early histories and soon after, more extravagantly, to their early fantasies—thus foisting off his “seduction” error on the contents of their minds when they were toddlers;
—that, consequently, there never was a need to import notions such as repression and the infantile-sexual basis of neurosis to account for what Freud “found” in the patients whom he now chose to regard in a psychoanalytic light;
—that the coercive tactics by which he attempted to win his patients’ agreement to his own theory-driven surmises about their infantile histories rendered him the chief begetter of our contemporary “false memory syndrome”;
—that, with his approval, his movement conducted itself less like a scientific-medical enterprise than like a politburo bent upon snuffing out deviationism; and
—that the “science” he invented was, and remains, a pseudoscience, in that it relies massively on unexamined dogma, lacks any safeguards against the drawing of arbitrary inferences, and insulates itself in several ways from the normal give-and-take of scientific debate.
Remarkably few of the letters above, written by eight American psychoanalysts and one British academic of a known Freudian persuasion, address any of these points in specific detail. Indeed, a number of the letters don’t just leave my theses unchallenged but grant that they may be substantially correct. Curiously, however, such concessions leave the writers’ general loyalty to Freudianism undiminished. Whereas the orthodox psychoanalysts in the group appear to be “massively into denial,” the more liberal ones would like to embrace just enough criticism of Freud to distance themselves from his errors—thus skirting the awkward fact that their method of making “advances in insight” remains exactly as subjective as his own.
It is, for the most part, the liberal, modernizing analysts who are represented in the letters above. As a result, one sees there only traces of the misty-eyed Freudolatry that used to characterize psychoanalytic discourse—traces, for example, such as Dr. Olds’s likening of Freud’s muddled self-analysis to a heroic self-appendectomy,5 or Dr. Ostow’s tribute to the humble Freud’s “exemplary” personal behavior.6 Nevertheless, some of these writers do claim that I have misrepresented Freud in important respects. Let us see if their charges hold up.
Dr. Jean Schimek was the first psychoanalyst to have squarely faced Freud’s conflicting accounts of his seduction theory.7 Now, understandably, Schimek prefers to renounce any credit for having inspired “The Unknown Freud.” Since he neglects to show where my “Freud bashing” was factually incorrect, however, his letter serves no purpose other than self-exculpation within the notoriously unforgiving Freudian community.
Nevertheless, I am glad for the opportunity to commend Schimek’s pioneering article and to point out the very modest extent to which my essay went beyond it, Briefly, Schimek establishes the untruthfulness of Freud’s later statements about what his seduction patients “told” him about their molestations in early childhood, and he then asks “why, in 1896, Freud presented his data in an ambiguous and inconsistent fashion, and why he saw them as much clearer and stronger (‘almost all of my women patients told me…’) once they had become evidence for universal oedipal fantasies rather than proof of the past misdeeds of some individual fathers” (Schimek, p. 961). My essay supplies the answer that is already implicit in this delicately posed question: Freud misrepresented what his hysterics had “told” him because it suited his later theoretical interests to do so.
It is too bad that James Hopkins couldn’t have studied Schimek’s article before writing his own letter, which does at least get down to specifics. Those details just don’t lead to the conclusions he thinks they do. It is Schimek, not Hopkins, who clearly recognizes Freud’s contradictions over “seduction” and who understands the nonclinical basis on which “the father” came to dominate the last phase of Freud’s prepsychoanalytic thought. I will draw on Schimek’s findings in the following response to Hopkins.
The core of Hopkins’s letter is his allegation that, by overlooking the evolution of Freud’s seduction theory in the last year of its existence, 1897, I have created a false discrepancy between Freud’s early and late, accounts of that theory, thus unjustly impugning his integrity. Specifically, says Hopkins, Freud did, in his private letters to Fliess, blame fathers for the molestations he believed his hysterical patients to have undergone—and so he was being strictly truthful when he later characterized his abandoned theory in the same terms.
Hopkins’s letter goes awry on several points that will require explanation, but it is also wrong in a global way that can be stated at once. My brief against Freud in the seduction matter was a double one. First, Freud later pretended that nearly all of his female hysterics had directly told him about early childhood molestations which in fact were sheer inventions of his own; and second, he eventually maintained that those patients had named their fathers as the culprits. If, as his three relevant papers of 1896 abundantly show, Freud conjectured the infantile scenes that his patients never did succeed in remembering, then his later versions of the story, including the one that incriminates fathers, are manifestly false. No conclusions drawn from the Freud-Fliess letters could challenge this assertion, which pertains to inconsistencies in Freud’s published writings. Hopkins’s laboriously reasoned indictment is thus much ado about nothing.
Hopkins would have us believe that Freud in all of his later statements was merely recalling the final, never published, phase of his seduction theory, in which “the father” indeed served as the evil protagonist. How odd, then, that fathers aren’t even mentioned in Freud’s first retrospective comments about the theory in 1914, when he began making self-serving misstatements about the authorship of the infantile scenes. Indeed, it took Freud until 1925, in his Autobiographical Study, to assert that most of his women patients in the 1890s had explicitly blamed their fathers. When he repeated that claim more strongly in 1933, in his New Introductory Lectures, his reason for doing so was made transparently clear by a following sentence: “It was only later that I was able to recognize in this phantasy of being seduced by the father the expression of the typical Oedipus complex in women” (Standard Edition, 22:120).8
A further aim on Hopkins’s part is to show, through several examples, that Freud’s hysterics did offer him uncoerced reports of sexual abuse, in direct contradiction of my claim that the scenes were invented. In making this argument, however, Hopkins reveals that he has misunderstood the seduction theory in all of its variations. As Schimek explains, Freud’s theory anticipated the retrieval of sexual material from two stages of a hysteric’s life: a molestation between the ages of two and five and a disturbing incident after the onset of puberty. The latter could be anything from “the stroking of the hand or the hearing of a mildly obscene joke” (Schimek, p. 941) to a fully incestuous relationship. The inevitability that some recollection on a patient’s part would fall into such a vast category rendered this aspect of his interrogations relatively uninteresting to Freud, even when adolescent incest was involved. If the seduction theory was not to topple, he would have to go further and show that the Ur-traumas from ages two to five had actually occurred.9 And those same “scenes” were to become no less indispensable to psychoanalysis itself, which came into being as an attempt to account for them as repressed oedipal fantasy. But since the scenes existed only in Freud’s head, the only thing that required explaining was his own fanaticism.
Hopkins’s error will become clearer if we look at one of the cases he cites, that of a patient who consciously recollected that her father had lasciviously fondled her between the ages of eight and twelve. Hopkins believes that such narratives gave Freud just the key information he was seeking. Freud, however, saw the matter very differently, and his account to Fliess, on April 28, 1897, of his two initial sessions with this patient displays the prodding and coaching that Hopkins is at such pains to deny.
The patient was a young woman who had become insomniac after seeing her brother hauled off to an insane asylum. Characteristically brushing aside that palpable trauma, Freud told her that “[i]n my analyses the guilty people are close relatives, father or brother.” Apparently without coercion, the woman then revealed her molestation by her father in her preadolescent years. Here again lay a likely source of mental disturbance in the present. For Freud’s purposes, however, such direct reporting of actual abuse beyond age five was little more than a challenge to his powers as a psychic detective. “Of course,” he relates to Fliess, “when I told her that similar and worse things must have happened in her earliest childhood, she could not find it incredible.”10
Did Freud in the “seduction” period, as Hopkins proposes, make serious attempts to guard against the effects of his own suggestion? Readers can judge for themselves by studying both the letter just quoted and the “Habemus papam!” letter of January 3, 1897, that Hopkins also attempts to enlist in his behalf. There Freud tells Fliess that he has solved the case of a patient (a cousin of Fliess’s) who must have been molested by her father:
When I thrust the explanation at her, she was at first won over; then she committed the folly of questioning the old man himself, who at the very first intimation exclaimed indignantly, “Are you implying that I was the one?” and swore a holy oath to his innocence.
She is now in the throes of the most vehement resistance, claims to believe him, but attests to her identification with him by having become dishonest and swearing false oaths.11
As I indicated in my essay, Freud believed that even the tortures inflicted by witch interrogators yielded uncontaminated psychic data—a position to which he still adhered after founding psychoanalysis.12 Not surprisingly, then, he expended as much ingenuity on the uncontrolled and egregiously leading pursuit of infantile “primal scencs” and repressed fantasies as he had previously devoted to infantile incest. This is not the Freud described in Hopkin’s letter, but so much the worse for Hopkins’s ability to read the record discerningly.13
The psychoanalysts represented above share a belief, widely held among the uninformed public, that Freud, though fallible, bequeathed us a precious store of permanently valid discoveries and concepts. The inventory above includes the unconscious, infantile sexuality, dream symbolism, repression, regression, projection, sublimation, denial, transference, countertransference, “Freudian slips,” and of course the centerpiece of it all, the universal Oedipus complex. These notions are thrown back at me as if only ingratitude had kept me from paying due obeisance to them. Astonishingly, most of the writers seem unaware that their conceptual stock-in-trade is even controversial, much less that it lacks corroboration that can be taken seriously outside the precincts of the Freudian village.
How can this be? The answer is that these analysts, like their colleagues around the world, fail to grasp what is required of an adequate scientific explanation. With Freud, they believe that the instancing of a causal hypothesis—showing that it “works” in “covering” the phenomenon in question—suffices to prove its worth. The mere fact that generations of Freudians have been able to organize their data according to Freudian categories strikes them as settling the matter.14 They thus inhabit a kind of scientific preschool in which no one divulges the grown-up secret that successful causal explanation must be differential, establishing the superiority of a given hypothesis to all of its extant rivals.
Whenever that standard has been applied, Freudian notions have failed to pass muster. Nor should we be surprised, since the entire psychoanalytic system was assembled deductively as an elaboration of Freud’s infantile-sexual etiology of neurosis, about which even the analysts themselves now feel distinctly queasy. Every Freudian idea, it turns out, suffers from several of the following deadly flaws: vagueness (no determinate consequences can be predicted by its use), excessiveness (the explained phenomena can be accounted for more satisfactorily by more plausible suppositions), logical dependency on other dubious notions, and superfluousness (the explained phenomena are themselves illusory products of the theory).
Take, for example, the concept of transference, regarded by virtually all modern analysts as the most axiomatic of Freudian theoretical entities. Transference as Freud understood it is the patient’s reliving of infantile cravings and disappointments through an unconscious casting of the therapist as a substitute parent. It is thus an artifact of the Oedipus complex, itself a colossal overgeneralization of Freud’s hunches about the origin of his own hysterical tendency.15 And since transference can be either “positive” or “negative,” without our possessing any guidelines for knowing which kind to expect next, no behavioral consequences flow from it, and it is therefore at once irrefutable and operationally devoid of meaning.
The usefulness of transference to Freud, however, was considerable. Like its constituent defense mechanism of “resistance,” transference explained why Freud’s patients failed to recall the “memories” he proffered them and why they acquired “no sense of conviction of the correctness of the construction that [had] been communicated” to them (SE, 18:18). In short, transference could be invoked to spare Freud from recognizing that he might be wrong.
The concept first acquired prominence, in fact, when “Dora” refused to accept Freud’s thesis that she was in love with the adulterous pedophile and chambermaid seducer “Herr K,” whose advances to his friend’s daughter Freud deemed “neither tactless nor offensive” (SE, 7:38n). Instead of asking himself whether Dora might not be a better judge of her own amorous feelings than he was, Freud decided that her love for Herr K—ultimately derived, as he explained to her, from her desire to commit sex acts with her father—had now blossomed into love of Freud himself. Thus when Dora dreamed of smoke, Freud concluded that she was really pining unconsciously for a kiss from his own cigarscented lips (SE, 7:74). And when Dora reasonably decided that nothing could be gained from continuing to consult such a physician, Freud once again laid all the blame on the tumultuous effects of transference (SE, 7:118-19).16
Needless to say, liberal contemporary analysts feel that they have purged transference of its wild-card hermeneutic function and its narrowly oedipal basis. In Dr. Marian Tolpin’s letter above, for example, little remains of the concept but a Cheshire cat smile—a bland hope on the part of patients that their “basic needs for adults’ fidelity” will be better met by therapists than they were by parents. I do not begrudge the liberals this retreat from Freud’s sexual house of horrors into Mr. Rogers’s neighborhood. But I must point out that their revised understanding of transference becomes less objectionable precisely to the degree that it sheds its uniquely psychoanalytic character.
Meanwhile, the concept inevitably remains entangled in the therapeutically questionable practice of fostering a “transference neurosis,” or childish overinvolvement with the analyst, which will then take years to “work through.” As Dr. Olds frankly points out above, another likely outcome is that “the regressed neurotic aspects of both partners” will bring about “disasters.” By fetishizing emotional distortions on both sides, moreover, the whole transference-countertransference rigmarole deflects attention from the cognitive dubiety of psychoanalytic formulations in general and of the analyst’s surmises in particular. All in all, then, this pivotal notion has proved itself to be not only scientifically vacuous but also considerably worse than useless as a guide to the rational addressing of patients’ initial complaints.
A similar critique could be made of every other Freudian heirloom prized by my correspondents. We have already seen, for instance, that Freud’s own favorite idea, repression, arose to meet a wholly imaginary need. When Freud conceded the absence of the early sexual events posited by his seduction theory, the concept of repression was elevated into an article of sheer faith in undetectable subterranean transactions, without even a hypothetical link to the recoverable misfortunes of children. In full-blown psychoanalytic theory, repression serves as a pseudo-explanation of a pseudo-phenomenon, the personality-forming renunciation by children of their primary desire to do away with one parent and copulate with the other. Well-designed experimental studies have not produced a shred of evidence for the existence of such a mechanism.17
The concept of repression has nonetheless survived and prospered, thanks to a conjunction of several factors: the analytic fraternity’s century-long cover-up of Freud’s bungling in the birth hour of psychoanalysis; Freud’s public relations success in enlisting repression to “explain” dreams, jokes, and errors;18 the enticingness of the concept as a means of facilely negating manifest appearances; and a failure, by both analysts and the lay public, to appreciate the difference between isolated traumatic amnesia (a real but unusual occurrence) and Freudian repression, which entails all the epistemic liabilities of the Oedipus complex, the castration complex, and a demonstrably erroneous idea of the way human memories are typically made unavailable to consciousness.
This last point deserves emphasis because of its bearing on the urgent question of the moment, false memory syndrome. As Richard Ofshe and Ethan Watters have shown, unscrupulous or incompetent therapists who induce patients to “recall” fictitious molestations with hallucinatory vividness are employing a souped-up but still recognizably Freudian idea of repression.19 They share with Freud the discredited belief that all experience, even from earliest infancy, is photographically stored and retained without normal degradation over time. Like Freud, they deem that only repression can account for the inaccessibility of a given memory at a given moment. Again, they subscribe to his groundless tenet that repression can block the memory not just of a sudden shocking assault but also of whole years’ worth of psychically unacceptable events. And most significantly, they also share his conviction that a patient’s disorientation and distress when confronted with alarming suggestions about his childhood must constitute a partial lifting of repression—that is, a delayed activation of the affect that could not be felt at the time.
Similarly, prosecutors who browbeat innocent persons into confessing to satanistic sexual crimes are reaping the legacy of Freud’s utter refusal to make allowance for the contaminating effect of suggestion. In his own words,
We must not be led astray by initial denials. If we keep firmly to what we have inferred, we shall in the end conquer every resistance by emphasizing the unshakeable nature of our convictions…. Moreover, the idea that one might, by one’s insistence, cause a patient who is psychically normal to accuse himself falsely of sexual misdemeanours—such an idea may safely be disregarded as an imaginary danger. (SE, 3:269).20
The psychoanalysts represented above are most exercised of all by my apparent imputation that their guild has made no intellectual or behavioral improvement since Freud’s day. But this is to misconstrue my argument. The outlandishness of Freud’s beliefs and practices virtually guaranteed that any sane, honest, and compassionate successor would make fewer incredible assertions and achieve better clinical results than he and the members of his doctrinaire and unethical circle did. If, as Dr. Olds tells us, analysts have learned through “trial and error” the imprudence of seducing their patients, I will not deny that this is a step in the right direction. And I, too, like Dr. Tolpin, find Erik Erikson’s avuncular wisdom more congenial than Freud’s relentless biologism. That Erikson has proved to be a better therapist and moral counselor than Freud strikes me as the safest bet in the world.21
Still, there is a problem here. Neither Erikson’s postulates nor those of any other neo-Freudian can be regarded as bearing the slightest scientific (as opposed to moralideological) weight. All of the defining traits of pseudoscience that I listed in note 20 of my essay apply equally to Freud’s work and to that of his improvers. For, although each of Freud’s ideas has been challenged from within his own tradition, that tradition itself remains one of deplorable conceptual sloppiness and question begging.
To my knowledge, for example, no modern analyst has renounced the cardinal Freudian investigative tool of “free association,” which is inherently incapable of yielding knowledge about the determinants of dreams and symptoms.22 None has even started to make due allowance for the leading and indoctrinating effects of the therapy itself. None, again, has revised the theory so as to endow it with clear predictive implications—a step whose absence means that any number of schismatic Freudian sects can proliferate without appeal to a factual basis for adjudicating between them. And none has removed the ultimate joker from the Freudian deck—the principle that an analyst is entitled, in Freud’s words, to “handle unconscious ideas, unconscious trains of thought, and unconscious impulses as though they were no less valid and unimpeachable psychological data than conscious ones” (SE, 7:113). As Malcolm Macmillan puts it, “We are never told that the so-called discoveries are dependent upon methods of inquiry and interpretation so defective that even practitioners trained in their use are unable to reach vaguely congruent conclusions about such things as the interpretation of a dream or a symptom[,] let alone the basic clinical characteristics of infantile or perverse sexuality or the reconstruction of the early stages of an individual’s development or…the functions that make up a given structure.”23
On this basis, moreover, I must qualify my praise of modern analysts for doing better than Freud in their therapeutic work. They want us to believe that the improvements they have achieved were made possible in part by a scientific honing of their concepts over time. It is true, certainly, that merely by refraining from reliance on such backward ideas as inevitable female masochism and the fateful consequences of masturbation, any contemporary therapist would have a head start over Freud. But because the liberalized versions of psychoanalysis continue to use amorphous uncharacterized terms and to make untested claims, the relationship between psychoanalytic dogma and therapeutic effects remains as imprecise and prayerful as ever.
In this connection, much can be learned from Dr. Peyser’s story of his female patient who returned to treatment because of anxiety about her impending marriage—an anxiety caused, Peyser later learned, by her involvement with a second and more alluring man. She was of course “fully conscious” of this problem when she consulted Peyser, but because of indirections that are built into psychoanalytic technique, the topic didn’t come up, and the doctor’s fees, we can safely assume, kept mounting. (“We go on for a while without any increase in understanding of the matter or change in the situation….”) After again suspending the treatment for a month, however, the patient returned to announce that an astute prior dream interpretation on Peyser’s part had enabled her to tell him about her dilemma at last. (He had already guessed, but, good Freudian clinician that he is, he hadn’t wanted to intrude.) And then comes the less than cathartic denouement: “Now we were able to work on [her secret] and help resolve it so that she could become ‘unstuck’ and proceed with her life”—but in which direction and with what success we are not told.
This narrative really seems to illustrate the way psychoanalysis itself can become an extra burden for a client. One gets the impression that merely keeping the therapeutic relationship going had become a goal for both parties and that a fear of displeasing her analyst was needlessly costing this woman a good deal of time and money. Would she not have done better to discuss her problem with a few sympathetic friends? And can Peyser be sure that it was really his dream interpretation, and not some other development in the woman’s life, that allowed his sessions with her to resume?
And then there is the question of whether Peyser had “correctly” decoded his patient’s snake-in-the-shower dream. That someone who, at the time, was keeping two lovers busy suffered from “ambivalence towards the phallus” appears far from self-evident. It may be, of course, that Peyser and his patient were using dreams and their glossing as an Aesopian language for the discreet trading of hints; as the psychoanalyst Judd Marmor observed long ago, patients in various styles of psychotherapy learn to edit their dream reports in ways that suit the theoretical expectations of their doctors. What must be firmly rejected, however, is Peyser’s implication that the unique correctness of Freudian ideas allowed him to reach an outcome (whatever it was!) that couldn’t have been attained in any number of less roundabout ways.
For all the advanced company he keeps in “the Rapaport-Klein Group,” Dr. Peyser is still enmired in the primitive post hoc ergo propter hoc style of thought that pervades psychoanalytic discourse. As independent students of therapeutic outcomes understand, it is not enough to observe that, after a lapse of months or years, some favorable change occurred in a patient’s attitude or mood. The question must always be whether factors specific to the therapist’s mode of treatment—and not factors shared by all treatments or factors originating outside the treatment—brought about the good result. The same problem bedevils Dr. Ostow’s letter, which reports on a follow-up of thirty-seven of his former patients. It is sad enough that, even though Ostow had employed “medication along with analysis,” a full 62 percent of those patients had improved very little or not at all. But more pathetic still is Ostow’s total unawareness that, thanks to his failure to control for nonpsychoanalytic effects, his survey lacks any validity.
There is, however, one letter above from a correspondent who has spent a lifetime doing just what I am recommending here, the comparative study of Freudian and non-Freudian therapeutic outcomes. Lester Luborsky believes that I need to undertake a crash course of reading on the topic. But Luborsky goes badly wrong in several assertions, the least important of which is his claim that I am unfamiliar with his writings. As early as 1980, I was not only citing his work but also disputing the unwarranted partisan conclusions that he persists in drawing from it.
In his letter, Luborsky asserts that all psychotherapies (that is, “talking cures”) may be about equally effective and that I am therefore out of line in calling psychoanalysis “indifferently successful” and “vastly inefficient.” This only shows that Luborsky has yet to learn what the words “indifferently” and “inefficient” mean. As I wrote in 1980, “if one therapy worked about as well as another, only people with severely impaired reasoning, or with motives other than a wish to be speedily cured, would choose the one that is most disruptive of their budgets and work schedules.”24
Luborsky is on record as believing that Freudian analysts are in possession, not of a counterintuitive and embattled system of decoding, but of “a unique store of clinical wisdom.”25 He recognizes, however, that psychoanalysis has had to retreat from the claim of superior curative power that Freud cited as the cardinal proof of his theory’s correctness. Long ago, therefore, Luborsky adopted a more furtive strategy, that of making psychoanalysis look as inconspicuous as possible within a modestly cheerful assessment of all psychotherapies. This, once again, is the purpose of his present letter.
But Luborsky has fared poorly even in this low-profile endeavor. Consider, for example, the book by Glass et al. mentioned in the remedial reading list he has prepared for my edification. Glass himself later acknowledged that his 1980 study failed to cover a single “outcome evaluation of orthodox Freudian psychoanalysis.”26 Moreover, the criterion of therapeutic effectiveness employed by both Glass et al. and Luborsky—namely, better results than no treatment at all—has been rejected as too lax by a number of independent researchers, who cogently maintain that placebo treatment, not an absence of treatment, ought to serve as the baseline of comparison. And according to authors who have specifically reanalyzed and disputed the work of Glass et al., “there is no evidence that the benefits of psychotherapy are greater than those of placebo treatment.”27 Thus Luborsky’s attempt, in his letter, to tuck psychoanalytic treatment beneath the skirts of short-term “dynamically oriented [i.e., Freudian] psychotherapy” is as futile as it is shabby, given the failure even of such brief therapy to show significantly better results than hand-holding control treatments.
The real import of Luborsky’s work, as he himself elsewhere admits, is that psychotherapies succeed (when they do) thanks to factors that they all share—that is, placebo factors.28 Thus, contra Freud, occasional happy outcomes of Freudian therapy are incapable of vouching either for the truth of psychoanalytic notions about the mind or for the posited mechanism of psychoanalytic cure. No doubt it is motivationally useful for each of the myriad extant psychotherapies to offer its clients some structure of belief—whether it be about undoing infantile repression, contacting the inner child, surrendering to the collective unconscious, or reliving previous incarnations—but as Luborsky understands, such notions are window dressing for the more mundane and mildly effective process of renting a solicitous helper.
Once this point sinks in, psychoanalytic patients may well question why they should be spending years reconstructing early memories, fantasies, and feelings which, even if they should happen to be genuine, will prove therapeutically inert. And if some patients still won’t care, the devisers of their medical benefits surely will.
I reserve for last the haughty letter composed jointly by Drs. Harold P. Blum and Bernard L. Pacella, the executive director of the Sigmund Freud Archives and president of the American Psychoanalytic Association, respectively. These eminences charge me with many “gross misunderstandings” but are able to name only one, my failure to realize that a certain letter in the Archives originally restricted until the year 2102 is now available for viewing. No such date, however, appears in my essay. I suppose that Blum and Pacella must be referring to an actual letter that they know to have been originally destined for release in 2102. Perhaps they can tell us which letter it is, how recently it was declassified, and how it first came to be salted away for an intended age.
I raise these questions because, insofar as the Blum-Pacella letter attempts to deny that “the Sigmund Freud Archives has concealed documents to protect Freud’s reputation,” it whitewashes a sordid history that Blum knows only too intimately. Blum was appointed to replace Kurt Eissler when the latter’s reign of Stalinesque censorship, which began with the founding of the archives in the early 1950s, was exposed to worldwide ridicule by Janet Malcolm in the 1980s. It was that mortifying episode, not any long-standing policy, that eventually induced the Archives’ trustees to begin counteracting Eissler’s mischief by giving Blum a different mandate. And even so, the current “Restricted Section” catalog, as of December 1993, still includes whole sets of documents that are supposed to remain inaccessible until such dates as 2020, 2050, 2053, 2056, 2057, and 2113.
What Blum more particularly fails to disclose is that the Eissler regime has cast a sinister afterglow over his own contrary efforts. Eissler remains the executor of all documents donated by Anna Freud in the wake of the Jeffrey Masson brouhaha that Malcolm so entertainingly related, and he has continued to guard those documents against possible defilers of Freud’s shrine. When Eissler ruled the Archives, moreover, he solicited gifts of documents for the Library of Congress but “redonated” them in the name of the Archives, thus affording himself the right to impose absurdly long periods of sequestration. 29 It is a pity that Blum feels he must put such shameful conduct under the rug in the interest of closing Freudian ranks against the “scurrilous” Crews.
But Blum also has some explaining of his own to do. On October 8, 1989, he told an interviewer:
We recently released letters that were considered highly sensitive and that everyone was waiting to see, namely, the Freud-Anna Freud and the Freud-Minna Bernays correspondence. There have been wild speculations about Freud’s having had an affair with Minna. That correspondence is available now to all, and they can draw their own conclusions. But no one has yet inferred from anything in the letters that there is any evidence of any impropriety.30
The documents characterized here include the same Freud-Minna letters of 1893-1910 that Peter Gay declared missing when, having been told that they were ready for examination, he applied to see them in 1989. In fact, however, the letters were neither missing nor accessible. Rather, they were under restriction, and they still are. If Dr. Blum himself has lost track of them, he can find them (I am told) in Container Z3, whose contents are banned from view until the year 2000. Is it believable that Blum was unaware of that fact when he said the opposite in 1989?31
The Blum-Pacella letter is also noteworthy for the speed with which it performs an agile two-step that is attempted in some of the other letters as well: praising “the enduring discoveries of [Freud’s] revolutionary genius” and assuring us that presentday psychoanalysis has left those same treasures safely behind where they will cause no further harm. Freud’s propositions, say Blum and Pacella, “are no longer vital for the validation of psychoanalytic formulation.” Well, what is the new basis of such validation? Quite simply, there is none at all that could impress an independent observer.
I have claimed above that psychoanalysts cannot seem to grasp the rudiments of scientific explanation. As if to illustrate the point, Drs. Blum and Pacella remind us that “Lady Macbeth washes her hands because of underlying guilt, not because her hands are literally dirty.” The logic here is that since both Shakespeare and Freud touched on the same phenomenon, guilt, Freud’s structure of postulates about guilt is thereby validated. Yes, in just the way that the undeniable existence of stars demonstrates the propositions of astrology.
And then there is the sublimely fatuous clincher: “The vulgar idiom ‘jerk off,’ conveys thinly disguised castration anxiety.” Nowhere could one find a more perfect instance of Freudian question begging and dogmatic intellectual slumber. I would like to instruct the president of the American Psychoanalytic Association that something other than a penis comes off as a result of masturbation and that still another castration threat, Ockham’s razor, could be usefully employed here. But will he even understand my criticism? Writing in these pages nearly twenty years ago, Peter Medawar called doctrinaire psychoanalytic theory “the most stupendous intellectual confidence trick of the twentieth century.”32 He could have added that like many another such instrument of deception, its first and most enduring dupes are its own practitioners.
To the Editors:
Frederick Crews includes an amiable critique of my book, Freud’s Russia, in his essay on “The Unknown Freud” [NYR November 18, 1993]. I would like to clarify some of the points raised. Freud’s many kin now known to have resided in the Russian Empire were not in Lithuania, but chiefly in Odessa, where his mother spent part of her childhood. It was the paternal line that Freud traced to Lithuania, whence they began to emigrate in the 18th century. Some unknown relatives, I conjecture, must have remained behind, eventually to endure the worst official Russian anti-semitism. In any case, family roots on both sides made Russian history and politics personally significant to Freud.
I would not characterize Freud, after 1917, as a “disillusioned revolutionary.” He scoffed at the grandiose Bolshevik schemes as early as 1919, before the “Russian experiment” had even begun. Skepticism and irony toward political and religious authority were always hallmarks of his character. On the other hand, he never became a misanthrope, with malice toward the species. He had hope, even in the mid-‘thirties, that the Jews would some day thrive under more enlightened conditions. And he believed that nutrition, pharmacology, and radical organic therapies could in time displace the imperfect art of psychoanalysis, to some degree.
Freud’s ill-will toward Dostoevsky, such as it was, I do not describe as “gratuitous.” The underlying factor, I believe, was Dostoevsky’s late antisemitism, which had become known in the West in Freud’s circle, though it was not well documented. On the other hand, Freud profoundly admired Dostoevsky’s “great intellect” deployed against religious faith (“The Grand Inquisitor”). This indicates the essential rapport between them, and in turn raises the question of Freud’s own Jewish identity, which had great strength on social and personal levels, but none in terms of conventional faith. These are some of the essential elements in Freud’s labored “psychoanalysis” of Dostoevsky, but of course not the whole story.
I have no bone to pick with Freud for the lapses in his art. A number of drugs now used for depressive patients like Freud’s may cause sudden suicide with no prior tendency. There is no evidence, I think, that Freud’s psychoanalytic sessions caused fatalities. He made mistakes, but his therapy was a pioneering theory in an age with no medical options. Real suffering drove patients to seek his help. My own interest in Freud has less to do with his clinical methods than with the design and humor of his world view, and with his idiosyncratic constitution recently summed up by a Harvard psychiatrist as “crafty and inventive” (George E. Vaillant, The Wisdom of the Ego).
This was all I wanted to say, until Professor Crews published his short letter to the editors [NYR, December 16, 1993]. There he declares that a brief interview with Freud published by Giovanni Papini in 1934 is really “a spoof” and so “should be struck from the record.” He gives no explanation whatsoever, but assures us that he has been “reliably informed.” That is harmless enough. One might even suppose it is itself a spoof to incite more letters to the editor. But I object to his letting on that I was the one who caused him to swallow Papini without question, because I quoted the interview from a standard source (Ruitenbeek’s Freud As We Knew Him, 1973) “where it is treated as a serious document.” Apparently Crews failed to notice that even Ruitenbeek cautions the reader, in a note above the text, that the piece’s “veracity has been questioned.” In the interview, Freud says that the entire achievement of psychoanalysis was determined by literary vogues of Europe from the 1880’s on. As I say in my book, this was clearly “the embellished truth,” if true at all, and I was very careful to qualify my use of the material (Freud’s Russia, 38-39). If the interview is a spoof, maybe the joke was on Papini. The literary fantasy is not at all out of character for Freud (who at that very time routinely referred to his Moses as a “novel” in progress), and there is more than a grain of truth to it. The Papini material is just an intriguing retrospect, not a matter of great importance. But it is interesting, so one hopes that Crews will cast off his cloak of mystification, and give us the facts about Papini.
James L. Rice
Frederick Crews replies:
In denying that Freud was a “disillusioned revolutionary,” James L. Rice makes it appear that I regard Freud as having once been an ardent fellow traveler of Bolshevism. Not at all. That phrase of mine appears in a paragraph that has nothing to do with the Russian revolution. What I do say, later, is that although Freud “feared Russian extremism as strongly as he was drawn to it,” he initially looked to the Soviet assault on the old order for a political equivalent of his own scientific revolutionism. It is Rice himself, in Freud’s Russia, who writes of Freud’s “revolutionary idealism, which lasted (with growing reservations) into the early years of the Stalin era” (p. 12). Again, Rice detects “some measure of optimism about ‘the Russian experiment’ on Freud’s part, at the outset of Lenin’s rule” (p. 166). And he quotes Freud himself, in a 1930 letter to Arnold Zweig, to the effect that “any such hope [of human improvement in Russia] that I may have cherished has disappeared in this decade of Soviet rule” (p. 166).
I am sorry if I saddled Rice with my personal sense of Freud’s lurking nihilism. Freud’s Russia does show that Freud was drawn toward what he and others perceived as a “Russian” strain of nihilism, but more in the sense of a passion for destruction than of exasperation with the defective human race. Although there is plenty of evidence for this latter apprehension of Freud, Rice’s disavowal of it should be noted.
Rice needn’t have insisted, however, that he takes a more sanguine view of Freud’s accomplishments than I do. I made the same point myself, referring to his and other authors’ “mixed feelings about Freud’s stature and the legitimacy of psychoanalytic claims.” Rice uncovers the fanciful character of Freud’s analyses in every examined instance but, like many another humanist, shrinks from facing the wholesale unfoundedness of psychoanalysis as a hermeneutic system. For Rice, Freud is still a great if eccentric discoverer whose Interpretation of Dreams, for example, deserves praise for its “insight into the structure and function of dreams” (p. 60)—even though Rice’s own unraveling of the Wolf Man’s dream specimen would seem to point in the opposite direction. My own view is that people who write confidently about “the structure and function of dreams” should first learn something about controlled research on the topic, which seriously undermines Freud’s claims.
Rice wants us to remember that Freud felt empathy as well as dislike for Dostoevsky. Just how deeply Freud respected the novelist, however, seems more open to question than Rice acknowledges. Dostoevsky endowed some of his major characters with a high degree of conscious psychological reflection, thus anticipating some features of Freud’s doctrine but suspending them, as Freud could not, in sophisticated fictive uncertainty and irony. Such a figure must have struck Freud above all as a rival who deserved the treatment he always reserved for his adversaries: reduction to a helpless example of his own pet notions about unconscious infantile compulsion.
Rice also feels compelled to point out that Freud’s interventions never caused fatalities. Had I said that psychoanalysis is lethal? And is Rice really so complacent as to approve a therapy on the grounds that its patients remain alive? (Compare, above, the admission by the psychoanalysts Herbert Peyser and Marian Tolpin that Freud’s errors “led to much improperly imposed suffering” and “were extremely harmful to some of his patients.”) In contrasting Freud’s method to perilous drug therapy, moreover, Rice shows an unawareness that Freud administered cocaine and morphine to his early hysterics, at once endangering their health and compromising any inferences he might otherwise have been able to draw about the efficacy of his “talking cure” alone.
Finally, three informed readers—Anthony Stadlen, John Richardson, and Rolando Amador—have reported independently that Giovanni Papini’s supposed interview with Freud was one of several mock encounters that were easily recognizable as such in his satirical book Gog, which appeared in both Italian and English in 1931. I have belatedly examined the book, and I can only wonder how Hendrik Ruitenbeek ever dared to reprint the Freud chapter as nonfiction. Objecting to my truthful remark that I was lulled by his own serious treatment of the “interview,” Rice now seems to maintain that he was not taken in. One wonders, then, why he says on page 38 of Freud’s Russia that “On 8 May 1934, [Freud] was interviewed by the writer and journalist Giovanni Papini. Freud told Papini that his true vocation had always been that of the novelist or poet,” etc. Rice is in general an excellent scholar, but evidently he has not learned how to own up candidly to a mistake.
Speaking of which, I must enter two further corrections to my own essay. The great Russian psychologist who crossed paths with Sabina Spielrein was of course Lev, not Alexander, Vygotsky. (John Kerr made the same slip.) And as I had discussed in Skeptical Engagements but managed to forget, Freud (twice) underwent cauterization of his nose—not the Emma Eckstein surgery—at Fliess’s hands. This point is not necessarily a minor one, since Freud’s nasal suppurations—which he chiefly treated with cocaine!—were one sign among many that he was using cocaine heavily in the period of confused and often lurid brooding that yielded the “discovery” of the Oedipus complex.
American Psychiatric Association, Treatments of Psychiatric Disorders: A Task Force Report of the American Psychiatric Association (American Psychiatric Association, 1989).↩
"The Outlook for Psychoanalysis," Bulletin of the New York Academy of Medicine, Vol. 59, No. 5, pp. 451–463.↩
To repeat, those sources are Adolf Grünbaum's The Foundations of Psychoanalysis (University of California Press, 1984) and Malcolm Macmillan's Freud Evaluated: The Completed Arc (North-Holland, 1991). Less technically inclined readers, I pointed out, can survey the case against Freudian psychoanalysis in Allen Esterson's briefer Seductive Mirage (Open Court, 1993). For an elaboration and extension of Grünbaum's argument, see also his new Validation in the Clinical Theory of Psychoanalysis: A Study in the Philosophy of Psychoanalysis (International Universities Press, 1993).↩
Ernest Jones, The Life and Work of Sigmund Freud, 3 volumes (Basic Books, 1953–1957), Vol. 1, p. 306. Jones discusses all of the traits I am mentioning here.↩
I have discussed the incoherence and absurdity of Freud's self-analysis in Skeptical Engagements (Oxford University Press, 1986), pp. 6–62.↩
According to Ostow, Freud never told us what a good person he was. On the contrary, his pervasive account of himself as a self-sacrificing man of science has proved to be his most enduring creation. As David Olds says above, Freud's personality included "grandiosity, narcissism, self-delusion and megalomania." It is now widely acknowledged that he was also manipulative and vindictive, even to the extent of plotting the successful plagiarism of his former best friend's unpublished ideas and of driving a severely depressed ex-protégé (Viktor Tausk) to suicide by coldly ordering his analyst to abandon him. Yet this veteran of the world's only self-analysis possessed no insight whatever into the darker side of his nature. As he wrote to James Putnam in 1915, "I believe that when it comes to a sense of justice and consideration for others, to the dislike of making others suffer or taking advantage of them, I can measure myself with the best people I have known. I have never done anything mean or malicious . If only more of [an urge towards the ideal] could be found in other human beings!" (Quoted in Jones, Vol. 3, pp. 314–15.)↩
Jean C. Schimek, "Fact and Fantasy in the Seduction Theory: A Historical Review," Journal of the American Psychoanalytic Association, Vol.35 (1987), pp. 937–965.↩
As Peter Swales has pointed out to me, the very fact that we refer to a "seduction theory" about the rape of small children attests to Freud's success in the airbrushing of history. Once Freud had adopted his notion (actually borrowed from Fliess) of infantile sexuality and had endowed all children with a wish to "seduce" a parent, it became useful for him to claim that his patients had symmetrically (mis)remembered their own "seductions." I will keep to Freud's retrospective nomenclature here, but students of his thought would do well to change the name of the seduction theory to the "molestation theory."↩
"If the first-discovered scene is unsatisfactory, we tell our patient that this experience explains nothing, but that behind it there must be hidden a more significant, earlier, experience" (SE, 3:195–96)."↩
The Complete Letters of Sigmund Freud to Wilhelm Fliess, 1887–1904, translated and edited by Jeffrey Moussaieff Masson (Harvard University Press, 1985), p. 238; italics added.↩
Freud-Fliess letters, pp. 220–221.↩
"Why," Freud asked Fliess, "are [the accused witches'] confessions under torture so like the communications made by my patients in psychic treatment?" (p. 224). Freud's answer was that the "witches" were fantasizing in a manner that was true in every detail to the experience of their repressed infantile molestations. Much later, he broached the subject of witch trials again with his psychoanalytic colleagues, telling them: "We find unmistakably infantile elements in those fantasies that were not created by torture but merely squeezed out by it." See Minutes of the Vienna Psychoanalytic Society, Vol. 2, 1908–1910, edited by Herman Nunberg and Ernest Federn (International Universities Press, 1967), p. 123.↩
Hopkins stumbles in other respects as well. It is pointless to argue, as he tries to do, that Freud's "father etiology," which was soon transmuted into the Oedipus complex, rested solidly on his clinical cases. Everyone knows that it came directly from his self-analysis. Schimek, referring to the very cases cited by Hopkins, observes that "It is hard to tell what was presented by the patients as memories or as dreams and hallucinations; it is also difficult to separate Freud's suggestions and interpretations from the patients' direct and spontaneous statements. Furthermore, two out of the three cases refer to later periods of childhood, and in one instance the father is only indirectly incriminated" (Schimek, p. 952).
Similarly, when Hopkins justifies Freud's shift to an oedipal etiology by citing its superior therapeutic results, he is whistling in the dark. According to the Freud-Fliess letters, many of Freud's hysterics had forsaken his services by 1897. Does Hopkins think that Freud got back in touch with them, broke the news that they were all suffering from Oedipus complexes, and thereby relieved them of their symptoms? And where do we learn about the critical mass of new patients who did so much better from the outset? Freud was eager, as Hopkins inadvertently documents, to draw hasty correlations between symptom abatement and interpretation. He knew, however, that his finished cases were nothing to boast about.
Hopkins's whole letter manifests a desire to take what Freud thought he was doing (being inductive à la John Stuart Mill, correlating hypotheses with therapeutic outcomes, etc.) as sufficient evidence of his actual procedures, which were aprioristic and peremptory in the extreme. From Freud's point of view as a rhetorician, Hopkins would seem to constitute his ideally gullible reader.↩
I make no exception here for "responsible" Freudians like Dr. Peyser, who appears to agree that "Freud's methods of proof are not adequate for a truly scientific discipline." Amid its ecumenical gestures, Peyser's letter glibly refers to Freud's "empirically invaluable" findings and "first order contributions of great importance." This is to say that Peyser's homage to scientific prudence, like his attempt to portray my friends Adolf Grünbaum and Frank Sulloway as admirers of psychoanalysis, is nothing more than a gambit.↩
For the misgivings of analysts themselves about the Oedipus complex, see Macmillan, Freud Evaluated (note 1 above), pp. 489–491. Anthropological objections are summarized by Bruce Bower, "Oedipus Wrecked," Science News, Vol. 140 (October 19, 1991), pp. 248–250. And for a powerful challenge to the concept from an informed evolutionary perspective, see Martin Daly and Margo Wilson, "Is Parent-Offspring Conflict Sex-Linked? Freudian and Darwinian Models," Journal of Personality, Vol.58 (March1990), pp. 163–189.↩
As David Olds mentions above, transference also supposedly accounted for the famous passion of "Anna O" for the alarmed Josef Breuer, who, Freud told us, fled in consternation from Anna and her hysterical pregnancy. Olds could profit from reading Henri Ellenberger's investigation of that prepsychoanalytic event, which never actually occurred; it was a malicious fiction invented by Freud to discredit his former mentor and benefactor and to advertise his own superior courage. See Ellenberger, "The Story of 'Anna O': A Critical Review with New Data," Journal of the History of the Behavioral Sciences, Vol. 8 (1972), pp. 267–279.↩
For gaining an appreciation of the difference between Freudian and scientific standards of research design, there is still no better source than Hans J. Eysenck and Glenn D. Wilson, The Experimental Study of Freudian Theories (Methuen, 1973).↩
It was The Psychopathology of Everyday Life (1901) that chiefly caught the fancy of Freud's lay admirers, who continue to believe that "Freudian slips" neatly demonstrate the truth of psychoanalysis. It has been shown, however, not only that Freud's theory of parapraxes is conceptually dubious but that the book announcing it contains not a single satisfactory illustration of that theory. See Sebastiano Timpanaro, The Freudian Slip: Psychoanalysis and Textual Criticism (1974; reprint NLB, 1976).↩
"Making Monsters," Society, Vol. 30 (March/April 1993), pp. 4–16.↩
This is Freud in quaint pursuit of his own pet "misdemeanor," masturbation. Modern analysts, of course, do not share his Victorian prejudice in this regard. Nor have they taken much interest in incest as a literal tragic event. Yet by continuing to turn their backs on the critical problem of experimenter effects, and by "normalizing" the relatively rare and physiologically based phenomenon of traumatic amnesia, they are not without their own share of responsibility for our national epidemic of false memory accusations. In this connection, see Paul R. McHugh, "Psychotherapy Awry," The American Scholar, Vol. 63 (Winter 1994), pp. 17–30.↩
Dr. Tolpin wishes that I had written a friendly essay about Erikson instead of a harsh one about Freud. In my Skeptical Engagements she can find a whole chapter that correlates Erikson's sweetening of Freudian dogma with his protean adaptability to shifting currents of American ideology.
Tolpin also makes much of my dereliction in implying that Erikson "recommended Freud's treatment of Dora as a model for the treatment of adolescents and young adults." I implied no such thing. Erikson, I said, reported that the Dora case was still (in 1962) being touted in psycho-analytic training as "the classical analysis of the structure and genesis of hysteriá." My statement revealed nothing of Erikson's own views about hysteria, much less about the unmentioned treatment of adolescents.↩
On this point, see Macmillan's Freud Evaluated, Chapter 15–a devastating critique of the entire psychoanalytic means of gathering and interpreting data.↩
Macmillan, Freud Evaluated, p. 505. This last point applies forcefully to Erikson, whose humanistic pronouncements have been grafted onto a schematized, fanciful extension of Freud's empirically unanchored theory of psychosexual stages. Note, too, that Erikson's reading of Dora's dreams, like dozens of other mutually in compatible efforts, offers no basic challenge to the open-season license of Freudian dream interpretation but merely exercises that license, as Dr. Tolpin puts it, "in the light of emerging identity theory." This is a game that any number may play, but to no purpose other than the exemplification of predetermined lessons.↩
Skeptical Engagements, p. 21.↩
Lester Luborsky and Donald P. Spence, "Quantitative Research on Psychoanalytic Therapy," Handbook of Psychotherapy and Behavior Change: An Empirical Analysis, second edition, edited by Sol L. Garfield and Allen E. Bergin (Wiley, 1978), p. 360.↩
Gene V. Glass and Reinhold M. Kliegl, "An Apology for Research Integration in the Study of Psychotherapy," Journal of Consulting and Clinical Psychology, Vol. 51 (1983), p. 40.↩
Leslie Prioleau, Martha Murdock, and Nathan Brody, "An Analysis of Psychotherapy versus Placebo Studies," Behavioral and Brain Sciences, Vol, 6 (1983), p. 275.↩
"The most potent explanatory factor [for the apparent equivalence of outcomes] is that different forms of psychotherapy have major common elements"—a helping relationship with a therapist is present in all of them, along with other related, nonspecific effects such as suggestion and abreaction" (Luborsky et al., 1975, p. 1006).↩
Eissler does, however, grant echt Freudians occasional selective access to some restricted papers. Such a policy can have no other purpose than to perpetuate the Freud legend.↩
William Jeffrey, "A Conversation with Harold Blum," The American Psychoanalyst, Vol. 24, No. 3 (Fall 1990), p. 16.↩
Even the available Freud-Minna letters are not altogether unrestricted. Scholars who apply to examine them are given photocopies in which the names of Freud's patients have been deleted, thus causing needless uncertainty about identities which can hardly be considered sensitive after the lapse of a century or so.↩
P.B. Medawar, "Victims of Psychiatry," New York Review, January 23, 1975, p. 17.↩
American Psychiatric Association, Treatments of Psychiatric Disorders: A Task Force Report of the American Psychiatric Association (American Psychiatric Association, 1989).↩
“The Outlook for Psychoanalysis,” Bulletin of the New York Academy of Medicine, Vol. 59, No. 5, pp. 451–463.↩
To repeat, those sources are Adolf Grünbaum’s The Foundations of Psychoanalysis (University of California Press, 1984) and Malcolm Macmillan’s Freud Evaluated: The Completed Arc (North-Holland, 1991). Less technically inclined readers, I pointed out, can survey the case against Freudian psychoanalysis in Allen Esterson’s briefer Seductive Mirage (Open Court, 1993). For an elaboration and extension of Grünbaum’s argument, see also his new Validation in the Clinical Theory of Psychoanalysis: A Study in the Philosophy of Psychoanalysis (International Universities Press, 1993).↩
Ernest Jones, The Life and Work of Sigmund Freud, 3 volumes (Basic Books, 1953–1957), Vol. 1, p. 306. Jones discusses all of the traits I am mentioning here.↩
I have discussed the incoherence and absurdity of Freud’s self-analysis in Skeptical Engagements (Oxford University Press, 1986), pp. 6–62.↩
According to Ostow, Freud never told us what a good person he was. On the contrary, his pervasive account of himself as a self-sacrificing man of science has proved to be his most enduring creation. As David Olds says above, Freud’s personality included “grandiosity, narcissism, self-delusion and megalomania.” It is now widely acknowledged that he was also manipulative and vindictive, even to the extent of plotting the successful plagiarism of his former best friend’s unpublished ideas and of driving a severely depressed ex-protégé (Viktor Tausk) to suicide by coldly ordering his analyst to abandon him. Yet this veteran of the world’s only self-analysis possessed no insight whatever into the darker side of his nature. As he wrote to James Putnam in 1915, “I believe that when it comes to a sense of justice and consideration for others, to the dislike of making others suffer or taking advantage of them, I can measure myself with the best people I have known. I have never done anything mean or malicious . If only more of [an urge towards the ideal] could be found in other human beings!” (Quoted in Jones, Vol. 3, pp. 314–15.)↩
Jean C. Schimek, “Fact and Fantasy in the Seduction Theory: A Historical Review,” Journal of the American Psychoanalytic Association, Vol.35 (1987), pp. 937–965.↩
As Peter Swales has pointed out to me, the very fact that we refer to a “seduction theory” about the rape of small children attests to Freud’s success in the airbrushing of history. Once Freud had adopted his notion (actually borrowed from Fliess) of infantile sexuality and had endowed all children with a wish to “seduce” a parent, it became useful for him to claim that his patients had symmetrically (mis)remembered their own “seductions.” I will keep to Freud’s retrospective nomenclature here, but students of his thought would do well to change the name of the seduction theory to the “molestation theory.”↩
“If the first-discovered scene is unsatisfactory, we tell our patient that this experience explains nothing, but that behind it there must be hidden a more significant, earlier, experience” (SE, 3:195–96).”↩
The Complete Letters of Sigmund Freud to Wilhelm Fliess, 1887–1904, translated and edited by Jeffrey Moussaieff Masson (Harvard University Press, 1985), p. 238; italics added.↩
Freud-Fliess letters, pp. 220–221.↩
“Why,” Freud asked Fliess, “are [the accused witches’] confessions under torture so like the communications made by my patients in psychic treatment?” (p. 224). Freud’s answer was that the “witches” were fantasizing in a manner that was true in every detail to the experience of their repressed infantile molestations. Much later, he broached the subject of witch trials again with his psychoanalytic colleagues, telling them: “We find unmistakably infantile elements in those fantasies that were not created by torture but merely squeezed out by it.” See Minutes of the Vienna Psychoanalytic Society, Vol. 2, 1908–1910, edited by Herman Nunberg and Ernest Federn (International Universities Press, 1967), p. 123.↩
Hopkins stumbles in other respects as well. It is pointless to argue, as he tries to do, that Freud’s “father etiology,” which was soon transmuted into the Oedipus complex, rested solidly on his clinical cases. Everyone knows that it came directly from his self-analysis. Schimek, referring to the very cases cited by Hopkins, observes that “It is hard to tell what was presented by the patients as memories or as dreams and hallucinations; it is also difficult to separate Freud’s suggestions and interpretations from the patients’ direct and spontaneous statements. Furthermore, two out of the three cases refer to later periods of childhood, and in one instance the father is only indirectly incriminated” (Schimek, p. 952).
Similarly, when Hopkins justifies Freud’s shift to an oedipal etiology by citing its superior therapeutic results, he is whistling in the dark. According to the Freud-Fliess letters, many of Freud’s hysterics had forsaken his services by 1897. Does Hopkins think that Freud got back in touch with them, broke the news that they were all suffering from Oedipus complexes, and thereby relieved them of their symptoms? And where do we learn about the critical mass of new patients who did so much better from the outset? Freud was eager, as Hopkins inadvertently documents, to draw hasty correlations between symptom abatement and interpretation. He knew, however, that his finished cases were nothing to boast about.
Hopkins’s whole letter manifests a desire to take what Freud thought he was doing (being inductive à la John Stuart Mill, correlating hypotheses with therapeutic outcomes, etc.) as sufficient evidence of his actual procedures, which were aprioristic and peremptory in the extreme. From Freud’s point of view as a rhetorician, Hopkins would seem to constitute his ideally gullible reader.↩
I make no exception here for “responsible” Freudians like Dr. Peyser, who appears to agree that “Freud’s methods of proof are not adequate for a truly scientific discipline.” Amid its ecumenical gestures, Peyser’s letter glibly refers to Freud’s “empirically invaluable” findings and “first order contributions of great importance.” This is to say that Peyser’s homage to scientific prudence, like his attempt to portray my friends Adolf Grünbaum and Frank Sulloway as admirers of psychoanalysis, is nothing more than a gambit.↩
For the misgivings of analysts themselves about the Oedipus complex, see Macmillan, Freud Evaluated (note 1 above), pp. 489–491. Anthropological objections are summarized by Bruce Bower, “Oedipus Wrecked,” Science News, Vol. 140 (October 19, 1991), pp. 248–250. And for a powerful challenge to the concept from an informed evolutionary perspective, see Martin Daly and Margo Wilson, “Is Parent-Offspring Conflict Sex-Linked? Freudian and Darwinian Models,” Journal of Personality, Vol.58 (March1990), pp. 163–189.↩
As David Olds mentions above, transference also supposedly accounted for the famous passion of “Anna O” for the alarmed Josef Breuer, who, Freud told us, fled in consternation from Anna and her hysterical pregnancy. Olds could profit from reading Henri Ellenberger’s investigation of that prepsychoanalytic event, which never actually occurred; it was a malicious fiction invented by Freud to discredit his former mentor and benefactor and to advertise his own superior courage. See Ellenberger, “The Story of ‘Anna O’: A Critical Review with New Data,” Journal of the History of the Behavioral Sciences, Vol. 8 (1972), pp. 267–279.↩
For gaining an appreciation of the difference between Freudian and scientific standards of research design, there is still no better source than Hans J. Eysenck and Glenn D. Wilson, The Experimental Study of Freudian Theories (Methuen, 1973).↩
It was The Psychopathology of Everyday Life (1901) that chiefly caught the fancy of Freud’s lay admirers, who continue to believe that “Freudian slips” neatly demonstrate the truth of psychoanalysis. It has been shown, however, not only that Freud’s theory of parapraxes is conceptually dubious but that the book announcing it contains not a single satisfactory illustration of that theory. See Sebastiano Timpanaro, The Freudian Slip: Psychoanalysis and Textual Criticism (1974; reprint NLB, 1976).↩
“Making Monsters,” Society, Vol. 30 (March/April 1993), pp. 4–16.↩
This is Freud in quaint pursuit of his own pet “misdemeanor,” masturbation. Modern analysts, of course, do not share his Victorian prejudice in this regard. Nor have they taken much interest in incest as a literal tragic event. Yet by continuing to turn their backs on the critical problem of experimenter effects, and by “normalizing” the relatively rare and physiologically based phenomenon of traumatic amnesia, they are not without their own share of responsibility for our national epidemic of false memory accusations. In this connection, see Paul R. McHugh, “Psychotherapy Awry,” The American Scholar, Vol. 63 (Winter 1994), pp. 17–30.↩
Dr. Tolpin wishes that I had written a friendly essay about Erikson instead of a harsh one about Freud. In my Skeptical Engagements she can find a whole chapter that correlates Erikson’s sweetening of Freudian dogma with his protean adaptability to shifting currents of American ideology.
Tolpin also makes much of my dereliction in implying that Erikson “recommended Freud’s treatment of Dora as a model for the treatment of adolescents and young adults.” I implied no such thing. Erikson, I said, reported that the Dora case was still (in 1962) being touted in psycho-analytic training as “the classical analysis of the structure and genesis of hysteriá.” My statement revealed nothing of Erikson’s own views about hysteria, much less about the unmentioned treatment of adolescents.↩
On this point, see Macmillan’s Freud Evaluated, Chapter 15–a devastating critique of the entire psychoanalytic means of gathering and interpreting data.↩
Macmillan, Freud Evaluated, p. 505. This last point applies forcefully to Erikson, whose humanistic pronouncements have been grafted onto a schematized, fanciful extension of Freud’s empirically unanchored theory of psychosexual stages. Note, too, that Erikson’s reading of Dora’s dreams, like dozens of other mutually in compatible efforts, offers no basic challenge to the open-season license of Freudian dream interpretation but merely exercises that license, as Dr. Tolpin puts it, “in the light of emerging identity theory.” This is a game that any number may play, but to no purpose other than the exemplification of predetermined lessons.↩
Skeptical Engagements, p. 21.↩
Lester Luborsky and Donald P. Spence, “Quantitative Research on Psychoanalytic Therapy,” Handbook of Psychotherapy and Behavior Change: An Empirical Analysis, second edition, edited by Sol L. Garfield and Allen E. Bergin (Wiley, 1978), p. 360.↩
Gene V. Glass and Reinhold M. Kliegl, “An Apology for Research Integration in the Study of Psychotherapy,” Journal of Consulting and Clinical Psychology, Vol. 51 (1983), p. 40.↩
Leslie Prioleau, Martha Murdock, and Nathan Brody, “An Analysis of Psychotherapy versus Placebo Studies,” Behavioral and Brain Sciences, Vol, 6 (1983), p. 275.↩
“The most potent explanatory factor [for the apparent equivalence of outcomes] is that different forms of psychotherapy have major common elements”—a helping relationship with a therapist is present in all of them, along with other related, nonspecific effects such as suggestion and abreaction” (Luborsky et al., 1975, p. 1006).↩
Eissler does, however, grant echt Freudians occasional selective access to some restricted papers. Such a policy can have no other purpose than to perpetuate the Freud legend.↩
William Jeffrey, “A Conversation with Harold Blum,” The American Psychoanalyst, Vol. 24, No. 3 (Fall 1990), p. 16.↩
Even the available Freud-Minna letters are not altogether unrestricted. Scholars who apply to examine them are given photocopies in which the names of Freud’s patients have been deleted, thus causing needless uncertainty about identities which can hardly be considered sensitive after the lapse of a century or so.↩
P.B. Medawar, “Victims of Psychiatry,” New York Review, January 23, 1975, p. 17.↩