Sites of the Unconscious: Hypnosis and the Emergence of the Psychoanalytic Setting 9780226058009

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Sites of the Unconscious

Sites of the Unconscious Hypnosis and the Emergence of the Psychoanalytic Setting andreas mayer

The University of Chicago Press Chicago and London

Andreas Mayer is a research scholar at the Max Planck Institute for the History of Science in Berlin. The University of Chicago Press, Chicago 60637 The University of Chicago Press, Ltd., London © 2013 by The University of Chicago All rights reserved. Published 2013. Printed in the United States of America 22  21  20  19  18  17  16  15  14  13   1  2  3  4  5 isbn-13: 978-0-226-05795-8 (cloth) isbn-13: 978-0-226-05800-9 (e-book) Originally published as Mikroskopie der Psyche: Die Anfänge der Psychoanalyse im Hypnose-Labor © Wallstein, Göttingen, 2002 Translated by Christopher Barber, revised and expanded by the author Library of Congress Cataloging-in-Publication Data Mayer, Andreas, 1970–  Sites of the unconscious : hypnosis and the emergence of the psychoanalytic setting / Andreas Mayer.    pages. cm.   Includes bibliographical references and index.   isbn 978-0-226-05795-8 (cloth : alk. paper)—isbn 978-0-226-05800-9 (e-book)  1. Hypnotism—History.  2. Psychotherapy—History.  3. Freud, Sigmund, 1856– 1939.  4. Charcot, J. M. (Jean Martin), 1825–1893.  I.  Title. rc495.m34 2013 615.8'512—dc23 2013005919 a This paper meets the requirements of ansi/niso z39.48-1992 (Permanence of Paper).

To the memory of Lydia Marinelli (1965–2008)

Contents

List of Abbreviations  viii Introduction  1

p a r t o n e  French Cultures of Hypnosis 1 “Experimental Neuroses”: Hypnotism at the Salpêtrière Hospital

11

2 The Controversy between Paris and Nancy over Hypnotic Suggestion

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3 “Amour expérimental”: Facts and Fetishes at the Musée Charcot

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4 The Question of Lay Hypnosis

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p a r t t w o  The Emergence of the Psychoanalytic Setting 5 Paris–Vienna: A Problematic Transfer

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6 Freud and the Vicissitudes of Private Practice

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7 The Psychotherapeutic Private Practice between Clinic and Laboratory

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8 Experimentalism without a Laboratory: The Psychoanalytic Setting

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Conclusion  222 Acknowledgments  229 Bibliography  231 Index  251

Abbreviations

b f: Letters from Eugen Bleuler to Sigmund Freud (1905–6). In Lydia Marinelli and Andreas Mayer. Dreaming by the Book: Freud’s “The Interpretation of Dreams” and the History of the Psychoanalytic Movement. Translated by Susan Fairfield. London: Other Press, [2002] 2003. b h: Bernheim, Hippolyte. Hypnotisme, suggestion, psychothérapie: Études nouvelles. Paris: Doin, 1891. b s: Bernheim, Hippolyte. De la suggestion et de ses applications a la thérapeutique. 2nd ed. Paris: Doin, [1886] 1888. f f: The Complete Letters of Sigmund Freud to Wilhelm Fliess 1887–1904. Edited and translated by Jeffrey Moussaieff Masson. Cambridge, MA: Belknap Press, 1985. gw : Freud, Sigmund. Gesammelte Werke. 18 vols. In colloboration with Marie Bonaparte, Prinzessin Georg von Griechenland. Edited by Anna Freud, Edward Bibring, Willi Hoffer, Ernst Kris, and Otto Isakower. London: Imago Publishing, 1939–52. Suppl. vol. edited by Angela Richards, and Ilse Grubrich-Simitis. Frankfurt: S. Fischer, 1987. oc: Charcot, Jean-Martin. Œuvres complètes. 9 vols. Paris: Bureaux du Progrès medical and Lecrosnier & Babé, 1888–94. sa : Freud, Sigmund. Studienausgabe. 10 vols. and suppl. vol. Edited by Alexander Mitscherlich, Angela Richards, and James Strachey. Frankfurt: Fischer Verlag, 1969–1975. se: Freud, Sigmund. The Standard Edition of the Complete Psychological Works of Sigmund Freud. 24 vols. Edited and translated by James Strachey. London: The Hogarth Press, 1953–1974. td: Freud, Sigmund. Die Traumdeutung. Leipzig: Deuticke, 1900.

Introduction

In the years 1877–78, several English physicians and scientists traveled to Paris to observe a number of astonishing phenomena at the Salpêtrière Hospital. The renowned French neurologist Jean-Martin Charcot was about to develop a new experimental approach to the study of the neuroses, in particular to one of its most elusive and enigmatic forms, hysteria. The striking phenomena demonstrated on his patients in a state of unconsciousness—the transfer of symptoms through the body by the use of magnets and metals, the ordering of the automatic execution of various physical and mental tasks— suggested that, in a daring fusion of older and rather suspect practices, derived from mesmerism, with the most recent cutting-edge laboratory apparatus, a new powerful experimental method had been created. The integration of mesmeric practices into scientific medicine, performed by one of the most eminent neurologists of his day, provoked divided and passionate reactions. While some English observers noted the extreme rarity of Charcot’s cases, others were outright skeptical about the facts presented, clinging to the old wisdom that hysterics were astute women well versed in the arts of deception. They raised the suspicion that Charcot, despite his great authority and reputation, may have been the prey of a few cunning simulators. Other commentators in turn stood up to defend the neurologist and hailed his scientific stroke of genius for having “taken these emotional and wretched women, these waste products thrown off in the evolution of the . See Russell Reynolds, “Hemianaesthesia in the Clinique of Professor Charcot,” The Lancet (12 May 1877): 678–80; (2 June 1877): 787–88. . Anon., “Metallo-Therapeutics,” The British Medical Journal (27 October 1877): 601–2; “Metalloscopy and Metallo-Therapy,” The British Medical Journal (3 November 1877): 652.



introduction

race” in order to experiment with them “as to produce results as clear, as true, and as pure as the chemist can obtain with the inanimate elements in the laboratory.” By the mid-1880s, hypnotism counted as one of the most promising candidates for a new experimental science of the unconscious mind with the neurological clinic at its center. Not only in scientific circles, but also in a flourishing popular culture of novels, plays, and stage shows in which the social and political implications of hypnosis were played out, sometimes in satirical or grotesque fashion, Jean-Martin Charcot became its most emblematic representative. When, at the peak of the public interest in the Parisian hypnotic demonstrations, the French writer and anarchist Octave Mirbeau published a detailed description of his own visit to the Salpêtrière, he did not hesitate to proclaim the nineteenth century to be “the century of nervous illnesses,” from a double point of view: “in the first place, because they will have been mistress and cause of all its events; and then, because it will have studied and known the secrets of their evil.” In the coupling of the scientific hypnotist and his experimental subject, he recognized the rise of a new fundamental division of mankind into those who were dominated by their unconscious and a small elite of scientists, entitled to know and to rule. Convinced by the power of science to throw light on the mysteries of the human mind and to master them, Mirbeau crowned his appraisal with the prediction that “this century might be remembered as neither the century of Victor Hugo, nor that of Napoleon, but as the century of Charcot.” By the time of his death, in 1893, Charcot’s ambitious experimental program around hypnosis had already fallen apart, and a young Viennese doctor who had studied with him and acted as his German translator would recognize in him his master and soon the precursor of the new science of the unconscious that would appear, a few years later, under the name of psychoanalysis. With Sigmund Freud’s rise to fame in the twentieth century, Charcot then appeared for a long time as the figure whose research into hysteria had not done more than set the stage for the ultimate insights of psychoanalysis yet to come, namely that neuroses were caused by sexual repression, only to be lifted by the talking cure. Whereas Charcot was now featured as . George M. Beard, The Study of Trance. Muscle-Reading and Allied Nervous Phenomena in Europe and America, with a Letter on the Moral Character of Trance Subjects and a Defence of Dr. Charcot (New York: [s.n.], 1882), p. 37. . Octave Mirbeau, “Le siècle de Charcot,” [L’Evénement, 29 May 1885] in Chroniques du Diable (Paris: Les Belles Lettres, 1995), p. 121. . Ibid. . Sigmund Freud, “Charcot,” SE 3:9–23.

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a kind of evil clinical genius, a “seer,” an arranger of scenes lacking both the adequate conceptual apparatus and forms of treatment, Freud could be presented as the exponent of a new theoretical and therapeutic approach who would, by delivering the keys of interpretation, make the strange and cruel theatre of the Salpêtrière at last intelligible. However, historiographies gravitating around the person of Freud, written either in the style of hagiographic appraisal or in a debunking vein, could not bypass the problem of where the actual rupture between hypnosis and psychoanalysis should be located. The fact that Freud started his own career as a nerve specialist, using various techniques of hypnosis and suggestion for at least a decade, from 1885 to 1895, has led his biographers to relegate this earlier period to a mere prelude to the true and momentous discovery of the unconscious in his famous self-analysis. Such heroic accounts, as they prevailed in the aftermath of Ernest Jones’s biography of Freud from the 1950s, were to be challenged by a number of historians who attempted to reinsert the history of psychoanalysis into the history of magnetism and hypnotism. In 1970, the Swiss psychiatrist Henri F. Ellenberger published a bulky study of such a kind, claiming that shamanism, mesmerism, hypnosis, psychoanalysis, and other forms of psychotherapy were all elements in a long chain of what he proposed to term “dynamic psychiatry.” In contrast to biographical hero-worship, but also to an epistemologically oriented historiography emphasizing ruptures that characterized the work of many French historians and theorists,10 Ellenberger stressed the continuities between a vast array of seemingly heterogeneous traditions and realms of cultures. In the wake of . The most widely known example for this legendary and anachronistic historiography is the book by the art theorist Georges Didi-Huberman, Invention of Hysteria: Charcot and the Photographic Iconography of the Salpêtrière, trans. Alisa Hartz (Cambridge, MA: MIT Press, [1982] 2003); see also, Daphne de Marneffe, “Looking and Listening: The Construction of Clinical Knowledge in Charcot and Freud,” Signs 17 (1992): 71–111. . Freud himself provided already during his lifetime various versions of his own career as a practitioner of hypnosis. See Sigmund Freud, “A Short Account of Psycho-Analysis” [1924], SE 19:191–209; “An Autobiographical Study” [1925], SE 20:7–70. For the legendary account of the “self-analysis,” see esp. Kurt R. Eissler, “An Unknown Autobiographical Letter by Freud and a Short Comment,” International Journal of Psycho-Analysis 32 (1951): 319–24; and Ernest Jones, The Life and Work of Sigmund Freud (New York: Basic Books, 1953), 1:319–27. . Henri F. Ellenberger, The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry (New York: Basic Books, 1970); see also the later collection of essays Beyond the Unconscious: Essays of Henri F. Ellenberger in the History of Psychiatry, ed. Mark S. Micale, trans. Françoise Dubor and Mark S. Micale (Princeton, NJ: Princeton University Press, 1993). 10. The most influential being without doubt Michel Foucault. For a discussion of Foucault’s complex relationship with psychoanalysis, see John Forrester, “Michel Foucault and



introduction

Ellenberger’s work, the history of animal magnetism and hypnosis has been studied in greater detail by a number of historians and philosophers. The scholarship in the 1980s and 1990s can be roughly divided into three different currents: the first takes a critical stance vis-à-vis psychoanalysis and a positive one toward hypnosis, with the attempt to propose an alternative genealogy running from Anton Mesmer to Sigmund Freud and even beyond;11 the second one, in contrast, aims to make sense of mesmerism, animal magnetism, and hypnosis as distinct cultural forms within various social and intellectual contexts;12 the third one, mostly inspired by the work of Michel Foucault, looks at the historical transformations of diagnostic categories (such as “hysteria” or “traumatic neurosis”) and their potential effects on human subjects.13 The present study, while indebted to the cultural-historical and epistemological sensibilities of the second and third currents, shifts its focus from larger cultural or social contexts and the work of classification to the concrete sites of knowledge production. It suggests that the material setup of clinics, museums, laboratories, or consulting rooms played a critical role in the project of making hypnotism into an experimental science of the unconscious mind. In contrast to the person-centered and often polemical approaches to the history and prehistory of psychoanalysis, this book takes up

the History of Psychoanalysis,” in The Seductions of Psychoanalysis: Freud, Lacan, and Derrida (Cambridge: Cambridge University Press, 1990), pp. 286–316. 11. See e.g., the work of the hypnotist Léon Chertok in collaboration with various authors: Léon Chertok and Raymond de Saussure. The Therapeutic Revolution: From Mesmer to Freud, trans. R. H. Ahrenfeldt (New York: Brunner / Mazel, 1979); Léon Chertok and Mikkel BorchJacobsen, Hypnoses et psychanalyses (Paris: Dunod, 1987); and Léon Chertok and Isabelle Stengers, A Critique of Psychoanalytic Reason: Hypnosis as a Scientific Problem from Lavoisier to Lacan, trans. Martha Noel Evans (Stanford, CA: Stanford University Press, [1989] 1992); less partial and more panoramic is the work of Alan Gauld, A History of Hypnotism (Cambridge: Cambridge University Press, 1992). 12. For France, see esp. the work of Jacqueline Carroy, Hypnose, suggestion et psychologie: L’invention de sujets (Paris: Presses Universitaires France, 1991); Les personnalités doubles et multiples: Entre science et fiction (Paris: Presses Universitaires France, 1993); and, for Britain, Alison Winter, Mesmerized: Powers of Mind in Victorian Britain (Chicago: Chicago University Press, 1998). 13. See esp. Ian Hacking, Rewriting the Soul: Multiple Personality and the Sciences of Memory (Princeton, NJ: Princeton University Press, 1995); and in a more programmatic fashion, “Making Up People,” in Historical Ontology (Cambridge, MA: Harvard University Press, 2002), pp. 99–114; in a different vein, see the work of Ruth Leys, Trauma: A Genealogy (Chicago: Chicago University Press, 2000); and Allan Young, The Harmony of Illusions: Inventing PostTraumatic Stress Disorder (Princeton, NJ: Princeton University Press, 1995).

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lessons from ethnographic and historical studies of scientific laboratories,14 proposing a genealogy of the sites, practices, and inscription technologies particular to hypnotism. Sites of the Unconscious analyzes the emergence of hypnotism in the late nineteenth century as a key episode in the experimentalization of the unconscious mind, retracing the historical process by which controlled procedures for producing knowledge of psychic phenomena were introduced, applied, and propagated throughout different clinical settings. By developing a symmetrical approach,15 this books attempts to elucidate how conflicts centered on the theories and experimental techniques of hypnosis paved the way for the familiar psychoanalytic setting established by Sigmund Freud in Vienna around 1900. In contrast to a person-centered historiography, as it prevails notably in the works devoted to Freud and psychoanalysis, it adopts a historical-sociological approach that takes a wider range of actors and processes into account. While language may appear today, to analysts and scholars alike, as the only “stuff ” psychoanalytic practice has to deal with,16 the historical constitution of this practice can hardly be understood without taking into account its material and social components.17 The first part deals with the most comprehensive and influential attempt to install hypnotism as a new form of experimental research in France, 14. For two exemplary studies in the history and sociology of science of this kind, see Bruno Latour, The Pasteurization of France (Cambridge, MA: Harvard University Press, [1984] 1988); and Steven Shapin and Simon Schaffer, Leviathan and the Air Pump (Princeton, NJ: Princeton University Press, 1985); for an overview on ethnographic laboratory studies, see Karin KnorrCetina, “Laboratory Studies: The Cultural Approch to the Study of Science,” in The Handbook of Science and Technology Studies, ed. Sheila Jasanoff et al. (London: Thousand Oaks, 1995), pp. 140–66. 15. According to the symmetry postulate, as it was formulated in the sociology of scientific knowledge, both the winners and the defeated in a scientific controversy should be treated alike. For the initial formulation, see David Bloor, Knowledge and Social Imagery (London: Routledge / Kegan Paul, [1976] 1991). 16. See e.g., the classic text by Emile Benveniste, “Remarques sur la fonction du langage dans la découverte freudienne,” in Problèmes de linguistique générale (Paris: Gallimard, 1966), 1: 75–87. 17. The present study would have been impossible without Lydia Marinelli’s exemplary work on the history of the texts and objects of psychoanalysis. For an appraisal of her work, see Andreas Mayer, “The Historian of the Freud Museum: Lydia Marinelli,” Psychoanalysis and History 11, no. 1 (2009): 109–15; and “Shadow of a Couch,” American Imago 66, no. 2 (2009): 137– 47. For a criticism of the more recent Freud scholarship and a programmatic formulation, see Lydia Marinelli and Andreas Mayer, “Forgetting Freud? For a New Historiography of Psycho­ analysis,” Science in Context 19, no. 1 (2006): 1–13.



introduction

Jean-Martin Charcot’s research program at his hospital service at La Salpêt­ rière in Paris and the controversies that ensued between his “Paris school” and the so-called Nancy school led by his antagonist, Hippolyte Bernheim. Whereas the received view presents Bernheim as the clear winner in this controversy, I suggest in the first two chapters that the perceived superiority of his demonstrations in themselves cannot account for his triumph over Charcot’s doctrine of “grand hypnotism.” Rather, I distinguish what I argue are two incompatible cultures of hypnotism, stressing their different emphases on the relation between clinical practice and knowledge, their different ways of deploying hypnosis (the one therapeutic, the other experimental), and the contrast between centralized hierarchies of knowledge constructed within the Salpêtrière school and the rather loosely structured group at Nancy. These differences were constitutive of the epistemological and political characteristics of the two competing cultures of hypnotism: Bernheim’s focus on the numbers of patients hypnotized and the “suggestive” group atmosphere facilitated mass hypnosis in contrast to the Charcot school’s emphasis on the individual patient as an exemplar of a rare type. Mobilizing an impressive apparatus of mechanical recording devices, Charcot and his team attempted to definitively exclude the possibility of patients’ simulation under hypnosis, an attempt Bernheim and his followers countered with an emphasis on the notion of the experimental subject’s imagination. Chapter 3 singles out a decisive moment within the struggle between the two schools, namely the strategies associated with the Musée Charcot at the Salpêtrière and its heterogeneous collection of objects in contesting Bernheim’s debunking strategies. The young psychologist Alfred Binet and the doctor Charles Féré sought to ensure that their experimental protocols endorsed the assumption that the experimental subjects used at the Salpêtrière were no more than mere registration devices. The chapter displays the increasingly complex strategies developed in the face of the common and openly acknowledged problem of erotic relations existing between research subjects and experimenters. In the context of the hypnotic experiments as they were performed at the museum, Binet also coined the concept of fetishism in its new sexological meaning. Chapter 4 contrasts methodically the responses of Charcot’s and Bernheim’s adherents to the question of lay hypnosis, with the Paris school insisting on the pathological character of the hypnotic state and the necessary medical expertise required to master it, whereas Bernheim and his followers were more open to the possibilities of stage magnetism and to a wider diffusion of the therapeutic technique of “suggestion” among nonmedical practitioners. Joseph Delbœuf, a Belgian philosopher, mathematician, and

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lay hypnotist who became actively involved in the debates about hypnosis, served as the control instrument for these two cultures. He demonstrated how the registers of academic experimentalism could be fused easily with the language of stage magnetism, and how his rapprochement of the theory of suggestion with normal dream activity fostered a practice of self-observation as a legitimate parallel investigation to hypnotic experiments on prepared subjects. However, Delbœuf ’s conception of hypnotism, which tended to abolish the asymmetry, either epistemological or moral, between hypnotist and hypnotized, remained a marginal position. The second part of the book reconstructs the reception of French hypnotism in the German-speaking countries in the years from 1880, arguing that Freud’s abandonment of hypnosis and development of the psychoanalytic setting was less a flash of singular genius than a fitful response to the problematics raised by the French controversies and the ensuing difficulties that a nerve specialist had to face in private practice. Chapter 5 provides an account of how Freud’s attempt to transplant Charcot’s model of experimental hypnotism ran into difficulties. In Vienna, the question of hypnotism was hotly debated, in part around the familiar issue of simulation but, more interestingly, against the backdrop of debates about the closeness of the experimental hypnotist to the stage magnetists. The contrasting receptions given to hypnosis in Viennese psychiatry are brought out by examining the work of Theodor Meynert, exponent of a descriptive brain-psychiatry and suspicious of the therapeutic and experimental claims associated with hypnotism and suggestion, and the subsequent observational, experimental, and therapeutic approach of Richard von Krafft-Ebing, Meynert’s successor in 1892 in the chair of psychiatry. In an instructive and consequential debate in 1893, Krafft-Ebing was vigorously attacked by followers of the Salpêtrière school. The ensuing public scandal around Krafft-Ebing and his practice of the suggestion method cast a further shadow on hypnosis as an experimental and therapeutic approach. Chapter 6 then details how the problems played out in public scandals about hypnotic suggestion were reflected on the microlevel of Breuer’s and Freud’s private practice. With his technical revisions, Freud gradually shifted away from hypnosis, initially still keeping up its semblance. Reconstructing in minute detail the work of a number of German and Swiss doctors and scientists in the 1890s, chapter 7 charts the emergence of the private consulting room of hypnotherapists and a new literature promoting the redefinition of the hypnotic subject as a skilled self-observer. I look at one key episode, the establishment of what I propose to term “introspective hypnotism” by Freud’s exact contemporary Oskar Vogt, who aimed to solve



introduction

the problem of simulation by subordinating all physical components of the hypnotic setting to the continuous verbal expression of the subject’s state of mind. A number of crucial features of the later psychoanalytic setting and the “talking cure” were, I suggest, first put into place by Vogt and his followers. In chapter 8, I address the distinctive features of Freud’s psychoanalytic setting and their variations between 1900 and 1914, showing how differences between the Paris and Nancy schools resurface in this historical trajectory. Crucial here is the function of Freudian self-analysis, with the interpretation of dreams and slips of the tongue conceived not as reckless singular acts but as slow and collective processes that favor interactive practices of reading and writing over the stabilization of a special mental state during treatment—as was the case in hypnotic experimentation. In light of the uncertainty about the mental state of the hypnotic subject, Freud’s strategy allowed him to detach his technique from the situated character of his own practice and to elaborate a form of “virtual analysis” (initially often conducted in the form of correspondence). While Freud retained the claim of psychoanalysis performing an experimental situation, he set apart his own setting from the objectifying practices that had dominated hypnotism as an experimental and therapeutic endeavor. The specificity of the psychoanalytic setting emerges, I argue, not suddenly and of a piece but, rather, gradually, in response to investigators’ failure to establish laboratory-like conditions for the production of hypnotic states, a consequence of their inability to control their research subjects and to rule out the possibility of simulation. I conclude with remarks about the development and future of psychoanalytic practice. With respect to the seemingly endless debates about its supposed scientificity, I argue that a detailed historical reconstruction of its genesis proposes a different outlook: the development of a knowledge about the unconscious in a relatively closed setting cannot be properly understood within a normative framework; rather, the emphasis on its local and situated character raises the question about the new places in which psychoanalytic knowledge is likely to flourish.

part one

French Cultures of Hypnosis

1

“Experimental Neuroses”: Hypnotism at the Salpêtrière Hospital

When the young Viennese doctor Sigmund Freud received a travel stipend for Paris in winter 1885 to study neuropathology at Jean-Martin Charcot’s clinic at the Salpêtrière Hospital, he was only one of many curious and skeptical physicians and scientists who wanted to see the “highly surprising” findings of the famous neurologist with their own eyes. Attempts to make hypnosis part of a new experimental approach to understanding the nature of nervous diseases had emerged and proliferated in French hospitals since the late 1870s, and they found their most ambitious representative in Charcot and his definition of “grand hypnotism.” Although it is widely acknowledged that Freud’s encounter with Charcot was a decisive moment for the future development of psychoanalysis, most historical accounts of the French research on hysteria and hypnotism tend to cast this episode as a mere “prehistory” of the Freudian enterprise. In his writings, Freud himself has largely contributed to a portrait of Charcot as a “seer,” a visuel, a genius of clinical observation, thereby fostering a historiography according to which the appeal of hypnotism as an experimental program was explained by the prestige and personal fascination exerted by a single great clinician. Numerous contemporary and later accounts devoted to the “artist” Charcot speak of the same fascination,

. Sigmund Freud, “Report on My Studies in Paris and Berlin Carried Out with the Assistance of a Travelling Bursary Granted from the University Jubilee Fund (October, 1885—End of March, 1886),” SE 1:5–15, p. 6. The list of other visitors is long; among the physicians involved in the development of hypnotism as a new experimental or therapeutic approach were Eugen Bleuler, Max Nonne, and Auguste Forel. . Freud, “Charcot,” SE 3:9–23.

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chapter one

be it in a hagiographic or in a debunking key. This person-centered focus has led to a neglect of an essential factor in the attractiveness of experimental hypnotism, namely the promise of a new scientific psychology, grounded in the material and social surroundings of the neurological clinic. One of the major reasons (if not the most important one) for the short success of Charcot’s research project lay in the multiple facilities brought together in his clinic at the Salpêtrière, which he presented as a “living pathological museum.” His attempts to integrate the contested practices of animal magnetism into a laboratory setting were critically dependent on a material apparatus conceived to detach the action of hypnosis from the person of the hypnotist. Somewhat ironically, then, Charcot’s posthumous fame is largely attributed to a personal factor that he sought to eliminate once and for all from a new scientific psychology based on a novel form of clinical experimentation. In this chapter, I aim to specify the ways in which unconscious processes were made observable and manipulable within a geography of sites installed at Charcot’s clinic between 1877 and 1882, during the formulation of a new experimental program—grand hypnotisme—designed to elucidate one of the most elusive and problematic neuroses of the nineteenth century, hysteria. The Clinical Geography of Charcot’s New Research Center In the nineteenth century, the Salpêtrière numbered among the largest and most important hospitals in Paris. The neurologist Jean-Martin Charcot played a decisive role in the modernization of the hospital: during the course of his career, the clinic he headed developed from an institution primarily devoted to the accommodation of poor and elderly women into a world-

. For a debunking reading, heavily influenced by a psychoanalytic reading of hypnotism, see Didi-Huberman, Invention of Hysteria. . Jean-Martin Charcot, Leçons sur les maladies du système nerveux recueillies et publiées par MM. Babinski, Bernard, Féré, Guinon, Marie et Gilles de la Tourette (Paris: Bureaux du Progrès médical / Lecrosnier & Babé, 1890), OC 3:3. . In his social-constructivist history of psychology, Kurt Danziger recognizes the French clinical research on hypnotism as one of the three models of experimental psychology, the other two being Francis Galton’s anthropometric measurement of human faculties and Wilhelm Wundt’s laboratory in Leipzig. See Kurt Danziger, Constructing the Subject: Historical Origins of Psychological Research (Cambridge: Cambridge University Press, 1990), pp. 49–64. Danziger’s differentiation of sites of psychological experimentation with their diverging definitions of psychological experimental subjects provides a useful starting point. However, when the recombination of diverse practices in newly established sites (such as the private practice of doctors) is taken into account, the unity of clearly identifiable models can hardly be maintained.

“ex per imen ta l neu roses” at the sa lpêtr ièr e

13

famous neuropathological research center. In 1882 a professorship for nervous disorders was created especially for Charcot, allowing him to focus on the systematic teaching of neurological and psychological disorders. The seat of this new research and teaching center consisted of a building complex adjoining the existing clinic. It housed a number of facilities, including an autopsy ward, a physiological-chemical laboratory, an electrodiagnostic laboratory, ophthalmologic and otologic cabinets (for measuring visual and aural capacities), a photographic studio linked to a pathological-anatomical museum with a department for plaster and wax casts, and a large lecture hall equipped with the most modern projection devices. The German physician Ludwig Hirt, who visited the Salpêtrière in 1883, numbered the beds under Charcot’s supervision at between 600 and 650. With 250 beds, the “ward for hystero-epileptic women” was the hospital’s largest, whereby the parallel ward for men housed twenty beds. Such appellations show that the patient population had increasingly come to be differentiated according to specific disorders. Treatment in the hospital was free, whereby a small number of patients—the pensionnaires payantes—paid a modest fee entitling them to single rooms and additional meals. The patient population, which Charcot referred to as his “material,” generally originated from the lower classes, although a slowly increasing minority of patients came from the petite bourgeoisie. A hospital stay lasted at least three weeks, but usually months and

. Considering his fame and importance, it is surprising that there is still no satisfying comprehensive single monograph devoted to Charcot. From the very first attempts, written by several of his pupils, to the most recent studies in the history of medicine, a hagiographic trend per­sists. See Achille Souques and Henry Meige, “Jean-Martin Charcot,” Les Biographies Médicales 335 (May–June–July 1939): 321–52; Georges Guillain, J.-M. Charcot, 1825–1893: Sa vie—son œuvre (Paris: Masson & Cie, 1955); Christopher G. Goetz, Michel Bonduelle, and Toby Gelfand, Charcot: Constructing Neurology (Oxford: Oxford University Press, 1995); and the slightly modified French version by the same authors, which appeared under the title Charcot: Un grand médécin dans son siècle (Paris: Michalon, 1996). One of the best studies on Charcot to date is still the documentation of a seminar held by Marcel Gauchet and Gladys Swain at the Ècole des Hautes Études en Sciences Sociales in Paris in the 1980s, which also provides a convincing rebuttal of the anachronistic distortions that characterize Didi-Huberman’s study. See Marcel Gauchet and Gladys Swain, eds., Le vrai Charcot: Les chemins imprévus de l’inconscient (Paris: Calmann-Lévy, 1997). . Ludwig Hirt, “Das Hospiz ‘La Salpêtrière’ in Paris und die Charcot’sche Klinik für Nervenkrankheiten,” Breslauer ärztliche Zeitschrift 9 (1883): 1–12, p. 8. . An exacting study of the patient population of the Salpêtrière has not yet been attempted. The information on the institution’s history given here follows the accounts of Marc S. Micale, “The Salpêtrière in the Age of Charcot: An Institutional Perspective on Medical History in the Late Nineteenth Century,” Journal of Contemporary History 20 (1985): 703–31; and Gladys Swain,

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often years, which allowed the doctors to observe individual cases over an extended period of time. To supplement the “material” gathered for research and teaching purposes with “more mild cases and those of incipient gravity,” an outpatient clinic was erected along the outer wall, where on each day of the week a different physician diagnosed “all needy sufferers of nervous disorders.” Charcot’s neuropathological service placed the head physician at its center: the cabinet de consultation, where he examined his patients, was located at the middle of a complex of buildings housing the laboratories, the museum, and the lecture hall. Thus the head physician’s daily rounds to the patients’ beds were replaced by a different form of examination: it was not the doctor who visited the patients, but rather the patients who were summoned to various sites where they served in the study or demonstration of clinical facts. As Hirt noted after his visit, Charcot “personally examined and discussed hundreds of interesting and rare neurological cases each year before a small circle of privileged listeners” in his consulting room during his daily three-hour morning visits to the Salpêtrière.10 Other guests at the clinic, such as the Russian mathematician Sofia Kovalevskaya, characterized Charcot as “the sovereign ruler of this kingdom of neuroses.”11 By the 1880s, the neurologist had become a well-known public figure, particularly on account of his venture into hysteria research using the hypnotic techniques depicted in numerous popular accounts.12 Charcot’s famous Tuesday lectures—held at the policlinic beginning in 1881 and transcribed by his students—served a dual purpose.13 Firstly, by of“L’appropriation neurologique de l’hystérie,” in Le vrai Charcot, ed. Marcel Gauchet and Gladys Swain (Paris: Calmann-Lévy, 1997), pp. 13–95. . Hirt, “Das Hospiz ‘La Salpetriere,’ ” p. 10. 10. Ibid., p. 12. 11. Sofia Kovalevskaya, “Hypnotism and Medicine in 1888 Paris: Contemporary Observations,” SubStance: A Review of Theory and Literary Criticism 25, no. 1 (1996): 3–23, p. 17. 12. The first novel to depict Charcot’s work was published by the journalist and writer Jules Claretie, Les amours d’un interne (Paris: Dentu, 1881). For a later example in a more debunking vein written by a former medical student, see Léon Daudet, Les morticoles (Paris: G. Charpentier et E. Fasquelle, 1894). After Charcot’s death, a number of dramatic works were published as well. See esp. André de Lorde, Une leçon à la Salpetrière: Tableau dramatique en deux actes (Paris: Grand Guignol, 1908). For an analysis of the interconnections between fiction and science, see Carroy, Les personnalités doubles et multiples. 13. Two different versions of the Tuesday lectures exist. The first is an edition based on the notes taken by Charcot’s assistants Blin and Colin as well as by his own son Jean-Baptiste, who also served as his assistant at the time. Copies of this 1888–89 edition did not receive very wide diffusion (one has been preserved in Charcot’s library at the Salpêtrière, and it was used

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fering semipublic outpatient treatment the doctors were offering a free service, which in return provided them with cases not represented in the inpatient population. Thus the clinic’s access to patients was expanded to include “mild” and “incipiently severe” cases.14 Secondly, the lectures presented an audience of physicians in training with a cross section of examinations in which the doctor demonstrated how he reached a conclusive diagnosis when confronted with a specific symptomatology. In the lectures, one or more patients appeared before an audience as objects of comparison and generally received an “instantaneous diagnosis.”15 The object of these publicly performed examinations was not only to present a variety of typical cases, but also to demonstrate the steps to be taken by the physician in reaching an unequivocal diagnosis.16 However, the improvised character of these lectures emphasized by many visitors (including Freud)17 and some later authors has been exaggerated. Before the presentation, Charcot’s assistants examined the patients and carefully prepared “an initial list of diagnoses with the greatest possible precision” for their master. The list was presented to Charcot upon his arrival at the clinic, and from the cases deemed “most interesting at first sight”18 he selected the patients who would provide him with the material for

for a 2002 reprint). The second edition, largely rewritten by Charcot himself, became more widely known, especially in the German-speaking world through Freud’s annotated translation, which appeared in 1892, the same year as the French edition’s publication. Jean-Martin Charcot, Leçons du mardi à la Salpêtrière: Policlinique 1887–1889. Notes de Cours de M.M. Blin, Charcot et Colin, 2 vols. (Paris: Tchou pour la Bibliothèque des introuvables, [1888–89] 2002); Leçons du mardi à la Salpêtrière: Policlinique. Vol. 1, 1887–1888. Notes de Cours de M.M. Blin, Charcot et Colin, 2nd ed. (Paris: Bureaux du Progrès médical / Delahaye & Lecrosnier, 1892); Poliklinische Vorlesungen: Vol. 1, Schuljahr 1887–88, trans. Sigmund Freud (Leipzig: Deuticke, [1892] 1894). Only a small selection has been made available in English in Charcot the Clinician: The Tuesday Lessons. Excerpts from Nine Case Presentations on General Neurology Delivered at the Salpêtrière Hospital in 1887–88 by Jean-Martin Charcot, ed. and trans. Christopher G. Goetz (New York: Raven Press, 1987). Unless otherwise noted, all citations of the Tuesday lectures in this book derive from the 1892 French edition. 14. Hirt, “Das Hospiz ‘La Salpetriere,’ ” p. 10. 15. A. Lubimoff, Le Professeur Charcot: Étude scientifique et biologique, trans. Lydie Rostopchine (Saint Petersburg: A. S. Souvorine, 1894), p. 40. 16. Joseph Babinski, “Préface,” in Charcot, Leçons du mardi à la Salpêtrière, 1:2. 17. Freud, “Charcot,” SE 3:18. 18. Georges Guinon, “La policlinique de M. Pr. Charcot à la Salpêtrière,” in Clinique des maladies du système nerveux: M. le Professeur Charcot. Leçons du Professeur, Mémoires, Notes et Observations parues pendant les années 1889–90 et 1890–91 (Paris: Alcan, 1893), 2:431. If there were no “interesting” cases among the outpatients, Charcot also used patients from the clinic for his demonstrations in the policlinic.

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his lecture. Once the lecture was over, the work was turned over to the chef de clinique, who, assisted by some externs, completed the consultation. More generally, the Tuesday lectures served Charcot in demonstrating his mastery of the clinical art of observation, which often allowed him to track down the relevant symptoms at first glance. Most of the neurological conditions were deciphered in a differential diagnosis based on tiny characteristic signs that could be observed on the patient’s body (difficulties in walking, trembling hands, blinking eyes, paralysis of facial or other muscles etc.). When observation of the patient alone was not sufficient for reaching a decisive diagnosis, Charcot resorted to various instruments, such as Skoda’s percussion hammer for testing the reflexes. The use of such instruments reinforced the asymmetry between doctor and patient: it indicated the physician’s position of power, replacing the history of illness recounted by the patient and his or her family with a controlled medical semiology.19 In this semipublic forum, Charcot thus demonstrated how in “uncovering” symptoms the neurologist must refrain from forms of gaining evidence in which the patient and family members are treated as reliable witnesses. First of all, information obtained from patients is of dubious value for establishing a correct diagnosis, because they “make up theories that are not, of course, always based on a correct grasp of the facts.”20 Thus, when patients describe their illnesses, their statements are generally translated into technical terminology by the physician, who at times disabuses them of their faulty thinking or silences them. For Charcot, the “naive accounts” provided by patients are occasionally of interest, “but one must put them in order, since they are almost always formulated very haphazardly.”21 Sometimes, the description itself becomes the indicator for the diagnosis: “When a patient comes along with some sort of written account, saying, ‘I have put down some notes on my condition because I don’t want to take up too much of your time.’ They are all neurasthenics, particularly those of the sort with marked tendencies toward hypochondria.”22 Hence the physician presents himself as the authority who is able to distinguish true symptoms from patients’ exaggerations and imprecisions.

19. See Jens Lachmund, Der abgehorchte Körper: Zur historischen Soziologie der medizinischen Untersuchung (Opladen: Westdeutscher Verlag, 1997); and Lachmund, “Making Sense of Sound: Auscultation and Lung Sound Codification in Nineteenth-Century French and German Medicine,” Science Technology & Human Values 24, no. 4 (1999): 419–50. 20. Charcot, Leçons du mardi à la Salpêtrière, 1:146. 21. Ibid., p. 402. 22. Ibid.

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And yet the main problem with the patient’s speech is not that it is imprecise and haphazard by the standards of clinical knowledge, but that it is potentially deceitful. Charcot even professes that most of the information provided by patients and their families is intended to lead the physician astray and keep him from discovering the true cause of the illness: Among the family members there is a solidarity, a conspiracy of silence. To satisfy your questions they make up a tale based on lies, at times involuntary untruths. A dog was raging about in the countryside, the child was afraid, and so on. And sometimes you will hear the child himself repeat the story, believing it is true because he has heard it told so often. The physician, whose duty it is to get to the bottom of things and see them as they are, must not be duped by such babbling.23

According to Charcot, then, the true cause of illness is commonly to be found in heredity. The histories narrated by patients and their relatives, which can become the oral tradition of a whole family, thus serve as a means to “escape from the uncomfortable idea of a hereditary destiny.”24 Therefore, from the very beginning of the examination, the statements of the patient and his or her family are considered mendacious: for Charcot, they cannot serve as a point of departure in the scientific search for truth. The medical lecture functions as the public representation of a struggle in which the patient’s will to deceive the physician is subjugated to the doctor’s will to discover the truth. In his interrogation, Charcot separates witnesses belonging to the same family for the purpose of bringing to light family secrets: “Plus il y a d’affection de famille et moins il y a de vérité pour le médécin.”25 Discarding the extravagant stories told by patients, the Salpêtrière physicians prefer the synoptic representational form of the family tree, in which they enter the illnesses of family members as revealed in the course of interrogation.26

23. Ibid., p. 147. 24. Ibid., p. 297. 25. “The more affection amongst family members, there is, the lesser truth for the doctor.” Charcot, quoted in Lubimoff, Le Professeur Charcot, p. 40. In his history of sexuality, Foucault has emphasized Charcot’s central role as one of the medical experts who advocated the isolation of the individual patient from his or her family. See Michel Foucault, The History of Sexuality, vol. 1, An Introduction, trans. Robert Hurley (London: Penguin Books, [1976] 1984), pp. 111–12. 26. For example, Charcot stated of a patient suffering from Graves’ disease: “Her family tree, her pedigree, as the English say, speaks clearly enough” (Charcot, Leçons du mardi à la Salpêtrière, 1:236). The dogma of heredity followed by the clinicians of the Salpêtrière was related more to the dominant cultural idea of “degeneration” than to earlier research practice. See Goetz, Bonduelle, and Gelfand, Charcot: Constructing Neurology, chapter 7.

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While the Tuesday lectures held at the outpatient clinic shaped the public image of Charcot and his “theatrical,” visually oriented style, another crucial site of his new research center has received little attention: the museum of pathological anatomy, known as the Musée Charcot, which was set up in the immediate vicinity of Charcot’s consulting room, and where demonstrations of clinical cases were frequently undertaken. 27 Summoning patients to this location facilitated comparison with pieces from the museum’s collections. It housed a large quantity of natural anatomical specimens, a collection of brains, a series of lifelike wax casts (busts as well as entire figures), and, as a special attraction, a large collection of images combining photographs of Salpêtrière patients (or engravings created after them) with reproductions of works by Rubens, Raphael, and other European masters. The collection served several functions: on the one hand, it was an archive, providing evidence to substantiate the universality of the clinical pictures presented by Charcot. In this respect it embodied the program of “retrospective medicine” formulated by the positivists, in which the artistic testaments of earlier eras could be interpreted through a materialist semiotic (a sort of natural grammar of symptoms), thus confirming the factuality of the conditions diagnosed.28 On the other hand, the objects and images preserved in the museum functioned as a supplement to the clinic. One might even assert that they served as its model, for Charcot proudly referred to his clinic as his “living pathological museum.”29 The casts and reproductions were to fill in the gaps in the tableau of diseases that could be demonstrated using living cases. The dead and living objects were two aspects of a single grand pathological collection. In summary, Charcot’s clinic established a spatial framework that amplified the developing trend in nineteenth-century clinical medicine toward putting the doctor in a position of power over the patient. Within this configuration, which isolated patients from their families and subjected them to 27. On the history of the Musée Charcot, see Andreas Mayer, “ ‘Ein Übermaß an Gefälligkeit’: Der Sammler Jean-Martin Charcot und seine Objekte,” in Meine . . . alten und dreckigen Götter: Aus Sigmund Freuds Sammlung, ed. Lydia Marinelli (Frankfurt: Stroemfeld, 1998), pp. 46–59. 28. Rubens’s depictions of the “possessed,” for example, served within this strategy as a guarantee that Charcot’s description of grande hystérie correlated with a natural phenomenon and did not represent a mere artifact. This program of a materialist semiotic was closely related to the anticlerical orientation of French medicine, as has been argued by Jan Goldstein, “The Hysteria Diagnosis and the Politics of Anti-Clericalism in Late Nineteenth Century France,” Journal of Modern History 54 (1982): 209–39. 29. Charcot, Leçons sur les maladies du système nerveux, OC 3:3.

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a system of medical control, the patient had already been more or less disempowered.30 However, Charcot altered an important aspect of this power relationship: he reversed the practice of the doctor’s rounds, in which the patient was immobile and the doctor went from bed to bed. Instead, it was the patient—inasmuch as he or she was not fully immobile—who was summoned by the doctor to a semipublic setting. For inpatients, this meant being transported by the assistants to the consulting room (or to the museum or the policlinic if the presentation was to take place before a larger audience). This structure converged with the clinical methods that produced defined medical disorders on the basis of visible differentiations. The doctor either compared the symptoms of a living patient directly with those of another patient, or he made a differential diagnosis with the aid of the objects housed in the pathological-anatomical museum. In the work of medical reasoning, the physician’s “art” of observation established relationships of similarity between various cases—the “specimens”—provided by the collection of patients. In such nosographic practice, the central clinical unit was not the individual case (the afflicted individual), but the “typical” clinical picture, which was expressed varyingly in a number of cases. In this configuration, “types” were not determined by quantitative criteria (as in statistics). Thus a case displaying a disease entity in its purest form was often a “rare find.” The representation of all stages of a disease’s development, which generally could not be provided exclusively by living cases, was dependent on the integration of the clinic with the policlinic and the museum, which expanded the “material” at the disposal of medical research. The museum, then, is presented by Charcot as the ordering principle of his entire clinic: “The clinical types offer a representative overview with numerous examples, permitting one to consider at a glance the disease in its various stages, whereby the gaps arising with time in this or that category are soon filled in again. We are, in other words, in possession of a sort of living pathological museum, whose resources are considerable.”31 The Experimentalization of the Unconscious With his research into hysteria, Charcot aimed to develop an experimental approach of resolutely neurological orientation in opposition to psychiatric 30. See Nicholas D. Jewson, “The Disappearance of the Sick-Man from Medical Cosmology,” Sociology 10, no. 2 (1976): 225–44. 31. Charcot, Leçons sur les maladies du système nerveux, OC 3:4; and echoed by Freud when he evokes his master’s “museum of clinical facts,” “Charcot,” SE 1:13.

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conceptions, which viewed the condition as a kind of madness. The definition of hysteria as a neurosis—with the assumption that a lesion of the nervous system was its possible cause—also ran against popular and clinical traditions that located the seat of hysteria in the uterus.32 In Paris, the ground for Charcot’s concept of grande hystérie had already been largely prepared by the work of Étienne Georget and Paul Briquet, who had considered hysteria to be a neurosis of the brain. Charcot introduced a new differentiation, classifying hysteria as a “grand neurosis” (grande névrose) affecting the patient’s overall nervous condition, while “local” or “simple” neuroses only influenced one nerve or a group of nerves. Understood as a nervous disorder, hysteria represented a challenge for localization theories, since its “seat” could not be made visible through postmortem dissection. Thus the methods of pathological anatomy had reached the limits of visibility: hysterical symptoms did not correspond with any “anatomical substrate.”33 Furthermore, hysteria posed a problem to differential diagnosis, because it deceptively imitated organic disorders (where material lesions could be found), in a kind of “neuromimesis.” Initially Charcot was able to use the convergence of the symptomatology of hysteria with familiar neurological disease entities to his advantage: it allowed him to “draw an analogy to the anatomic seat behind the commonly shared clinical picture” and to speak of a “dynamic lesion.”34 Making hysteria a problem of neuropathology did more than take it out of the hands of psychiatrists: it displaced the focus of interest from the “histories” told by the patients to the symptoms manifesting themselves on their bodies.35 It also meant abandoning the idea that hysteria was the privilege of 32. Already at the end of the eighteenth century, English and Scottish doctors (such as Thomas Sydenham and William Cullen) had outlined a neurological conception of “hysteria.” See Esther Fischer-Homberger, Die traumatische Neurose (Bern: Hans Huber, 1975), p. 12. For a more general overview of the literature on hysteria, see Mark Micale, Approaching Hysteria: Disease and Its Interpretation (Princeton, NJ: Princeton University Press, 1995). In her cultural history of hysteria in France, Nicole Edelman retraces the opposition between the neurogenital and neurocerebral theorizations of hysteria, identifying the 1850s as a pivotal decade witnessing a gradual dissociation of the disease from the female sex. In contrast to many other authors, however, she argues that even Charcot retains elements of the older neurogenital theories by focusing on the ovaries as one of the triggering zones of hysterical attacks. See Nicole Edelman, Les métamorphoses de l’hystérique: Du début du XIXe siècle à la Grande Guerre (Paris: La Découverte, 2003), esp. chapter 11. 33. Charcot, Leçons sur les maladies du système nerveux, OC 3:15. 34. Ibid., pp. 16–17. 35. For Charcot, the stories told by his patients were nothing but confused “novels” that distracted from the true symptoms. The story told by his first hysteria case was thus classified as

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the female sex.36 Charcot and his assistants were searching for ways in which the appearance of symptoms and their often rapid transformation could be made visible and controllable. Initially this strategy was expressed in the segmentation of hysterical convulsions into three or four phases based on the model used in structuring epileptic attacks. The progression of an attack in phases was the governing principle underlying grande hystérie: this conception allowed hysteria to be categorized in the same nosographic class as epilepsy, with heredity being their common root (which also explains the term hystéro-épilepsie). The major architect of the hysterical attack was Paul Richer (1849–1933), later professor of anatomy at the École des Beaux-Arts, whose synoptic tableau of the various phases became canonical for the Salpêtrière school.37 The various positions adopted during the attack were seen in correspondence with earlier artistic traditions depicting demonic possession, represented in a variety of reproductions assembled by Richer and Charcot. These strategies of visualization aimed at proving the universality of the clinical picture of grande hystérie on the basis of the formality or plasticity of hysterical symptoms.38

“all together a novel, a case of rape (?), in which it is difficult to find one’s way out.” Leçons sur les maladies du système nerveux. Recueillies et publiées par Bourneville (Paris: Bureaux du Progrès medical / Lecrosnier & Babé, [1872–73] 1892), OC 1:287; Lectures on the Diseases of the Nervous System, Delivered at La Salpêtrière, trans. George Sigerson (Philadelphia: Blakiston [1877] 1879), p. 193. Although these “novels” were comprehensively recorded in his clinic by his assistants, Charcot’s lectures on hysteria never deviated from the stable symptoms of the clinical picture, which he referred to as “stigmata.” 36. The scandalous or revolutionary nature of Charcot’s treatment of male hysteria seems to have been overrated in the past. An interpretation of the gender bias in Charcot’s conception of hysteria is given by Edelman, Les métamorphoses de l’hystérique, pp. 147–78. For a differing interpretation, see Mark Micale, “Charcot and the Idea of Hysteria in the Male: Gender, Mental Science, and Medical Diagnosis in Late Nineteenth-Century France,” Medical History 34 (1990): 363–411; and Micale, Hysterical Men: The Hidden History of Male Nervous Illness (Cambridge, MA: Harvard University Press, 2008), pp. 117–61. 37. Paul Richer, Étude descriptive de la grande attaque hystérique ou hystéro-epileptique (Paris: Delahaye, 1879); Étude clinique sur l’hystéro-épilepsie ou grande hystérie (Paris: Delahaye / Lecrosnier, 1881). 38. Following the republication of the photographs from the Iconographie photographique de la Salpêtrière in the work of Didi-Huberman (Invention of Hysteria), the link between the hysterical attack and its photographic depiction has captured the interest of many authors in art and cultural history. As I shall argue in the following, the relative marginality of a publication such as the Iconographie for Charcot’s experimental project becomes evident when other forms of visualization are taken into account.

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In addition to setting the symptomatology of hysteria within a visual framework, Charcot elaborated a number of experimental practices that made use of new techniques for manipulating patients’ bodies. The program developed at the Salpêtrière, which prized hysterical patients as its “first class experimental subjects,”39 was designed to produce and reproduce symptoms by using hypnosis as an experimental method. The experimental turn in the study of hysteria was intended to establish its nosographic classification on an objective basis, whereby the disorder was defined using three discrete pathological body states: catalepsy, lethargy, somnambulism. These were the stages of Charcot’s grand hypnotisme, which could be produced experimentally with the help of various techniques. In the following, I expound the strategies by which Charcot sought to establish hypnosis as an experimental technique in clinical research. First, by appropriating and redefining the original therapeutic program of healing hysterical symptoms using metals and magnets. Second, by developing a script according to which hypnotic suggestion appeared as a purely physical-physiological procedure. Third, through the introduction of new self-registering physiological instruments into the clinic to rule out the possibility of deception on the part of the subject. This also constituted an attempt to reconfigure the power relationship between doctor and patient by installing a system of control based on inscriptions. And fourth, by placing the new “subjects” in a position analogous to that of laboratory animals in physiological vivisection. “transfert”—a convergence of interests Charcot’s effort to reproduce clinically established symptoms of hysteria through the use of hypnosis began with the work of a commission examining a curious case. The doctor Victor Burq was endeavoring to achieve scientific recognition for a therapeutic procedure that he had been practicing for years. He claimed to have proven that certain metals exert a strong physiological effect on “hysteric-epileptic” individuals, often leading to the disappearance of symptoms, especially the characteristic disturbance of the senses (anesthesia and hemianesthesia). Burq claimed that each patient displayed an “idiosyncrasy” for certain metals, which he ascertained through “metalloscopic” examination—laying various metals on the skin and observing the effect they produced—before deciding upon the indicated therapy. In 1876, Claude Bernard, at the time president of the Paris Société de biologie, agreed 39. Charles Féré, “Sensation et mouvement,” Revue philosophique 20 (1885): 337–68, p. 347.

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to form a commission for the purpose of investigating Burq’s claims. Among the members of the commission were Charcot and his colleagues Amédée Dumontpallier and Jules Bernard Luys.40 The two reports produced by the commission, which dealt first with metalloscopy and then with metallotherapy, were for the most part of a positive tenor. They initiated a renaissance of the earlier practices of animal magnetism at the Salpêtrière, where Charcot allowed Burq to conduct a series of experiments on his patients, and subsequently at other Parisian hospitals as well.41 This “rediscovery” of earlier clinical knowledge involved a convergence of various interests. Burq’s persistent interest in obtaining the rehabilitation of his therapeutic procedure under the auspices of the Société de biologie, France’s most important institution for life sciences, came together with the Parisian commission members’ interest in making hysterical symptoms reproducible. Hence, from the very beginning, the commission divided its work into two separate areas. First and foremost, the experiments conducted at the Salpêtrière focused on metalloscopy, in other words on the “direct observation . . . of the phenomena produced by the metal’s action on the surface of the skin, particularly in hysterics.”42 The investigation of metallotherapy—of whose benefits the commission members were skeptical—was considered a secondary issue. Charcot later defined his standpoint as follows: 40. There are two differing versions of this historical episode: the first claims that it was Burq who initially wrote a letter to Claude Bernard concerning the matter, whereupon the latter assembled the commission. According to the second version, the initiative for forming the commission derived from Charcot, who had previously convinced himself of the genuineness of Burq’s claims after allowing him to experiment on his patients at the Salpêtrière. The first version is outlined in Anne Harrington, “Metals and Magnets in Medicine: Hysteria, Hypnosis and Medical Culture in Fin-de-Siècle Paris,” Psychological Medicine 18 (1988): 21–38. The greater plausibility of the second is demonstrated by Marcel Gauchet, “Les chemins imprévus de l’inconscient,” in Le vrai Charcot, ed. Marcel Gauchet and Gladys Swain (Paris: Calmann-Lévy, 1997), pp. 97–208. 41. The structures at these other Parisian hospitals were similar to those of the Salpêtrière. Dumontpallier and Luys, who at La Charité and La Pitié were experimenting with hypnosis at the same time as Charcot and his pupils, pursued other strategies and utilized other practices. Regarding the diversity of these experiments, see Anne Harrington, “Hysteria, Hypnosis, and the Lure of the Invisible: The Rise of Neo-Mesmerism in Fin-de-Siècle French Psychiatry,” in The Anatomy of Madness: Essays in the History of Psychiatry, ed. W. F. Bynum, R. Porter and M. Shepherd (London: Tavistock, 1988), 3:226–46. On the popular exposition of Dumontpallier’s and Luys’s cases, see Edelman, Les métamorphoses de l’hystérique, pp. 182–93. For a critical contemporary report, see Kovalevskaya, “Hypnotism and Medicine in 1888 Paris.” 42. Jean-Martin Charcot, “Études physiologiques de l’hystérie (Extrait de l’Exposé des titres scientifiques de M. Charcot),” [1883] OC 9:213–19, pp. 213–14.

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The phenomena referred to as metalloscopic can be obtained with the aid of a variety of agents. Thus one must first determine the shared and essential physical condition for all of these agents, and then study the physical modifications resulting from the presence of this condition. The problem is twofold: physical and physiological; a resolution thereof will make it possible to determine the practical consequences to be drawn.43

In setting its new priorities, the commission was pursuing a strategy of assimilation: instead of testing primarily the therapeutic effect of Burq’s practices, the commission employed his competence with various clinical resources in expanding the field of experimentation to include a wider range of physical agents. While the effects of the metals were being certified by the commission’s work, Charcot and his pupils at the Salpêtrière were already launching an experimental program that replaced the metals with a number of other agents, including magnets and static and faradic electricity as well as other “mechanical” influences on the senses of the hysterical patients, among them hypnotic “suggestion.” The experimental program—in which the Parisian clinicians produced and reproduced facts using a range of practices that specialists visiting from England called “wonderful and suggestive”44—operated against the background assumption that, in the end, all of the phenomena could be explained on the basis of the effects of electricity.45 In this program, the doctors broadened their intervention to include more extensive areas of the patient’s body than had previously been involved in research at the Salpêtrière. The first form of quasi-experimental intervention had involved the localization of specific “hysterogenic zones” distributed on the body, to which the doctor could apply pressure in order to trigger or halt hysterical attacks. The clinicians located the source of the attacks in the ovaries, and they developed a special apparatus for compressing them. The effectiveness of this intervention 43. Ibid., p. 214. 44. Arthur Gamgee, “An Account of a Demonstration on the Phenomena of HysteroEpilepsy and on the Modification Which They Undergo under the Influence of Magnets and Solenoids Given by Professor Charcot at the Salpêtrière,” The British Medical Journal 2 (1878): 545–48, p. 547. 45. In a therapeutic context this led to the recognition of electrotherapy: Jean-Martin Charcot, “De l’emploi de l’éléctricité statique en medicine,” (1881) OC 9:483–501. Subsequently, the Salpêtrière clinic set up a special cabinet for the treatment of outpatients, “equipped with an overabundance of apparatus necessary for static, galvanic and faradic treatment.” Hirt, “Das Hospiz ‘La Salpetriere,’ ” p. 11. A historical analysis of the varying positions is found in Margaret Rowbottom and Charles Süsskind, Electricity and Medicine: History of Their Interaction (San Francisco: San Francisco Press, 1984).

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represented a means of differentiating hysteria from epilepsy: an attack was classified as “epileptic” (and not as “hysteric”) when it could not be stopped using the pressure method.46 Charcot and his pupils expanded this form of intervention, localizing a number of further “points” and “zones” by testing the body of each patient for the existence of such points and recording the information on special cards (see fig. 1). The discovery of the pressure points, which the doctors localized in different places on each patient, occurred either by “chance” during the examination or through the “revelations of the patient, who generally preserves the secret and protects the part.”47 Often the way in which the patient positioned herself with respect to the doctor was enough to set the latter on the trail of where the corresponding point could presumably be found: “It was observed that one patient was always carefully turning her face toward the doctor or other persons, and thus a sensitive zone on her back between her shoulders was discovered. Rubbing this area once or twice was enough to trigger an attack.”48 After the doctor had localized these points, he was able to use them in monitoring and controlling the course of hysterical attacks. Within the framework of the new experimental program, the radius of medical intervention expanded. Not only was the doctor able to activate and deactivate the body of the hysteric by means of pressure applied to specific zones: he could directly produce, displace, and negate a number of symptoms on the patient’s body. In contrast to the zones that were localized on every individual who was classified as a hysteric, these symptoms (disturbances of the senses, paralyses, contractures) related to body surfaces or limbs hemilaterally or bilaterally. This expansion of the field of possible intervention was facilitated by a striking phenomenon that emerged during the testing of Burqian metalloscopy, which the Parisian clinicians took as a point of departure for further experimentation. This phenomenon, known as transfert, referred to the disappearance of a hemilateral anesthesia caused by the application of a metal and its simultaneous symmetrical manifestation in the other half of the body. The commission selected the term transfert in analogy to the “transfer” of a sum of money by a bank from one account to another (without loss or gain). Such quantitative-economic vocabulary corresponded to the experimental setup in use, which measured the hearing acuity of both

46. Richer, Étude descriptive de la grande attaque hystérique, p. 27. 47. Charcot, quoted in George Sigerson, “A Lecture on Certain Phenomena of Hysteria Major: Delivered at La Salpêtrière on November 17th, by Professor Charcot,” The British Medical Journal 30 (November 1878): 789–91, p. 789. 48. Ibid.

f i g u r e 1 .  Schematic map of the main “hysterogenic zones,” identified by Charcot and his pupils. From Richer, Étude clinique.

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ears instrumentally and translated it into two series of numbers that could be compared directly.49 Thus the commission’s original task of testing a therapeutic method (metallotherapy) of healing sufferers of hysteria was reversed in the experimental production of hysterical symptoms using a variety of procedures. This reversal, which resulted in the increasing experimental exploitation of the transfert phenomenon, occurred thanks to two factors: Firstly, the symptoms reproduced (such as hemianesthesia) had already been established in earlier clinical case collections (such as Briquet’s Traité de l’hystérie). It was the evidence of these symptoms (their constant presence in the patient’s “condition”) that had initially facilitated a connection between the earlier therapies of magnetism and the new “modern” scientific medicine of the Salpêtrière. Secondly, the graphic or quantitative “standardization” of the symptoms created by the new instruments made it possible to generalize this phenomenon and apply it to all senses that could be measured in the laboratory. These new methods for stabilizing symptoms facilitated a widening of experimental intervention through the physical agents used by Burq and led to the development of a quantitative vocabulary in which symptoms became capitalizable.50 Thus the switch from a therapeutic to an experimental program was an effect of the medical culture developing in the Parisian clinics, and it gave rise to a new configuration in which the ancient and suspect practices of animal magnetism were combined with the newest cutting edge technologies of experimental physiology. By guaranteeing a reliable index for the condition of each experimental subject and making it reproducible with the aid of a specific set of practices, the phenomenon of transfert marked the beginning of the career of Charcot’s “experimental hypnotism.” a laboratory of hypnosis The use of hypnosis in clinical experiments at the Salpêtrière, which arose as a consequence of the metalloscopy episode, cannot be understood as the mere “return” of the earlier tradition of mesmerism or animal magnetism

49. Jean-Martin Charcot, “De la métalloscopie et de la métallothérapie,” [1878] OC 9:233– 52, p. 237. 50. This capitalist vocabulary returned in the experimental use of hypnosis, for example, in the statement that “one could say that a pain could be increased at the desired rate” by administering various suggestions (Charcot, Leçons du mardi à la Salpêtrière, 1:230).

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in scientific medicine.51 In Charcot’s endeavor to create a new experimental system in the clinical space,52 he drew initially on two distinct models of experimentation within the life sciences: the first, heavily attacked and disputed in public, was Claude Bernard’s doctrinal formulation of animal vivisection; the second, on the rise and as an unbloody alternative to Bernard’s approach, was Etienne-Jules Marey’s “graphic method” with the use of self-recording physiological instruments, which at the time was widening its scope to include the study of all kinds of human and animal movement.53 Between 1877 and 1882 Charcot and his team integrated elements of both models into their clinical research, in order to make “hypnotism” a synonym for a set of physical procedures whose effects on the body of the experimental subject could be understood in purely mechanical terms. The resonance of their ideas with Bernard’s Introduction à l’étude de la médecine expérimentale (1865) lent weight to Charcot and Richer’s claim that the hypnosis experiment offered an opportunity for investigating a number of pathological alterations of the nervous system on the body of the living patient, an opportunity offered neither by normal organisms nor by animals: Between the regular functioning of the organism and the spontaneous disorders caused by illness, hypnotism can open a path of experimentation. The hypnotic state is in effect nothing but an artificial or experimental nervous

51. As Alison Winter has shown for Britain, mesmerism was, despite its controversial nature, less repressed than some of the earlier historiography has suggested (Winter, Mesmerized ). For the French context, see Carroy, Hypnose, suggestion et psychologie. 52. The term “experimental systems” is used here following the terminology proposed by Rheinberger who defines them as the “smallest integral working units of research . . . , systems of manipulation designed to give unknown answers to questions that the experimenters themselves are not yet able clearly to ask” and as such “vehicles for materializing questions.” Hans-Jörg Rheinberger, Toward a History of Epistemic Things (Stanford, CA: Stanford University Press, 1997), p. 28. 53. The comparative approach to human and animal locomotion is first outlined in EtienneJules Marey, La machine animale (Paris: Masson, 1873); for Marey’s “discours de la méthode,” see his La méthode graphique dans les sciences expérimentales et principalement en physiologie et en médicine (Paris: Masson, 1878). After having been largely forgotten, Marey has become the subject of a veritable industry over the past twenty years. For subtle and critical historical accounts of his self-recording physiology, see Soraya de Chadarevian, “Graphical Method and Discipline: Self-Recording Instruments in Nineteenth-Century Physiology,” Studies in History and Philosophy of Science 24 (1993): 267–91; Robert Brain, “The Graphic Method: Inscription, Visualization, and Measurement in Nineteenth-Century Science and Culture,” PhD diss. (Los Angeles: University of California, 1996); and Robert Brain, “Standards and Semiotics,” in Inscribing Science: Scientific Texts and the Materiality of Communication, ed. Timothy Lenoir (Stanford, CA: Stanford University Press, 1998), pp. 249–84.

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state, whose multiple manifestations can be caused to appear or disappear at the whim of the observer.54

However, Charcot would make use of Bernard’s doctrine with a characteristic twist. In a few famous pages of his Introduction, Bernard had formulated the imperative that medicine advance from the stage of a passive observational science into that of a truly active experimental science: “With the help of these active experimental sciences, man becomes an inventor of phenomena, a real foreman of creation; and in this respect we cannot set limits to the power that he may gain over nature through future progress in the experimental sciences.”55 Correspondingly, Bernard postulated a hierarchy for pathological medicine in which the practice of nosography and of pathological anatomy would in the end be subordinated to experimental physiology. Nosography was limited to the classification of diseases, while anatomy could only make observations on dead bodies. According to Bernard’s reasoning, his experimental physiology was of a superior order because it was able to experiment on living animal bodies and then seek physical and chemical explanations on the basis of these findings.56 In his account of the method in use at the Salpêtrière, Charcot did not hesitate to reverse this hierarchy, thereby citing, quite ironically, Bernard as an authority: “One must never,” he [Bernard] said, “subordinate pathology to physiology. It must always be the other way around. One must first pose the medical problem as it is given by observation of the illness and then attempt to provide the physiological explanation. Doing otherwise puts one in danger of losing sight of the patient and distorting the illness.”57

When Charcot presented his 1882 report on grand hypnotisme before the Paris Académie des sciences during his campaign for membership, he also reserved the highest status for clinical observation and nosographic classification. Hysteria, now referred to as an “experimental neurosis,” is presented in a schematic tableau of three typical stages that are experimentally reproducible in isolation or in varying sequences: catalepsy, lethargy, and

54. Jean-Martin Charcot and Paul Richer, “Contribution à l’etude de l’hypnotisme chez les hystériques; du phénomène de l’hyperexcitabilité neuromusculaire,” [1881–83] OC 9:309–421, p. 310. 55. Claude Bernard, An Introduction to the Study of Experimental Medicine, trans. Henry C. Greene (New York: Dover, [1865] 1957), p. 18. 56. Ibid., pp. 112–15. 57. Charcot, Leçons sur les maladies du système nerveux, OC 3:9.

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somnambulism.58 Charcot defines all three stages as abnormal constant states of somatic excitability, which can be produced and neutralized artificially. The official presentation of hysteria under this new definition reflected a strategy of reducing the phenomena produced in experimental practice to a schematic tableau of three stages, of which two had already been precisely described and validated in earlier clinical observations.59 By only describing the “regular, in a certain sense classic types” in their “perfect development and abstraction,”60 Charcot was able to exclude cases deviating from this model (the formes frustes, the “rudimentary forms”) and to avoid having to discuss in any great detail the diversity of practices being used in the experiments conducted in his clinic.61 This diversity becomes apparent when one turns to the reports that were published not only locally by Charcot and his pupils, but also from the very beginning in the pages of the British Medical Journal. The English physiologist Arthur Gamgee, who witnessed hypnosis experiments at the Salpêtrière in 1878, provides one of the very first detailed accounts of how Charcot put his patients into a “mesmeric condition” before an audience of prominent visitors: Being assembled in the laboratory attached to his wards, Professor Charcot brought before us a young patient aged twenty affected with hystero-epilepsy. In this patient, there exists left-sided hemianæsthesia, which is associated with hyperæsthesia in the right ovarian region. . . . Professor Charcot brought this patient before us to demonstrate that usually it is possible in patients affected with hystero-epilepsy to induce the mesmeric condition. The patient being seated opposite to him, at the distance of about two feet, he steadily maintained the index finger of his right hand at a short distance from the centre of her forehead; she was directed to look steadily at the finger, and did so. 58. Jean-Martin Charcot, “Note sur les divers états nerveux déterminés par l’hypnotisation chez les hystériques,” (lue à l’Académie des Sciences, séance du 13 février 1882) Le progrès médi­ cal 10, no. 7 (1882): 124–26. 59. The stages “catalepsy” and “lethargy” had already been described by both Briquet and Lasègue in numerous cases: Paul Briquet, Traité clinique et thérapeutique de l’hystérie (Paris: Masson, 1859); Charles Lasègue, “Des catalepsies partielles et passagères,” Archives Générales de Médicine (October 1865): 385–402. 60. Charcot, “Note sur les divers états nerveux,” p. 124. 61. Charcot’s 1882 report was later widely interpreted as a revolutionary breakthrough achieving the recognition of hypnosis in science (see, for example, Ellenberger, The Discovery of the Unconscious), being worthy of particular note because it came long after an extended debate involving contradictory commission reports which the Académie des sciences ended in 1840 by resolving that it would no longer investigate any form of magnetic experimentation. See Carroy, Hypnose, suggestion et psychologie, p. 128.

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Several minutes elapsed (the time was not actually noted), and the patient did not seem sensibly affected. She declared that “today she had no desire to sleep.”—At 10.4. a.m., the previous attempts, which may have lasted ten minutes, having failed, Professor Charcot, placing his head on a level with that of the patient, commenced to stare fixedly into both her eyes. At 10.6, the eyelids drooped, and, at the same time, began to wink in a rapid tremulous manner; this phenomenon continuing throughout the whole duration of the induced sleep, and being, Professor Charcot remarked, constant; at the same time, a tonic contraction of the flexors of both forearms occurred, the fists becoming temporarily clenched.—At 10.7, the patient being asleep, Professor Charcot told her to rise and take a chair. She did so, her eyes being closed and her eyelids tremulous. Having seated herself, he told her to write her name. Pen, ink, and paper being furnished her, she sleepily wrote her own name, and afterwards, when ordered, Professor Charcot’s, her eyes remaining closed the whole time. Whilst writing, the skin over the right wrist was transfixed by a thick needle, but the patient appeared quite unconscious of the operation, continuing to write with the needle in situ. . . . Professor Charcot then blew into her eyes, and she awoke. The act of awaking, in her case and in that of all hystero-epileptics who have been thrown into the mesmeric sleep, is accompanied by a peculiar reflex: there is an automatic and sudden act of expulsion of saliva—as it were a slight effort to spit.62

This early report already contains all of the elements that would define the experimental action script of the Salpêtrière school.63 In the first stage of the experiment, the patient is put into a hypnotic state, whereby a certain symptom is suggested to her (in this case not only hemilateral, but total anesthesia). The practices in use here are initially those derived from animal magnetism (such as fixation of the gaze on a finger, the hypnotist’s eyes or an object). In the second stage, the specific features of the induced state that are constant (trembling eyelids, contractions) are observed on the body of the hypnotic subject. In the third stage, she is instructed to perform simple motoric tasks (e.g., writing her own name and that of the experimenter). Simultaneously, the experimenter tests the genuineness of the suggested symptoms (in the case of anesthesia by the penetrating the skin). In the last and final stage, the hypnotic state is ended by means of a mechanical action (blowing into the eyes, pressing the ovaries).

62. Gamgee, “An Account of a Demonstration,” p. 545. 63. “Action scripts” fix the various activities of the agents involved in an experiment. Within a certain experimental machinery, the script determines the performance demanded of the subject and thus also defines his or her radius of action.

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Within this script, the practices of hypnotic suggestion have been expanded considerably: in the fixation method, taken up from the Scottish physician James Braid,64 the induction of a hypnotic state is linked to the physical presence of the doctor, who “captures” the patient’s gaze by fixing it upon himself. In the various practices for capturing the subject’s gaze described in the Iconographie photographique de la Salpêtrière, the gaze is understood as a material object, which the hypnotist must take into his possession (see fig. 2). This “being taken into possession” characterizes the state of “fascination,” in which the hypnotized person belongs solely to the hypnotist: One stares fixedly at the patient, or one causes her to stare at one’s fingertips. From this point on, the subject follows you everywhere, but without losing eye contact: if you bend over, she bends over too, and if you turn quickly, she turns quickly as well to regain your gaze. If you move forward quickly, the subject plunges forward after you straight on. This experience must be handled with great caution, since the patient does nothing to catch her fall and will tumble directly onto her skull if she is not retained.65

Although the technique described by Désiré-Magloire Bourneville and Paul Régnard represented his point of departure, Charcot was from the very beginning designing a strategy that moved away from a situation in which the hypnotist directly displayed his power over the subject. Such practices were clearly associated with the performances of stage magnetism. In the experiments that Charcot performed in his lectures and published with his pupils in academic journals, he presented the induction of a hypnotic state not as the action of one body upon another, but rather as the action of various stimuli upon the nervous system of the subject. Thus the Salpêtrière doctors emphasized that “hypnotism” resulted not only from the “fixation of the gaze, the fatiguing of vision and the convergence of the visual axes in the inner strabismus” (as in Braid’s procedure), but also from tactile and aural stimuli.66 Correspondingly, the new script included a variety of mechanical agents that allowed the experimenters to vanish behind the laboratory machinery. The experiment, then, is set up according to Bernard’s influential definition of the physiological experiment as a “provoked observation,” in which the scientist 64. James Braid, Neurypnology or the Rationale of Nervous Sleep Considered in Relation to Animal Magnetism or Mesmerism and Illustrated by Numerous Cases of Its Successful Application in the Relief and Cure of Disease: A New Edition, ed. Arthur Edward Waite (London: George Redway, [1843] 1899). 65. Désiré-Magloire Bourneville and Paul Régnard, Iconographie photographique de la Sal­ pêtrière (Paris: Bureau du Progrès médical / Delahaye & Lecrosnier, 1879–80), 3:180. 66. Richer, Étude descriptive de la grande attaque hystérique, pp. 124–25.

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f i g u r e 2 .  The hypnotist taking possession of his subject. From Bourneville and Régnard, Iconographie photographique de la Salpêtrière.

constantly switches between the role of the inducing experimenter and the note-taking observer: Now, from the moment when the result of an experiment appears, the experimenter is confronted with a real observation which he has induced and must note, like any other observation, without any preconceived idea. The experimenter must now disappear or rather change himself instantly into an observer.67

In this sense Charcot and his pupils referred to the “stages” of grand hypnotisme as “provoked observations” (or alternately as “experiments” and “observations”).68 As in the curious formulation of Bernard’s model, which represents an idealization of experimental practice,69 the physician appears in turn as an actively intervening experimenter and as a passively registering observer. As a means of achieving fixation, the doctor’s gaze was substituted by a bright electric light, before which the patient fell into a state of cataleptic immobility. Charcot demonstrated this effect for an international audience of scientists in the following manner. After he had himself hypnotized the patient several times using the fixation method, he allowed his guests to 67. Bernard, An Introduction to the Study of Experimental Medicine, p. 22. My italics. 68. Richer, Étude descriptive de la grande attaque hystérique, p. 125. 69. Given the highly controversial nature of animal vivisection, Bernhard’s text performs an abstraction from the “gruesome kitchen” of the laboratory by characterizing this practice as a rationally conducted dialogue with nature.

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repeat the procedure themselves in order to demonstrate that his personality had no special influence on it: “It sufficed merely to open the patient’s eyes and stare into them for an instant, to throw her into a profound sleep, from which she could be aroused by certain stimuli, and especially by blowing into the face.”70 Then the patient was led into a darkened room, “in which a spiral of platinum heated by a powerful gas blow-pipe emitted a light almost as intense as a magnesium light. If she stared into the flame for an instant, she immediately fell asleep and passed into a cataleptic condition; her limbs, placed in the most unnatural positions, retained these until someone moved them into a new attitude.”71 Another setup in which the experimenter was made to “disappear” from the scene involved aural and tactile sensations (see figs. 3 and 4). Here the subject was exposed to powerful vibrations produced by an oversized tuning fork: The patients G. and B. are seated upon a box that serves to amplify a strong tuning fork, which is made of bell metal and vibrates sixty-four times per second. It is set in vibration by means of a wooden stick violently struck between its branches or by a bow rubbed against its open extremity. After a few moments, the patient falls into catalepsy; the eyes remain open, she seems completely absorbed and she is no longer conscious of anything occurring around her.72

In addition to this impressive technical machinery, which both conveyed the experimental subjects into the desired state of submission and provided the entire operation with powerful symbols, very simple arrangements were also used. For the purpose of creating “intense and unexpected noise,” the experimenters used gongs, which had the additional advantage of allowing patients who responded satisfactorily to this procedure to be able to produce the desired effect themselves when ordered to do so (see figs. 3 and 4).73 All of these procedures allowed the doctors to withdraw from the scene of the experiment and record the observations they produced. The sudden elimination of the stimulus (the light or sound) was found to produce an abrupt transition from the cataleptic to the lethargic stage. With the help of various techniques, the doctor was able to “communicate” with the hypnotic subject in both of these states via various “channels”: the cataleptic subject “is motionless and appears as if fascinated, the eyes open, the gaze frozen, the 70. Gamgee, “An Account of a Demonstration,” p. 545. 71. Ibid., p. 546. 72. Jean-Martin Charcot, “Catalepsie et somnambulisme hystériques provoqués,” [1878] OC 9:253–64, p. 262. 73. Richer, Étude descriptive de la grande attaque hystérique, p. 136.

f i g u r e s 3 a n d 4 .  These series of photographs demonstrate how Charcot’s subjects were to be transported first into states of catalepsy by the exposure to acoustic and optical stimuli, then into states of lethargy by their sudden suppression. From Bourneville and Régnard, Iconographie photographique de la Salpêtrière.

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physiognomy impassive.”74 In this state, setting the patients’ limbs into various positions was discovered to give rise to expressive movements in other body parts, especially the face. In a series of experiments, Charcot and Richer built on Duchenne de Boulogne’s experiments on the expression of emotions, according to which certain forms of facial expression were localized in particular muscles. In his research, Duchenne had used faradic electricity as a means of artificially inducing muscular contraction in the face and other body parts.75 In a similar vein, Charcot and Richer studied the influence of various body positions on the physiognomy of their subjects, and conversely the bodily influence of stimuli applied to the facial muscles using faradic electricity. In these experiments the subject was “transformed into a sort of expressive statue, a motionless model, representing with striking accuracy most varied expressions.”76 In the lethargic state, on the other hand, subjects proved to be unreceptive to all “suggestions” of this sort, although increased muscular sensitivity made it possible to trigger the contraction of certain muscles through the application of mechanical stimuli. Here the experimenter carried out the intervention by pressing his finger against the point on the skin under which the corresponding nerves were located. Later a short wooden stick was used for this purpose.77 Within this ensemble of practices, a differentiation was made between “mechanical” stimuli (shock, pressure, massage) and “electrical” stimuli (mag­ netism, induced current).78 Under this classification, the fixation of the gaze on that of the experimenter proved to be only one of several possible mechanical influences whereby, as Charcot and Richer insisted in their reports,

74. Charcot, “Note sur les divers états nerveux,” p. 124. 75. G.-B. Duchenne (de Boulogne), Mécanisme de la physionomie humaine ou analyse électro-physiologique de l’expression des passions, 2nd ed. (Paris: Librairie J.-B. Bailliere et Fils, [1862] 1876). See also Andrew Cuthbertson: “The Highly Original Dr. Duchenne,” in Duchenne de Boulogne, The Mechanism of Facial Expression (Cambridge: Cambridge University Press, 1990), pp. 225–56. For Duchenne’s experimental strategies and artistic ambitions, see Stéphanie Dupouy: “Künstliche Gesichter. Rodolphe Töpffer und Duchenne de Boulogne,” in Kunstmaschinen: Spielräume des Sehens zwischen Wissenschaft und Ästhetik, ed. Andreas Mayer and Alexandre Métraux (Frankfurt: Fischer, 2005), pp. 24–60. 76. Jean-Martin Charcot and Paul Richer: “Note on Certain Facts of Cerebral Automatism Observed in Hysteria During the Cataleptic Period of Hypnotism,” Journal of Nervous and Mental Diseases 10, no. 1 (1883): 1–13, p. 9. [“Note sur quelques faits d’automatisme cérébral observés pendant la période cataleptique de l’hypnotisme chez les hystériques. Suggestion par le sens musculaire,” OC 9:434–46, p. 443]. 77. Charcot and Richer, “Contribution à l’etude de l’hypnotisme chez les hystériques.” 78. Ibid.

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“the personality of the experimenter did not play any role.”79 Skeptical visitors were treated to demonstrations of the impersonal nature of these processes in that they were invited to reproduce the phenomena on the patients themselves. Here reports of numerous “incidents” or “accidents” confirming the findings of the Salpêtrière school played a key role in convincing skeptics.80 One of these relates an incident in which a curious English visitor precipitated an “accident” after a public demonstration of the hypnosis experiments: As the crowded audience, composed of physicians and students of different nationalities, separated, one of them seized the occasion, whilst close behind a patient whose case has been described above, to press with his hand upon the sensitive area in her back. Possibly, he was skeptical of the fact related; but, if so, the result must have convinced him of its reality. The patient fell immediately upon the tiled floor of the corridor in a state of lethargy. The reckless culprit escaped in the confusion; but his act, which naturally caused great annoyance in an institution where every care is taken to guard against accidents, remains to prove the reality of the phenomenon he appears to have disbelieved.81

control by inscriptions It was not only through numerous reports of such impressive demonstrations that the “facts” of Charcot’s new experimental research on hysteria became widely known, but also through visual representations, which became a distinctive trademark of the work done at the Salpêtrière. Against the popular notion (largely derived from the later reception of the Iconographie photographique de la Salpêtrière) that photography served as the major technology in Charcot’s representation of hypnotized subjects, it must be noted that the “experimental neuroses” were observed and represented within a variety of visual systems. The purpose of the photographs, which were first produced in a special laboratory by Bourneville and Régnard, later by Albert Londe,82 79. Charcot, “Catalepsie et somnambulisme hystériques provoqués,” OC 9:264. 80. The extraclinical phenomenon with which hypnotic states produced in the laboratory were compared was shock to the nervous system induced by technical catastrophes such as railway accidents, which had previously become a subject of interest on account of the consequences for insurance companies. See Fischer-Homberger, Die traumatische Neurose. 81. Sigerson, “A Lecture on Certain Phenomena of Hysteria Major,” p. 791. 82. Londe entered Charcot’s service in 1882. He gives a retrospective account in Albert Londe, “Le service photographique de la Salpêtrière,” Archives d’éléctricité médicale experimentales et cliniques 7 (1899): 282–96.

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was mostly to fix and file what had already been put into visual form by drawing. While photography was used as an archival technique, the introduction of physiological instruments to record the subject’s movements during the three stages of hypnotism in the form of inscriptions was a more original and important epistemic strategy. The use of Marey’s graphic method, which Charcot and his intern Paul Richer advocated in a series of experiments, demonstrated a further step in objectifying the phenomena.83 The presentation of the experimental results made use of a variety of techniques to visualize the evidence. In the case of the “grand hysterical attack,” Richer attempted to register the convulsions manifested during the course of an attack using Marey’s self-registering instruments. Body movements are translated into curves paralleling, on a second visual level, figurative representations of the patient produced by drawing or photography. In this experimental setup, the myograph, placed on the forearm muscles of the patient during the first “epileptoid period,” measures more than an isolated local phenomenon (the action of the muscle): the curve it produces represents the attack’s overall motoric development. Since it reproduces “the physiognomy of the epileptoid attack in its entirety,” this inscription is regarded as a “confirmation” of the observations.84 Thus the patient’s body and its movements during the course of the attack are represented in three ways: by the myograph’s curve drawn on a blackened cylinder roll, by observers’ drawings or photographs detailing various phases of the attack, and finally by the narration of its development in technical nomenclature. These various forms of representation are compiled into a synoptic tableau (see fig. 5). As a method of representing the hysterical attack, however, Marey’s instruments came up against a problem: the attack could only be captured in its first (epileptoid) period, and not in its entirety, because the subsequent periods were not “accessible to this means of investigation on account of their violence and their wide range of movement.”85 Thus the new experimental system built around grand hypnotisme concentrated on reversing the balance of forces between the hysterical body and the experimental machinery: here the stages making up this “artificial pathology” were defined through signs 83. Marey was professor at the Collège de France and had been elected as Claude Bernard’s successor to the Académie des sciences in 1878, a powerful position which also served the widespread propagation of his self-recording physiology, published the same year in his monumental book La méthode graphique. It is not unlikely that the heavy use of Marey’s instruments in the first phase of the hypnosis experiments at the Salpêtrière was also related to Charcot’s own campaign to enter the Académie des sciences. 84. Richer, Étude descriptive de la grande attaque hystérique, p. 28. 85. Ibid., p. 3.

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f i g u r e 5 .  Epileptoid period of the hysterical-epileptic attack. From Richer, Étude descriptive.

that could be translated into “inscriptions” by Marey’s devices. With the help of the graphic method, the clinicians of the Salpêtrière aimed to create and impose a semiology that was anchored in standardized and reproducible body states. The sign that the researchers elevated to the “obligatory sign” (signe obligé) of the “lethargic” state was hyperexcitability of the reflexes (hyperexcitabilité neuro-musculaire).86 In order to delimit the specific nature of this state, a percussion was conducted using the reflex hammer in both a waking state and under hypnosis. The “propagation” of the reflex was registered using a setup involving multiple myographs on the patient’s arms and legs. Comparison of the curves showed that under hypnosis reflex activity lengthens over that of the waking state, and that the intensity and duration of muscle contraction can increase.87 At first the movement triggered by the “abrupt shock” of the percussion produces a tendency toward contraction, in which the curve drawn by the myograph is “transformed into a plateau,” which for Richer and Charcot represented a “sketch of the contraction.”88 By repeating the percussion, they could at times extend the hyperexcitability over the entire bodies of some patients. Initially this new form of evidence stabilized the symptom itself, whose constancy could be measured and reproduced in the form of a graph or an 86. Ibid., p. 146. 87. Charcot and Richer, “Contribution à l’étude de l’hypnotisme chez les hystériques,” pp. 309–12. 88. Ibid., p. 320.

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“inscription” made by applying self-registering devices directly to the body. The translation of symptoms into inscriptions expanded the space of medical observation: measurement of the body surface (the skin) and figurative description of the symptoms’ plasticity were augmented by a form of representation designed to trace the irradiation of the reflex within the nervous system. Thus Charcot and his pupils were not only pursuing the epistemic strategy of orienting their experiments around the paradigm of localizing neuroses in the nervous system or in the brain.89 The graphic method also allowed the Salpêtrière doctors to displace the balance of forces in the hypnosis laboratory in their favor: since most of the hysterical attack was not accessible to this recording method, neuromuscular hyperexcitability was elevated to the “obligatory sign” of hypnotism, whereby its constancy could be measured, regulated, and visualized in the form of a sum of excitation. At the same time, Charcot and his pupils used the self-registering instruments as a new means of facilitating control over the will of their experimental subjects. The devices were to create an objective index for the existence of hypnotic states, thus eliminating any suspicions that the hypnotic subjects were simulating. The use of the graphic method as a means of eliminating the patient’s “will” was of central significance to the credibility of the experiments demonstrated at the Salpêtrière.90 Not only did the self-registering instruments developed and refined by Marey translate symptoms themselves into a regulable visual system: they were also seen as a reliable means of differentiating simulation from genuine hysteria. In view of the criticisms raised against their experiments early on, Charcot and his pupils sought to forestall all possible objections relating to their hypnotic subjects’ conscious or unconscious deception. Thus transfert represented an indisputable fact, because its discovery was accorded to “chance” and because it numbered among the

89. See Anne Harrington, “The ‘Experimental Evidence’: Metalloscopy and HemiHypnosis,” in Medicine, Mind, and the Double Brain: A Study in Nineteenth-Century Thought (Princeton, NJ: Princeton University Press, 1987), pp. 166–205. 90. In view of the machinery mobilized in the experimental study of hysteria, Foucault’s sharply contrasting depictions of Pasteur’s bacteriological laboratory and Charcot’s clinic put forth in his lectures on “psychiatric power” cannot be maintained. Michel Foucault, Psychiatric Power: Lectures at the Collège de France 1973–1974, ed. Jacques Lagrange, trans. Graham Burchell (London: Palgrave Macmillan, [2003] 2006), pp. 339–40. The medical culture of the Salpêtrière can hardly be subsumed under a model of the exercise of power in which the will of the doctor and the will of the patient confront one another directly. In Charcot’s clinic, hypnosis does not represent the royal road of the patient’s total subjugation under the doctor. As will be shown in the next chapter, it was actually Bernheim in Nancy who embodied the project of implementing hypnotic suggestion exclusively for the purpose of increasing the doctor’s power.

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phenomena that “patients would know neither to invent nor to simulate.”91 Nevertheless, a number of British scientists uttered the suspicion that the “stages” of grand hypnotisme could be more the result of the subject’s “expec­ tant attention” than of the effects of magnets or electric currents.92 In 1877, an observer who was present at Charcot’s first demonstrations expressed his reservations in an anonymous report for the British Medical Journal. In his eyes, the subjects were to be regarded as “women of the most artful type, . . . confirmed hysterics, who may have succeeded . . . in misleading their physicians; their imagination was possibly so far impressed by the mystic apparatus of the metalloscope and public demonstrations to which they were subjected, as to have itself effected a very considerable amelioration in their symptoms.”93 On account of the great powers of imagination and deceptive artifice they accorded to these women, the English doctors considered Charcot’s patients to be unsuitable for experimental purposes: “Hysterics of the exaggerated type of the three hystero-epileptics of the Salpêtrière are the worst subjects in the world on whom to base any scientific conclusions.”94 Charcot endeavored to counter this critique by defining the key task of the “truly informed physician” as “tracking down deception everywhere it appears, and separating from the real symptoms, which are a fundamental part of the illness, the simulated symptoms that the artifice of the patient would like to add to them.”95 He wanted to show that his hystero-epileptic patients were not the worst hypnotic subjects, but the best. Through the use of the graphic method, Charcot installed a new control apparatus, in which earlier forms of surveillance based on the traditional power relationships of clinical institutions were partly transformed by a system functioning on the basis of inscriptions. Charcot’s awareness of the problem of simulation and his sharpening of surveillance techniques become apparent in his presentations of various hysteria cases between 1872 and 1886. In the discussion of his very first case 91. Charcot, “De la métalloscopie et de la métallothérapie,” OC 9:239. 92. Daniel Hack Tuke, “Metalloscopy and Expectant Attention,” The Journal of Mental Science 24 (1878): 598–609. 93. Anon., “Metallo-Therapeutics,” p. 602. 94. Anon., “Metalloscopy and Metallo-Therapy,” p. 652. Regarding the definition of the hysterical subject as “mendacious” see the famous report by Charles Lasègue, “Les hystériques, leur perversité, leurs mensonges,” Annales médico-psychologiques, 6th ser., vol. 5 (1881): 111–18. However, the English critique of the Salpêtrière experiments was based primarily on other observations, which emphasized the influence of the patient’s attention on the somatic alteration of a particular bodily organ. 95. Charcot, “Note sur les divers états nerveux,” p. 126.

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of hysterical ischuria (the almost complete and life-threatening retention of urine), he describes in detail the way in which the doctor must protect himself from being deceived by its cunning and “capricious” sufferers.96 His control system exploited both the patient’s condition (her more or less complete immobility) and the power resources provided by the clinical setting: And so you see, this woman was condemned absolutely to remain in bed; it was impossible for her to make use of her limbs, and these conditions were excellent for facilitating surveillance. Additionally, I also made sure to place her in the vicinity of two devoted invalids, like her confined to bed, who were ready to reveal to me any deception that they discovered. Here I have the best police, that of the women over the women, and as you know, when women form a complot amongst themselves, it rarely succeeds. This information suffices, I think, to convince you, my sirs, that in this first period simulation was impossible.97

Not satisfied with merely providing his own account of his surveillance measures, Charcot also had two colleagues from the Société de biologie attest to the efficacy of his system. Subsequently, the contraction of the patient’s upper arms diminished and the patient became more mobile. Charcot specified the additional measures he took: The right upper extremity had become nearly free. Thus it was urgent that we protect ourselves from every cause of error. In addition to the ordinary surveillance, from which there was not a moment’s departure, we also took recourse to the following precautions: from time to time the patient’s bed was searched, and she was allowed to use neither containers nor catheters, etc. Finally I succeeded in persuading her that it would be of advantage, in order to remedy the persisting contracture on the left, to bind her arms by means of a straightjacket; she consented. The straightjacket, by the way, was not in absolutely continual use; it was removed during meals, during which time the patient was supervised by the persons who served her food.98

This first control system was endowed with a stability based on exploitation of the social configuration of the clinic to ensure constant surveillance. Its functioning was examined by two respected colleagues and legitimated 96. Jean-Martin Charcot, “De l’ischurie hystérique,” [1872] OC 1:275–99. The patient in question was Justine Etchevery, whose complicated traumatic history was later recorded by Bourneville. Charcot for the most part ignored it in his original lecture, delivered in May 1872 (later transcribed and annotated by Bourneville). For more details on this case, see Goetz, Bonduelle and Gelfand, Charcot: Constructing Neurology, pp. 188–92. 97. Charcot, “De l’ischurie hystérique,” OC 1:288. 98. Ibid., p. 292.

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by a scientific authority. The doctor’s power depended not only on social forms of authority (the loyalty of the nurses, persuasion of the patient by the doctor, the corroboration of scientific colleagues), but also on the course taken by the disease, and thus this control system had to be all the more flexible in adapting to sudden and unexpected transformations. With regard to hysteria, whose development in each individual case was hard to predict, continual “testing” of the patient was necessary to rule out the simulation of a symptom. In order to prove the genuineness of hysterical ischuria, for example, doctors regularly subjected the patient to a rigorous regimen of trials to ensure that she was not secretly drinking her urine and deceiving them. In this medical control system, every small change in the patient’s command over her body functions had to be exactly registered on a daily basis and examined for possible deceptions.99 A few years later, by 1885, the introduction of several of Marey’s selfrecording instruments allowed Charcot to enhance his control system and detach it from the social interactions between doctors, patients, and clinical staff. Now the continual and direct observation of the patient to confirm the “genuineness” of her condition was supplanted by inscriptions produced mechanically by instruments attached to the subject’s body. In the verification of a catalepsy in which a limb maintained the position into which the experimenter manipulated it, the “length of time that a cataleptic individual remains in the position into which he is put, for example with a horizontally extended arm” was no longer sufficient evidence for ruling out possible simulation: “[Marey] drums are attached to the extended arms of both the simulator and the cataleptic: they serve to register, by way of the graphic method, even the smallest oscillations of a limb. Simultaneously, a pneumograph is applied to the chest, providing a curve of respiratory movement.” This twofold experimental setup made it possible to differentiate the “regular” curves of the cataleptic individual from those of the simulator, who would soon betray himself through irregular curves, in other words through the “fatiguing” of the muscles and his attempt to disguise it (see figs. 6–8).100 In this machinery, the drum measured fatigue “objectively,” while the pneumograph discovered the “subjective” simulation betrayed by more rapid respiration.

99. Bourneville provides a detailed account of the various “tests” that the patient must undergo in order to rule out any suspicion that she is a simulator. See Désiré-Magloire Bourneville, Recherches cliniques et thérapeutiques sur l’épilepsie et l’hystérie (Paris: Bureau du Progrès medical / Delahaye & Lecrosnier, 1876), p. 163. 100. Charcot, Leçons sur les maladies du système nerveux, OC 3:18.

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f i g u r e s 6 – 8 . The genuineness of catalepsy was tested in Charcot’s clinic with the help of Marey’s self-recording physiological instruments. Here a pneumograph and a myograph were combined in order to rule out deception by the subject. The regular curves of the good female subject (fig. 7) are opposed to the unsettled picture derived from a male simulator (fig. 8). From Charcot, Leçons sur les maladies du système nerveux, vol. 3.

Thus respiration served as the bodily function providing an index for the “will” of the subject.101 In view of the “capriciousness” of hysteria, Charcot and his pupils accepted as indubitable only those symptoms that could be subjugated to their system of mechanical control. The three types of “experimental neuroses” that the Salpêtrière school put at the center of its doctrine were defined by a hierarchy of symptoms ranging from the “most objective” (those verifiable by the graphic method) to the “most subjective.” At the top of this hierarchy were immobility (and partial anesthesia) and the persistence of the limbs in 101. On pneumography see Marey, La méthode graphique, pp. 539–58; on Marey’s drum, ibid., pp. 444–55.

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the position set by the experimenter (in catalepsy) as well as “neuromuscular hyperexcitability” (in lethargy), which could lead to a complete rigidity of the body. In comparison to earlier descriptions of the symptomatology of hysteria, Charcot’s approach sought to define the disorder using only “obligatory signs” produced in his new experimental system. Thus the solution to the simulation problem was found in the application of physiological selfregistering instruments, which made the patient’s will just as open to measurement as physiologically defined symptoms. With this new machinery, then, the doctor established an additional asymmetry, putting the patient’s will fully under his control by making it readable in a medium that must remain inaccessible to the patient. Although the act of deception was here redefined by using an anonymous technical apparatus, emblematic of the values of “mechanical objectivity,” the practical integration of these devices into the experimental system of Charcot’s clinic was not systematic, but partial and opportunistic.102 the hysteric and the decapitated frog The initially positive reception of the Salpêtrière’s hypnosis research among many scientists can also be explained by Charcot’s new approach to linking physiological experimentation and clinical practice. The noted British physiologist Arthur Gamgee, who lamented the “disastrous policy of depriving the physiologist of medical experience,” welcomed the forms of clinical experimentation practiced by Charcot and other Parisian clinicians: “Why should we study the phenomena of reflex action, as they are manifest by a decapitated frog, at first-hand, and get our knowledge of such startling facts . . . at second-hand, from the physicians who observe them?”103 The analogy between the decapitated laboratory frog and the hysteric as objects of experimentation was by no means merely rhetorical. In the experimental system installed at the Salpêtrière, patients were accorded the same status as the frogs of physiological research. In particular, the analogy between physiological experiments on animals and the experiments conducted on the hysterical women of the Salpêtrière was facilitated by the use of mechanical inscription technologies (such as the graphic method) in both cases. From the very beginning, Charcot’s experimental interventions involving hysteria operated in the vicinity of animal physiology. Initially the analogies 102. For the rise of the epistemic values of objectivity, see Lorraine Daston and Peter Galison, Objectivity (New York: Zone Books, 2007). 103. Gamgee, “An Account of a Demonstration,” p. 548.

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related to observed symptoms: thus in his first major hysteria case, which he presented as a “rarity,” Charcot devoted most of his attention to ischuria, which had also been produced in guinea pigs under experimental conditions in the laboratory.104 In his accounts of his program of experimentation, Charcot discusses the attacks of his hystero-epileptic hypnotic subjects in the same register used for the actions of animals in physiological experiments. The existence, he states, of hysterogenic points (or zones) that can be used to trigger or stop attacks through the application of pressure “will remind you of the experiments of M. Brown-Séquard on the guinea-pig, where pressure on a particular part, after the operation, gave rise to a paroxysm which he terms epileptic, but which I would willingly regard as hystero-epileptic.”105 In a later series of experiments, physiologist Charles-Édouard Brown-Séquard also demonstrated the functional exchangeability of humans and dogs by using vivisection to produce transfert in the animals. He attributed it to an interplay of “inhibition” and “dynamogenesis,” stating that “the study of inhibition and dynamogenesis in the human and in the animal displays its perfect analogy in the phenomena appearing in hypnotism.”106 Hypnotism appeared as a purely economic process, in which various stimulations of the nervous system give rise to a displacement of sums of excitation: “Hypnotism is nothing more than a highly complex state of energy redistribution in which the nervous system and the other organs are thrust under the influence of an irritation that was originally either peripheral or central.”107 In Germany, the use of hypnosis on animals for experimental purposes had already begun early.108 These experiments were intended to replicate in a modified form the procedure for putting chickens into a state of tonic immobility first described by the Jesuit polymath Athanasius Kircher in the late seventeenth century. In this “admirable experiment,” a chicken was made immobile for a short while by holding its head down against the ground and 104. Charcot, “De l’ischurie hystérique,” OC 1:275–99. 105. Sigerson, “A Lecture on Certain Phenomena of Hysteria Major,” p. 789. 106. Charles-Edouard Brown-Séquard, “Recherches expérimentales et cliniques sur l’inhi­ bition et la dynamogénie: Application des connaissances fournies par ces recherches aux phénomènes principaux de l’hypnotisme et du transfert,” Gazette hebdomadaire de médecine et de chirurgie, 2nd ser., 19, no. 9 (1882): 136–38, p. 136. 107. Ibid., p. 137. 108. Johann Czermak, “Über ‘hypnotische’ Zustände bei Thieren,” Archiv für die gesammte Physiologie des Menschen und der Thiere 7 (1873): 107–21; Wilhelm Preyer, “Das ‘Magnetisiren’ der Menschen und Thiere,” in Naturwissenschaftliche Thatsachen und Probleme: Populäre Vorträge (Berlin: Gebrüder Paetel, 1880), pp. 153–98.

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drawing a straight line along the floor.109 At the beginning of the experimental phase of his research on hysteria, Charcot repeated this famous experiment with a few modifications, suggesting that the chicken enter a state resembling catalepsy: To complement the studies of light-induced catalepsy, Charcot calls to mind the well-known experiment in which a cock or hen is put into a state analogous to catalepsy in the human by directing its beak toward a white line drawn on the floor. The experiment is reproduced by placing a cock before a Drummond lamp. Soon there arises a state resembling catalepsy, but which is never followed by lethargy. . . . Charcot, without seeking to explain this phenomenon, is content to relate it to one that can be observed in hysterics, thus putting forward an issue of comparative pathology that is certainly of interest.110

Comparisons of experimental subjects with laboratory animals were frequent among the doctors of the Salpêtrière and their collaborators. Charles Féré, who conducted some of the first psychological experiments with hysterics, for instance, did not hesitate to call them “first-class experimental subjects, who deservedly could be seen as the frogs of experimental psychology.”111 The frog served as a favored analogy not only because it was considered the emblematic laboratory animal of experimental physiology, but also because (in contrast to the dog) it proved to be particularly well suited for “hypnotic” experiments.112 In the experimental hypnotism of the Salpêtrière, then, the animal and the hysterical subject were presented as equivalents, both with regard to the specific practices of the experimenting doctor and to the forms of agency accorded to the patient. Within the action script, the experimental subject was assigned the role of a reflex machine, in whose body the doctor could produce and reproduce a stable somatic symptomatology.

109. Athanasius Kircher, “Experimentum Mirabile: De Imaginationem Gallinae,” in Ars Magna Lucis et Umbrae, Lib. II, Part I (Rome: Scheus, 1646), pp. 154–55. 110. Charcot, “Catalepsie et somnambulisme hystériques provoqués,” OC 9:261–62; see also “Episodes nouveaux de l’hystéro-épilepsie: Zoopsie. Catalepsie chez les animaux,” [1878] OC 9:289–96. Charcot also repeated the transfert experiments with magnets on frogs to test their receptivity (Gamgee, “An Account of a Demonstration,” p. 547). Charcot’s rejection of animal experiments in his clinic was limited to vivisection. 111. Féré, “Sensation et mouvement,” p. 347. 112. See E. Biernacki, “L’hypnotisme chez les grenouilles. Actions réciproques de certains medicaments et de l’hypnotisme,” Archives de physiologie, 5e ser., 3 (1891): 275–307; and Eduard Gley, “Étude sur les conditions favorisant l’hypnose chez les animaux,” L’Année psychologique 2 (1895): 70–78.

2

The Controversy between Paris and Nancy over Hypnotic Suggestion

The “experimental neuroses” as they were demonstrated at the Salpêtrière soon came under attack. In 1884, Hippolyte Bernheim (1840–1919), professor at the faculty of medicine in Nancy, published a pamphlet taking its cues from the critiques voiced by English physicians, who suspected that the phenomena produced in Charcot’s clinic were partly the result of the subjects’ “expectant attention.” The tenor of their critique was that the experimental subjects were merely concentrating their attention on the part of the body in which the doctors were seeking to produce a given phenomenon by means of mechanical influence. This supposition raised the possibility that two parallel processes were in operation (a physical action relating to the magnets, and a psychical action within the patient), making it impossible to decide with certainty which process had in the end elicited the symptom. Bernheim, however, went further than these critics, seeing the mental functioning of suggestion as more than a mere source of interference in the experiments. He claimed that all of the phenomena could be traced back to this one factor: “Tout est dans la suggestion.” In a series of demonstrations, Bernheim attempted to show that he could elicit all of the hypnotic phenomena that had been produced at the Salpêtrière (paralysis, anesthesia, contractions, etc.) from a series of nonhysterical subjects in a waking state. “Verbal suggestion” or a “simple command” were sufficient to produce these symptoms. Merely pretending to use a magnet was enough to produce complex hallucinations and other characteristic . Tuke, “Metalloscopy and Expectant Attention.” . Hippolyte Bernheim, De la suggestion dans l’état hypnotique et dans l’état de veille (Paris: Doin, 1884). A more extensive and polemical book appeared two years later: De la suggestion

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disturbances of perception and sensitivity. Bernheim stated that he could not isolate the three stages of Charcot’s grand hypnotisme. He also could not observe their typical clinical characteristics (such as neuromuscular hyperexcitability) in a constant form. The stages, if they existed at all, he maintained, varied according to the individual disposition of the person to whom they were suggested and the special mode of suggestion. Bernheim’s critique opened a controversy between two competing schools in Paris and Nancy, which for a number of years would dominate the further development of hypnosis in clinical and psychological research. The numerous demonstrations performed and published by critics of the Salpêtrière school’s findings aimed at shifting the focus from experimentally oriented laboratory hypnosis to a wide-ranging therapeutic application of hypnotic suggestion. Thus Bernheim’s return to the earlier practices of animal magnetism occurred in direct opposition to the epistemic objectives of Charcot and his followers. As I have detailed in the preceding chapter, the members of the 1878 Paris commission had strategically reformulated Dr. Burq’s original therapeutic program of metallotherapy into one that was exclusively experimental. In treating neuroses, the Salpêtrière’s therapeutic approach generally centered on physical methods, such as electrotherapy, hydrotherapy, and other techniques, for which a number of specialized apparatus were invented. For Charcot, the “psychical element” of therapy was limited to the “change of social milieu, withdrawal from feeble or complaisant relatives, separation from other hysterical patients, discipline, moral and mental hygiene.” In Bernheim’s clinic, on the other hand, suggestion was accorded the status of a privileged remedy, a new technique so powerful that it could overcome the limitations of most “physical” forms of treatment (not only in the case of neuroses, but also for a number of organic illnesses). Working under the assumption that the suggestive component was already present latently in every form of physical and psychical treatment, the doctor only had to bring it under his control in order to make treatment as successful and efficient as possible. et de ses applications a la thérapeutique, 2nd ed. (Paris: Doin, [1886] 1888), hereafter abbreviated as BS. . Many of the elements of this opposition can already be noted in Bernheim’s earlier published clinical lectures: the accentuation of the patient’s individuality (in contrast to a nosographic tableau); questioning of the patient as the most important supplement to information obtained in clinical examination; and a different style of reconstructing case histories, which remains tied to the particularities of individual cases. See Hippolyte Bernheim, Leçons de clinique médicale (Paris: Berger-Levrault, 1877). . Charcot, “De l’emploi de l’électricité statique en medicine,” OC 9:499.

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Bernheim’s turn to the earlier practices of animal magnetism differed markedly from the form in which the Salpêtrière school had assimilated Dr. Burq’s therapeutic method into its experimental program. The Nancy professor allied himself with the country physician Ambroise-Auguste Liébeault (1823–1904), who had long propagated the healing effects of sleep for a variety of nervous disorders, using the method of “suggestion” derived from various magnetizers. Thus the group that formed around the two men, dubbed by the Parisians the “school of Nancy,” displayed a clear allocation of roles: Liébeault played the role of the pioneer, considered a maverick by medical science, and operating on its margins. Bernheim was the respected clinician who integrated the unorthodox practices into modern clinical medicine and endeavored to set them in an acceptable theoretical framework. The two other scholars who were repeatedly identified with the school of Nancy, the physiologist Henri Beaunis (1830–1921) and the professor of law Jules Liégéois (1833–1908), also played a strategically important role in the dispute with the Salpêtrière school. Differences of opinion, however, were common within the Nancy group, and this “open” and egalitarian discussion climate was often contrasted with Charcot’s leadership style, which was depicted as doctrinaire and authoritarian. Correspondingly, the controversy developing between the two schools was also interpreted as an attack from the provinces against the Parisian establishment. For many of those involved, the imbalance of power was already expressed in the contrasting of grand and petit (or “common”) hypnotism. . In his 1866 book on sleep (republished in 1889 under a different title), Liébeault presents his method of suggestion as the legacy of Abbé Faria and of the Scottish surgeon James Braid. See Ambroise Liébeault, Du sommeil et des états analogues considérés surtout au point de vue de l’action du moral sur le physique (Paris: Victor Masson et Fils / Nicolas Grosjean, 1866), p. 355. . The common account of the two schools, with the usual biases, is summarized by Gauld, A History of Hypnotism, pp. 306–62. In a more nuanced vein, some authors have put the homogeneity of the two schools into question. Jacqueline Carroy, for instance, adopts the tenor of Beaunis’s unpublished memoirs, in which he writes: “There never was a School of Nancy in the true sense, since the word ‘school’ implies a body of coherent and coordinated doctrine in which everything is approached collectively, in other words, in which all of the members share the same ideas. . . . It is only Bernheim’s status, his authority, his function as the professor of the clinic, that has given rise to the misnomer ‘School of Nancy.’ ” Henri Beaunis, Mémoires (n.d., after 1914), p. 418; quoted after Carroy, Hypnose, suggestion et psychologie, p. 62. Anne Harrington, on the other hand, claims that in contrast to the more homogeneous Nancy group, the Parisian medical culture of hypnosis was divided into a number of heterogeneous schools (see Harrington, “Metals and Magnets”). . Joseph Delbœuf, Le magnetisme animal: À propos d’une visite de l’École de Nancy (Paris: Alcan, 1889).

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At the University of Nancy, one of France’s largest and best-equipped new universities outside of Paris, the integration of the earlier practices of animal magnetism into modern clinical medicine took place on a different basis than at the Salpêtrière. In the following, I will detail how these differences became manifest: first and foremost in practices, particularly in the use of hypnotic suggestion and in the crucial role that the doctor’s speech was assigned in this context; then, in the application of the hospital’s power resources and the physician’s social authority in achieving suggestive effects in the patient’s psyche. Another difference with major consequences lay in Bernheim’s reopening of the question of simulation, which Charcot claimed to have settled through mechanical control procedures. Finally, the Nancy group was working toward a redefinition of the hypnotized subject within the action script of the experiments: the subject now appeared as a morally shapeable individual defined by his or her activity (and thus his or her capacity to “resist” the procedure in use). Hypnotic Suggestion as a Therapeutic Method in Nancy Bernheim claimed to have found out about the technique of hypnotic suggestion through a faculty colleague, who had, by 1881, become convinced of its curative power by Liébeault. In the village Pont-Saint-Vincent near Nancy, the country doctor practiced in a garden house on his property, treating several dozen patients per day free of charge. His diverse clientele was made up of patients frequently described by sympathizers of the Nancy school as victims of scientific medicine and its terrors: “Only the desperate come to Dr. Liébeault. They are the patients who have already tried all of the doctors, swallowed all of the drugs (including antipyrine), subjected themselves to all of the tortures, from vesication and cauterization to the showers and the electric shocks.” According to a contemporary’s report, the consulting room was abustle with activity: patients often came with their relatives or friends, and Liébeault treated multiple patients simultaneously. The doctor hardly ever occupies himself with any patient for more than ten minutes or a quarter of an hour. Those who are waiting—as well as friends or family members who sometimes accompany the patients—are seated on the chairs and benches along the walls, chatting amongst themselves, and not always softly. It happens on occasion that this disturbs the treatment of a pa. Mary Jo Nye, Science in the Provinces: Scientific Communities and Provincial Leadership in France, 1860–1930 (Berkeley: University of California Press, 1986). . Delbœuf, Le magnetisme animal, p. 33.

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tient, and then the doctor exhorts them to lower their voices. His admonition only causes a momentary pause in the chatter, which quickly resumes as before. While L. is treating a patient and administering suggestions, he often speaks to others as well, inquiring about their health and exchanging greetings and handshakes with new arrivals or patients taking their leave.10

After a brief examination, the patient is seated on a chair. He or she has already been prepared for the treatment by spending an hour or two watching other patients be put to sleep. In Liébeault’s method of “multiple suggestion,” which incorporates the techniques of various magnetizers,11 the fixation of the patient’s eyes is accorded less significance than the words spoken by the doctor while he stares into them. If the eyelids do not descend, the doctor closes them and recites the “most important symptoms for producing sleep” (need to sleep, heaviness of the eyelids, weakening of the senses). These symptoms are repeated in a “soft voice,” until the idea of sleeping has become “fixed.” As soon as the patient has gone to sleep, the doctor makes suggestions, which are hardly ever varied: You will get better; your digestion will be good; you will sleep well; you won’t cough anymore; your circulation will be free and regular; you will feel great strength in your limbs; you will walk with ease etc. He hardly ever varies these couplets. He goes after all illnesses at once, and it is up to the client to recognize his own. Of course he also makes some special recommendations . . ., but the general recommendations take up the largest space.12

In Liébeault’s practice, the voice plays a privileged role: the doctor “speaks uninterruptedly in a strong and resonant voice. It is the ‘communicative warmth’ of his voice, his ‘contagious persuasion,’ that gives the patient the courage to heal himself.”13 If the suggestions have no immediate effect, the doctor generally supports them through gestures and physical contact, justifying them with the unfailing efficacy of his words: “A la longue, la suggestion finit toujours par trouver sa destination.”14 The intonation, rhythm, and pacing of speech are the deciding factors in whether the suggestion becomes “fixed.” For this reason, Liébeault warns the hypnotist against changing his 10. Wilhelm Renterghem, “Liébeault et son école: Causeries,” Zeitschrift für Hypnotismus 4 (1896–97): 334–75; 5 (1896–97): 46–55, 95–127; 6 (1896–97): 11–44; here 4 (1896–97), pp. 348–49. 11. Ambroise Liébeault, “Confessions d’un médecin hypnotiseur,” Revue de l’Hypnotisme 1 (1886–87): 105–10, 143–48, p. 107. 12. Delbœuf, Le magnetisme animal, p. 34. 13. Renterghem, “Liébeault et son école,” p. 350. 14. “Sooner or later, the suggestion always finds its destination.” Liébeault, quoted in Delbœuf, Le magnetisme animal, p. 37.

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mode of speech in order to quicken the procedure and hypnotize more patients within a short amount of time. He notes that this special manner of speaking has a direct influence (via the brain) on the patient’s body, and that an overly rapid or brusque approach can hinder the suggestion’s realization. When he “no longer inculcated the ideas with calmness and gentleness, but rather spoke flamingly and with a certain brusqueness,”15 his patients were reported to suffer attacks and even to faint sometimes. It was apparently more than coincidental interest that caused Bernheim, in May 1882, to ask the colleague who had become an advocate of Liébeault’s to present a few cases demonstrating the latter’s method at the Société de médecine of Nancy. A few weeks earlier, Charcot had given a lecture before the Académie des sciences in which he defined the famous three stages of grand hypnotism.16 In Liébeault’s rather simple method of suggestion, Bernheim discovered a resource that could be exploited in developing an alternative culture of hypnotism in opposition to the experimental system set up in Paris. Firstly, suggestion served as a vehicle for radically calling into question the effects of physical agents in hypnosis experiments. Thus the adherents of the Nancy school sought to demonstrate the functional interchangeability of magnets and verbal suggestion, with the latter becoming the most important strategic resource in the numerous demonstrations conducted and published by Bernheim as a challenge to Charcot and his followers.17 Secondly, hypnosis was integrated into clinical medicine as a complement to traditional physical treatment methods. This practical integration developed various scenarios for augmenting the doctor’s existing position of power in the clinical setting. Thirdly, Bernheim attempted to formulate a theory of suggestion on the basis of these strategic and practical considerations. Although this theory endeavored to explain the phenomena observed in both the experimental and the clinical context, it hardly went beyond simplistic formulas. There was a tendency to rationalize the practices—especially the use of the voice—by translating them into a speculative brain physiology.18 15. Liébeault, “Confessions d’un médecin hypnotiseur,” p. 107. 16. BS: x; Charcot, “Note sur les divers états nerveux.” 17. See especially the early cases reported in BS, in which magnets and verbal suggestion were used in alternation. Anne Harrington notes that Bernheim conducted a series of experiments using magnets shortly after Charcot, whereby he in no way expressed doubts concerning their “aesthesiogenic effect.” Harrington, Medicine, Mind, and the Double Brain, pp. 181–82, n. 4. 18. According to Bernheim’s theory of hypnosis, it is not the voice that exerts an effect, but rather the idea that is introduced into and accepted by the patient’s brain. Thus the interaction between doctor and patient can be described as a “struggle of the brains” in which the patient can respond with a “countersuggestion” to every suggestion made by the doctor. Bernheim’s fol-

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Bernheim transferred Liébeault’s practices to the hospital in Nancy, where he was in charge of more than half the beds. His patients were housed in eight rooms (four for men, four for women), whereby the rooms were separated into units of two by the consulting rooms and the professors’ treatment rooms (cabinets). Outpatient cases were treated on the first floor, while the upper stories were inhabited by “pensioners,” who for a fee were admitted to the hospital for a longer period of time.19 With its integration into clinical medicine, suggestion was accorded a different status: it was not the sole remedy (as it had been under Liébeault), but one method among many, which the doctor administered during his daily rounds analogously to medication, combining it with physical treatment methods. The formulation of the doctor’s suggestions was no longer diffuse and general, but rather targeted at a specific symptom and adjusted according to the individual illness. Here suggestion was aimed at achieving the lasting elimination of one or more symptoms. The integration of suggestion into the conventional instrumental apparatus of the clinic, however, has profound implications for the practice of medicine and for the relationship between doctor and patient. It expands and complicates the possible effects of the instruments and medications in use. Any and every action taken by the doctor, be it the prescription of a medicine or the use of an instrument in examination, becomes a potential trigger of “indirect suggestion.” In his demonstrations, Bernheim often employs the repertoire of techniques of modern clinical medicine to show that their effects derive not from any physical influence on the patient’s body, but from his or her belief in them: I can produce suggestive phenomena of transfer in a hypnotized somnambulist. For example, I put his left arm into the cataleptic condition in a horizontal position, and, as I bring a stethoscope up to the other arm, I say that the catalepsy is going to be transferred to this side. In a minute the right arm is stretched out horizontally, while the left arm falls motionless. If I again bring the stethoscope near the left arm, it assumes a horizontal position, and the right falls motionless, and so on. I can also induce wry-neck, paralysis and suggestive contracture, and transfer them from one side of the body to the other, simply by means of the idea suggested to the subject that the stethoscope produces this phenomenon.20 lowers in Germany and Switzerland (such as Auguste Forel and Oskar Vogt) endeavored later to develop a theory of suggestion that was more closely related to brain research (see chapter 8). 19. Delbœuf, Le magnetisme animal, p. 50. 20. Hippolyte Bernheim, Suggestive Therapeutics, trans. Christian A. Herter (New York: Putnam’s Sons, [1889] 1998), pp. 145–46 [BS:204, my emphasis]. On the controversy surrounding the introduction of the stethoscope into clinical practice, see the sociological studies by Jens

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Here Bernheim is caricaturing the Parisian doctors’ use of instruments and physical agents in hypnosis experiments. The magnet can be replaced by an arbitrary object, “by a knife, a pencil, a bottle, a piece of paper, or by nothing at all,”21 and the suggestion remains just as effective. Thus Bernheim presents himself as a critic who is seeking to purify psychotherapy of specific material agents by utilizing a host of instruments in demonstrations while simultaneously denying their effect. For example, numerous experiments with the “suspension apparatus for spinal disorders,” a notorious invention of Charcot’s, are used to show that it is not the stretching of the nerves or the alteration of blood supply that affects the patient, but rather suggestion alone.22 The consequences of Bernheim’s generalization of the suggestion formula beyond the set framework of the experiment would be far reaching. Within the space of the clinic it entailed a new complication for any kind of clinical practice: the unintended suggestion that can suddenly be lurking behind any and every medical intervention. A “Suggestive Atmosphere”: Bernheim’s Clinic In Nancy, the heightening of the doctor’s power over the patient remained tied to the social configuration of the clinic. In contrast to the mechanized control systems in use at the Salpêtrière, the Nancy method of suggestion emphasized the social structure of the hospital ward and of the doctor’s rounds: the patients’ faith in the medical staff and the visible grouping and organization of patients in the rooms were key factors in achieving results through suggestion. Even in his first pamphlet, Bernheim reports that he is able to put “seven or eight patients to sleep in no time at all; they fall to the floor like flies.”23 The most important criterion that he formulates for a true hypnotist is a quantitative one: “A person is not a hypnotist when he has hypnotized two or three subjects who hypnotize themselves without help. He is a hypnotist

Lachmund, Der abgehorchte Körper; “Between Scrutiny and Treatment: Physical Diagnosis and the Restructuring of 19th Century Medical Practice,” Sociology of Health & Illness 20 (1998): 779–801; and “Making Sense of Sound.” 21  BS:130. 22. Hippolyte Bernheim, Hypnotisme, suggestion, psychothérapie: Études nouvelles (Paris: Doin, 1891), pp. 61–62, hereafter abbreviated as BH. 23. Bernheim, De la suggestion dans l’état hypnotique, p. 6.

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when, in hospital service where he has authority over the patients, he influences eight or nine subjects out of ten.”24 The quantitative factor stands in contrast to the criteria of Charcot’s experimental practice, in which the group of “good” subjects is formed by a very small number of “exemplary” cases. Thus Bernheim polemically contrasts the rare state of grand hypnotisme with “thousands of cases” in which these phenomena cannot be produced.25 The success of the Nancy suggestion techniques is dependent on the specific form of “impression management” that the doctor is able to achieve. During the treatment he must continually demonstrate his authority and win the patients’ trust: “The operator must have calm and cool assurance. If he hesitates or even has an air of hesitation, the subject follows this hesitation and it has a counter-suggestive influence. He does not go to sleep or awaken.”26 In his struggle with the patient, the doctor must win his or her trust, whereby the technique is adjusted to suit each individual. With many patients a “gruff ” approach destroys all chances of success, while with others it is imperative. Suggestion must be adapted to each individual. The vigorous injunction, made in a commanding tone, even with a threat, is suitable for some patients with rebellious and rough natures. . . . Abruptness is not suitable for most hysterics, whereas gentle insinuation usually succeeds well. Fear, intimidation, and strong emotions can act as counter-suggestions and create crises or other nervous manifestations.27

Bernheim’s treatment of hysteria cases exemplified this strategy. In one case of “aged hysteria with convulsive fits,” he repeatedly threatened the patient with the “hot iron” in order to tear her out of her autosuggestion: “I then made suggestions through intimidation. I warmed up the thermocautery, and stated that if she hadn’t gotten up in 10 minutes, the cautery strips would be placed on her stomach. When the cautery arrived she awakened, got up,

24. BH:92. 25. The number of cases is specified as a means of providing evidence for the success of suggestion as a therapeutic model and of guaranteeing that its use is widened to include larger population groups. Thus the “statistics” of the cases cured by Liébeault, which Bernheim estimates at over 1,000, played an important role for the early hypnosis movement in its efforts to convince a skeptical audience of physicians and clients. Liébeault himself gives the estimate of 7,500 (Liébeault, “Confessions d’un médecin hypnotiseur.”). 26. BH:90. 27. Hippolyte Bernheim, New Studies in Hypnotism, trans. S. Richard Sandor (New York: International Universities Press, [1891] 1980), p. 158 [BH:214].

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and walked.”28 In another case, here a nervous locomotion disorder, the doctor’s overly gruff approach almost went so far as to make a cure impossible: At the beginning I had hypnotized her a number of times in order to resolve the painful contracture; at every session I noted that the stiffness was decreasing. . . . Convinced that suggestion could and must succeed, I wanted to proceed too quickly. I was abrupt with the subject. I made her raise her arm to the vertical, and I insisted on immediately restoring mobility. But the pain had not been sufficiently neutralized, and the patient became frightened. At each session, her fear that I could cause her pain paralyzed my suggestion. I obtained nothing. I believed she had an incurable myelitis. The nurse, acting gently, allowed the patient to relax her muscles herself, encouraging her without violence and doing what I was unable to do.29

In this description of the suggestion method, the doctor’s actions show themselves to be a potential trigger of further symptoms, making a cure more difficult. A corrective is offered by the social competence of his staff and by his ability to manage his own presence. Thus the treatment remains in all its stages tied to the risky and unpredictable course of the illness. Bernheim generally interprets this unpredictability as “resistance” or “countersuggestion”: In certain subjects it also happens that the power of suggestion is used up. These patients, especially the hysterics, harden against it. When they notice what is happening, they let themselves be hypnotized, listening to what one says without accepting the suggestion. Consciously or unconsciously, they make a sort of countersuggestion. Some of them even seem to derive a malicious satisfaction from thwarting the doctor’s efforts and lengthening their illness.30

In order to end this “malicious” spread of symptom formation, Bernheim recommends that the doctor devote no more exertions to such patients, and instead simply consider them cured: E. L. seems to have a tendency to unceasingly generate a host of painful symptoms. One day I stop hypnotizing her, and pass by her bed saying simply: ‘That one there is doing fine, she is cured.’ She has no more crises, no longer complains, remains in hospital for about ten days, and then leaves in good health.31

28. Ibid., p. 233 [BH:296]. 29. Ibid., p. 160 [trans. mod.; BH:216]. 30. BS:413. 31. BS:412.

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It is not, however, the ability of the doctor alone, his personal ‘tact’ in dealing with patients, that decides whether these resistances can be broken or not. A decisive factor in the treatment’s success is the particular “suggestive atmosphere of the clinic” in which the patient is treated. It is thus important that the person to be hypnotized “has spent several days in a suggestive atmosphere and is infused with the idea that everyone is suggestible.”32 This preparation in the clinic is effective because the new patient sees other patients being hypnotized and being cured of their symptoms. Thus Bernheim customarily begins by putting other patients to sleep in the presence of the new patient. This serves the dual purpose of convincing doubters of the reality of hypnosis and of demonstrating the “naturalness” and harmlessness of the procedure. Beyond offering a physiological explanation, the analogy between hypnosis and sleep provided the supporters of suggestion with an important rhetorical resource. The proximity of the hypnotic state to a normal function of the human body made its carefully dosed usage an attractive alternative to medication.33 Suggestion was a method that proved to be strongly tied to the locality. Efforts to transplant it into other settings (the doctor’s office, the patient’s family home) made this problem readily apparent. In the city, there are many people who have been terrorized about the dangers of hypnotism by incompetent doctors. In the hospital, there are defiant patients who imagine that one wishes to experiment on them. One meets some resistance. The person to be hypnotized should, if possible, be in positive surroundings and have confidence in the operator. Then, in a little while, the ground is prepared, and the subject surrenders himself without afterthought.34

The delegation of suggestion to family members, in cases where the patient did not undergo long-term hospitalization at the clinic, also proved difficult. Still, it became “indispensable with symptoms that take hold of the patient

32. BH:88. 33. Delbœuf emphasized the contrast between morphine, an agent terrible that transforms and damages the organism, and magnetic sleep: “The brother of natural sleep, an amiable and steerable brother, which at will takes on or pushes back dreams and rocks the patient in a sweet nothing or a happy illusion.” Delbœuf, Le magnetisme animal, p. 54. Freud and other doctors (such as Auguste Forel), who had visited the Nancy clinic and become advocates of Bernheim, also adopted this strategy in garnering acceptance for hypnosis as a therapeutic method. See chapter 8. 34. Bernheim, New Studies, p. 66 [trans. mod.; BH:89].

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suddenly, such as choking fits, nausea, bouts of anxiety, paroxysms, heart palpitations, crises.”35 Liébeault accommodated for this necessity by employing an assistant to visit patients who could not leave their homes. Some patients with nervous disorders experienced sudden relapses after being discharged from the hospital, making it necessary to prescribe medication. It was also found that certain bodily sensations could trigger an autosuggestion leading to an attack. Since the relatives entrusted with administering suggestion were not aware of key factors, such as proper timing, the continual presence of the doctor and the constant supervision of the clinic proved necessary. This is one of the difficulties of suggestive therapeutics. Not all patients obey suggestion in the long run. The illness itself constitutes a suggestion which can dominate those made previously. . . . It is necessary in this case for the patient to be in a special clinic surrounded by trained people who are knowledgeable in the use of suggestion and can administer it whenever it becomes necessary. Unhappily, patients do not voluntarily submit to this kind of continuous surveillance when their symptoms are intermittent.36

The Problem of Simulation In Nancy, the problem of simulation was treated differently than in Charcot’s clinic at the Salpêtrière. With the help of the graphic method, the Paris clinicians had defined a number of “obligatory signs” of the hypnotic state for the purpose of testing its genuineness. In the Nancy clinic, by contrast, such considerations played hardly any role. Thus the criticism that its hypnotic subjects were simulating was soon raised by adherents of the Salpêtrière school (such as Paul Janet and Alfred Binet), and by other skeptical observers as well (such as Joseph Delbœuf ). Bernheim countered this criticism by citing one of his own experiments. In evaluating the phenomena observed, he claimed that the subject, even though he “objectively” seemed to be simulating hemilateral hysterical blindness, was not simulating after all: When a prism is placed before the good eye, and there is an object before the prism, I ascertain that the subject sees both images of the object, the one just as distinctly as the other; and yet one of these images is produced by the eye that allegedly does not see anything. Thus this eye sees after all; however, the subject does not see with this eye; and he is not simulating. An impression is produced on the retina, and the brain perceives it and sees, but the subject’s imagination, unknown to him, neutralizes the image. When the prism’s decep35. Delbœuf, Le magnetisme animal, pp. 44–45. 36. BH:286.

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tion diverts the imagination, and it cannot come into play and act in a logical fashion, the subject sees. This happens as if he were simulating.37

In his argumentation, Bernheim was attacking more than the individual clinical facts produced in the Salpêtrière laboratory: he was also categorically rejecting the machinery in use in Paris for testing experimental subjects’ tendency to simulate. In its practice, the Nancy clinic distanced itself from other scientists’ attempts to define an objective index for the genuineness of the hypnotic state. Bernheim maintained that in the end apparatus and instruments could not decide the problem of simulation: the experimenter could not conclusively specify the form in which the subject’s power of imagination was intervening. Thus the doctor was left in continual uncertainty regarding the state of the hypnotized patient: “It is often difficult to penetrate the psychical condition of hypnotized subjects; observation and analysis are delicate matters. Some cases remain doubtful; simulation is possible, and it is easy; and it is still easier to believe in simulation where it does not exist.”38 Hence there arose the paradox that both doctor and patient could be deceiving themselves about what was happening in hypnosis. Bernheim even remarked that, in the case of a readily influenceable person, the impression often emerged after the fact that he or she had been simulating. In the lighter stages of hypnosis and after reawakening, such a patient is able to reflect upon his state. Sometimes he has the feeling that he is simulating or that he is complacent. Behind the doctor’s back he boasts in good faith that he has not slept but has only pretended to sleep. He is not always aware that he is unable to simulate, that his complacency is involuntary [sa complaisance est forcée], and that this is due to a weakening of his will or of his power of resistance.39

Thus the subject’s later claim of having simulated plays no role in deciding the genuineness the phenomena produced. The Nancy group never developed a coherent position in specifying objective criteria for hypnotic states. The physiologist Beaunis, like the doctors of the Salpêtrière, turned to the graphic method in an attempt to define the state of somnambulism on the basis of a number of alterations of the vegetative nervous system, which were beyond the willful control of the subject. With the help of the sphygmograph, he demonstrated how the subject’s

37. Hippolyte Bernheim, “Des hallucinations négatives suggérées: Réponse à M. le professeur Delbœuf,” Revue de l’Hypnotisme 3 (1889): 225–29; p. 227; my italics. 38. BS:18. 39. BS:19.

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heartbeat could be sped up or slowed down through suggestion.40 Charcot’s adherents, however, considered this setup inadequate for completely controlling the “will” of the subject. Thus Alfred Binet, in his review of the study, criticized Beaunis for not having used a pneumograph as well, as was usual at the Salpêtrière: “It is only regrettable that Mr. Beaunis has not taken care to also monitor his subjects’ respiration, since it is well known that a normal individual can indirectly modify his heartbeat by controlling his breathing. . . . Only the use of the graphic method could have alleviated all doubt.”41 Bernheim, on the other hand, achieved results differing greatly from those of Beaunis in his own experiments with the sphygmograph.42 Like Liébeault, he was satisfied to confirm the artificial production of catalepsy or anesthesia through a subsequent test (whether the arm remained in a certain position, penetration of the skin with a needle).43 In the Nancy suggestion method, the criteria for the genuineness of the hypnotic state were of a moral nature. In lieu of the Salpêtrière’s mechanical control system, Bernheim rested his judgments on his appraisal of the patient’s character and the visible forms in which it was communicated to the doctor in clinical interaction: “Their expression, their behavior, their intonation of voice and manner of relating a story, all denote conviction and sincerity.”44 The doctor was continually operating within an implicit characterology, which coalesced on the basis of various observations. The reports of nurses, the statements of relatives, the letters written by the patient provided a set of indicators that allowed the doctors to form an overall picture of the moral person. On the basis of such clues, Bernheim inferred the inability of certain hysterical patients to voluntarily simulate: “The simulations of hysterics are not absolutely voluntary—our patient was not malicious or cunning. The letters she wrote to her family showed that she was a poor girl who was naive, ingenuous, and lacking any perversity or guile.”45

40. Henri Beaunis, Recherches expérimentales sur les conditions de l’activité cérébrale et sur la physiologie des nerfs. Vol. 2: Études physiologiques et psychologiques sur le somnambulisme pro­ voqué (Paris: Baillère et Fils, 1886), pp.17–29. 41. Alfred Binet, [review of Beaunis, Recherches expérimentales], Revue philosophique 22 (1886): 440–41; p. 441. 42. BS:71–72. 43. Hippolyte Bernheim, “Valeur relative des procédés d’hypnotisation,” in Premier Congrès international de l’hypnotisme expérimental et thérapeutique: Tenu à l’Hôtel-Dieu de Paris, du 8 au 12 Août 1889. Comptes rendus, ed. Edgar Bérillon (Paris: Doin, 1889), pp. 99–101. 44. Bernheim, Suggestive Therapeutics, p. 176 [BS:248]. 45. Bernheim, New Studies, p. 234 [BH:297].

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Another criterion played a key role in evaluating the phenomena produced in hypnosis: the “genuineness” of the various scenes created through suggestion seemed to be authenticated by the intensity with which the hypnotized person acted out the suggested role and was able to credibly communicate it in actu in the experimental setting. Bernheim relates how a laundress “endowed with remarkable intelligence, understands any act which is suggested to her, identifying with the role forced upon her imagination with the highly expressive visage and astonishing verity of a true artist.”46 A war veteran under hypnosis was returned to a battle in which he participated: He reflects for an instant, as if to arouse memories. They come back to him, form pictures in his mind, and force themselves upon him with striking vividness. . . . Thus he dreams the drama that has been suggested to him, seeing himself with his comrades in his former existence, repeating aloud what they say to him, what he answers, gesticulating, as if he were at once spectator and actor.47

The doctor is captivated by the subject’s dramatic performance: what he sees as an observer is the “externalization” of the action that his own suggestion has exerted on the subject’s brain. Thus physiognomy becomes a privileged index of the phenomenon’s genuineness, inasmuch as the “inner struggle” with which the subject attempts to resist the suggestion is reflected there: The entire physiognomy conveys with incredible fidelity and strength the inner movements preceding the execution [of the suggestion], revealing the entire struggle between the subject’s will and the fatality of the idea provoked by the hypnotist. Such a spectacle would be highly instructive for artists and actors, for anyone who must render this supreme quality of art: expression.48

Charcot and Richer had taken the opposite approach, utilizing the experiments of Duchenne de Boulogne to demonstrate how various emotional states could be triggered through the mechanical stimulation of specific facial muscles. Here as well, the scientists saw their work—an “expressive statue” produced by an experimental machinery—as a model for the artist.49 In Nancy, the question of simulation was ultimately decided by the moral integrity of the doctor, his experience, and his judgment.50 The tenet that

46. BS:85. 47. Bernheim, Suggestive Therapeutics, pp. 65–66 [trans. mod.; BS:91–92]. 48. Henri Beaunis, “L’expérimentation en psychologie par le somnambulisme provoqué,” Revue philosophique 20 (1885): 1–36, 113–34, p. 116. 49. Charcot and Richer, “Note on Certain Facts.” 50. BS:68–69.

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hypnosis is universally applicable (and not confined in its efficacy to pathological cases, as it was for the Salpêtrière) did not lead the Nancy clinicians to draw the radical conclusion that, like their subjects, they themselves could also fall victim to deceptions.51 In view of the normalization (i.e., depathologization and potential mass implementation) of hypnotic suggestion that he propagated, Bernheim obviously saw “suggestibility” as a universal phenomenon, which is latently present in all individuals. The specific differences between individuals were thus determined by the degree of mastery with which these weaknesses of consciousness could be controlled.52 The Nancy school presented the hypnosis experiment as a scene in which the doctor knows how to effectively demonstrate his mastery over these “weaknesses” of the brain. He is more than a virtuoso of impression management who knows how to expand the compass of his power. The doctor is accorded a moral and educative function as well: he must show not only “passion for the truth,” but also “love for his fellow human being.” The power that he can exert over others “should make him more discriminating and also more demanding of himself. It is not enough that his intentions are pure: they must be above every suspicion.”53 Suggestible Subjects According to the Nancy group, the hypnotic subject’s realization of a suggestion depended solely upon his or her degree of heightened “suggestibility”: “The only thing that can be said with certainty is that people who are receptive to suggestion have a particular aptitude for transforming the idea they

51. Delbœuf, however, drew a contrary and radically skeptical conclusion from his observations of the Nancy clinic, in which he both expanded Bernheim’s selective use of a dramatic register to include all hypnotic phenomena and postulated a symmetry between experimenter and subject. From this standpoint, the doctor can never know whether or not he himself has become the victim of his subject’s (unconscious) suggestion (see chapter 5). 52. The doctor and the patient group thus form the social microcosm from which the widely influential “crowd psychology” of the 1890s would take its cues. See Gabriel Tarde, The Laws of Imitation, trans. E. C. Parsons (New York: Holt [1890] 1903); Gustave Le Bon, The Crowd: A Study of Popular Mind (London: TF Unwin [1895] 1896); and Robert A. Nye, The Origins of Crowd Psychology: Gustave Le Bon and the Crisis of Mass Democracy in the Third Republic (London: Sage, 1975). For a recent critical discussion of Tarde’s notion of imitation and its relation to hypnotism, see Bruno Karsenti, “Imitation: Returning to the Tarde-Durkheim Debate,” in The Social after Gabriel Tarde: Debates and Assessments, ed. Matei Candeia (New York: Routledge, 2010), pp. 44–61, esp. pp. 48–50. 53. Beaunis, “L’expérimentation en psychologie,” p. 10.

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been given into an act.”54 Bernheim and his colleagues did not relate this transformation—even in the case of purely motoric actions—to a specific experimental setup triggering a neurological mechanism, but rather to the in­ dividuality and interpretive capacity of the hypnotized subject alone. Hence the Nancy clinic did not classify its subjects according to a typology (as the Salpêtrière did), but according to the varying degrees to which they could be influenced. “Suggestibility is composed of stages and different modes, almost as numerous as subjects themselves.”55 This accentuation of patients’ individuality, and refusal to categorize them according to an abstract system, was rooted in a clinical practice of reconstructing case histories that differed radically from that of the Salpêtrière. In his early lectures, held around the time when he took the chair of the University of Nancy’s medical faculty in 1873, Bernheim had already emphasized the primacy of the afflicted individual over the abstractions of a symptomatology organized around types: “Pathology has rendered you familiar with abstract notions of disease. But sickness is an abstraction that doesn’t exist. There are only sick individuals, there are only suffering organisms.”56 In investigating “subjective” symptoms, he insisted on the necessity of basing diagnosis on interrogation, which—unlike Charcot—he did not consider to be a dubious and imprecise source of information: “Interrogation, the most difficult and possibly most important of all clinical procedures! A precise diagnosis often rests on interrogation alone, because here the clinician is exposing symptoms that don’t exist any longer, but which existed at a certain moment in the past. By interrogating the patient, he reconstructs the entire prehistory [évolution antérieure] of morbid phenomena.”57 Thus the problem of reconstructing pathological development was solved differently than it was in Charcot’s typology of successive tableaus: “It is through questioning that the clinician establishes the chronological succession of various organic dysfunctions, whose development constitutes the drama of the disease.”58 As individuals in need of individualized treatment, the “suggestible” patients in Nancy are not, as in the action script of the Paris experiments, assigned the role of passive reflex machines: they are defined by their potential activity. Although Bernheim also makes reference to animal experiments and

54. Bernheim, De la suggestion dans l’état hypnotique, p. 85. 55. Bernheim, New Studies, p. 70 [BH:96]. 56. Bernheim, Leçons de clinique médicale, p. 3. 57. Ibid., p. 6. 58. Ibid.

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to the automatism of the “decapitated frog,”59 he in the end does so in avocation of a position contrary to that of the Paris clinicians: The subjects who manifest motor-automatism are not pure automatons: they hear and remember that they were able to hear when they wake; they often reply to questions; they try to resist suggestions, and struggle against the attitudes or movements which are commanded. Consciousness is not destroyed; the will is still alive, but it is powerless against the exaggerated automatic action.60

By defining the hypnotic subject on the basis of his or her independent activity, the Nancy clinicians were able to describe the forms of resistance that he or she could display in not carrying out a suggestion. In addition to straightforward refusal or a dramatically staged “inner” struggle, Bernheim and his colleagues also noted forms of “hidden resistance,” which exploited details neglected by the hypnotist in making the suggestion: I suggested to Ms. A. E. that she would not be able to pronounce any vowel except for o, and that she would replace all others with this vowel. Having given this suggestion, I caused her to awaken, but I had forgotten to also give her the suggestion that she should speak. Thus she fell into an absolute mutism lasting for almost half an hour, until the point at which I, wishing to torment her no longer, freed her of the suggestion.61

In the experimental setting, the “moral being” of the subject displays itself to the Nancy clinicians in its undisguised state: “The virtual being that exists at the foundation of our self and can reveal itself when an impulse is given, is known to no one. She [the hypnotic subject] also does not know it. You hypnotize her, and this moral being shows itself naked and in all of its sincerity.”62 Hence the doctor is continually called upon to act as a moral authority: suggestion involves not only individual symptoms, but also “the passions, the emotions, the character . . . , which he [the doctor] can form at will.”63 Thus repeated hypnotization is seen as a new form of traitement moral culminating in the education of the patient: “Hypnotism should not become an object of 59. Bernheim makes reference to the Russian physiologist Vasily Danilevsky (1852–1939), who analogizes animal and human hypnosis. Danilevsky describes animal hypnotism as a sort of “physically transmitted order” (Bernheim, New Studies, p. 80), in which the experimenter communicates to the animal that it should maintain its position, as in a verbal suggestion made to a human being. Despite this reference, Bernheim in the end draws the opposite conclusion: “In almost all of the observed cases, a psychical stimulus is the cause.” (BH:109). 60. BS:201. 61. Beaunis, “L’expérimentation en psychologie,” p. 120. 62. Ibid., p. 119. 63. Ibid., p. 24.

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amusement or a sort of parlor game; rather it must remain what it is in reality: a method of scientific study, a means of physical and psychical treatment, and an instrument of moralization.”64 Two Cultures of Hypnotism Within French psychopathology, the major debates around hypnosis and suggestion evolved around the opposition between two clinical cultures of hypnotism.65 The first and most important difference between the two cultures involved the particular social and local forms of organization from which they emerged. The doctors and scholars who followed Bernheim were not a school—like Charcot’s—organized around a doctrine with a differentiated division of labor. The Salpêtrière was a research center linked to other hospitals and institutions, and its resources also included several journals published by its own publishing house (the Bureaux du Progrès médical). In Charcot’s ward, a number of young interns worked on carefully organized projects aimed at experimentalizing, formalizing, and universalizing his conception of grande hystérie. The strategies implemented in producing and representing subjects and objects arose from the clinic’s centralist structure, in which diverse clinical and experimental configurations were interlinked. In developing its experimental system, the Salpêtrière school incorporated both earlier clinical and more recent nonclinical methods (i.e., practices originating both in magnetic “metallotherapy” and in experimental physiology), as well as newer psychological approaches. In a process of assimilation, earlier practitioners (such as Burq) and later young psychologists and philosophers (such as Alfred Binet and Pierre Janet) came to the hospital in order to cooperate with the doctors.66 The group in Nancy differed from Charcot’s

64. Ibid., p. 10. 65. It should be noted that there were other uses of hypnotism within the French clinic that somewhat diverged from the Paris-Nancy debates (as Anne Harrington and Nicole Edelman have stressed), but their impact was less forceful than the opposition between Charcot’s and Bernheim’s adherents, which also had a widespread echo in the popular press. 66. It is conspicuous that throughout his career Charcot often felt a bond to an earlier generation of doctors as exemplary figures or models (most notably Duchenne de Boulogne). Conversely, he assembled around himself a younger generation of pupils to whom he embodied an amiable father figure. These characteristics of the Parisian patronage system stood in stark contrast to the structure of the Nancy group, whose members (with the exception of the older doctor Liébeault) were all of more or less the same age. This has led some historians to propose a psychoanalytic interpretation of the familial structure of the Charcot school. See e.g., Toby Gelfand “Sigmund-sur-Seine: Fathers and Brothers in Charcot’s Paris,” in Freud and the History

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school in its relative openness, which was expressed both in its experimental and therapeutic style, and in its readiness to accept laymen as equals. The group positioned itself in direct opposition to the academic medical establishment in Paris, which was striving to achieve a monopoly on the practice of hypnotism. Emblematic in this respect was the alliance that the leader of the Nancy group, Hippolyte Bernheim, entered into with the older country doctor Liébeault. While the Salpêtrière school wanted to limit the practice of hypnotism to closed institutions such as the clinic, the Nancy group aimed at opening the field of competition to include lay practitioners. A second difference involved the practices implemented in experimentation and public presentation. Here a contrast can be observed between a culture that was for the most part oral, and a visual-graphic culture. While the voice and the hypnotist’s speech played a privileged role for Liébeault and Bernheim, the “experimental hysteria” of the Salpêtrière was represented using visual media: photographs of hypnotic subjects in various states, artistic reproductions (in the museum), and inscriptions created with the aid of the graphic method. The Salpêtrière’s representations served both as a means of control and a means of demonstration: they were conceived to create an objective index for the existence of hypnotic states, and thus to negate the suspicion raised by skeptical experts that experimental subjects might be simulating. For the Nancy clinicians, who saw verbal suggestion as the only effective procedure, this index lay in the subject’s state of “suggestibility” toward the hypnotist, which was evaluated via the genuineness of his or her observable verbal or gestural expressions. As a consequence of this rejection of the machinery set up at the Salpêtrière, the question of simulation again became undecidable. The two differences outlined above were closely linked to the ways in which the two cultures made use of the clinic’s power resources. Charcot stood within the French tradition of pathological anatomy, which transformed the clinic into a laboratory through the introduction of new instruments and through spatial differentiation. The Nancy method of suggestion accentuated the social structure of the hospital ward and of the doctor’s rounds (the patient’s trust in the doctor, the visible grouping of patients in rooms). Consequently, Bernheim’s sole criterion for evaluating the hypnotist’s effectiveness was his ability to hypnotize the greatest number of patients within the “suggestive atmosphere” of his clinic. The Salpêtrière school, by contrast, divided the hypnosis experiment into multiple scenes, in which the doctor of Psychoanalysis, ed. Toby Gelfand and John Hilldale Kerr (Hillsdale, NJ: The Analytic Press, 1992), pp. 29–57.

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summoned the patient away from the ward to a different location (the museum, the policlinic, the laboratory). Here the utilization of mechanized procedures (the graphic method, photography) shaped the power relationship so as to keep up with the mobility of the patient and his or her symptoms. The older methods of clinical surveillance, which were rooted in the clinic’s social resources, were reconfigured in a reference system based on inscriptions. Correspondingly, the two cultures of hypnotism defined their experimental subjects differently. Charcot’s hypnosis laboratory assigned human subjects a status equivalent to that of laboratory frogs in experimental physiology. It established this analogy through its experimental practices and representation forms (e.g., the graphic method), which assigned patients the role of automatons that developed certain constant somatic states triggered by simple reflex responses. The phenomenon known as transfert, in which experimental intervention caused various symptoms to “jump” to the other side of the body, was seen as a means of demonstrating the purely mechanical functioning of the subject and his or her unconscious. By raising suspicions regarding this mechanized form of experimentation, whose effects they attributed exclusively to the experimenter’s verbal suggestion (or the subject’s autosuggestion), Bernheim and his allies assigned a different significance to the subject’s activity. In the Nancy experiments, the subject’s realization of a suggestion was related solely to his or her ability to convert the idea into an action. Since this action represented an individual response, it became an interpretive act through which the subject could enter “resistance.” Within both cultures speculative theories were forged to explain the unconscious phenomena manifested in their experiments: Bernheim established laws of “ideodynamism,” while Charcot aligned himself with theories of brain physiology and associationist psychology imported from England. Nonetheless, these theories did not go beyond formulaic statements, and they were not in the foreground of the controversy. Their uses were both epistemic and political: on the one hand, they affirmed the possibility of gaining positive knowledge of unconscious phenomena and anchored the doctor’s privileged position as an expert; on the other hand, they articulated the two cultures’ opposing conceptions of the social relationship between doctor and patient.

3

“Amour expérimental”: Facts and Fetishes at the Musée Charcot

The historiography of hypnotism generally reduces the outcome of the con­ troversy between the Salpêtrière school and the Nancy group to the simple dictum that the latter won the day. From this perspective, Charcot’s attempt to integrate hypnosis into an experimental system appears as a strange scien­ tific aberration, in which a few “star patients” were trained as ideal demon­ stration subjects under the doctors’ suggestive influence. Consequently, the facts of grand hypnotisme are dismissed as mere artifacts. Bernheim had first offered his polemical interpretation as an explanatory model in 1886: Only once did I see a subject who exhibited the three periods of lethargy, cata­ lepsy and somnambulism. It was a young girl who had been at the Salpêtrière for three years, and why should I not state the impression which I retained of the case? Subjected to a special training by manipulations, imitating the phe­ nomena which she saw produced in other somnambulists of the same school, taught by imitation to exhibit reflex phenomena in a certain typical order, the case was no longer one of natural hypnotism, but a product of false training [un produit de culture faussé], a true suggestive hypnotic neurosis.

Many authors have taken Bernheim’s polemical assertion to be a sufficient ex­ planation of Charcot’s experimental hypnotism. In contrast with this histo­­ . Bernheim, Suggestive Therapeutics, p. 90. . Alan Gauld discusses briefly the various explanations advanced by Pierre Janet in his retrospective historical account (published in 1919) of how a great clinician like Charcot could have been misled over hypnotism. Pierre Janet, Les médications psychologiques, 2nd ed. (Paris: Alcan, 1925), 1:151–76. Although Janet accepts Bernheim’s conclusion that grand hypnotisme with its three stages is ultimately a product of dressage, he locates its historical origins not in the Salpêtrière, but in the persistence of the earlier popular culture of animal magnetism, i.e., he

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riographic model, which explores external factors (political, social, or psy­ chological) only in explaining the work of the losers, a different picture emerges if one looks at this famous controversy from a symmetrical perspec­ tive. In the light of the specific features of the two competing cultures of hyp­ notism, it can hardly be maintained that Bernheim’s demonstrations were properly speaking experimental refutations of the phenomena produced at the Salpêtrière. How could they have been, given that the Nancy school had neither an equivalent patient population at its command, nor had it ever developed effective means of ruling out the possibility that its subjects were simulating? It was precisely by pointing to the impossibility of ever settling the issue of simulation that Bernheim threatened Charcot’s project of limit­ ing hypnosis to an experimental procedure confined to the clinical labora­ tory. From the point of view of the Nancy group, hypnosis could never be purified, for it was inevitably contaminated by suggestion. The dematerialization of hypnosis experimentation cultivated by Bern­ heim and his followers was soon countered by a number of strategies within Charcot’s school demonstrating the validity and superiority of the experi­ mental system installed at the Salpêtrière. This chapter focuses on a crucial moment at the height of the controversy, when a peculiar material setting at the Parisian clinic, the Musée Charcot, became the key vehicle in this effort. The unexpected twists and turns that arose in the process ultimately led to a reconfiguration of the hypnosis experiment. A “Museum of Clinical Facts” Even at the highpoint of the controversy between the two cultures of hypno­ tism, Charcot avoided entering into direct confrontation with Bernheim or his adherents. The public defense of grand hypnotisme was thus largely left to Charcot’s assistants. While Joseph Babinski, Georges Gilles de la Tourette, and Paul Richer emerged as zealous defenders of the physiological conception claims that certain patients were trained by magnetizers before serving as subjects in Charcot’s demonstrations. Gauld, then, is strongly inclined to the view that the answer is to be found in a sociological analysis of the “strange, hothouse subculture” of the Salpêtrière (Gauld, A History of Hypnotism, p. 315). . In a debunking vein, the philosopher Mikkel Borch-Jacobsen has adopted such a point of view in order to dismiss Charcot’s male cases of traumatic neurosis as mere artifacts. Mikkel Borch-Jacobsen, “How to Predict the Past: From Trauma to Repression,” History of Psychiatry 11 (2000): 15–35. Likewise, he maintains, the unconscious in the Freudian sense only became a reality through suggestion. For a sharp critique of this position and its multiple contradictions, see Leys, Trauma, pp. 160–72.

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of hypnotism and the doctrine of the three stages, a major turn occurred in a series of striking experiments conducted by the young psychologist Alfred Binet (1857–1911) and the doctor Charles Féré (1852–1907) at the Musée Char­ cot, whose results were published and discussed in the pages of Ribot’s Revue philosophique. The museum housed a variety of collections, and it was also frequently the site of patient demonstrations, generally before a small and selected audience. Recounting his visit to the clinic in December 1885, the Belgian scholar Joseph Delbœuf gives a description of the site: A large room, a sort of museum, whose walls and even ceiling are decorated with a considerable number of drawings, paintings, engravings and photo­ graphs, which represent either group scenes or one single patient, naked or dressed, standing, sitting or lying; or one or two legs, a hand, a torso or an­ other part of the body. All around, cabinets filled with skulls, spinal cords, tibias, humeri exhibiting this or that anatomical particularity; dispersed in the room, on tables or in cases, a mess of bottle banks, instruments and appara­ tus; the unfinished wax figure of a naked old woman lying on a kind of bed; a number of busts, also one portraying Gall, painted green.

This miscellany of specimens, images, instruments and other objects, which in the eyes of the distanced observer could only appear as a curious and des­ ultory juxtaposition, was intimately bound up with the specific practice of research and teaching at Charcot’s clinic. In 1875 the neurologist had already begun trying to convince the hospital administration of the necessity of such a collection, “which would assemble, at only a small cost, the most interest­ ing, diverse and multifarious pieces to be found at the Salpêtrière.” Four years later the site was officially named after Charcot, although the various items making up the collection were the outcome of a collective enterprise, of “a competition involving everybody, masters and pupils alike.” Thus the function of the Musée Charcot was not only to serve the self-representation of its founder, as in many other cases of medical collections of this period. Set . For Binet and the significance of his stay at Charcot’s clinic for his later psychology, see esp. François-Louis Bertrand, Alfred Binet et son œuvre (Paris: Alcan, 1930), pp. 11–30. A later study by Theta Wolf provides yet another asymmetric and flawed account of the controversy with Bernheim and the Nancy school. Theta Wolf, Alfred Binet (Chicago: Chicago University Press, 1973). . Joseph Delbœuf, Une visite à la Salpêtrière (Brussels: Merzbach / Falk, 1886), pp. 6–7. . Jean-Martin Charcot, “Clinique médicale: Hospice de la Salpêtrière,” Le progrès medical (4 December 1875): 718–19. . Jean-Martin Charcot, “Clinique médicale: Hospice de la Salpêtrière,” Le progrès medical (22 November 1879): 913.

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f i g u r e 9 . Musée Charcot, La Salpêtrière. This seems to be the only existing photograph of the pathological-anatomical museum set up by Charcot and his pupils, possibly dating from the early 1890s. The bust on the left, executed by Paul Richer, represents a female patient suffering from a paralysis of the tongue and the larynx. On the right, the wax cast of a patient affected by tabes, the so-called ataxical Venus, which would later be presented in a glass box, resembling a sarcophagus.

up in the immediate vicinity of Charcot’s medical cabinet, the pathologicalanatomical museum combined collections related to different clinical pic­ tures. The majority of items were natural anatomical specimens (skeletons, bones, skulls) including a collection of brains, and there was also a series of lifelike wax casts (busts as well as entire figures), most of them being the work of Paul Richer. These objects were displayed in six large glass cases, with two notable exceptions: the bust of a woman serving to illustrate la­ bioglossolaryngeal paralysis and the wax figure of a female patient, known as the “Venus ataxique,” first positioned on a bed and later in a kind of sar­ cophagus (see fig. 9). Both figures had been modeled after patients living in the clinic in order to serve as study objects after their deaths. The collec­ tion of bones and brains was also organized according to clinical pictures: “a pathological anatomy” that, according to the description of one of Charcot’s students, “was not dead and abstract as in books, but resurrected, animated, quasi brought to life, allowing the fundamental signs of the lesions to come . See the report written on the occasion of the dislocation of the museum in 1906: Louis Alquier, “Musée Charcot,” dossier, Archives de l’Assistance Publique, Paris.

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plastically into view, teaching how they were to be seen, and leaving behind indelible memories.” Thus the collections of the museum were organized as a supplement to the clinic, which in turn could appear as a “living pathological museum.”10 According to Charcot’s conception of the nosographic type, it hardly seemed possible that a given clinical entity could be studied and demonstrated in an exhaustive manner on a single case. Types were to be found only partially in rare cases, a condition which made them ever more precious and worthy of preservation. The array of casts and reproductions was designed to facilitate demonstration of these types, and also to break them down analytically and establish their essential features by way of confrontation with a variety of less pronounced cases.11 Within this conception of nosography, then, it was nec­ essary to observe patients comparatively not only together with other living specimens, but also with objects from the clinical collection. And yet the Musée Charcot and the adjacent medical cabinet exhibited another important feature: they housed a large collection of images combin­ ing photographs of Salpêtrière patients (or engravings made after them) with copies of works by Rubens, Raphael, and other European masters, most of them executed by Paul Richer. As one visitor noted, the walls of Charcot’s cabinet were full of “small images depicting scenes from the life of saints, ecstatic virgins, exorcisms and the healing of the possessed, visions, deeds of witchcraft and magic.”12 This art gallery depicting convulsions, contortions, and rare physical deformities was designed as an archive rooting the facts displayed in Charcot’s clinic in history. In this respect it embodied the pro­ gram of “retrospective medicine” formulated by the positivists,13 in which the artworks of earlier eras could be interpreted through a “materialist semiotic” (a sort of natural grammar of symptoms), thus confirming the factuality of the conditions diagnosed.14 . Paul Peugniez, J.-M. Charcot, 1825–1893 (Amiens: Imprimerie Picarde, 1893), p. 6. 10. Charcot, Leçons sur les maladies du système nerveux, OC 3:3. 11. For Charcot’s insistence on the study of types as the point of departure for clinical re­ search, see Charcot, Leçons du mardi à la Salpêtrière, 1:344. 12. Carl Gerster, “Beiträge zur suggestiven Psychotherapie,” Zeitschrift für Hypnotismus 1 (1892–93): 319–35, p. 319. See also the description by Henry Meige, “Charcot artiste,” Nouvelle Iconographie de la Salpetriere 11 (1898): 489–516, p. 495. 13. Emile Littré, “Un fragment de médecine retrospective” [1869], in Médecine et médecins (Paris: Didier, 1872), pp. 111–36. 14. Although the images of “demonic possession” acquired a special status in the claim that the hysterical attack as it was described by Charcot and Richer had already been observed inde­

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Within the space of the museum, the specific relationship between doc­ tors and patients was projected into a longer history represented in images and objects. While the genealogy of patients was evoked through references to a religious past whose manifestations were to be fully explained in the light of neuropathological observation, the doctors’ genealogy was made up by a gallery of busts and paintings of illustrious scientific precursors. Transferring Psychic Objects When, at the height of the controversy with the Nancy school, Charcot of­ fered the young psychologist Alfred Binet and his friend Charles Féré some of his most famous female patients for a series of experiments to be conducted at the museum, the aim was not only to repudiate Bernheim’s critique, but also to expand the scope of the Salpêtrière’s own experimental system by gaining control of the process of suggestion. Bernheim claimed that, in the end, it was impossible to explain how suggestion functioned exactly in the brain or the nervous system. The actual course taken by the ideas suggested by the hypnotist, he maintained, could only be observed indirectly, in the physiognomy of the subject and in the submission or “resistance” written there. Thus Bernheim postulated an autonomous domain of the psyche inac­ cessible to direct observation. This postulate was the keystone of his rejection of the experimental apparatus set up at the Salpêtrière, which was designed to make the unconscious visible, measurable, and manipulable. The adherents of the Nancy school were thus endeavoring to bring about a dematerialization of the hypnosis experiment.15 Binet and Féré answered this challenge with various strategies of materi­ alization and localization. For Charcot, it seemed evident that “psychology is nothing more than the physiology of a part of the brain.”16 Inspired by Duchenne de Boulogne’s experiments on the expression of emotions, he and pendently, it should be noted that the medical interpretation of artworks goes back to Charcot’s very first publications. Such interpretations can also be found in a large number of his travel al­ bums, which are still preserved in the family archives (Vallin-Charcot, Neuilly). On the history of Charcot’s private and medical collections, see Mayer, “Ein Übermaß an Gefälligkeit.” 15. However, Bernheim’s theorization of suggestion was just as much committed to a mate­ rialist point of view as that of the Parisians. The key difference between the two cultures rested in the forms in which elements of theory were materialized in experiments. 16. Jean-Martin Charcot, Lezioni cliniche dell’anno scolastico 1883–84 sulle malattie del sistema nervoso, trans. D. Miliotti (Milan: Vallardi, 1885), cited after Goetz, Bonduelle, and Gelfand, Charcot: Constructing Neurology, p. 143.

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Richer had established the line to be followed in investigating the “uncon­ scious cerebration” of his subjects.17 For this purpose, the patient was put into a state of cataleptic immobility and then exposed to mechanical and electrical stimulation of the facial muscles to produce various physiognomic expressions (astonishment, laughter, rage, etc.). Subsequently, the sub­ ject’s limbs automatically assumed a correspondingly expressive position: a “tragic” facial expression was accompanied by “tragic” gestures, a “cheerful” expression by corresponding arm movements. In this experimental setup, the subject was transformed into an “expressive statue,” which alternately assumed various elementary forms of expression. The subject could be im­ mobilized at will in the various poses, and thus it was easy to document them photographically.18 By 1885, Binet and Féré had transferred the action script developed by Charcot and his pupils from the “simple” state of catalepsy to the more complex psychical state of somnambulism. Their first publications targeted against the Nancy school demonstrated that the power of the experimenter encompassed a “great number of automatic phenomena”: through verbal suggestion he could cause the somnambulant subject to “move, act, think and feel according to his whim.”19 In their experiments, Binet and Féré set out to prove that the striking phenomenon of transfert could be also be pro­ voked in the psychological realm: using magnets, they endeavored to dis­ place not only physiological phenomena of motility and sensitivity from one side of the body to the other, but also ideas (fantasies, hallucinations, etc.), and more complex sequences of action and emotional states. These experi­ ments took up and even enhanced the theatrical style of some of Bernheim’s demonstrations, and in doing so they used some of the objects assembled in the museum. Blanche Wittmann, possibly the most emblematic of all female subjects presented at the Salpêtrière,20 was forced in one of these experiments

17. This term had been introduced by the English physiologist William B. Carpenter. On the history of this concept see Thomas Laycock, “Reflex, Automatic, and Unconscious Cerebra­ tion: A History and a Criticism,” The Journal of Mental Science 21 (1876): 477–98; 22 (1876): 1–17. For the French reception of the concept, see the essay by Marcel Gauchet, L’inconscient cérébral (Paris: Seuil, 1992). 18. Charcot and Richer, “Note on Certain Facts.” 19. Alfred Binet and Charles Féré, “L’hypnotisme chez les hystériques: I. Le transfert psy­ chique,” Revue philosophique 19 (1885): 1–25, p. 8. 20. Wittmann features prominently in Louis Brouillet’s famous painting Une Leçon Clinique à la Salpêtrière, exhibited 1887 at the Salon. See Goetz, Bonduelle, and Gelfand, Charcot: Constructing Neurology, pp. 92–93.

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f i g u r e 1 0 . Bust of Franz Josef Gall, Hôpital de la Salpêtrière, Bibliothèque Charcot, Paris. Photo by Andreas Mayer.

to mock the bust of phrenologist Franz Joseph Gall by thumbing her nose at it while being exposed to magnetic force (see fig. 10). Wit . . . is in the state of somnambulism. We place a bust of Gall on the table close to her. We suggest to the patient that she thumb her nose at the bust. A magnet is placed near her right hand. The patient is awakened, and as soon as she sees the bust she grimaces and thumbs her nose at it with her left hand. After three or four seconds she begins again, and we count a series of fourteen such gestures, all of which are executed with the left hand. The last move­ ments are weaker, as if they were atrophied; the gesture is poorly rendered. She raises her hand to the level of her mouth without opening the fingers. In the meantime the right hand has begun to tremble slightly. The left hand stops. Wit . . . seems disquieted, turning her head this way and that while looking at the bust of Gall and saying: “This man is revolting.” She scratches her ear with her right hand, and then she begins to thumb her nose a number of times with her right hand. These gestures persist for ten minutes. She is well

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aware that the gestures are ridiculous. When she stops for an instant, a slight implication of the gesture at the bust is sufficient to get her started again im­ mediately. We remove the magnet, and the transfer occurs from right to left, with the same characteristics. We give the patient a task to occupy her hands, and she regularly interrupts the task every three or four seconds to thumb her nose. From time to time, she complains of a headache oscillating from one parietal region to the other.21

In such experiments, Binet and Féré sought to materialize and localize the psy­ chical processes at work in verbal suggestion. To this end, the experimenter converts the suggested idea (mocking a certain person) into a sequence of actions that the patient can execute on a material object (the bust of Gall) serving as a prop. The figure of speech “thumb one’s nose” is translated into a sequence of discretely observable actions, whereby the question of whether the gesture is executed by the right or left hand establishes the assumed “seat” of the activated nerve centers. The oscillating pains in the patient’s head sub­ stantiate the reality of a fluctuating locality in the brain.22 Hence this experiment produced a series of actions that can be described in two ways: from the perspective of the subject, the act is voluntary, since she “finds the bust ‘revolting’ and believes that she is thumbing her nose at it for this reason.”23 For the experimenter, by contrast, there is only the action of the magnet on the nervous system or the brain, which displaces the action from one hand to the other. The strategy of the entire experiment, then, is to make the compulsions under which the subject is acting invisible to her. The magnet is hidden under a piece of cloth and betrays its presence exclusively through its effect on her actions. Thus the scene designed for the patient’s radius of action creates the semblance of a voluntary action (mocking the bust) by making the determining element (the magnet) disappear. Further­ more, the bust of Gall toward which the action is carried out also carries a symbolic dimension: even though, by 1885, Gall’s phrenological system had been refuted and largely discredited in French academic circles, his principle of localizing human faculties in the brain was still recognized as foundational for materialist approaches in the human sciences.24 Thus the experimental 21. Ibid., p. 9. 22. For the physiological underpinnings of these experiments in the brain, see Harrington, Medicine, Mind and the Double Brain. 23. Binet and Féré, “L’hypnotisme chez les hystériques,” pp. 9–10. 24. This holds true especially of criminal anthropology, which starts to flourish in the late 1870s in Italy and France. For the ambiguous reception of Gall’s heritage in France, see Marc Renneville, Le langage des crânes: Une histoire de la phrénologie (Paris: Sanofi-Synthélabo, 2000), pp. 285–92.

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scenario acquires a symbolical dimension: in her mocking gestures, the ex­ perimental subject confirms—unknowingly and against her will—the local­ ization theory upon the bust of its most famous exponent. Pinning Down Hallucinations The strategy of materialization and localization pursued at the Salpêtrière was first and foremost designed to counter Bernheim’s criticism that transfert was not the result of physical agents, but rather of gesturally or verbally communicated suggestions. Binet and Féré also aimed to modify Bernheim’s definition of suggestion. According to his definition, the effect of sugges­ tion was founded on the “suggestibility” of the subject, who transformed the suggested idea into an action.25 Binet and Féré took up this definition, but with the crucial addition that “the idea is an epiphenomenon; taken by itself, it is only the indicative sign of a certain physiological process, solely capable of producing a material effect.”26 Like Bernheim, they took the hyp­ notic subject’s suggestibility to be the result of sensory impressions stored in the nervous system, which were reactivated in the experiment by a stimulus. However, they held that the activation of these sensations in the experiment did not show the subject’s “free play of fantasy,” but a preexisting pathologi­ cal condition. With this theorization of suggestion, Binet and Féré countered Bern­ heim’s attempt to make the success or failure of hypnosis dependent upon the varying degrees of suggestibility latently present in every normal indi­ vidual. Binet, who was steeped in the French reception of associationist psy­ chology, claimed that the chain of associations stimulated in the hysterical subject was localized in memory in the form of a materially recorded trace. Only by reactivating such a trace in the hypnotized person, and causing it to be realized in motoric action, could any idea given by the hypnotist function as a suggestion.27 The relationship between the hypnotizing doctor and his patients, which the Nancy group cast in moral terms, was thus translated into a physicalist vocabulary: here the “intensities” of the various suggestions and, 25. Bernheim, De la suggestion dans l’état hypnotique, p. 85. 26. Alfred Binet and Charles Féré, Animal Magnetism (New York: D. Appleton, [1887] 1890), p. 173. 27. Charcot and his pupils absorbed these elements of English association psychology both through the experimental context of aphasia research (as conducted by Paul Broca) and through the popularization of these theories by Ribot. See esp. his widely read work on memory and personality, which went into numerous editions: Théodule Ribot, Diseases of Memory (London: Paul, [1881] 1898); and Les maladies de la personnalité (Paris: Alcan, 1885).

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reciprocally, the subject’s corresponding (abnormal) states of “excitability” are the factors determining whether a suggestion is realized or remains with­ out effect.28 However, Binet and Féré were faced with a problem: Bernheim’s rep­ resentation of suggestion as a continually open struggle between the com­ manding doctor and the resisting patient could not be refuted through observation, because many of the processes assumed to be taking place within the subject could not be made perceivable. In contrast to motoric symptoms (paralysis of limbs or certain disturbances in writing or speaking), which could be directly observed and verified, the appearance of suggested hallu­ cinations could only be established inductively through queries or by ob­ serving gestures and speech: “A hallucination . . . , however dramatic it may be, always remains the personal possession of the patient; it is impossible to study it directly like a paralysis or a contracture.”29 Thus their initial strategy was to tear this “personal possession” away from the patient and turn it into an object of observation. In the present context, hallucinations were an obvious choice as a vehicle for such an objectifying strategy. The associationist psychology to which Bi­ net subscribed dissolved the unity of the self, assuming that the mind was made up of fusions and dissociations of sensations and images. According to Hippolyte Taine’s widely influential work On Intelligence (1870), which drew heavily on older research into animal magnetism and on the study of dreams and visions, every mental image is supposed to have an automatic force tend­ ing toward a “certain particular state; to hallucination, false recollection, and the other illusions of madness.”30 Under such premises, the distinction be­ tween normal acts of perception and hallucinations, and the boundaries be­ tween the interior dimension of the self and external reality, become tenuous. According to one of Taine’s famous formulations, hallucination should not be dismissed as “false external perception”; rather perception must be quali­ fied as “true hallucination,” a kind of internal dreamlike state that proves to match external reality.31 With their experiments at the museum, Charcot and his pupils, then, sought to validate the theory of knowledge and perception formulated by Taine, who also attended a number of demonstrations.32

28. Alfred Binet, “L’intensité des images mentales,” Revue philosophique 23 (1887): 473–97. 29. Binet and Féré, “L’hypnotisme chez les hystériques,” p. 21. 30. Hippolyte Taine, On Intelligence (London: L. Reeve, [1870] 1871), p. 71. 31. Ibid., p. 224. 32. Delbœuf mentions Taine’s presence at a demonstration by Charcot at the Salpêtrière Museum (Une visite à la Salpêtrière, p. 9). Binet’s first book-length study, La psychologie du

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Working under such premises, it is not surprising that Binet and Féré accorded the suggested hallucination the ontological status of an object per­ ceived in space: The patient exteriorizes and situates the hallucinatory image in the same way as an image of normal perception. The psychological mechanism of the two operations is the same. What’s more, the hallucination is not an isolated manifestation: it shows itself to be constantly accompanied and sustained by external perceptions.33

In the museum, they designed a concrete experimental setup, which was sup­ posed to geometrically specify the location of a hallucination in the exper­ imental space. For Binet and Féré, the hallucinations artificially produced in the state of somnambulism represent actual “projections” of the images stored in the brain onto the real outer world. In a set of experiments, the subject is shown blank cards or plates, whereby the suggestion is made that one of the cards carries a portrait of the experimenter. The subject can suc­ cessfully distinguish the card—marked on the back with a special symbol for the experimenter—from the others and can even give a detailed description of the imaginary portrait.34 In order to substantiate the reality of the hallucinations they are produc­ ing in geometric space, Binet and Féré use a great diversity of optical tools and instruments (prisms, magnifying glasses, lorgnettes, mirrors, microscopes). After the perception of a nonexistent object is suggested to the hypnotized subject, the experimenters place an optical instrument between the subject and the supposed location of the imaginary object in space. The modification of the object is then deduced by questioning the subject and observing her behavior. In order to prevent the subject from deceiving the experimenter, her field of vision is limited by a special setup.35 In considering why subjects see these objects and their modifications through the instruments just as they would real objects, Binet and Féré exclude the explanations proffered by Bern­ heim: that the subject already knows which instrument is being used and is adjusting her description accordingly, or that she sees how the instrument raisonnement (1886), presented itself mostly as an experimental verification of the work of Taine and Ribot. The Salpêtrière was a hospital where a tradition in the study of hallucination existed since the first half of the nineteenth century, at least in the realm of psychiatry. For a historical overview, see Jean Paulus, Le problème de l’hallucination et l’évolution de la psychologie d’Esquirol à Janet (Paris: Droz, 1941). 33. Alfred Binet, “L’hallucination,” Revue philosophique 17 (1884): 377–412, 472–502, p. 401. 34. Binet and Féré, Animal Magnetism, pp. 224–26. 35. Binet, “L’hallucination,” p. 482.

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modifies the real objects in her field of vision and deduces the modification of the hallucination.36 The new experimental psychology at the Salpêtrière develops under the premise that experimental subjects have no knowledge. They are merely re­ cording devices, whose memory registers every occurrence with astonishing exactitude: “When hypnotized, some hysterical subjects become so sensitive, such delicate reagents, that no word or gesture escapes their notice; they see, hear and retain everything, like registering instruments.”37 Since they record external occurrences without understanding their inner mechanisms, they have no knowledge of how the instruments function or of the laws of phys­ ics, which the experimenters consider to be the most plausible explanation for the phenomena they are producing: “The hallucinatory image is associ­ ated with an external and material point of reference, and the modifications produced by the optical instruments on this mark modify the hallucination in turn.”38 This mechanical-physical register of localizing the hallucination geomet­ rically in the experimental space is augmented by a further register, which is derived from the patient’s speech: the images are alive, they have a certain “vitality,” and thus they can also “die.”39 This biological register complements and relativizes the optical-mechanical perspective, in which the mental im­ age is equated with a photographic print: The images are not by any means dead and inert things; they have active properties; they attract each other, become connected and fused together. It is wrong to make the image into a photographic stereotype, fixed and im­ mutable. It is a living element, something which is born, something which transforms itself, and which grows like one of our nails and our hairs. Mental activity results from the activity of images, as the life of the hive results from the life of the bees, or, rather, as the life of an organism results from the life of its cells.40

36. BS, p. 94. 37. Binet and Féré, Animal Magnetism, p. 192 (trans. mod.). 38. Ibid., p. 237 (trans. mod.). 39. Ibid., p. 253. 40. Alfred Binet, The Psychology of Reasoning: Based on Experimental Researches in Hypnotism, trans. Adam Gowans Whyte (Chicago: The Open Court Publishing Company, [1886] 1899), pp. 187–88. Although these statements are attributed to the experimental subjects, this may be a variation of Taine’s famous comparison between the living body as a “polypus of mutually dependent cells” and the active mind as a “polypus of mutually dependent sensations and images” (Taine, On Intelligence, p. 71). It also constitutes a critique of the popular com­ parison of the brain with a photographic apparatus, which was operative in Francis Galton’s

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With this dual register—optical-mechanical and psychobiological—Binet and Féré are attempting to capture both the fixedness and the mobility of the hallucinations produced in hypnotic subjects. Not only does the hallucina­ tion correspond to an “externalization” of various mental images in the outer world: it also actualizes the way in which they are interconnected.41 This spe­ cific form of interconnection is assumed to be preexistent in the subject. It represents a piece of unconscious history, which can be extracted through various practices of suggestion: “When, some time afterwards, the subject was again hypnotized, the same se­ ries of hallucinations occurred spontaneously. So, again, if the subject was re­ minded of his normal life, or, rather, if an hallucinatory suggestion was made to him, the memory of subsequent events was evoked in its turn, and formed a tableau or hallucinatory scene. In this way a subject may be constrained to live over again a part of his life, and secrets are revealed which would never have been uttered in the waking state, nor even perhaps under hypnotism.”42

In this series of experiments, Binet and Féré were entering into areas that had been excluded from the first hypnosis experiments at the Salpêtrière because they had seemed too complex or because no vehicle of measurement had been available to eliminate suspicions of simulation. In the action script governing Charcot’s earlier experimentation, the hypnotized subject’s radius of action had been mostly limited to a few simple motoric acts (reading, writing), all of which could be readily controlled by the operator. In its public presentation of cases, the Salpêtrière school’s strategy had been to concentrate primarily on the first two stages of grand hypnotisme: catalepsy and lethargy. In the state of catalepsy, Charcot claimed to be able to demonstrate “l’homme machine in all of its simplicity, as La Mettrie had conceived it.”43 Binet and Féré’s self-observations of visions. Galton designed his famous “composite photographs” in order to demonstrate the working of a perfect mind. His device underwent different receptions in psy­ chopathology and later also in psychoanalysis. See Francis Galton, Inquiries into Human Faculty and Its Development (London: Macmillan, 1883). For the later reception of Galton’s device, see Carlo Ginzburg, “Family Resemblances and Family Trees: Two Cognitive Metaphors,” Critical Inquiry 30 (2004): 537–56; and Andreas Mayer, “Thinking in Cases, Picturing Types: On the Afterlife of Galton’s Composite Photographs in Psychoanalysis,” The Annual of Psychoanalysis 38, forthcoming. 41. Alfred Binet and Charles Féré, “Expériences d’hypnotisme sur les images associées,” Revue philosophique 21 (1886): 159–63, p. 162. 42. Binet and Féré, Animal Magnetism, p. 222. 43. Charcot, Leçons sur les maladies du système nerveux, OC 3:337. The difficulties with which the unconscious phenomena of somnambulism had initially confronted Charcot are shown by the fact that he at first limited the condition somnambulique to only two states (catalepsy,

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experiments initially took a similar approach, but they led to a differentiation of the various stages of hypnotism under which somnambulism could no longer be adequately described as a form of “automatism”: “The automatism of catalepsy is its dominant character. . . . It has been justly said that a cata­ leptic subject ceases to have a personality; that there is no cataleptic ego. . . . The condition of the somnambulist is very different; he is no automaton, but a person endowed with character, aversions, and preferences.”44 Thus Binet and Féré modified and expanded the action script for the study of unconscious phenomena: in analogy to the unconscious objects assumed to be existing within his or her mind, the hypnotic subject is now allowed greater mobility and a larger radius of action in the experimental space. He or she is made to play out longer scenes, which usually involve various ma­ terial objects. This elaboration also necessitates a new configuration of the hypnosis experiment: strategies of localization and materialization enable the experimenters to maintain control of the expanded experimental space (and of the subject’s radius of action). In order to make visible the unconscious history recorded in the nervous system, the subject herself is used as a record­ ing device. Binet seeks to induce the patient “to objectify a phenomenon that is completely subjective” by having her “draw imaginary portraits, themes and designs of all sorts” that he suggested to her: “Unfortunately the women at hand were quite ignorant; they did not know how to hold a pencil, and one of them could not even read. Nevertheless, the drawings I obtained seemed much superior to the coarse drawings that these women executed in a waking state.”45 The picture drawn by the patient is not evaluated according to aes­ thetic criteria, but rather according to the exactness with which it reproduces the image stored in memory. The experimenters classify their subjects as “in­ telligent” on the basis of the facility with which the unconsciously drawing hand is able to create a picture. However, such experiments designed to visualize unconscious objects led to another problem: since the sequences of action executed by the sub­ ject—from the initial suggestion to the completed activity—were often quite long and involved, there arose the danger that they would remain incompre­ hensible without a more detailed verbal account by the experimental subject. In contrast to Charcot, who discarded the patients’ verbal accounts in favor

lethargy). Only later did he expand it into the triad of catalepsy, lethargy, and somnambulism that he presented before the Académie des sciences. The third state could not be clearly defined through a signe obligé (such as neuromuscular hyperexcitability). 44. Binet and Féré, Animal Magnetism, p. 143. 45. Binet, “L’hallucination,” p. 483.

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of signs observable on their bodies or of the inscriptions of self-recording instruments attached to them, Binet cautiously introduced a form of interro­ gation to find out what the patient had registered unconsciously: “It is good to know what the subject thinks about her state. However, one should never go too far and take everything that she says literally.”46 The danger of possible simulation was to be ruled out by an approach that combined the question­ ing of subjects with a special trick designed to create an “objective index” for their statements. Binet and Féré claimed that, using suggestion, they could plant a reflex into the subject’s psychical mechanism, which would automati­ cally uncover every lie by “marking” it with a special word: We suggest to G. in somnambulism that every time she is going to tell a lie or make an exaggeration she cannot help but cry out: “Good heavens!” This exclamation will be set off with the fatality of a reflex, and she will not hear it nor perceive it in any way. In this way we create an apparatus that is set to give an alarm signal every time our subject wants to deceive us. . . . To assure ourselves that the apparatus is continuing to function, it is sufficient to give her the suggestion to lie from time to time. For example, we order the som­ nambule, when she awakes, to affirm that she has already eaten, which is false. When she awakes we say to her: “Are you hungry?”—“No, I have already eaten, I assure you that I have already eaten. Oh, good heavens!”47

Fetishistic Object-Relations Not only did the experiments conducted by Binet and Féré aim to material­ ize and localize the hallucinations of the hypnotic subject as objects in space: these strategies for controlling patients’ actions were also an answer to their tendency to make the experimenter himself into an emotionally charged object. In a report to the Paris Sociéte médico-psychologique, Charles Féré described the effect that the experimenting physician exerted after a certain period of time on patients serving as subjects: When hypnotizable hysterics have served as subjects of the same experimenter for several days, they are often left in a state of permanent obsession. They are, as it were, just as possessed when they are awake during the day as they are in their dreams at night. This state of mind is accompanied by spontaneous hallu­ cinations whose form varies, but whose object is always the experimenter. . . . If several subjects in the same condition confide in one another, there can re­ sult a sort of epidemic of hysterical delirium, in which the hallucinations are 46. Binet, “L’intensité des images mentales,” p. 493. 47. Ibid., pp. 494–95.

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followed by compulsive or violent acts. . . . We have experienced the begin­ nings of this sort of persecution, and it has been sufficient to show us that such experiments must be conducted with the greatest prudence.48

Binet also noted that, as a result of hypnosis, subjects sometimes developed an “elective” somnambulism that clearly showed “a sexual attachment to the hypnotist.”49 The Iconographie de la Salpêtrière, which was edited by Bourne­ ville and Régnard, reported on the course taken by several such cases, in which a doctor had become the object of a patient’s sexual fantasies. Initially, the sexual factor, although acknowledged in principle, was perceived as a purely mechanical process independent of the patient’s actual relationship to the doctor. When, in the course of their experiments, the doctors of the Salpêtrière triggered orgasms in their hysterical patients, they were explained away as the result of pressure on specific “erogenous zones”: The aforementioned W. offered such a zone at the level of the upper part of her sternum; simply pressing it provoked an abundant secretion of vaginal fluid. This phenomenon was provoked several times without the observer’s knowledge. Had he not taken the indispensable precaution of never being alone with the subject, he would have found himself exposed to the gravest accusations.50

For the doctors, the erogenous zones simply represented additional entries to be made when mapping the pressure points distributed over the hysteric’s body, which were seen as a means of systematically regulating and control­ ling her symptoms.51 In Binet and Féré’s reconfiguration of the hypnosis experiment, the emo­ tionally charged relationship between experimenter and subject could not be easily ignored. Now the subject is no longer treated as an automaton—ma­ nipulable via reflex mechanisms such as the pressure method or immobiliz­ able through hypnosis for the purpose of investigating individual motoric symptoms—but as a personality that can move freely in space. Her radius of action has been expanded considerably, both with regard to the use of various props and to the temporal horizon of the experimental space. In this new configuration, the subject’s “unconscious reasoning” cannot be related to an observable sequence of actions on a one-to-one basis. Although the

48. Charles Féré, “Les hypnotiques hystériques considérés comme sujets d’expérience en médicine mentale,” Archives de Neurologie 6 (1883): 122–35, pp. 134–35. 49. Binet, “L’intensité des images mentales,” pp. 477–78. 50. Féré, “Les hypnotiques hystériques,” p. 131. 51. See chapter 1, pp. 25–26.

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experimenters continue to maintain that the subject cannot simulate, they admit that she can steer the experiment into unexpected directions by mak­ ing the scientists into emotionally charged unconscious objects. Hence Binet and Féré devise a number of strategies for bringing such unintended develop­ ments under control. In one technique for negating erotic attachment, the hypnotist uses sug­ gestion to give its object an unappealing trait designed to reverse the affect into its opposite: One persuades the hypnotized subject that the assistant has a false nose, green eyes, a hunchback or a distasteful odor. The patient, when she has been awak­ ened and returned to her everyday surroundings, will break out in laughter when she sees him or turn away with horror. She still sees the imaginary de­ formity, and often retains this hallucination for several days.52

Another suggestion causes the experimenter to disappear entirely: One gives the hypnotized subject the suggestion that when she awakens she will not see one of the persons who participated in the experiment. When she awakens, it becomes apparent that the person has become completely invis­ ible to the patient. According to the manner in which the suggestion has been made, the subject can remain in rapport with the person via some other sense, such as hearing or touch, or the suppression is complete and covers all of the senses.53

The “trick” of making the doctor disappear, which in the initial configura­ tion of the Salpêtrière hypnosis experiments was achieved through various material arrangements, has now become simply the object of a suggestion, and thus it has been shifted directly into the relationship between hypnotist and subject. The eroticized forms in which the experimenter takes the posi­ tion of an object are no longer excluded, but rather investigated in several series of experiments. Thus, within the setting of the Musée Charcot, the ex­ periment becomes an increasingly reflexive medium, which makes the doc­ tor/patient relationship itself into the object of investigation. Commensurate with the specific locality of experimentation, this form of reflexivity takes on a special form of object-relation, which must be termed “fetishistic” in precisely the sense that Binet himself adopts in his famous article “Le fé­ tichisme dans l’amour” (1887).54 According to his definition, fetishism entails 52. Binet, “L’hallucination,” p. 487. 53. Binet and Féré, “L’hypnotisme chez les hystériques,” p. 23. 54. As I have argued in an earlier essay, the term “object-relation” should in this context not be understood in its later psychoanalytic conception. Andreas Mayer, “Objektwelten des

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sexual attraction toward an inanimate object (shoelaces, nightcaps, aprons) or a “fraction of a living person” (such as an eye, a hand, a foot, or hair, but also the voice or the smell of the beloved).55 Such “fetishes” play a central role in the various experiments that Binet and Féré conduct at the museum: both the experimenter and the subject are constantly being fractured into vari­ ous components, being made to disappear and reappear, being charged with positive or negative affects. The experimenters develop several techniques of using material objects from the Musée Charcot as a means of stabilizing and diverting the emotions displayed by the patient. For example, they hypnotize Blanche Wittmann and give her the task of caressing or kissing the bust of Franz Josef Gall, which initially has been charged with a negative affect. Jo­ seph Delbœuf describes such an experiment: The hypnotized Alsatian woman received the order that when she awoke she would kiss the painted green bust of Gall . . . and then return to her chair and go back to sleep. She obeyed immediately. She made her rounds of the room as if she wanted to stretch her legs, examining the bones and the instruments exhibited in the display cases, pausing for an instant to lift the veil of a wax figure of an old woman, and taking various objects in her hand and then re­ turning them to their places, until finally she stood before “the green man.” That is how Féré had referred to him. She went on, returned again and took him in her hands. Then she put him back. The show was most amusing. She was clearly engaged in an inner struggle. At last she yielded and kissed the

Unbewußten: Fakten und Fetische in Charcots Museum und Freuds Behandlungspraxis,” in Wissen als Sammeln: Das Sammeln und seine wissenschaftsgeschichtliche Bedeutung, ed. Anke Te Heesen and Emma Spary (Göttingen: Wallstein, 2001), pp. 169–98. Here it primarily relates to the ensemble of practices that was systematically implemented in the hypnosis experiment in order to make plausible theories regarding the unobservable “inner” psychical objects of experimental subjects. With regard to fetishism, I take it to be a new category emergent in these experiments and do not intend to claim that the patients were revealed to be “fetishists” whereas the doctors were not, as Hartmut Böhme implies in his criticism of my work: Hartmut Böhme, Fetischismus und Kultur: Eine andere Theorie der Moderne (Reinbek bei Hamburg: ro­ roro, 2006), pp. 387–88. 55. Alfred Binet, “Le fétichisme dans l’amour,” Revue Philosophique 24 (1887): 143–67, 254– 74, p. 144. Although he considered it to be a predominantly male perversion, it should be noted that Binet also discusses a number of female cases. For a larger historical and conceptual fram­ ing, see the indispensable collection by Emily Apter and William Pietz, eds., Fetishism as Cultural Discourse (Ithaca, NY: Cornell University Press, 1993); and the important work by William Pietz, “The Problem of the Fetish, I,” Res 9 (1985): 5–17; “The Problem of the Fetish, II,” Res 13 (1987): 23–46; “The Problem of the Fetish, IIIa,” Res 16 (1988): 105–24; and Le fétiche: Généalogie d’un problème, trans. Aude Pivin (Paris: Editions de l’Eclat, 2005).

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plaster figure on both cheeks. Thereafter she returned to her chair and went back to sleep.56

This account demonstrates how the subject’s radius of action has been ex­ panded: between receiving and executing the suggestion, Blanche Wittmann is able to engage in a number of intermediary actions not specified therein, which the adherents of the Nancy school would have described in moral terms as being forms of “resistance” against the suggested action. Whereas the chosen suggestion—kissing the “disgusting” bust of Gall—is designed to provide an impressive demonstration of the power of experimental hypno­ tism to the skeptical observer Delbœuf, the actual execution of the suggested act is left up to the subject’s “tactical” intelligence. In the final analysis, how­ ever, the strategies of localization and materialization mobilized by Binet and Féré aim to pinpoint the subject’s tactics in space and trace them back to a determining source.57 According to their theory, every seemingly spontane­ ous movement or remark corresponds to a trace in memory, to a form of “unconscious reasoning,” which could be reconstructed through later inter­ rogation of the subject. The Tactical Intelligence of Subjects Charles Richet, one of the first physicians in Paris to experiment with hyp­ notic phenomena, had defined the “psychical state” of his somnambulant subjects as one of “stillness”: If the psychical state of somnambules is to be captured in a single word, then I would say that it is silence. In place of the babble of thoughts that runs in our heads when we are awake, there is nothing in the somnambule, neither consciousness nor memory. He does not think, he does not have ideas, and it takes a noise from outside to awaken him from the torpor into which he has sunk.58

Initially, the doctors in Paris and Nancy had also defined the state of their hyp­ notized subjects in similar metaphors, as a “complete standstill of thought, 56. Delbœuf, Une visite à la Salpêtrière, p. 37. 57. “Strategies” and “tactics” refer to the use of material and discursive resources that are available to the participants within the framework of the experiment. Here I adopt in modi­ fied form a differentiation that Certeau introduced for the use of everyday objects. Michel de Certeau, The Practice of Everyday Life, ed. Luce Giard, trans. Timothy J. Tomasik (Minneapolis: University of Minnesota Press, [1980] 1998). 58. Charles Richet, “Du somnambulisme provoqué,” Revue philosophique 20 (1880): 337–74, 462–84, p. 481.

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a state of intellectual inactivity or tranquility.”59 Proof of this state of un­ consciousness, which was described as mental immobility, was found in the subject’s complete amnesia concerning the suggestion that had been admin­ istered. The hypnotic subject was equated with a decapitated laboratory ani­ mal. The effect of hypnosis—like that of a poison or anesthetic—was thought to be the paralysis of higher mental functioning (will, consciousness), leading to a complete automation of psychical activity: “The intelligence has become automatic, like the gait or the flight of a decapitated pigeon.”60 In carrying out the actions induced by suggestion in Binet and Féré’s new configuration of the hypnosis experiment, the somnambulist subjects proved the existence of a certain “intelligence,” for which the analogy of the automa­ ton was no longer sufficient: “When care is taken to suggest a somewhat com­ plex act, whose performance necessitates some combination, we may observe that the subject thinks out such combinations although they have not been suggested to him. This inventive process shows that comparing him to an automaton does not explain everything.”61 The patient displayed this intel­ ligence in various tactical forms of movement within the experimental space. In response to these new observations, the experimenters explained all of the unusual or unexpected actions that the hypnotic subject could execute in the course of the experiment as the “manifestation of unconscious memory.”62 The various “objectivizations” and localizations of unconscious phenomena from the subject’s “inner world” via the metaphorical registers of associa­ tionist psychology, as well as the use of various material objects within the experimental space, went hand in hand with strategies for keeping patients’ tactical radius of action under control. The new action script of the hypnosis experiment developing in Binet and Féré’s work at the Salpêtrière clearly dis­ tinguished itself from earlier practices. Here the relationship between doctor and patient underwent a transformation giving rise to new risks—and po­ tentially even a new reversibility—through the introduction of a new form of fetishistic object-relation. Within the Salpêtrière’s culture of hypnotism, this new configuration led to a displacement of the balance of power between experimenter and sub­

59. Beaunis, “L’expérimentation en psychologie,” p. 124. 60. Richet, “Du somnambulisme provoqué,” p. 479. 61. Alfred Binet and Charles Féré, Le magnétisme animal, 4th ed. (Paris: Félix Alcan, [1887] 1890), p. 286. 62. Afred Binet and Charles Féré, “Recherches expérimentales sur la physiologie des mouve­ ments chez les hystériques,” Archives de physiologie normale et pathologique 19, vol. 10, 3d ser. (1887): 320–73, p. 346.

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ject. In the action script that Charcot and his pupils had followed in the first hypnosis experiments, the doctor—acting alternately as experimenter and observer—played a dual role following the model that Bernard had outlined for physiological experimentation. As soon as he had fulfilled the first role by producing a phenomenon through active intervention, he was to disap­ pear into the second role. The new script pushed the old model to its most extreme limits with regard to one of its essential aspects: in causing the ex­ perimenter to disappear—completely and sensu stricto—while allowing him to continue affecting the senses of the subject, it accorded the experimenter himself the role of an object. Within an action script aimed at deciphering the activities of hypnotic subjects as externalizations of impressions fixed in the brain, the subjects were understood as “perfect registering instruments,”63 which stored all of the gestures and details of the experiments. While the experimenters were inducing subjects to externalize the material stored in their brains by playing out scenes, the subjects were already recording the events of the experiment. Thus in questioning a female patient, Binet discovered: She could practically have held a course on paralysis through suggestion. She knows what psychical paralyses are and that they are produced by imagina­ tions; she also knows that they can be produced by a shock to the joints; she knows that the reflexes are heightened, that muscular sensitivity is lost, etc. . . . Finally she knows how a subject is put to sleep and how suggestions are ad­ ministered, so well that one day I could hypnotize her and give her the order to put her friend Cl . . . to sleep and give her certain suggestions.64

Moreover, if the test subject proved to be a perfect registering instrument, which also registered the experimenter in his characteristics and his actions, then she could also take his place. Such a reversibility of roles was not possi­ ble in Charcot’s original action script, because the asymmetrical relationship between experimenting doctor and hysterical patient could not be displaced. The technical devices and instruments used to capture the patient’s activity established a clear distribution of roles. In Charcot’s hypnosis experiments the doctor functioned as an author, as the “the foreman of creation,” who used the “signature” of his subject to “authenticate” his work.65 Analogously to the physiological experiment, a reversal of epistemic subject and registered object was not possible here: the hypnotized hysteric could not conversely

63. Binet and Féré, Le magnétisme animal, p. 192. 64. Binet, “L’intensité des images mentales,” p. 493. 65. See chapter 1, pp. 30–31.

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affect the experimenter or make him into the “object” of an experiment, be­ cause her faculty of raisonnement was categorically denied (as in the case of animals or the insane).66 The first configuration of the hypnosis experiment at the Salpêtrière put this asymmetry of subject and object into practice. It defined a suitable hypnotic subject exclusively on the basis of his or her reflex mechanisms, which could be translated into measurable quantities: a “state of subjugation.” In the course of Binet and Féré’s experiments, the action script was modi­ fied by granting the power of reason to the subject, initially under the as­ sumption that it could be satisfactorily traced to physiological mechanisms (the association of visual “impressions” in the brain). This led to a redistribu­ tion of power in the experimental space. In the new action script, the doc­ tor could still increase his power over the patient by disappearing through suggestion. At the same time, this absence, in which he was always present, made it possible for him to become, in a fetishistic relationship, the object of the “obsession” or the artificially induced love of his subject, from which he had to detach himself with the aid of other techniques. What had initially appeared as an augmentation of the experimenter’s power proved to be a potential trap as well: now the doctor was an object (if not the central object) of the experiment, for whom various material objects could provisionally substitute as placeholders. What had begun as a defense of Charcot’s grand hypnotisme ended with a reversal that gave rise to new problems and questions. The decision of the controversy between the two cultures of hypnotism in favor of the latter had already been long in coming behind the scenes. More interestingly, the ef­ forts of the former to fend off this defeat through the strategic widening of the hypnosis experiment’s radius of action and the introduction of material objects led to internal displacements at the Salpêtrière as well. Here the rela­ tionship between experimenter and subject was transformed in such a way that the tactical intelligence of the latter was in the end able to gain the upper hand.

66. See Claude Bernard’s argument against a displacement of the asymmetry of the epi­ stemic subject and object: “Only man is capable of acquiring experience (expérience) and per­ fecting himself through it. . . . The man who has lost [the power of] reason, who is insane, no longer learns from experience; he no longer reasons experimentally. Thus the experiment (expérience) is the privilege of reason.” Claude Bernard, Introduction à l’étude de la médecine expérimentale (Paris: Flammarion, [1865] 1984), p. 40.

4

The Question of Lay Hypnosis

From the very beginning, the rise of experimental hypnotism in the medical cultures of Paris and Nancy was paralleled by a thriving popular culture of stage magnetists, seers, and somnambulic cabinets. The performances of famous “magnetists” touring throughout Europe, such as Donato and Hansen, created a public that became susceptible to lay explanations of hypnotic phenomena. In many respects, these spectacles posed a challenge to the advocates of scientific hypnotism: in the eyes of the layperson, they did not seem to differ essentially from what could be observed in the clinics or laboratories; thus scientists delving into the field of hypnotism had to be keen to distinguish themselves from the business of showmen. A more serious problem was posed by the question of who was to be considered a reliable witness in giving testimony of such phenomena. Since the hypnotization of subjects drawn from the audiences of popular shows yielded copious case material published in the daily press and in popular novels, it remained difficult to restrict testimony about hypnosis to the clinical space. The most attention has been attracted by those spectacular court cases that multiplied in the late 1880s around the question of “criminal suggestions” or so-called laboratory crimes. These cases raised the question of the extent to which a hypnotized individual could effectively be ordered to commit a crime, either directly under hypnosis or at a later date.

. For the famous Chambige case, see Jacqueline Carroy and Marc Renneville, “Le crime de Chambige (1888): Entre psychologie et literature,” Ritm 38 (2008): 193–208; Ruth Harris, Murders and Madness: Medicine, Law, and Society in the Fin de Siècle (Oxford: Clarendon Press, 1989); and Jean-Roch Laurence and Perry Campbell, Hypnosis, Will, and Memory: A PsychoLegal History (New York: The Guilford Press, 1988). The criminal hypnotist would continue to

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In this chapter, I turn to the question of the rhetorical and practical options that the popular culture presented to those involved in the debates surrounding experimental hypnotism. The Belgian philosopher and mathematician Joseph Delbœuf, who presented himself as a skeptical layman, used the culture of stage magnetism as a vehicle for an epistemological critique of the medical cultures of hypnosis. Among medical experts, however, the performance of hypnotic experiments on stage precipitated a dispute regarding the medical monopoly on the practice of hypnosis. In this controversy Charcot and his adherents pursued the strategy of confining the practice of hypnosis to the clinic, whereby they spoke out for a prohibition of public demonstrations and of lay hypnotists. In their view, the expert could put his knowledge to the best use in closed institutions such as hospitals and prisons, and not in an open, market-driven environment. Bernheim and the Nancy school took a less exclusionary stance, supporting an opening of the clinic and recognizing the successes of popular practitioners and of lay hypnotists like Delbœuf. Its adherents argued against a medical monopoly on hypnosis and advocated its widespread use in psychology and pedagogy. Stage Magnetism and Lay Hypnosis In the 1870s, at the time when Charcot and other French physicians began taking an interest in hypnotism, a flourishing popular culture of “magnetic societies” and “cabinets” existed in the major European cities. A great deal of public attention was drawn by the performances of traveling magnetists, which generally took place in theaters, casinos, and private apartments. In France, after the rejection of animal magnetism by the academic establishment, a popular culture of magnetic demonstrators and healers continued to draw large audiences. The Danish stage magnetist Carl Hansen and the Belgian Donato (Alfred d’Hondt) continued this tradition, but on a much larger scale: in addition to the regional capitals, they toured the European metropolises, leaving a trail of scandals, court cases, and extensive reports in the press.

haunt the imagination of fiction writers and the film industry; see Stefan Andriopolous, Possessed: Hypnotic Crimes, Corporate Fiction, and the Invention of Cinema (Chicago: University of Chicago Press, 2008). . One of the key figures in this respect was the Baron Jules Denis Du Potet de Sennevoy (1796–1881) whose doctrines also inspired the various Parisian mesmeric and magnetic societies founded after 1845. See Carroy, Hypnose, suggestion et psychologie, pp. 48–56.

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The performances of Carl Hansen (1833–1897) closely imitated the ritual of a scientific demonstration. Like many of his predecessors, he appeared onstage as a “professor,” maintaining the bearing of a distinguished man of learning with his tailcoat, glasses, and black beard. The evening began with an introductory lecture on the history of animal magnetism and the functioning of its powers, which was followed by experiments designed to demonstrate the validity of the claims that had been made. For this purpose, the magnetist selected from a group of audience volunteers those individuals who showed themselves to be “receptive.” Hansen tested this receptivity by having the volunteers stare into a piece of glass mounted in black wood, a metal ball, or simply into his eyes, whereby he stroked his hand over each person’s body and made quick movements in front of his or her face. After the “receptive” individuals had been selected through this procedure, they were put into a sleeplike state, in which the magnetist produced muscular rigidity, anesthesia, and various hallucinations. In the demonstrations Hansen vaunted his unlimited power over his subjects: some of them were put into unexpected poses (that of prayer, for instance), while others were made to act out absurd suggestions (such as holding a piece of fabric in their arms as if it were a child). The most spectacular feat was the “human plank,” in which the operator made the subject’s entire body assume a completely rigid posture and then put him across two chairs so that he could step onto him with his full weight (see fig. 11). Hansen’s claim of being in possession of an irresistible magnetic power contributed to the revival of the debate surrounding the existence of a mesmeric fluid. Proof of his extraordinary abilities was not only provided firsthand by the spectacular demonstrations before the eyes of his audiences, but also by his subjects’ subsequent testimonials in the press. Here the accounts of subjective experiences given by people with no special qualification were treated as certifications of the magnetist’s special power. An accountant whom Hansen had publicly hypnotized in Leipzig, for instance, described

. According to numerous newspaper reports of Hansen’s tour through Germany, the performances always followed the action script outlined below. The shows of the Belgian magnetist Donato, who appeared predominantly in the French-speaking countries, followed a similar script. See Georges Gilles de la Tourette, L’hypnotisme et les états analogues au point de vue médico-légal (Paris: Plon / Nourrit, 1887), pp. 440–50; for a contemporary documentation on Hansen’s tours, see Friedrich Zöllner, Die transcendentale Physik und die sogenannte Philosophie: Eine deutsche Antwort auf eine “sogenannte wissenschaftliche Frage” (Leipzig: Staackmann, 1879).

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f i g u r e 1 1 . Presentation of the Danish stage magnetist Carl Hansen, which features some of his most notorious and disputed feats, such as the “human plank.” From Zöllner, Die transcendentale Physik.

to the press how he had fallen under the “spell of magnetism.” The magnetic demonstrator had exploited the man’s “receptivity”: [He fixed] my gaze in his large eyes, aglow as if with an uncanny fire, and then [took] both of my hands in his, holding the thumbs tightly. The impression made upon me by this man and his strongly protruding eyes, with their wide open pupils, was astonishingly powerful and irresistibly captivating. Involuntarily, I found myself taken prisoner by a special power. It actually seemed as if a magnetic adhesive were flowing from his widely opened eyes.

The subjects described their feelings of powerlessness toward the magnetist, attributing to him the special abilities that he claimed to possess, and thus confirming the existence of a special magnetic force. Despite the effectiveness of these reports, Hansen also took an active role in obtaining optimal press coverage, appearing unannounced in newspaper offices and staging impromptu demonstrations for the purpose of convincing journalists who had expressed doubts. On one such occasion, Hansen claimed to have brought under his spell the editorial staff of the Dresdner Nachrichten, whose mem-

. Leipziger Nachrichten, 6 April 1879, quoted in Zöllner, Die transcendentale Physik, pp. 424–25.

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bers then testified in an extensive article how they had “far beyond any doubt felt the power of the undefinable fluid.” The spectacular incidents arising from such public demonstration of states of trance were negotiated in a public arena where medical experts staked their claim to a position of authority over “laymen.” For a large part of the professional world, Charcot and his school had transferred the spectacle from the stage to the laboratory, successfully using the technological resources of modern science in divesting the phenomena of any “miraculous” traits and describing them in objective clinical terms. The same ontological interest in unconscious phenomena also caused a number of scientists in Germany (among them Fechner, Wundt, Möbius, and Heidenhain) to reproduce and test the experiments of the stage magnetists. Enter the Critic: Joseph Delbœuf There were skeptical observers who took the practices of the stage magnetists as a point of departure for an epistemological critique of the medical cultures of hypnotism. In his first major study, which was published in the Revue philosophique, the Belgian philosopher and mathematician Joseph Delbœuf discussed Donato’s shows within the framework of his comparison of the experiments he had observed at the Salpêtrière and in Nancy. In addition to attending Donato’s performances in Liège, Delbœuf also closely studied the way in which the showman recruited and maintained his clientele. In contrast to Hansen, Donato did not test the receptivity of his subjects on stage, but in private seances. Thus he formed his own “school” in each city that he visited, developing a “sort of free masonry,” in which a specific type of subject was trained. Delbœuf, who had visited both the Salpêtrière and Bernheim’s clinic

. Dresdner Nachrichten, 22 April 1879, quoted in Zöllner, Die transcendentale Physik, p. 433. . For an overview of the reactions to Hansen’s Germany tour in medical circles, see Gauld, History of Hypnotism, pp. 302–4. . At the time of the controversy surrounding hypnotism, Delbœuf, who had been educated as a mathematician, physicist, and philosopher, held a chair at the University of Liège. For a more recent reception of Delbœuf, see François Duyckaerts, Joseph Delbœuf, philosophe et magnetiseur (Le Plessis-Robinson: Synthélabo, 1993); and Jacqueline Carroy and Pierre-Henri Castel, eds., Delbœuf et Bernheim: Entre hypnose et suggestion (Paris: Université X-Nanterre, 1997). See also the new edition in French of his selected writings, Joseph Delbœuf, Le sommeil et les rêves et autres textes, ed. Jacqueline Carroy and François Duyckaerts (Paris: Fayard, 1993). . Joseph Delbœuf, “De l’influence de l’éducation et de l’imitation dans le somnambulisme provoqué,” Revue philosophique 22 (1886): 146–71, p. 159.

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in Nancy as a participating observer at the height of the controversy, treated the popular culture of magnetism and the medical culture of hypnotism as varying manifestations of a single social phenomena, which obeyed the same basic mechanism. According to his theory, the experimenters were inspired by their initial results, and had become fixated upon continuing to obtain such results, believing them to be essential and characteristic. The subjects, who were thus influenced and almost guided, served in turn as models for the newcomers, who saw them and heard them speaking. Thus a latent training process had developed according to the different traditions of each milieu, giving rise to the various schools which today are in conflict.

In contrast to Bernheim, Delbœuf was not just proposing a different explanation for hypnotic suggestion: he also made the evolution of these specific cultures of hypnotism into the object of his experimentation. Not content to merely formulate his own relativistic theory of psychological knowledge, he turned to an active approach in which he sought to transfer the observations he had made in various locations to a metalaboratory designed to produce empirical material for his critique. The site of Delbœuf ’s experiments was his own home in Liège, where he endeavored to reproduce the phenomena he had observed in Nancy and Paris using a variety of subjects. Among those recruited by Delbœuf for this purpose were his servants, patients that physician friends put at his disposal, and persons who had been used by the magnetic demonstrator Donato for his shows. The experiments were not reserved for a private circle: Delbœuf also presented them publicly at his university philosophy lectures, where his students served as witnesses.10 However, on account of the insufficient resources at his disposal, the scholar was unable to maintain the claim that he was subjecting the facts produced in the clinical cultures of hypnosis to a rigorous test. Delbœuf could not verify the “obligatory” physiological signs essential to the Salpêtrière school’s definition of a suitable hypnotic subject, because he had neither its instruments nor its patient population. And yet his aim was of a fundamentally different nature. The skeptic conceived his metalaboratory as a space in which he could restage the social configurations of the various cultures of hypnosis without having recourse to their material equipment. Behind this endeavor was the epistemic strategy of depathologizing the hypnosis experiment. From the very beginning, Delbœuf took an active stance in presenting himself as a layman acting out of both scientific and humanitarian interest. His published

. Ibid., p. 160. 10. Ibid., pp. 165–66.

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accounts made use of a descriptive language that did not privilege medical vocabulary.11 In his report on the experiments in which he participated at the Musée Charcot in winter 1885, Delbœuf characterized the patients presented to him both as virtuosic actors and as “puppets,” “automatons,” “mannequins,” and “laboratory frogs,” as covetable “meat for experimentation” and “laboratory specimen.” In order to put an end to the epistemic uncertainty triggered by the oscillation of the object, Delbœuf aligned himself with Bern­ heim’s critique that the experiments were producing “phenomena of autosuggestion, or rather of suggestion unknown to both sides, whereby the experimenter is just as much deceived as the subject.”12 However, Delbœuf went further than Bernheim, systematically demonstrating in Liège that by using psychical suggestion alone he could train an inexperienced hypnotic subject into one who was on par with the patients he had observed at the Salpêtrière. In the course of his demonstration, which required only two sessions, he translated the objective symptomatology of grand hypnotisme into the register of stage magnetism, coming to the conclusion that “somnambules are excellent actors, who enter fully into the spirit of their role. Nevertheless, even in this respect, a certain education seems indispensable to me. It is often necessary to guide them, to train them.”13 In his view, the specific “education” of the subject in hypnosis experimentation was a phenomenon that preceded any and every clinical description. In his role as a participant observer, then, Delbœuf developed a quasiethnographic perspective on the clinic, understanding it as a kind of theater. Sometimes he also intervened in order to change the course of an experiment. He modified, for instance, the action script of an experiment that Binet and Féré had demonstrated to him at the Musée Charcot, seeking to disprove the subject’s purported amnesia for all actions suggested to her under hypnosis.14 In this experiment Blanche Wittmann was caused to steal an object (the experimenter’s cap), describe its qualities, and put it in her pocket. After being returned to a waking state, she was questioned regarding each of her individual actions, whereupon she responded that she could remember none of them. In demanding a repetition of the experiment, Delbœuf retained the 11. Delbœuf, Une visite à la Salpêtrière, p. 49. The vehicles of publication selected by Delbœuf also evidenced this strategy: in addition to the Revue philosophique, he also published in nonscientific liberal magazines like the Journal de Liège or had pamphlets printed at his own cost. See the unpublished letter from Delbœuf to Forel, Ramet/Liège, 1 October 1889, Museum of the History of Medicine, University of Zurich. 12. Delbœuf, Une visite à la Salpêtrière, p. 26. 13. Delbœuf, Le magnetisme animal, pp. 19–20. 14. Delbœuf, Une visite à la Salpêtrière, pp. 39–41.

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basic script but changed the props in use and the point in time at which the subject was awakened from the hypnotic state. Additionally, the experimenter suggested to the hypnotized patient that she was smoking a cigar and that its burning ash had fallen on her scarf. She was then given the command to extinguish the fire in a pitcher of water. Just as she was plunging the scarf into the pitcher, he awakened her from the hypnotic state. When questioned, the patient assumed on account of the disorderly arrangement of the props and the “incomplete” execution of the action that she had been dreaming, whereupon she remembered the entire scene. Delbœuf cited her statement as evidence supporting his theory that suggestions administered to hypnotized subjects must already be prefigured in their dreams as normal psychological phenomena: “For every hypnotized person, the key to the suggestions he is capable of receiving is furnished to us by his dreams. That is to say, one can obtain from him those acts which as result of his character, his education and his habits present themselves spontaneously during his sleep.”15 For Delbœuf, this analogy between hypnotic hallucinations and dreams or waking fantasies legitimized a practice of experimental psychology that—unlike that of the Salpêtrière—did not consider pathologically disposed patients to be privileged research instruments. The self-observation of “normalpsychological” manifestations such as dreams thus appeared as a method of equal validity.16 Although Delbœuf initially sympathized with the Nancy school, his observations eventually led him to formulate a divergent explanation of hypnotic phenomena. He described the interaction between hypnotist and hypnotized subject neither as a physiological laboratory experiment nor in terms of a power struggle. What occurs in hypnosis is a special sort of “theater”: a process involving mutual “sympathy,” in which experimenter and subject share a form of communication and collaboration of which they both have no knowledge.17 Delbœuf explained, for example, a Salpêtrière experiment using suggestion to prohibit the subject from speaking neither as a mechanical process affecting a certain region of the brain nor as the effect of the doc15. Delbœuf, Le magnetisme animal, p. 112. 16. See Joseph Delbœuf, Le sommeil et les rêves; “Une hallucination à l’état normal et conscient,” Revue philosophique 20 (1885): 513–14. This analogy was subsequently adopted by the doctors who endorsed Bernheim’s methods as a means of redefining the status of a suitable experimental subject (see chapter 7). 17. Joseph Delbœuf, “Einige psychologische Betrachtungen über den Hypnotismus gelegent­ lich eines durch Suggestion geheilten Falles von Mordmanie,” Zeitschrift für Hypnotismus 1 (1892): 43–48, 84–90, p. 90.

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tor’s will on the patient’s power of imagination: “It is not simulation, but it is something approaching it. On the part of the subject, there is an excess of complaisance: he could speak, but he commits himself to remain silent.”18 Through this description of the processes at work in hypnosis experiments, Delbœuf detached their problematic epistemology from the doctor’s perspective. Hence it was not the breaking of the patient’s “resistance” that posed the major difficulty, but rather the way in which the patient appeased the experimenter by producing all of the phenomena he wished to see. The experimental subjects were deceiving the doctors where they least expected it: in the manifestation of symptoms supporting medical theories or classifications. The subjects ask themselves what is wanted of them, guessing and venturing it. The experimenter obtains what he expects, or he must only imagine that the phenomenon has a physical significance conforming with a law of physics. As long as he does not mistrust himself, he will unknowingly guide his subjects along the path he would like to see them take. Thus a play is acted out in which persons of very good faith deceive one another.19

In order to support the plausibility of this theory, Delbœuf frequently took recourse to rhetorical figures culled from the earlier literature of animal magnetism. He assumed that the Salpêtrière doctors were, like the magnetists, so captivated by their feeling of power over their patients that they fell victim to a sort of initial deception, which perpetuated itself in an endless chain of imitations. In his experiments in Liège, the skeptical philosopher put himself in the position of the hypnotizing doctor so as to introspectively describe the latter’s feelings upon experiencing his first successes: “I had made a somnambule. At this thought—one must pardon this trivial detail—I experienced an indescribable emotion. It was with a sort of religious reverence that I suggested to her visual and aural hallucinations, and with which I noted her impressions.”20 According to Delbœuf, a sympathetic emotional bond rooted in mutual deception is the key factor in the success of hypnosis. On the one hand, the 18. Delbœuf, Une visite à la Salpêtrière, p. 31. 19. Delbœuf, Le magnetisme animal, p. 22. 20. Delbœuf, “De l’influence de l’éducation,” p. 150. This form of récit de conversion, in which the magnetist recounts being convinced of the reality of the phenomenon at the point in time when he first “made a somnambule” has been identified by Jacqueline Carroy in the treatises on animal magnetism of the early nineteenth century (Hypnose, suggestion et psychologie, pp. 37–39).

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patient attributes a power to the hypnotist that he does not possess. The belief in the hypnotist’s power is nothing more than a “therapeutic aid”21 promoting the patient’s own self-healing. On the other hand, the doctor erroneously attributes the power he exercises to the procedure by which the patient is put into a hypnotic state, or at least by which his critical faculties are diminished and his suggestibility heightened. In truth, the active party in hypnosis is the patient or his “willpower,” to which the therapist appeals, regardless of whether he is a physician or a “charlatan”: All hypnotic manifestations owe their existence exclusively to the person being treated. . . . The hypnotist’s entire effect rests in the patient’s conviction that he has such influence. Fundamentally, every hypnotist deserves to be considered that which certain scientific circles have recently become fond of referring to Donato and Hansen as, believing that one has thus denigrated their art and established one’s own superiority.22

The asymmetry between the hypnotist and the hypnotized person—essential to the medical cultures of hypnosis—does not exist in Delbœuf ’s skeptical account. While the French doctors’ experimental practice sought to demonstrate physiological determinism on their hypnotized subjects, the Belgian scholar accorded the latter a much broader scope of action. Not only can patients resist suggestions by developing their own autosuggestions: they can also hypnotize the doctor. It is possible that the doctor only believes that he is the one giving the suggestions, although in truth he is only commanding that which the subject already expects. Within the symbiotic relationship between hypnotist and subject, it is no longer possible to clearly define who acts and who is acted upon. In the end, the multiplicity of methods and of material and social arrangements amounts to a form of communication having the appearance of a monologue. And yet no self is articulated in this therapeutic communication, but rather a form of sympathy that withdraws from any and every epistemological interpretation: When I am with a sick person, I am seized by a keen pity for his illness; when he suffers I share his pains, and when he weeps it moves me to tears. Thus there is a common bond between him and me. Is it not in the end this “sympathy” that causes me, in that I speak to him, to in a certain sense be speaking to myself, and vice versa? Does it not also cause him, in that he hears my words, to believe that he is hearing himself speaking?! Is not this sympathy the secret

21. Delbœuf, “Einige psychologische Betrachtungen,” p. 48. 22. Ibid., p. 45.

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of those who successfully give solace for such suffering, which is the same as their own? . . . If this way of seeing is correct, does it not then follow that, in a certain sense, it is the patient who hypnotizes the hypnotist?23

Thus Delbœuf ’s experiments led him to the radically skeptical conclusion that every hypnotic process can be explained as a form of “unconscious training,” whose processes cannot become transparent to either experimenter or subject in the experimental situation. Accordingly, it is impossible to achieve knowledge of the unconscious on this path (i.e., a stabilization of the unconscious in the form of objects or of observable “states”). The psychological metalaboratory in Liège was conceived not only as a control instrument for the various cultures of hypnotism, but also as a test track for developing a more humane form of treatment for mental suffering. Taking various restagings of the experiments conducted in Paris and Nancy as his point of departure, Delbœuf established not only an epistemological critique, but also a therapeutic position that disputed the doctor’s monopoly on the power to heal mental disturbances. The philosopher legitimized his own practice as a lay hypnotist by making the success of the treatment exclusively dependent on the activity of the patient. Delbœuf ’s publications were not aimed at founding a new school in opposition to the existing ones, but at reorganizing the attitudes of laypersons toward hypnotic phenomena: the layperson, who could only attribute the healing qualities of hypnosis to the power of the hypnotist, was to be made to recognize that he or she was in possession of its curative potential.24 Challenging the Medical Monopoly on Hypnosis At the very same time, the adherents of the Salpêtrière school, who defined hypnosis as an artificially produced pathological state, were speaking out for a prohibition of the lay practice of hypnosis and of the public shows of stage magnetists. They branded such shows, in contrast to the semipublic seances of somnambulic cabinets and spiritist societies, as the “most dangerous exploitation of magnetism from the point of view of public health.”25 In

23. Ibid., p. 90. 24. Delbœuf ’s position can be seen in the context of the historical development of an “alternative” medicine in opposition to scientific or “orthodox” medicine. On this historical development, see Robert Jütte, Geschichte der alternativen Medizin: Von der Volksmedizin zu den unkonventionellen Therapien von heute (Munich: Beck, 1996); and James Whorton, Nature Cures : The History of Alternative Medicine in America (Oxford: Oxford University Press, 2002). 25. Gilles de la Tourette, L’hypnotisme et les états analogues, p. 440.

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violently unleashing pathological states in persons of labile disposition, the itinerant demonstrators were accused of spreading a “fever,” a “delirium,” a collective “poisoning.” Thus the doctors, who were called upon to testify as expert witnesses in a number of cases, translated the public demonstrations directly into the clinical situation, where they alone possessed the power of definition. Gilles de la Tourette, one of the most zealous defenders of the Salpêtrière school’s position, denounced Hansen’s practice by pointing to his selection criteria in his search for suitable subjects: “His practiced eye chooses among the unfortunate youths of pale complexion, the anemics, the neuropaths, to put it bluntly. He makes them run in a circle, driving them on with his gestures and words until their stamina is at an end. Then he stops, turning their heads brusquely and suddenly fixing and hypnotizing them. That is Hansen’s ‘coup.’ ”26 The strategies implemented at Charcot’s hypnosis laboratory presented themselves to a community of doctors who could not deny the facticity of the phenomena in question, but who nevertheless sought to weaken the interest mobilized in public space. Charcot and his pupils had transferred the “wondrous” and “mysterious phenomena” of the magnetic experiments into an action script where it was not the hypnotist’s special qualities (i.e., the magnetic fluid emanating from his hands or eyes or his “will”) that produced the facts, but rather an impersonal machinery, which affected the subject’s nervous system on a purely mechanical basis. In this assimilation of magnetism into the hypnosis laboratory, its manifestations were traced to physiological laws, in other words, to the pathological conditions of the patients who functioned as subjects. Their statements regarding what they had experienced while under hypnosis were for the most part irrelevant in establishing clinical facts. The truth of experimental hypnosis rested solely upon the observation of bodies, which were manipulable analogously to animals in physiological experiments, and upon the establishment of clearly visible indicators. In view of the events accompanying the public hypnosis shows, Charcot wrote an article in 1887 not only calling for their prohibition, but also formulating a clearly staked claim to a medical monopoly on the practice of hypnotism for experimental or therapeutic purposes: In the name of science and art, medicine has in recent times finally taken definitive possession of hypnotism. It is justified in doing so, because medicine alone knows how to apply hypnotism in a proper and appropriate manner, be it for treating illness, be it for conducting physiological and psychological

26. Ibid., p. 442.

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research. In the domain recently conquered, medicine shall reign from now on as an absolute sovereign jealous of her rights, repelling formally any and every intrusion.27

To illustrate the dangers of using hypnosis outside the clinic, Charcot recounted a number of relevant cases in his lectures before foreign guests.28 This claim to a medical monopoly on hypnosis was a subject of fierce controversy at the first Congrès international de l’hypnotisme expérimental et thérapeutique, which was held in Paris in 1889. In the very first session, Paul-Louis Ladame, an adherent of Charcot, read a report on the “necessity of prohibiting public demonstrations of hypnotism.”29 As evidence of the danger posed by the traveling magnetists, he cited the “hypnotic insanity” to which a number of school pupils had fallen victim after one of Donato’s demonstrations in Switzerland. He also recounted how students who had attended one of his own lectures on hypnotism had suddenly fallen into a somnambulic state a year later. In Ladame’s report, the hypnotized layperson appeared, analogously to the subject’s passive role in the Salpêtrière hypnosis experiments, exclusively as a victim, who had to be liberated from the magnetist’s manipulating grasp: The hypnotized person is surrendered as a spectacle to a crowd vibrating with unhealthy emotions, turned into an object of public ridicule, brutally fascinating and hallucinating the wildest insanity; he is driven to execute the grotesque or criminal suggestions ordered by the magnetizer, at the risk of compromising his mental and physical health. In public demonstrations the hypnotic subject is most definitely a victim.30

Ladame also used this opportunity to attack bothersome critics such as Delbœuf for their use of hypnotic techniques. The latter soon mounted a counterattack, demanding the right to use hypnotism “as a powerful instrument 27. Jean-Martin Charcot, “Des dangers des représentations publiques des magnétiseurs; nécessité de leur interdiction,” OC 9:479–80; p. 480. 28. See the report of the German neurologist Max Nonne, who visited the Salpêtrière at this time: “In Charcot’s clinic I saw only cases that had already been confined to the ward for years, whereby it must be mentioned that in a leçon he urgently warned of the ‘dangers of hypnotism,’ recounting several relevant cases. It is said that Charcot does not hypnotize his private patients, and in his lectures he recommended that one should only hypnotize in a hospital.” Max Nonne to Auguste Forel, Hamburg, 13 February 1889, quoted in Auguste Forel, Briefe—Correspondance 1864–1927, ed. Hans H. Walser (Bern: Hans Huber, 1968), p. 218. 29. Ladame in Edgar Bérillon, ed., Premier Congrès international de l’hypnotisme expérimental et thérapeutique: Tenu à l’Hôtel-Dieu de Paris, du 8 au 12 Août 1889. Comptes rendus (Paris: Doin, 1889), pp. 28–30. 30. Ibid., p. 30.

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of psychological analysis.”31 Delbœuf threw back at Charcot’s adherents the accusation that they had aimed at lay hypnotists, stating that they were the ones who were shamelessly exploiting their patients. Behind their claim to a “moral monopoly” he suspected nothing more than their own pecuniary interest. Denigrated to the same level as the “charlatans,” Delbœuf took the offensive, declaring himself their representative, while reproaching the doctors who spoke out for a medical monopoly on hypnosis for their ingratitude toward the tradition of animal magnetism, which they had inherited. In Delbœuf ’s appeal, it was the magnetic demonstrators who were the actual inventors of hypnotism, and their art had been exploited by the Salpêtrière school.32 Taking as a point of departure his counterdemonstrations, which were designed to prove that hypnotic phenomena were theater effects, the scholar annulled the differentiation between prescientific magnetism and scientific-medical hypnotism, whose facts could only be produced in the clinical laboratory. Thus Delbœuf even rejected the term “hypnotism” as a deceptive mislabeling, calling for the reintroduction of the earlier term “animal magnetism.”33 The Nancy group supported Delbœuf in this controversy, although its members pursued a different strategy with regard to the stage shows. Instead of strictly distancing themselves from lay practices, as Charcot and his followers did, they called for a comprehensive appropriation of lay practices by the clinic. This alliance with the protagonists of extraclinical cultures of hypnosis aimed at transferring their methods into the clinical space, and developing them there as a “rational” form of “psychical treatment.” Here Bern­ heim and his adherents in the German-speaking world played a special role by developing various strategies for factoring out the epistemological problems so as to bind hypnotic phenomena exclusively to the psychiatric clinic or the private practice. These physicians were ontologically interested in the treatment of pathological symptoms and in a new experimentalization of the unconscious. In terms of the politics of their profession, they were interested in heightening medical authority through the assimilation of extraclinical resources. Freud, in a handbook article on “Psychical Treatment,” summarized these interests in the following manner: Hypnosis endows the physician with an authority such as was probably never possessed by the priest or the miracle man, since it concentrates the subject’s whole interest upon the figure of the physician; it does away with the auto31. Delbœuf in Bérillon, Premier Congrès international, p. 49. 32. Ibid., pp. 55–56. 33. Delbœuf, “Einige psychologische Betrachtungen,” p. 44.

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cratic power of the patient’s mind which . . . interferes so capriciously with the influence of the mind over the body; it automatically produces an increase of the mind’s control over the body . . . ; and, owing to the possibility of arranging that the instructions given to the patient during hypnosis shall only become manifest subsequently, in his normal state—owing, that is, to posthypnotic suggestion—hypnosis enables the physician to use the great power he wields during hypnosis in order to bring about changes in the patient in his waking condition.34

The most radical implementation of such a model of social authority was carried out at the Zurich clinic Burghölzli by the psychiatrist and brain researcher Auguste Forel. Soon to occupy a strategic position in the network of Nancy school adherents throughout Europe, he went far beyond Bernheim’s demonstration of the hypnotist’s competence: Forel claimed to have put the clinic’s entire staff under his control by means of suggestion.35 In view of such interests, which manifested themselves in the creation of new sites of medical research, Delbœuf ’s epistemological critique of hypnotism remained an isolated position of marginal influence. The reception of the French research took place in local medical cultures, as will be shown in the next chapters, primarily through doctors who had no doubts regarding the possibility of acquiring positive knowledge of the unconscious, and of using it as the basis for developing new methods of psychical treatment.

34. Sigmund Freud, “Psychical (or Mental) Treatment,” SE 7:283–302, p. 298. 35. See Auguste Forel, Rückblick auf mein Leben (Zurich: Europa, 1935), pp. 132–34.

part two

The Emergence of the Psychoanalytic Setting

5

Paris–Vienna: A Problematic Transfer

The reception of French hypnosis research proceeded along widely diverging paths in various national and local cultures. It cannot be described as a linear process of diffusion from one or two centers, as it was by most of the adherents of Charcot’s and Bernheim’s approaches. In seeking to obtain widespread acceptance of the facts of experimental hypnotism, Charcot’s followers faced a major obstacle: they only existed in their pure form in a small number of clinical cases at the Salpêtrière. Doctors who wanted to replicate the experiments either had to have equivalent subjects and instrumentation at their disposal, or they had to travel to Paris. Although the rhetorical alternative offered by Bernheim did not link the success of its suggestion techniques to a specific symptomatology, his methods were also tied to the local conditions of the Nancy clinic. In both cultures of hypnotism, the local setting and its social configuration played a central role in the production of clinical facts. Thus the transfer and adaptation of each method posed specific demands that encountered corresponding barriers and resistances in other medical cultures. The following chapters expound the problems encountered by the “translators” of French hypnotism in the German-speaking countries. In the medical culture of Vienna, which is the focus of the next two chapters, the research conducted in Paris and Nancy met with much resistance, and as a consequence it was only embraced by a few psychiatrists and neurologists. Parallel to the opposition between the adherents of Charcot and Bernheim, . The following does not seek to provide a comprehensive account of the German-speaking reception of French hypnotism. The abundance and diversity of the literature is demonstrated by Max Dessoir, Bibliographie des modernen Hypnotismus (Berlin: Carl Duncker, 1888).

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further controversies arose in Austria, Germany, and Switzerland around the medical use of hypnosis. Physicians disagreed strongly about the risks posed to medical authority by practices widely associated with the shows of stage magnetists. They faced the dilemma of whether to reject the performers’ tricks outright as unscientific and morally dangerous—thereby drawing a clear boundary between scientific medicine and quackery—or appropriate these practices for experimental testing and potential therapeutic application. Translation Problems For a long time, the Viennese medical establishment was opposed to the therapeutic or experimental use of hypnosis. Historically this rejection of hypnosis had been prepared by the reaction to the practices of Mesmer and the magnetists in the first half of the nineteenth century. Following protracted discussions in scientific societies and the final discrediting of animal magnetism as “charlatanry” in the 1840s, endeavors involving similar phenomena were banned to the fringes of the medical culture. The few hypnosis experiments that were conducted took place in the context of experimental physiology, either in the laboratory or in the suitably furnished rooms of doctors’ private apartments. Experimenting on animal bodies was the preferred practice, since this strategy offered two major advantages: every form of willful simulation could be ruled out, and the experimenter was unconstrained in the use of vivisectional interventions. Experiments involving humans, when not conducted in the laboratory using colleagues as subjects, were at most carried out in doctors’ private offices. Experimentation on patients in the clinic was considered a risky undertaking, and it was only possible with the approval of a head physician. In contrast to France, where clearly defined medical cultures developed in individual clinics, hypnosis in Austria remained the province of a few outsiders, who took varying approaches in assimilating the research of Paris and Nancy.

. See Gereon Wolters, ed., Franz Anton Mesmer und der Mesmerismus: Wissenschaft, Scharlatanerie, Poesie (Konstanz: Universitätsverlag Konstanz, 1988). For the French reception in the context of the Enlightenment, see Robert Darnton, Mesmerism and the End of the Enlightenment in France (Cambridge, MA: Harvard University Press, 1968); for Britain, see Winter, Mesmerized. . Czermak, “Über ‘hypnotische’ Zustände bei Thieren”; Preyer, “Das ‘Magnetisiren’ der Menschen und Thiere.” . See Moriz Benedikt, Elektrotherapie (Vienna: Tendler, 1868), p. 417.

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This atmosphere of relative disinterest was enlivened by an event that attracted widespread public attention in Vienna: when the Danish magnetizer Carl Hansen gave several performances at Vienna’s Ring Theater during his 1880 European tour, a number of medical experts felt obliged to take a critical stance toward the phenomena presented. Those Viennese doctors who had been convinced of the reality of hypnotic phenomena through their own isolated experiments on patients or animals saw Charcot’s experiments as a rhetorical resource for translating “popular” notions regarding the magnetist’s powers into the language of physiology. They adopted the same strategy as Gilles de la Tourette and other exponents of the Salpêtrière school, describing the stage shows as hypnosis experiments avant la lettre, but declaring that they should only be conducted by medical experts. The neuropathologist Moriz Rosenthal, for instance, gave an explanation of catalepsy combining Charcot’s findings on increased muscular reflex excitability with earlier hypotheses on the alteration of cerebral circulation and nutrition. As proof of this theory, he cited the paleness characteristic of cerebral anemia, which his patients displayed in the hypnotic state. Hence Rosenthal explained Hansen’s success through his careful selection of hypnotic subjects: “Fragile, rather anemic, slightly hysterical females, and male individuals just out of their pubescent years or of inherited nervousness” provided “favorable mediums for the magnetic demonstrations.” A similar line of argumentation was pursued by Moriz Benedikt, head of the department of electrotherapy and neuropathology at the Vienna General Policlinic, who had repeatedly traveled to the Salpêtrière to participate in hypnotic demonstrations. He was unwilling to let cataleptic manifestations be explained away as products of the imagination or the “will” to simulate— a recurring argument against hypnotism ever since the Paris Académie des sciences had rejected Mesmer’s hypothesis of a fluidum acting as physical cause. In countering this argument, he insisted that the imagination and the will were entirely made up of “psychotoxic stimuli, which stimulate or exhaust various brain centers” and could thus be studied according to the “laws of stimulus and response.” Benedikt was one of those outsiders who benefited from the tolerance of Johann von Oppolzer, who had allowed him

. Moriz Rosenthal, “Der sogenannte thierische Magnetismus im Lichte moderner Wissenschaft betrachtet,” Wiener Medizinische Blätter 3, no. 7 (1880): 153–55, p. 155. . For a historical analysis of this key trial, see the excellent essay by Simon Schaffer, “Self Evidence,” Critical Inquiry 18 (1992): 327–62, esp. pp. 349–58. . Moriz Benedikt, “Über Katalepsie und Mesmerismus,” Wiener Medizinische Blätter no. 10 (1880): 250–52, p. 251.

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to experiment on several “nervous women” from his ward at the Vienna General Hospital in the 1860s. It was actually a few years before the start of Charcot’s hypnosis experimentation that Benedikt had put these patients into cataleptic states and published his findings in the book Elektrotherapie. In a lecture before the Society of Physicians during the “Hansen fever,” he emphasized the necessity of demystifying cataleptic phenomena through care­ ful experimental investigation. In addition to citing the analogy to the loco­ motor system of animals, Benedikt, speaking in the third person about himself, also outlined the mental automatisms underlying hallucinations in the hypnotic state: He also made repeated reference to the fact that cataleptic subjects reproduce completely long sequences of auditory impressions from conversations experienced passively years ago, with his explanation being that under favorable conditions they exceed the stimulus threshold and are transmitted to the articulation centers below or without the intervention of consciousness. Likewise, he stated that the brain is a photographic plate that registers all visual impressions, and that upon it under favorable conditions all details in natural illumination and color can later enter into consciousness, with the same being true of all other sensory perceptions. This brightness of memory is frequent among cataleptics, with it being projected outward according to a physiological law and having full actuality for the patient.10

For the most part, such discussions among medical experts occasioned by Hansen’s demonstrations had negative ramifications for the wider clinical reception of hypnosis. After the police had intervened at one of the performances, the Lower Austrian Provincial Board of Health commissioned the university medical faculty to submit a report stating whether several of Hansen’s demonstrations (especially the feat of the “human plank”) endangered the health of his volunteer subjects. The commission, whose members included both decided opponents of hypnotism—like the psychiatrist Theodor Meynert—and moderate supporters like Rosenthal, Benedikt, and Heinrich Obersteiner, answered the board of health’s query in the affirmative. This led to a prohibition of Hansen’s shows. In the wake of the ban, the reception of French hypnosis research was slow and scattered. Moritz Rosenthal experimented with several of his colleagues on a small number of female patients diagnosed as hysterics, some . A brief professional biography of Benedikt is found in Erna Lesky, Die Wiener medizinische Schule im 19. Jahrhundert (Graz: Böhlau, 1965), pp. 390–93. . Benedikt, Elektrotherapie, p. 417. 10. Benedikt, “Über Katalepsie und Mesmerismus,” p. 250.

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of them from his private practice, some of them from the Vienna General Hospital. In an effort to verify the existence of the hypnotic states produced at the Salpêtrière, he reproduced several variations of the Parisian experiments with transfert, which he also demonstrated in his lectures. The women, who displayed various “psychical symptoms” (such as memory disturbances, intermittent loss of consciousness, headaches, and dizziness), were hypnotized alternately by eye closure or by fixation using a polished piece of glass in combination with the inhalation of chemical substances.11 The alternating use of these two methods was designed to support the theory that the symptoms derived from blood vessel constriction in the brain and the resulting cerebral anemia. Rosenthal and his colleagues noted that many anemic patients experienced a sudden return of memory after having inhaled a small dose of amyl nitrate. Similar findings produced by parallel experiments on animals led them to assume that the substance caused a widening of the arteries and a relaxation of vascular contractions in the brain. It was also possible to provoke the phenomena of transfert in this manner.12 Thus the Viennese neuropathologists posited a vasomotor explanation of hypnotism (unlike Charcot, who initially sought its causes in electrical processes). The neurologist Heinrich Obersteiner, who headed a private psychiatric sanatorium in the Viennese suburb Oberdöbling, also showed great interest in the French experiments, whereby his reception of them was predominantly of a literary nature. In contrast to Charcot, however, he advised against experimenting solely on hysterics, at least until the symptomatology of hysteria had been satisfactorily explained. He recommended selecting “healthy persons” for the experiments and devoting less attention to the three stages described by the Salpêtrière school, focusing instead on the “preliminary stage” of hypnosis, because “in this stage the subject is in a position to also make observations upon him- or herself.”13 Sigmund Freud’s early interest in hypnosis was also characterized by a combination of literary and highly limited clinical reception of the new experimental techniques of Charcot and his followers. At this time Freud was an extern (Sekundararzt) at the Vienna General Hospital, where he began to 11. Rosenthal, “Der sogenannte thierische Magnetismus”; Moritz Rosenthal, “Untersu­ chungen und Beobachtungen über Hysterie und Transfert,” Archiv für Psychiatrie und Nervenkrankheiten 12 (1882): 201–31, pp. 206–207. 12. Rosenthal, “Untersuchungen und Beobachtungen,” p. 223. 13. Heinrich Obersteiner, Der Hypnotismus (Vienna: published by the author, 1885), p. 14. Obersteiner is an early example for medical self-observation in the hypnotic state, which later was used by some of Bernheim’s followers to redefine the status of a suitable experimental subject. See chapter 7, pp. 173–82.

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specialize in the clinical treatment of nervous diseases, after having initially devoted his attention to studies in anatomy and physiology.14 Wanting to observe Charcot’s newest work on hysteria and hypnotism firsthand at the Salpêtrière, he obtained a half-year travel grant that allowed him to stay in Paris during the winter of 1885–86. Through Benedikt and Obersteiner, whom he knew personally,15 he was well acquainted with the literature, but he was lacking patients upon whom he could experiment using the new techniques. In his report, Freud justified his study trip by emphasizing the resources that were unavailable to him in Vienna (especially Charcot’s copious supply of high-quality “patient material”)16 and discussing his plan to verify with his own eyes the “findings of the French school—some of them (upon hypnotism) highly surprising, and some of them (upon hysteria) of practical importance.”17 Freud visited the Salpêtrière just as its scholarly dispute with Bernheim and his adherents was reaching its first highpoint, at a time when Charcot’s pupils were engaged in devising various strategies for bringing the process of suggestion under control within their experimental system. In contrast to the skeptical observer Delbœuf, who witnessed numerous experiments around the same time and concluded that the subjects were acting out of an “excess of complaisance,”18 Freud stated in his report that the hypnotic phenomena were “occurrences plain before one’s eyes, which it was quite impossible to doubt, but which were nevertheless strange enough not to be believed unless they were experienced at first hand.”19 Thus he disregarded the epistemological critique of Charcot’s experiments, which emphasized the rarity of its subjects, in favor of an ontological interest: according to Freud, with his cases Charcot had established a firm basis for the symptomatology of hysteria, then substantiating the universality of these signs through a collection of historical visual evidence.20 Upon returning to Vienna, Freud reentered its medical

14. The best account of the time Freud spent in Meynert’s psychiatric clinic at the Vienna General Hospital is still Albrecht Hirschmüller, Freuds Begegnung mit der Psychiatrie: Von der Hirnmythologie zur Neurosenlehre (Tübingen: Edition Discord, 1991). 15. See Gerhard Fichtner and Albrecht Hirschmüller, “Sigmund Freud, Heinrich Obersteiner und die Diskussion über Hypnose und Kokain,” Jahrbuch der Psychoanalyse 21 (1988): 105–37. 16. Sigmund Freud, “Reisestipendiengesuch,” GW  suppl. vol.:48–49. 17. Freud, “Report on My Studies,” SE  1:6. 18. Delbœuf, Une visite à la Salpêtrière, p. 31. 19. Freud, “Report on My Studies,” SE  1:13. 20. Sigmund Freud, “Hysteria,” SE  1:41–59, p. 41. It can be assumed that Freud hypnotized patients at the Salpêtrière, since in his report he mentions his “personal acquaintance

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world as a translator and follower of Charcot.21 He became an advocate of the clinical practice of French neuropathology, which based its definitions on types exhibited by a small number of cases and treated phenomena that did not conform to them as mere deviations. In this respect he took a stance against the German physicians who criticized Charcot’s equation of hysteria with traumatic neurosis, emphasizing that the French neurologist had rightly begun “by considering the typical and simpler cases, whereas his German opponents had started with the study of the indeterminate and more complicated examples.”22 Here Freud had implicitly given recognition to hypnosis as an experimental method that played a decisive role in delimiting and diagnosing a disease entity. In the controversy with his Berlin critics Hermann Oppenheim and Robert Thomsen, Charcot had demonstrated how he could artificially reproduce a paralysis caused by unexpected mechanical trauma (e.g., the shock of a railway accident) in his subjects using verbal suggestion. For the Parisians, hypnotic suggestion functioned as the privileged experimental resource that facilitated their understanding of “traumatic neurosis.”23 with the phenomena of hypnotism, which are so astonishing and to which so little credence is attached” (Freud, “Report on My Studies,” SE 1:13). In view of Bernheim’s later critique of the hypnosis experiments conducted at the Salpêtrière, Freud refined his position: for example, he voiced doubts regarding the experiments of Binet and Féré as well as those of Babinski, which demonstrated the transfert of symptoms from one patient’s body to another using magnets. The facts demonstrated by Charcot, however, were excluded from this critique. See Sigmund Freud, “Preface of the Translation of Bernheim’s Suggestion,” SE 1:75–85, pp. 78–79; and Sigmund Freud, “Referat über Obersteiner, ‘Der Hypnotismus mit besonderer Berücksichtigung seiner klinischen und forensischen Bedeutung, Wien 1887,’ ” [1888] GW suppl. vol.: 105–6, p. 106. Whether Freud witnessed the experiments by Binet and Féré during his stay in Paris is unclear, but it seems unlikely, since they are unmentioned in the letters he wrote from Paris to his fiancée Martha Bernays (unpublished correspondence, Freud Collection, Library of Congress). 21. Moritz Heitler, “Rezension von J. M. Charcot, ‘Neue Vorlesungen über die Krankheiten des Nervensystems, insbesondere über Hysterie. Deutsche Ausgabe von Dr. Sigmund Freud.’ ” Wiener medizinische Wochenschrift 36, no. 47 (1886): 1579–80. 22. Freud, “Report on My Studies,” SE 1:12. 23. Freud had translated into German the lectures in which Charcot had used this line of argumentation, annotating them with footnotes in which he communicated his own observations regarding these cases. See Jean-Martin Charcot, Neue Vorlesungen über die Krankheiten des Nervensystems insbesondere über Hysterie, trans. Sigmund Freud (Leipzig: Toplitz/Deuticke, 1886), pp. 272–306. Further investigation of the differences between “psychical” and “organic” paralysis was the topic of a research paper that Freud had begun at the Salpêtrière but did not publish until several years later. See Ola Andersson, Studies in the Prehistory of Psychoanalysis: The Etiology of Psychoneuroses and Some Related Themes in Sigmund Freud’s Scientific Writings and Letters 1886–1896 (Norstedts: Svenska Bokförlaget [Studia Scientiae Paedagogicae

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However, the production of Charcot’s “types” was tied to the local conditions of his research center at the Salpêtrière, to a clinical demonstration practice in which the doctor had various patients appear in succession before an “audience,” and to various strategies for establishing universality through the collection and archiving of objects as well as visual and textual evidence. Additionally, Charcot and his pupils had at their disposal a network of journals produced by the Bureaux du Progrès médical, an in-house publishing company, which primarily served as vehicles of dissemination for his doctrines. Freud, having gone into private medical practice upon his return from Paris, did not have such structures and resources at his command. Undaunted, he made himself into the propagator of the new French research in Vienna, in this way seeking to distinguish himself from the city’s medical establishment—particularly from his earlier teacher, the psychiatrist and brain anatomist Theodor Meynert. The major obstacles Freud was confronting became readily apparent at a meeting of the Vienna Society of Physicians held on 15 October 1886, where Freud gave a lecture reporting on his stay in Paris. Having no patients to present to the assembled physicians, nor the battery of instruments in use at the Salpêtrière, Freud limited himself in his lecture “On Male Hysteria” to a verbal account of Charcot’s grande hystérie, which he exemplified using a case from the latter’s Lectures on the Diseases of the Nervous System. He had just translated the book into German, and the case he presented also appeared simultaneously as a preprint in the Wiener Medizinische Wochenschrift.24 In his lecture before the Vienna Society, then, Freud’s strategy was more literary than clinical: his assertions were supported by the text and the authority of Charcot, as whose pupil and translator he appeared. In the subsequent discussion, Rosenthal, Meynert, and other doctors cited clinical observations that contradicted Charcot’s assumptions, and they called for practical evidence based on studies involving larger numbers of patients. Meynert mentioned several cases from his clinic “in which, generally following traumatic insults, psychical alterations with epileptic convulsions and disturbances of consciousness appeared,” conditions he called epilep-

Upsaliensia III], 1962); and Gauchet, L’inconscient cerebral, pp.137–68. Regarding the differences between Charcot and the German doctors on the question of traumatic neuroses, see the account in Fischer-Homberger, Die traumatische Neurose. 24. Sigmund Freud, “ ‘Über männliche Hysterie’: Bericht über Vortrag in der Gesellschaft der Ärzte in Wien vom 15. 10,” Wiener Medizinische Wochenschrift 36 (1886): 1444–47; Charcot, Neue Vorlesungen, pp. 307–30.

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toid.” He then raised the question of “whether all of these cases offered the regularity of the series of symptoms described by Freud.”25 Freud took this question as a challenge and presented a clinical demonstration a short time later. Since he was unable to transfer the elaborate examination techniques of the Salpêtrière to his private practice, he had to turn to his colleagues for support. His friend Carl Koller, for example, endowed him with a perimeter: used for measuring anomalies in the field of vision, this instrument was one of the Salpêtrière’s basic tools for objectifying hysterical symptoms.26 With the help of this instrument, Freud could demonstrate in his test subject the disturbances of vision that Charcot had described as typifying grande hystérie.27 The ophthalmologist Leopold Königstein assisted Freud by conducting the more complex eye examinations constituting the second part of the patient demonstration. The patient himself had been referred to Freud by another hospital physician. In selecting this experimental subject, Freud circumvented Meynert’s proposal that one of his own patients be used as a test case, which had amounted to a direct challenge to his former student.28 25. Meynert in the discussion of Freud, “Über männliche Hysterie,” p. 1446. Freud’s lecture on male hysteria has received conflicting evaluations in numerous historical accounts. In contradiction to Freud’s version, in which he depicts himself as the victim of a concerted effort to exclude his ideas (Freud, “An Autobiographical Study,” SE 20:15–16), which his biographer Jones also endorses (Ernst Jones, Life and Work of Sigmund Freud, [New York: Basic Books, 1957], 1:229–31), Ellenberger (Discovery of the Unconscious, pp. 437–42) and Sulloway see justification for the Viennese physicians’ critique. Frank Sulloway, Freud, Biologist of the Mind: Beyond the Psychoanalytic Legend (Cambridge, MA: Harvard University Press, [1979] 1992), pp. 35–37. A more balanced view is found in Hirschmüller, Freuds Begegnung mit der Psychiatrie, pp. 211–13. 26. Freud explained his wish in a letter to Carl Koller dated 13 October 1886, stating that he was “a clinician primarily concentrated on the study of hysteria, and today one can no longer publish without [measuring the] field of vision.” Sigmund Freud, Briefe 1873–1939, ed. Ernst and Lucie Freud, 2nd ed. (Frankfurt: S. Fischer, 1966), pp. 228–29. In Paris he had already equipped himself with a dynamometer for the purpose of, as he wrote to his fiancée Martha Bernays on 27 January 1886, “studying my own nervous states,” ibid., p. 206. 27. Sigmund Freud, “Observation of a Severe Case of Hemi-Anaesthesia in a Hysterical Male,” SE 1:18–31. Freud originally published this article together with his colleague Leopold Königstein as “Beiträge zur Kasuistik der Hysterie: 1. Beobachtung einer hochgradigen Hemianästhesie bei einem hysterischen Manne,” Wiener medizinische Wochenschrift 36 (1886): 1633–38, 1674–76. 28. This is all the more likely, seeing that Freud quite certainly had knowledge of the cases mentioned by Meynert. In the period leading up to the public debate regarding the therapeutic use of hypnosis, several patients were treated by both Meynert and Freud. See Albrecht Hirschmüller, “Freuds ‘Mathilde’: Ein weiterer Tagesrest zum Irma-Traum,” Jahrbuch der Psychoanalyse 24 (1989): 128–59. Freud himself wrote in his retrospective account that the doctors in charge

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Without doubt, Freud had planned to demonstrate the symptoms specified by Charcot using a number of cases from his private practice. The case he presented was conceived as the first of a series of “Contributions to the Etiology of Hysteria,” as the publication’s title shows. Both Freud and Königstein argued before the Vienna Society of Physicians that a large number of similar cases existed, but that they had not been satisfactorily diagnosed. In beginning his presentation, Freud stressed that his case was in no way rare, and that such cases were frequent but often “overlooked.”29 Königstein assisted Freud by explaining the “cardinal symptoms of ocular hysteria,”30 which he measured comprehensively using a perimeter and a Snellen apparatus. He also supported Freud with his authority as an eye specialist, emphasizing that the rarity of hysteria was at least in part the result of most doctors’ negligence in conducting examinations. Nonetheless, the case that Freud had at his disposal was not ideal for his specific purposes: several of the decisive signs upon which Charcot had based his experimentalization of hysteria were not to be found on the patient’s body. Freud was not able to demonstrate transfert, nor could he localize any “hysterogenic zones” (the latter being used in Charcot’s pressure method to trigger a hysteric attack, thus proving that a patient should be classified as “hysteric” and not “epileptic”). Although Freud, with the help of various instruments, was able to show step-by-step the symptoms of hemianesthesia on his subject, he could neither experimentally demonstrate their hysterical nature nor lastingly stabilize them. Thus he was forced to use other strategies, which Charcot and his pupils had also employed. In order to make the diagnosis of hysteria plausible, Freud took recourse to the patient’s family history, insinuating a hereditary disposition. Here he made reference to the oral statement of a colleague, whom he claimed to have met by chance that same day: The second son is of special interest for us; he plays a part in the aetiology of his brother’s illness and seems to have been a hysteric himself. For he told our patient that he had suffered from attacks of convulsions; and, by a strange coincidence, this very day I met a Berlin colleague who treated this brother in Berlin during an illness and had diagnosed him as suffering from hysteria—a diagnosis which was also confirmed in a hospital there.31

of the ward had refused him permission to observe the patients (Freud, “An Autobiographical Study,” SE 20:15). 29. Freud, “Observation of a Severe Case,” SE  1:25. 30. Königstein, in Freud and Königstein, “Beiträge zur Kasuistik der Hysterie,” p. 1676. 31. Freud, “Observation of a Severe Case,” SE  1:25.

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Freud also evaded the lack of stability shown by the hemilateral anesthesia by diverting attention toward the optimistic therapeutic outlook it opened: “It is on this instability of the disturbance of sensitivity that I found my hope of being able to restore the patient in a short time to normal sensitivity.”32 As Freud emphasized in a letter to his friend and colleague Carl Koller, his stay in Paris at Charcot’s clinic had taught him an entirely new mode of clinical observation.33 His transfer of these skills to the Viennese medical world, however, proved less successful than his literary reception of French research on hysteria and hypnosis. More than his practical demonstrations, it was his translations of Charcot’s and Bernheim’s books that earned him the status of a key propagator of the new French clinical approaches to nervous diseases.34 Freud outlined his own viewpoint in forewords that he composed especially for the German editions of these works, and he also made generous use of footnotes in supporting and criticizing the theories of each of the French doctors. Thus he aimed to steer clinical reception in Vienna, around which much controversy was already beginning to develop. At the Vienna General Policlinic, for instance, the laryngologist Johann Schnitzler, his son Arthur, and the hydropathist Wilhelm Winternitz were making eclectic use of the therapeutic potential of the new hypnosis research. The growing clinical reception gave rise to a controversy, and yet in Vienna the lines along which doctors took sides differed markedly from those of the conflict between the two French cultures of hypnosis. Although the doctors arguing for the use of hypnotic suggestion were generally adherents of the Nancy position, and those against it mostly sided with Charcot, the dispute centered on a much more fundamental question: should the new methods be implemented and demonstrated at all, or should they be rejected outright? With suggestion coming into use as a therapeutic method, the issues of safety and morality it raised within medical practice would not admit cut-and-dried solutions as in the case of the Hansen commission. In regard to the use of hypnosis 32. Ibid., p. 31. 33. Freud to Carl Koller, 13 October 1886 (Freud, Briefe, p. 228). 34. To date, Freud’s work as a translator has not been systematically investigated. Some insights are provided by Andersson, Studies in the Prehistory of Psychoanalysis; Toby Gelfand, “ ‘Mon cher Docteur Freud’: Charcot’s Unpublished Correspondence to Freud, 1888–1893,” Bulletin of the History of Medicine 62 (1988): 563–88; and Toby Gelfand, “Sigmund-sur-Seine.” Volume 1 of SE and the supplementary volume of GW provide excerpts of Freud’s translations, including the forewords and a selection of footnotes. For an interesting study of Freud as a translator, undertaken in the context of the disputes over the new French translation of Freud’s complete works into French, see Michèle Pollak-Cornillot, “Freud traducteur: Introduction à la traduction des œuvres de Freud,” PhD diss. (Paris: Université René-Descartes, 1990).

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as an experimental method, these issues were exacerbated by the undecided problem of simulation, and by the experiments’ proximity to the practices of the stage magnetists. Polemics Surrounding the “Wiener Nancyer” In their therapeutic exploitation of hypnosis as propagated by the Nancy group, the first Viennese doctors to make use of the French research either remained silent or expressed cautious approval, but without implementing the suggestion method on a widespread basis. Heinrich Obersteiner—in whose private sanatorium Freud worked shortly before his trip to Paris— praised hypnotic suggestion as a remedy for nervous diseases, but he did not make comprehensive use of the method in treating his wealthy upper-class clients.35 “Psychical treatment” was understood more as the curative effect of removing the patient from his or her usual surroundings in favor of the tranquility of the sanatorium: “Often the sanatorium is the direct cure, inasmuch as transferring the patient to different and more suitable surroundings remedies the cause of the illness by severing the patient from the overtaxing demands of profession or family.”36 The sanatorium was designed as a site to compensate the irritating stimuli of urban life by creating a microcosm in which the doctor and personnel ceaselessly endeavored to provide the “tranquility” and “diversion” needed to restore a shaken nervous system. The main disadvantage of a stay in the sanatorium—the limitation of the patient’s personal freedom—was made up for by the luxuries and pleasant pastimes it offered. Sanatorium life alternated between time spent in isolation rooms—“furnished as much as possible like normal rooms (and sometimes like quite elegant salons), but so that there is no danger of the particular patient destroying the furniture etc. or using it as a weapon”37—and time spent in various leisure facilities (e.g., exercise room, 35. Obersteiner, Der Hypnotismus, pp. 42–43; Julius Krueg, “Behandlung,” in Die Privatheilanstalt zu Ober-Döbling. Wien, XIX. Bezirk, Hirschengasse 71: 2. Bericht über die Leistungen der Anstalt vom 1. Juli 1875 bis 30. Juni 1891, ed. Heinrich Obersteiner (Leipzig: Deuticke, 1891), pp. 147–48. During his work there Freud described the patients as “all rich people: counts, countesses, barons the like” (Freud, letter to Martha Bernays, 8 June 1885, Sigmund Freud, Letters of Sigmund Freud 1873–1939, ed. Ernst L. Freud, trans. Tania and James Stern [London: Hogarth Press, 1961], p. 151). For an overview of private clinics in this era, see Edward Shorter, “Private Clinics in Central Europe 1850–1933,” Social History of Medicine 3 (1990): 159–95; for Austria see Heinrich Schlöss, Die Irrenpflege in Österreich in Wort und Bild (Halle: Marhold, 1912). 36. Richard von Krafft-Ebing, quoted in Krueg, “Behandlung,” p. 142. 37. Krueg, “Behandlung,” p. 144.

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bowling alley, game room). In this context, the use of therapeutic suggestion was limited to maintaining an elevating atmosphere throughout the sanatorium: “One form of suggestion, however, is in fashion with us, which skillful tutors have always known to apply in guiding their charges, namely the exertion of a tireless, gentle and loving, but continual and unceasing influence that avoids any hint of the peevish schoolmaster.”38 The experimental testing of new therapies on sanatorium patients of the upper classes was soundly rejected: “A private sanatorium is the last place in which one can risk daring experiments.”39 In the mid-1880s, doctors at several Viennese public clinics increasingly began to combine the therapeutic use of hypnotic suggestion with a variety of experimental demonstrations. As in Paris and Nancy, their patients predominantly came from the lower classes. At the laryngological department of the General Policlinic, head physician Johann Schnitzler, together with the hydrotherapist Wilhelm Winternitz, conducted hypnoses on a number of patients suffering from functional aphonia (loss of the voice without any observable organic cause). At this time Winternitz had already visited Nancy and convinced himself personally of the effectiveness of Bernheim’s suggestion method.40 Schnitzler’s reception of the various methods of hypnosis in use in Paris and Nancy, on the other hand, was of an eclectic and literary nature, whereby he adopted the methods he found suitable into his clinical practice. Like the doctors of the Salpêtrière, he sought to eliminate any suspicion of simulation by selecting “uneducated” patients from the lower classes for his experiments.41 Initially Schnitzler integrated the new therapeutic method into the usual ritual of medical examination in such a way that it went practically unnoticed by the patient. In order to put the patient into a hypnotic state, he instructed

38. Ibid., pp. 147–48. 39. Ibid., p. 148. Although this statement applied to medications, suggestion treatment itself was very often seen as a direct analogue of medication. In principle, such a conception was already implied in Bernheim’s use of suggestion (see chapter 2). Moriz Benedikt, a decided opponent of the method, warned repeatedly of the “poisoning” of the brain and of patients’ exposure to other harmful side effects. See Anon., “Internationaler Kongress für Psychiatrie in Paris: Sitzungen vom 5. bis 10. August 1889,” Internationale Klinische Rundschau 3 (1889): 1562–65, p. 1565. 40. Winternitz in the discussion of Theodor Meynert, “Über hypnotische Erscheinungen,” Wiener Klinische Wochenschrift 1 (1888): 451–53, 473–76, 495–99, p. 498. 41. Johann Schnitzler, “Exstirpation von Nasenpolypen in der Hypnose nebst Bemerkungen über Anwendung des Hypnotismus bei Neurosen des Larynx,” Internationale Klinische Rundschau 2 (1888): 1257–60; p. 1260.

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f i g u r e 1 2 . A laryngoscopic investigation. From Johann Schnitzler’s Klinischer Atlas der Laryngologie, edited by his son Arthur.

her to fix her gaze on the reflector mounted on his forehead, the use of which was standard in laryngoscopic examination (see fig. 12). After a short period of sleep during which the doctor verified the signs of catalepsy, the patient awoke in full possession of her voice. Thus hypnosis had a “spontaneous” effect that required no apparent intervention on the part of the doctor. As a consequence, Schnitzler also noted cases of “unintentional hypnosis,” whose cause he identified as the excessive glare created by a faulty adjustment of the reflector.42 Johann Schnitzler’s son Arthur, who at the time was working as an assistant in his department, continued these experiments on the patients and published short case histories in the Internationale Klinische Rundschau.43 Together with Winternitz he later expanded this experimentation, which at first served exclusively curative purposes, by presenting a series of “demon42. Ibid., p. 1259. 43. This journal, published by Johann Schnitzler and edited by his son Arthur, soon featured extensive reports on the new methods of treatment. During these years, Arthur Schnitz­ ler also published numerous reviews of new French literature relating to hypnotism, and of Freud’s translations as well. See the review of Hippolyte Bernheim’s “ ‘Die Suggestion und ihre Heilwirkung’: Autorisirte deutsche Ausgabe von Dr. Sigm. Freud” [1889], in Arthur Schnitz­ ler, Medizinische Schriften, edited and introduced by Horst Thomé (Vienna: Zsolnay, 1988), pp. 210–215.

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strations” at the policlinic, which were attended not only by colleagues from other departments but also by doctors from other hospitals.44 Here Arthur Schnitzler administered suggestions to his “mediums,” as he referred to his experimental subjects, in which he or one of the other doctors present became the objects of brief role-plays. Using two of the clinic’s patients, he demonstrated “transformations of the personality,” whereby his use of a dramatic register in describing their abilities came close to Delbœuf ’s position (see chapter 5). In one case, for example, he noted that in the somnambulic state “the subject’s ability to assume a pose appropriate to a given role was extraordinarily developed. It was the pose of a queen, which she had certainly picked up from visits to the theater.”45 Transferring the demonstration forms of the French hypnosis experiments to Austrian clinics in this way precipitated the first major controversy surrounding hypnosis, which was played out in the key medical journals and in the Vienna Society of Physicians. The strategy of the critics toward the experimental and therapeutic use of hypnosis went beyond questioning individual facts or successful cures: there was fundamental disagreement among doctors regarding both the production of clinical facts and the forms of public demonstration suitable for presenting them. Theodor Meynert, psychiatrist and brain anatomist, was a key protagonist in the controversy. In several lectures held before the Society of Physicians, he set forth his comprehensive critique of every form of experimentation with hypnotic phenomena. From the very beginning, Meynert denied them the “dignity of facts.”46 Initially he raised the classic objection that “afflicted individuals,” such as patients diagnosed with hysteria, could be simulating, and that they were not a reliable source of “evidence”: “There is no manifestation of so-called hypnotic suggestion that could not just as well be brought about by caprice as by a

44. Arthur Schnitzler, My Youth in Vienna, trans. Catherine Hutter (New York: Rinehart Holt/Winston, 1970), p. 270. 45. Arthur Schnitzler, [review of H. Bernheim] “ ‘Die Suggestion und ihre Heilwirkung,’ p. 213. Schnitzler opted not to publish an extensive report on his experiments, because, as he later wrote, they “did not result in any new information” (Schnitzler, My Youth in Vienna, p. 270). In the course of the controversy between the supporters and opponents of hypnosis experimentation, Schnitzler discontinued his semipublic demonstrations as well as the medical use of suggestion. The subject did, however, find its way into one of the episodes of the drama cycle Anatol (“Die Frage an das Schicksal,” 1893), and in veiled form into his one-act drama “Paracelsus” (1893), which was also appreciated by Freud. See Freud’s letter to Fliess, 19 March 1899, Sigmund Freud, The Complete Letters of Sigmund Freud to Wilhelm Fliess 1887–1904, ed. and trans. Jeffrey Moussaieff Masson (Cambridge, MA: Belknap Press, 1985), here after abbreviated FF:348. 46. Meynert, “Über hypnotische Erscheinungen,” p. 476.

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pathological condition.”47 Thus Meynert equated the experiments conducted by the Viennese doctors with those published by Bernheim, in which simulation remained an open problem, inasmuch as their credibility depended on a moral criterion, namely the trustworthiness of the experimental subject. He did not discuss in any detail the methods that Schnitzler and other doctors had actually used. Although Meynert’s critique of the Nancy methods fundamentally assumed the standpoint of the Salpêtrière school, which understood hypnosis as a series of pathological states, he also distanced himself from the latter’s experimental practice. In contrast to Charcot and his pupils, he made two demands of a clinical fact: Firstly, it must appear “spontaneously” and be accessible to “pure” observation in the clinic. This means that the doctor must take care not to intervene actively; otherwise he is in danger of becoming the “cause of the disease,” and thus of no longer being able to observe it in its natural form.48 Secondly, the mechanisms of observable hypnotic phenomena must be fully explainable on the basis of physiological knowledge to date: “The best criterion of credibility is the understanding of the mechanisms at work. One must first eliminate as unreliable those manifestations that do not arise within the framework of understandable mechanisms.”49 In limiting the criterion for a fact to “pure” clinical observation, which could be explained—for the most part speculatively—through current brain anatomy research, Meynert contrasted “spontaneous hypnotism” with “artificial hypnotism,” stating that the former was the sole legitimate field of observation. The latter was not only in danger of producing artifacts instead of facts, but also of entering into the vicinity of “charlatans”: Spontaneous hypnotism is thus scientific clinical observation’s point of entry into the phenomena of hypnotism. However, the boundary line beyond which science repels a field of knowledge that is no longer factual and that is below its interest, lies in the wild terrain of the marvelous, in statements and ideas characterized by an abrupt plunge from the level of physical and physiological conformity with natural law.50

Meynert’s lectures also comprised a demonstration of how this separation of facts and artifacts was to occur, thus establishing a countermodel to the ex47. Theodor Meynert, “Über Zwangsvorstellungen,” Wiener Klinische Wochenschrift 1 (1888): 109–12, 139–41, 170–72, p. 139. 48. Meynert, “Über hypnotische Erscheinungen,” p. 453. 49. Meynert, “Über Zwangsvorstellungen,” p. 140. 50. Meynert, “Über hypnotische Erscheinungen,” p. 452.

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periments of doctors like Freud, Schnitzler, and Winternitz, who had adopted hypnotic methods in their clinics or private practices. He confronted several patient case studies, drawn up and published by his assistants, with the classification of grand hypnotisme specified by Charcot.51 Thereby Meynert altered the sequence of the three stages, and even added a fourth, referring to it as the “somniant stage,” in which the patient fell into a dreamlike delirium.52 With this strategy he offensively engaged in a reception that stood in contrast to Freud’s true-to-the-text transfer of Parisian experimental practice. Meynert linked the Paris observations with the earlier theoretical assumption—which he shared with neuropathologists like Rosenthal—that hypnotic phenomena arose through vasomotor processes, primarily states of exhaustion in the brain. On this basis he equated them with various mental disturbances (such as obsessions) and classified them as a form of “insanity.” How did the advocates of hypnotic suggestion methods answer this critique? In view of the tenor of most historical accounts, one must first make it clear that the controversy cannot be simplified to a personal conflict between Meynert and his former student Freud.53 The public debate was played out exclusively on the level of published accounts, and thus Freud later referred to it as an “acrimonious literary dispute.”54 Freud made strategic use of his translation of Bernheim’s book on suggestion, adding a lengthy foreword outlining his own reception of the French controversy, in which Meynert’s criteria for clinical facts were rendered superfluous. The opponents of hypnosis experimentation raised the objection that there exist “completely subjective symptoms,” which make it impossible to eliminate self-deception on the part of the experimenter and arbitrary deception on the part of the subject.55 Citing Charcot and his pupils’ stabilization of the symptomatology of hysteria in grand hypnotisme, Freud rejected the allegation of a disruptive

51. Gabriel Anton, “Hypnotische Heilmethode und mitgetheilte Neurosen,” Jahrbücher für Psychiatrie 8 (1889): 194–211. 52. Meynert, “Über hypnotische Erscheinungen,” p. 453. 53. Such biographical simplifications are found throughout the literature. See for instance, Siegfried Bernfeld and Suzanne Cassirer Bernfeld, Bausteine der Freud-Biographik, trans. Ilse Grubrich-Simitis (Frankfurt: Suhrkamp, 1981), pp. 181–83. 54. Sigmund Freud, Die Traumdeutung (Leipzig: Deuticke, 1900), p. 251, hereafter abbreviated TD. 55. Gabriel Anton in the discussion of Ludwig Frey’s lecture, in “Sitzungsbericht der Wiener Gesellschaft der Ärzte vom 31. 5. 1889,” Wiener Klinische Wochenschrift 2, no. 23 (1889): 470–73; no. 24 (1889): 488–90; p. 473; Meynert, “Über Zwangsvorstellungen,” pp. 139–40; Meynert, “Über hypnotische Erscheinungen,” pp. 451–52.

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influence through conscious suggestion on the part of the experimenter or his subjects by referring to the obligatory sign of neuromuscular hyperexcitability that he had seen demonstrated at the Salpêtrière.56 With regard to the physiological mechanism of hypnotic phenomena, however, Freud did not take a clear stance, although he denied the possibility of localization in the nervous system called for by Meynert.57 Hence the published dispute between Meynert and Freud revolved primarily around the question of which reception of Charcot’s experiments was appropriate: one that recognized the experimental system installed at the Salpêtrière, in which hypnotic phenomena could become the point of departure for a scientific study of the physiological unconscious; or a reception that transferred Charcot’s observational data into another clinical reference system (that of Meynert’s psychiatric clinic) by relating them to theories of brain anatomy. Parallel to this dispute regarding the status of clinical facts in hypnosis experiments, a controversy developed in the Vienna Society of Physicians over the therapeutic use of hypnotic suggestion as propagated by Bernheim and his followers. Meynert’s epistemological position was closely linked to his moral reservations toward the new method of psychical treatment, specifically toward the relationship it created between doctor and patient. If hypnosis was to be understood as a pathological state, as “experimentally produced idiocy,” it stood in opposition to earlier forms of psychotherapy (such as traitement moral ) conceived to educate the patient into a self-determined, freely acting subject.58 For Meynert, the “freedom” of the subject was by no 56. Freud, “Preface to the Translation of Bernheim’s Suggestion,” SE  1:79–80. 57. Ibid., p. 119. This primarily theoretical controversy continued in heightened form in Theodor Meynert, “Beitrag zum Verständniss der traumatischen Neurose,” Wiener Klinische Wochenschrift 2 (1889): 475–76, 498–503, 522–24; and in Sigmund Freud, “Review of Auguste Forel’s Hypnotism,” SE  1:91–102. In his effort to discredit Charcot’s experimental use of hypnosis, Meynert also adopted some of the strategies used by Bernheim. In this context, Freud’s critical attitude toward the Nancy position is understandable, since the latter offered critics a number of rhetorical resources for rejecting the clinical use of hypnosis. Freud writes in his letter of 29 August 1888 to Fliess, in which he justifies his Bernheim translation: “I undertook the work very reluctantly, and only to have a hand in a matter that surely will deeply influence the practice of nerve specialists in the next years. I do not share Bernheim’s views, which seem to me one-sided, and have tried to defend Charcot’s point of view in the preface—I do not know how skillfully, but I do know for sure, unsuccessfully. The suggestive (that is, Bernheim’s iatrosuggestive theory) acts like a commonplace charm on German physicians, who need make no great leap to get from the simulation theory where they stand now to suggestion theory.” FF :24. 58. Meynert, “Über hypnotische Erscheinungen,” p. 496. Bernheim and his adherents claimed to be continuing the earlier French tradition of psychical treatment. The Viennese neuropathologists’ understanding of “psychical treatment” (as traitement moral was generally

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means a metaphysical concept; rather it was closely linked to the “spectrum of associations” set free by an individual’s brain activity: “One can interpret the word freedom, despite all of its legitimacy in a relative sense, as a numeric concept. The larger the number of associations that can be integrated into a psychical action, the larger the sum of association impulses possible for the triggering or non-triggering of a movement, and the larger the manifestations of freedom.”59 The actions of the hypnotized person show themselves to be unfree because a “restriction of association” blocks his access to the interplay of positive and negative thoughts and emotions that precede the execution of an act. Thus hypnotic suggestion is not a form of treatment in which two rational subjects meet on equal footing. It was not only for health reasons that Meynert considered the artificial production of a hypnotic state “dangerous,” seeing in it an inherent threat to “psychical balance.” He also considered hypnosis “distasteful” because it demonstrated the “repellent phenomenon of the servile subjugation of one human being by another.”60 In the controversy before the Vienna Society of Physicians, Meynert cited case histories published by his assistants, using them polemically in drastically demonstrating the dangers of hypnosis. One of these was the case of a craftswoman who had already been treated by hypnosis for headaches in another ward of the General Hospital. This treatment had allegedly worsened her condition to such an extent that she had in the end been transferred to Meynert’s psychiatric clinic.61 The case was presented as a “hypnotic neurosis” in which an “antihypnotic treatment”62 was necessary. Here the translated; see Freud, “Psychical (or Mental) Treatment.”) differed considerably: Rosenthal, for example, favored the treatment of nervous disorders using a therapy concept under which “psychical symptoms” (such as memory disturbances, headaches, and dizziness) were treated using exclusively physical methods of therapy. The effect of “psychical therapy” was—in contrast to the arsenal of hydro- and electrotherapy, the use of narcotics (such as morphine or chloroform) and of “antispasmodic metal preparations” as well as the dosed administering of iron, quinine, and bromide—limited exclusively to the stimulation of the patient’s willpower. Moriz Rosenthal, Klinik der Nervenkrankheiten: Nach seinen an der Wiener Universität gehaltenen Vorträgen, 2nd ed. (Stuttgart: Enke, 1875), p. 484. For the introduction of the term “psychotherapy” in the wake of Bernheim’s work, one may consult Jacqueline Carroy, “L’invention du mot de psychothérapie et ses enjeux,” Psychologie Clinique 9 (2000): 11–30; and Marcel Gauchet and Gladys Swain, “Du traitement moral aux psychotherapies: Remarques sur la formation de l’idée contemporaine de psychothérapie,” in Swain, Dialogue avec l’insensé: Essais d’histoire de la psychiatrie, ed. Marcel Gauchet (Paris: Gallimard, 1994), pp. 237–62. 59. Meynert, “Über hypnotische Erscheinungen,” p. 497. 60. Ibid., p. 498. 61. Ibid., pp. 475–76. 62. Anton, “Hypnotische Heilmethode,” p. 199.

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opponents of hypnotic treatment made use of a strategy similar to that of Charcot’s followers, limiting their studies to a few pathological cases and generalizing their course of development: “One makes the patients into that which one would like to heal. To hypnotize means to make hysterical.”63 The advocates, in contrast, depicted such cases as exceptions, interpreting the “constitution of the subject”64 as the decisive criterion for the method’s positive functioning. They specified a large number of cases in which the doctor could not conduct suggestion treatment by following a preestablished course, but instead had to adjust it in each case according to the individual “idiosyncrasies” of the patient.65 In opposition to Meynert’s insinuation of the “distastefulness” and “dangerousness” of hypnotic treatment as regards the relationship between doctor and patient, the Viennese adherents of the Nancy school drew attention to numerous therapeutic successes that had contributed to the “heightened esteem of and respect for the medical art.”66 Stating that he had already successfully treated hundreds of cases using Bernheim’s suggestion method, the physician Ludwig Frey emphasized that his patients did not display symptoms of exhaustion or diminished cognitive capacity, but rather an “excellent feeling of vitality”: The patients tend to stare at the hypnotist with an expression of unending thankfulness. I have often experienced how someone who was tormented by the most terrible neuralgic pains went to sleep and then awakened without any pain at all, overcome with joyful sobbing like a child and attempting to express his deep thankfulness in the most exaggerated manner.67

For Meynert, however, the euphoric emotion that overcame both the hypnotized person and the hypnotist was a sign of the moral decline of the medical profession. He considered both the “ecstatic gaze often encountered when speaking about hypnotism with patients who have been treated using the method” and the “strongly sexualized” relationship between patient and doctor to be a direct contradiction of therapy designed to educate its subjects to develop their willpower, cognitive capacity, and self-mastery.68 The moral compunctions of the Viennese opponents of the suggestion method were rooted not only in their concerns about the transfer of practices 63. Meynert in the discussion of Frey’s lecture, in “Sitzungsbericht,” p. 490. 64. Freud, “Review of Auguste Forel’s Hypnotism,” SE  1:100 (trans. mod.). 65. Frey [lecture and discussion] “Sitzungsbericht,” pp. 470–71. 66. Ibid., p. 471. 67. Ibid. 68. Meynert in the discussion of Frey’s lecture, in “Sitzungsbericht,” pp. 490–91.

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into the clinical space that sexualized the relationship between doctor and patient. They saw a much greater danger in the effect of hypnosis on the public at large, which extended far beyond the confines of the clinic and was thus no longer under the control of medical experts: “In the eyes of the layman, hypnosis is a new mysticon. It arouses great expectations, which, even if they are not entirely responsible for it favorable effect, certainly exert a powerful influence.”69 The use of a method that derived a large part of its effect from “doctorly posturing and deception” unavoidably lowered the physician to the level of the “charlatan.”70 To Meynert, the systematic use and widespread application of hypnosis appeared literally as a “mental disease,” whose spread would inevitably lead to a mass poisoning of brains.71 For those who pathologized the method of hypnotic suggestion and speech concerning it a priori, a politics of containment was the only possible counterstrategy. In a report from the 1889 International Congress for Psychiatry in Paris, it is noted that Moriz Benedikt after deploring the “great uncertainty regarding the question of hypnosis and suggestion” proposed to stop any discussion about it altogether, “since the entire world is preoccupied with it. The speaker maintains an attitude of the greatest caution toward this subject, since the procedure is a poisoning, a poisoning of a very dangerous nature.”72 Although the “Wiener Nancyer,” as Benedikt ironically referred to the advocates of suggestion therapy,73 concurred with the prohibition of nonmedical hypnosis, they simultaneously presented the appropriation of the new therapeutic methods as the only effective strategy for combating the “charlatans”: “Hypnotism should not be allowed to become the common property of humanity, but it should become the common property of doctors. . . . It is the duty of physicians to tear this curative method from the hands of laymen and to exploit it further.”74 The Krafft-Ebing Scandal Having set the goal of appropriating hypnotic methods for scientific medicine, Bernheim’s Viennese follwers had to demonstrate that the “miraculous”

69. Anton in the discussion of Frey’s lecture, in “Sitzungsbericht,” p. 473. 70. Meynert, “Über hypnotische Erscheinungen,” p. 499. 71. Meynert, “Verständniss der traumatischen Neurose,” p. 524. 72. Anon., “Internationaler Kongress für Psychiatrie in Paris,” p. 1565. 73. Moritz Benedikt, Hypnotismus und Suggestion: Eine klinisch-psychologische Studie (Leip­ zig: Breitenstein, 1894). 74. Frey, [lecture and discussion] “Sitzungsbericht,” p. 472.

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phenomena could be isolated, purified, and objectified within the bounds of the clinic. Underlying this strategy was a conception of “facts” that did not depend—as Meynert’s did—on the demands of theoretical explanation, but rather on the mobilization of a sufficient number of witnesses providing consistent testimony regarding the nature of the phenomena produced. The psychiatrist Richard von Krafft-Ebing (1840–1902), who after Meynert’s death in 1892 was appointed as his successor at the Vienna General Hospital, was the first to undertake this endeavor. His clinical practice of experimentally producing and demonstrating facts was diametrically opposed to that of his predecessor. Krafft-Ebing was of the opinion that psychiatry could not stake claim to anything beyond the status of a purely descriptive science, which was forced to proceed “on the basis of tireless unbiased observation and recording of clinical phenomena. In view of the current level of our knowledge, attempts at explanation can only represent ingenious hypotheses. As an attempt at induction, a hypothesis is justified, but for many there is the danger that, like certain mentally ill patients, they confuse the creations of fantasy with reality, giving the hypothesis the value of a fact.”75 It was not only in this empirical definition of a fact that Krafft-Ebing polemically distanced himself from Meynert’s epistemological stance that a phenomenon could not be considered factual without a physiological or anatomical explanation. His use of experimental and didactic demonstrations in the psychiatric clinic also differed considerably from previous practice at the Vienna General Hospital. The Second Psychiatric University Clinic had been established in 1875— with Meynert as its director—in the hospital’s “observation rooms,” which provided temporary accommodation for “persons suspected of being insane.”76 An extensive description of these cases was irrelevant in the context of Meynertian brain psychiatry, and thus the facility’s spatial limitations and rapid patient turnover were of no particular consequence. It offered neither a medical examination room nor any other space suited for demonstrations involving patients. All in all, the state of the clinic represented a major problem for Krafft-Ebing. His plan of establishing a comprehensive program of demonstration-based medical instruction, in which students would learn about the typical developmental processes of the most important mental disorders through the presentation of a number of typical cases, was confronted by the many disadvantages of a “restless” and unstable clinic: “It can 75. Richard von Krafft-Ebing, “Die Entwicklung und Bedeutung der Psychiatrie als klinischer Wissenschaft,” Wiener Klinische Wochenschrift 2 (1889): 817–20, 843–45, p. 820. 76. See Hirschmüller, Freuds Begegnung mit der Psychiatrie, pp. 83–85; and Lesky, Die Wiener medizinische Schule, pp. 185–86.

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offer a profusion of glimpses of current states to the students, but not the structured development of a psychotic process.”77 In order to overcome this deficiency, Krafft-Ebing called for a closer integration of the psychiatric and neuropathological clinics.78 Cases were to be presented not in the rooms of the clinic, but in the lecture hall of the university. Krafft-Ebing’s demonstrations were obviously inspired by Charcot’s lectures, although he did not go so far as to emulate the latter’s establishment of set forms of presentation on various days at various sites. He also differed in his epistemological principles, for example, regarding the categorization of individual cases according to clinical types. For Krafft-Ebing, the question of whether demonstration should take the single case or the type as its point of departure was for the most part decided on the basis of “the personality of the patient and the form of his illness.”79 It was not only in his introduction of a novel form of case presentation that Krafft-Ebing oriented his work toward the French model: he also took an active stance for the use of hypnosis as an experimental and therapeutic procedure. In contrast to other doctors, who like Johann and Arthur Schnitzler, Winternitz, or Freud communicated the results of their initial experimentation indirectly or very summarily, he repeatedly presented two of his cases publicly and devoted extended publications to them. The cornerstone of both case histories was the complete inclusion of their clinical diaries, which precisely documented the experiments conducted over a period of several months in stenographic protocols. This form of documentation corresponded to the stipulations of an old Austrian law concerning animal magnetism, which required doctors to “keep a complete diary [of such treatment] and submit it to the authorities upon request.”80 Thus the diary was a document intended for legal use, which generally only appeared in scientific publications in excerpts.81 In a scientific context, the novelty of

77. Richard von Krafft-Ebing, Der klinische Unterricht in der Psychiatrie: Eine Studie (Stuttgart: Enke, 1890), p. 28. 78. Krafft-Ebing, “Die Entwicklung und Bedeutung der Psychiatrie,” pp. 843–44. 79. Krafft-Ebing, Der klinische Unterricht in der Psychiatrie, p. 32. 80. Court Chancellery Decree of 24 October 1845, line 36098, quoted by Richard von KrafftEbing, “Gutachten des k.k. obersten Sanitätsrathes bezüglich der gesetzlichen Regelung des Hypnotismus in Österreich,” [1896] in Arbeiten aus dem Gesammtgebiet der Psychiatrie und Neuropathologie, vol. 2 (Leipzig: Barth, 1897), pp. 153–60, p. 156. 81. Arthur Schnitzler, whose contemporaneous experiments are also preserved in similar protocols, opted against publication, although he included excerpts from them as footnotes in his review of Freud’s first Bernheim translation (Schnitzler, “Die Suggestion und ihre Heilwirkung”).

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Krafft-Ebing’s publishing strategy was that he used such protocols as a means of presenting individual cases in their entire development. The book in which he first did so was An Experimental Study in the Domain of Hypnotism, which was originally published in 1889. To a large extent this new form of documentation responded to the interest shown in the use of hypnosis by a wide juridical audience, which had become aware of the legal problems entailed in the creation of altered states of consciousness.82 The experimental subject Ilma S. was the twenty-nine-year-old daughter of a merchant, who had fled from a clinic in Budapest to Graz, where she was confined to the psychiatric clinic for observation following her arrest for theft by the police.83 Krafft-Ebing, at the time professor at the clinic, diagnosed the patient, whose history described a series of guises and attempts to assume new identities, as a hysteric with homosexual tendencies. Thus he categorized the case as one of numerous other cases of “contrary sexual feeling,” which at the Graz clinic had routinely been treated using the school of Nancy’s suggestion method.84 Quite certainly, Krafft-Ebing also chose this patient for a protracted series of experiments because she had already been hypnotized frequently in Budapest, which made it possible to use her in demonstrating various phenomena. Here he was in opposition to most of the French 82. Most of Krafft-Ebing’s publications should be seen in this legal context. Although they did not use these forms of documentation, the most important introductory texts on hypnotism in the German-speaking world all originally developed in this context; e.g., Auguste Forel, Der Hypnotismus: Seine Bedeutung und seine Handhabung, 1st ed. (Stuttgart: Enke, 1889). For an overview of issues relating to hypnotism and crime, see Laurence and Campbell, Hypnosis, Will, and Memory. 83. Within the scarce literature on Krafft-Ebing, this case history has received little attention; see Renate Hauser, “Sexuality, Neurasthenia, and the Law: Richard von Krafft-Ebing,” PhD diss. (London University, 1992); and the flawed study by Harry Oosterhuis, Stepchildren of Nature: Krafft-Ebing, Psychiatry, and the Making of Sexual Identity (Chicago: University of Chicago Press, 2000). In an article devoted to the case, Emese Lafferton has reconstructed the identity of Ilma S. by using Hungarian sources: “Hysteria and Hypnosis as Ongoing Processes of Negotiation: Ilma’s Case from the Austro-Hungarian Monarchy,” History of Psychiatry 13 (2002): 177–96, 305–26. Lafferton does not, however, situate Krafft-Ebing’s experimental practices in the polemic context of the controversies and scandals surrounding hypnotic suggestion. 84. Richard von Krafft-Ebing, Psychopathia Sexualis, with Especial Reference to Contrary Sexual Instinct: A Medico-Legal Study, trans. Charles G. Chaddock (Philadelphia: Davis, 1892), pp. 231–33. In the routined “suggestive removal” of homosexual tendencies, which served as a “support for [the doctor’s] moral influence” (ibid., p. 341), the male patient repeated the following hypnotic suggestions until an observable alteration of his behavior occurred: “1. I abhor onanism, because it makes me sick and miserable; 2. I no longer have inclination toward men, for love of men is against religion, nature and law; 3. I feel an inclination toward women, for woman is lovely and desirable, and created for man.” (ibid.).

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doctors, who in the course of the controversy between Paris and Nancy had called for the exclusion from experimentation of patients who had already been hypnotized or who had served as the “mediums” of somnambulic cabinets.85 Krafft-Ebing attempted to turn his patient’s tangled history to his advantage by presenting her from the very beginning as a victim, who was fleeing from a medical culture in which hypnotism had become omnipresent. Thus Ilma S. explained her escape from the Budapest clinic by stating that she had “found the constant hypnotizing unbearable.”86 It had begun in the course of court proceedings and continued at the clinic, “not only by physicians having the right to do it, but also by unauthorized persons, and even by laymen; and, in consequence of these hypnotic experiments with S., the impulse was given which made her the subject of articles in the newspapers.”87 Krafft-Ebing endeavored to exploit this difficulty in two ways: Firstly, he used his subject’s aversion toward hypnotism as an answer to his critics’ allegation that she was simulating or being too “complaisant” toward the experimenter. Secondly, the case offered an opportunity to distance medical hypnotism from the experiments undertaken by “laymen,” thus anchoring it in the territory of the clinic. Considering the case of Ilma S. to be ideal for refuting the arguments of critical doctors, Krafft-Ebing quickly published it in the aforementioned book, which was aimed at disarming the opponents of hypnotism and strengthening the psychiatrist’s power of definition over the lay use of hypnosis. At the highpoint of the controversy between Meynert and the “Wiener Nancyer,” Krafft-Ebing attempted to present a series of measures that could be taken to put the spreading culture of hypnotism under the control of medical experts. The first measure was to isolate the subject from all influences that could have an undesired effect on the experiment. Initially this aim was realized by only “undertaking the hypnotic experiments . . . in the presence of a number of physicians, portis clausis, and with the witnesses bound to tell the patient nothing of what took place during hypnosis.”88 Like the Salpêtrière school, Krafft-Ebing operated under the assumption that the phenomena produced by hypnosis were unconscious, meaning that they occurred on a “purely mechanical” basis and could not be remembered by the subject in a waking

85. Bernheim, Suggestive Therapeutics, p. 104. 86. Richard von Krafft-Ebing, An Experimental Study in the Domain of Hypnotism, trans. Charles G. Chaddock (New York: Putnam, 1896), p. 2. 87. Ibid., p. 19 (trans. mod.). 88. Ibid., p. 31 (trans. mod.).

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state. Thus the cautionary rule that doctors whisper to each other or converse in Latin during the experiments was soon abandoned.89 This line of thinking also led Krafft-Ebing to have no misgivings about using his patient for a number of demonstrations in various medical societies. A second measure was the head physician’s exclusive right to conduct hypnosis. Only in exceptional cases were assistants or nurses authorized to use the method. Here Krafft-Ebing was attempting to maintain control of the subject’s transition between the three stages of hypnosis. Both of these measures encountered difficulties in the everyday life of the clinic. Other patients, for example, intervened by informing Ilma S. about the experiments being conducted on her: “To-day a fellow patient read in the newspaper about the experiments before the medical society, and had the indiscretion to tell the patient about it. As a result, she is very angry and amazed, and her confidence in the professor is shaken.”90 Thus Krafft-Ebing’s efforts to maintain exclusive control over hypnosis within his clinic failed on account of its social and material environment. Even the most banal factors could take on “hypnotic significance”: Ilma S. was unknowingly hypnotized by other patients, who compassionately laid their hands on her forehead,91 while ticking clocks and various shiny objects put her into a state of “autohypnosis.” It was not only such interventions arising from the everyday life of the clinic that interfered with Krafft-Ebing’s experimentation. In a hypnotized state, Ilma S. also demanded that he apply practices which other doctors and even laypersons had previously used on her: To the question as to what could be done to help her sleep well, the answer was obtained: “Then you must do as Professor Jendràssik.” “How did he do that?” “I can only tell you that if you command me.” “I command you.” The patient, her raised voice trembling with agitation, said: “He did it by means of fixed gaze, while he laid the magnet with his hand over it on my head; but that hurt me very much.”92

This referral to the practices of his predecessors, which are unknown to Krafft-Ebing, forces him to resort to various improvisations (e.g., cobbling together a fake magnet, because a real one is not immediately available). 89. Ibid., p. 36. 90. Ibid., p. 60. 91. Ibid., p. 105. 92. Ibid., p. 106.

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It also gives rise to a correspondence with the patient’s earlier hypnotists for the purpose of garnering information on previously used practices. Hereby Krafft-Ebing is also informed of symptoms that his predecessor has already “implanted via suggestion.”93 In order to retain control of the hypnosis experiment, the medical expert is forced to enter into an alliance with the protagonists of hypnosis cultures outside of his clinic and risks, as the previous example demonstrates, to endorse the script and the practices of animal magnetism in which the “lucid” subject details the correct procedures to adopt.94 Krafft-Ebing’s second thoroughly documented hypnosis case, which he presented at an 1893 meeting of the Association of Psychiatry and Neurology in Vienna, precipitated a scandal in which this problematic aspect of hypnosis experimentation was publicly exposed. For his demonstration, KrafftEbing selected a woman who had not been diagnosed as hysterical, but whose favorable “predisposition” for hypnotic experiments had been discovered by an aristocratic amateur hypnotist. Before his colleagues, Krafft-Ebing presented the posthypnotic transformation of his experimental subject into three different “personalities,” each of which depicted an earlier phase of her life in a short scene. In doing so, he was transferring for the first time to the Viennese medical world the diagnosis of “personality alteration” or “variation,” which was increasing dramatically in France. Albert Pitres, an adherent of the Salpêtrière school, had described in detail a number of hypnotic states that he had used in returning a patient to earlier phases of her life by suggestion.95 Suspicions that the subject might be simulating were combated in two ways: Firstly, Pitres questioned her in such a manner as to ascertain whether her memories of all later life events were inaccessible to her in the hypnotic state. Here the doctor made an appearance in the patient’s delirium, playing the role of someone who could have been present at the particular historical episode. This form of object-relation, with the difficulties in exiting the delirium it entailed, had already been an issue in the experiments of Binet and Féré at the Musée Charcot (see chapter 4). Secondly, Pitres tested the functioning of hysterogenic zones—as used in Charcot’s method of triggering hysterical attacks—previously isolated on the patient’s body. For the French

93. Ibid., pp. 25–27. 94. For the various links between animal magnetism and the practices of hypnotism in France, see Carroy, Hypnose, suggestion, et psychologie. 95. Albert Pitres, Leçons cliniques sur l’hystérie et l’hypnotisme faites à l’hôpital Saint-André de Bordeaux, 2 vols. (Paris: Octave Doin, 1891). The first famous case of such a “multiple personality” was published in 1888 by Bourru and Burot. See Hacking, Rewriting the Soul.

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clinicians, the absence of these psychical and somatic indicators proved that the patient was in a state of “altered personality,” or, to use Pitres’s terminology, of écmnesie.96 Without making specific reference to these French experiments, KrafftEbing integrated the production of various “personalities” into his own practice, whereby he modified the experimental situation on account of the specific context of the Viennese controversy. In selecting a subject who had not been diagnosed as hysterical, he clearly showed himself to be an adherent of Bernheimian suggestion. In his publication of the case, Krafft-Ebing used the form of a “dramatization” that reproduced the entire experiment as a dialogue between experimenter and his subject. In doing so, he took great care that his description of the artificially produced phenomena avoided the register of the stage shows, which other Viennese doctors (like Arthur Schnitz­ ler) were making use of at the time. Actually, he wanted his case to force a decision on whether hypnosis experiments were “the grand comedy” or a “reach into the unconscious life of the experimental subject.”97 Krafft-Ebing formulated the claim that the phenomena made visible were not “an ideal personality or role produced by suggestion,” but rather “a reproduction of earlier selves” from the unconscious of his subject.98 He presented his results as an empirical refutation of Meynert’s claim that hypnosis constricts the subject’s capacity to associate by creating a state of “experimentally produced idiocy.”99 Krafft-Ebing furthered his argument by carefully avoiding any terminological localization of the facts he was demonstrating within the framework of association psychology or brain physiology. Thus the hypnotic state could not be interpreted as a “constriction,” but rather as an “expansion” of the psyche, because the medical expert’s techniques gave him unlimited access to the unconscious images stored in the subject’s memory.100 For Krafft-Ebing, objective proof of the existence of his psychological facts was provided by three means of verification: firstly, the repetition of 96. Pitres, Leçons cliniques sur l’hystérie, 2:290. 97. Richard von Krafft-Ebing, in Anon., “Die Rückversetzung in einen früheren Lebensabschnitt (Hypnotische Experimente),” Neues Wiener Tagblatt no. 163 (15 June 1893): 4–5. 98. Richard von Krafft-Ebing, Hypnotische Experimente, 2nd ed. (Stuttgart: Enke, 1893), p. 11. 99. Ibid., p. 44. 100. Here Krafft-Ebing’s position differed fundamentally from that of researchers like Pitres, who defined the state of écmnesie on the basis of precisely the fact that it was no longer possible to awaken patients—in contrast to those under conventional hypnotic suggestion—from their delirium through a further suggestion. For Charcot’s adherents, this persistence of memory disturbance provided further proof of the reality of the occurrences reproduced.

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the experiments and the “psychological congruence” of the results obtained thereby; secondly, family members’ attestation that the “personality” produced experimentally identified truthfully with earlier phases in the subject’s life; thirdly, comparison of writing samples produced by the subject during the experiment with documents from earlier life phases. Hence the forms of evidence mobilized by Krafft-Ebing were not observable indices or zones on the subject’s body (as with Pitres and other adherents of the Salpêtrière school). Instead, they were derived solely from the testimony of “laypersons,” that is, of the subject’s family or of her lay hypnotist. From the very beginning, this line of argumentation elicited intense controversy, whose scope extended far beyond the confines of the Viennese medical world and ended in a scandal. Much of the debate it aroused was waged in the daily news­ papers. Moriz Benedikt, one of the many doctors present at the demonstration who concurred with Meynert’s standpoint, criticized the experiments vehemently. He took a stand as a decided opponent of the Nancy school, whose experiments he rejected as “a colossal accumulation of errors, illusions and vociferous aberrations around a small kernel of truth.”101 Benedikt, who adhered to the experimental practice of the Salpêtrière school and thus traced the experimental subject’s capacity to be hypnotized to her pathological disposition, pronounced Krafft-Ebing’s “medium” a hysteric, whose “comedies” could be exposed by any psychologist.102 Krafft-Ebing answered Benedikt’s vitriolic attack—which appeared in the daily press where the scandal was further fueled—by undertaking a second demonstration of his subject for an audience of medical specialists behind closed doors. He also published a second, expanded edition of his original report.103 In this replication, he also utilized physiological measurements borrowed from the Salpêtrière’s experimental practice: initially, Krafft-Ebing sought to disarm the claim that his subject was a hysteric by measuring her field of vision using a perimeter; during the hypnosis, the subject’s vital functions were monitored by a pneumograph and a myograph, whereby several doctors (including Freud) were invited to verify that she was not simulating.104 Thus Krafft-Ebing endeavored to support his original objectification tactics 101. Benedikt, Hypnotismus und Suggestion, p. 41. 102. Moritz Benedikt, “Die hypnotischen Experimente,” Neues Wiener Tagblatt no. 165 (17 June 1893): 5. 103. Anon., “Wieder eine hypnotische Séance,” Neues Wiener Tagblatt no. 191 (13 July 1893): 3–4; Krafft-Ebing, Hypnotische Experimente, pp. 35–37. 104. In the press, both the psychiatrist Karl Mayer and Freud were quoted as authorities that all the provoked phenomena were “pure facts.” Before the audience of doctors, Freud was reported to have “underlined the extraordinary importance and the seriousness of the matter,

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with a battery of supplemental physiological measurements in the style of Charcot. Benedikt, who was not present at this demonstration, pursued the counterstrategy of publishing a pamphlet exposing the evidence provided by the medium’s family as fraudulent. First and foremost, he used the disclosure of the subject’s true name, which was unknown to Krafft-Ebing, as a means of casting doubt on the credibility of the documentary evidence from her earlier life phases.105 Benedikt’s ability to publicly discredit the experimental subject by using information concerning her that was circulating on a daily basis led him to conclude that “Mr. Krafft-Ebing’s medium is not hysterical . . . , because it is likely that the whole affair is the play-acting of a girl, for whom playing at hypnosis is a means of amusing herself or attracting attention.”106 Krafft-Ebing had proven himself to be a “dilettante,” who had “no idea of women’s cunning, deceptive artifice and addiction to the spotlight.”107 Thus the Vienna controversy translated the debate between Nancy and Paris into two divergent positions regarding the factors that qualified the hypnotizing doctor as a psychological expert in an experimental or therapeutic situation. Krafft-Ebing derived a good part of his training as a hypnotist from his risky alliance with the popular culture of hypnotism. He later admitted that he had known the medium and her lay hypnotist for a longer period of time, and that in experiments undertaken at private gatherings he had learned the fundamental “tricks” involved in producing various unconscious states.108 Similarly to the case of Ilma S., the experiment took on the attributes by adding that he accepts the judgement of Professor Krafft-Ebing without any reservations” (Anon., “Wieder eine hypnotische Séance,” pp. 3–4). 105. Benedikt, Hypnotismus und Suggestion, pp. 74–76. 106. Ibid., p. 73. 107. Ibid., p. 78. 108. Berta Szeps-Zuckerkandl recounts such a demonstration in a private salon, which was attended by the famous Austrian actor Alexander Girardi, as well as by numerous members of the Vienna medical faculty (including Theodor Billroth): Krafft-ebing whispered something to the medium, whereupon the woman was visibly disquieted and began, after she had awakened, to move about the room shyly and anxiously. Then she approached Girardi. None of us, including him, noticed a thing. And yet the medium had, at Krafft-Ebing’s command, plucked out his watch with the dexterity of an international pickpocket. Like a dog bringing back a ball, she took it to Krafft-Ebing. Billroth, who had already given signs of his displeasure, sprang up enraged. “I’m not going to go along with this swindle any longer,” he cried out, “this is a scandal, a farce.” And to Krafft-Ebing, who stood there frozen, he said, apostrophizing: “Swindler.” Quite certainly, such a thing is not to be found in the annals of Viennese university circles. (Berta Szeps-Zuckerkandl, Ich erlebte fünfzig Jahre Weltgeschichte [Stockholm: Bermann Fischer, 1939], pp. 165–66)

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of a demonstration,109 in which his subject’s suitability was underwritten by the culture of lay hypnotism, from which he had recruited her for his work. His psychiatric access to the hypnotic phenomena was limited to translating them into an open classificatory system of “states”: neither had the subject been examined under isolated conditions (in the clinic), nor had the experimenter dissociated the lay hypnotist’s “tricks” from their original context. Krafft-Ebing cited unconscious states that the amateur had been able to produce in the presence of members of the medium’s family, giving them the same evidential weight as his own experiments. Benedikt, however, made other demands on the physician well versed in psychology: only by forming his judgments in continual mistrust of the patient and her social milieu could he obtain information of any value. To prove his authority in the experimental and therapeutic use of hypnosis, he cited a number of retrospectively published “memoirs,” which illustrated the “medical psychologist’s” diverse techniques of exposing deception.110 Recounting a number of episodes in which he had challenged the stage magnetist Hansen, Benedikt demonstrated how the neuropathologist must separate “miracles” from “facts,” uncompromisingly translating mediums’ inexplicable ability to assume various personalities and speak unknown languages into the vocabulary of physiological laws. According to this explanation, hypermnesia was not a supernatural gift, but rather the existence of a series of memory images fixed in the brain, which simply were projected outward mechanically.111 Like Charcot, Benedikt also gave precedence to observable symptoms on the subjects’ body over their statements.112 Thus, as a necessary prerequisite of any psychological hypnosis experiment, he demanded a medical system of control that used constant surveillance in producing domesticated subjects, whose social and psychological status had been clearly established.113 For want of any form of psychological control mechanism, Krafft-Ebing’s open alliance with “adventuresses, mistresses, coquettes and their male hangers-on” 109. Krafft-Ebing, Hypnotische Experimente, p. 14. 110. Moritz Benedikt, “Aus der Pariser Kongresszeit: Erinnerungen und Betrachtungen.” Internationale Klinische Rundschau 3 (1889): 1531–33, 1573–76, 1611–14, 1657–59, 1699–1703, 1739–42, 1858–60. 111. Benedikt, Hypnotismus und Suggestion, p. 32. 112. Benedikt, “Aus der Pariser Kongresszeit”; Moritz Benedikt, “Hypnose, hypnotische Suggestion und Kriminalogie,” Wiener Medizinische Wochenschrift 42 (1892): 1665–69. 113. According to Benedikt’s pessimistic opinion, this unambiguity was not to be achieved using “the hysterical individual” as the sole research instrument: “This instrument works with an irregularity that we cannot control, and we lack the necessary training to be able to use it for measurement, or even for close approximation.” Benedikt, Hypnotismus und Suggestion, p. 25.

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f i g u r e 13 . The caricaturist Theodor Zasche depicts the psychiatrist Krafft-Ebing here as a carnival barker who claims to be able to transform an old lady into a baby. From “Wiener Luft,” supplement to the “Figaro,” 1893.

discredited his experiments from the very beginning: “Compromised persons and those not registered with the police are the last people whose statements and behavior can be trusted a priori. The experimenter himself risks sinking to the level of a prestidigitator” (see fig. 13).114 For Benedikt, Krafft-Ebing was a poor psychologist not merely for having transported a show from the somnambulic cabinet into a scientific society without subjecting it to systematic physiological control mechanisms: the admission of evidence dependent on the subject’s family members had invali114. Ibid., p. 85.

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dated his argumentation entirely. The form of medical expertise practiced by Charcot that I have outlined in chapter 1 and to which Benedikt was indebted presumed a basic antagonism between doctor and patient. The techniques of isolation and control implemented at the Salpêtrière served to “expose” painful secrets kept in the family, which often could provide decisive insight in diagnosis. In several case histories, Benedikt demonstrated how the family doctor, operating as a sleuth and interrogator, must discover and disclose the patient’s secrets, for the most part sexual, through acute observations of the patient’s family life: “If the doctor guesses the state of affairs and proceeds with a certain diplomatic finesse and delicacy, he can be sure that a confession will be forthcoming.”115 He emphasized “how deeply the doctor must penetrate into the patient’s psychology and life history in order to be effective and assess the value of his curative methods.”116 The investigation of family secrets and the “secret sexual life of nervous patients”117 was presented as a procedure defying formalization, in which the physician’s tact—“a certain degree of artistic-psychological instinct”118—in the end led to a correct diagnosis. Benedikt also implicitly adopted a number of techniques entailing “psychological acts of violence,” which Bernheim’s book on suggestion recommended for dealing with hysterical patients. His purpose in doing so, however, was to underline their difference from his own methods: Benedikt maintained that his patients found their own path to “mental-hygienic selfgymnastic,” while the suggestion technique had a demoralizing influence on patients, making them “shatteringly aware of being the will-less tools of a medical trick.”119 Several conclusions can be drawn from the scandal surrounding KrafftEbing’s hypnosis experiments. Of central importance was the degree to which patients serving as experimental subjects within the medical culture of hypnotism became public figures. Krafft-Ebing’s cases were problematic,

115. Benedikt, “Aus der Pariser Kongresszeit,” pp. 1613–14. 116. Ibid., p. 1612. 117. Ibid., p. 1613. 118. Ibid., p. 1657. 119. Ibid., pp. 1657–58; Benedikt, Hypnotismus und Suggestion, p. 54. Benedikt felt that psychical treatment was only appropriate as a preparation for the actual therapeutic procedures, which were all physical in nature; see Moritz Benedikt, “Magneto-Therapie und Suggestion,” Neurologisches Centralblatt 12 (1893): 185–88. He saw magnetic therapy—which by this time was no longer in use at the Salpêtrière—as the suitable ersatz for hypnosis, not only because it operated under the assumption that a physical agent was exerting direct influence on the patient’s nervous system, but also, and most important, because it vested an external object with the procedure’s power, thus facilitating a “distanced” relationship between patient and doctor.

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and not only in terms of the facts they were used to demonstrate: many critics found them objectionable because they confirmed the suspicion raised by Meynert and others that the new experimental culture could not be confined to locations defined and controlled by medical experts. Defining the bounds of medical expertise itself became a problem, since both of Krafft-Ebing’s subjects had already been trained in a popular culture of hypnosis. In neither case did he succeed in disentangling the experimental subject from that culture: In the case of Ilma S., the experimenter was often forced to resort to the practices of his predecessors, which he could only infer by questioning her or by making educated guesses. The second case’s vicinity to stage hypnotism was all too apparent: not only the lay hypnotist, but also the subject’s entire family was involved in the case’s fabrication. It was not only a public of medical specialists who influenced the subject by intervening in demonstrations: reports in the newspapers played a role in shaping the two cases before Krafft-Ebing even had a chance to communicate them formally on the basis of his protocols. The public status of the subjects also affected the experimenting doctor’s form of case publication and authorship. Since the medical cultures of hypnosis had not developed a standard practice for anonymizing experimental subjects, it was not difficult for critics to discover and exploit their identities. The doctors of the Salpêtrière and the Nancy clinic, for example, used the initials or the first letters of the patient’s last name, and often specified his or her social status.120 Other authors even included their patients’ full names without any consideration for the consequences of doing so. In view of this practice, one medical observer expressed doubt as to whether it was “opportune to identify the patients using their entire names and not only their initials. . . . After all, more laypersons than physicians buy hypnosis literature.”121 The daily press’s disclosure of the subject’s identity in both of Krafft-Ebing’s cases represented an ethical as well as an epistemological problem. On the one hand, it marred the relationship of trust between hypnotic subject and ex-

120. The same applies to the photographs of patients in various hypnotic states, which the Parisian doctors published in Iconographie de la Salpêtrière and other works. This practice is also encountered in later publications by Pierre Janet, who continued to work at the Salpêtrière long after Charcot’s death. Parallel to the use of photographs, his cases studies also feature extreme fictionalizations of the patients and their case histories. See Pierre Janet, De l’angoisse à l’extase, vol. 1 (Paris: Alcan, 1926). 121. Julius Pauly, “Über einige neuere Publicationen auf dem Gebiete des Hypnotismus,” Wiener Klinische Wochenschrift 2, no. 4 (1889): 78–80; no. 10 (1889): 206–8; no. 12 (1889): 245–47; no. 17 (1889): 348–50; no. 21 (1889): 428–30; here no. 21 (1889), p. 429.

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perimenter. On the other hand, skeptics could mobilize the hypnotic subject to another form of testimony, thus redefining the object of the experiment. Before this background, maintaining a distinction between the register of the stage shows and of clinical scientific experimentation became problematic for everyone involved. In view of the risky alliance between scientific experts and the culture of lay hypnosis, the nature of the facts presented in the demonstrations remained open. Thus the experimenter risked not only sinking to the level of the arranger of a scene—or, as in Benedikt’s polemic, to a “prestidigitator”122—but also of appearing involuntarily as the object of his own experiment. The status of the hypnotic subject and of the unconscious states induced remained epistemically ambiguous: skeptics could either declare the phenomena demonstrated to be the result of willful deception, or of a hysterical disposition that went unrecognized by the doctor. In the controversy, many physicians based their arguments on the latter strategy, polemicizing against the dangers of the new form of psychical treatment and contrasting it with earlier physical conceptions of therapy.

122. Benedikt, Hypnotismus und Suggestion, p. 85.

6

Freud and the Vicissitudes of Private Practice

Public controversies and scandals were not the only obstacle standing in the way of the clinical transfer of the Nancy suggestion method to Vienna. When, a few years later, Krafft-Ebing published two hysteria cases that he had treated using Bernheim’s method, he noted that “failure” was the norm in his Viennese psychiatric clinic: “It takes splendidly exceptional cases to keep one from completely losing sight of the value of hypnotic treatment.” One of the main causes for these failures, as he saw it, lay in the difficulties of integrating a ward for patients suffering from nervous diseases into the psychiatric clinic. This ward, which was reserved for men as in Charcot’s clinic at the Salpêtrière, consisted of “a single large room, in which seriously ill patients are continually going in and out, making it impossible to provide the quiet and isolation desirable for hypnotic treatment.” Isolation was considered a necessity by the Viennese doctors who used suggestion therapy in other wards of the General Hospital. Firstly, it regulated the patient’s communication with other persons in the hospital. This helped to control the public circulation of information regarding treatment within the clinic and avoid the pitfalls experienced in cases such as that of Ilma S. Secondly, it made it possible to uncover more quickly the highly complex methods of simulation used by some patients to feign symptoms.

. Richard von Krafft-Ebing “Zur Suggestivbehandlung der Hysteria gravis,” [1896] in Arbe­ iten aus dem Gesammtgebiet der Psychiatrie und Neuropathologie (Leipzig: Barth, 1897), 2:182. . Ibid., p. 183. . See e.g., Gustav Singer, “Über Spontangangrän und Simulation bei Hysterie,” Wiener Medizinische Presse 34 (1893): 965–69; 1014–18.

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In this context, the most promising terrain for the cultivation of the new methods of psychical treatment was the private practice. Here the doctor was much freer to develop new configurations facilitating the isolation of the patient in an undisturbed atmosphere. In this stepwise process of development, the initial aim was to transfer the practices of suggestion treatment from the clinic to the consulting room of the physician in private practice. Before a more detailed description of these new settings in the wider context of the German-speaking countries is undertaken in the next chapter, I will need to outline the position that Sigmund Freud assumed as a doctor in private practice within the specific context of the Viennese medical world. Conflicting Ceremonies of the Cure Many of the doctors who had visited Nancy repeatedly ascribed the success of the French clinicians to the specific localities in which their experiments and cures took place. After his visit to Liébeault and Bernheim in the summer of 1889, Freud came to the conclusion “that a good part of this success is due to the ‘suggestive atmosphere’ which surrounds the clinic of these two physicians, to the milieu and the mood of the patients—things which I cannot always provide for the subjects of my experiments.” Benedikt, who was one of the few opponents of suggestion therapy to have extensive experience as a hypnotist, also emphasized the “psychical hold” exerted by the therapeutic setting on a female patient whom he had hypnotized on a number of occasions: “The feeling that I could so completely paralyze her impressed itself with instinctive intensity onto her psychological behavior toward me. In the salon, at dinners, on the promenades etc. she was mentally free in her interactions with me. When, however, she entered my cabinet as a patient, she lost all of her power of thought and will, even if she knew that hypnosis was not on the agenda.” Benedikt associated this effect with the “ceremony” of the cure, which awakened in the patient “mystic” notions of the physician’s power. For doctors in private practice like Freud and Breuer, there were a number of obstacles impeding the therapeutic exploitation of this power. In Vienna, hypnotic treatment was generally not tied to any specific location: only in cases necessitating examination with cumbersome apparatus (such . Freud, “Review of Auguste Forel’s Hypnotism,” SE 1:100. . Benedikt, “Aus der Pariser Kongresszeit,” p. 1659. . Ibid.

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as electrotherapy) was it possible for the doctor to summon private patients to his office. Otherwise, daily house calls or rounds in private sanatoriums were the routine. Thus the doctor using hypnosis was not able to operate in a stabilized setting that allowed the isolated observation of patients. He found himself struggling to gain his footing on conflict-laden terrain, confronting the unforeseeable disruptions arising from the patient’s resistances or the intervention of family members. These difficulties to achieve isolation and control over the course of the treatment were compounded by the fact that the social status of private patients was generally higher than that of the patients used for hypnosis experiments at the policlinic. For the doctor experimenting with hypnosis in a clinical setting, the educated patient, who was able to acquire background knowledge about the method by reading popular literature and medical handbooks, was not a suitable experimental subject. Johann Schnitzler, for example, expressly noted in a discussion of one of his cases that the patient does not belong to the class of people who read popular literature on hypnotism, one could well say for the purpose of misleading or impressing the doctor if he happens to try using hypnosis. [The] patient is too limited and uneducated for such ruses. However unpleasant the latter may be for the woman herself, the patient’s lack of mental superiority is of great value to the hypnotist; it rules out one of the most dangerous sources of error in the study of hypnotism.

The nerve specialist who applied the methods of hypnotic suggestion in his private practice on well-situated patients, then, had to devote his attention to what they read and to their critical attitude toward the treatment, “individualizing” his techniques as needed. Such difficulties became particularly apparent in the course taken by the therapy of a female patient who was initially treated by Krafft-Ebing at a private sanatorium in Graz and then by Breuer and Freud in Vienna between 1891 and 1893. As the surviving records indicate, Freud evaluated her as “precocious” in his anamnesis, noting: “Pa-

. In his sociological account of the emergence of the psychoanalytic setting, Abram de Swaan has insisted on this point. Conceived in the vein of Norbert Elias’s theory of the civilization process, his approach ignores however the specific problems of the various techniques of hypnosis Freud and other doctors had to confront and tends to idealize its experimental character. See Abram de Swaan, “On the Sociogenesis of the Psychoanalytic Setting,” in Norbert Elias, ed. Eric Dunning and Stephen Mennell (London: Sage, [1978] 2003), 4:171–202. . Schnitzler, “Exstirpation von Nasenpolypen in der Hypnose,” p. 1260.

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tient does nothing but read and write.” In a letter to Krafft-Ebing, she complained about the use of hypnosis on her and theorized how the technique had triggered her “nervous conditions.” She mentioned to Freud that “generally the pressure on her had provoked the first convulsive states in her face.”10 Freud prescribed “hypnosis using Bernheim’s method, but not often,”11 and avoided the practices of pressing and stroking that the patient had criticized. His treatment, however, remained unsuccessful. In his unpublished case history, which dates from 1893, Freud blamed its failure on the first attempts at hypnotization and on the patient’s subsequent “hysterical fits”: From then on she remained her own doctor, granting us the right to comfort her, be kind to her, listen to her rebukes as long as we respected the ceremonial with which she had surrounded herself and did not interfere with her cherished habits. She also criticized us doctors mercilessly and met every detail of our treatment with the invincible misgiving that it would only do her harm.12

In Freud’s evaluation, the “significant intelligence of the patient,”13 who posited a causal relationship between the hypnotic treatment and her nervous crises, stood in opposition to the suggestive therapy and rendered it impossible. The patient withdrew from the “ceremony” with which Breuer and Freud had planned to treat her and devised her own “ceremonial” in her family household as a means of mastering her symptoms. In the private practice, the power relationship between the doctor and the patient’s family members generally proved to be unfavorable for hypnotic treatment. In his first published case history involving hypnotic therapy, Freud described the manner in which the doctor was received at house calls: Far from being welcomed as a saviour in the hour of need, I was obviously being received with a bad grace and I could not count on the patient’s having much confidence in me. I at once attempted to induce hypnosis by ocular fixation, at the same time making constant suggestions of the symptoms of sleep. . . . Before I left the house I was also under the necessity of contradicting

. See Freud’s report quoted in Albrecht Hirschmüller, “Eine bisher unbekannte Krankengeschichte Sigmund Freuds und Josef Breuers aus der Entstehungszeit der ‘Studien über Hysterie,’ ” Jahrbuch der Psychoanalyse 10 (1978): 136–68, p. 157. 10. Ibid., p. 153. 11. Ibid., p. 156. 12. Ibid., p. 160. 13. Ibid.

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a worried remark by the patient’s husband to the effect that a woman’s nerves might be totally ruined by hypnosis.14

The skeptical attitude of family members toward the doctor was also apparent in another of Freud’s early hypnosis treatments, namely that of Elise Gomperz, who belonged to a prestigious Viennese family. While the patient cooperated willingly in the treatment, her husband, the philologist Theodor Gomperz, remained steadfast in his disapproval of the method: Only more and more confession and hypnosis—and we haven’t seen any miracles from it yet. The only change of condition I have been able to ascertain is continual deterioration. All sensible people, with the exception of Breuer and Freud, warn unceasingly against the continuation of these experiments, which until now have been less than futile. . . . Hypnosis, in my opinion, is like a newly invented medication for which no one knows the correct dosage, and which, like other (and precisely the most effective) curatives, has a poisonous effect when used improperly.15

On account of the scandal surrounding Krafft-Ebing’s experiments, hypnotic suggestion became a heatedly discussed topic in Vienna’s intellectual circles, and Gomperz was quick to condemn it to his wife as a “school of hallucination” that was only worsening her symptoms.16 The resistance of family members toward hypnotic therapy also interfered directly with its functioning, because the doctor was generally not left alone with the patient. Usually a witness—someone from the family or its circle of friends—was present at the sessions. Freud noted in his lexicon article on “Hypnosis” (1891) that the presence of family members often “disturbs the patient very considerably and decidedly diminishes the physician’s influence. Moreover the subject-matter of the suggestions which are to be imparted in the hypnosis is not always suitable for conveyance to other people closely connected with the patient.”17 Krafft-Ebing also criticized a Hungarian law requiring the presence of a third person, because this violated the “relationship of trust” between doctor and patient, “which often was the equivalent of that of the Father Confessor to the Penitent.”18 In cases involving sexual problems he thus recommended using a deaf person as a witness. 14. Sigmund Freud, “A Case of Successful Treatment by Hypnotism,” SE 1:117–28, p. 119. 15. Theodor to Elise Gomperz, 8 January 1893. Quoted in Robert A. Kann, Theodor Gom­ perz: Ein Gelehrtenleben im Bürgertum der Franz-Josefs-Zeit (Vienna: Verlag der Österreichischen Akademie der Wissenschaften, 1974), pp. 234–35. 16. Theodor to Elise Gomperz, 7 April 1893. Ibid. 17. Sigmund Freud, “Hypnosis,” SE 1:105–14, p. 107. 18. Krafft-Ebing, “Gutachten des k.k. obersten Sanitätsrathes,” p. 159.

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Originally Freud had seen the advantage of hypnotic suggestion in its facilitation of the doctor’s “undreamt-of influence on another person’s psychical life,” allowing him to “experiment on a human mind in a way that is normally possible only on an animal’s body.”19 The private medical practice, however, did not offer a favorable context for developing hypnosis along the lines of physiological laboratory experiments. In view of the difficulties entailed in gaining access to “rare” cases presented at Charcot’s clinic (and to the corresponding apparatus), Freud had pragmatically declared himself a follower of Bernheim in the controversy surrounding the therapeutic use of hypnosis. Nevertheless, he soon outlined the deficiencies of the suggestion technique in order to develop it into an experimental method.20 The first and foremost problem was the question of the patient’s mental state, which was left open by the renunciation of any means of monitoring somatic indicators on his or her body. The doctor’s only sources of data were his physiognomic observations and the conclusions that could be drawn regarding the patient’s inner state via interrogation. This central epistemological problem was indivisibly linked to the social relationship between doctor and patient: the former was continually confronted with the statements of the latter—some of them contradictory, some of them inconveniently well informed—which were “bound to shake his authority.”21 The second problem Freud noted was the difficulty involved in finding the proper dosage for the technique: “The degree of hypnosis attainable does not depend on the physician’s procedure but on the chance reaction of the patient.”22 A third problem lay in the tendency of both doctor and patient to fatigue rapidly in view of “the contrast between the deliberately rosy colouring of the suggestions and the cheerless

19. See Freud, “Review of Auguste Forel’s Hypnotism,” SE 1:98–99. 20. Ibid., p. 134. Regarding Freud’s pragmatism, see chapter 5, p. 128. The experiences that caused Freud to reach these conclusions derived mostly from his treatment of two wealthy female patients: Fanny Moser, the patient known as “Emmy von N.,” and Anna von Lieben (“Cäcilie M.”) in the Studies on Hysteria. Although he treated Fanny Moser in 1889–90, Freud’s notes were not published until 1895. The case of Anna von Lieben (1847–1900) was especially important, since she had consulted Charcot and seems to have traveled with Freud to Nancy in 1889. See Ola Andersson, Studies in the Prehistory of Psychoanalysis, pp. 74–76; Lisa Appignanesi and John Forrester, Freud’s Women (New York: Basic Books, 1992), pp. 86–103; Henri F. Ellenberger, “The Story of ‘Emmy von N.’: A Critical Study with New Documents,” [1977] in Beyond the Unconscious, pp. 273–90; and Peter Swales, “Freud, His Teacher, and the Birth of Psychoanalysis,” in Freud: Appraisals and Reappraisals. Contributions to Freud Studies, ed. Paul E. Stepansky (New Jersey: The Analytic Press, 1986), 1:3–82. 21. Freud, “Hypnosis,” SE 1:111. 22. Ibid.

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truth.”23 Thus the doctor was not able to take a standardized approach, being forced instead to “be on the look-out for a starting-point for his suggestions, a new proof of his power, a new change in his hypnotizing procedure. For him too, who has, perhaps, internal doubts about success, this presents a great and in the end exhausting strain.”24 In this new context, hypnosis could no longer be equated with experiments on animal bodies, as it had been in Charcot’s grand hypnotism; rather it proved to be “a sort of venture into the animal-taming business, which one in the long run cannot endure alongside other occupations.”25 Factoring Out the Problem of Simulation In view of these many obstacles and instabilities, Freud, together with his older friend and colleague Josef Breuer, turned again toward the experimental practices of Charcot and his adherents. In their “Preliminary Communication,” first published in 1893, “On the Psychical Mechanism of Hysterical Phenomena,” the two Viennese doctors presented a therapeutic method for remedying hysterical symptoms that was based on the investigation of repressed traumatic experiences under hypnosis and the subsequent verbal abreaction of the associated affect. Breuer and Freud integrated the techniques of confession demonstrated by Charcot and Benedikt—a tactical but unformalizable procedure for mentally influencing hysterical patients—into a proper method designed to facilitate the causal investigation of hysteria. Although Freud had in 1888 already mentioned this new approach as an alternative to the suggestion technique,26 it was not until the 1895 publication of the Studies on Hysteria that the “cathartic method” was presented in a detailed case study.27

23. Ibid., p. 113. As a footnote in his translation of the Leçons du mardi shows, Freud adopted this critique on the exercise of suggestion from Charcot, who had advised doctors using suggestion therapy “to consider from the first, how, in the possible case of a failure, you can make certain of a retreat ‘in good order.’ ” Sigmund Freud, “Preface and Footnotes to the Translation of Charcot’s Leçons du mardi de la Salpêtrière (1887–88),” SE 1:141. 24. Freud, “Hypnosis,” SE 1:113. 25. Sigmund Freud, “Bericht über einen Vortrag ‘Über Hypnose und Suggestion,’ ” [lecture at the Vienna Medical Club, 27 April and 4 May 1892] in GW suppl.: 166–78, p. 174. 26. Freud, “Hysteria,” SE 1:56–57. 27. After marrying his niece Martha, Freud was certainly familiar with Jacob Bernays’s study on Aristotle: “On Catharsis: From Fundamentals of Aristotle’s Lost Essay on the ‘Effect of Tragedy’ (1857),” American Imago 61, no. 3 (2004): 319–41. See also Martin Treml, “Zum Verhältnis von Jacob Bernays und Sigmund Freud,” Luzifer-Amor 19 (1997): 7–32.

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In the case history of “Anna O.,” which Breuer first published thirteen years after treating the patient, the therapy is based on the investigation of her “ideas inadmissible to consciousness” in a hypnotic state.28 The pathological phenomena emerging in the patient’s autohypnotic “absences” consisted of hallucinatory scenes, speech disturbances, and the alternating use of various foreign languages. Breuer assumed that his patient “was split into two personalities of which one was mentally normal and the other insane,”29 and made use of the concept “hypnoid hysteria.”30 In his later account, the cathartic method involved a true-to-detail reproduction of past life phases under hypnosis, which the doctor could bring about by inducing his patient to express them in words. Breuer’s technique for making the patient recount her personal history and “relive” episodes in it resembled to a great extent the practices employed by Binet and Féré in their hypnosis experiments (see chapter 3). Unconscious memories could be elicited by the exposition of items connected to her habits: “One had only to hold up an orange before her eyes (oranges were what she had chiefly lived on during the first part of her illness) in order to carry her over from the year 1882 to the year 1881. This re-living of the previous year continued till the illness came to its final close in June, 1882.”31 For Breuer, the genuineness of the scenes reproduced was conclusively verified by the coherence and the “internal consistency” of his patient’s narrative and by written evidence provided by her family.32 He stated that he would have been forced to rely on mere supposition “had it not been that every evening during the hypnosis she talked through whatever it was that had excited her on the same day in 1881, and had it not been that a private diary kept by her mother in 1881 confirmed beyond a doubt the occurrence of the underlying events.”33 In the case history, the genuineness of the phenomena produced in hypnosis was guaranteed by a verbal and textual system of

28. Breuer, in Josef Breuer and Sigmund Freud, Studies on Hysteria, [1893–95] SE 2:225. Breuer noted at this point that the expression bewusstseinsunfähig is “not unambiguous and leaves much to be desired. It is, however, constructed on the analogy of ‘Hoffähig’ [admissible to the court of a sovereign, cf. French entrée] and may in the meantime be used for lack of a better term.” As Strachey notes in his translation, it could also mean “incapable of consciousness” or “incapable of being (or becoming) conscious.” 29. Breuer, in ibid., p. 45. 30. See Albrecht Hirschmüller, The Life and Work of Josef Breuer: Physiology and Psycho­ analysis (New York: New York University Press, [1978] 1989), pp. 166–69. 31. Breuer, in Breuer and Freud, Studies on Hysteria, SE 2:33. 32. Ibid., p. 63. 33. Ibid., p. 33.

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reference that was provided by the patient herself and by her family. The only physiologically observable index available to Breuer was the intensification of the symptom in question during the process of “talking away” (Absprechen). In the end, the criterion for whether a patient was simulating was rooted not in her “hysterical disposition but, as Moebius has so aptly said, on its being complicated by other forms of degeneracy—by innate moral inferiority.”34 Thus the case history made use of the same line of argumentation as KrafftEbing, which in the wake of the scandal sparked by his public demonstrations had in the meantime been largely discredited. In the context of the scandalous affairs surrounding hypnosis, Breuer and Freud had abstained from using their private patients for public demonstrations. In their publications and presentations of their method before medical societies they limited themselves to cursory and schematic references to their cases.35 As an 1895 discussion among the members of the Vienna Association for Psychiatry and Neurology shows, such presentations were nonetheless precarious for both doctors and patients being used as experimental subjects. At one meeting, the Viennese physician Kauders presented several hypnosis experiments in which a commercial school pupil was healed of his writing cramp and developed various hallucinations in which he communicated with his mother as an imaginary object. For the experimenter, the genuineness of the phenomena was, as in Krafft-Ebing’s cases, proven solely by the character of the patient and his family: “honorable and credible people.” Hence the suspicion of simulation raised by the audience of doctors during the discussion was not only a threat to the scientific authority of the doctor: potentially it could also damage the reputation of the patient and his family.36 In view of this problematic situation, Breuer and Freud implemented a number of strategies designed to factor out the simulation problem while maintaining this familiar system of reference. Initially they limited themselves to a strictly textual communication of their cases, whereby they used pseudonyms and altered information relating to places and family circumstances to such a degree that a discovery of the patients’ identity was hardly possible. As authors, Breuer and Freud assumed a position more secure than it was possible to achieve in a clinical demonstration. Only if they had access to informal background knowledge concerning the treatment in ques-

34. Ibid., p. 243. 35. See Sigmund Freud, “On the Psychical Mechanism of Hysterical Phenomena: A Lecture,” SE 3:27–39. 36. Anon., “Verein für Psychiatrie und Neurologie: Sitzung vom 12. Februar 1895,” Wiener Klinische Wochenschrift 28 (1895): 514–516, pp. 515–16.

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tion would medical critics have been able to mobilize the patients—who bear pseudonyms such as “Anna O.,” “Emmy v. N.” or “Elisabeth v. R.” in the text—to another form of testimony.37 Thus the epistemological debate was transferred completely to the realm of literary retrospective diagnosis, whose object was no longer the patient’s observable body, but solely her textual representation within the case history.38 The historization of cases was another strategy taken by the two authors to protect the efficacy of their method against critiques explaining away its successes as the product of suggestive influences or simulation. The retrospective publication of the “Anna O.” case study allowed the authors to present her as a first pure case from the “pre-suggestion era,” in which conscious simulation on the part of the patient could be eliminated.39 Freud presented the case in a lecture as the “first case in which a physician succeeded in elucidating all the symptoms of the hysterical state”40 and positioned it alongside Charcot’s experiments, which actually were conducted at a later date. Drawing this connection made it possible to outline a seamless historical account of experimental hypnotism that conveniently left out the critique raised by Bernheim and Delbœuf against the facts produced at the Salpêtrière. 37. Fanny Moser (“Emmy von N.”), who was treated not only by Freud, but also by Auguste Forel, Otto Wetterstrand, and Oskar Vogt, was quoted as follows in a critique of his method: “Even Freud’s most celebrated case, Mrs. Emmy von N., complains bitterly to this very day about this experience, while she praises the healing effects of a later sleep cure involving purely suggestive treatment.” Korbinian Brodmann, “Zur Methodik der hypnotischen Behandlung,” Zeitschrift für Hypnotismus Zeitschrift für Hypnotismus 6 (1897): 1–10, 193–214; 7 (1898): 1–35, 229–46, 266–84; 10 (1902): 314–75, here 7 (1898): 234; see also Ola Andersson, “A Supplement to Freud’s Case History of Emmy v. N. in ‘Studies on Hysteria’ 1895,” Scandinavian Psycho­ analytic Review 2 (1979): 5–16. On the competition between Freud’s approach and Vogt’s and Brod­mann’s treatment, see chapter 7, pp. 130–37. 38. Thus—as is most readily apparent in the case of “Anna O.” (Bertha Pappenheim)—the clinical debate is continued in retrospective diagnoses, making use of historical sources (such as Breuer’s letters or unpublished case histories). See Henri F. Ellenberger, “The Story of ‘Anna O.’: A Critical Review with New Data,” [1972] in Beyond the Unconscious, pp. 254–72. An overview of various retrospective psychoanalytic interpretations of the case is provided in Max Rosenbaum and Melvin Muroff, eds., Anna O: Fourteen Contemporary Reinterpretations (New York: The Free Press, 1984). Up to the present, much secondary literature that endeavors to reconstruct the course of treatment of this famous case is set in a polemic context. Some authors have used the scholarship of Ellenberger and Hirschmüller to debunking ends and qualified Bertha Pappenheim, on a rather speculative basis, as a “gifted simulator.” See e.g., Mikkel Borch-Jacobsen, Remembering Anna O: A Century of Mystification (New York: Routledge, 1996), esp. pp. 91–92. 39. Josef Breuer and Sigmund Freud, “On the Psychical Mechanism of Hysterical Phenomena,” SE 2:3–17, p. 7. 40. Freud, “On the Psychical Mechanism,” SE 3:29–30.

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Finally, compared to the medical writing to date, Freud’s case histories developed a number of novel narrative strategies. The five main cases of the Studies on Hysteria vary not only with respect to the therapeutic approaches adopted, but also on the level of their concrete textual presentation. The only case that is reproduced in a manner similar to Krafft-Ebing’s cases, chronologically recounting the course of the treatment in protocol form, is that of Emmy von N. Even here Freud repeatedly adds additional information in the form of “footnotes and interpolated comments,” which represent the result of later experiences.41 The third and fifth case studies alter the actual temporal progression of the therapy, which the author expressly notes. Thus these texts provide an after-the-fact account of the treatment “as it might have taken place under favourable conditions.”42 The case histories presented in the Studies on Hysteria do not derive their weight as evidence from being detailed reproductions of clinical diaries, but from the plausible dovetailing of the doctor’s observation of symptoms with the patient’s life history as reconstructed from her narrative. Freud’s Revision: Analysis without Hypnosis In the four case histories that Freud wrote for the Studies on Hysteria, the attempts to factor out the problem of simulation took a further turn, which introduced a gradual revision of the method Breuer had used in the case of “Anna O.” In chronological order, each case demonstrated an application of the cathartic method that increasingly forwent the induction of a hypnotic state. In the book’s last chapter, Freud distanced himself from Breuer’s theoretical views, describing a modified variant of his own therapeutic method that was designed to make the disclosure of unconscious objects entirely independent of the use of hypnosis.43

41. Freud, in Breuer and Freud, Studies on Hysteria, SE 2:48. 42. Ibid., p. 107. 43. It is not possible here to provide a detailed analysis of the reception of the Studies on Hysteria or to explore the differences between the theoretical positions of Freud and Breuer. Two useful introductions are provided in Andersson, Studies in the Prehistory of Psychoanalysis and Hirschmüller, The Life and Work of Josef Breuer. For more recent accounts, see Johann Georg Reicheneder, “Sigmund Freud und die kathartische Methode Joseph Breuers,” Jahrbuch der Psychoanalyse 15 (1983): 229–50; Reicheneder, Zum Konstitutionsprozeß der Psychoanalyse (Stuttgart: Frommann / Holzboog, 1990); Kurt R. Eissler, “Eine Verzögerung in Freuds Gebrauch der kathartischen Methode,” Jahrbuch der Psychoanalyse 40 (1998): 31–43; and John For-

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This technical revision was a result not only of Freud’s changing position with regard to the theory of neurosis,44 but also of the practical difficulties encountered in his attempts to implement hypnosis in his private medical practice according to the standards of a controlled laboratory situation. Gradually, Freud shifted away from the dominant trend of the hypnosis movement in the German-speaking world, embodied by Auguste Forel’s Zeitschrift für Hypnotismus, with which he had pragmatically affiliated himself for a short time.45 The majority of physicians involved with the movement were attempting to expand the doctor’s consulting room into a laboratory by orienting their use of the method toward achieving the greatest possible depth of hypnotic sleep.46 Freud, in contrast, had in his 1891 lexicon article already declared the insignificance of the various degrees for the depth of hypnotic states established by researchers like Bernheim and Forel. From the observation that it was nonetheless possible to put a patient who did not accept the doctor’s suggestion to enter hypnotic sleep into an altered state of consciousness, Freud concluded that the method should not be restricted to “cases in which the patient becomes somnambulistic or falls into a deep degree of hypnosis. In cases . . . which in fact only have the appearance of hypnosis, we can achieve the most astonishing therapeutic results, which, on the other hand are not to be obtained by ‘waking suggestion.’ Here too, therefore, it must nevertheless be a question of hypnosis—whose only purpose, after all, is the effect which is brought about in it by suggestion.”47 In the third case history of the Studies on Hysteria, Freud demonstrated a modification of his technique that retained several elements of suggestion treatment, but without undertaking to define the specific qualities of the mental state induced in the patient.

rester and Laura Cameron, “ ‘A Cure with a Defect’: A Previously Unpublished Letter by Freud concerning ‘Anna O.,’ ” International Journal of Psychoanalysis 80 (1999): 929–42. 44. For this argument, see Hirschmüller, The Life and Work of Josef Breuer, pp. 177–83. 45. In the first volumes of the Zeitschrift für Hypnotismus, Freud was listed, alongside numerous other European physicians, as one of the journal’s collaborators. The first and only journal article in which Freud reported on a case in which he used the Bernheimian method of hypnotic suggestion was published here. See Freud, “A Case of Successful Treatment by Hypnotism.” For a condensed bibliographical account of the journal and its history in relation to Freud’s early work, see Terence A. Tanner, “Sigmund Freud and the Zeitschrift für Hypnotis­ mus,” Arc de Cercle 1, no. 1 (2003): 75–142. 46. See below, chapter 8. 47. Freud, “Hypnosis,” SE 1:110.

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When, therefore, my first attempt did not lead either to somnambulism or to a degree of hypnosis involving marked physical changes, I ostensibly dropped hypnosis, and only asked for “concentration”; and I ordered the patient to lie down and deliberately shut his eyes as a means of achieving this “concentration.” It is possible that in this way I obtained with only a slight effort the deepest degree of hypnosis that could be reached in the particular case.48

As soon as the patient has assumed a reclined posture, Freud begins the “analysis,” using simple direct questions as the vehicle for investigating unconscious objects (associations in the form of images or thoughts). If the patient’s confession falters, with the patient not remembering something or not wanting to say it, Freud uses a trick acquired from Bernheim: I inform the patient that, a moment later, I shall apply pressure to his forehead, and I assure him that, all the time the pressure lasts, he will see before him a recollection in the form of a picture or will have it in his thoughts in the form of an idea occurring to him; and I pledge him to communicate this picture or idea to me, whatever it may be. He is not to keep it to himself because he may happen to think it is not what is wanted, not the right thing, or because it would be too disagreeable for him to say it. There is to be no criticism of it, no reticence, either for emotional reasons or because it is judged unimportant. Only in this manner can we find what we are in search of, but in this manner we shall find it infallibly. Having said this, I press for a few seconds on the forehead of the patient as he lies in front of me; I then leave go and ask quietly, as though there were no question of a disappointment: “What did you see?” or “What occurred to you?”49

This technique circumvents the question of the patient’s state of consciousness entirely: any alteration thereof is demonstrated exclusively by the patient’s speech, upon which the progress of the analysis depends. The patient’s state is no longer defined by a bodily sign that must be stabilized (such as catalepsy); rather, following Bernheim’s example, it is “marked” by the doctor’s “mild word of command and a pressure with the hand.”50 Although the state produced by this technique bears—for the patient—some “resemblance to hypnosis,”51 Freud rejects any and every more exacting theoretical definition: “The mechanism of hypnosis is so puzzling to me that I would rather not make use of it as an explanation.”52 Thus Freud continues to pursue a 48. Freud, in Breuer and Freud, Studies on Hysteria, SE 2:109. 49. Ibid., p. 270. 50. Ibid., p. 109. 51. Ibid., p. 268. 52. Ibid., p. 271.

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strategy that factors out the epistemological problems of hypnotism in favor of his ontological interest in the realm of the unconscious. This allows him to employ the tricks of applying pressure, which Bernheim used to “mark” hypnosis, without accepting Delbœuf ’s skeptical conclusion that the entire method functions solely through its theatrical effect and the patient’s belief in the doctor’s power to cure. Freud instead operates under the assumption that the unconscious objects inhabiting the patient’s memory are laid out “as in a well-kept archive” and that they can be returned again to consciousness through the doctor’s “analysis.”53 In persuading his patients to reveal their hidden secrets, Freud dispenses with the use of external points of reference or physical objects as found in the experiments of the Salpêtrière and in Breuer’s treatment of “Anna O.” In this method the doctor also does not enter the scenes reproduced by the patient to steer their direction. In the method of “concentration,” the patient’s unconscious inner world is accessed exclusively through her verbalized selfobservations, whose flow is maintained by the doctor’s continual querying and pressuring. For the doctor, the one and only observable point of reference around which this new method revolves is the patient’s resistance—revealed in her physiognomy and behavior—to the investigation of unconscious psychical material. The use of this concept also shows Freud’s debt to Bernheim, who had used it in describing the ways in which a hypnotized person combated unpleasant suggestions (see chapter 2). Freud, however, now elaborates the concept of resistance in two key ways: Firstly, he couches it in quantitative terms, making it possible to set the entire course of a treatment in the theoretical framework of a struggle between various forces. Thus Freud translates the doctor’s concrete investment of energy in conducting a hypnotic treatment—the “venture into the animal-taming business”54—into a theory that reduces the patient’s activity to a single formula: “He is evidently quite unable to do anything but put up resistance.”55 Secondly, Freud sees “resistance” or “defense” as the patient’s conscious or unconscious maneuver of avoidance: “people who are not hypnotizable are people who have a psychical objection to hypnosis, whether their objection is expressed as unwillingness or not.”56 With this turn, Freud transposes all of the obstacles to hypnosis emerging in the therapeutic situation—a web of diverse local factors including the patient’s social milieu, her previous knowledge of the technique, the 53. Ibid., p. 288 (trans mod.). 54. Freud, “Bericht über einen Vortrag,” GW, suppl.:174. 55. Freud, in Breuer and Freud, Studies on Hysteria, SE 2:279. 56. Ibid., p. 268 (trans. mod.).

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influence of relatives, and so forth—into the inner psychical realm of the patient, his or her unconscious. In moving away from the hypnotic treatment by keeping up its semblance, Freud pursued the aim of creating an isolated and controllable space for the “psychical treatment” of nervous disorders. Thus he was drawing the consequences of the problems surrounding the culture of public demonstration that was characteristic of hypnotism. Not only was the degree to which the medical expert could steer the hypnosis experiment limited: the physician himself was continually putting his own symbolic authority at risk in the public arena. In view of the epistemic looping effect of the popular culture of hypnosis on its subjects, physicians who became adherents of Bernheimian suggestion elaborated new strategies of representation and objectification in order to develop a psychology of the unconscious on the basis of their observations of individual cases.

7

The Psychotherapeutic Private Practice between Clinic and Laboratory

During the 1890s, most of the European doctors who adopted the methods of hypnotic suggestion for therapeutic purposes took Bernheim’s clinic as the prototype for their own psychotherapeutic practice. Transferring the suggestion method used in Nancy to other cultures demanded an extensive reconfiguration of the experimental and therapeutic culture of hypnotism that had arisen under the local particularities of the French clinics. In accordance with Liébeault’s and Bernheim’s emphasis on speech, the first suggestion therapists turned away from the practices of Parisian laboratory research. The psychiatrist Otto Binswanger, for example, noted in 1887 that “almost all careful and conscientious observers . . . had in the course of their studies of hypnotism advanced from the production of hypnotic states using physicaltechnical aids to those using psychical influence by means of suggestion.” Even though some of the physical procedures for achieving hypnosis were retained, the complex machinery implemented by Charcot and his assistants at the Salpêtrière to produce a clearly defined set of hypnotic states gave way to a new setting, in which the doctor’s speech could elicit its maximum effect. Although this new configuration distinguished itself through a practice of hypnotization in which psychical processes were no longer materialized and localized directly, the theories underlying it were just as materialistic as those of Charcot and Bernheim. Most of the adherents of this movement, which formed around the Swiss psychiatrist Auguste Forel and his journal Zeitschrift . Otto Binswanger, “Hypnotismus. Pathologischer Theil,” in Real-Encyclopädie der gesammten Heilkunde, ed. Albert Eulenburg, 2nd ed., vol. 10 (Vienna: Urban / Schwarzenberg, 1887), pp. 90–124, p. 117.

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für Hypnotismus, sought to elaborate theoretical frameworks that could ground Bernheim’s rudimentary theorization of suggestion in contemporary brain research. As a result, their descriptions of the interaction between hypnotist and patient were cast in a vocabulary mixing moral and physiological terms. On the one hand, explanations for the suggestion method’s ability to produce certain phenomena were replete with concepts such as the “inhibition” and “dynamogenesis” of “ideational complexes” in the brain. On the other hand, numerous handbooks and introductions to the therapeutic use of hypnosis featured a host of practical tips for the doctor—how he should set up his consulting room, the role he should assume in interacting with his patients—in order to elicit the desired effect. According to the theoretical premises of this movement, the hypnotic state was physiologically identical with natural sleep. The only thing differentiating it from natural sleep was the hypnotist’s ability to exert control over it. In the following, I will show how new sites for psychotherapeutic treatment were created that emerged parallel to Freudian psychoanalysis: the private consulting room for hypnotic treatment was for the most part designed to channel the idea of sleep into the patient’s brain. In the transfer of the suggestion method to the private practice, the French clinics’ emphasis on visibility was minimized and superseded by the arrangement of the consulting room as an acoustic space. This new configuration of introspective hypnotism reflected a redefinition of the hypnotic subject as a spectator, who was to voluntarily concentrate his “attention” on mental objects through selfobservation. For this purpose, doctors also allowed themselves to be put into hypnotic states: both to help them understand the experiences of their patients and to present themselves as ideal experimental subjects. Thus doctors replaced patient demonstrations with another form of testimony, in which they reported on their own self-observations under hypnosis and in dreams. By means of an increasing systematization of controlled self-observation in the hypnotic state, they aimed to solve the simulation problem, which for Bernheim’s followers had remained open. Despite the rapid demise of Charcot’s experimental system after his death in 1893 and the public discredit of other attempts to bring hypnosis under experimental control, the ambition to create a site able to compete with the first psychological laboratories per. The focus here is on the rise of the private practice of the nerve specialist or psychotherapist. Hence I do not discuss the introduction of the technique of hypnotic suggestion into the psychiatric hospital, which occurred most prominently at Burghölzli in Zurich under Auguste Forel in the late 1880s.

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sisted for at least another decade in the development of the private psychotherapeutic practice. Voice Commands: The Soundscape of the Hypnotic Consulting Room In many respects, the consulting rooms of medical practitioners of hypnosis in the German-speaking world contrasted sharply with the Parisian clinics where hypnosis experiments were conducted on patients. Here the doctor’s aim was to calm the senses, not to stimulate them. The furnishings of the consulting room were carefully conceived to put the patient into a tranquil state of mind. Leopold Löwenfeld’s widely read handbook on hypnotism recommended that its material arrangement “create favorable surroundings for falling asleep, or at least not interfere with it.” Treatment should therefore best be conducted in a “quiet room . . . , whose lighting should be subdued.” From the standpoint of the suggestion therapist, the stimulation of sudden sensory impressions using brightly flashing lights or gongs and oversize tuning forks could at best induce “scare hypnoses,” which could only lead to a worsening of symptoms. The spontaneous phenomenon with which hypnosis is equated here is not the shock triggered by a mechanical accident or coincidence, but sleep induced in stages through a series of ideas or images. Hence the suggestion therapist seeks to structure space and time in such a way as to put into practice the equation of hypnosis with sleep. The method’s main objective is to enable the patient—“dressed in comfortable clothing and positioned on an armchair, sofa or the like”—to fall asleep quickly. As much as possible, the practices of suggestion are adjusted to conform with the patient’s individual sleeping habits at home: “Persons who are accustomed to take their afternoon nap in an armchair are seated

. Leopold Löwenfeld, Der Hypnotismus: Handbuch der Lehre von der Hypnose und der Suggestion, mit besonderer Berücksichtigung ihrer Bedeutung für Medicin und Rechtspflege (Wiesbaden: Bergmann, 1901), p. 108. . Ibid. . Ibid., p. 97. . The thematization of the pathological effects of noise in big cities took the equation of hypnosis and sleep as its point of departure; see Theodor Lessing, Über Hypnose und Suggestion: Eine psychologisch-medizinische Studie (Göttingen: Friedrich Kronbauer, 1907). See also Lessing’s pamphlet, which appeared in Löwenfeld’s series Grenzfragen des Nerven- und Seelenlebens: Theodor Lessing, Der Lärm: Eine Kampfschrift gegen die Geräusche unseres Lebens (Wiesbaden: Bergmann, 1908). . Löwenfeld, Der Hypnotismus, pp. 108–9.

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accordingly; others, who can only sleep reclined with their head resting on a cushion, are positioned in a manner that gives them the necessary support etc.” Thus the medical hypnotist’s consulting room is usually equipped with a host of newly designed pieces of furniture, which can be adjusted to accommodate the special positioning of the patient’s body. The mechanized forms of the chaise longue, sofa, couch, and armchair developed and refined in the second half of the nineteenth century (in part specifically to meet the needs of medical treatment and surgery) allow the greatest possible number of positions between sitting and lying. The comfort of such multifunctional “patent furniture” results from its “active” accommodation of the body. Many doctors employ specially designed hypnosis beds or armchairs with moveable backrests in adjusting to their patients’ bodily needs. This accommodation of the individual patient’s body reflects a trend toward facilitating a restive and relaxed posture, which Sigfried Giedion identified in his history of the mechanization of furniture as a countercurrent to historicist interior design. Such “uncomfortable” furnishings were to be found in the museum and consulting room of the Salpêtrière, and also in Charcot’s private practice. Some visitors pilloried the “unnatural” postures that this material arrangement—featuring pieces of furniture styled after various historical epochs—forced patients to assume: “The consumptive and the melancholic squirmed on Baroque prie-dieux from the thirteenth [sic] century. Patients plagued by muscular atrophy stretched their emaciated limbs on griffons, snakes or gargoyles. Imagine the patient’s hellish tortures on this old junk.”10 The fact that in retrospect such critics primarily saw the inhumanity of scientific medicine reflected in the furnishing of medical facilities demonstrates how self-evident the adjustment of the consulting room to accommodate the individual patient’s bodily attributes and needs had become. While the comfort of the chairs used by patients or doctors had played no role in the execution of the Salpêtrière’s hypnosis experiments,11 by the . Ibid. . Giedion has well demonstrated how this new furniture entered various domains of private and public life during the second half of the nineteenth century. “Comfort actively wrested by adaptation to the body, as against comfort passively derived from sinking back into cushions”: even if this opposition may seem a bit too schematic, it captures the vision of those who adopted a physiological attitude toward furniture. Sigfried Giedion, Mechanization Takes Command: A Contribution to Anonymous History (New York: Oxford University Press, 1948), p. 390. 10. Léon Daudet, Devant la douleur (Paris: Grasset, 1931), p. 19. 11. Questions of distinctive taste were much more important to doctors like Charcot, who himself built imitations of historical furniture together with his wife for his own home. See Mayer, “ ‘Ein Übermaß an Gefälligkeit.’ ”

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1890s doctors using hypnosis for treatment and experimentation understood the arrangement of the material setting and the adjustment of furniture to ensure the patient’s comfort as a constitutive factor in the induction of a hypnotic state. For Albert von Schrenck-Notzing, one of Germany’s most zealous exponents of hypnotism,12 minor details were decisive in the treatment’s success or failure: “Everything depends on the little things. A cushion improperly placed, a reclined position that is slightly uncomfortable, cold feet or minute disturbances can destroy the effect entirely.”13 Since the hypnotist is acting primarily “through the ensemble, through a very comfortable position” and “letting the patient lie tranquilly,”14 he avoids any complex manipulation of the body or use of instruments. Rarely are objects used to fix the gaze, since the fixation method is, like the use of light, identified with the Salpêtrière school. According to Auguste Forel, this method “does not achieve hypnosis, at the most a hysterical attack. With the fixation method, hypnosis is unsuccessful in most cases; suggestion functions for the majority of subjects.”15 In the action script of the suggestion method, the hypnotist’s physical intervention recedes in favor of a more or less exclusively verbal interaction between doctor and patient. Here the doctor induces hypnosis through his soft and monotonous speech, and the patient tells of his or her experiences in hypnotic sleep after awakening. The doctor’s success in putting the patient to sleep depends, as Liébeault noted early on, primarily on his manner of speaking. The new medical authorities on hypnosis advised against the use of “imperative suggestions,” especially in the case of “educated patients,” who often come to the doctor “with an outspoken horror at the ‘blind obedience’

12. Freiherr Albert von Schrenck-Notzing (1862–1929) was one of the first medical doctors to write a dissertation on hypnotism, Ein Beitrag zur therapeutischen Verwertung des Hypnotismus (Leipzig: Vogel, 1888). As a student he cofounded the Munich Psychological Society (in 1886 together with the philosopher Carl du Prel), later famous for its parapsychological séances. See Corinna Treitel, A Science for the Soul: Occultism and the Genesis of the German Modern (Baltimore: Johns Hopkins University Press, 2004), chapter 2; and Spiritismus und ästhetische Moderne: Berlin und München um 1900. Dokumente und Kommentare, ed. Priska Pytlik (Tübingen: Francke, 2006). 13. Letter from Schrenck-Notzing to Auguste Forel, 20 December 1889, in Forel, Briefe— Correspondance 1864–1927, ed. Hans H. Walser (Bern: Hans Huber, 1968), p. 237. 14. Ibid. 15. Auguste Forel, “Einige Bemerkungen über den gegenwärtigen Stand der Frage des Hypnotismus nebst eigenen Erfahrungen,” Münchener Medizinische Wochenschrift 35, no. 5 (1888): 71–76, p. 72. See also Eugen Bleuler, “Der Hypnotismus,” Münchener Medizinische Wochenschrift 34, nos. 37–38 (1887): 699–717, p. 717.

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of the hypnotized person.”16 If they used them at all, doctors resorted to physical interventions, such as stroking the body or manually closing the eyes, mainly when treating male patients: the male doctor was continually seeking to avoid any “sexual arousal” of the female patient.17 As a practitioner of hypnosis, the doctor should avoid causing any unpleasant sensations. In this regard he must devote careful attention to personal hygiene: For the hypnotist, one cannot stress enough the importance of keeping any unpleasant odors away from the patient, and of substituting pleasant odors if possible. Above all, the hypnotist must devote the greatest attention to his own person, and especially to his hands. I have very often heard from patients how pleasant the feeling is when the warm, dry, lightly perfumed hands of the hypnotist gently glide over the eyes and face. Conversely, other patients have assured me that at the touch of a cold or damp hand, or even worse of one smelling of tobacco or disinfectant, they experience disgust and would never fall asleep.18

The doctor must not only demedicalize his deportment and appearance in his interaction with patients: he must also adjust his personal presence completely to the sensitivities of each individual. Even “the sound of his voice” can “have an irritating effect on easily excitable or nervous natures.”19 Before beginning the treatment, the doctor engages each patient in a conversation about hypnosis, explaining carefully the method’s functioning and effect. This also gives patients an opportunity to air fears that may have arisen in their minds through what they have heard or read about hypnosis, and to express their expectations regarding the treatment. Sensationalist accounts of hypnotism, especially in fiction, were a frequent cause of trouble. Beginning with Guy de Maupassant’s Le Horla (1887), numerous horror novels in which a hypnotist brings people under his power, generally with criminal intentions, formed a public image of hypnosis that was often detrimental to treatment. This problem is evidenced by the 1892 publication of a collection of expert statements aimed at correcting popular distortions regarding the medical use of suggestion. In its pages, the Berlin neurologist Albert Eulenburg mentions the case of a female patient who “happened to read Samarow’s horror novel 16. Brodmann, “Zur Methodik der hypnotischen Behandlung,” (1898), p. 9. 17. Ibid., p. 275. 18. Wilhelm Brügelmann, “Psychotherapie und Asthma,” Zeitschrift für Hypnotismus 2 (1893–94): 84–93, 107–15, p. 91. 19. Brodmann, “Zur Methodik der hypnotischen Behandlung,” (1898), pp. 274–75.

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f i g u r e 1 4 . Albert von Keller: Hypnose at Schrenck-Notzing’s, c. 1885. Keller’s depiction of the dimly lit hypnotist’s consulting room underscores the mysterious power of hypnotic suggestion, here administrated on a female subject, whose head is unrecognizable, with a tense female witness watching the scene in a chair. (c) 2012 Kunsthaus Zürich.

Unter fremden Willen [1888], whereupon she was afflicted by such a blind fear of hypnotism that she renounced any and every treatment and departed with all possible haste.”20 The association of hypnosis with parapsychological research, as it soon became manifest in the work of Schrenck-Notzing and other students of hypnotism, was another source of trouble (see fig. 14). Physicians combated the negative or uncanny image of hypnosis conveyed by contemporary fiction and art by attempting to explain the method’s functioning to the patient in the greatest possible detail. As Löwenfeld’s

20. Albert Eulenburg, “Gutachten über Hypnose und Suggestion,” [1890] in Die Suggestion und die Dichtung: Gutachten über Hypnose und Suggestion von Otto Binswanger, Emil DuboisReymond et al., ed. Karl Emil Franzos (Berlin: Fontane, 1892), pp. 14–30, p. 24. Gregor Samarow was one of the many pseudonyms used by the German politician and writer Oskar Meding (1828–1903). For a discussion of the connections between fiction writing and the experimental cultures of hypnosis in France, see Carroy, Les personnalités doubles et multiples.

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handbook stresses, neglecting to provide such explanation significantly decreases the method’s chances of success, not only in the case of educated patients, but also in the case of “persons of the lower classes”: Of course the physician must adapt his explanation to the individual’s level of education and take into account the ideas regarding hypnosis that he or she has already acquired via other channels. Very often he must combat erroneous or completely outlandish notions, which—unfortunately this must be said—derive in part from statements emanating from the medical profession.21

The doctor’s persuasive explanation is considered to be a condition for and a part of the suggestion method’s success: the patient is instructed, reassured, and enlisted as an active participant. A patient of the Stockholm suggestion therapist Otto Wetterstrand, for example, reported that “even after the conversation with the doctor, I felt as if the cure had already begun. I was more relaxed, as if the very idea of having confided in a fellow human being had returned to me a part of my earlier inner harmony.”22 In beginning the treatment in this way, the doctor is following the example of Liébeault, presenting himself as a friend and adapting his suggestions completely according to the wishes of the patient. In Forel’s handbook, the hypnotist no longer appears as a Mephistopheles with his incantations, but as the healing doctor, or at least as a reliable man of science, whose methods are fully natural and not supernatural. Furthermore, it is within his power to make hypnosis appealing and desirable to the hypnotized person through suggestion. . . . This explains why the majority of persons who are hypnotized in this manner return for more and view the hypnotist as a friend.23

And yet this depiction of suggestion treatment as a service performed by the physician, in which he is to serve his clients accommodatingly, stands in contrast to numerous recommendations regarding the tricks that the doctor can 21. Löwenfeld, Der Hypnotismus, p. 106. 22. Otto G. Wetterstrand, “Selbstbeobachtungen während des hypnotischen Zustandes (Angaben zweier Patienten),” Zeitschrift für Hypnotismus 4 (1896): 112–21, p. 116. The Viennese physician Weisz claims precedence as one of the first suggestion therapists to make use of a method in which the initial consultation already carries the first suggestion: “Thus I awaken the patient’s interest and increase it, with the effect that the patient passes into hypnotic sleep with this suggestion, and that the following suggestions fall on favorably prepared soil.” D. Weisz, “Beiträge zur Suggestivtherapie,” Wiener Medizinische Wochenschrift 43 (1893): 1546–49, 1593–95, 1626–28, p. 1627. 23. Forel, Der Hypnotismus, 1st ed., p. 74.

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use to overcome his patients’ resistance or “catch them off guard.” Thus Forel advises doctors to administer suggestions in quick succession, giving each impulse “the subjective character of a dream, an experience, a perception or action before the patient becomes aware of it.”24 Here—as in Freud’s description of the treatment—the suggestion method is depicted as an antagonistic play of forces, in which the doctor must retain the upper hand. Forel understands suggestion as a sort of “joust between the dynamisms of two brains; one dominates the other to a certain degree, but only under the condition that it handles the other with intelligence and tact, agilely stimulating and exploiting its inclinations, and most of all not making it untoward.”25 The questions posed to the patient during the initial consultation situate him or her both as a client with his or her own concrete wishes and concerns and as a subject of clinical-psychological experimentation. The doctor encourages the patient to recount the history of his or her problems independently and completely, so that he is informed of the patient’s medical history in the greatest possible detail. Thus the course of hypnotic treatment can be individually adapted to the patient’s idiosyncrasies. Just as importantly, the doctor’s comparison of the patient’s oral account with his own observations, which at times are augmented by physical examination, reveals “whether and to what extent ‘imagination’ plays a role, as well as the patient’s degree of sensitivity and the depth with which autosuggestions, if they exist, have become implanted.”26 The investigation of the patient’s background and way of life, and especially of his or her sleep habits and dreams, serves as an indicator for “the nature of the patient’s intelligence, will and emotional makeup,”27 from which the doctor forms an image of the “patient’s overall personality” that indicates the direction in which he is to proceed.28 In addition to the doctor and the patient, a witness is often present during treatment. The presence of a third person (generally a family member or a trusted friend of the patient), something which the Nancy clinicians already saw as a minimum requirement of the hypnosis experiment, serves to protect both the patient and the doctor.29 However, many patients refuse this 24. Ibid., pp. 29–30. 25. Auguste Forel, Der Hypnotismus: Seine psycho-physiologische, medicinische, strafrechtliche Bedeutung und seine Handhabung, 3rd ed. (Stuttgart: Enke, 1895), p. 74. 26. Gerster, “Beiträge zur suggestiven Psychotherapie,” p. 322. 27. Ibid. 28. Brodmann, “Methodik der hypnotischen Behandlung,” (1898) p. 229. 29. Bleuler, “Der Hypnotismus,” p. 717; Auguste Forel, Der Hypnotismus: Seine psychophysiologische, medicinische, strafrechtliche Bedeutung und seine Handhabung, 2nd ed. (Stuttgart: Enke, 1891), pp. 116–17.

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practice, “because they do not wish to share the details of their illness with anyone but the doctor treating them.”30 In such cases, Löwenfeld advises doctors to circumvent the patient’s resistance to the presence of friends or family members by “sending the patient’s companion or any other witness into an adjoining room and leaving the door to the hypnotization room open.”31 Confronted with fearful or skeptical patients, many doctors resort to the strategy of demonstrating a successful hypnotization before the eyes of the patient. Löwenfeld’s handbook, for example, in some cases even recommends substituting the initial consultation completely with such a demonstratio ad oculos, because it stimulates “in the beholder an unconscious imitative instinct, which makes it much easier to put him to sleep.”32 This approach counters problems arising from the absence of the clinic’s “suggestive atmosphere,” which enabled the doctor to hypnotize several patients at once by taking advantage of the visually transmitted multiplication effect facilitated by the ward. Most of the doctors who transferred the suggestion method from the Nancy clinic to their private consulting rooms had to overcome the difficulty of adapting it to the individualized treatment of paying patients. On the one hand, particularly in the case of patients from the upper classes, they had to assure the privacy of treatment. According to Freud, for example, the main problem with group treatment as practiced in Nancy was that “the ailments of each individual are discussed before a large crowd, which would not be suitable with patients of a higher social class.”33 On the other hand, the medical practitioner of hypnosis could not easily do without this “powerful assisting factor”34 in inducing a state of heightened suggestibility in patients. Faced with this dilemma, most practitioners sought solutions allowing them to exploit the effects of “psychical infection” in the private consulting room while protecting the privacy of individual patients. Group hypnosis was a frequently used strategy for adopting and reconfiguring the arrangement of the clinic into a form suitable for private medical practice. Most doctors also saw an economic advantage in this approach, because it enabled them to treat a large number of patients within a short period of time. It made it unnecessary to summon suitable persons to the

30. Löwenfeld, Der Hypnotismus, p. 108. 31. Ibid. As is illustrated by a brief case history noted in Studies on Hysteria, Freud handled touchy situations by positioning family members behind the patient, where they were at least outside of his or her field of vision. Freud, in Breuer and Freud, Studies on Hysteria, SE 2:100–101. 32. Löwenfeld, Der Hypnotismus, p. 107. 33. Freud, “Hypnosis,” SE 1:108. 34. Ibid.

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office for the purpose of providing a visible demonstration,35 and more important, “the group hypnosis of multiple members of the female sex” conveniently solved the touchy problem for the male hypnotist of having a witness present.36 However, group hypnoses in which patients were treated individually also gave rise to undesired side effects. The first attempts undertaken by Schrenck-Notzing illustrate the nature of the problem: Every day I put three to five people to sleep at the same time, but I am not overjoyed with the results. Although the people fall asleep more easily, they incorporate every little conversation or noise into their dreams. Thus I have repeatedly experienced how a patient in his nighttime dreams saw himself subjected to a bloody operation at the place on his body where I had suggested a burn wound to another patient in a previous session. Or a patient coughs, and immediately others begin to cough as well etc. They have a reciprocal suggestive effect on one another, and often that is not good.37

To control such suggestive reciprocity, doctors using hypnosis developed various arrangements for ordering patients as a group while simultaneously separating them spatially and acoustically. The prototype for such facilities was set up by Otto Wetterstrand on the third floor of a large house in Stockholm’s aristocratic quarter. A visitor described it as an apartment consisting of three rooms connected by folding doors. A dark red, very thick rug covers the hardwood floor, deadening the noise of steps. The rooms are furnished like a parlor cluttered with all sorts of easy chairs, sofas, chaise longues and settees, each covered with a white spread. Here and there a partition serves to shield off some patient. Between two and four in the afternoon the parlor is never empty. There is a constant to and fro of patients. You enter the room, make yourself comfortable, receive your suggestion and then leave at your given time. Everything happens with hushed voices, and you hear nothing but a whisper here, a quiet snore there, a chair that is moved, the swishing sound of a robe. The doctor multiplies himself and finds time within these few hours to see the thirty to forty patients who spend a certain time or an entire afternoon here, putting them to sleep, giving them suggestions and then waking them up again.38

35. Löwenfeld, Der Hypnotismus, pp. 107–8. 36. Brodmann, “Methodik der hypnotischen Behandlung,” (1898) p. 269. 37. Schrenck-Notzing to Auguste Forel, 11 December 1889, in Forel, Briefe—Correspondance, p. 235. 38. Renterghem, “Liébeault et son école,“ p. 53. For Wetterstrand’s methods, see Otto Georg Wetterstrand, Hypnotism and Its Application to Practical Medicine: Together with Medical Letters on Hypno-Suggestion, etc., trans. Henrick G. Petersen (New York: G. P. Putnam’s Sons, 1897).

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Here the private medical consultation is modeled on Liébeault’s practice, whereby the reciprocal visibility and audibility accorded to patients by the latter is moderated in this setting by its material arrangement and by the rising and falling voice of the hypnotist. Usually Wetterstrand begins with patients who have already been hypnotized, whispering suggestions to them so softly that only they can hear them: “Thus W. exploits the powerful suggestive effect of the sight of so many people falling asleep so quickly while avoiding the interference caused by [unintended] mass suggestion. If W. wants to give a suggestion to two or more patients, he raises his voice accordingly.”39 Now the key agent in the practice of medical hypnotism is no longer the fixation of the gaze, but the use of the voice: hence the loudness or softness, the quickness or slowness with which a suggestion is administered can be decisive in the success or failure of the treatment. Accordingly, practical guides to hypnotism are filled with precise directions for speaking, such as: “Speak the last sentence with an increasingly lowered voice, which finally diminishes to a whisper.”40 The changing setting of medical hypnotism shows that doctors using suggestion had almost completely ceased to credit its effects to visible demonstrations, but rather to the creation of a special soundscape, which constituted the hypnotic group primarily as an acoustic community.41 Oskar Vogt’s specially constructed hypnotic chambers in the Bavarian spa Alexandersbad, inspired by Wetterstrand’s practice, separated patients by means of sounddiffusing cubicles among which the hypnotist circulated. Although patients were shielded from and unable to observe one another during individual treatment, the voice of the doctor, as he made his rounds and administered suggestions, created a link between them. Within a visually separated but acoustically unified space, individuals lying on various pieces of furniture became a group, shaped and controlled by the hypnotist moving through the sound-deadened interior. By modulating his voice to suit the suggestion being administered, the doctor formed variable acoustic zones, creating a suggestive background mood, before which words directed toward a certain 39. Forel, Der Hypnotismus, 2nd ed., p. 120. 40. Löwenfeld, Der Hypnotismus, p. 113. 41. I adopt the notions of the “soundscape” and the “acoustic community” from the historical-anthropological study of Murray Richard Schafer, The Tuning of the World (London: Random House, 1977). A soundscape is a sound or combination of sounds that forms or arises from an immersive environment. Acoustic communities are constituted by such soundscapes and their boundaries (e.g., the range of a speaker’s voice, or in the case of a village, the area within which its church bells can be heard).

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patient emerged, remaining comprehensible only to their addressee as the doctor lowered his voice and bent toward the individual ear. Vogt’s collaborator Korbinian Brodmann relates how the doctor went “from patient to patient in the hypnosis rooms, initially giving appropriate sleep suggestions to each one in a loud or moderately lowered voice, and then, as soon as this had taken effect, administering the individual therapeutic suggestions in a murmuring or whispering voice that could not be understood by the surrounding patients.”42 The hypnotist’s rising and falling voice functioned on two levels, both separating and unifying the hypnotized group: while it was addressed successively to the individual symptoms of each spatially isolated patient, it also diffusely affected all of the patients simultaneously by creating a tranquilizing and suggestive atmosphere. In this new ensemble of private hypnosis practice, all strategies—as found in Bernheim’s clinic in Nancy—oriented toward increasing suggestibility through visibility were reduced to a minimum. Here the doctor went out of his way to avoid spectacular or exciting demonstrations. The “psychical preparation” for hypnosis rested solely on the subtle presentation of patients unified in sleep: Onlookers should merely become accustomed to the sight of the comfortably sleeping patients lying there. They should get to know the quieting effect of hypnotic sleep, freeing themselves of all of their mysterious and frightening notions and coming to accept the idea that there is no reason for differentiating the peaceful slumber of hypnosis from normal sleep.43

Introspective Hypnotism The reconfiguration of hypnotic treatment in private medical practice went hand in hand with a redefinition of the hypnotic subject. Medical hypnotists no longer defined the subject’s state primarily on the basis of externally visible reflexes, but as a certain distribution of psychical “attention,” whose stable manifestation was reached by the elimination of undesired stimuli in a setting featuring subdued lighting and deadened acoustics.44 According to

42. Brodmann, “Methodik der hypnotischen Behandlung,” (1898) p. 268. 43. Ibid., p. 246. 44. This conception of attention did not emerge until the second half of the nineteenth century, in the context of the cultural and scientific problematization of new modes of experiencing space and time in modern industrial societies. For a recent attempt to come to terms with this complex issue, see for instance Jonathan Crary, Suspensions of Perception: Attention, Spectacle,

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the theoretical premises of doctors using hypnosis, the subject is composed of a sum of ideational complexes located in the brain, which can be dissociated or associated with the help of suggestion: “Under closer observation, suggestion shows itself to be an intervention in the associative dynamics of the mind. It dissociates that which was associated, and associates that which was not associated. Nonetheless, its primary intervention is inhibitory, a dissociation of associated (unconscious) mental (cerebral) automatisms.”45 In order to uncover the causes of psychical symptoms and reconstruct the patient’s personal history, hypnosis aims both to “inhibit” pathogenic complexes and to stimulate others. This reconstruction is, however, dependent on the communications of the person being hypnotized: aside from monitoring a few outward indicators, such as physiognomic expression, the experimenter leaves the deciphering of psychical processes up to the subject. In the new configuration, the subject is first and foremost a spectator of his own unconscious, which he or she is to observe and describe in the form of isolated objects. Thus both patients and doctors are expected to be proficient in techniques of self-observation. For the majority of French doctors experimenting with hypnosis, selfobservation was a method inferior to the expert medical observation of patients. Charcot had presented the Salpêtrière hypnosis experiments as the beginning of a new experimental psychology, which through clinical observation delivered the necessary scientific corrective to introspection. In practice this meant that at the Salpêtrière the rare cases of “hypnotizable hysterics”— and not doctors who occasionally conducted psychometric experiments on themselves—were the preferred experimental subjects. According to the assumptions of Charcot’s pupils, the patients’ “pathological excitability” made it possible, through a quasi-microscopic effect, to demonstrate the psychical phenomena of normal individuals in “considerable magnification.”46 As a means of revising the status of the suitable experimental subject, the physicians who decided to follow Bernheim, in addition to conducting counterdemonstrations on their patients, soon adopted the strategy of letting themselves be hypnotized, and of publishing the observations made in this state. The appendix of Auguste Forel’s hypnosis handbook, which was first published in 1889, offers a model for the rhetoric of such self-observation and Modern Culture (Cambridge, MA: MIT Press, 1999), who also refers to the spectacles of hypnosis, but without entering into its respective practices of observation in detail. 45. Forel, Der Hypnotismus, 1st ed., p. 49. 46. Féré, “Sensation et mouvement,” pp. 364–65.

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under the title “Two Hypnotized Hypnotists.” In the first case, the author recounts a form of “compulsive sleep,” accompanied by paralytic states and hallucinations, which regularly overcame him during the afternoon at the hospital where he worked. Forel reports on this phenomena as he experienced it at the time, but in retrospect he interprets it as a form of autohypnosis: “Now I understand clearly that I was autohypnotized, and that the autosuggestion of catalepsy or motoric inhibition gained increasing strength through its repetition and through the difficulty I had in freeing myself of it, because it increasingly convinced me of its power.”47 Initially the hypnotist’s presentation of himself as his own object of experimentation serves to underpin the assertion that “suggestibility is a characteristic of the normal human brain.”48 Thus it is aimed at disarming Charcot’s experimental approach, which selected its subjects exclusively on the basis of their pathological disposition. Here Forel resorts to the strategy, often employed in scientific controversies, of using himself or parts of his body in an experiment, thus producing evidence and modifying the experimental setup by bringing his own social authority to bear.49 However, the doctor does not assume the role of an experimental subject in a real test situation. Instead he presents himself within a retrospective textual report as an ideal experimental subject. At the same time, he proposes a model for the way in which doctors should describe their own experiences, especially in their endeavor to understand the processes at work in the persons they hypnotize. Among such descriptions, confessions of the affects arising in or caused by hypnotic states come to play an increasing role. The psychiatrist describes not only the disturbance of motor function but also the feelings of anxiety accompanying it and his “desperate efforts” to awaken from the involuntary somnial state. In a later edition of his handbook, Forel strengthened this accent by adding the comment: “At the time I began to fear that I would no longer be able to get out of this state, and I carefully avoided falling asleep in the afternoon.”50 This “subjective” admission of the strong emotional aftereffect of autohypnosis is utilized in a form that avoids diminishing the scientific observer’s

47. Forel, Der Hypnotismus, 1st ed., pp. 87–88. 48. Ibid., p. 88. 49. See Simon Schaffer, “Self Evidence.”; and Schaffer, From Physics to Anthropology—and Back Again (Cambridge, UK: Prickly Pear Press, 1994). Delbœuf had already used such strategies by slipping into the role of the experimental subject during a patient presentation at the Musée Charcot. See Delbœuf, Une visite à la Salpêtrière, p. 9. 50. Forel, Der Hypnotismus, 3rd ed., p. 222.

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“objectivity.” For Forel and his audience, the strong affect serves as the sole indicator of the veracity of the author’s recounted memories. The subjective staging of memories is thus a key aspect of this psychological objectivism.51 The second case of a “hypnotized hypnotist” reported in Forel’s handbook provides an immediate demonstration of this model. Here the psychiatrist Eugen Bleuler recounts his experiences in the hypnotic state, into which he has been put by Forel and other colleagues. Bleuler presents himself as a difficult subject, who up to this point has resisted all attempts at hypnotization (including those of the stage hypnotist Hansen). From the very beginning, he formulates a program for his first self-observation under hypnosis: “I was ready and willing to be hypnotized, but nonetheless attempted to resist most of the suggestions as a means of learning the power of the latter, and their influence.”52 Bleuler describes his state as one of “pleasant and contented tranquility,” in which he maintained “full mental clarity . . . in observing himself.”53 From simple symptoms to complicated sequences of action, Forel and his colleagues conduct the complete standard repertoire of hypnotic experiments on the psychiatrist, which he then describes from the perspective of the subject. To a large extent, Bleuler’s self-observation was conceived as a sort of repetition of his clinical observation of patients, in which he was testing the scope of potential resistance to the hypnotist’s influence on his own person. In his first report on his experiences with hypnotism, he had noted that the

51. The difference of this approach from the objectivism of the few previously published self-observations made by doctors under hypnosis is clearly illustrated by the following report, which is limited to a strictly physiological vocabulary: In these experiments, which I conducted together with my friend Professor Fleischl, he initially induced contraction in the muscles of my left hand that bend the thumb. There remained the doubt in my mind, however, that I might well be helping to cause the movement voluntarily. Then he stroked the outer edge (ulnar side) of my hand, and I expected the little finger to bend. To my great astonishment, the little finger did not bend: it stretched out. The latter movement had to happen, since the muscle that is responsible for it (abductor digiti minimi) is located there. But in this semihypnotic state, my anatomical knowledge had forfeited a certain degree of exactness. Instead of the expected success, another success arose, and I became convinced that this muscle contraction had occurred fully independently of the activity of my will. (Obersteiner, Der Hypnotismus, pp. 15–16) 52. Eugen Bleuler, “Zur Psychologie der Hypnose,” Münchener Medizinische Wochenschrift 36, no. 5 (1889): 76–77; [reprinted in Auguste Forel, Der Hypnotismus: Seine Bedeutung und seine Handhabung, 1st ed. (Stuttgart: Enke, 1889), pp. 81–86]. 53. Ibid.

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self-observations recounted to him by hypnotized subjects were for the most part contradictory: “Some people think that they have not slept at all, and believe that they have only obeyed the orders of the operator to please him. If they are challenged to resist these orders and themselves resolve to do so, they find that this is beyond their power.”54 This observation, which Breuer and Freud had also made in the wake of Bernheim,55 had allowed the practition­ ers of his suggestion technique to detach the simulation problem from the statements of experimental subjects. Nonetheless, it remained uncertain as to which psychical process lay at the basis of this “dissociation.” The methodical induction of various phenomena on the doctor’s body and his subsequent account of his “self-perception”56 were intended to garner him an epistemically privileged position, and to free the definition of the hypnotic state from the frequently unreliable statements of his patients. The doctors saw the involuntary actions that they were induced to carry out under hypnosis as the hypnotist’s effect on their “unconscious.” Thus Forel cited Bleuler’s account as evidence for the “important role that unconscious cerebral activity plays in suggestion.”57 In this context, the “unconscious” does not refer to a precisely elaborated theory, but to an ensemble of practices that psychiatrists like Bleuler and Forel configured anew in the clinical space. Their techniques of questioning and observing patients integrated methods of self-examination that they developed in part from their own everyday practice, in part from other sources. One of these extramedical sources was observation of the genesis and modification of dream images, which were set in direct analogy to the phenomena of hypnosis. The analogy between dream and hypnosis had already served Delbœuf in a demonstration proposing an alternative definition for the status of the hypnotized subject in the Salpêtrière school’s experiments.58 Forel considered dreams to be the spontaneous counterpart of the suggestions administered in hypnosis

54. Bleuler, “Der Hypnotismus,” p. 701. 55. Breuer and Freud, Studies on Hysteria, SE 2: 228–29. 56. Wetterstrand, “Selbstbeobachtungen,” p. 118. 57. Forel, Der Hypnotismus, 1st ed., p. 88; Bleuler, “Zur Psychologie der Hypnose,” p. 77. 58. See chapter 4. An early overview of French dream research in the nineteenth century is found in Raymond de Saussure, “La psychologie du rêve dans la tradition française,” in Le rêve et la psychanalyse, ed. René Laforgue (Paris: Maloine, 1926), pp. 18–59. For a more detailed historical account of this tradition, see Jacqueline Carroy and Nathalie Richard, eds., Alfred Maury, érudit et rêveur: Les sciences de l’homme au milieu du XIXe siècle (Rennes: Presses universitaires de Rennes, 2007); and Jacqueline Carroy, “Les rêveries de Gabriel Tarde: Sciences des rêves et auto-fictions,” in Gabriel Tarde, Sur le sommeil: Ou plutôt sur les rêves (Lausanne: Éditions BHMS, 2009), pp. 1–44.

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experimentation: “Intense dreams (and the dumbest affects as well) can often influence our thoughts and actions for days, often more than the most beautiful logic. . . . We only know of the effects of dreams that we remember. Suggestion, however, proves to us that the forgotten ones can also continue to have an effect.”59 The degree to which the analogy between the dream and the hypnotic state had become firmly established is shown by Forel’s definition of the hypnotic state using a number of criteria that are characteristic of dream life: firstly, the images of dreams are the equivalent of hallucinations, since they simulate true occurrences; secondly, they are accompanied by “intense affective impulses” and can have “powerful retroactive effects on the central nervous system”; thirdly, dream images, in contrast to those of waking life, are “very deficiently associated,” because the brain finds itself in a state of “inhibition.”60 He also mentions further common qualities, such as the allegorization of sensory stimuli and the appearance of ethical and aesthetic “defects” in the personality of the dreamer, which he also attributes to “inhibition.”61 As a supplement to his first published self-observation, Forel included a collection of his own and others’ dreams to illustrate analogies between dream images and hypnotic hallucinations, whereby this collection was expanded in later editions of his handbook. Both the accounts included in Forel’s book and the tenor of the new medical reception of earlier dream research as a whole were characterized by incompleteness and selectivity: dreams were not deciphered for their latent meaning or associative connections, but served as an illustration of the state of artificially induced “dissociation” characteristic of hypnosis.62 The publication of self-observations and dream reports, which paralleled clinical observation, aimed to establish new practices of psychological experimentation. The doctors who made use of hypnotic suggestion claimed that their method put “into the hands of the psychologist the scientific method of experimentation, which he had previously been lacking.”63 In Germany a 59. Forel, Der Hypnotismus, 3rd ed., p. 54. 60. Forel, Der Hypnotismus, 1st ed., pp. 21–22. 61. Forel, Der Hypnotismus, 3rd ed., p. 53. 62. The parallel, but divergent, neuropathological reception of dream research at the Salpêtrière is reflected in the work of Pierre Janet. Here the patient’s dream is considered in its interaction with the symptoms of hysteria before the background of a pathological disposition. See Pierre Janet, The Mental State of Hystericals: A Study of Mental Stigmata and Mental Accidents, trans. Caroline Corson (New York: G. P. Putnam’s Sons, 1901). 63. Forel, Der Hypnotismus, 1st ed., p. 49.

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number of societies dedicated to the development of an experimental psychology based on the phenomena of hypnotism were formed after the French model. The central publication forum for this project was a journal founded by Forel in 1892, the Zeitschrift für Hypnotismus, Suggestionstherapie, Suggestionslehre und verwandte psychologische Forschungen, which initially was edited by an international collective of physicians and psychologists. However, the adherents of this largely European hypnosis movement, who advanced extensive psychological theories on the basis of their clinical practice, soon came into conflict with academic psychology, as it was represented by Wilhelm Wundt. Wundt attacked the hypnosis movement in a sharp polemic published in his own journal Philosophische Studien, denying the scientific validity of the hypnotic experiments and implying that the theories behind them were perilously near to occultism.64 The psychologist admitted in principle the value of self-observation, but only in accordance with the strict criteria for scientific experimentation that he had established in his own laboratory.65 The introspection practiced by Forel and Bleuler differed fundamentally from the “exact self-observation” demanded of subjects in Wundt’s Leipzig laboratory, because under hypnosis the self-observing individual was no longer in a position to voluntarily control his activity or adhere to an experimental plan. Thus Wundt relegated hypnotic phenomena, alongside dreams or hallucinations produced by drugs, to the category of artificially induced “abnormal states,” which once initiated robbed the subject of his capacity for introspection. He doubted whether the concentration necessary for self-observation could be achieved at all in the hypnotic state: “Deeper hypnotic sleep makes self-observation impossible on account of the amnesia that accompanies it. Even when using light hypnosis, which does not exclude the possibility of remembering, it is difficult to obtain useful statements from dependable

64. Wilhelm Wundt, “Hypnotismus und Suggestion,” Philosophische Studien 8 (1893): 1–85. The link with occultism was evident in the case of Schrenck-Notzing and other members of the Munich Psychological Society (such as Du Prel or Dessoir), but not as systematic as Wundt implies. His position on the subject of occultism had already formed more than a decade earlier, when he was involved as a witness in Zöllner’s experiments with the American medium Henry Slade. See Treitel, A Science for the Soul, chapter 1; and Klaus Staubermann, “Tying the Knot: Skill, Judgment and Authority in the 1870s Leipzig Spiritistic Experiments,” British Journal for the History of Science 34 (2001): 67–79. 65. See Wilhelm Wundt, “Selbstbeobachtung und innere Wahrnehmung,” Philosophische Studien 4 (1888): 292–309; and Danziger, Constructing the Subject, pp. 34–36.

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persons practiced in psychological observation.”66 According to this criterion, the observations of the doctors themselves were just as inexact as those of their patients: they were “hardly more than a conformation of that which could already be deduced from the general behavior of hypnotized persons.”67 In developing his own theoretical ideas, Wundt confronted Forel’s published self-observation with one of his own. Initially his account pursues the same strategy of retrospective self-diagnosis. The psychologist also discusses a “dreamlike state,” experienced more than thirty years before, during his hospital residency, which the retrospective account defines as “a light degree of spontaneous somnambulism.”68 Wundt, however, takes a different approach, not only providing a general description of this state, which he compares with fainting spells and the use of narcotics, but also linking it to a specific lapse in the performance of his clinical duties. He describes in detail how, in a sleep-drunken state, he administered a dose of iodine tincture to a female patient instead of the needed painkilling opiate. Wundt also specifies the elements of this erroneous chain of associations of which he was conscious, and those of which he was not: I knew exactly that only iodine tincture was stored in that particular place, and that the medication I had administered was iodine. But with just as much certainty, I had transferred all of the characteristics of laudanum [the opiate] to the iodine, and thereby forgotten completely those of the latter. Even the amazement of the nurse could not cause me to have any doubts of what I was imagining. Only when I had again returned to my room did I become aware of what had happened; I was fully awake and realized instantly that I had acted in a sort of somnambulistic state. Frightened by the thought that the patient could have been harmed, I woke my fellow assistant, and in the early morning I also reported the incident to our professor. I only regained my calm when it became evident that my fears were unfounded.69

In his account, Wundt employs the same strategy used by Forel: retrospective diagnosis, as a means of qualifying the somnambulistic state as “spontaneous” and not artificially induced, combined with the confession of a strongly affective aftereffect guaranteeing to his medical readers the truthful reproduction of the incident in his memory. Nonetheless, the narrative is in every

66. Wundt, “Hypnotismus und Suggestion,” p. 29. 67. Ibid., p. 30. 68. Ibid., p. 33. 69. Ibid., pp. 31–32.

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detail formulated so as to be seamlessly translatable into Wundt’s own associationist terminology: It is not the fact that I suggested to myself “Iodine is a tranquilizing medication,” but rather the reason why I imagined it to be so that is of interest. Here the concept of “autosuggestion” is of no help. . . . Apparently two entangled associations are involved: the bottle, with its brown contents and its familiar surroundings, awakens the usual idea of iodine tincture, while at the same time it awakens the idea of laudanum, with its quality as a tranquilizing medication. From the elements of these two ideas there emerged into the foreground of perception from the one group the name “iodine tincture,” from the other the concept “tranquilizing medication,” both of them tied to the perception of a brown fluid found in a glass bottle.70

Thus Wundt dismisses Forel’s and Bleuler’s concepts of the “unconscious” and of “autosuggestion” as mere pseudo-explanations, in order to replace them with his own theoretical formulation.71 This led him—in accordance with Meynert, who had rebuked the use of suggestion as a therapeutic tool in the same terms—to define the hypnotized subject as a will-less automaton, whose “constricted consciousness” was helplessly exposed to the sensory deceptions and drives unleashed by hypnosis. Thus the hypnotized individual was found deficient in all of the qualities demanded of a good experimental subject in the Leipzig laboratory. Like most of the critics of hypnotism, Wundt shored up his epistemological judgment by adding a moral assessment of the relationship between the hypnotist and the hypnotized subject, which he condemned as a form of slavery: The relationship of dependence in which the hypnotized subject stands toward the hypnotist is one of slavery, which is, admittedly, only temporary. During its existence, however, it is a slavery under aggravating circumstances, because it denies the slave not only the right of disposal, but also of any possibility of such right over his will. In all of the ways into which a human being can enter into a relationship with another human being, this, which makes one into the machine of the other, is the most immoral.72

In order to achieve an effective redefinition of the hypnotic subject, the advocates of hypnotic suggestion had to establish a new configuration of 70. Ibid., p. 33. 71. As Métraux emphasizes, Wundt employed similar strategies in his attack on Freud’s The Interpretation of Dreams. See Alexandre Métraux, “Räume der Traumforschung vor und nach Freud,” in Die Lesbarkeit der Träume, ed. Lydia Marinelli and Andreas Mayer (Frankfurt: Fischer, 2000), pp. 127–87. 72. Wundt, “Hypnotismus und Suggestion,” p. 79.

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practices that could permanently invalidate the epistemic and moral objections of their critics. The Fractionation Method: Oskar Vogt’s Laboratory of Hypnosis Within the hypnosis movement in the German-speaking countries, the German physician and brain anatomist Oskar Vogt (1870–1959) worked with great constancy for several years on the conception and realization of a hypnosis laboratory designed to expand suggestion technique into a proper method of experimental psychology.73 Initially Vogt’s endeavor was aimed at vindicating the “discredit” into which the “experimentation of the hypnotists” had fallen among German academic psychologists.74 In the process, he developed both a new theoretical definition of suggestion and a specific technique for training experimental subjects. The relationship between the hypnotist and the hypnotic subject was now presented as the ideal configuration of a psychological experiment. Vogt sought to convince the psychologists that hypnotic states of consciousness could be systematically induced in any person, and that these states not only fulfilled Wundt’s stipulations for methodically planned self-observation, but also expanded its object of research to include unconscious phenomena. By establishing the doctor’s practices of introspection as the model for the hypnotic state in the patient as well, he presented physicians making eclectic use of suggestion with a unified and consistent technique for turning even difficult and resistant patients into good subjects. At the same time, self-observation became a necessary condition for the “psychological training” demanded by the practitioner. The major forum for this dual strategy was the Zeitschrift für Hypnotismus, whose profile and 73. Because Vogt, after 1900, primarily turned his attention to brain anatomy and published almost no further work on his hypnotization technique, his method has to this day received almost no mention in the historiography of hypnotism, psychotherapy, and psychoanalysis. Ellenberger only mentions him in passing (Ellenberger, The Discovery of the Unconscious, p. 254), and Gauld briefly discusses his brain-physiological theories (A History of Hypnotism, pp. 537–43), but without setting them in the scientific and political context. For such a contextualization, see Michael Hagner, “Gehirnführung. Zur Anatomie der geistigen Funktionen, 1870–1930,” in Ecce Cortex: Beiträge zur Geschichte des modernen Gehirns, ed. Hagner (Göttingen: Wallstein, 1999), pp. 177–205. Satzinger’s monograph provides the first reconstruction of several episodes in the 1890s that were of significance in Vogt’s career as a medical hypnotist, but it does not give an account of the concrete practices involved. Helga Satzinger, Die Geschichte der genetisch orientierten Hirnforschung von Cécile und Oskar Vogt in der Zeit von 1895 bis ca. 1927 (Stuttgart: Deutscher Apotheker Verlag, 1998). 74. Oskar Vogt, “Die directe psychologische Experimentalmethode in hypnotischen Bewussteinszuständen,” Zeitschrift für Hypnotismus 5 (1897): 7–30, 180–218, p. 7.

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title changed considerably in its third year.75 In 1896, Oskar Vogt replaced the former collective of authors as the sole publisher and editor of the journal, which from this point on stood “under the special patronage” of his mentor Auguste Forel.76 Vogt’s difficulties in establishing hypnosis as a method of experimental psychology were similar to those encountered by other doctors in the German-speaking countries. Lacking strong institutional support and resources, he was forced to developed his method in a number of places, first in Leipzig where he served as an assistant to the psychiatrist Paul Flechsig in early 1895. Initially his efforts to establish his own laboratory failed due to the resistance and competition of his colleagues, especially psychiatrists and academic psychologists who, like Wundt and his students, viewed hypnosis with suspicion. After the failure of Vogt’s attempts to open a “hypnotic clinic” in Leipzig, mostly on account of Flechsig’s opposition, he practiced at the Bavarian spa Alexandersbad during the summer of 1896. Together with the neurologist Korbinian Brodmann (1868–1918), whom he met there, he created a facility designed especially for group hypnoses. He also adapted this arrangement of the hypnotic clinic for the “neurological central station” that he set up privately in Berlin in 1898 for the purpose of methodically conducting individual hypnoses (see fig. 15). Oskar Vogt and his wife Cécile, who had received her neurological training at the Salpêtrière under Pierre Marie, one of Charcot’s former assis­ tants, subsequently planned a research center attached to Berlin University consisting of a brain anatomical collection, a “medical-psychological institute,” and a “policlinic, which alongside its humanitarian ambitions” would deliver the “necessary patient material for teaching and research purposes.”77 At first glance the projected combination of brain research, hypnosis experimentation and therapeutic practice in one institute resembles that of Charcot’s neurological research center at the Salpêtrière. But in contrast to the research conducted in Paris, which juxtaposed patients with objects from the anatomical museum’s collection, the Vogts’ private Berlin institute aimed to strictly separate its various areas of research. This separation of psychological 75. See Oskar Vogt, “Zum Programm,” Zeitschrift für Hypnotismus 3 (1895): 356–59. 76. Beginning with the fourth volume, the journal was published under the title Zeitschrift für Hypnotismus, Psychotherapie sowie andere psychophysiologische und psycho­pathologische Forschungen. With the tenth volume, the journal was again renamed, this time to Journal für Psychologie und Neurologie, which was published by Forel and Vogt and edited by the latter’s collaborator Korbinian Brodmann. 77. Oskar Vogt, “Denkschrift vom 3.10.1899,” manuscript submitted to the Prussian Ministry of Education and Science, quoted in Satzinger, Geschichte der genetisch orientierten Hirnforschung, pp. 68–69.

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f i g u r e 1 5 . Oskar and Cécile Vogt, with their staff in their Berlin laboratory, studying a brain, among them Korbinian Brodmann (at the microscope). Undated photograph, around 1900. By permission of the C. & O. Vogt-Archiv, C. & O. Vogt-Institut für Hirnforschung, Universitätsklinik Düsseldorf.

and brain-anatomical practice was in part occasioned by the oppositions that Vogt and his team faced from a number of professors at the Frederick William University of Berlin,78 but it also corresponded with the dematerialization of the hypnosis experiment begun by Bernheim and his followers. Vogt and his collaborators attempted to establish an exclusively verbal index for the depth of the hypnotic state. Within this configuration, the subject’s suitability for hypnotic exper­ imentation is defined primarily by his or her “capacity for sober selfobservation,” including the ability to “adequately verbally express” the observed objects.79 Vogt lays down precisely articulated conditions for the introspection demanded of his experimental subjects: first and foremost, their “will” to self-observation must remain constant, and the object to be observed must “be present in its full intensity.”80 Thus he excludes from the experiment

78. In particular, the psychologist Carl Stumpf dismissed Vogt’s competence as an experimental psychologist; see Satzinger, Geschichte der genetisch orientierten Hirnforschung, p. 76. 79. Oskar Vogt, “Zur Methodik der ätiologischen Erforschung der Hysterie,” Zeitschrift für Hypnotismus 8 (1899): 65–83, p. 71. 80. Ibid., p. 74.

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both a number of sleep phenomena, like the dream, in which the will of the subject is weakened, and Wundt’s practices of retrospective writing. Vogt’s second energetically formulated condition is that during the experiment, the subject must retain his or her capacity for focused attention—“a certain quantum of psychical energy”81—so as to be able to direct it toward the objects to be isolated. Thus he identifies powerful affective states, as manifested in the Salpêtrière’s hypnosis experiments and in the “abreaction” described by Freud and Breuer, as disturbing factors. In his definition of an ideal subject, Vogt combines the criteria of academic psychologists like Wundt with the findings of psychopathological research. During the experiment, the subject should be in complete possession of his or her will and able to direct his or her attention toward “inner” psychical objects according to a prearranged plan. At the same time, a state of “dissociation” should enable him or her to observe these objects in their full intensity. Vogt describes this state of dissociation as “systematic partial alertness” (systematisches partielles Wachsein), which “displays full alertness for all of the elements of consciousness belonging to the [psychical] system of the experiment, but for all others a deep sleep inhibition.”82 Under this definition, the hypnotic state—in contrast to the self-observation practiced by Forel and Wundt—does not lead to will-less automatism or release morally inferior instincts. It is, rather, characterized by logical reasoning and discernment.83 For Vogt, the exemplary hypnotic subject is the psychologically trained doctor, who knows how to educate the persons undergoing his method into “good” subjects—in both an epistemic and a moral sense. His published self-observations were conceived not only as an example for other doctors but also for his patients, who were to be both cured of their symptoms and trained as suitable experimental subjects. This strategy of fulfilling a “normalpsychological” definition of a good subject resulted from the initial instability and heterogeneity of Vogt’s patient supply.84 Like most of Bernheim’s 81. Ibid. 82. Vogt, “Die directe psychologische Experimentalmethode,” p. 200. 83. Vogt retained the analogy between hypnosis and dream, although he differentiated dreams according to the depth of sleep. Thus he was able to equate deep-sleep dreams with a state of partial alertness and limit the “illogical associations” and “ethical defects” frequently observed by Forel, Wundt, and other dream researchers to dreams in light sleep, which he described as a “diffuse” state of dissociation having “only a loose connection to the core of the individual’s personality.” Oskar Vogt, “Spontane Somnambulie in der Hypnose,” Zeitschrift für Hypnotismus 6 (1897–98): 79–93; 7 (1897–98): 285–314, here 6 (1897–98): 80. 84. Initially, the few cases published by Vogt originated from Flechsig’s Leipzig clinic, where he for a short time worked as an assistant; see “Gesichtspunkte, Methode und Statistik von

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followers, Vogt was in the contradictory position of operating under the theoretical premise that “somnambulism can be induced in every mentally healthy individual”85 while being dependent on patients from the neuropathic clinic for obtaining his first practical experience with hypnosis. This situation led him to the conclusion that “it is the duty of the doctor, in all cases of illness suitable for hypnotic treatment, to train ‘somnambulic hypnosis’ through consistent disciplining.”86 Moreover, this disciplining was to be achieved in “educated patients” of the upper classes, who were not willing to be given orders, as was usual in the suggestion practice at Nancy. Hence the treatment commenced with a theoretical explanation of its aims: here Vogt began by “energetically refuting all of the false interpretations of the nature and functioning of hypnotherapy brought forth by his patients.”87 This measure was designed to draw in patients who had been previously hypnotized by other doctors using “physical” practices (such as the application of an allegedly “electrified hand”) and prepare them for purely verbal suggestive influences. During the initial consultation, Vogt inculcated in the patient an “awareness” for the qualities characteristic of a good experimental subject, whereby he made profuse assurances that he “never wanted to achieve blind obedience, that, on the contrary, he wanted to educate his patients to greater independence, to a heightened strength of will.”88 The “fractionation method,” which he developed for this purpose, organizes hypnosis as a slow process conducted in numerous gradated stages. The doctor begins by executing very brief hypnoses, which he interrupts repeatedly by awakening the subject and posing questions regarding his or her experiences: [Vogt:] “I’m putting my hand on your forehead, and the warmth from my hand is passing into your head.”—“Yes.”—“The warmth is spreading slowly from under my fingers to your eyes . . . do you feel that?”—“Yes!” (hesitating).—“The warmth is making you feel heavier, you feel how the warmth Dr. O. Vogt in Leipzig,” in Forel, Der Hypnotismus, 3rd ed., pp. 41–48. According to a letter from Vogt to Forel dated 7 February 1895 (Forel, Briefe—Correspondance, p. 305), he often hypnotized “fifty people during a single day” in the clinic’s “hypnotic ward.” The few cases published by Brodmann originate predominately from the spa Alexandersbad, as well as from the two doctors’ private practice, to which Forel regularly referred patients. 85. Vogt, quoted in Brodmann, “Zur Methodik der hypnotischen Behandlung,” (1898), p. 281. 86. Ibid. 87. Ibid., p. 243. 88. Ibid.

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is passing into your eyes and making them heavy. . . . The feeling is very distinct. . . . You feel that now!”—“Yes.” (The patient closes his eyes himself.)—“Now you are getting very comfortable, you feel how calm enters your body when you close your eyes.” . . . (an extended pause) . . . “Now I am waking you up again, and then you will fall back in more deeply. . . . 1, 2, 3, Awaken!”—In response to questioning: “My eyes got heavy and closed as if by themselves.”—“Now you will fall back into hypnosis and really fall asleep.”89

In contrast to Charcot’s pupils, who saw the success of the first hypnosis as the decisive test of whether a patient is suitable for the method or not, Vogt and his adherents considered these introductory practices to be “nothing more than a preliminary attempt, a check of the patient’s suggestibility.”90 The labeling of this step-by-step hypnosis as a “fractionation” draws on an “analogous nomenclature in chemistry, where a gradated distillation process is referred to as ‘fractionated.’ ”91 Thus Vogt and Brodmann are establishing a direct link between the objects of the chemical and bacteriological laboratory and the hypnotized subjects of their own private psychotherapeutic practice.92 The division of the procedure into short stages interrupted by continual questioning of the subject provides an indicator for his or her current state, thus establishing the doctor’s course of action at each stage. With this practice, the two physicians aim to tackle the epistemic uncertainty surrounding the achievement of hypnosis. In discarding the earlier control methods involving the patient’s body (such as the induction of automatic movements), the suggestion therapists are no longer able to verify “the degree . . . to which the psychical transformations in the hypnotized person correspond to our continuing suggestions.”93 Through the constant questioning of the patient during his or her adjustment to the arrangement and to the doctor, the fractionation method integrates the creation of a verbal index into the treatment itself. In addition to furthering this epistemic objective, the gradation of hypnosis, which can extend over hundreds of sessions, also serves to regulate the course of treatment of resisting patients.94 The resistance of many patients 89. Brodmann, “Zur Methodik der hypnotischen Behandlung,” (1902), p. 325. 90. Brodmann, “Zur Methodik der hypnotischen Behandlung,” (1898), p. 279. 91. Ibid. 92. Oskar Vogt, “Die Zielvorstellung der Suggestion,” Zeitschrift für Hypnotismus 5 (1897): 332–42. 93. Löwenfeld, Der Hypnotismus, pp. 115–16. 94. Vogt stated that it had taken him “700 sessions to achieve normal somnambulism in my best hysterical subject, and 200 sessions for my second-best subject.” Vogt, “Zur Methodik der ätiologischen Erforschung,” p. 76.

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to the attitude of “concentration” required by hypnosis often expresses itself in fits of laughing or crying, or through pronounced motoric phenomena (such as trembling or hysterical attacks), which appear during the initiation of treatment. In such cases, as the protocols published by Brodmann demonstrate, patients were guided by stages through suggestion into the position of calm necessitated by the setting: Patient is lying on a chaise longue, displays great restlessness and anxiety, her entire body flinches convulsively from time to time, and at every moment she writhes this way and that. 1st attempt: Dr. V.[ogt], without applying his hand: “Lie back very comfortably. . . . You can lie there very calmly . . . you will be able to remain lying longer and longer without having to throw yourself around . . . try it for a moment . . . so . . . you’re doing just fine . . . now we are finished. . . .” Duration: a few seconds.95

Over the course of a number of days, the patient is calmed and physically adjusted to the setting. Then the doctors dispel step-by-step the feelings of anxiety associated with some of the practices of hypnotism (such as the application of the hand): Continual convulsions of her entire body as long as Dr. V.[ogt]’s hand is resting on her forehead; the patient repeatedly attempts to push the hand away. Now the suggestion of tolerance of another hand is given: “You will now endure Dr. B.[rodmann]’s hand quite well, it won’t cause you any discomfort or fear. You won’t resist this hand at all.” This suggestion is realized immediately.96

Subsequently it becomes possible to transfer the effect achieved with the “other” hand to Vogt’s hand. Initially, the disciplining of such motorically expressed resistance seeks to calm the body, and then to create a positive emotional state, which is continually evaluated by questioning. As subjects increasingly adjust to hypnosis, they themselves demand that disturbing factors, both inward and outward, be eliminated. This sort of exemplary behavior is demonstrated by the extensive protocols published by doctors who themselves took turns at undergoing the procedure as a means of increasing its efficiency.97 The German doctor Johannes Marcinowski, for

95. Brodmann, “Zur Methodik der hypnotischen Behandlung,” (1902), p. 340. 96. Ibid., p. 341. 97. Vogt, “Die directe psychologische Experimentalmethode”; Johannes Jaroslaw Marcinowski, “Selbstbeobachtungen in der Hypnose,” Zeitschrift für Hypnotismus 9 (1900): 5–46, 177–90; Theodor van Straaten, “Zur Kritik der hypnotischen Technik,” Zeitschrift für Hypnotismus 9 (1900): 129–76, 192–201.

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example, who depicts himself as a “nervous” case, reports of his resistance to hypnotization: Today I am not able to bring forth and feel that pleasant lack of any particular thought. Ideas chase one another and trade off rapidly. The suggestions annoy me; Vogt’s voice is irritatingly loud and his words come too quickly. I ask V. to darken the room more, but to no avail; every attempt is less and less successful. Finally I have the feeling that I am just lying there with my eyes closed and getting angry.98

It is a part of the hypnotist’s task to strengthen the effect of the acoustically and visually deadened setting and to make external disturbances, such as street noise, clock ticking, or piano playing from a neighboring apartment, inaudible to his subject through suggestion.99 Vogt considers the subject’s isolation from disturbing acoustic influences to be a key precondition for achieving a state of “partial alertness,” in which the subject is able to observe his or her unconscious thoughts as isolated objects. The gaze into psychical inner space corresponds with complete silence in acoustic space, analogous to the self-disciplined silence of the urban audience in a theater or concert hall.100 Marcinowski himself uses the analogy of being a “spectator” able to observe the images of his unconscious “in all their detail without effort or attention, as in a theater,” or of “looking into a stereoscope, in which pictures switch mechanically before one’s eyes, one after

98. Marcinowski, “Selbstbeobachtungen in der Hypnose,” p. 10. 99. On the basis of his self-observations, Marcinowski established the following scale of acoustic impressions: a. Not hearing, “entendre,” deep sleep with amnesia. . . . b. Not listening “écouter,” completely ignoring and suppressing acoustic stimuli with attention fully absorbed in something else, as in the dreaming state. . . . c. Indifference to stimuli darkly approaching consciousness . . . , also with regard to the hypnotist’s voice. d. Attention now and then passively captured by the voice in a wavering state between darkly conscious and conscious hearing. . . . e. Hearing everything, with indifference. . . . f. Hearing everything, maintaining calm toward it. . . . g. Hearing everything, distracted and disturbed by it. . . . h. Hearing everything, irritated by it. . . . i. Hearing everything, annoyance expressed through emotionally charged movements. (Ibid., pp. 26–27) 100. Richard Sennett, The Fall of the Public Man (London: Penguin Books, [1974] 2002), pp. 205–18. Sennett describes the practice of self-discipline in public space as the reciprocal dependency of the silently passive spectator before the great performer or conductor. In the new setting of the hypnosis laboratory, the doctor appears less as a virtuoso performer (as in Bern­ heim’s clinic in Nancy) than as an invisible conductor, who is able to “channel” and “guide” ideas in his patient’s brain.

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the other.”101 Steered by the hypnotist’s suggestions, the subject can watch his childhood memories pass before his eyes as a series of “silent pictures.” In his hypnosis laboratory, Vogt and his colleagues developed an action script in which the hypnotized subject was physically immobilized through the stepwise gradation of hypnosis, but in which, by achieving a state of introspection focused according to a carefully conceived plan, the subject was given the opportunity to unfold a high degree of inner activity and flexibility. In this setting, the isolation of unconscious objects was linked closely to the minimization of all external visual and acoustic stimuli. In demanding the cultivation of physical and mental discipline, and implementing new verbal control techniques to achieve it, the fractionation method created a subject understanding itself as a personality that could be broken down into its individual elements and reassembled. “Psychical Analyses”: Vogt versus Freud In developing their new method, Vogt and Brodmann were entering into competition not only with academic experimental psychology, but also with doctors like Freud and Breuer, who were also trying to transfer French hypnotism as it was practiced in the hospital to their private practice. In the Zeitschrift für Hypnotismus, Freud’s publications were reviewed and critically discussed by the two German hypnotists, especially regarding the most recent development of the conducting of “psychoanalysis” without the achievement of a hypnotic state.102 In 1898, Brodmann claimed that Vogt had been able to retrieve pathogenic memories in multiple cases of hysterical amnesia by way of “psychical analyses” (Psychoanalysen), following a similar approach to the one outlined in the Studies on Hysteria. The recommendation for a lasting therapy, however, differed crucially from the Freudian approach: for Vogt and Brodmann, the depth of the hypnotic state remained the essential indicator for the curative power of psychotherapy.103 101. Marcinowski, “Selbstbeobachtungen in der Hypnose,” p. 22, pp. 14–15. 102. See especially the reviews by Brodmann of Freud’s articles “Further Remarks on the Neuro-Psychoses of Defence,” (1896) [Zeitschrift für Hypnotismus 4 (1896): 260–62], and “On the Aetiology of Hysteria” (1898) [Zeitschrift für Hypnotismus 4 (1896): 387–89]. Vogt reviewed Sigmund Freud’s “Sexuality in the Aetiology of the Neuroses,” closing with the terse remark that “his method does not work with children, the feebleminded, the uneducated, and old people; it is at last only appropriate for those patients endowed with a normal mind.” Oskar Vogt, Review of Sigmund Freud, “Die Sexualität in der Aetiologie [der Neurosen],” Zeitschrift für Hypnotismus 8 (1899): 366–67, p. 367. 103. Brodmann, “Methodik der hypnotischen Behandlung,” (1898) pp. 33–35.

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The term “psychical analysis,” (psychische Analysen) as it was first used by Freud and Breuer, was by no means specific at this time. The aim of introspection was generally considered “analytic” in the sense of breaking down psychical phenomena into their elementary components (emotions, ideas, etc.), thereby loosely referring to chemistry.104 Freud used the term “psychoanalysis” for the first time in 1896 to bring together the various techniques he and Breuer had described in Studies on Hysteria in a unified method of research and therapy.105 In a programmatic article published in 1898, Freud explicitly differentiated his method for the first time from suggestion: “Since the manifestations of the psychoneuroses arise from the deferred action of unconscious psychical traces, they are accessible to psychotherapy. But in this case the therapy must pursue paths other than the only one so far followed of suggestion with or without hypnosis.”106 Competition between doctors in private practice, who made use of the same vocabulary, centered on their claims to be developing “symptomoriented” therapeutic techniques (like hypnotic suggestion) into a “causal” method.107 With regard to the construction of causal relationships based on material obtained from patients’ self-observation, the methods of the suggestion therapists differed from Freud’s psychoanalytic approach. Although Vogt cited the cases published by Breuer and Freud as a means of substantiating the existence of the phenomena he was investigating, he considered the Viennese doctors’ research to be “merely stimulating and not conclusive . . . , since it lacks indisputable psychological analyses.”108 Freud and Vogt’s epi­ stemic strategies diverged primarily in their approaches to bridging the gap between the empirical findings produced by clinical practice and the development of a general psychological theory of mind: while Freud operated within the opportunities offered by his clinical work with patients and modified

104. See, for example, Hugo Münsterberg, Über Aufgaben und Methoden der Psychologie (Leipzig: Abel, 1891); and Wilhelm Wundt, Logik: Eine Untersuchung der Principien der Erkenntnis und der Methoden wissenschaftlicher Forschung, Zweiter Band, Methodenlehre, 2nd ed. (Stuttgart: Enke, 1894), pp. 198–99. 105. Freud, “Further Remarks on the Neuro-Psychoses of Defence.” In contrast to Vogt and Brodmann, it was only later that Freud made the analogy between psychical and chemical analysis, often found in his correspondence with Wilhelm Fliess, explicit. See e.g., manuscript M, 25 May 1897, in FF:245–46; for a brief overview see Jean Laplanche and Jean-Bertrand Pontalis, The Language of Psycho-Analysis, trans. Donald Nicholson-Smith (London: Karnac, 1988), pp. 367–69. 106. Freud, “Sexuality in the Aetiology of the Neuroses,” SE 3:281–82. 107. See Freud, “Bericht über einen Vortrag”; Vogt, “Die Zielvorstellung der Suggestion.” 108. Vogt, “Die directe psychologische Experimentalmethode,” p. 17.

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the techniques developed thereby into a generally applicable “self-analytic” method, Vogt sought to establish criteria for psychopathological research and therapy by publishing only the self-observations of “normal” persons in his reports on hypnosis experiments. The criteria for causal analysis operative in the setting of the psychoanalytic practice and in that of the hypnosis laboratory refer to differing forms for cultivating practices of self-observation and elaborating models for the isolation of unconscious objects. The first key difference lies in the contrary definition of the theory and practice of self-observation developed within the two settings. According to Vogt’s assumptions, a certain distribution of attention must be brought about in the subject in order to make unconscious ideational complexes observable in the form of isolated elements. Self-observation, controlled by the hypnotist, is dependent on the disciplined subject’s concentration and adherence to an experimental plan. In this configuration, the subject’s discernment and capacity for self-criticism are key conditions for the isolation of the object—otherwise his or her statements cannot be evaluated effectively. Eliminating the subject’s critical attitude would make introspection impossible in two ways: firstly, the subject could not concentrate his or her “will” on the object to be observed; secondly, the subject would not be in a position to provide the experimenter with an “adequate verbal expression” of what he or she has observed. Hence Vogt and his adherents arrive at the problem of how the hypnotic state can be induced not only in themselves but also in hysterical patients, in a form that completely revises the conception of the hypnotized subject as a will-less and uncritical automaton.109 Their solution is to bring about a temporally extended transition to the hypnotic state in a long series of small steps. In order to obtain the highest possible degree of concentration from the patient in a carefully controlled acoustic space, the hypnotic state is systematically “fractionated” in a quasi-chemical analysis. It is not until this process has been completed that the patient’s statements are considered reliable. Freud, in contrast, operates under the assumption that the unconscious is repressed, and that the patient is always exercising resistance (or defense) against the discovery of the ideational complex: “The hysterical patient’s ‘not knowing’ was in fact a ‘not wanting to know’—a not wanting which might be to a greater or lesser extent conscious. The task of the therapist, therefore, lies in overcoming by his psychical work this resistance to association.”110 Thus 109. Vogt, “Zur Methodik der ätiologischen Erforschung der Hysterie,” p. 76. 110. Breuer and Freud, Studies on Hysteria, SE 2:269–70.

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the true bedrock of the “experimental situation,” as it is established from Studies on Hysteria to The Interpretation of Dreams, is found in a “quantitative” factor, in a “struggle between motives of varying strength or intensity,” which the doctor must decipher in a variety of ways.111 The patient’s current state is evaluated not through his verbal statements themselves, but through the degree to which they reveal resistance, which in the broadest sense is defined as every obstacle to the progress of the analysis.112 The doctor “deciphers” this resistance by closely observing the patient’s physiognomy and manner of speaking. If a subject in Vogt’s laboratory were to complain about an acoustic disturbance (street noise, the ticking of a clock, piano playing) interfering with his concentration, the experimenter would treat this statement as an important description of his current state, which necessitates a further modification of the procedure.113 For Freud such a statement is nothing more than an expression of the patient’s resistance: “ ‘My mind is distracted to-day; the clock (or the piano in the next room) is disturbing me.’ I have learned to answer such remarks: ‘Not at all. You have at this moment come up against something that you would rather not say. It won’t do any good. Go on thinking about it.’ ”114 In this context, the nature and purpose of the self-observation demanded of the patient differs greatly from that of Vogt’s approach. Although a special distribution of attention is also essential to the success of the method of free association, Freud introduces another revision with regard to the experimental cultures of hypnotism: he now dispenses with the induction of a special hypnotic state, whose mechanisms he from this point onward refers to as “puzzling.”115 In a further turn, he declares disciplined self-observation— the virtue demanded by Vogt of his experimental subjects—to be the main source of resistance to the “analysis.” The patients’ “will” (their “conscious searching and reflecting”) is what stands in the way of the therapeutic imperative to “adopt an attitude of completely objective observation toward the psychical processes taking place in them.”116 It is on the basis of this introspective practice that Freud, in The Interpretation of Dreams, defines the process of “self-analysis” undertaken by both patients and doctors as “uncritical

111. Ibid., p. 270. 112. Freud, The Interpretation of Dreams, SE 4:297. 113. Straaten, “Zur Kritik der hypnotischen Technik,” pp. 156–57. 114. Breuer and Freud, Studies on Hysteria, SE 2:279. 115. Ibid., p. 271. 116. Ibid.

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self-observation,” whose aim is to uncover and communicate “embarrassing” (aggressive, sexual) wishes.117 The doctor using the psychoanalytic method is able to see whether the self-observer is successfully “suppress[ing] his critical faculty” by observing his facial expression: In reflection there is one more psychical activity at work than in the most attentive self-observation, and this is shown amongst other things by the tense looks and wrinkled forehead of a person pursuing his reflections as compared with the restful expression of a self-observer. In both cases attention must be concentrated, but the man who is reflecting is also exercising his critical faculty; this leads him to reject some of the ideas that occur to him after perceiving them, to cut short others without following the trains of thought which they would open up to him, and to behave in such a way towards still others that they have never become conscious at all and are accordingly suppressed before being perceived.118

A second major difference in the conduct of “psychical analyses” is the way in which causal relationships are drawn between the psychical elements isolated through self-observation. In Freud’s method it is the doctor who establishes causality: both from the patient’s narrative (the “confession”) and from various observable signs (physiognomy, verbal expression, biographical details), which serve as indicators of his or her psychical state. The tech­ nique of using insistence and pressure outlined in the Studies on Hysteria establishes a clear distribution of roles: the patient is assigned a predominately passive role, in which he or she is impelled to reproduce the material without being able to uncover “important connections.”119 The doctor, in contrast, “conducts” the patient’s attention, overcoming resistance by applying pressure and drawing causal relationships between elements that he either culls from the patient’s narrative or posits by conjecture. This division of labor arises from the patient’s inability to see anything more than “individual memories” on account of the narrow “defile of consciousness.” Thus the psychotherapist has the task of “put[ting] these together once more into an organization which he presumes to have existed”120 and of getting the patient to “confess” and accept the causal relationships between the memories that

117. Sigmund Freud, The Interpretation of Dreams, SE 4:101–2. 118. Ibid. See also Freud’s remarks in his discussion of the pressure technique: “The patient’s facial expression must decide whether we have really come to an end, or whether this is an instance which requires no psychical elucidation, or whether what has brought the work to a standstill is excessive resistance.” Breuer and Freud, Studies on Hysteria, SE 2:294. 119. Ibid, p. 292. 120. Ibid., p. 291.

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the doctor has made accessible. At the end of the analysis, there arise “as the climax of its achievement in the way of reproductive thinking . . . thoughts . . . which the patient will never recognize as his own, which he never remembers, although he admits that the context calls for them inexorably, and while he becomes convinced that it is precisely these ideas that are leading to the conclusion of the analysis and the removal of his symptoms.”121 Vogt counters this practice of “analysis” with the assertion that causal relationships can only be established by the patients themselves in the course of making their confessions: “A patient who must be impelled to make confessions is unsuitable for exact experimentation. The first demand that we must make of our experimental subjects is that they verbalize unreservedly and with all openness that which they can identify through self-observation.”122 In contrast to Freud, Vogt operates under the assumption that the patient must, after having been disciplined to experience the hypnotic state in individual gradated stages, be capable of following the path of the analysis step-by-step and reassembling him- or herself as a new subject from this “fractionated” position. From the standpoint of this practice, Freud’s interpretations cannot but appear as arbitrary “causal constructions,” which are suggested to or forced upon the subject in order to confirm the theory. Vogt, in contrast, demands that the reconstruction of causal relationships depend solely on the statements of the subject: “In the Freudian method it is the experimenter who constructs the causal relationships from the patient’s individual statements. . . . The experimenter must refrain from making any construction of this sort. He must leave the entire analysis, the discovery of all causal relationships, to the subject.”123 The distribution of roles in the production of causality in Freud’s and Vogt’s methods sheds light on the third divergence, namely their handling of the balance of power between doctor and patient. In both methods, the patient’s role oscillates between that of an equal—a fellow researcher—and of an instrument serving the doctor in the study of unconscious processes. Freud, in view of his quantitative definition of therapy, depicts this partnership as a purely working relationship, in which resistance is to a large degree dissolved by the patient’s “intellectual interest”: “By explaining things to him, by giving him information about the marvelous world of psychical process into which we ourselves only gained insight by such analyses, we make him himself into a collaborator, induce him to regard himself with the 121. Ibid., p. 272. 122. Vogt, “Methodik der ätiologischen Erforschung,” p. 352. 123. Ibid., p. 354.

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objective interest of an investigator, and thus push back his resistance, resting as it does on an affective basis.”124 In the actual progression of the analysis, however, the patient primarily plays the role of a passively reproducing supplier of “material,” which only the doctor’s interpretation can set in causal relationship. In Vogt’s setting, the patient must be educated into a fellow researcher on equal footing, who also concurs with the experimenting doctor on the exact verbal formulation of his observations. Thus the suggestion therapist’s aim is to achieve an egalitarian handling of the rapport between the hypnotist and the hypnotic subject. The prerequisite of this relationship is the systematic disciplining of the subject into a spectator of his or her own unconscious, who, after successfully adopting the introspection technique, can also practice self-observation without the experimenter’s guidance. In the ideal case, then, the fractionation of the subject in this asymmetric dyad gives rise to a self-governing monad.125 Finally, Freud and Vogt also diverged crucially on the level of publication strategies. Initially Vogt only published self-observations that he had either culled from the literature and reinterpreted according to his theory, or that he himself, colleagues, or family members had conducted.126 Vogt used these cases to illustrate the efficacy of his methods, whereby for the most part he left their definition and publication up to his colleague Brodmann. This dogmatic form of representation blurs the method’s gradual and decentralized historical development, and it also plays down the fact that it was formulated with the cooperation of a shifting and heterogeneous body of subjects: the ideal experimental subject of the as-yet-to-be-established laboratory seems to already exist virtually in the texts of the doctor’s self-observations. Contrastingly, the case histories of patients, which are limited to retrospectively published vignettes, play a primarily illustrative role. The protocols of doctors who, for the purpose of formulating a critique (like Marcinowski), ex124. Breuer and Freud, Studies on Hysteria, SE 2:282. 125. A similarly egalitarian model of psychological experimentation was applied in the work of the Würzburg school founded by Oswald Külpe, which Wundt countered with the same critique as the hypnosis experiments. See Martin Kusch, “Recluse, Interlocutor, Interrogator: Natural and Social Order in Turn-of-the-Century Psychological Research Schools,” Isis 86 (1995): 419–39. Some of this school’s exponents were influenced by Vogt’s control techniques or made use of them in modified form. See, for example, August Messer, “Experimentell-psychologische Untersuchungen über das Denken,” Archiv für die Gesamte Psychologie 8 (1906): 1–224. 126. Oskar Vogt, “Zur Kenntniss des Wesens und der psychologischen Bedeutung des Hypnotismus,” Zeitschrift für Hypnotismus 3 (1895–96): 277–340; 4 (1895–96): 32–45, 122–67, 229–44; Vogt, “Die directe psychologische Experimentalmethode.”

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plicitly put themselves in the patient role and underwent Vogt’s procedure are considerably more extensive. Their critique’s aim, however, was not to examine Vogt’s theories, which essentially shaped his setting’s configuration, but to enhance the method’s efficiency. Freud, as the preceding chapter has argued, took recourse to historicizing strategies and a quasi-novelistic style in presenting the development of his psychoanalytic method from a series of chronologically arranged case histories. Such a form of representation, then, followed less a dogmatic than a genetic mode.127 “Self-analysis” in the Freudian sense, albeit taking up cues from the medical culture of introspective hypnotism, presented itself as necessarily provisional and incomplete. It remains to be shown how the design of the psychoanalytic setting itself was inextricably connected to a textual form in which the dynamic relationship between doctor and resistant patient became operative.

127. Freud himself continually emphasized the contrast between dogmatic and genetic modes of representation of his psychoanalytic method. See, for example, Sigmund Freud, “Some Elementary Lessons in Psycho-Analysis,” (1938), SE 23:281–86.

8

Experimentalism without a Laboratory: The Psychoanalytic Setting

In spite of the manifold difficulties Freud encountered during the 1890s as a practitioner of hypnosis and of the cathartic method, he did not entirely abandon the idea that psychotherapeutic practice could be developed into an experimental situation. However, the consequences he drew from it differed considerably from the positions adopted by the leading medical exponents of hypnotic suggestion in the German-speaking countries. In opposition to Oskar Vogt’s attempts to turn the psychotherapeutic consulting room into a site able to compete with the laboratories of experimental psychology, Freud refused to make his approach dependent on the in situ production of a mental state in the subject that could be systematically varied according to various conditions. As I have argued in the last chapter, the specificity of the psychoanalytic setting, with the technique of self-analysis at its core, becomes evident when its emergence is seen within a history of observational practices conceived to obtain knowledge of the unconscious mind. In the following I will show how, in contrast to the attempts of medical hypnotists to create laboratory environments for the introspective practice of their subjects, Freud developed his self-analysis of dreams and slips of the tongue primarily as a writing exercise. This displaced the situated character of early psychoanalytic practice toward a virtual setting. At this stage, the transmission and transformation of psychoanalysis was bound less to the consulting room than to the desk: it occurred in letter exchanges between Freud and his disciples, patients, and critics. Within the early psychoanalytic movement in Vienna and Zurich, several of its members felt the urge to develop what seemed to be merely an art of interpretation into a stable experimental method. The clinical cultures in which these first variants of the psychoanalytic setting materialized were of crucial importance in this process. Ultimately, the conflicting

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attempts to create new laboratory-like situations led to a reconfiguration in which Freud posited the ensemble of chair and couch as the distinctive and classic setting. “Self-Analyses”: Writing, Reading, and Dreaming In the summer of 1897 the spell began to break, and Freud undertook his most heroic feat—a psychoanalysis of his own unconscious. It is hard for us nowadays to imagine how momentous this achievement was, that difficulty being the fate of most pioneering exploits. Yet the uniqueness of the feat remains. Once done it is done forever. For no one again can be the first to explore those depths.

Ernest Jones’s depiction of Freud’s self-analysis as the heroic discovery of the dark continent of the unconscious has loomed large over the historiography of psychoanalysis, be it in a hagiographic or a debunking key. There is no doubt that the notion of “self-analysis” is designed to confront the reader with a singular event, truly revolutionary and fundamental, and having a somewhat mystical ring. When in 1950 a first abridged edition of the correspondence between Freud and his friend Wilhelm Fliess (1858–1928) was published, it revealed the latter’s crucial role in the development of psychoanalysis. In the same hero-making vein as Jones and Kurt Eissler, the French psychoanalyst Didier Anzieu provided a detailed chronological reconstruction of Freud’s self-analysis. Although Fliess’s role is here taken into account, Freud’s self-analysis is placed within the Western philosophical canon . Jones, The Life and Work of Sigmund Freud, 1:319. . For Jones, Freud’s self-analysis seems to be the only event which is not historically datable. Whereas every chapter throughout his book indicates in its heading the exact period of time it covers, an exception is made for the chapter devoted to the self-analysis (ibid., pp. 319–27). This section mentions only the initial date and leaves the final date blank, stressing both the “unfinished” and “incomplete” character of this exceptional analysis. This framing of the self-analysis as an “endless beginning” suggests that it has the nature of a mystical event. For a discussion of this narrative figure, see Michel de Certeau, The Mystic Fable: The Sixteenth and Seventeenth Centuries, trans. Michael B. Smith (Chicago: University of Chicago Press, [1982] 1995). It is no coincidence that Ellenberger groups Freud’s self-analysis together with the experiences reported by religious mystics and poets, reclassifying all these diverse singular events under the category of “creative illness.” Henri F. Ellenberger, “The Concept of ‘maladie créatrice,” in Beyond the Unconscious, pp. 328–40. . Eissler, “An Unknown Autobiographical Letter by Freud and a Short Comment”; Didier Anzieu, L’Auto-analyse: Son rôle dans la découverte de la psychanalyse par Freud: Sa fonction en psychanalyse (Paris: Presses Universitaires de France, 1959), chapter 1. A later, reworked version of Anzieu’s book also appeared in English translation under the title Freud’s Self-Analysis, trans. Peter Graham (Madison, WI: International University Press, 1986).

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of achieving true self-knowledge, and thus it is interpreted as a radical epistemological break with earlier practices of clinical observation through hypnotism and introspection in experimental psychology. This historiographic model writes the epistemic project of psychoanalysis out of the history of science and medicine entirely. As a consequence, it cannot address the technical and historical significance of Freud’s self-analysis. As I have argued at the end of the last chapter, the earliest usage of the notion of self-analysis—in the letters Freud wrote to Fliess during his work on the book that would become The Interpretation of Dreams—refers to a specific introspective procedure developed at a time when self-observation was still acknowledged as the chief practice from which psychological facts were to be gained. This becomes evident in the first edition of the book, where the term “self-analysis” does not denote a singular event, but is introduced in the chapter about “The Method of Interpreting Dreams”: No doubt I shall be met by doubts of the trustworthiness of “self-analyses” [Selbstanalysen] of this kind; and I shall be told that they leave the door open to arbitrary conclusions. In my judgment, the situation is in fact more favourable in the case of self-observation than in that of other people; at all events we may make the experiment and see how far self-analysis takes us with the interpretation of dreams.

It should be noted that “self-analysis” appears for the first time in Freud’s book in the plural form, and even in quotation marks. It is used interchangeably with the more frequent “self-observation.” In the entire book, the term is used in the singular only once, in the context of a dream in which Freud carries out the dissection of his own body.  Thus, in the first edition of The Interpretation of Dreams, “self-analysis” refers to a new technique proposed by Freud to his readers. It was not until the second edition, published in 1909, that he took the decisive turn of recasting the entire book as a part of his own personal history: “It was, I found, a portion of my own self-analysis, my reaction to my father’s death—that is to say, to the most important event,

. For historical accounts of the importance of introspection in psychology, see Edward Boring, “A History of Introspection,” Psychological Bulletin 50, no. 3 (1953): 169–89; and Kurt Danziger, “The History of Introspection Reconsidered,” Journal of the History of the Behavioral Sciences 16 (1980): 241–62. . Freud, The Interpretation of Dreams, SE 4:105. . See Freud, The Interpretation of Dreams, SE 5:454, 477. In his entire published work, Freud very rarely uses the term. See Samuel A. Guttman, Randall L. Jones, and M. Stephen Parrish, The Concordance to the Standard Edition of the Complete Psychological Works of Sigmund Freud (Boston: G. K. Hall, 1995), pp. 4708–9.

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the most poignant loss, of a man’s life.” Although Freud did not make substantial changes in the new edition, this remark in the preface indicates a transformation of its status. The book is now declared to be not only the exposition of self-analysis as a new method for the observation and interpretation of dreams: it is also presented as the incomplete testimony of the author’s subjective response to his father’s death. The way Freud phrases this remarkable shift leaves no doubt that he considers his own personal experience to be a universal one. As a consequence, neither the incompleteness of the exposition of his case, nor his subjective motivations, present an obstacle to developing an objective method. On the level of the presentation of his dream material and its interpretation, The Interpretation of Dreams posits the author as a prototype, whose exemplary analyses should enable any reader to reproduce the act of selfanalysis on his or her own dreams, and thus to confirm the Freudian theory that dreams are the fulfillment of repressed wishes. Freud’s turn to a textual device responded to one of the central problems in the application of suggestion therapy to intelligent patients who were avid readers of the literature on hypnotism and nervous diseases. The failure of experimental or therapeutic hypnosis to achieve lasting success must be attributed to a large extent to the two unwelcome and disturbing positions the reading hypnotic subject was able to take toward the hypnotist: complaisance (complacency) or resistance. Within the medical hypnosis movement as it had emerged in the late 1880s around Bernheim, Liébeault, and Forel, the problem of how to deal with the reading patient on the level of textual presentation was sometimes addressed, but not in a consistent form. The laborious practices for training and controlling hypnotic subjects developed by Vogt and Brodmann in the 1890s clearly took the opposite approach, supposing that any epistemic uncertainty or practical resistance could be overcome by “fitting” the patient into the material setting. Other hypnotists, in contrast, wanted to expand the range of “posthypnotic suggestion” or of suggestive “infection” occurring in group hypnosis, phenomena that could not easily be channeled and . Freud, The Interpretation of Dreams, SE 4:xxv–xxvi. When this shift is placed in its concrete historical context and linked to the politics of the psychoanalytic movement, Freud’s sudden confession in the preface to the second edition appears in a different light. By 1907, the year when the second edition of the book was completed, Freud had started to elaborate the Oedipus complex as a universal pattern structuring human sexuality. The rewriting of The Interpretation of Dreams in the context of the emergence of the psychoanalytic movement is analyzed in closer detail in Lydia Marinelli and Andreas Mayer, Dreaming by the Book: Freud’s “The Interpretation of Dreams” and the History of the Psychoanalytic Movement, trans. Susan Fairfield (London: Other Press, [2002] 2003).

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were often considered dangerous side effects in the medical use of hypnosis. A popular introduction to the technique of suggestion opened with the following motto: “A suggestion: You will read this book, even if you struggle against it. And the more you struggle against it, the sooner you will fall under its spell.” Even if the idea of such a written “spell” seems crudely naive, it captures well the trend toward dissociating the effects of hypnotic suggestion from the intricate material arrangements set up by medical hypnotists. By initially conferring the transmission of his new psychoanalytic technique entirely to the text, Freud followed a similar path. Self-analysis, with its method of writing down “free associations,” was initially an activity bound to the desk, and it drew in fact on a variety of older practices of self-observation. The Psychopathology of Everyday Life provided the first full-fledged account of such a form of experimental psychology, which did not depend on the complex social and technical organization of the laboratory. In the book, a number of phenomena involving memory disorders as they were observed and demonstrated by neurologists on their patients were explored from a very different perspective. The beginnings of this new practice may again be found in Charcot’s Salpêtrière. In his eclectic 1886 study The Psychology of Reasoning, Alfred Binet, at that time still a zealous defender of the doctrine of grand hypnotism, had demonstrated how phenomena closely resembling paraphrasia and paragraphia (the inappropriate substitution of one word, syllable, or letter by another in speaking or writing observable in certain neurological diseases) could also be studied introspectively “by setting oneself the problem of finding a proper name which one knows but which one cannot presently recall to memory at the time. Experimental psychology may thus be studied without a laboratory.”10 . Hans Schmidkunz, Der Hypnotismus in gemeinfasslicher Darstellung (Stuttgart: Zimmer, 1892), p. 1. . In The Interpretation of Dreams Freud indicates that he performed his dream analyses “by the help of writing down” his ideas as they occurred to him (Freud, SE 4:103). In his short version of the dream book, On Dreams (Sigmund Freud, SE 5: 633–86), he gives the following description of the technique: “It will . . . be enough to say that we obtain material that enables us to resolve any pathological idea if we turn our attention precisely to those associations which are ‘involuntary,’ which ‘interfere with our reflection,’ and which are normally dismissed by our critical faculty as worthless rubbish. If we make use of this procedure upon ourselves, we can best assist the investigation by at once writing down what are at first unintelligible associations.” (SE 5:636) A detailed reconstruction of these processes of note-taking and rewriting is hardly possible, since only very few notes and fragments of Freud’s dream analyses have survived in the Freud Archives of the Library of Congress. 10. Binet, The Psychology of Reasoning, pp. 124–25 (trans. mod.). The book drew heavily on Théodule Ribot’s reception of English and Scottish associationism in France. Binet’s recom-

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A crucial and distinctive element within the virtual setting of Freudian self-analysis, however, was the imperative to ruthlessly disclose the painful motives lying behind manifestations of distorted language. The Interpretation of Dreams—in contrast to Psychopathology, which employs short examples taken from the everyday life of the educated in demonstrating the allpervasive influence of the unconscious—centers around the case of its author and the gradual revelations of his intimate life for the sake of science. Freud enounced the rule of relentless self-disclosure elegantly by citing Delbœuf ’s earlier remark that “every psychologist has the obligation to confess even his own weaknesses, if he thinks that it may throw light upon some obscure problem.”11 This hint both shows and conceals how much Freud’s writing was steeped in the older literature of dream research, in which dreams and other involuntary visions were rigorously scrutinized.12 As I have pointed out in the last chapter, the self-exposure of the dreamer for the sake of psychological analysis had also become a prominent theme in the debates about hypnotism as an experimental method in the 1890s. When Freud ventured to expose himself as an erring doctor in the famous dream of Irma’s injection, he was to a certain extent elaborating on the already familiar theme of the medical hypnotist under the spell of autohypnosis, unable to perform his duties.13 It is even possible that Wundt’s 1892 account of his almost fatal mendation of such a simple introspective method stood in marked contrast to the focus on clinical observation that dominated the beginnings of French experimental psychology, and also to the heavy apparatus of the emerging laboratories of “physiological psychology” in Germany and the United States. The favoring of introspection in other social institutions, such as the school and the family, also reflects a particularity of the French situation: the professional psychologist, despite the creation of a new laboratory at the Sorbonne in 1889, found himself devoid of a strong institutional position providing him access to subjects. See Jacqueline Carroy, Annick Ohayon, and Régine Plas, Histoire de la psychologie en France: XIXe–XXe siècles (Paris: La Découverte, 2006), esp. pp. 40–48. 11. “Tout psychologiste est obligé de faire l’aveu même de ses faiblesses s’il croit par là jeter du jour sur quelque problème obscur.” Freud, The Interpretation of Dreams, SE 4:105; Delbœuf, Le sommeil et les rêves, p. 39. 12. For a general overview, see the work of Tony James, Dream, Creativity, and Madness in Nineteenth-Century France (New York: Oxford University Press, 1995), esp. pp. 169–95. For Freud’s reception of French dream research, see Jacqueline Carroy, “Dreaming Scientists and Scientific Dreamers: Freud as a Reader of French Dream Literature,” Science in Context 19, no. 1 (2006): 15–35. 13. In a more dramatic vein than Forel and Wundt (see chapter 7), Oskar Vogt reports an episode in which he failed to get out of bed when he was called to see a severely ill patient: A few years ago, I was woken up at night by the father of a child who had again become severely ill. I rose, opened the window, spoke to the father, who told me that the child

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blunder of administering the wrong drug to a patient provided an inspiration for Freud’s famous Irma dream, which was notated and analyzed three years later.14 However, where the medical hypnotists and their critics engage in a rhetoric of confession in order to redefine the virtues of the good experimental subject, Freud’s elaborate version of this genre in The Interpretation of Dreams is designed to transfer the transformation of the subject into the process of reading and writing itself. Throughout the first chapters of the book, Freud presents the demonstration of his dream theory as a constant struggle between the author and his imaginary skeptical reader. The aim of the text is to turn the actual reader into a Freudian self-analyst, and for this purpose the author sets out a number of rules at the beginning of chapter 2. There, in a key passage, Freud asks the reader “to make my interests his own for quite a while, and to plunge, along with me, into the minutest details of my life; for a transference of this kind is peremptorily demanded by our interests in the hidden meaning of dreams.”15 The reader is compelled to take the author’s position and tacitly endorse the method of self-analysis demonstrated by Freud on himself. Once having entered the intricate process of reading, dreaming, and writing, the reader is to go through various stages of doubt before, in the ideal case, he overcomes his resistance and confirms the theory of wish-fulfillment.16 was dying, and promised to come to his house immediately. Despite doing this, I went to bed again and continued sleeping. The next day, I went to see the child at the usual time, found the door closed and learned from the neighbors to my great surprise that it had died. No memories of what had happened during the last night occurred. In the evening, I came to see the parents. The father received me in a very unpleasant manner. As a reason for his unpleasant behavior, he told me the aforementioned story. (Vogt, “Zur Kenntniss des Wesens und der psychologischen Bedeutung des Hypnotismus,” p. 32) 14. An offprint of Wundt’s study on hypnotism (1893) is still preserved in Freud’s library; see Gerhard Fichtner and Keith Davis, eds., Freud’s Library: A Comprehensive Catalogue (London: The Freud Museum, 2006), no. 3649. In his correspondence with Fliess, Freud specified after the publication of his book that he had dreamt the dream in the night of 23–24 July 1895, and that he had analyzed it “the following day” (letters to Fliess, 12 June and 18 June 1900, FF:417–19). In a footnote to the case study of Emmy v. N., Freud had first mentioned that he wrote down his dreams in order to trace in himself the “compulsion towards association” that he observed in his patients (SE 2:69). 15. Freud, The Interpretation of Dreams, SE 4:106. 16. As John Forrester has persuasively argued, The Interpretation of Dreams was to a large extent modeled on Freud’s correspondence with Fliess, his first reader and censor, and thus initially conceived as a device by which all further readers should be transformed according to the position assigned to them in the text. John Forrester, “Dream Readers,” in Dispatches from the

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In the first years of psychoanalytic practice, the major testing ground for this model was the culture of self-observation as it had developed in the psychiatric clinic. The tracking of dreams and slips of the tongue—in the normal mind the functional equivalents of hysterical symptoms—was designed to provide a basis for converting the medical exponents of introspective hypnotism into Freudian dream analysts. Maybe the most important case in this respect was the psychiatrist Eugen Bleuler, who in 1899 had succeeded Auguste Forel as the director of the Burghölzli clinic in Zurich and still figured as a specimen case of the “hypnotized hypnotist” in the handbook of his former master.17 While Forel and Vogt soon adopted a negative stance toward psychoanalysis,18 Bleuler inaugurated the first positive reception of Freud’s new techniques in psychiatry. Beginning in 1901, Bleuler actively studied Freud’s work together with his assistants Franz Riklin and Carl Gustav Jung at Burghölzli. Since Freud had still not written a textbook introduction to psychoanalysis, declaring The Interpretations of Dreams to be “the forerunner of an initiation to his technique,”19 Bleuler set out to learn it by reading the book. From his correspondence with Freud, it becomes evident that he tried for a time to acquire the method by writing down his dreams and interpreting them with his medical assistants and his wife.20 Although the Burghölzli hospital in Zurich became a flourishing culture of introspection under his directorship, it must be noted that Bleuler had

Freud Wars (Cambridge, MA: Harvard University Press, 1997), pp. 138–83. However, it should be noted that the actual responses of Freud’s readers did not necessarily conform to this model of an ideal reception and conversion. 17. See chapter 7. Forel, Der Hypnotismus, 1st ed., pp. 87–88. The appendix was republished in the later revised editions of Forel’s handbook. 18. Beginning in 1907, Forel polemicized in his correspondence against the “cult around Freud” (Freudcultus) pervading the Burghölzli clinic. As an alternative, he supported two of his Swiss followers who advocated a variant of Breuer’s cathartic method, Ludwig Frank and Dumeng Bezzola (the latter under the label “psychosynthesis”). See Christian Müller, “Auguste Forel and Dumeng Bezzola: An Exchange of Letters,” Gesnerus 46 (1989): 55–79, p. 64; and also Forel’s correspondence with Frank (Forel, Briefe—Correspondance, esp. pp. 393–95). Vogt had already voiced his criticism in reviews written in the late 1890s (see chapter 8). 19. Sigmund Freud, “Freud’s Psycho-Analytic Procedure,” SE 7:249–54, p. 252. 20. Only a part of Bleuler’s correspondence with Freud has been preserved in the Freud collection of the Library of Congress; some excerpts have been published in English by Franz Alexander and Sheldon Selesnick, “Freud-Bleuler Correspondence,” Archives of General Psychiatry 12 (1965): 1–9. The letters dealing with Bleuler’s self-analysis were first published in full in English translation as an appendix to Marinelli and Mayer, Dreaming by the Book, hereafter abbreviated as BF. Freud’s answers to these early letters, however, seem not to have been preserved in the Bleuler family archive (Michael Schröter, personal communication).

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slowly turned away from hypnotism as it had been practiced by his mentor Forel in favor of the association test introduced by Francis Galton, which by then had already been adopted with various modifications in numerous psychological, psychiatric, and forensic contexts.21 In Bleuler’s view, the association test promised not only a firm basis for psychiatric diagnosis, but also an objective science of character: “In the activity of association there is mirrored the whole psychical essence of the past and of the present, with all its experiences and desires. It thus becomes an index of all the psychical processes which we have but to decipher in order to understand the complete man.”22 The Zurich variant of Galton’s test used a list of one hundred words to which the subject had to react with another word as quickly as possible, whereby the reaction time was registered. Over a period lasting a few years, both doctors and patients of the clinic were obliged to undergo the test, producing data for statistical analysis and becoming anonymous representatives of normal and pathological populations. Significant delays in response and the use of odd words led the experimenters to posit the existence of “unconscious complexes.” The specific mental makeup of the subject could then be determined through his or her deviations from the standards established by the association experiment. Thus, for Bleuler and his assistants, it seemed obvious that Freud’s technique of self-analysis represented a special variant of introspection, which could be used as a complement to the association test. The early reception of Freudian psychoanalysis, and of the technique of dream analysis in particular, was shaped by its assimilation into an established experimental clinical culture that combined the association test with other methods, including hypnotic suggestion and automatic speaking and writing.23 What made dream analysis attractive to Bleuler was certainly the ease with which it could be juxtaposed with forms of automatic writing, thus providing an objective picture of the workings of the unconscious mind. Contrary to many of his psychiatric colleagues, he advocated the study of 21. Francis Galton, “Psychometric Experiments,” Brain 2 (1879): 149–62. For an overview, see Samuel C. Kohs, “The Association Method in its Relation to the Complex and Complex Indicators,” American Journal of Psychology 25 (1914): 544–94. 22. Eugen Bleuler, “Über die Bedeutung von Assoziationsversuchen” [1904], in Diagnos­ tische Assoziationsstudien: Beiträge zur experimentellen Psychopathologie, ed. Carl Gustav Jung (Leipzig: Barth, 1910), 1:1–6, p. 4. 23. In accordance with this blend of experimental techniques, Bleuler’s psychological theories were highly eclectic. See Eugen Bleuler, “Versuch einer naturwissenschaftlichen Betrachtung der psychologischen Grundbegriffe,” Allgemeine Zeitschrift für Psychiatrie und psychischgerichtliche Medicin 50 (1894): 133–68.

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automatic writing in hypnotic states and of thought transference as observed in lucid women and other mediums.24 To Bleuler, who reportedly walked through the hospital with a bunch of cards on which he constantly noted his observations,25 it must have seemed quite natural to conduct his whole analysis with Freud in writing. Thus, in 1905, the psychiatrist started to send his dream reports and his associations to Freud, who interpreted them. From the outset, Bleuler insisted that his letters were to be read in two ways, thereby suggesting a split in his role as a correspondent. On one level, he slipped into the role of a patient and disciple sending in his material anonymously; on another, however, he maintained the role of a skeptical colleague who was still not convinced by Freud’s theories. Hence he declared his anonymous reports and associations to be not “material for dream interpretation, but rather the basis of a critique of the technique.”26 With this division of roles, Bleuler put himself into exactly the position that the author of The Interpretation of Dreams had designed for professional readers of the book. During his epistolary analysis with Freud, which lasted a few months, Bleuler attempted to transform the writing down of his associations into an experimental setup resembling the Swiss variant of the association test. In seeking to detect material traces of his unconscious complexes, he assigned a crucial role to his typewriter, a dear instrument which accompanied him on travels and even into his bed when he fell ill.27 “As long as one isn’t too skilled, the typewriter is a very good reagent to complexes,”28 Bleuler explained, implicitly referring to a method where the typist uses only two fingers and cannot read and write at the same time, because he has constantly to shift the focus of his attention.29 This self-imposed handicap was conceived to produce 24. See Eugen Bleuler, “Bewußtsein und Assoziation,” [1905] in Diagnostische Assoziationsstudien: Beiträge zur experimentellen Psychopathologie, ed. Carl Gustav Jung (Leipzig: Barth, 1910), 1:229–57. 25. Jakob Klaesi, “Eugen Bleuler, 1857–1939,” in Grosse Nervenärzte, ed. Kurt Kolle (Stuttgart: Thieme, 1956), 1:7–15. Bleuler’s notes were stored in his slip boxes which are to a large extent still preserved at the archive of the University clinic in Zürich. I discuss the techniques of objectifying dreams in this period in my study Dream Archives (forthcoming). 26. Bleuler to Freud, 14 October 1905, BF:166 (trans. mod.). 27. See Klaesi, “Bleuler,” p. 10. From his letters to Freud, we learn that Bleuler had just started using a typewriter. In a later series of dream reports, the typewriter figures prominently in one example; Eugen Bleuler, “Träume mit auf der Hand liegender Deutung,” Münchener Medizinische Wochenschrift 60 (1913): 2519. 28. Bleuler to Freud, 5 November 1905, BF:171. 29. For a later criticism of this method of typing, see Hermann Scholz, Die Schreibmaschine und das Maschineschreiben (Leipzig: Teubner, 1923).

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misspellings that would lead the trained eye of the graphological expert to hidden meanings and the unconscious complexes behind them. In carefully preserving and highlighting his typos, Bleuler was looking for traces from which interpretation could proceed. Although Bleuler and Freud met on this common ground, the psychiatrist’s intellectual resistance to the dream theory did not wane.30 When, in 1910, Bleuler finally published his critical account of Freud’s new theories and methods, he inscribed them into the older configuration of self-observation, asserting that their “factual foundations . . . did not go beyond facts which the observing psychologist has known for quite some time already.”31 In this text Bleuler also disclosed some of the results of his epistolary analysis with Freud. While fully subscribing to the freshly forged notion of the “Oedipus complex” and portraying himself as a typical case,32 he still doubted the universality of Freud’s dream theory, preferring explanations that were couched in terms of “autosuggestion.” Bleuler’s reception of Freudian dream interpretation, then, had made a place for psychoanalysis in the experimental culture of Burghölzli. But it was no more than one method among others in a quite eclectic array. The virtual setting, as it was designed by Freud in his new textual device, proved to be quite unstable, and in the absence of clear methodological treatises and training institutions, the differences between hypnotic suggestion, the cathartic method, and Freudian psychoanalysis were not apparent to many doctors. For the majority of patients, psychotherapy largely remained synonymous with hypnosis. Tracking the Complex: Attempts at Stabilizing the Psychoanalytic Setting In marked contrast to the medical advocates of hypnotic suggestion, who gave very detailed accounts of their procedures, Freud refrained from publishing extensive methodological essays. The specific material setting of psychoanalytic treatment was actually not even set down in the scattered remarks made in his technical papers. It is therefore uncertain whether around 1900 the psychoanalytic setting consisted of the now well-known arrangement in which

30. In particular, he refused Freud’s assumption that he was in a position of “emotional resistance” toward psychoanalysis. Bleuler to Freud, 17 October 1905, BF:168. 31. Eugen Bleuler, “Die Psychoanalyse Freuds: Verteidigung und kritische Bemerkungen,” Jahrbuch für psychoanalytische und psychopathologische Forschungen 2 (1910): 623–730, p. 623. 32. Ibid., pp. 647–48.

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the freely associating analysand lies stretched out on a daybed with the silent or interpreting analyst sitting behind him or her on a chair. Although Freud specifically notes in The Interpretation of Dreams that it is “an advantage for him [the patient] to lie in a restful attitude and shut his eyes,”33 this positioning of the body in a calm and comfortable position was not the central factor in his new method. Its cornerstone was, rather, the doctor’s injunction to maintain “a completely impartial attitude,” which committed the patient to follow the rule of telling the analyst “whatever comes into his head” and pursue the many “trains of thought” that opened up.34 Through such uncensored release of associative movement within the patient’s psyche, the psychoanalyst could make his way through the unconscious. Free association was not tied exclusively to an immobilization of the body: Freud carried out a number of analyses while walking with his patients or pupils.35 In a short account published in 1904 in Löwenfeld’s book Die psychischen Zwangserscheinungen, Freud specified for the first time how doctor and patient were to be positioned in the consulting room: Without exerting any other kind of influence, he [Freud] invites them [the patients] to lie down in a comfortable attitude on a day-bed, while he himself sits on a chair behind them outside their field of vision. He does not even ask them to close their eyes, and avoids touching them in any way, as well as any other procedure which might be reminiscent of hypnosis. The session thus proceeds like a conversation between two people equally awake, but one of whom is spared every muscular exertion and every distracting sensory impression which might divert his attention from his own mental activity.36

According to this description, Freud adopted the spatial arrangement used by Löwenfeld, Vogt, and other contemporary medical hypnotists of the 1890s, but without the related practices for putting the patient into what was supposed to be a sleeping state. The positioning of the doctor outside the reclining patient’s field of vision, which is mentioned here for the first time and would become one of the distinctive features of the Freudian setting, had already been suggested by Vogt’s trainees. The German doctor Johannes Marcinowski, in a report on his observations published in 1900, urged his colleagues “to sit so that it is difficult for the patient to look his doctor in

33. Freud, The Interpretation of Dreams, SE 4:101. 34. Ibid. 35. See the letter from Freud to Fliess, 16 May 1897, FF:244. 36. Freud, “Freud’s Psycho-Analytic Procedure,” SE 7:250 (trans. mod.).

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the eye.”37 According to his argument, the justification for this asymmetric division of visibility was to be found in the specific nature of the procedure. Since suggestion therapy aimed at getting the patient to shut his eyes as quickly as possible, it required very precise observation of the eyes. “The clouding of the gaze through accumulation of lachrymal fluid given the lack of eyelid movement, a certain rigid expression in the eye, these are things . . . that the hypnotist must lie in wait for and be able to use immediately in his suggestions.”38 Certainty regarding a given state of consciousness, which Vogt’s fraction­ ation method sought to achieve through constant questioning of the subject, was to be further heightened by this new seating arrangement. The asymmetry enabled the doctor to constantly draw conclusions regarding the patient’s mental states from signs visible on the body, and to take advantage of these clues. In this respect, another critic of Vogt’s method remarked that the hypnotist doctor must “strive to collect useful material for his suggestions through close observation of objective phenomena, and through precise attention to subjective phenomena manifested by the person to be hypnotized.”39 Freud’s new setting, which only dispensed with closing the eyes and with any manipulation—already very limited in contemporary hypnosis—of the patient’s face and body, was conceived to provide the doctor with clues allowing him to reveal the patient’s secret motives. In his “Fragment of an Analysis of a Case of Hysteria,” better known as the “Dora” case, Freud cites several examples of “symptomatic acts” observed in his patient that visibly confirmed his own interpretations. Such automatic acts carried out by the patient, accidentally or in passing, during psychoanalytic treatment were thought to betray unconscious motivations. Accordingly, when Dora refused to remember childhood masturbation at his insistence, Freud interpreted her playing with a small purse as “a further step towards the confession”: “For on that day she wore at her waist—a thing she never did on any other occasion before or after—a small reticule of a shape which had just come into fashion; and as she lay on the day-bed and talked, she kept playing with it—opening it, putting a finger into it, shutting it again, and so on.”40 In this case study, 37. Marcinowski, “Selbstbeobachtungen,” p. 182. Marcinowski (1868–1935), who authored a couple of popular books on nervousness and psychotherapy, would in 1909 join the psychoanalytic movement and be one of the first physicians in Germany to introduce psychoanalytic treatment at a private sanatorium. 38. Ibid. 39. Straaten, “Zur Kritik der hypnotischen Technik,” p. 154. 40. Sigmund Freud, “Fragment of an Analysis of a Case of Hysteria,” SE 7:7–122, p. 76 (trans. mod.).

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Freud showed how the psychoanalyst, by carefully noting such symptomatic acts, could complement dream reports and subsequent associations with additional “circumstantial evidence”: “He that has eyes to see and ears to hear may convince himself that no mortal can keep a secret. If his lips are silent, he chatters with his finger-tips; betrayal oozes out of him at every pore.”41 Endorsing such a criminalist approach, in which the patient’s repressed wishes were revealed by a concatenation of visible proofs, the first psychoanalysts in Vienna and Zurich worked on further modifications of the setting.42 The most influential variant in the early period combined the technique of dream analysis with the psychometric association experiment as practiced at the Burghölzli clinic in Zurich. Under Bleuler’s directorship, his assistants C. G. Jung and Franz Riklin cast the diagnostic association test as an enhanced version of ceremonials like courtroom interrogation or religious confession. They drew a close analogy between the unknown complexes split off from the patient’s ego and criminal acts, whereby the doctor was to uncover these complexes step-by-step and confirm them through the patient’s confession. Jung’s starting point was the method of “investigative diagnostics” (Tatbestandsdiagnostik), which had been developed by criminologists and psychiatrists for obtaining confessions from suspects.43 In his own variant of the association test, the complex is conceived as a formation comprising elements of an “offense,” which can be divided up again into individual emotional stimulus words (psychical equivalents of the murder weapon, site of the crime, etc.). These “emotionally invested” words are combined in a list with additional “indifferent” words. The words are read to the subject, who is instructed to react as quickly as possible with another word. By measuring reaction times and closely observing telltale irregularities in the subject’s behavior during the test (and in repetitions of it), the doctor is able to establish links between specific words, from which he infers the hidden complex. The following “psychoanalytic” part of the experiment consists of presenting the

41. Ibid., pp. 77–78. 42. This initial configuration of the setting, with its emphasis on clues, largely thrives on what Carlo Ginzburg in a classic essay has identified as an epistemological model of the human sciences. See Carlo Ginzburg, “Clues: Roots of an Evidential Paradigm,” in Clues, Myths, and the Historical Method, trans. John and Anne C. Tedeschi (Baltimore: Johns Hopkins University Press, 1989), pp. 96–125; for a more recent formulation, see Carlo Ginzburg, “Réflexions sur une hypothèse,” in Mythes, emblèmes, traces: Morphologie et histoire, trans. Monique Aymard et al. (Paris: Verdier, 2010), pp. 351–64. 43. Carl Gustav Jung, “Die psychologische Diagnose des Tatbestandes,” Schweizerische Zeitschrift für Strafrecht 28 (1905): 369–408.

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subject with a protocol of his or her associations and reactions times and then posing further questions in order to test more speculative interpretations. In the case of one of Jung’s female patients, a visible manifestation of resistance is provoked in the following manner: “Patient states stubbornly and with visi­ ble resistance that her only association for yearning is homesickness. I insist that something else will occur to her. Suddenly she emits a loud laugh, which she immediately suppresses: ‘Oh no, now I’ve had enough—this is boring!’ We got the same reaction for desire. There must be some heavily repressed erotic wish at work here.”44 The publications of Jung and his colleagues demonstrate great precision in notating the wording and tone of the patients’ statements. Through the transcription of the patients’ associations and their subsequent conversations with the doctor, of which extensive sections are published in the case studies, Jung obtains material that quickly guides him to “convictions,” that is, to a revelation of the patients’ complexes that soon produces a confession. By precisely measuring response times and painstakingly tracking associations, the doctor also claims to garner evidence of the patients’ resistance, and of their transference of erotic or hostile affects to the experimenter.45 This practice, then, is conceived to objectify the relationship between doctor and patient in a textual or graphic form, whose readability—as in the mechanized simulation controls of Charcot’s hypnosis research at the Salpêtrière—is assumed to be asymmetrical.46 The combination of the association test, with its statistical style of reasoning, and psychoanalytic technique, with its attention to individual cases and details, presents a new strategy for achieving objective knowledge about human subjectivity. In Vienna, the criminological approach developed by Jung and his colleagues led some of Freud’s early adherents to modify the psychoanalytic setting accordingly. The neurologist and sexologist Wilhelm Stekel, one of the most widely read early popularizers of psychoanalysis, took inspiration from the writing practices of the Zurich psychiatrists and combined them

44. Carl Gustav Jung, “Assoziation, Traum und hysterisches Symptom,” [1906], in Diagnostische Assoziationsstudien (Leipzig: Barth, 1910), 2:29–66, pp. 44–45. 45. Ibid., p. 43. 46. In 1907, Jung and the American neuropsychiatrist Frederick Peterson used a combination of galvanometric measurement of skin resistance with respiratory curves, a technique that would lead in the following year to the development of the polygraph. See Frederick Peterson and Carl Gustav Jung, “Psycho-Physical Investigations with the Galvanometer and Pneumograph in Normal and Insane Individuals,” Brain 30 (1907): 153–218; for a historical study, see Kerry Segrave, Lie Detectors: A Social History (Jefferson, NC: McFarland, 2004), chapter 1.

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with elements from older forms of observation in neuropathology.47 In this variant, the most important piece of furniture is not the couch upon which the patient is expected to lie down, but the desk behind which the doctor sits noting the patient’s symptomatic acts on a sheet of paper.48 Seating the patient across from the doctor allows him or her a wider scope of action. Once again the doctor assumes the role of an observer, much as in Charcot’s neuropathological practice, but with the difference that all of the patient’s behavior must be decoded according to a symbolic key. The way in which a patient entered his consulting room already revealed to Stekel the former’s “secret intentions”: “A patient suffering from an obsessive-compulsive neurosis displayed a strange symptomatic act. . . . The man kept storming into my room, asking me for a key. This also symbolized his train of thought.”49 In contrast to the Swiss psychiatrists, who had at their disposal subjects belonging to the “uneducated” and lower classes, Stekel and his Viennese colleagues’ clientele consisted mostly of wealthy and well-read patients. Their knowledge about various forms of psychotherapeutic treatment would prove to be a serious challenge to the first generations of psychoanalysts. In one case, Stekel found himself confronted by a young man who arrived with a long autobiographical account of his own illness, which also bore traces of his own understanding of psychoanalysis and suggestion.50 In his text, the patient recounted his childhood memories, “sexual wishes,” and strange dreams, explaining everything through repression and psychical conflicts. He expressed the desire to be hypnotized, and Stekel responded with an initial hypnotic session during which he made the suggestion that the patient bring him a dream in order to continue the treatment in a psychoanalytic form. The epistemic feedback effects that often made hypnotic treatment difficult or impossible also haunted psychoanalysis in this early period. The

47. In the 1890s, Wilhelm Stekel (1868–1940) worked at Krafft-Ebing’s clinic, where he also became familiar with hypnosis and other forms of treatment such as electrotherapy. He then went into private practice as a general practitioner and became one of the founding members of Freud’s Wednesday Psychological Society. 48. Wilhelm Stekel, Nervöse Angstzustände und ihre Behandlung (Berlin: Urban / Schwarzenberg, 1908), p. 288. This book, in the first edition introduced by Freud, was later translated into English, however after Stekel’s break with the psychoanalytic movement and thus in a largely rewritten form: Conditions of Nervous Anxiety and Their Treatment, trans. Rosalie Gabler (London: Kegan Paul, Trench, Trubner, 1923). Stekel returned to his technical modifications later more critically in his book Psychoanalysis and Suggestion Therapy (London: Kegan Paul, Trench, Trubner, 1923), pp. 5–6. 49. Stekel, Nervöse Angstzustände, p. 296. 50. Ibid., pp. 183–85.

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fact that patients became “voracious readers” of psychoanalytic literature, as Stekel noted, led him to warn his colleagues of their knowledge: “The psychoanalyst who educates his patients through readings is like the strategist who hands the enemy his battle plan.”51 As an example, he described a patient who studied “the psychoanalytic literature day and night, pretending to assist in his treatment. When I objected, he replied that reading reminded him of various incidents. He conscientiously noted all his associations, so that the analytic hour was barely long enough. And yet it was not more than a game: despite the abundance of associations and recollections, he always remained on the surface.”52 Instead of guiding them into a self-analytic process, reading psychoanalytic literature helped the patients acquire a better strategic position in mobilizing their resistance against the analyst’s interpretations. This problem had no easy solution, since private patients’ access to such literature could not be systemically controlled, as it was in the sanatorium or the clinic.53 Objects Blanked Out: Freud’s Scene of Treatment In the early phase, the psychoanalytic setting emerged in various forms, each of them modifying in its own way Freud’s first recommendations on the positioning of doctor and patient. In both the Zurich psychiatric clinic and Stekel’s Viennese private practice, the doctor refrained from making the patient lie down. Instead, other physical measures were taken to regulate the patient’s associative and motoric flexibility. In the Zurich association experiment, the sitting subject was asked to suppress all motor function and focus his or her attention on the task of rapid association. By meticulously noting deviations in the patient’s responses, the doctor was able to infer and track down unconscious complexes. Stekel’s practice, by contrast, offered his patients a stage for performing their “symptomatic acts,” thus enhancing the psychoanalyst’s position as a seemingly detached observer. Here the patient’s flexibility was not suppressed, but stimulated. Both of these variants make

51. Wilhelm Stekel, “Die Ausgänge der psychoanalytischen Kuren,” Zentralblatt für Psychoanalyse 3, no. 3/4 (1913): 175–88, p. 176. 52. Ibid. 53. For a discussion of the manifold interactions between reading patients and forms of psychoanalytic publication in the early period, see Lydia Marinelli, Tricks der Evidenz: Zur Geschichte psychoanalytischer Medien, ed. Andreas Mayer (Vienna: Turia & Kant, 2009), chapter 3.

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it clear that Freud’s specific positioning of doctor and patient had not established a fixed rule within the two most important branches of the early psychoanalytic movement. In both instances, the interaction between patient and doctor took place in a face-to-face situation allowing reciprocal observation. This configuration entailed a symmetric division of visibility, the asymmetry of the doctor-patient relationship being relegated to the doctor’s use of writing, which allowed him to maintain a position of advantage.54 In view of the modifications of setting and technique undertaken by his earliest disciples, Freud laid down for the first time in detail his criteria for the realization of a psychoanalytic treatment. In several shorter essays published between 1911 and 1915, he set out to formulate a number of practical recommendations to his followers. These texts responded to the fact that—apart from The Interpretation of Dreams—there was still no general introduction to the technique of psychoanalysis. Freud had for a while planned to write a “general treatise on the psychoanalytic method” (he worked on it between 1908 and 1910), but he abandoned the project, leaving this task to others.55 For the most part, Freud’s essays on technique referred directly or indirectly to concrete practical problems that had arisen in working with his first analysands. In the long run, however, they would provide the historical, technical, and theoretical underpinnings of the psychoanalytic setting, which subsequently became canonized as the so-called classical model.56 The spatially asymmetric positioning of doctor and patient that Freud shared with some of the practitioners of hypnotic suggestion became the central and most distinctive aspect of the psychoanalytic setting. And yet the “ceremonial” of making the patient lie down on a daybed and moving the doctor out of sight was more than a mere historical remnant of hypnosis.57 The technical justification of this measure resided in Freud’s aim of “preventing the transference from mingling with the patient’s associations 54. As the publications and case notes of many early practitioners show, it was common practice for the psychoanalyst to take shorthand notes of the patient’s associations during the session. 55. Freud announced this treatise at the Second International Psychoanalytic Congress in Nuremberg. See Sigmund Freud, “The Future Prospects of Psychoanalytic Therapy,” SE 11:139–51. He would later encourage the Swiss pastor Oskar Pfister to write such a work. See Oskar Pfister, The Psychoanalytic Method (New York: Moffat, Yard, [1913] 1917). 56. See Leo Stone, The Psychoanalytic Situation: An Examination of Its Development and Essential Nature (New York: International Universities Press, 1961). 57. Sigmund Freud, “On Beginning the Treatment (Further Recommendations on the Technique of Psycho-Analysis),” SE 12:123–44, p. 133.

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f i g u r e 1 6 . Sigmund Freud’s consulting room, Photo Edmund Engelmann. 1938. By permission of the Freud Museum, London.

imperceptibly, of isolating the transference and allowing it to come forward in due course sharply defined as a resistance.”58 This definition also reveals the extent to which Freud continued to understand the task of the psychoanalyst as one of observation. If the doctor remained visible, he would inevitably become an object of the patient’s associations and would be limited in his position as an observer. His visibility would also distract the patient from focusing on his or her own recollections, and thus constitute an obstacle to the unearthing of unconscious material in the course of analysis. With regard to this crucial rule of the classical model, the invisibility of the analyst, one must bear in mind that in lieu of Freud’s person, the patient’s gaze was attracted, if not provoked, by the multitude of objects surrounding him in the consulting room of Berggasse 19. Whereas the couch was a familiar piece of furniture in doctors’ offices at the time,59 the prominent display of a collection of antiquities in showcases, on the shelves of the library, and even on the walls was a rather unexpected sight (see fig. 16). On their first visit, many patients had the irritating impression that Freud was presenting himself less as a physician than as the curator of some odd private archaeological 58. Ibid., p. 134. 59. See Lydia Marinelli, “Die Couch: Vorstellungen eines Möbels,” in Tricks der Evidenz, pp. 245–66, esp. pp. 250–53.

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museum.60 Sergei Pankejeff, the famous patient known as the “Wolf Man,” noted that the “rooms must have been a surprise to any patient, for they in no way reminded one of a doctor’s office. Here were all kinds of statuettes and other unusual objects, which even the layman recognized as archaeological finds from Egypt.”61 The writer H. D. (Hilda Doolittle), who shared Freud’s passion for antiquities, told him at her second analytic session “how the first impression of his room had overwhelmed and upset” her: “I had not expected to find him surrounded by these treasures, in a museum, a temple.”62 For many patients, however, the even greater surprise came with the start of the treatment itself, when the presence of all these objects was declared to be completely insignificant to the analytic work.63 In order to reveal the inner psychic objects of a patient’s past, the mass of archeological objects visible to him or her in the consulting room at the beginning of the treatment were to be related to the only invisible object, namely to the doctor himself.64 The psychoanalytic session, then, must begin with a demonstration of the blank out of the object world surrounding the patient in the consulting room. In Freud’s treatment, the multitude of archeological objects do not serve a positive role. They refer neither to the patient’s concrete history, nor are they used as materializations of unconscious objects, as in the former hypnosis experiments.65 During the course of an analysis, Freud sometimes evoked the antiquities in a didactic fashion, as representatives of the unconscious, albeit in a purely negative sense: as “relics” whose color was lost in the excavation work, or as objects designed for a tomb and thus preserved by having been

60. In the wake of the publication of Edmund Engelman’s photographic documentation of Freud’s home and office, an abundant literature has developed around Freud’s collection and the relationship between psychoanalysis and archeology. See esp. John Forrester, “Collector, Naturalist, Surrealist,” in Dispatches from the Freud Wars, pp. 107–37; and Lydia Marinelli, ed., Meine . . . alten und dreckigen Götter: Aus Sigmund Freuds Sammlung, 2nd ed. (Frankfurt: Stroemfeld, 2000). 61. “My Recollections of Sigmund Freud” [1951], in The Wolf-Man by the Wolf-Man, ed. Muriel Gardiner (Harmondsworth: Penguin Books, 1971), p. 139. 62. H. D. [Hilda Doolittle], “Advent” [2 March 1933], in Tribute to Freud (Manchester: Carcanet, 1985), p. 119. 63. In this respect the analysis of H. D. was rather untypical: the discussion of Freud’s collection of antiquities seems to have played a large role in it. However, this peculiar aspect is also linked to her own strong interests in mythology and archeology. For a critical discussion of H. D.’s encounter with Freud, see Cathy Gere, Knossos and the Prophets of Modernism (Chicago: Chicago University Press, 2009), esp. chapters 5 and 6. 64. Freud, “On Beginning the Treatment,” p. 138. 65. Such as the experiments by Binet and Féré discussed in chapter 3.

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buried away for centuries.66 Whereas the representative function of the single objects is restricted to the demonstration of a loss, as a collection the objects refer the patient to Freud as the “transference object.” For the analyst to function as such a “transference object,” he must not only remain invisible to the patient, he must also reject any desires and questions expressed by the patient during the treatment. Positioning the patient on the couch, against which most patients protest, is already seen as being the first refusal of a wish, namely the wish for a “cozy” social interaction between therapist and patient. Freud assumed that the specific arrangement of the cure automatically resulted in the patient developing a “transference love” for the doctor treating him. The patient comes with an emotional readiness, which Freud sees as corresponding to the “suggestibility” of the hypnotic subject. Hence the primary goal of therapy was to attach the patient to the person of the doctor: “To ensure this, nothing need be done but to give him time. If one exhibits a serious interest in him, carefully clears away the resistances that crop up at the beginning and avoids making certain mistakes, he will of himself form such an attachment and link the doctor up with one of the imagoes of the people by whom he was accustomed to be treated with affection.”67 In this way Freud translated the experiences he had gained from hypnotism into a rule of treatment requiring an attitude of “abstinence” from both analyst and patient. This demand applied not only to the satisfaction of sexual wishes on the part of the patient, but also to the consistent renunciation of everything the suggestion therapists had done to make the treatment “pleasant” and “reassuring” for the patient. According to Freud, the model for the psychoanalyst was to be found in the surgeon, “who puts aside all his feelings, even his human sympathy, and concentrates his mental forces on the single aim of performing the operation as skillfully as possible.”68 In

66. “I then made some short observations upon the psychological differences between the conscious and the unconscious, and upon the fact that everything conscious was subject to a process of wearing away, while what was unconscious was relatively unchangeable; and I illustrated my remarks by pointing to the antiques standing about in my room. They were, in fact, I said, only objects found in a tomb, and their burial had been their preservation: the destruction of Pompeii was only beginning now that it had been dug up.” Sigmund Freud, “Notes Upon A Case of Obsessional Neurosis,” SE 10:155–249, p. 176; see also the recollections of Roger E. Money-Kyrle about his analysis with Freud: “Looking Backwards—and Forwards,” The International Review of Psycho-Analysis 6 (1979): 265–72, p. 267. 67. Freud, “On Beginning the Treatment,” pp. 139–140. 68. Sigmund Freud, “Recommendations to Physicians Practicing Psycho-Analysis,” SE 12:111–20, p. 115.

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Freud’s manipulation of the setting, both its material components and the social relationship between doctor and patient are undeviatingly separated from the actual analysis, which—as in the “self-analyses” conducted in written form—is conceptualized as a virtual exchange of messages. Accordingly, Freud no longer describes his treatment as an interaction between two persons, but as a bodiless communication between conscious and unconscious parts of the psychoanalyst and of the patient, analogous to the transmission of sound waves: To put it in one formula: he [the doctor] must turn his own unconscious like a receptive organ towards the transmitting unconscious of the patient. He must adjust himself to the patient as a telephone receiver is adjusted to the transmitting microphone. Just as the receiver converts back into sound waves the electric oscillations in the telephone line which were set up by sound waves, so the doctor’s unconscious is able, from the derivatives of the unconscious which are communicated to him, to reconstruct that unconscious, which has determined the patient’s free associations.69

This conception of psychoanalytic practice was realized not only through the asymmetric distribution of visibility and the blank out of the object world, but also through a practical measure fixing the doctor in the role of an attentive listener during the psychoanalytic session: during the hour of treatment, the therapist was to refrain from using any instrument to keep a written record. At the beginning of his clinical account of a “Case of ObsessiveCompulsive Neurosis” (the so-called Rat Man), Freud warned against “the practice of noting down what the patient says during the actual time of treatment. The consequent withdrawal of the physician’s attention does the patient more harm than can be made up for by any increase in accuracy that may be achieved in the reproduction of his case history.”70 Hence Freud criticized the Swiss practice of combining the association test with the psychoanalytic technique of free association and noting in shorthand all of the patient’s reactions. Instead, he recommended that the analyst take time in the evening to write down from memory the ideas and stories related by each patient treated during the day. In order to be able to perform such a feat of memory, the analyst was to put himself in the same uncritical state of “evenly suspended attention” demanded of the patient in his self-observation.71

69. Ibid., pp. 115–16. 70. Freud, “Notes upon a Case of Obsessional Neurosis,” SE 10:159. 71. Freud, “Recommendations to Physicians,” SE 12:113.

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Removing recording and writing instruments from the scene of treatment shifted the balance of power between doctor and patient. Although the reaction words noted down in the association experiment had enabled the Swiss psychiatrists to use them as evidence in breaking their subjects’ resistances and getting them to confess, this writing technique had a disadvantage: the complete documentation of all the analysand’s utterances and reactions also gave him the possibility of leading the analyst astray. In this respect, Freud also advised against adopting the practice of Stekel and other psychoanalysts who asked their patients to note their dreams immediately upon waking and bring them to the session: “In therapeutic work, this rule is superfluous; and patients are glad to make use of it to disturb their sleep and to display great zeal where it can serve no useful purpose.”72 In Freud’s new conception of the psychoanalytic setting, then, the common and familiar starting point for any epistemic investigation of dreams, namely their transposition into a written text by the dreamer, was discarded. Karl Abraham tested this idea on his patients and came to conclusions that tended to confirm Freud’s skepticism: dream notation proved to be either an expression of resistance against the treatment or a form of transference. Although Freudian dream analysis was born out of writing, material recording devices were now banned from both the consulting room and the patient’s nightstand.73 Ultimately, the “classical” conception of the setting as laid down by 1914 required an operation of translating every single component of the doctorpatient relationship into the technical terms chosen by Freud. Thus the psychoanalyst was treating not an “ordinary,” but a “transference-neurosis . . . , an artificial illness which is at every point accessible to our intervention.”74 Even if Freud still evoked the ideal of the laboratory-like setting that had once been the linchpin of experimental hypnotism, his actual practice proceeded

72. Sigmund Freud, “The Handling of Dream-Interpretation in Psycho-Analysis,” SE 12: 91–96, pp. 95–96. 73. Karl Abraham, “Sollen wir die Patienten ihre Träume aufschreiben lassen?” Internationale Zeitschrift für Psychoanalyse 1 (1913): 196–99. See also the report by Wortis, who was in analysis with Freud in the 1930s: “He also spoke of a little technical matter: remembering dreams. One should make no special effort to remember them, he said, and it is futile to note them down at the bedside with pencil and paper. By trying too hard, the resistance is simply moved to the side to cover something else, and it was in any case significant to note what was remembered most easily. If one has natural interest and pleasure in thinking of a dream, that is another matter.” Joseph Wortis, Fragments of an Analysis with Freud (New York: Simon & Schuster, 1954), p. 52. 74. Sigmund Freud, “Observations on Transference-Love: Further Recommendations on the Technique of Psycho-Analysis,” SE 12:159–71, pp. 154–55.

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in a very different direction: psychoanalysis became the performance of an art of memory in situ in combination with the retrospective writing of case notes. With the institutionalization of psychoanalytic training according to Freud’s rules, the consulting room became the central site in the production of psychoanalytic knowledge. The earlier practice of self-analysis, which called for the analysand to write down and analyze his dreams by the book, had given way to a new configuration in which the most promising path to the unconscious was found by lying on the couch.

Conclusion

When a patient today comes to his first psychoanalytic interview, the particular conditions of the setting may require some technical, but hardly any historical justification. Were a patient to devote his attention first and foremost to the furnishings of the consulting room, to the couch on which he is asked to lie down or the chair on which he is to sit, thereby disregarding the person of the analyst, he would certainly appear, in psychoanalytic terms, as a rather curious case. The thought that the material arrangement of the setting also has a history and a meaning pertinent to the ways in which unconscious processes can become objects of knowledge requires a distance that the interpretive machinery of psychoanalysis tends to abolish. While “to be on the couch” has become a convenient shorthand expression for the intricate and laborious process of undergoing psychoanalysis, the social and material conditions and the deep historicity of the Freudian enterprise have been neglected in favor of human-centered, psychological readings. Popular films and novels depicting the vicissitudes that Freud and his followers had to cope with (either in heroic or comic garb) have largely served to reinforce this familiar image of the talking cure, with its asymmetric distribution of roles. The agents in these works of fiction are always people with their human, alltoo-human concerns, not things. Despite the transgressive and critical edge that some of these works may display toward psychoanalytic practice, such criticisms can always be retranslated into the theoretical terms of psychoanalysis and thus find an explanation within its interpretive system. Fiction, then, seems to open doors which for the anthropologist must remain closed, for ethical, but also for epistemological reasons. And yet it would be absurd to claim that films or novels can provide us with a realistic account of psychoanalytic practice comparable to that undertaken in an-

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thropological surveys (if such a study were possible at all). It is certainly no coincidence that in many films, beginning with Fritz Lang’s Dr. Mabuse, the open and spectacular culture of hypnosis coexists with the closeted spaces of psychoanalysis. Hence, in many Hollywood productions up to the 1960s, the psychoanalyst can make his appearance on the silver screen as the hypnotist’s legitimate successor, secret accomplice, or decided opponent. Although feature films can reveal a lot about the ways in which psychoanalysis was made acceptable to larger audiences, and thus may serve as an indicator of its normative status within a certain culture, they cannot provide a substitute for an analysis of its practice and its concrete conditions, since they often blur its distinctive position with regard to other forms of treatment. The impossibility of studying psychoanalytic practice as an anthropologist in situ (unless one decides to become a member of the tribe and slips into the role of the patient) wanes to a certain degree when one adopts an approach that brings its historical and situated character, down to its very material components, to the fore. The historian’s curiosity, then, is at the initial stage not unlike that of the unruly patient, who looks—and keeps looking—at the profusion of objects in Freud’s consulting room, asking questions about all the things surrounding him, both the precious ones, such as antiquities and carpets, and more mundane features, such as the arrangement of chairs and couches. At first glance this imagined consulting room scene may recall the shifting gaze of the poet Hilda Doolittle as she portrays herself in her semifictional tribute, entering the mythical office at Berggasse 19 and all the while denying the famous “Professor” the attention he seems to expect. “You are the only person who has ever come into this room and looked at the things in the room before looking at me,” are the words the poet attributes to a baffled Freud. Even if the shift of perspective from the great man toward the collection of precious objects around him can be read as a defiant move, the entire mise-en-scène remains caught up in the web of Freudo-centric historiographies, be they hagiographic or debunking in tone. . It is known that Freud himself always remained rather hostile toward the representation of psychoanalysis in film. See Paul Ries, “Popularize and/or Be Damned: Psychoanalysis and Film at the Crossroads in 1925,” International Journal of Psycho-Analysis 76 (1995): 759–91; Lydia Marinelli, “Verfilmte Psychoanalyse,” in Psyches Kanon: Zur Publikationsgeschichte rund um den Internationalen Psychoanalytischen Verlag (Vienna: Turia & Kant, 2009), pp. 111–39; and Lydia Marinelli, “Smoking, Laughing, and the Compulsion to Film: On the Beginnings of Psychoanalytic Documentaries,” American Imago 61, no. 1 (2004): 35–58. . H. D. [Hilda Doolittle], Tribute to Freud, p. 98. . As a corrective to Doolittle’s retrospective version of the events in Tribute to Freud, one may consult her own letters to her friend Bryher, which convey a rather different and certainly

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The perspective that I have developed in this book has followed a rather different approach, which has taken to heart what I understand to be the essential lessons of much work in the history and sociology of science over the past thirty years: first, the principle that controversies and conflicts in a certain field be treated in a symmetric manner, regardless of who may be declared to be the winning or the losing party; second, the value of an analytic focus on the concrete sites and practices of knowledge production, in particular on their material components and their forms of social organization. These methodological choices have moved my study in a direction that clearly contrasts with approaches in which single persons or ideas are at center stage. Here hypnotism and psychoanalysis—in their various attempts to stabilize knowledge about the unconscious—have been considered as a collective enterprise in which new sites of experimentation and therapeutic intervention have come into being. In the case of hypnotism, a detailed reconstruction of the material setting of its laboratories and consulting rooms has provided us with a clearer sense of what the actual stakes of the controversies over its practices were. The first part of this book has shown how, within the experimental system that Charcot and his collaborators designed around hypnosis at the Salpêtrière, it was crucial to locate unconscious processes in the nervous system and to turn them into controllable objects. Bernheim’s counterdemonstrations, in contrast, did more than dispute a few isolated facts: they aimed to demolish the entire system by pointing to the uncontrollable factor of suggestion in the Paris experiments. Since the culture of hypnotic suggestion as it became associated with the so-called Nancy school (which was in fact a more loosely organized group around Bernheim and his master Liébeault) appeared, at least for a decade, as the winner in the struggle with Charcot and his adherents, many historical accounts have succumbed to the temptation of endorsing its point of view and declaring the facts coming out of the Salpêtrière to be mere “artifacts” rougher image of her analysis. See Susan Stanford Friedman, ed., Analyzing Freud: The Letters of H. D., Bryher, and Their Circle (New York: New Directions, 2002). For a trenchant historical critique of this episode, see Gere, Knossos, pp. 164–71. . This does not necessarily mean that one must adopt, in the sense of an extended principle of symmetry, a metaphysics that also assigns agency to things. For such a formulation, see Latour, The Pasteurization of France, and for its critique, Simon Schaffer, “The Eighteenth Brumaire of Bruno Latour,” Studies in the History and Philosophy of Science 22 (1991): 174–92. For the realm of science and psychotherapy, Latour has stated his views more recently in On the Modern Cult of the Factish Gods (Durham, NC: Duke University Press, 2010). Introducing the neologism “factish,” however, does not seem to be a solution to the problem.

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created by suggestion, simulation or, in more recent parlance, “social construction.” When one declares the debate closed, however, it becomes impossible, at least from an epistemological point of view, to fully clarify the stakes of the controversies surrounding hypnosis, or to make any sense of the long persisting attempts to create laboratories of hypnosis. In his Short Account of Psycho-Analysis, Freud acknowledged that it “is not easy to over-estimate the importance of the part played by hypnotism in the history of the origin of psychoanalysis. From a theoretical as well as from a therapeutic point of view, psychoanalysis has at its command a legacy that it has inherited from hypnotism.” In this book, I have attempted to unfold the various epistemological and sociological implications of this legacy from the point of view of a historian of science. The manifold controversies and reconfigurations of hypnosis research, and its ultimate failure to establish a stable experimental culture in the French- and German-speaking worlds, became constitutive for the specific shape of the psychoanalytic setting. In a number of aspects, it may seem that psychoanalysis has succeeded where hypnosis failed. Nevertheless—despite a hagiographic literature that presents the Freudian self-analysis as a radical break with earlier theoretical, therapeutic, and experimental approaches to the unconscious—it cannot be plausibly maintained that hypnosis was ultimately superseded by psychoanalysis. The emergence of the psychoanalytic setting may ultimately be best described in terms of a gradual shift, and not of a dramatic rupture; as a series of small events, gestures, and moves that led to very concrete, at times seemingly trivial displacements: removing the doctor’s hand from certain zones of the patient’s body, while applying it to others; passing from the systematic use of shock, noise, or bright light attained by heavy apparatus to the calm and comfort of a dimly lit homelike setting; increasingly transferring the task of speaking during the treatment from doctor to patient; positioning the patient not face-to-face with the doctor but on the couch; at first keeping the doctor within the patient’s field of vision and then removing him entirely; shifting from an intricate system of observation and control through inscription devices to the instauration of an art of memory in which note-taking or written protocols are largely suppressed. In the development of the various methods of psychotherapeutic treatment, the positioning and manipulation of things and of bodies mattered as much as the words uttered and their interpretation. Although they were now largely removed from sight, techniques of the . See e.g., Borch-Jacobsen, “How to Predict the Past”; and Remembering Anna O. . Freud, “A Short Account of Psycho-Analysis,” SE 19:192.

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body continued to underpin the sophisticated techniques of the mind as they were exercised within the new culture of the “talking cure.” At the time of the consolidation of the “classical setting,” Freud insisted on the total suppression of the visual and material elements that were so characteristic of the experimental and therapeutic cultures of hypnotism. The only instrument of the psychoanalyst, he now claimed, is speech. In the opening lecture of his Introductory Lectures on Psycho-Analysis, delivered in 1916, Freud implicitly evoked the memory of his former master Charcot to highlight the new methods of conducting and teaching psychoanalysis. Whereas the medical teacher can play “the part of a leader and interpreter who accompanies you through a museum, while you gain a direct contact with the objects exhibited and feel yourself convinced of the existence of the new facts through your own perception,” the first lesson about psychoanalysis would be that there is strictly nothing to be seen or demonstrated: The talk of which psychoanalytic treatment consists brooks no listener; it cannot be demonstrated. A neurasthenic or hysterical patient can of course, like any other, be introduced to students in a psychiatric lecture. He will give an account of his complaints and symptoms, but of nothing else. The information required by analysis will be given by him only on condition of his having a special emotional attachment to the doctor; he would become silent as soon as he observed a single witness to whom he felt indifferent. For this information concerns what is most intimate in his mental life, everything that, as a socially independent person, he must conceal from other people, and, beyond that, everything that, as a homogenous personality, he will not admit to himself. Thus you cannot be present as an audience at a psychoanalytic treatment. You can only be told about it; and, in the strictest sense of the word, it is only by hearsay that you will get to know psycho-analysis. As a result of receiving your instruction at second hand, as it were, you find yourselves under quite unusual conditions for forming a judgement. That will obviously depend for the most part on how much credence you can give to your informant.

With this last reference to the skeptical listener who is directly addressed as the party to be convinced within a purely literary representation of psychoanalytic practice, Freud uncoupled it from the culture of open public demonstrations that marked hypnotism. As I have argued throughout this book, this move was a pragmatic solution to risks and difficulties surrounding hyp-

. With “techniques of the body” I refer, of course, to the classic paper by Marcel Mauss, “Les techniques du corps,” Sociologie et Anthropologie (Paris: PUF, 1959), pp. 365–86. . Sigmund Freud, “Introductory Lectures on Psycho-Analysis,” (1916–1917), SE 15:17–18.

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notic treatment. The most serious problem, the unwanted epistemic effects of the reading patient, was addressed in a novel technique designed to draw such patients into processes of reading and writing according to Freud’s own theory of dreams. But this coup, without doubt ingenious and effective from a technical point of view, did not solve once and for all the epistemological predicaments inherited from hypnosis. The closure of the psychoanalytic treatment led to a new distribution of sites, public and private, that would mark its culture and the knowledge emerging from it until the present day. Freud discarded the ostentative transparency and the accumulation of data constitutive of experimental psychology in favor of a processing of knowledge through informal structures and publication forms that emphasized their highly selective and mediated character. Neither inside nor outside the seemingly closed world of psychoanalysis, however, would the “classical model” of the Freudian setting prove to be a stable and entirely irreversible configuration.

Acknowledgments

This book is a new, revised and expanded English version of a study that first appeared in German ten years ago. Some sections had to be updated, to incorporate new research, others completely rewritten, such as the introduction and the final chapter. The book’s main argument, however, has not been affected by these changes. Producing an English version of a book that was conceived in German and deals to a great extent with the transfer of clinical knowledge from France to Austria, Germany, and Switzerland proved to be not always an easy task. The first part is devoted to the French cultures of hypnotism, whose two major representatives, Charcot and Bernheim, were translated by Freud himself. In contrast to the original German version, Freud’s translations of these authors could not be used here (their critical historical discussion, a work that is hardly begun, could be an entire book in itself). As most of the existing English translations of the French literature on hypnotism turned out to be inaccurate or incomplete, it was necessary to come up with better solutions. I am very grateful to Chris Barber, who translated the core chapters of the book, for many thoughtful and illuminating discussions on terminological issues. Research that has contributed to this book has appeared earlier in the following publications: “Introspective Hypnotism and Freud’s Self-Analysis: Procedures of Self-Observation in Clinical Practice,” Revue d’Histoire des Sciences Humaines 5 (2001): 171–96; “Objektwelten des Unbewußten: Fakten und Fetische in Charcots Museum und Freuds Behandlungspraxis,” in Wissen als Sammeln: Das Sammeln und seine wissenschaftsgeschichtliche Bedeutung, edited by Anke Te Heesen and Emma Spary (Göttingen: Wallstein,

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2001), 169–98; and “Lost Objects. From the Laboratories of Hypnosis to the Psychoanalytic Setting” Science in Context 19, no. 1 (2006): 37–65. Working with the University of Chicago Press has been a great pleasure. In particular, I want to thank my editor Karen Darling, who handled the manuscript with enthusiasm, efficiency, and skill. Without the possibility to consult libraries and archives, this book would not have been possible at all. I thank especially the library of the Max Planck Institute for the History of Science, its head, Urs Schöpflin, and the entire staff for the enormous help and assistance in providing access to sometimes obscure and rare material. I also thank the Freud Museum London and its director, Carol Siegel, and particularly Rita Apsan, the Kunsthaus Zürich, the C. & O. Vogt-Archiv (C. & O. Vogt-Institut für Hirnforschung, Universitätsklinik Düsseldorf), Véronique Leroux-Hugon at the Bibliothèque Charcot at the Salpêtrière, and Anne-Marie Vallin-Charcot, who gave me access to the private papers of Jean-Martin Charcot. For valuable information on Freud’s correspondence, I am grateful to Albrecht Hirschmüller and Michael Schröter. I would also like to thank my research assistants Lewe Paul and Tina Plokarz who were of great help in the preparation of the final manuscript. Discussing my work with students during seminars I taught over the past decade, particularly at the Department of History and Philosophy of Science at the University of Cambridge, the University of Chicago, and the École des Hautes Études en Sciences Sociales in Paris, has also allowed me to test and to nuance my views. I am therefore very grateful for the critical engagement of all the students who attended my courses. Among the many scholars with whom I have consulted during the gestation of this project, I would like to express my gratitude in particular to Jacqueline Carroy, John Carson, Lorraine Daston, Nicole Edelman, John Forrester, Carlo Ginz­burg, Ruth Leys, Elizabeth Lunbeck, Françoise Meltzer, and Alison Winter. Special thanks go to Yvonne Wübben for being so supportive during the final stages. I am aware that I have incurred many intellectual debts over the years during which I produced the initial version of this book. The greatest one I owe without doubt is to Lydia Marinelli, whose long friendship and collaboration opened my eyes to a different way of writing about the history of psychoanalysis, remote from the old well-trodden paths, but without forgetting its travails and lurking pitfalls. I feel that there is hardly a page in this book that has not been enriched by our conversations. Thus I dedicate this book to her memory.

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Index

Page numbers followed by “f ” refer to figures.

Abraham, Karl, 220 action script: of hypnosis experiment, definition 31n63; of the Salpêtrière school, 30–37, 46–48; of Liébeault in Nancy, 52–54; redefinition by Bernheim, 65–66; transfer from catalepsy to somnambulism at the Salpêtrière, 76–77; ex­ pansion of, by Binet and Féré, 83–85; of the stage magnetists, 95–96; animal magnetism: and historiography of hypno­ tism 3–4; Charcot’s integration of its practices at the Salpêtrière, 22–27; Bernheim’s turn to earlier practices of, 51 animals, use of hypnosis on, 47–48 “Anna O.” case study, 153, 155, 155n38, 156, 156n43 Anzieu, Didier, 199 associationist psychology, 79–80, 79n27, 180–81 association test, diagnostic, 211–12 attention, 173, 173n44, 185, 189–90, 192–94, 202n9, 207, 209–10, 212, 219; expectant, 41, 49. See also self-analysis, self-observation. autohypnosis, 174–76. See also introspective hypnotism Babinski, Joseph, 71, 117n20 Beaunis, Henri, 51, 51n6, 61–62 Benedikt, Moriz, 113–14, 116, 152; as a critic of suggestion therapy, 123n39, 131; as a critic of Krafft-Ebing’s hypnotic experiments, 139–45; on “ceremony” of cure, 147 Bernard, Claude, 22–23, 28–29, 32–33, 38n83, 91, 92n66

Bernheim, Hippolyte, 6; clinic of, 56–60; “coun­ tersuggestion” or “resistance” of patients, 58– 59; critique of experimental hypnotism and, 48–49; integration of suggestion as a therapy into hospital in Nancy, 55–56; mass appli­cation of suggestion and, 57n25; objective criteria for hypnotic states and, 62; primacy of af­ flicted individual and, 50n3, 65–66; problem of simulation as defined by, 60–64; school of Nancy and, 51; social structure of the clinic and, 56–57; theory of hypnosis of, 54n18; turn to practices of animal magnetism, 51. See also Nancy school of hypnosis, suggestion, suggestibility Billroth, Theodor, 140n108 Binet, Alfred, 6, 60, 62, 72, 202, 202n10; attempts to substantiate reality of hallucinations, 81– 84; expansion of action script for study of unconscious phenomenon by, 84; modifying Bernheim’s definition of suggestion, 79–80; transferring psychic objects and, 75–79 Binswanger, Otto, 161 Bleuler, Eugen, 11n1, 176–77, 205, 206–7, 207n29; Freud’s theories and, 208; writing practices in self-analysis, 207 Bourneville, Désiré-Magloire, 32, 37 Braid, James, 32 Breuer, Josef, 152–55, 191 Briquet, Paul, 20 Brouillet, Louis, 76n20 Brodmann, Korbinian, 183, 187, 190 Brown-Séquard, Charles-Édouard, 47

252 Burghölzli hospital (Zurich), 205–6 Burq, Victor, 22–23, 50 Carroy, Jacqueline, 4n12, 51n6, 101n20 cases: rarity of in Charcot’s practice, 1, 14, 19, 47, 57, 120, 151; in relation to clinical types, 74 case histories, Freud’s narrative strategies, 156–60 catalepsy, 43, 45f cathartic method, 152, 153 “ceremony” of hypnotic cure, 147–49 Charcot, Jean-Martin, 1, 6, 63; biographical stud­ ies of, 13n6; classification of hysteria as “grand neurosis” by, 20; clinical art of observation, 16–19; concept of grande hystérie of, 20–21; control systems and, 42–43; deception and, 41–42; efforts to reproduce symptoms of hys­teria through hypnosis and, 22–24; exper­ imental system for hypnotism of, 28–29; Freud as translator and follower of, 116–17, 117n23, 226; hypnotism and, 2; investigation of “un­conscious cerebration” and, 75–76, 76n17; neuropathological service, 14; novels and plays about, 14n12; posthumous fame of, 11–12; strat­ egies implemented hypnosis laboratory of, 104–5; Tuesday lectures of, 14–18; use of selfregistering instruments and, 40–41. See also Musée Charcot; Paris school of hypnosis Chertok, Leon, 4n11 clinical types: as defined by Charcot, 19, 30; related to collection, 74; three types of experi­ mental hypnosis, 45; clues, as an epistemological model in early psy­ choanalysis, 210–211 “complaisance,” of experimental subjects, 101, 116, 201 complex, of associations, 173–74, 192, 206–8, 211–12, 214 confession, techniques of, 152, 158, 175, 195, 204, 210–12 consulting room, 4; Charcot’s, 14, 19; Liébeault’s, 52–53; of hypnosis doctors, 147, 162–72; Freud on positioning of doctor and patient in, 209–10; furniture in, 164–65; in Germanspeaking world vs. Parisian clinics, 163; main objective of, 163–64 criminalist approach, 211–13; modification of psychoanalytic setting and, 212–13 Cullen, William 20n32 Danilevsky, Vasily, 66n59 Danziger, Kurt, 12n5 Delbœuf, Joseph, 6–7, 59n33, 60, 64n51, 72, 80n32, 88–89, 94, 97n7, 116, 125, 155, 159, 175n49; con­ troversy over medical monopoly on hypnosis, 105–6; self-observation of dreams, 100, 177, 203; sympathetic bond between hypnotist

index and subject, 100–3; use of stage hypnotism for epistemological critique of medical cultures of hypnosis, 97–99 demonstrations, for skeptical patients, 170 diagnostic association test, 211–12 Donato (Alfred d’Hondt), 94, 105; Delbœuf ’s criticism of performances of, 97–103 Doolittle, Hilda (H.D.), 217, 217n63, 223 “Dora” case, 210–11 Dr. Mabuse (film), 223 dreams: analogy with hypnotic state, 177–78, 185n83; early rejection of analysis of, 206–7; French research on, 177n58; influenced by sug­ gestions, 85, 171; notation of, 220; selfobservation of, 100, 162, 169 Duchenne (de Boulogne), 36, 36n75, 63, 67n66, 75 Dumontpallier, Amédée, 23, 23n41 “ecmnésie,” 138 Edelman, Nicole, 20n32 Eissler, Kurt, 199 Ellenberger, Henri F., 3–4, 182n73, 199n2, 155n38 epileptoid period, presentation of, 38, 39f experimental neuroses, 29–30, 37; criticisms of, 59; types of, 45–46 experimental psychology: development of, hypnotic suggestion and, 178–79; at Salpêtrière Hospital, 82 Experimental Study in the Domain of Hypnotism, An (Krafft-Ebing), 134 experimental systems, for hypnotism, 28; defini­ tion, 28n52 family members, hypnotic treatment and, 149–50. See also isolation Féré, Charles, 6, 48, 72, 75–79; attempts to substantiate reality of hallucinations, 81–84; expansion of action script for study of un­ conscious phenomenon by, 84; modifying Bernheim’s definition of suggestion, 79–80 fetishistic object-relations, 85–89; definition, 87n54 fixation method, 32, 33–34, 165 Flechsig, Paul, 183 Fliess, Wilhelm, 128n57, 199–200, 204n16 fluidum, mesmeric, 95–96 Forel, Auguste, 11n1, 107, 155n37, 161–62, 162n2, 165, 169, 183, 205; definition of hypnotic state and, 178; dreams and, 177–78; founding of journal Zeitschrift für Hypnotismus, Suggestionstherapie, Suggestionslehre and verwandte psychologische Forrschungen, 179; Wundt’s polemic and, 179–82 Forrester, John, 204n16 Foucault, Michel, 3n10, 17n25, 40n90 fractionation method, 186–90, 210

index free associations, 202, 209 French hypnosis research, reception of in medical culture of Vienna, 111–15 Freud, Sigmund, 3n8, 11, 119n25; avoidance of us­ ing private patients for public demonstrations, 154; consulting room of, 215–17, 216f, 217n60; criteria for realization of psychoanalytic treat­ ment, 215; deficiencies of suggestion technique, 151–52; difficulty of achieving isolation and control of patient and, 148–49; dream notation and, 220; early interest in hypnosis of, 115–16; hypnosis and, 2–3; im­portance of sugges­ tive atmosphere and, 147; lecture on male hysteria of, 118–19; manipulation of setting by, 219; model for psychoanalyst, 218; narrative strategies in case histories of, 156; obstacles confronting, in Vienna, 118–19; on position­ ing of doctor and patient in consulting room, 209–10; pragmatism of, 151, 151n20; psychical analyses and, 190–97; psychoanalytic setting and, 215–17; rebuttal of Meynert’s critique by, 127–28; recording patient’s reactions and, 219–20; representation of psychoanalysis in film and, 223n1; self-analysis and, 199–208; strategies to factor out simulation problem, 154–55; transfer of skills learned in Paris to Viennese medical world, 121; as translator and follower of Charcot, 116–17, 117n23, 121, 121n34; visit to Salpêtrière by, 116–17 Frey, Ludwig, 130 furniture, in consulting rooms, 164–65 Gall, Franz Josef, 77–78, 77f, 88 Galton, Francis, 12n5, 82–83n40, 206 Gamgee, Arthur, 30–31, 46 Gauchet, Marcel, 13n6, 128n58 Gauld, Alan, 51n6, 70n2, 182n73 genuineness criteria, for evaluating hypnosis, 63, 153–54 Georget, Étienne, 20 Giedion, Sigfried, 164, 164n9 Gilles de la Tourette, Georges, 71, 104, 113 Ginzburg, Carlo, 83, 211n42 Girardi, Alexander, 140n108 Goldstein, Jan 18n28 Gomperz, Elise, 150 Gomperz, Theodor, 150 grande hystérie, Charcot’s concept of, 20 grand hypnotism, 11, 51; doctrine of, 6; experi­ mental system built around, 38–39; stages of, 33, 54 graphic method, 28, 38, 40 group hypnosis, 170–71. See also hypnosis hallucinations, 80–81; Binet’s and Féré’s attempt to substantiate reality of, 81–84

253 Hansen, Carl, 94–97, 96f, 104; performances of, in Vienna, 113–14 Harrington, Anne, 51n6, 54n17, 67n65 Hirt, Ludwig, 13 Hollywood, psychoanalysis and, 223, 223n1 Hugo, Victor, 2 hypnoid hysteria, 153 hypnosis: challenging medical monopoly on, 103–7; controversy over claim to medical monopoly on, 105–6; first major controversy surrounding, 125–28; fixation method, 165; group, 170–71; psychoanalysis and, 224; two clinical cultures of, 67–69; use of, on animals, 47–48. See also lay hypnosis hypnosis treatments, witnesses and, 169–70 hypnotic states, Forel’s definition of, 178 hypnotic suggestion, 51, 54; controversy over therapeutic use of, in Vienna, 128–29; ex­ perimental psychology and, 178–79; the locality and, 59–60; moral compunctions of Viennese opponents of, 130–31; Nancy school and, 64–67, 224; Parisians and, 117–18; as therapeutic method in Nancy, 52–56; Wundt and, 179–82 hypnotic treatment: difficulty of achieving isola­ tion and control for, 148–49; power relation­ ship between doctor and patient’s family in, 149–50; specific location and, in Vienna, 147–48 hypnotism, 47; Charcot and, 2; Charcot’s experi­ mental system for, 28–29; clinical facts and, 125–26; Freud and, 2–3; Freud on importance of, in history of psychoanalysis, 225; historiog­ raphy of, 70–71; introspective, 7–8, 162, 173–82 hypnotists: hypnotized, 174–76 hysteria, 1; Charcot’s classification of, as “grand neurosis,” 20; classification problems of, 20; as experimental neurosis, 29–30; gender and, 20–21, 21n36; overview of literature on, 20n32; as problem of neuropathology, 20–21; stages of, 29–30, 30n59; use of photographs for, 37–38. See also hysterics hysterics, as experimental subjects in hypnotism, 1–2, 22–48, 141n113; compared to animals, 46–48 hysterogenic zones, 24–25, 26f, 120 Iconographie photographique de la Salpêtrière, 21n38, 32, 37 imagination, of experimental subjects, 41, 60–63, 91, 113, 169; and “complaisance,” 101 impression management, of doctor during hypnosis, 57 inscriptions, control by, 37–40 intelligence, of experimental subjects, 89–92 Internationale Klinische Rundschau, 124, 124n43 The Interpretation of Dreams (Freud), 200–1, 201n7, 203, 204n16

254 introspection, importance of for experimen­ tal psychology, 200n4, 203n10; difference from self-observation, 179–80; in Vogt’s and Brodmann’s suggestion method, 182–90; selfanalysis and, 205–7. See also self-observation, introspective hypnotism introspective hypnotism, 7–8, 162, 173–82. See also hypnotism investigative diagnostics (Tatbestandsdiagnostik), 211–12 Irma dream, 202–3 isolation of patient, from family, 25n17, 143, 146–48; from noise, 189 isolation rooms, 122 Janet, Paul, 60 Janet, Pierre, 67, 70n2, 144n120, 178n62 Jones, Ernest, 199, 199n2 Jung, Carl Gustav, 205, 211–12, 212n46 Keller, Albert von, 167 Kircher, Athanasius, 47–48 Koller, Carl, 119, 121 Königstein, Leopold, 119, 120 Kovalevskaya, Sofia, 14 Krafft-Ebing, Richard von, 7, 131–45, 148–51, 154, 156 Krafft-Ebing scandal, 131–45; conclusions drawn from, 143–45 Külpe, Oswald, 196n25 laboratories of hypnosis, 1–2, 27–37, 40, 61, 68, 104, 112, 182–90 Ladame, Paul-Louis, opposition to use hypnotism in public demonstrations, 105 Lang, Fritz, 223 lay hypnosis, 6; in Delbœuf ’s critique of medical cultures of hypnosis, 97–103; stage magnetism and, 94–97. See also hypnosis Liébeault, Ambroise-Auguste, 51, 52–54, 68 Lieben, Anna von, 151n20 Liégéois, Jules, 51 light, used to induce hypnosis, 33–35, 48, 163–65 localization theory, 78–79, 79 Londe, Albert, 37, 37n82 Löwenfeld, Leopold, 163, 167–68, 170, 209 Luys, Jules Bernard, 23, 23n41 Marcinowski, Johannes, 188–90, 209–10, 210n37 Marey, Etienne-Jules, 28, 28n53, 38–39, 38n83, 43 Marie, Pierre, 183 Marinelli, Lydia, v, 5n17, 201n7 materialization, strategy of, 78, 79 Mayer, Karl, 139n104 Mesmer, Anton, 4

index mesmerism, 1–4, 27–28, 112 metalloscopic examination, 22–24 metalloscopy, 23 metallotherapy, 23, 27 Meynert, Theodor, 7, 118–19, 128n57, 181; con­ troversy over therapeutic use of hypnotic sug­ gestion and, 128–30; critique of hypnotism, 125–27 Mirbeau, Octave, 2 Moser, Fanny (“Emmy v. N.”), 151n20, 155, 155n37 Musée Charcot, 6, 18, 71–75 Nancy school of hypnosis, 6, 50–52, 51n6; criteria for genuineness of hypnotic state of, 62; culture of hypnosis at, 67–68, 224–25; differ­ ences between Paris school and, 67–69; forms of resistance and, 66; hypnosis experiment and, 64; objective criteria for hypnotic states and, 61–62; primacy of afflicted individual and, 65–66; question of simulation and, 63–64; suggestible subjects and, 64–67; support of Delbœuf in controversy over use of hypno­ tism, 106–7. See also Bernheim, Hippolyte; Paris school of hypnosis Nonne, Max, 11n1 nosography, 29 Obersteiner, Heinrich, 115, 115n13; use of hypnotic suggestion, 122 observation, Charcot’s clinical art of, 16–19; experiment and, 29–34 occultism, 179, 179n64 On Intelligence (Taine), 80 Oppenheim, Hermann, 117 Oppolzer, Johann von, 113–14 Pankejeff, Sergei (“Wolf Man”), 217 Paris school of hypnosis, 6, 50; differences be­ tween Nancy school and, 67–69. See also Char­ cot, Jean-Martin; Nancy school of hypnosis; Salpêtrière hospital personal hygiene, of doctors, 166 Peterson, Frederick, 212n46 petit hypnotism, 51 photography, 37–38 physical treatment, 122 physiognomy, 63 Pitres, Albert, 137–38 polygraph, 212n46 power relationship, between hypnotist and subject, 32–34, 40n90, 41–46, 56–64, 68–69, 76, 90–92, 95–97, 101–3, 106–10, 147–52, 166–68 pressure points, discovery of, 25 private practice, 147; power relationship between doctor and patient’s family in, 149–50

index psychical analyses: Freud’s use of term, 191; Vogt vs. Freud, 190–97 psychoanalysis: fiction and, 222–23; Freud on conducting and teaching, 226–27; Freud on importance of hypnotism in history of, 225; Hollywood and, 223, 223n1; hypnosis and, 224 psychoanalysts, speech as only instrument of, 226 psychoanalytic setting, 7; emergence of, 225–26; Freud and, 215–17; modification of, and criminological approach, 212–13; stabilizing attempts for, 208–14 Psychology of Reasoning, The (Binet), 202, 202n10 Psychopathology of Everyday Life,The, 202 public demonstrations, Freud and Breuer and avoidance of using private patients for, 154 reading patients, 148, 201–4, 214, 227 reciprocity, suggestive, controlling for, 171 Régnard, Paul, 32, 37 resistance, of patients: to hypnotic treatment, 58–61, 66, 69, 75, 89, 101, 148, 159, 169–170, 176, 187–197; of patient’s family members to hypnosis, 150; redefined by Freud, 159; within psychoanalytic treatment, 201, 204, 208, 208n30, 212–14, Rheinberger, Hans-Jörg, 28n52 Richer, Paul, 21, 38, 39, 63, 71, 73, 74, 75–76, 76n17; use of graphic method, 38–40 Richet, Charles, 89 Riklin, Franz, 205, 211 Rosenthal, Moriz, 113, 114–15, 118, 127 Rubens, Peter Paul, 18n28 Salpêtrière hospital, 1; clinical site of, 12–14; culture of hypnosis at, 67; development of experimental psychology at, 82; experimental neuroses demonstrated at, 48; therapeutic ap­ proach of, 50. See also Paris school of hypnosis sanatoriums, design of, 122–23 Saussure, Raymond de, 177n58 Schnitzler, Arthur, 121, 124–25, 125n43 Schnitzler, Johann, 121, 123–24, 125n43, 148 Schrenck-Notzing, Albert von, 165, 165n12, 167, 171 scientific medicine, integration of mesmeric practice into, 1 self-analysis, 8; Freud and, 199–208 self-observation, culture of, 205 self-observation, theory and practice of, 192 self-observation method, 174–75 self-recording instruments, 28, 40, 43 simulation, problem of: and animal hypnosis in Vienna, 112; in Charcot’s clinic, 40–46; in Nancy, 60–64; in the experiments of Binet and Féré, 83–85; strategies of Freud and Breuer to factor out, 154–55;

255 soundscapes, of the hypnotic consulting room, 172–73 sphygmograph, 61–62 stage magnetism, 6–7, 32; lay hypnotism and, 94–97 Stekel, Wilhelm, 212, 213–14, 213n47, 213n48 Studies of Hysteria (Freud), 152; case histories in, 156–60 suggestibility, 64–67, 79, 102, 170, 173, 175, 187; as equivalent of “transference love” in psycho­ analysis, 218 suggestion, 6–7; Binet’s and Féré’s modification of Bernheim’s definition of, 79–80. See also hypnotic suggestion, technique of suggestion method: action script of, 165; doctor’s persuasive explanation and success of, 168–69 suggestive reciprocity, controlling for, 171 Swaan, Abram de, 148n7 Swain, Gladys, 13n6 symmetrical approach, in the history of hypno­ tism, 5, 70–71 tactics, of experimental subjects, 89–92 Taine, Hippolyte, 80 Thomsen, Robert, 117 transference, in early psychoanalysis, 212, 215–16, 220; object, 218 transfert, 40–41, 76; defined, 25–27; Freud’s in­ ability to demonstrate, 120 Tuesday Lectures, of Charcot, 14–18; editions, 14–15n13; Freud’s translation, 14–15n13 unconscious, experimentalization of, 19–22, 106; strategies of materialization of, 75–76, 83–84; objects, 85–89 unconscious cerebration, investigation of, 75–76, 76n17 verbal suggestion, 49–50, 165–66 Vienna General Policlinic, 113, 121, 123–25 Viennese medical establishment: hypnotic treat­ ment and, 147–48; performances of Hansen and, 113; reception of French hypnosis research by, 111–15; sides taken on hypnotic suggestion of, 121–22 visual representations, 37. See also photography voice, of doctor during hypnotic treatment, 53–54, 62, 68, 166, 172–73, 189n99 Vogt, Cécile, 183, 184f Vogt, Oskar, 7–8, 155n37, 182–90, 182n73, 184f; fractionation method of, 186–90; hypnotic chambers of, 172–73; psychical analyses and, 190–97; use of voice during hypnotic treat­ ment, 172–73, 189n99

256 Wetterstrand, Otto, 155n37, 168; facilities for con­ trolling suggestive reciprocity of, 171–72 Winter, Alison 28n51 Winternitz, Wilhelm, 121, 123 Wittmann, Blanche, 76–77, 76n20, 88–89, 99–100 witnesses, in consulting rooms, 150, 167f, 169–70, 170n31

index “Wolf Man” (Sergei Pankejeff ), 217 Wundt, Wilhelm, 12n5, 97, 179–82, 179n64, 185n83, 196n125, 203 Würzburg school, 196, 196n125 Zeitschrift für Hypnotismus, Suggestionstherapie, Suggestionslehre and verwandte psychologische Forschungen, 179, 182–83, 190