The Cut in the Building of Psychoanalysis: Sigmund Freud and Emma Eckstein, Volume I 9781138823495, 9781315742045

Citation preview

The Cut and the Building of Psychoanalysis, Volume 1

This volume presents a fresh perspective and new narrative of the origins of psychoanalysis, taking into account social, cultural, and contemporary relational views. Exploring Freud’s unconscious communication and identification with his patients, Emma Eckstein in particular, the book sheds new light on the logic which informed a number of events central to Freud’s self-analysis, and the theories he formulated to found and establish psychoanalysis. Divided into three parts, chapters trace how Freud’s oscillations between the reality of trauma and the creative power of fantasies were a direct result of his encounter with and treatment of Emma. Part 1 presents a historical reconstruction of the practice of castration in the treatment of hysteric women between 1878 and 1895; Part 2 examines the theories and practice produced by Freud between 1895 and 1896; and Part 3 explores and reconstructs Freud’s self-analysis, 1896–1899. The Cut and the Building of Psychoanalysis argues that Freud’s unconscious communication with Emma provided him with a crucial framework and path for his self-analysis. It will appeal to psychoanalysts, psychotherapists, and psychologists, as well as historians of medicine and science, social scientists and scholars interested in the history of Western thought and the mind in general. Carlo Bonomi, PhD, is supervising analyst at the Harry Stack Sullivan Institute of Psychoanalysis, Florence, Italy, and a faculty member of the Postgraduate School of Psychotherapy of the same institute. He has taught History of Psychology and Dynamic Psychology at the State University of Florence and is a former president of the Centre for Historical Studies of Psychoanalysis and Psychiatry. He is also Founding President of the Sándor Ferenczi Cultural Association.

Relational Perspectives Book Series Lewis Aron & Adrienne Harris Series Co-Editors Steven Kuchuck & Eyal Rozmarin Associate Editors

TOP The Relational Perspectives Book Series (RPBS) publishes books that grow out of or contribute to the relational tradition in contemporary psychoanalysis. The term relational psychoanalysis was first used by Greenberg and Mitchell (1983) to bridge the traditions of interpersonal relations, as developed within interpersonal psychoanalysis and object relations, as developed within contemporary British theory.  But, under the seminal work of the late Stephen Mitchell, the term relational psychoanalysis grew and began to accrue to itself many other influences and developments. Various tributaries – interpersonal psychoanalysis, object relations theory, self psychology, empirical infancy research, and elements of contemporary Freudian and Kleinian thought – flow into this tradition, which understands relational configurations between self and others, both real and fantasied, as the primary subject of psychoanalytic investigation.   We refer to the relational tradition, rather than to a relational school, to highlight that we are identifying a trend, a tendency within contemporary psychoanalysis, not a more formally organized or coherent school or system of beliefs. Our use of the term relational signifies a dimension of theory and practice that has become salient across the wide spectrum of contemporary psychoanalysis. Now under the editorial supervision of Lewis Aron and Adrienne Harris with the assistance of Associate Editors Steven Kuchuck and Eyal Rozmarin, the Relational Perspectives Book Series originated in 1990 under the editorial eye of the late Stephen A. Mitchell.   Mitchell was the most prolific and influential of the originators of the relational tradition.  He was committed to dialogue among psychoanalysts and he abhorred the authoritarianism that dictated adherence to a rigid set of beliefs or technical restrictions.  He championed open discussion, comparative and integrative approaches, and he promoted new voices across the generations.   Included in the Relational Perspectives Book Series are authors and works that come from within the relational tradition, extend and develop the tradition, as well as works that critique relational approaches or compare and contrast it with alternative points of view.  The series includes our most distinguished senior psychoanalysts, along with younger contributors who bring fresh vision.

Vol. 1 Conversing with Uncertainty: Practicing Psychotherapy in a Hospital Setting Rita Wiley McCleary Vol. 2 Affect in Psychoanalysis: A Clinical Synthesis Charles Spezzano Vol. 3 The Analyst in the Inner City: Race, Class, and Culture through a Psychoanalytic Lens Neil Altman Vol. 4 A Meeting of Minds: Mutuality in Psychoanalysis Lewis Aron Vol. 5 Holding and Psychoanalysis: A Relational Perspective Joyce A. Slochower Vol. 6 The Therapist as a Person: Life Crises, Life Choices, Life Experiences, and Their Effects on Treatment Barbara Gerson (ed.) Vol. 7 Soul on the Couch: Spirituality, Religion, and Morality in Contemporary Psychoanalysis Charles Spezzano & Gerald J. Gargiulo (eds.) Vol. 8 Unformulated Experience: From Dissociation to Imagination in Psychoanalysis Donnel B. Stern

Vol. 9 Influence and Autonomy in Psychoanalysis Stephen A. Mitchell Vol. 10 Fairbairn, Then and Now Neil J. Skolnick & David E. Scharff (eds.) Vol. 11 Building Bridges: Negotiation of Paradox in Psychoanalysis Stuart A. Pizer Vol. 12 Relational Perspectives on the Body Lewis Aron & Frances Sommer Anderson (eds.) Vol. 13 Seduction, Surrender, and Transformation: Emotional Engagement in the Analytic Process Karen Maroda Vol. 14 Relational Psychoanalysis, Vol. I: The Emergence of a Tradition Stephen A. Mitchell & Lewis Aron (eds.) Vol. 15 The Collapse of the Self and Its Therapeutic Restoration Rochelle G. K. Kainer Vol. 16 Psychoanalytic Participation: Action, Interaction, and Integration Kenneth A. Frank Vol. 17 The Reproduction of Evil: A Clinical and Cultural Perspective Sue Grand

Vol. 18 Objects of Hope: Exploring Possibility and Limit in Psychoanalysis Steven H. Cooper Vol. 19 Who is the Dreamer, Who Dreams the Dream? A Study of Psychic Presences James S. Grotstein Vol. 20 Relationality: From Attachment to Intersubjectivity Stephen A. Mitchell Vol. 21 Looking for Ground: Countertransference and the Problem of Value in Psychoanalysis Peter G. M. Carnochan Vol. 22 Sexuality, Intimacy, Power Muriel Dimen Vol. 23 September 11: Trauma and Human Bonds Susan W. Coates, Jane L. Rosenthal, & Daniel S. Schechter (eds.) Vol. 24 Minding Spirituality Randall Lehman Sorenson

Vol. 27 The Designed Self: Psychoanalysis and Contemporary Identities Carlo Strenger Vol. 28 Relational Psychoanalysis, Vol. II: Innovation and Expansion Lewis Aron & Adrienne Harris (eds.) Vol. 29 Child Therapy in the Great Outdoors: A Relational View Sebastiano Santostefano Vol. 30 The Healer’s Bent: Solitude and Dialogue in the Clinical Encounter James T. McLaughlin Vol. 31 Unconscious Fantasies and the Relational World Danielle Knafo & Kenneth Feiner Vol. 32 Getting from Here to There: Analytic Love, Analytic Process Sheldon Bach Vol. 33 Creating Bodies: Eating Disorders as Self-Destructive Survival Katie Gentile

Vol. 25 Gender as Soft Assembly Adrienne Harris

Vol. 34 Relational Psychoanalysis, Vol. III: New Voices Melanie Suchet, Adrienne Harris, & Lewis Aron (eds.)

Vol. 26 Impossible Training: A Relational View of Psychoanalytic Education Emanuel Berman

Vol. 35 Comparative-Integrative Psychoanalysis: A Relational Perspective for the Discipline’s Second Century Brent Willock

Vol. 36 Bodies in Treatment: The Unspoken Dimension Frances Sommer Anderson (ed.) Vol. 37 Adolescent Identities: A Collection of Readings Deborah Browning (ed.) Vol. 38 Repair of the Soul: Metaphors of Transformation in Jewish Mysticism and Psychoanalysis Karen E. Starr Vol. 39 Dare to be Human: A Contemporary Psychoanalytic Journey Michael Shoshani Rosenbaum Vol. 40 The Analyst in the Inner City, Second Edition: Race, Class, and Culture through a Psychoanalytic Lens Neil Altman Vol. 41 The Hero in the Mirror: From Fear to Fortitude Sue Grand Vol. 42 Sabert Basescu: Selected Papers on Human Nature and Psychoanalysis George Goldstein & Helen Golden (eds.)

Vol. 45 First Do No Harm: The Paradoxical Encounters of Psychoanalysis, Warmaking, and Resistance Adrienne Harris & Steven Botticelli (eds.) Vol. 46 A Disturbance in the Field: Essays in TransferenceCountertransference Engagement Steven H. Cooper Vol. 47 Uprooted Minds: Surviving the Politics of Terror in the Americas Nancy Caro Hollander Vol. 48 Toward Mutual Recognition: Relational Psychoanalysis and the Christian Narrative Marie T. Hoffman Vol. 49 Understanding and Treating Dissociative Identity Disorder: A Relational Approach Elizabeth F. Howell Vol. 50 With Culture in Mind: Psychoanalytic Stories Muriel Dimen (ed.)

Vol. 43 Invasive Objects: Minds under Siege Paul Williams

Vol. 51 Relational Psychoanalysis, Vol. IV: Expansion of Theory Lewis Aron & Adrienne Harris (eds.)

Vol. 44 Good Enough Endings: Breaks, Interruptions, and Terminations from Contemporary Relational Perspectives Jill Salberg (ed.)

Vol. 52 Relational Psychoanalysis, Vol. V: Evolution of Process Lewis Aron & Adrienne Harris (eds.)

Vol. 53 Individualizing Gender and Sexuality: Theory and Practice Nancy Chodorow

Vol. 60 The Origins of Attachment: Infant Research and Adult Treatment Beatrice Beebe & Frank M. Lachmann

Vol. 54 The Silent Past and the Invisible Present: Memory, Trauma, and Representation in Psychotherapy Paul Renn

Vol. 61 The Embodied Analyst: From Freud and Reich to Relationality Jon Sletvold

Vol. 55 A Psychotherapy for the People: Toward a Progressive Psychoanalysis Lewis Aron & Karen Starr

Vol. 62 A Relational Psychoanalytic Approach to Couples Psychotherapy Philip A. Ringstrom

Vol. 56 Holding and Psychoanalysis: A Relational Perspective Joyce Slochower

Vol. 63 Cyclical Psychodynamics and the Contextual Self: The Inner World, the Intimate World, and the World of Culture and Society Paul L. Wachtel

Vol. 57 The Play Within the Play: The Enacted Dimension of Psychoanalytic Process Gil Katz Vol. 58 Traumatic Narcissism: Relational Systems of Subjugation Daniel Shaw Vol. 59 Clinical Implications of the Psychoanalyst’s Life Experience: When the Personal Becomes Professional Steven Kuchuck (ed.)

Vol. 64 Traumatic Ruptures: Abandonment and Betrayal in the Analytic Relationship Robin A. Deutsch (ed.) Vol. 65 The Cut and the Building of Psychoanalysis, Volume 1: Sigmund Freud and Emma Eckstein Carlo Bonomi

The Cut and the Building of Psychoanalysis, Volume 1 Sigmund Freud and Emma Eckstein Carlo Bonomi

First published 2015 by Routledge 27 Church Road, Hove, East Sussex BN3 2FA and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2015 C. Bonomi The right of C. Bonomi to be identified as author of this work has been asserted by him in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data Bonomi, Carlo. The cut and the building of psychoanalysis/Carlo Bonomi. volumes cm Contents: Volume 1. Sigmund Freud and Emma Eckstein— Volume 2. Sigmund Freud and Sandor Ferenczi Includes bibliographical references and index. 1. Psychoanalysis—History. 2. Psychoanalysts. 3. Freud, Sigmund, 1856–1939. 4. Eckstein, Emma. I. Title. BF173.B647 2015 150.19′509—dc23 2014035777 ISBN: 978-1-138-82349-5 (hbk) ISBN: 978-1-315-74204-5 (ebk) Typeset in Baskerville by Swales & Willis Ltd, Exeter, Devon, UK

Contents

List of Figures

xi

Introduction

1

PART 1

The medical context

15

1 The castration of women and girls

17

2 Between body and psyche: the nerves

45

PART 2

Withstanding trauma

61

3 A gynecological scandal

63

4 The significance of Emma Eckstein’s circumcision to Freud’s Irma dream

86

PART 3

Topography of a split

123

5 The savior of children

125

6 The cornerstone

150

7 A bisexual monster

175

8 The crossroad

189

x Contents

9 The witch meta-psychology 10 The fatal skin Bibliography Index

208 233 255 271

Figures

2.1

Front page of Paul Möbius’s (1903) book Über die Wirkungen der Castration [On the Effects of Castration] 3.1 Belle Vue resort (1892) 4.1 Giulio Romano, Circumcision, 1520 ca, The Louvre 5.1 Cover of the journal Archiv für Kinderheilkunde, edited by Baginsky, Herz, and Monti (1884) 5.2 Front page of Adolf Baginsky’s (1895) monograph The Serum-Therapy of Diphtheria after the Observations in the Children Hospital Kaiser- und Kaiserin Friedrich in Berlin 5.3 Advertisement of Baginsky’s (1895) lecture on “The hygienic foundations of Mosaic constitution” 6.1 The legend of the Bishop and the Devil (ca. 1854) by Moritz von Schwind, Monaco, Schack-Galerie München, Bayerische Staatsgemaeldesammlungen 6.2 Moloch with child. Illustration contained in the work by Johann Lund Die alten jüdischen Heiligthümer, Gottesdienste und Gewohnheiten, edited by Heinrich Muhlius, Hamburg, 1711 9.1 Ancient and modern amulets from a plate of On the worship of Priapus in the Kingdom of Naples (1781) 10.1 Illustration of Balzac’s La Peau de chagrin, drawn by Adrien Moreau (1897) 10.2 Image of the chemical formula for trimethylamin, as presented by Lacan in seminar 2 10.3 The letter Shin of (or in) the Hebrew alphabet

55 67 95 137 141 143 151

162 211 235 247 248

7KLVSDJHLQWHQWLRQDOO\OHIWEODQN

Introduction

This book is many books at once. It is a book about the body but also about the soul. It treats the history of medicine as well as the topics of religion and morality. It speaks of facts and fantasies and of women and men. It focuses on the sexual organs and the person of Freud while also examining the role which one of his female patients played in his early theorizing and fathering of psychoanalysis. It is at once a scientific study and a fairy tale. Above all, however, it offers an effort to construct a more integrated narration of the origins of psychoanalysis. When I first turned to psychoanalysis during the 1980s, I was puzzled and surprised by the lack of a credible narration regarding the origin of our discipline. The canonic and hagiographic account of its origins was no longer viewed as reliable, while the revisionist accounts, though more historically faithful and intellectually accurate, only aimed to pinpoint and identify fallacies and contradictions rather than trying to understand their hidden logic. The pulse for a systematic commitment in the field only came later, when the first volume of the Freud–Ferenczi correspondence was published, in French, in 1992. Upon reading the opening volume of their exchanges, I was deeply impacted by a dream which Ferenczi had had. His dream was about self-castration and appeared to carry within itself a condensed representation of Ferenczi’s repressed fantasies about Freud’s self-analysis. Ferenczi’s dream in time served as the starting point of my effort to reinterpret the origins of psychoanalysis. The first edition of The Interpretation of Dreams was for the most part constructed out of Freud’s dreams and his analysis and associations to them. It featured an enormous act of self-revelation and disclosure by Freud which served as a hypnotic point of unconscious attraction by others towards him. There is a great deal of irony in the fact that orthodox and traditional psychoanalysis should present the analyst as an anonymous and impenetrable blank screen. Clinging to this fiction was perhaps a necessary reaction formation to combat the experience of being overwhelmed by the sheer number of personal facts which Freud offered and presented us through his dreams in his dream book, and other writings as well. In any case, I can recall that I felt overwhelmed when I began to

2 Introduction detect in Freud’s dreams fantasies of an endless reverberation of a single catastrophic event which tapped into a real and actual event of castration. This feeling was particularly difficult for me to withstand given that psychoanalysts have traditionally viewed “castration” as something exclusively symbolic. No analyst at that time dared to use the term “castration” to refer to a real actual event. Indeed, I can still recall a passage by André Green in which he argued and warned his readers that, at least in psychoanalysis, the issue of real castration was never what was in question. While I attempted to keep his precept and warning in mind the metaphoric dimension in time began to break down. With it, many of the crucial passages in Freud’s texts began to take on a meaning which was dramatically literal for me. In 1992 I decided to pay a visit to Professor Gerhard Fichtner, director of the Institute of History of Medicine at the University of Tübingen and a respected authority on Freud, to discuss my hypothesis, namely, that young Freud might have been impacted and unconsciously influenced in his theorizing by some case of real and actual castration he must have come across during his early years as a physician. Professor Fichter was at first perplexed when I presented my thesis to him and responded with silence. He soon stood up from his chair, however, and invited me to “follow” him to the institute’s library. Within a short period of time, and to my amazement, I was being presented by him with various medical books and articles, all in German, on the subject of the castration of women and the circumcision of children during the second half of the nineteenth century. A totally new medical scenario which had been strikingly neglected by historians of psychoanalysis surfaced before me at that point. I also undertook research in Berlin and found that Freud’s pediatric studies in that city in 1886, immediately after his studies in Paris with Charcot, had been misrepresented in various ways. At that point I simply assumed that Freud must have been shocked by the medical practice of attempting to cure masturbation in children through procedures and surgical interventions on the child’s sexual organs which prevailed at the time. André Haynal was informed of my research and invited me to present my ideas at a conference which he was organizing at that time with Ernst Falzeder: “100 Years of Psychoanalysis.” The conference, which took place in Geneva in September of 1993, allowed me to present my initial findings in a paper I entitled “Why have we ignored Freud the ‘paediatrician’? The relevance of Freud’s paediatric training for the origins of psychoanalysis” (Bonomi, 1994a). In it, I presented detailed information which was lacking in the psychoanalytic literature at the time. I was not so much interested in filling a gap but rather in the meaning of the gap itself. I was amazed by the fact that easily available information in this field had been systematically overlooked by psychoanalytic scholars and researchers until then. The gap itself was moreover overdetermined and tapped into two other important and critical questions. The first was whether Freud had circumcised his sons. Freud’s encounter with the practice of medical circumcision

Introduction 3 in the pediatric world, needless to say, itself functioned to raise questions about his own attitude towards this ancient Hebrew ritual. Since the question of whether Freud had circumcised his sons had yet to be officially established and to gain the consent of psychoanalytic scholars, I wish to briefly present and examine the available evidence on this topic. The first indication to appear in a published text that Freud had failed to circumcise his male children was presented by Gilman (1993, p. 86). The author, however, did not reveal his sources. In September of 1993, during the Geneva conference, the participants were led to reflect on this intriguing question. The only other participant in attendance who appeared to have been acquainted with this topic at the time was Peter Swales. As it turned out, his source was the same as the one on which Gilman had relied to present his claim, namely, an ephemeral “ocular demonstration” which could not be cited. Apparently, no one at that time had consulted the Matrikel books of the Israelitsche Kultusgemeinde in Vienna. I therefore asked Johannes Reichmayr if he could check these records once back in Austria. This revealed evidence which could be used both to support and deny the claim that Freud had circumcised his sons. I wrote and published a paper soon after in which I included a number of observations which had been offered to me by members of the Jewish community, including the remark that the lack of documentary evidence in the archives in Vienna failed to provide convincing evidence that Freud had not circumcised his boys. It turns out, however that “about half of the Jews born in Vienna at that time were not circumcised” and, further, that it was always possible that Freud had arranged to have his male children circumcised in private (Bonomi, 1994b, p. 73, fn. 25). In that same year an article by Emanuel Rice, entitled The Jewish heritage of Sigmund Freud, appeared in print. In it, the author reported having attended a lecture by Swales where the Welshman had proposed that none of Freud’s three sons had received circumcision. Rice for his part was “quite surprised to hear this rather startling information” and immediately questioned its veracity. In an interview that he conducted with Elliott Philipp in July of 1992, and in response to the question of whether Freud had circumcised his sons, Philipp answered in the affirmative, supporting the argument which Gilman and Swales had presented on the subject.1 The same question later resurfaced in a book by Franz Maciejewski (2002, p. 37, pp. 327–328, n. 13). His sources were once again the same: Gilman’s statement and the lack of entries in the communal records in Vienna regarding the circumcision of Freud’s male children. Maciejewski reported that, when asked about his sources, Gilman answered: “No record, no circumcision.” In that same year the archives of the Jewish community in Vienna were also consulted by Eddy de Klerk (2003b, 2008). On that occasion, he not only verified what had already been unearthed about Freud’s children but that Herbert Graf, Freud’s own Little Hans, had apparently not been circumcised as well (Klerk, 2004, p. 465). Jay Geller (2007, p. 38,

4 Introduction p. 230, n. 155) consulted these same archives only to find, as had previous scholars, that the name for the mohel, the person who performs the ritual of circumcision, had been left blank for each of Freud’s three sons and for Herbert Graf as well. Twenty years ago I maintained a prudent and neutral position on this delicate issue. During the last two decades, however, the evidence that Freud chose not to have his sons circumcised has not been challenged. I now feel that we can accept it as a fact and that the burden of proof rests with those who deny what the archives in Vienna appears to indicate and suggest, namely, that Freud did not circumcise any of his male children. The other key question was whether Emma Eckstein, Freud’s most important female patient during the crucial years when the foundations of psychoanalysis were being laid out by him, had herself been circumcised. There is a passage in a letter Freud wrote to Fliess which suggests as much. Our understanding of the origins of psychoanalysis would obviously benefit greatly from the reconstruction of Freud’s analysis of Emma and the emotional and intellectual reaction to the psychic derivatives of the childhood trauma which his female patient had endured as a result of her possible circumcision. During those early days this mutilating procedure was in fact presented and represented as a “cure” rather than a trauma. The fact has many implications. The most important is that Emma’s circumcision and its traumatic aspects could not be voiced or acknowledged either by her or her analyst during her analysis. Despite this, we can nevertheless still recognize through many of her symptoms – her leg paralysis and problems ambulating, her selfcutting and hysterical bleedings – a displacement of the cut on her genitals which she had likely endured. The crucial point then becomes: How had Emma’s trauma, precisely because it had neither been voiced nor acknowledged by Freud, impacted him? How was this unnamed and unnamable trauma embedded in the foundation of psychoanalysis? This basic and simple question, as far as I know, has never been addressed nor discussed by scholars and historians of psychoanalysis. The passage which hinted at Emma having been possibly circumcised was in fact suppressed, along with other vital material, when Freud’s letters to Fliess were first published by Marie Bonaparte, Anna Freud, and Ernst Kris (1950); the letters were published in English under the title The Origins of Psychoanalysis (1954). Princess Marie Bonaparte, as we know, purchased Freud’s letters to Fliess from a book dealer in Vienna in 1936. After resisting Freud’s suggestion that she destroy them she also challenged Anna Freud’s censorship of the material. The Princess decided to present Max Schur, Freud’s personal physician during his final difficult years, with a copy of the original letters in 1961, entrusting him with the mandate of rescuing the passages which had been cut and repressed from the initial version of the published letters. One may perhaps grasp the unconscious meaning of her mandate towards

Introduction 5 Freud’s former doctor. The princess, it turns out, had herself undergone not one but three similar operations (in her case the excision of the clitoris) in Vienna beginning in 1927, just six months after starting her analysis with Freud (Bertin, 1982, pp. 140, 141, 170, 180–182). Bonaparte’s mandate did not come to full fruition. When Schur published the excerpts in his 1966 article “Some additional ‘day residues’ of the specimen dream of psychoanalysis,” the passage which spoke of Emma Eckstein having possibly experienced circumcision as a child was presented by him as the product of a “fantasy” (p. 114). At the same time all the emotional drama was transferred by him towards another scene, the one touching on the faulty surgical operation which Fliess had performed on Emma’s nose during the early phase of her analysis with Freud. The drama had not yet terminated. The Complete Letters of Sigmund Freud to Wilhelm Fliess were finally published two decades later, in 1985. They were edited by Jeffrey Moussaief Masson, who had been appointed by Kurt Eissler, founder and director of the Freud Archives, as his successor. The appearance of Freud’s complete letters to Fliess had been preceded by the publication of Masson’s (1984) disruptive study The Assault on Truth: Freud’s Suppression of the Seduction Theory. Masson followed the pattern which Schur had established, thus pushing the displacement a step further. Masson viewed the faulty surgical operation of Emma’s nose as relevant to Freud’s abandonment of his seduction theory. Freud, Masson argued, had not only denied Fliess’s surgical malpractice but the reality of the traumatic seduction and abuse of children by adults as well. The issue of real or actual trauma was at that time beginning to re-enter discourse and social awareness. Masson, however, managed to exacerbate all dichotomies which had marked this field since the very beginning. What was the drama which was being staged in his “assault on the truth”? Masson repeated the displacement of the real trauma which Emma had suffered as a child (her circumcision) as a fantasy of seduction, transferring all the emotional turmoil from one scene to another. This was precisely what Freud himself had done at the very beginning, when he formulated his seduction theory relying on Emma’s fantasies while accepting them at face value. This replacement followed a well-known pattern which is not easy to detect in light of the fact that sexual abuse might itself be experienced as a castration. Psychically the two experiences are so similar that one can be exchanged for, or replaced by, the other. The more important point, however, is that Masson, while struggling for the acknowledgment of the reality of child abuse, overlooked and even “suppressed” the event of the genital trauma which Emma had endured. By substituting a fiction (the father’s seduction) for a real and actual trauma (Emma’s medical circumcision), Masson in the end managed to avoid the impact and wave which the event of her circumcision would have unquestionably produced upon the psychoanalytic movement. This is a point which Charles Rycroft appears to have realized. In his review of The Assault on Truth, Rycroft (1984) wrote:

6 Introduction Rather surprisingly, Masson does not refer to the fact that many child-rearing and surgical procedures involve literal violations of bodily integrity and must inevitably be experienced by small children as assaults, regardless of the conscious or unconscious motives of the parents and surgeons who inflict such traumas on their children. This is a curious omission, since it would be possible to resurrect the traumatic theory of neurosis on the basis of the mishandling of small children. Masson appears to have been impacted by Rycroft’s remark on his “curious omission” for he soon thereafter began to actively research the topic of female circumcision and clitoridectomy. He then edited and two years later published a collection of English translations of original German and French texts which had been published from 1880 to 1900, under the title A Dark Science: Women, Sexuality and Psychiatry in the Nineteenth Century. The published text illustrates and neatly captures the many “fallacies and contradictions underlying the nineteenth-century gynaecology and psychiatry” (Masson, 1986, p. 7). It fails, however, to integrate this knowledge with the genesis of psychoanalysis. Masson then decided to abandon the field of psychoanalysis altogether. He had good reasons for doing so. He had become the scapegoat of powerful group dynamics within the psychoanalytic establishment. Ultimately, however, the scandal which Masson had created and which led to his being excommunicated and banished from orthodox psychoanalytic circles was functional to the preservation of a taboo. The excerpt referring to Emma’s possible circumcision was finally published, yet no one saw it as a possible trace of an actual or real event. Circling back to the gap which I identified in my article “Why have we ignored Freud the ‘paediatrician’?”, three elements arrived to give form to it: (1) the generic impact of the castration of women and girls on Freud as a young medical doctor; (2) Freud’s private choice not to have his children circumcised; and (3) the specific emotional resonance on Freud as analyst of the genital trauma which Emma had endured as a child. These, I add, are the basic and core elements on which this book has been constructed. All three have been powerfully dissociated from the narration of the origins of psychoanalysis. The gestation period has been very long for reasons which are emotional and intellectual. The theme, moreover, was apt to provoke strong emotional reactions and had to be handled with care. The greatest difficulty was the question of Freud’s self-analysis, which provided the key and helped to identify and map his countertransference. Freud’s own resistances, denials, and displacements also played a vital part. Intellectual connections which today appear to me simple and obvious were very difficult to establish and required time and energy I was not ready or willing to devote to the task. The task was moreover to be carried out by more than a single person and I had to repeatedly postpone a more active commitment, waiting and hoping for the contributions of others.

Introduction 7 As time passed I decided to publish at least my historical research, which I did in a book written in Italian, my mother tongue; it was published in 2007 under the title Sulla soglia della psicoanalisi. Freud e la follia del bambino [On the Threshold of Psychoanalysis: Freud and the Insanity of the Child]. The threshold which I did not dare attempt to step beyond was represented by Freud’s dream of Irma’s injection. I soon arrived at the conclusion that Freud’s most famous dream had itself functioned as a sort of hinge to an essential transformation of the pre-Freudian world, the one where Freud operated as a medical doctor, and the world of psychoanalysis. In 2006 Elisabeth Roudinesco, who kindly honoured me by writing a preface to my book, invited me to deliver a paper at the Société internationale d’histoire de la psychiatrie et de la psychanalyse. I decided to take a bold step then and to present a paper entitled “Du sexe mutilé au culte du phallus” [From the mutilated genital to the worship of the phallus]. The thesis which I presented then was that Emma Eckstein, after experiencing and enduring castration as a child, developed hysterical symptoms which were characterized by genital paresthesias which led her to hallucinate that she had a penis. Hermann Nunberg’s (1947) claim that “the trauma of the circumcision released forces aimed at overcoming its effects,” and that “all of the phantasies, thoughts and habits, served a single purpose: preservation of the phallus” (p. 154), applies to women as well. The fact that Freud had become the depositary of the salvific penis which Emma fantasized was presented by me as the unconscious true source of Freud’s phallocentric doctrine. In other words, Emma’s psychic reaction to her cut not only managed to survive beyond her carnal body, but became a relic which was secretly preserved and worshipped in the psychoanalytic crypt. I was satisfied with my argument enough at the time to submit the text to the International Journal of Psychoanalysis. Its publication marked the beginning of an endless and continuing odyssey. The reaction of most of my peers and reviewers was initially one of bewilderment. Some simply failed to believe castration as a real and actual event and, further, were unwilling to entertain that women had suffered and endured castration procedures at the hands of male medical doctors. Others found the topic interesting but wanted more evidence and information. Since I was speaking of something which seemed completely foreign to many, the editor of the journal proposed that I divide the article into two parts, focusing only on the medical context and leaving aside the question of the possible impact which Emma’s castration might have had on Freud. In light of her belief that this was already a rich contribution, I decided to accept her advice and, with her generous assistance, reworked material which I had previously published in various forms. Despite the fact that my paper contained only half the message I wanted to convey, the final product was much improved and the International Journal of Psychoanalysis was indeed the best forum for presenting and airing my views then. However, a member of the editorial board objected to my thesis and vetoed its publication, even in its revised

8 Introduction form. Since the board member had such a right to veto, its publication was successfully blocked. I still today don’t know just why the psychoanalytic community had to be protected from a simple paper which treated the history of the castration of women by male doctors. The conflict within the editorial board lasted for more than a year; eventually the rules were changed and the paper was finally given a green light to appear in the journal. Entitled “The relevance of castration and circumcision to the origins of psychoanalysis. 1. The medical context,” it was published in its issue of June 2009. A widely revised version of it features as the opening chapter of this book. A few weeks after its appearance, I was contacted by a Dutch analyst, Eddy (Adrian) de Klerk, who wrote to say that he had found my article and argument illuminating. He himself had for many years been working on the idea that circumcision had operated as a sort of secret organizer of Freud’s entire system of thought. De Klerk also provided me with an important missing piece of the puzzle: the idea that the keyword in the Irma dream, “trimethylamin,” might be read as a nearly literal transcription of brith milah (Hebrew for circumcision). We exchanged our views for several months and I learned much from him, greatly benefiting from our exchanges. De Klerk sadly passed away in 2010, before he was able to shape his ideas into a consistent theory. Initially I simply did not know what to think of De Klerk’s striking hypothesis; at the time, it sounded like something remote and alien that had little value for my work and research. Two or three months later, however, strange thoughts began to percolate within me. They had little to do with brith milah, but were instead organized around the formula “from flesh to stones,” a phrase which began to repeat itself in my head as a sort of refrain and mantra. “Flesh and stone” was the title of a book by Richard Sennett (Flesh and Stone. The Body and the City in Western Civilization). Since I owned a copy, I decided to pull it out of my bookshelf and to go through it systematically. It failed to give answers to my many questions. Nevertheless, the idea of a fundamental analogy between body and architecture began to appeal to me and slowly gave way to the ideas which I attempt to unfold and present here. Not only the building of psychoanalysis began to be illuminated by the building of the Temple which, after its destruction, was replaced by the Book, but Emma Eckstein herself was now featuring as its chief cornerstone, namely as the “stone which the builders rejected” (Psalm 118:22). “Eckstein” was indeed the word Luther had called upon in his German translation of the Bible to refer to the cornerstone concept – akrogoniaios lithos in the Septuagint version. One of the most important insights of this new phase concerned a crucial knot in Freud’s Irma dream, the founding dream of psychoanalysis, namely the Greek word propylaea, which, referring to both an anatomical part of the body (the vaginal labia) and the ceremonial gateway of Greek temples as it does, allows us to affiliate and align the human body with an edifice and to thereby link flesh with stones. The “consecration” of the female vaginal

Introduction 9 labia had obviously been modeled on the Hebrew ceremony of milah in which the visible and tangible male reproductive organ, the penis, is consecrated to God. At this point I began to systematically think about and to refer to the birth of psychoanalysis in terms of a “foundation” – rather than a discovery, invention, or creation. I also had in mind Ferenczi’s use of the term “Bausteine,” that is to say, a “building block” or “foundation.” Ferenczi called upon this term to present his collected works with a title. His use of the word points directly to an issue which had deeply bothered him for years, to wit, the question of the ultimate ground from which psychoanalysis itself had sprung, the reason behind it all which made its birth necessary, the “Telos” inscribed within its birth and secretly transmitted through its legacy. In May 2011 I was invited to inaugurate the newly purchased Ferenczi House in Budapest. In the very office where Ferenczi had dictated his Clinical Diary I delivered a lecture entitled “The future of the Irma dream and the overwhelming task of withstanding trauma.” It was a short but dense presentation which focused on Freud’s specimen dream. My reading of the dream had not only been inspired by Ferenczi but, in particular, by his idea of “traumatic progression” which I turned to in order to help bring to light what I felt as the deeper dynamics at work within the founding dream of psychoanalysis. Freud’s traumatic progression involved an unconscious exploration of Emma Eckstein’s mind, I argued, and the brith milah inscribed and encoded within the body of the chemical formula (trimethylamin) stood as the transcription of the traumatic circumcision and castration she had suffered and endured as a child. This represented a radical departure from my previous perspective. Now the basic idea was that a piece of Emma Eckstein’s mind had been imported, like a foreign body, directly into the founding dream of psychoanalysis. I decided to submit my paper to the International Journal of Psychoanalysis, as a follow-up or second part to the article I had previously published on the “relevance of castration and circumcision” for the origins of psychoanalysis. This second piece was not accepted for publication, however. According to the editors and two reviewers, the main reason was that I had failed to present solid evidence that Emma Eckstein had undergone a castration procedure as a child. Moreover, according to at least one of the editorial readers, there was no evidence to support that Freud had not circumcised his male children. I wish to quote a comment offered me by one of the reviewers of the journal, the most prestigious in our field: “The author also stated . . . that Freud’s sons were not circumcised. This seems highly unlikely since Freud’s parents were alive and along with Martha, would have been deeply disturbed.” I am deeply grateful to this anonymous psychoanalyst and reviewer for his observation. It helped me to realize that his decision not to circumcise any of his sons was the concrete and factual way in which Freud had symbolically

10 Introduction killed his father. I also realized that the International Journal of Psychoanalysis would never publish my article and thus turned to The Psychoanalytic Quarterly for its possible publication. The revised text appeared in the June 2013 issue of the Quarterly under the title “Withstanding trauma: The significance of Emma Eckstein’s circumcision for Freud’s Irma dream.” It can be found as Chapter 4 of this volume. Shortly after its publication I received a letter from a New York lawyer who took issue with my description of the brith milah scene. She wrote: “I have been attending these ceremonies my whole life and have never witnessed a rabbi ‘applying his lips’ to a child’s penis. Nobody I know among my numerous Jewish friends and family has ever witnessed an action of this kind either among the Orthodox or less observant segments.” This cultivated woman, who otherwise liked and enjoyed my text, had a specific interest in the construction of testamentary reality. She nevertheless could not bring herself to accept the image of a rabbi “applying his lips” to a child’s penis. She thought that it was ignorant on my part to highlight the fact, a blatant inaccuracy which had undermined the value of my argument and even my credibility as a scholar and interpreter of psychoanalysis. Her unsolicited e-mail allowed me to realize just how degrading and shameful the orgal scene and image was for her, especially because the mouth is the organ of speech and words are the noblest products of our mind and spirit. I also realized that the fundamental reason why I had time and time again postponed bringing this book to completion issued in large part from my desire not to offend anyone and from it possibly eliciting angry and hostile responses. At the same time, I was also reminded of the fact that one of the greatest conquests of psychoanalysis concerned oral fantasies of incorporation and consoled myself by thinking that these conquests had all been made possible by the symbolic meaning of that shameful scene. At that point I felt that I simply had to go forward with the composition of the book and found myself entirely committed to bringing the project to completion. I say composition because I had accumulated so much material over two decades that the main problem now involved my having to pick and choose from a large amount of material and to organize the argument. English, not my native language, also surfaced as a problem. Luckily a friend and psychoanalytic colleague in the United States, Mario Beira, decided to accompany me on this last part of the journey. I don’t think that I would have been able to bring this manuscript to completion without his generous dedication and assistance. Mario not only edited the text chapter by chapter but, in many instances, served as a supervisor, pinpointing all the passages in which my thoughts remained overly condensed and my inferences too obscure. He has also enriched my argumentations during many junctures and, in particular, in relation to the question of the relevance of Freud’s Hebrew heritage for his fathering of psychoanalysis. My observations on this subject and topic have greatly benefitted from Beira’s feedback; among

Introduction 11 other things, he has alerted me to Gérard Haddad’s unique and perceptive interpretation of the trimethylamine chemical formula as embodying the Hebrew letter Shin, an interpretation which Beira himself has expanded on and further elaborated in his work. During the last phase of the project my emotional tone began to be more and more oriented towards the passive and regressive dimension of Freud’s unconscious response to the event of Emma’s childhood trauma. To recall Freud’s own phrasing, I slowly began to accept the inevitable. I imagined that Freud’s analysis of Emma had, since the very beginning, stirred memories for him that stretched far back to his early childhood years, including memories of the ceremony of his younger brother’s (Alexander) circumcision. These memories, suppressed by Freud, eventually broke through as he stood atop the Acropolis in Athens with Alexander, an event which, in 1936, exactly 50 years after his pediatric training, was immortalized by him in his essay “A disturbance of memory on the Acropolis”; it was that text, along with Moses and Monotheism (Freud, 1939), that combined to help give shape to Freud’s final legacy. This first volume will be soon followed by a second volume bearing the subtitle “Sigmund Freud and Saˉndor Ferenczi.” The deepest and essential aspects of Freud’s countertransferential reaction to Emma Eckstein’s trauma and symptoms will be identified, examined, and explored in this second volume. It begins with Freud’s formulation of his early seduction theory and ends with the Freud–Ferenczi debate on the possibility of disentangling in analysis the original traumatic memories from the synthetic reactions of the ego. Volume 1 of this two-volume study is divided into three parts: (1) The medical context; (2) Withstanding trauma; and (3) Topography of a split. Material found in part 1 treats the theme of the castration of women and girls and other practices featuring the manipulation of the female body by male medical doctors. These practices not only came to impact Freud and his theorizing of psychoanalysis but have been largely ignored by historians in our field in their work (Chapters 1 and 2). The material found in part 1 offers an important missing piece in the literature which allows us to restore and better understand the historical context, texture, and soil upon which the foundation of psychoanalysis was built. Part 2 focuses on Freud’s position against the practice of female castration as a cure for hysteric women. It features a new reading of the specimen dream of psychoanalysis, the dream of Irma’s injection (Chapters 3 and 4). I argue that Emma Eckstein’s childhood trauma (her circumcision) precipitated a psychic reaction in Freud which, despite his effort to defend against it, determined a number of central aspects of his self-analysis and theorizing activity. The third and final part of the book offers the building blocks for a new narration of the foundation of psychoanalysis. It does so by examining Freud’s identification with Emma, his rescue and restoration fantasies, and his elaboration of the themes of punishment for masturbation and castration anxiety. It is argued

12 Introduction that Emma’s fantasy of having a penis developed as a consequence of her genital mutilation and that it came to inform the theory of human bisexuality formulated by Fliess and endorsed by Freud. Finally, it is suggested that Freud’s emotional reaction to Emma’s circumcision tapped directly into his conflicts with Judaism, the religion of his ancestors, contributing to Freud’s decision not to have his own male children circumcised (Chapters 5 through 10).

Acknowledgments This entire work began taking shape more than two decades ago. The individuals who have figured in its development are many, starting with my wife Milica, who encouraged me to consider myself a citizen of the world. The initial steps have benefitted from Michele Ranchetti’s scholarship, his immense library as well as his international prestige. I am also indebted to Gerhard Fichtner, Albrecht Hirschmüller, and Edward Shorter, all important historians of medicine who have at one point or another assisted me. From the very beginning and throughout the course of these years André Haynal has constantly supported my research and encouraged me to develop it further. Robert Holt has been urging me to write this book since 1994. He has helped to edit several of my papers and commented on initial versions of this manuscript, always injecting them with wisdom and improved scholarship. Judit Dupont initially, and later Eva Brabant, have been supportive in many ways, particularly in their role as editors of the journal Le Coq-Héron, where a number of my papers have been translated and published in French. Maria Torok and Nicholas Rand have influenced my way of thinking in a substantial way. Judit Meszaros and Franco Borgogno, with whom I have established a friendship and fruitful collaboration during the last decade, have accompanied me in the difficult process of elaboration. The Ferenczian movement and its members have provided me with the environment which I needed, offering the possibility of discussing single aspects of my research with colleagues and friends, among them Ernst Falzeder, Peter Rudnytsky, Jay Frankel, Arnold Rachman, Benjamin Kilborne, Emanuel Berman, Lew Aron, José Jimenez Avello, Ann Luise Silver, and Judit Szekacs. My work has also benefitted from the receptive atmosphere provided by members of the editorial board of The International Forum of Psychoanalysis and, in particular, by Jan Stensson, Christer Sjodin, Marco Conci, and Michael Buchholz. I am also especially grateful to Eddy de Clerk, with whom I had an intense epistolary exchange in 2009, shortly before his death. Finally, I wish to extend a special word of thanks to Mario Beira, who grew into a close interlocutor as I labored to produce an organic and coherent text and to Adrienne Harris, who, after embracing my project without reservation, has faithfully accompanied it and seen it through to its destination. She has infused the final finished product with her enthusiasm, scholarship, and steadfast editorial assistance.

Introduction 13 Appreciation is expressed for permission to reprint in whole or in part the following works: Chapter 1: Bonomi, C. (2009). The relevance of castration and circumcision to the origins of psychoanalysis. 1. The medical context. International Journal of Psychoanalysis, 90: 551–580. Chapter 4: Bonomi, C. (2013). Withstanding trauma: The significance of Emma Eckstein’s circumcision for Freud’s Irma dream. The Psychoanalytic Quarterly, 82 (3): 689–740.

Editorial note In this book I quote from and cite many German and French texts published during the nineteenth century. Where a published English translation was available I have quoted it while citing the source in the bibliography, either alone or jointly, with the original German or French text. Where no English translation of a German or French text exists, translation of material cited is my own.

Note 1 Rice later obtained additional confirmation from Albrecht Hirschmüller, who sent him a transcription of the birth records of Freud’s sons taken from the records of the Israelitsche Kultusgemeinde in Vienna (Rice, 1994, pp. 251–252 and p. 257 n. 25).

7KLVSDJHLQWHQWLRQDOO\OHIWEODQN

Part 1

The medical context

7KLVSDJHLQWHQWLRQDOO\OHIWEODQN

1

The castration of women and girls

The vain sacrifice In his “self-dissection of the pelvis” dream – one of the most enigmatic of all the dreams dreamt by Freud during the period of his self-analysis – as he looked down at his own eviscerated pelvis, Freud was led to recall that his first publication involved an investigation of the nervous system of a fish which had been assigned to him by Ernst Brücke, one of his mentors and teachers of medicine. Freud’s own associations to his dream could have gone much further. Between 1876 and 1896, the year when the term “psychoanalysis” was coined by him, castration stood as one of the main forms used by doctors to treat nervous and psychic disturbances associated with hysteria. Precise figures are not available, but if we compare the low number of patients treated with some form or other of psychotherapy then (sudden shocks, hypnotic suggestion and catharsis, “mental orthopedics,” for example) with the number of castration procedures which Krömer (1896) identified in his 74-page article “Beitrag zur Castrationsfrage” [Contribution to the problem of castration], it seems that castration procedures were rather common in medical practice at the time. As the opening words of Krömer’s own text suggest, the issue was undoubtedly controversial: The question if morbid states and processes in the genital organs have an influence on the nervous system, and on mental illness, has been for 20 years in the middle of the psychiatric and medical controversies. Some accept such an influence and try to recover and cure the pathologic states of the body by surgical operations. Others deny such an influence. (p. 1) The term “castration” in those years referred almost exclusively to a surgical treatment of nervous, psychical, and “immoral” disturbances in women (nymphomania, for instance). Although the most relentless opponents qualified it as “a crime against society and a degeneration of our condition” (p. 2), Krömer’s conclusion, based on a review of more than 300 operations described

18 The castration of women and girls in the recent medical literature, was positive, holding that 70 percent of these surgical interventions could be considered successful. The procedure consisted of the removal of the ovaries,1 according to a surgical technique which had been introduced by the gynecologist Alfred Hegar in 1872 (in America the operation was first undertaken by Robert Battey, independently from Hegar, only three weeks later; in the American gynecological literature it was known as “Battey’s operation”). However, it was only after Hegar’s 1885 study Der Zusammenhang der Geschlechtskrankheiten mit nervösen Leiden und die Castration bei Neurosen [The Relationship of Sexual Illness to Nervous Diseases and Castration in Neuroses] that the practice of female castration really began to spread. The ostensible reason for removing the female ovaries in the case of hysteric women was their pathological form, mainly due to a supposed biological degeneration (Hegar, 1878). The anatomical criteria for such a diagnosis, however, was blurred and not even strictly required. In his study of 1885 Hegar stated: Castration in a neurosis which depends on a pathologic change of the sexual organ is recommended when other treatments have been unsuccessful, or are expected not to be successful. The disease must represent a danger to life, or definitely damage the psychic health, or make any activity and enjoyment of life impossible. By the operation the cause of the neurosis must be removed or a causal element, without the elimination of which a healing or improvement cannot be expected, is not taken away. In the last case the remaining aetiological elements should also be available to therapy. (p. 56) Such criteria fit any case of severe hysteria and Hegar, to put it simply, “did not refrain from the extirpation of apparently healthy organs,” as Krömer (1896, p. 7), a supporter of the treatment, indicated. A year and a half later Friedrich Merkel could note in his Beitrag zur Casuistik der Castration bei Neurosen [Contribution to the Study of Castration in the Neuroses] that in just a few months the number of operations reported in the medical literature rose from 180 to 215 (Merkel, 1887, p. 54). Merkel provided a list of 35 works published just in 1886 on the castration of hysterical women – an issue which by then had become the most discussed problem in psychiatric circles. Merkel’s list contained titles such as: Castration in Hysteroepilepsy by Böhmi, Cure of Hysteria by Castration by Forel, Cure of Moral Insanity by Castration by Heilbrunn, Castration of the Woman by Heydenreich, Contributions to the Problem of Castration by Prochownich, Castration of Woman in Nervous Diseases by Ruderhausen, On Castration in Neurosis by Schröder, On Castration of the Woman in Surgery by Tissier, and Hysteria Cured by Castration by Widmer (Merkel, 1887, pp. 55–56; original titles previously quoted in Bonomi, 1994b, p. 59). Oddly enough, this information is missing from the Studies, indeed from all studies on the origins of psychoanalysis.

The castration of women and girls 19 Sigmund Freud completed his studies in Paris and Berlin in 1886, the same year he opened his private practice in Vienna and gave his famous presentation at the Medical Society in Vienna on October 15, where he mentioned cases of both female and male hysteria. Freud later recalled the event of his presentation as the moment when he first broke from the medical establishment of his city. Freud’s break, as narrated by him, had been informed by the instance of an “old surgeon” who challenged him as he addressed his medical colleagues in Vienna: “But, my dear sir,” asked the old surgeon, “how can you talk such nonsense! Hysteron (sic) means the uterus. So how can a man be hysterical?” (Freud, 1925a, p. 15). The consistency of Freud’s narrative has been questioned by historians of psychoanalysis (Siegfried and Suzanne Bernfeld, 1952; Jones, 1953; Ellenberger, 1968, 1970; Sulloway, 1979; Hirschmüller, 1991). According to Sulloway, Freud’s memory and account of a hostile and irrational reception from his colleagues was not only in large part a myth, but grew into the prototype for similar legends about Freud’s life. And yet, if we relate Freud’s memory and account to the medical context, which, as we will see, was characterized by a growing opposition to the genital localization of the disease, one wonders if the narrative does not carry a hidden allusion within it to the practice of female castration. As Jones indicated in Sigmund Freud: Life and Work, (1953, p. 252), Freud had claimed in his presentation that, according to Charcot’s modern views, there was no connection between the disease and genital organs. We do not know if he also opposed the gynecological treatment of hysteria, but, as a matter of fact, to question the Greek etymology of “hysteria” in those years was not rare among the opponents of the sexual causes of the neurosis. For instance, in his 1883 article “Über Hysterie und deren Behandlung” [On hysteria and its treatment], Carl von Liebermeister referred to the Greek etymology of hysteria as an old and discredited belief, while opposing the gynecological treatment of the condition, claiming that: “Castration, extirpation of the clitoris and similar operations, are definitely to be advised against, when they are not required by a local illness” (p. 2149). Ten years later, in 1892, Friedrich Jolly, a well-known German professor of neurology and psychiatry, would write the following in an article on hysteria in children: Hysteria does not come from the uterus. The manifestations of hysteria appear much before sexual maturation, in boys as well as girls. They therefore have nothing to do with an affection of the uterus and, except in a rare few cases, nothing is to be expected from a gynaecological treatment. (Jolly, 1892, p. 843; italics added) A few pages later, and while once again stressing the “impossibility” of searching “for the seat of hysteria in the genitals,” Jolly addressed the question in the following way:

20 The castration of women and girls It is important to stress this point once again because, in spite of the fact that the theory of hysteria has been, with the passing of time, moving away from Romberg’s definition of it as a reflex-neurosis originating from the genitals, and toward a psychic conception of the disease, the contemporary vain sacrifice of a great number of ovaries has once again demonstrated that the latter idea enters practice only very slowly. (p. 855) Historians must read these lines with caution, for historians make use of written documents and must necessarily rely on the theories they find in published sources; here, however, we are informed by Jolly that, given the gap between theory and practice, theories in fact present us with a distorted representation of reality.2

The theoretical framework Not only has castration been overlooked, but the theoretical framework which supported the medical practice has been neglected as well. Edward Shorter (1992) is one rare author who has studied the context in which the group of pelvic treatments flourished. In his cultural history of psychosomatic illnesses, Shorter has demonstrated that the practice of castration was not a marginal oddity or an isolated error relegated to a few insane physicians. Rooted in a new scientific discourse of the “nerves,” it was instead a central component of a new therapeutic practice which emerged to treat the bourgeois social class. The idea that people could suffer a “neurosis” only rose in the second half of the eighteenth century. The history of the therapeutic procedures aimed at treating and curing bad nerves began with the notion of “spinal irritation,” which met with great success in the first half of the nineteenth century; it was later replaced by the notion of reflex neurosis. Thanks to the latter notion, which was based on the discovery of the reflex arc, Moritz Romberg would explain hysteria in 1846 as a reflex neurosis caused by irritation of the genital organs which propagate through the abdominal ganglia, provoking convulsions, paralysis, and the typical hysterical bolus. According to this view, the irritation of the genital organs caused a state of “irritable weakness” [reizbare Schwäche], which made it a medium for the propagation of the hysterical attacks beyond the periods of highest irritation, such as the premenstrual period. Romberg derived much of the background and data for his theory from contemporary English neuroanatomy and neuropathology, when translating Andrew Marshall’s and Sir Charles Bell’s works on the nervous system into German. For certain aspects, his approach was close to Laycock’s Treatise of the Nervous Diseases of Women, published in 1840, and belonged to the nineteenth-century tradition of the physiologic or cerebral unconscious which has been rediscovered by Marcel Gauchet (1992) as a precursor of the psychological unconscious. As Gauchet has pointed out, it was “within

The castration of women and girls 21 the framework of investigations on the influence of the uterus and of the ovaries on mental states” that Laycock “had been driven to the theory of the automatic action of the brain” (p. 46). It was precisely from this source that the notion of “unconscious cerebration” was developed in 1857; 40 years later it also arrived to inform the birth of the Freudian unconscious. Romberg’s role as a forerunner of Freud was pointed out by one of the first psychoanalysts, August Stärcke, in his article on “Psycho-analysis and psychiatry,” which, in 1919, won a prize which had been established by Freud.3 Stärcke wrote that psychoanalysis was reviving an older psychiatric tradition which had been represented by Moritz H. Romberg (1840–1846) and had been submerged by the then current emphasis on brain anatomy. Thus Stärcke (1921b) argued that psychoanalysis had been the normal continuation of the general line of development, of which the pre-Freudian psychiatry, since Charcot and Griesinger, constitutes simply an interruption, an incident, the temporary hypertrophy of a newly discovered principle; an incident, however, which has meant delay and stoppage in the discovery of the psychic nature of hysteria. (p. 363) Criticizing this more recent brain-based psychiatry, which was diverted from a wider clinical perspective and therapeutic usefulness, Stärcke wrote: A second and historically important fact, which we must not overlook, is that psychiatry has not always proceeded in such a helpless and fluctuating manner as in the last thirty or forty years. It had been on the best road to discover the fixation of the libido as the cause of the failure of adaptation. The word hysteria – which formerly comprised all kinds of cases that now are included in other psychotic types – bears witness to this. The oldest theories asserted that the wanderings of the uterus throughout the body were the cause of hysteria. When Galen proved that these wanderings were impossible, the blame was attributed to retention of semen or blood in the uterus, since the humours could decompose and the enlarged uterus would be damaged by poisonous products or by pressure. This was modified later to the view that conditions of irritation of the genitals could pass over to the nervous system. Romberg (1851) endeavoured to reconcile with each other the alternative conceptions of hysteria as a disease of the uterus or of the brain, conceptions in which he considered the theories of hysteria known at that time culminated. He maintained that hysteria was a reflex neurosis caused by genital irritation, he made the important observation, “that it is not necessary for a sensation to become conscious to produce reflex action . . . ” According to Jolly (1877) sexual abstinence and overstimulation are important causes of illness. After this the subject of sex disappeared more and more from psychiatry. Griesinger, Meynert and

22 The castration of women and girls the large number of brain anatomists, as well as the Salpêtrière School, became the authorities on the subject. Since Charcot, Pitres, Janet, and Raymond, hysteria has been considered a psychosis, as previously a great part of the psychoses were considered hysteria. The difference is that the latter view meant something, namely, the sexual origin of the psychoses, whereas the former view is only an expression of our infantile hope to discover somewhere in the brain chaste reasons for the indecent actions of hystericals. (pp. 362–363) Romberg is never mentioned by Freud in his work.4 And yet, since Stärcke was awarded a prestigious prize, we can safely surmise that Freud found nothing objectionable in the passage quoted, which speaks of the continuity between psychoanalysis and an older psychiatric tradition. This older psychiatric tradition has been overlooked by the scholars who have established the standards of the pre-history of psychoanalysis. According to the latter, the movements which came to influence Freud were the nineteenth-century German movement of biophysics and the clinical tradition of French psychiatry, evolutionism, not the early reflex theory. The reflex theory is not mentioned either by Jones (1953) or by Ellenberger (1970), who enlarged the focus from Freud to the contemporary views on sexuality neglected by Jones. Romberg is instead mentioned in Hirschmüller in his 1978 work on Life and Work of Josef Breuer, where it is pointed out that Romberg’s “highly un-modern” understanding of hysteria as a sexual reflex neurosis was revived by Breuer (p. 196) and, further, that after having been pushed back by the theory of Charcot, it survived in the work of some neurologists and many gynecologists (pp. 225–226). In spite of the accuracy of his reconstruction of nineteenth-century scientific ideas, Sulloway (1979) simply misses the impact of this tradition and the name of Romberg does not appear at all in his work. Laycock’s “reflex theory” is mentioned by him in only two footnotes. The oversight is likely due to the fact that Sulloway was mainly interested in Freud’s “crypto-biologism” – Laycock’s biological contributions and the influence of Fliess’s bio-periodicity are in fact very well represented. Even after Gauchet’s (1992) rediscovery of the relevance of this physiological tradition for the later concept of a psychological unconscious, the historians of psychoanalysis have persistently disregarded it. A fine example of this oversight and neglect can be found in George Makari’s book on the creation of psychoanalysis, in which neither Romberg nor the reflex neurosis theory is discussed (Makari, 2008).

The broader context: the great fear of masturbation In the second half of the nineteenth century, Romberg’s theory was called upon to justify the amputation of the clitoris and the removal of the ovaries

The castration of women and girls 23 in “the bold attempt at conquering the protean demon of hysteria” – as James Israel ironically phrased it in 1880 (p. 241). In order to understand why sexual organs became so important for medical theories on the “nerves,” we must necessarily consider what Stengers and Van Neck (1984) called “the great fear of masturbation.” These authors have shown that, before the famous book by Tissot (1760), masturbation was not treated with punishment and that a new punitive attitude towards masturbation only began to spread throughout society later, in the second half of the nineteenth century. This new attitude slowly conquered new subjects, women and children, and only grew more and more sadistic with time. The turn was well documented by René Spitz, the psychoanalyst, who wrote: While in the eighteenth century medical men endeavored to cure masturbation, in the nineteenth century trying to suppress it. This shift is sharply visible in Chart I which shows the sudden rise of repressive, and surgical measures in the treatment of masturbation beginning with 1850. While up to 1849, masturbation was treated mostly with hydrotherapy, diet, etc., between 1850 and 1879 surgical treatment was recommended more frequently than any of the other measures. It is only in the second half of the nineteenth century that sadism becomes the foremost characteristic of the campaign against masturbation. (Spitz, 1952, p. 499) It should be noted that Spitz decided to publish his research because even in psychoanalytic circles one does not always realize how extremely cruel the persecution of the masturbator has been up to our day; nor is it generally known that these sadistic practices found support among authoritative physicians and that they were recommended up to almost a decade ago in official textbooks (p. 504). The difficulty in dealing with these “sadistic practices” is not a prerogative of psychoanalytic circles, since all references to repressive treatments are missing, even in Laqueur’s (2003) sophisticated book on the cultural history of “solitary sex,” where the danger represented by masturbation is elegantly identified with the qualities that were in the process of becoming central to the definition of the modern self: desire, privacy, and imagination. Differently from Laqueur, Spitz as well as Stengers and Van Neck have demonstrated how the medical repression of masturbation in the second half of the nineteenth century gave rise to treatments such as the amputation or scarification of the clitoris, used both on sexually mature women and little girls, and infibulation, preferred by Broca, the great anatomist (cf. Stengers & Van Neck, 1984, p. 125), as well as the cauterization of the labia and circumcision (for both males and females). In short, besides psychological threats and mechanical treatment, a whole family of

24 The castration of women and girls mutilating procedures existed which was utilized to repress the “evil” (cf. also Barker-Benfield, 1976; Scull & Favreau, 1986; Gollaher, 1994; Darby, 2003, 2005a, 2005b). These punishments were presented not as a chastisement but as a “cure.” When the priest replaced the physician in the role of confidant of moral anguish, the traditional belief in the damage caused by masturbation began to be medicalized, with the theory of reflexes providing an apparently rational justification for the surgical removal of the supposed sources of the “evil.” Castration in the strict sense, namely the extirpation of the sex glands, was perceived as the most “objective” among the group of mutilating treatments, because it derived its prestige and justification from the discovery of the ovaries as regulators of sexuality. The amputation of the clitoris, and other mutilations of the external genitals which were practiced mostly on children (because of the immaturity of the sexual glands), kept a closer connection with the punitive aim and were thus more apt to bring into light the contradictions implicit in the modern reorganization of morality. Masturbation is not mentioned in the Bible, the book presenting us with the fundamental moral code of Western civilization. The subject matter was considered unimportant in antiquity; during the Middle Ages it was seen as a “venial” sin and it was only with the rise of modernity that masturbation emerged as a problem which required eradication and treatment. According to Spitz, the cruel and sadistic methods used to repress masturbation marked a turning point in Western civilization. Its repression was associated with two factors: individual freedom5 and the notion that public health was the concern and responsibility of state authorities. The processes of urbanization and secularization, I believe, played an important role in creating the conditions for this new social phenomenon, which, as it turns out, failed to spread differently throughout European countries. Italy, for instance, remained nearly untouched by it.

The juridical status of castration Thanks to the terrorism that surrounded masturbation, and the beliefs in the necessity of finding a cure, the cruelty of the treatment could be more or less completely dissociated. However, the typical situation was that indignation and compliance were unequally distributed. Certain treatments were regarded with abhorrence, while others were not. The best example is that of castration: whereas the castration of men was usually regarded with abhorrence, the castration of women was not, as pointed out by Conrad Rieger (1900) in Die Castration in rechtlicher, socialer und vitaler Hinsicht [Castration in Legal, Social and Vital Perspectives]. Rieger belonged to a new generation of psychiatrists who struggled against the idea that insanity was caused by sin and wrote this book to contribute to “the emancipation of psychiatry from the superstitions of medicine and to the realization of the autonomy of psychiatry” (p. 1).

The castration of women and girls 25 Opposing the “furor operatorius chirurgicus,” Rieger pointed out the contradiction implied by the fact that only females were castrated. According to him, contemporary ideas on the sexual organs were affected by archaic beliefs – for instance, the idea that a man without testes had suffered a vital wound, whereas a woman without ovaries had not. He further claimed and argued that the testes had a value (representing the source of energy, will, and intellect) which was lacking when compared with the ovaries. In sum, the testes were viewed by him as “good,” while the ovaries were fantasized and seen as the manifestation of an “evil” (pp. 64–65). These representations were informed by a mythological remnant, itself captured in the etymology of the word “testes,” deriving from the Latin “testes” (i.e., witness), which implied the idea that a man without testes was not a reliable subject or to be trusted (p. 104). Rieger in his work also discussed the fallacies concerning the juridical status of castration. For instance, he noted that even if the removal of the ovaries in a healthy woman might be seen as a crime by some jurists, the criminal intent could never be proven or substantiated because, instead of identifying the true reasons for the operation, the physician would give as indicatio causalis indirect reasons: the idea that the woman was suffering too much or was simply too nervous or feeble, for instance. In short, women were never represented as healthy individuals in contemporary discussions whereas the castration of a man was perceived as a vital injury of a healthy being.6 Strangely enough, nowhere in Freud’s work, or in that of his interpreters, do we find such observations and comments. They are of course pivotal for helping to contextualize Freud’s lifelong meditation on castration. The subject of castration, in Freud, appears to be dramatically unconnected to its medical context. The contrast is rendered even sharper if we consider that Rieger, an enlightened psychiatrist, dismissed Freud’s etiological views in 1896 as “a simply gruesome old-wives’ psychiatry.”7

On abhorrence and indignation We also need to consider that the perception of a mutilation as involving a mutilation is not always obvious. This becomes clear when we reflect on the different emotional responses to the ritual genital mutilations which are performed even today on young girls in parts of Africa and the Middle East. What is seen as a sign of proud affiliation within a given community is seen with abhorrence by those who do not share the same mental space. Only when cultural isolation is overcome, and diverging perceptions of the same “symbolic wound” come into contact, are the conditions for a conflict created and contradictions able to be brought into light. If we return to nineteenth-century medical practices, the only treatment performed on females which has aroused a sentiment of indignation was excision of the clitoris. Clitoridectomy for girls and circumcision for boys

26 The castration of women and girls were frequently considered as equivalent, yet they had very different histories, which are related to a different emotional response. The excision of the clitoris in young women was introduced by Isaac Baker Brown in London and Charles Brown-Séquard in Paris. It began to spread in the 1860s and soon became “fashionable” and acceptable as a practice. However, it also soon began to provoke indignation and to elicit the opposition of some physicians, who perceived it as a mutilation of the body. This emotional reaction was likely based on the fact that the clitoris resembles a small penis. As Freud put it in 1905, the science of biology had been “obliged to recognize the female clitoris as a true substitute for the penis” (p. 195). Was the excision of the clitoris rejected because it was evocative of the ablation of the penis in a man? While the abhorrent practice of the excision of the clitoris in time began to decline, it did not disappear. In Europe it was performed until the end of the nineteenth century (Shorter, 1992) and from time to time resurfaced under new scientific motivations – as is well known, Princess Marie Bonaparte underwent a clitoridectomy in the 1920s, hoping to more easily be able to achieve vaginal orgasm (Bertin, 1982). The practice persisted for a long time in the United States (Scull & Favreau, 1986; Warren, 2004). We must add that the practice did not elicit particularly strong opposition from psychoanalysts. Dangar Daly (1950), for instance, associated the custom of extirpating the clitoris with the idea that “the women may give up their aggressivity, become more docile and develop satisfactorily as wives.” He then arrived at the conclusion “that this primitive custom rests on sound psychological premises” (p. 221). Reviewing this article, Jacob Arlow (1952) failed to find anything arguable in Daly’s argument and simply summarized the question by saying that “Circumcision tended to counteract the pathological tendency to inversion in males by removing the female element (prepuce equals vagina).” He then quickly added that clitoridectomy “accomplished the corresponding object in the female” (p. 437). Daly’s psychobiological view that male circumcision and clitoridectomy promoted heterosexual adaptation was in fact quoted approvingly by several psychoanalytic authors. In contrast with clitoridectomy, male circumcision was not perceived as a form of mutilation, most likely because of the unconscious association of the foreskin with the vagina (Ferenczi, 1924; Nunberg, 1947). Symbolically, it represented the suppression of the feminine and vulnerable part of the self. In the medical literature, from the 1850s the foreskin was regarded as a source of nervous and physical disease. Circumcision was believed to act a prophylaxis against syphilis and, in cultural terms, was central to the late Victorian redefinition of manliness in terms of self-restraint and cleanliness: “Widely believed to dampen sexual desire, circumcision was seen positively as a means of both promoting chastity and physical health” (Moscucci, 1996, p. 65). This cultural atmosphere made it possible for the operation to survive the decline of the reflex neurosis theory, shifting from the original status of cure/punishment to the status of a universal hygienic measure. As

The castration of women and girls 27 McGee phrased the matter in 1882: “whether it be curative or not it is conservative, and removes one source of irritation from an exquisitely sensitive organ. I would favor circumcision ... independent of existing disease as a sanitary precaution” (p. 103). Increasingly identified with personal cleanliness, good morals, sound health, and upright character, circumcision began to be advocated in Anglo-Saxon countries as an element of public health. Neonatal circumcision was set as a routine in the United States, becoming “so commonplace that physicians and parents scarcely considered it surgery at all” (Gollaher, 1994, p. 5). The real study of this social phenomenon became indeed possible only after the decline of the “scientific ritual” (Gollaher, 2000; Darby, 2005a). The first effective attack on the legitimacy of routine circumcision in America was mounted by a paper provocatively entitled “The rape of the phallus” (Morgan, 1965), as if the only way to provoke indignation consisted in representing the operation as a “rape.” The feelings of abhorrence toward the practice were indeed decreased as a result of the shift from the original motivation to the hygienic conception. Freud never endorsed the hygienic argument when it came to the practice of male circumcision. According to him, male circumcision was equivalent to, and a substitute for, castration. Although the original punishment was later softened, it was still unconsciously equated by him with castration (Freud, 1913a, p. 153, footnote 1; 1916–1917, p. 165; 1918a, p. 86; 1910b, p. 95).

Masturbation and hysteria in childhood The manifestations of sexuality in children started to become a medical issue in connection to a vast reorganization of the notions of childhood, morality, and insanity (Bonomi, 2007). In the first half of the nineteenth century, the common idea was that children could not become insane as they were simply too close to “Nature” to be affected by a malady which originated from “civilization” and consisted in a permanent perversion of “morality.” Children were not yet “innocents” and did not belong to the moral world. Their minds were too weak or too unstable to be part of it; they could therefore not be affected by the moral maladies of civilization. This system of values changed around the middle of the century, when a new paradigm set in: the idea that children too could be affected by insanity.8 Between 1860 and 1880 observations on early perverse behaviors began to be collected by physicians. They discovered that masturbation was found in very young children, even in babies. Until then, however, the common idea was that masturbation in children unavoidably resulted in idiocy and death – and precisely because the effects were irreparable, nothing was done to prevent them! Such a permissive attitude changed with the new paradigm which viewed insanity as capable of being prevented. This situation produced a new state of alarm, a new social awareness about the necessity of keeping children under constant observation. The struggle

28 The castration of women and girls against masturbation in children became at this time a way of protecting them from the morbid effects of the bad habit on their nervous system. An example of this new mentality and outlook is presented in the article “Über die Reizung der Geschlechtsteile, besonders über Onanie bei ganz kleinen Kindern, und die dagegen anzuwendenden Mittel” [On the stimulation of the sexual parts, especially on onanism in very small children, and the means to employ against it] published in 1860 by the German paediatrician F. J. Behrend. Many different things were gathered under the label of “Reizung” (stimulation); this included endogenous stimulation, stimulation aroused by contact with clothing, self-stimulation, as well as the kind of “stimulation” caused by seduction or abuse. The last factor was never missing in the list of possible causes of the evil, and its role would grow more and more important with time. The finding of onanism (a term which was often preferred to “masturbation”) in very young children and babies had two main implications. The first was that “imagination” could not play the same role in children as in adults: the onanistic movements in a two-year-old child could not be read as the bodily manifestation of an inner secret fantasy, and, being perceived as automatic actions, they were explained as the effect of a nervous reflex – a point completely overlooked by Laqueur (2003), who based his cultural history of solitary sex on the privacy of “imagination.” Laqueur did not include childhood in his study, thereby brushing aside the most important effect of the modern obsession about masturbation: the transference of the problem (and of the anguish) from adulthood to childhood. The consequences of this transference were essentially two. The first was that bodily reflexes were considered not accessible to moral precepts. Scolding and reproaches had no effect on the infantile mind. Identifying the problem, Behrend (1860) wrote: Dr. Johnson suggests that we undertake a small operation in order to provoke such a pain with its wound that it would leave in the child a lasting psychic impression and would make any attempt at masturbation painful. In boys the operation should be done on the prepuce, making a cut, etc. In girls it should, similarly, consist of a strong cauterization on the labia majora or inside the vagina entrance or, as doctor Gros suggests, of small excisions all around the clitoris. (Behrend, 1860, pp. 328–329) Acting directly on the body was necessary because of the deficiencies of the mind: the physician took direct action on the child’s body in order to directly reach the mind and create a lasting memory. In spite of all physical justifications, the “operation” had from the very beginning a psychic goal, since the body was viewed as a supplement to the mind. Later on, medical theories and prescriptions would cover up the transparency of the original motivations.

The castration of women and girls 29 The second consequence was the close association with Verführung [seduction]. When physicians, gynecologists, and pediatricians began recording cases of masturbation in small children, seduction was always listed among the stimuli which could set in the bad habit. In the 1880s, however, it was becoming apparent that seduction was different from spicy food, soft clothing, intestinal worms, and so on. The Viennese Ludwig Fleischmann, for instance, reported in his 1878 paper “Über Onanie und Masturbation bei Säuglingen” [On onanism and masturbation in babies] two cases of babies who, having been stimulated by their nursemaids, masturbated even before weaning. He stressed that masturbation and vulvovaginitis were a consequence of a lack of hygiene, arising “incomparably more often by the continuous sleeping together with older persons or, in older girls, by staying together with playmates of the other gender” (p. 48). Thus, when appearing in children, the “solitary” vice was always evocative of Verführung [seduction], and the urge to stop the contamination was so strong that doctors were often led to recommend extreme solutions. Fleischmann endorsed circumcision in boys, the scarification of the clitoris in girls, or the amputation of the clitoris when the evil had already set in. With respect to babies, he wrote that such measures were not necessary and one could try to make only a “cauterization of the Labia or of the entrance of the vagina” (p. 49) or perhaps apply mechanical devices aimed at preventing self-stimulation. Henoch, the father of German pediatrics, discussed the case history of a seven-year-old child in his 1881 article on hysteria in children. After sleeping in the same bed with an older girl, the child became addicted to masturbation and, later, developed symptoms usually caused by the hyperstimulation of the genital nerve, such as pains, paresis, and anesthesia in the legs, and enuresis nocturna (Henoch, 1881, p. 1009). The boy, hospitalized at the Charité of Berlin, was cured in about one month by isolating him from his family. Commenting on the case history in the conclusion of his paper, Henoch remarked that the disturbance had been the same as that which usually took place in women and girls and was to be cured by “operation.” The contradiction between the cause (seduction) and the remedy (operation) was becoming apparent. Henoch remained skeptical about the great importance generally attributed to masturbation in the origin of hysteria in children. Despite this, he nevertheless recommended to his readers that they should always think to onanism and, where this can be proved, to repress it as much as possible because, even though it alone is not the real cause of the disorder, nevertheless it can pave the way to its development through the hyperstimulation of the nervous system and prevent healing. (p. 1009) It was also becoming increasingly difficult to point the finger only at servants. To many pediatricians it was evident that many of the sexual abuses involving

30 The castration of women and girls children were carried out within and by direct members of the child’s family. In the 1877 Handbook of School Hygiene, Baginsky indicated that masturbation in children often originated in the abuses of “loathsome nursemaids” and nannies, or of elder boys or girls. In later works he emphasized the role played, in general, by the parents. In the first edition of his Lehrbuch der Kinderkrankheiten für Ärzte und Studierende [Handbook of Pediatrics for Doctors and Students], he recommended that hysteric children be taken away from their families (Baginsky, 1883, pp. 379–380). In the third edition of his book he remarked that the frequency of hysteria in children in the superior social milieu was “terrific” while also stating that its main cause was to be searched for and found in “the bad example given by hysteric fathers or mothers” (Baginsky, 1889, p. 490). In 1884, in a doctoral dissertation on hysteria in children written by a student of Baginsky, the author reported several case histories taken from “the practice of Baginsky,” among them a 13-year-old girl, daughter of a hysteric mother, with a severe form of compulsive masturbation which was beyond willpower: while masturbating the girl “explained in tears that she could not avoid doing it” (Schäfer, 1884, p. 407). In the Handbook of Pediatrics for Doctors and Students Baginsky seemed to have in mind these kinds of situation when he wrote: Children are aware of the faulty [Unrecht] character of their behavior, and not infrequently after the onset of their perverse or criminal action they utter sentences such as “I cannot avoid it” or “I had to do it”. The awareness, however, does not prevent the repetition of the deeds. (Baginsky, 1883, p. 379) In the doctoral dissertation written by Baginsky’s student it was further stated that the diagnosis of onanism was mainly based on an examination of the genitals, the swelling and inflammation of the penis, of the labia majora, and of the vagina (Schäfer, 1884, p. 407). The text also notes that the illness and abnormalities of the urogenital apparatus were a cause of reflex neurosis and, further, that the neurosis could be “healed by the elimination of the cause” (p. 407). These statements were published in the Archiv für Kinderheilkunde. According to Jones (1953, p. 206), Freud “arranged to abstract the neurological literature on children” for this journal, founded and edited by Adolf Baginsky. Many articles on hysteria in children appeared during those years, with the question of genital stimulation in children being particularly discussed; this was because, as Herman Smidt put it in his study of 1880: only when hysteria had been recognized as a functional disturbance of the womb, or as a sexual disturbance in a larger sense, did it become possible to understand its onset in children whose sexual organs have not yet acquired their functions. (p. 1)

The castration of women and girls 31 In an accurate review of the late-nineteenth-century pediatric German literature, Carter (1983) remarked that “infantile hysteria regularly received more attention than male hysteria [and that] it was usually associated with infantile sexuality” (p. 186). As the same author went on to note, “in many respects, Freud’s early work on infantile sexuality and on hysteria seems to be completely compatible with this literature” (p. 195). What Carter did not know is that Freud himself had belonged to this world and was intimately acquainted with this literature.

Adolf Baginsky and the “secrets of children’s diseases” On the occasion of the death of Oscar Rie – close friend and pediatrician to the Freud children – Freud wrote a letter to Marie Bonaparte recalling that he had met Rie 45 years earlier, when he had announced among his medical activities the treatment of infantile nervous diseases. Rie visited Freud’s office, initially as a graduate student and later when he worked as Freud’s assistant.9 This is a piece of information missing from most, if not all, of the studies on the origins of psychoanalysis. Freud opened his private practice as a neurologist in Vienna on Easter Sunday of 1886: how is it possible that he presented himself then as a specialist in the treatment of nervous disturbances in children? Whereas everyone knows that Freud attended Charcot’s lectures in Paris, his studies with Adolf Baginsky in Berlin are still today largely unknown. When Freud visited Paris, Max Kassowitz offered him a post in the children hospital. Kassowitz was in the process of renovating the institution and was hoping to affiliate the hospital with the university. Freud did not know much about children, even whether he would like working with them; he therefore needed to complete his studies and to gain some experience with children. He did not have much time: Kassovitz’s proposal arrived in February 1886 and Freud had to return to Vienna by April. He was uncertain as to where he could gain the experience needed and finally decided to travel to Berlin and to undergo a short period of training with Adolf Baginsky. Freud spent three to four weeks in Berlin in March of 1885. Baginsky was running a private polyclinic in the city; located in Johannisstrasse 3 Hochparterre, it had simply been called, since 1872, Poliklinik für kranke Kinder.10 Freud began to receive patients at the institution on Mondays, Wednesdays, Fridays, and Saturdays, from 12 to 1 p.m, starting in March 1886. On March 10 he wrote to his future wife Martha Bernays to say that he found the children in the clinic more attractive and moving than adult patients: “As long as their brains are free of disease, these little creatures are really charming and so touching when they suffer.” This was likely the moment when Freud made the decision to accept the post which had been offered him by Kassowitz, because, as he added in his communication to Martha: “I think I would find my way about in a children’s practice in no time.”

32 The castration of women and girls According to the register of lessons of the Friedrich-Wilhelm-Universität, during the winter semester Adolf Baginsky held two courses: the first, for which there was a financial charge, focused on the pathology and therapy of infantile illness and included demonstrations. The second, free of charge, was on the dangers to which students of scholastic institutions were exposed.11 These were presumably the same courses that Freud attended for two weeks. In his letter of March 19, 1886 to his fiancée, Freud wrote to say that he regretted not being able to remain for the courses which were being offered during the vacation. A few weeks later, on Easter Sunday 1886, Freud opened his private practice in Vienna. Shortly thereafter he began to work at the institute directed by Kassowitz, the Öffentliches Kinder-Kranken-Institut [Public Institute for Children’s Diseases], where he would work three days a week for ten years, from 1886 to 1896. During the initial years, Freud also taught courses on nervous diseases in children.12 The institute had been founded by Joseph Johann Mastalier in 1788, immediately after the building of the Vienna General Hospitals, in the frame of the enlightened sanitary policies of Kaiser Joseph II. Its aim was to provide free treatment to children of poor families. However, and in distinction to traditional charity institutions for the poor, and like the Dispensary for Sick Children built in London two decades earlier, it was guided by the new public value acquired by the notion of “health” under the Enlightenment. During most of the nineteenth century the institute remained a two-room apartment (waiting room and ambulatory). It was only under the direction of Kassowitz that it progressively enlarged and reformed according to the arising spirit of specialization and that it grew into an important research center. Shortly after the publication of a memorial book celebrating 150 years of its existence (Hochsinger, 1938), it was closed as a result of the Anschluss. At the time, it was the oldest hospital for children in the world. Max Kassowitz, a specialist of the physiology and pathology of the skeleton’s growth, became its director in 1882. In 1886 he donated an apartment and began remodeling it, creating two departments for general medicine, and five specializations: surgery (Richard Wittelshöfer; later Ignaz Rosanes), dermatology (Eduard Schiff), nervous diseases (Sigmund Freud), diseases of the ear (Josef Pollak), and diseases of the nose and throat (Eduard Ronsburger). In 1889 an ophthalmological department was added (Leopold Königstein); and in 1894 a third general medicine department (Oscar Rie). All the “departments” were ambulatory and run by a physician, sometimes with the help of one or two assistants. These posts were not financially rewarding: the main benefit consisted in the large quantity of clinical material for experience, research, and private clients. During this period the annual number of visits by patients increased from about 6,000 in 1886 to 17,400 in 1898. These figures alone are sufficient to dismiss the persisting denial of the relevance of Freud’s neuropediatric activity for the origins of psychoanalysis.

The castration of women and girls 33 It is patently obvious that Freud examined hundreds of children each year and that only very few of them were affected by severe neurological diseases; the rest were evidently affected by “nervous” disorders which would become typical of the psychoanalytic caseload. Yet Freud would systematically minimize his participation in the world of children’s medicine. In The Aetiology of Hysteria, for example, he wrote: It seems to me certain that our children are far more often exposed to sexual assaults than the few precautions taken by parents in this connection would lead us to expect. When I first made enquiries about what was known on the subject, I learnt from colleagues that there are several publications by paediatricians which stigmatize the frequency of sexual practices by nurses and nursery maids, carried out even on infants in arms. (Freud, 1896c, p. 206) Freud had no need to “learn from colleagues” since he had presented himself as a specialist on nervous disturbances in children from the time he had opened his clinical practice in Vienna. Yet, what he might have learned in this field from Adolf Baginsky has remained completely separated from the official history of psychoanalysis. Significantly, in his letter to Martha Bernays of March 10, 1886, while formulating the wish to dedicate his professional life to treat sick children, Freud wrote that he could not reveal to her the “secrets of children’s diseases.” What kind of “secrets” were these? Baginsky’s understanding of pediatrics was based on social hygiene.13 Medicine in those years underwent a radical reorganization and become primarily a “science.” In the course of the transformation from therapy to science, microscopic anatomy and the research of pathologic alterations became the leading disciplines. Baginsky, however, was critical of the new direction because, being based on the “Körper” [the dead body] it neglected the “Leib” [living body], the person or suffering of the whole human organism. This was particularly true with regard to children as they did not exist outside a social group. According to Baginsky, the child was not a separate being, and his life, that is, the child’s “Leib” or living body, was not independent from the life of the community. The principle that guided Baginsky’s teaching was that the causes of pediatric diseases had to be searched for first of all in the group to which the child belonged rather than in the “Körper” or dead body separated from a community. Baginsky’s stress on sexual etiology was an expression of, and a consequence of, his concern for the social causes of diseases in children. He was one of the founders of school hygiene in Germany. In his 1877 Handbook of School Hygiene, he claimed that “masturbation makes its appearance already in babies” and that the evil, usually caused by “certain external stimuli” and especially by “seduction” (Baginsky, 1877, p. 465), was apt to produce many illnesses given the fragility of the child’s nervous system. The difference

34 The castration of women and girls depended on the higher “Reflexerregbarkeit” [the higher excitability of the reflexes], according to which the same “insignificant stimuli . . . which in the adult pass away without leaving traces . . . [in children] can provoke violent explosions” (p. 443). The most noxious “stimuli”, claimed Baginsky, were “sexual excesses.” The latter, according to him, caused severe damages to the “central nervous system” (p. 451) and were the causa movens of chorea (p. 457), a co-cause of epilepsy (p. 461), as well as the source of a vast repertoire of nervous and psychic diseases. His belief was that onanism in infancy affected the whole physical development. In children the signs of the bad habit had to be searched for on the external genitals. To quote Baginsky (1877): What one can observe in boys is a penis which is more developed than usual, a longer foreskin, visibly torn, often injured and rather swollen; in girls scratched external genitals, sometime with purulent mucous secretions. Sometimes the origins of the evil are to be found in the stimulation produced by worms, other times in the persisting constipations, and finally in the abuses of loathsome nursemaids and nannies who want to calm down the children playing with their genitals. However, in other cases there are no traces of these things; one can only suppose that what brings the hand on the small genitals is a stimulus coming from the central nervous system. (p. 466) Although he did not reject the possibility that the stimulus to onanism came from the central nervous system, Baginsky was more inclined to assume that the evil [das Übel] was caused by peripheral stimuli, such as lack of hygiene or, more frequently, seduction. Baginsky’s stress on seduction was well grounded in his view of the lack of independence of the child’s body from the social body. Despite the fact that he accepted the emerging notion of a sexual instinct in children (the “stimuli coming from the central nervous system”), Baginsky was more inclined to assume that the evil came from outside. In any case, his conclusion was that The evil is one of the worst since the child who has succumbed to it falls more and more down because of the continuous sexual excitement of the central nervous system. The vicious circle which is set in is a complete one, and by irradiating from the center to the periphery and by damaging the center from the periphery, it slowly spoils the functions of the brain and causes severe sicknesses such as epilepsy and psychosis. Obviously, at the end, pathology is unable of separating the causes from the effects. Every onanist represents a threat to [those who are] pure, because the imitation of onanism is infectious and masturbation tends to spread more than other evils. (p. 467)

The castration of women and girls 35 The necessity of psychoanalysis, its absolute urge, is rooted in the division between pure and impure. Freud, however, would undo this split. Masturbation was for Baginsky a plague (he listed it within the “infectious” group of nervous system diseases) and the duty of the modern physician was to fight it. How? Referring in his handbook of 1877 to the case of a one-and-a-half-year-old child who had been cured by him of the evil by mechanical means aimed at preventing the onanistic movements of the legs, Baginsky wrote that “for other children other means are necessary, according to the circumstances” (p. 467). Although he avoided giving details, we can assume that these did not differ from what was reported in the medical literature of the time. A student of Baginsky, Samuel Schäfer, published in 1884, in the Archiv für Kinderheilkunde, a study on hysteria in children. It represents a precious source of information on what Freud might have learned in 1886, precisely because it was a “doctoral dissertation” inspired by the practice and teachings of Baginsky. The study contains more references to “sexual aetiology” than any other study at that time. In it, the author claimed that, just as sexual deprivation and overstimulation were said to be the main cause of hysteria in adults, similarly also in children’s hysteria the cause had to be sought in bad sexual habits, primarily onanism (p. 401). The author further stressed that, despite the uncertainty of the method, the diagnosis of onanism was mainly based on an examination of the genitals, the swelling and inflammation of the penis, of the labia majora and the vagina (p. 407). Finally, the study also states that among the main determining causes of children’s hysteria, a not secondary role is played by the illness and abnormalities of the urogenital apparatus, such as congenital phimosis, agglutination of the prepuce with the glans, inflamed and stretched clitoris. All of these conditions are able to produce special nervous states by reflex, which can also be healed by the elimination of the cause. (p. 407) This passage is unequivocal: it refers to the family of surgical treatments which were supposed to eliminate the local source of the overstimulation of the “urogenital nerve.” We can therefore conclude that Freud, through the teaching of Baginsky, came in contact with the extension of Romberg’s reflex theory to infancy as well as with the two most impressive sides of the medical struggle against masturbation and hysteria in children: the idea that seduction played the leading role in the spreading of the “plague” and the tendency to fight the “evil” by means of surgical procedures. Concerning seduction, both the continuity and the discontinuity with the so-called “seduction theory” of hysteria, which Freud would formulate ten years later, should be noted. The continuity is given by the emphasis on seduction (probably, by mentioning the “secrets of children’s diseases,” Freud was alluding to it) and on the physical irritation of the genitals. In the

36 The castration of women and girls theory that Freud would formulate in 1896, however, the notion of “seduction” would acquire a psychological meaning which was previously lacking in the literature. In the work of Baginsky, seduction was assumed to be an agent within the framework of the reflex neurosis theory, and since within the world of reflexes it is impossible to distinguish between an intentional act of seduction and the physical irritation of the genitals caused by rough clothes or lack of hygiene, the meaning of seduction as an action performed on a mind by another mind was ultimately disavowed. We can now better understand the strange plea against castration of women in Jolly’s 1892 article on hysteria in children: by opposing the view of hysteria as a reflex neurosis originating in the genitals, he was actually opposing the medical practice of genital mutilation in children. The mutilating practice indeed elicited a strong opposition which, however, was rarely expressed in a direct way. Around 1880, the belief in the damage caused by masturbation began to be countered by a new doctrine, based on the reversal of the cause-and-effect relationship between masturbation and insanity (cf. Stengers & Van Neck, 1984). Whereas before, the common idea was that masturbation caused insanity, now it was increasingly repeated that masturbation was the effect of insanity (and a symptom of degeneration). The earlier reflex theory was replaced by theories which shifted the focus from the responses to peripheral stimuli to the properties of the central nervous system. In the coming years the notion of hysteria went through an impressive change: it lost its traditional somatic localization and became a psychological disorder, moving away from Romberg’s definition as a reflex neurosis originating from the genitals. The belief that masturbation in children was induced by others was also replaced by a less “innocent” view of childhood. This occurred in the last two decades of the century when, as Stephen Kern (1973, p. 137) phrased it, the idea of child sexuality was “in the air.” At the dawn of the new century, even Baginsky would finally join the emerging psychological perception of the child, recognizing that “drives and passions, conscious and unconscious deviations from the right moral way, which we strikingly meet in the adult, are to be found already shaped in the child” (Baginsky, 1901, p. 98; cf. Bonomi, 2007, p. 114). One of the main consequences of this turn was that “imagination” was finally discovered as a characteristic of the child’s mind – and more than this, as its main feature. According to the new social representation of the child, which emerged in the last two decades of the century, being fueled by “passions,” the imagination of the child appeared now colored by sexual fantasies. Thanks to the shift from the periphery to the center of the nervous system, from the “reflexes” to the “brain,” the idea that masturbation was caused by seduction or abuse was overcome. At the same time, the practice of genital mutilation as a “cure” for masturbation and related nervous disturbances began to decline, at least in Europe, since in America the social

The castration of women and girls 37 representation of the child as “innocent,” as well as the “operation” aimed at eliminating bad habits, would remain for a much longer period of time. By the way, we do not have to think that the medical practice faded away immediately. Ivan Bloch, one of the protagonists of the new “sexology,” discussing the treatment and cure of masturbation in his 1907 book The Sexual Life of our Times, writes the following lines, which were kept in later editions of the text as well: The methods of the older physicians, who appeared before the child armed with great knives and scissors, and threatened a painful operation, or even to cut off the genital organs, may often be found useful, and may effect a radical cure. The actual carrying out of small operations is also sometimes helpful. (p. 421) Bloch also quotes as examples of successful treatment the cutting off of the foreskin with scissors, the repeated cauterization of the vulva, the introduction of a ring in the foreskin, and so on. Significantly, these lines by Bloch were quoted by Mabel Huschka, a psychoanalyst, in a 1938 study on the frequency with which parents dealt destructively with the child masturbating. In her paper, based on 320 children (228 boys and 92 girls) referred by a pediatric clinic for psychiatric consultation, Huschka found that 128 children, or 40 percent, were actually punished, usually by direct and drastic threats of physical injury to the genitals. These threats were still seen as a prolongation of the drastic forms of management, which were professionally advised until recently. Later on the connection between castration anxiety and real threats was simply lost, with castration itself transforming into a purely symbolic issue.

Ambiguities References to female castration were not lacking in Freud’s early work; they were, however, so brief and indirect that they were systematically overlooked or misunderstood by scholars. For instance, in his 1888 article on hysteria, Freud wrote that the importance of “abnormalities in the sexual sphere . . . is as a rule over-estimated. In the first place, hysteria is found in sexually immature girls and boys . . . Furthermore, hysteria has been observed in women with a complete lack of genitalia” (pp. 50–51). Freud’s words are probably referring to the consequences of castration but have been interpreted by numerous authors (among them, Sulloway (1979) and Eissler (2001)) as proof of his initial ignorance of infantile sexuality. In his posthumous book, besides interpreting the passage as evidence of “Freud’s naiveté and innocence when he entered the field of psychopathology,” Eissler (2001, p. 70) quoted the text while also adding an astonishing interpolation “[sic!].” Noticing that Eissler had failed to follow up on his

38 The castration of women and girls interpolation, Robert Holt (2002) raised the following question when reviewing Eissler’s book: “Why, one wonders, was Eissler so incurious about the relation between this etiological theory and other, contemporary ideas about the causes of hysteria?” In fact, by reading the passage as proof of Freud’s “naiveté and innocence,” Eissler was simply ignoring the fact that, in those years, the same arguments were being used in the debate for and against castration. A similar lack of curiosity cannot be attributed to Sulloway, who has systematically questioned the canonical narration of the origins of psychoanalysis. Nevertheless, he too overlooked this aspect of the medical milieu, missing the many connections between it and Freud’s work in a way that affected his conclusions about the pre-Freudian issue of infantile sexuality. Sulloway did not realize that it became an issue in the framework of the modern (i.e., medicalized) struggle against the moral and physical “plague” of masturbation, becoming only secondarily an object of theoretical interest and scientific curiosity. Obviously we cannot make Freud responsible for the misreadings of the historians of psychoanalysis. Their attitude would have likely been different had Freud addressed the topic of female castration in a more open and direct way – as he recommended that we do when speaking about sexual matters with children (Freud, 1907). In spite of the fact that Freud never did quite address the subject of female castration in his enormous work, he would again and again speak of “castration” and even managed to produce a “castration theory of femininity.” We don’t know why Freud preferred to push this topic aside and remained vague about the topic. The effect on his followers was that, on the one hand, they restlessly fantasized about the psychic reality of castration, while also systematically neglecting, ignoring, and denying its material reality. Historians of psychoanalysis have never succeeded in overcoming this split. Amazingly, all attempts at calling attention to it have failed. Hirschmüller (1978a), discussing the questions related to the topic “Sexuality in the aetiology of neuroses” (pp. 225–236), pointed out the inconsistencies between Freud’s early statements and his later claims, calling “un-understandable” the claim, which appears in “On the history of the psychoanalytic movement” that, by searching in sexual life for the sources of neurosis, he took up “the fight for a new and original idea” (Freud, 1914, p. 13). Freud’s claim in my opinion involved a fundamental and recurrent ambiguity since, immediately afterwards, he admitted that the idea was neither new nor original (Freud, 1914, p. 13). Similarly, in his 1925 “An autobiographical study,” Freud described his discovery of sexual aetiology as “an apparently original discovery” (1925a, p. 24). The problem with these definitions is that they are correct, but not for the reasons provided by Freud. They are correct because, as Stärcke stressed in his 1921 article, there was a continuity between psychoanalysis and the old psychiatry à la Romberg (Stärcke, 1921b). Instead of openly outlining the scientific filiations, however, Freud traced back the “apparently original

The castration of women and girls 39 discovery” to (insignificant) spicy insinuations by Charcot, Brouardel, and Chrobak, which were immediately forgotten by the young student who was as “innocent and ignorant” about sexual problems as he was (Freud, 1914, pp. 13–15). For instance, the gynecologist Chrobak, who referred a female patient to Freud for treatment, had once confided to him that the prescription for successfully treating her malady was “Penis normalis dosim repetatur.”14 Why did Freud avoid referring to the tradition represented by Romberg? My impression is that what made Romberg’s tradition difficult to swallow for Freud were its therapeutic consequences, the involvement of the physical manipulation of the genital organs, ranging from massage to ablations. In a way, this would make his explanation of what he accepted and what he rejected of that tradition far too complicated. The “innocent” anecdote concerning Chrobak nevertheless carried a bitter irony, since in Krömer’s review on castration, though being described as a gynecologist who preferred conservative methods of cure, Chrobak is cited as having operated on 146 women – the largest number attributed to a single surgeon in the review – with an uncommon rate of success, namely on more than half of all cases (Krömer, 1896, p. 53). If we further question his witty remark about the woman patient he had sent to Freud, we find additional traces of the “vain sacrifice”: in his letter to Martha of May 15, 1886, Freud wrote that the patient would be operated on by Chrobak, and a few days later, in a letter of May 23, wrote again to say: “My other female patient is in the same sanatorium. She was operated on yesterday” (Masson, 1985, p. 19). Freud was even more ambiguous in relation to the issue of infantile sexuality. In The Aetiology of Hysteria, he claims that when he made enquiries about what was known on the subject of seduction, he “learnt from colleagues that there are several publications by paediatricians which stigmatize the frequency of sexual practices by nurses and nursery maids, carried out even on infants in arms” (Freud, 1896c, p. 207). But wasn’t the struggle against the plague of masturbation and seduction the obsession of his teacher in neuropediatrics? And wasn’t Freud himself a “children’s doctor” who had been directly engaged with nervous and hysterical children in the institute for sick children in Vienna, which Kassowitz had directed from 1886 to 1896? Why, then, did he write that he had been informed only indirectly and recently of sexual practices on children through books? Why the need, on Freud’s part, to distance himself from the world of pediatrics? This same distancing attitude characterized Freud’s 1914 report, where he wrote that his discovery of infantile sexuality had been “founded almost exclusively on the findings of analysis in adults, which led back into the past,” since he “had no opportunity of direct observations on children” (Freud, 1914, p. 18; italics added). Freud’s claim is striking and confusing. While true that Freud’s attitude immediately transformed into irony – since he also added that “the nature of the discovery was such that one should really be ashamed of having had to make it” (Freud, 1914, p. 18) – the systematic way in which he avoided mentioning or referring to his

40 The castration of women and girls training with Baginsky and to his neuropediatric work with children (he would restrict it to the study of cerebral palsy) gives the impression of a taboo which also involved two other overlooked elements of the prehistory of psychoanalysis: the reflex neurosis theory and castration.

The paradox of a “cure” which is a “punishment” It was only in 1933 that Freud spoke openly of circumcision “as a cure or punishment for masturbation” in children, and only in reference to his American patients (Freud, 1933, p. 87), thus still maintaining a great distance, both in time and space, from his 1886 pediatric training with Baginsky, an experience which allowed him to come directly in contact with the contradictions implicated in something that only 50 years later would be described by him as “a cure or punishment.” Let us try to focus on the elusive character of the question revealed by the conjunction between “cure” and “punishment.” How can we keep in mind something which appears now as a “cure” and again as a “punishment” – i.e., how can we keep in mind something that we cannot avoid splitting into two disjoined situations? And don’t we find here a reason why the practice of castration has escaped the attention of scholars? In fact, if we decompose the matter into a “cure” or into a “punishment,” its relevance to the origins of psychoanalysis simply fades away, since the positive existence of a certain kind of cure or of a certain kind of punishment adds nothing to our understanding of psychoanalysis. And yet, our understanding of the matter immediately changes once we realize that it is the link between incompatible elements that is ultimately here in question. If psychoanalysis was able to break through as a new type of knowledge, it was precisely because of its unprecedented position in relation to contradiction. How did Freud develop his capacity for staying with ambiguities and contradictions, something that would grow into a central quality and trait of the psychoanalytic attitude itself? This is a basic and fundamental question which needs to be addressed. In not considering it, even otherwise accurate and scholarly historical reconstructions are simply left incomplete and disregard a vital, important, and critical link. Freud (1919b, p. 243) once said that, concerned with uncanny things as it is, psychoanalysis had “itself become uncanny.” Rather than disregarding them, the first task of a history of the origins of psychoanalysis which strives to go beyond mere biography and historiography should involve squarely facing the traces of the uncanny things that we meet in its history. My claim is that the practice of castration is one of these traces, and, further, that it has been systematically overlooked precisely because of its uncanny quality, a fact which makes its emotional working through and intellectual integration in a coherent narration a difficult task. More precisely, the line of thought which I have tried to develop since the

The castration of women and girls 41 conference on 100 Years of Psychoanalysis organized by André Haynal and Ernst Falzeder in 1993 – when I raised the question “Why have we ignored Freud the ‘paediatrician’?” (Bonomi, 1994a) – is that the ignored, neglected, or rejected subject matter of castration contains – in ways that are still to be explored – elements which will modify, impact, and enlarge our understanding of the origins of psychoanalysis. My idea is that Freud himself was confronted with the practice of castration, was deeply shocked by it and, further, that his capacity of staying in the middle of contradictions was the effect of a post-traumatic process of working through. I also believe that if we want to achieve an understanding of the origins of psychoanalysis which is both emotionally and intellectually challenging, we must necessarily pass through a similar process. We should be able to integrate the idea of seduction with that of castration, confronting the contradictions of a “cure” which, at the same time, is also a “punishment,” or seeing in the “cure” a repetition of the “evil,” an assault on the genitals aimed at curing the products of an imaginary or real sexual assault, in the same manner that a sudden shock was employed to clear away the effects of a previous sudden shock. It is this kind of contradiction that I have tried to explore in my book On the Threshold of Psychoanalysis where, referring to castration, I wrote: Was it possible to trace a boundary line between the therapeutic aims and the punitive intentions? Are we sure that the physicians who recommended it and the surgeons who practised it, were convinced that they were curing a sick body? In which measure did they know that the objects of their treatment were emotional states full of dread and overflowing with anxiety? Moreover, don’t we perceive, in this merging, the echo of the old identity between the causes and the cure of the evil? Was the performed cure not a reproduction of the same evil it pretended to oppose? Wasn’t it an assault on the genitals? And wasn’t such an assault aimed at curing the consequences of an imaginary or real sexual assault, just as a sudden shock was used to clear away the effects of a sudden shock? . . . The contradictions of medical wisdom seem to thicken around this edge, which mark a break in the certainties of modern man. It is from this break that psychoanalysis would originate. In the core of psychoanalysis we would find, in fact, the problem of the repetition of the trauma within the therapy, the crucial issue of retraumatization. (Bonomi, 2007, p. 105)

Notes 1 Until the eighteenth century the ovaries did not have a name of their own and were simply called “the female testicles.” The female body was generally considered inferior to the male body because all the male sexual organs had been retained inside the body. The vagina was considered a kind of unborn penis, the womb a stunted scrotum, and the ovaries internal testes (Laqueur, 1990).

42 The castration of women and girls 2 This might well be an important reason why scholars have overlooked the impact of castration on Freud, though it is probably not the only one. In his book on the history of the unconscious, Ellenberger (1970), in the chapter devoted to “Sexual psychology and pathology,” pinpointed a split between neurologists, who followed Charcot’s view of hysteria, and gynecologists, who persisted in believing in sexual etiology. Hirschmüller (1978a, p. 225) made a similar point, adding that this belief was shared by some neurologists as well. The gap between theory and practice, however, was dropped and not explored any further. 3 The prize was established from funds given by Anton von Freund for the best psychoanalytic work. Other recipients of the prize included Simmel, Abraham, and Reik in 1918, and Róheim the same year. 4 Romberg’s name was mentioned in the chapter on “Theoretical considerations” which Breuer contributed to the Studies on Hysteria (Breuer & Freud, 1895, p. 220). 5 “As long as Catholicism ruled the patriarchal family, the individual was responsible within a hierarchical system; . . . With the introduction of Protestantism, a basic shift in the system of authoritarian relations took place. The individual had become ‘free’. He was no longer responsible to intermediate superiors, only to himself and to God. With this the individual became the responsible authority for himself and for his family. . . . Each father began to realize that he had to regulate the conduct of his family on his own responsibility. His bewilderment about the distinction between venial and mortal sin became more and more intolerable. In a manner reminiscent of phobic and compulsive processes, the feeling of guilt soon extended from the mortal to the venial sins. Unavoidably, phobic defenses were erected against sexuality in general, and particularly against those of its forms which were most difficult to check and control. As in the compulsive ritual, it was against the least controllable, least harmful, furthest removed derivatives that the battle raged strongest” (Spitz, 1952, pp. 496–497). 6 This statement by Rieger (1900) is contained in p. I of the supplement [Ergänzung zu] p. 10 ff. 7 Rieger (1896); see Masson, 1985, p. 203. Since Rieger belonged to a new generation of psychiatrists who were attempting to distance themselves from the contradictions of nineteenth-century psychiatry (he was one of the first to develop a test battery to detect damages to the brain), Sulloway (1979) remarked that Freud’s opponents “saw him not so much as a ‘depraved revolutionary’ on this subject but as a misguided reactionary who was harking back to the superstitions of the past” (p. 454). Guiding himself by Rieger’s 1929 autobiography, Sulloway indicated that Rieger and his contemporaries “had been trained in a period when mystical tendencies, including attempted exorcism of sexual demons from the body of the hysteric, were still remembered in psychiatric circles.” Sulloway was unable, however, to relate Rieger’s break with the horror which the practice of castration had provoked. 8 Gynecological psychiatry played a certain role in the new awareness: Scanzoni, in 1859, Althaus in 1866, and Aman in 1874 found that a series of disturbances were caused by masturbation before puberty (Smidt, 1880, p. 3). At this point it became a well-established wisdom that the predisposition to hysteria was rooted in “the sexual vices that appear in childhood, especially to masturbation” (p. 17).

The castration of women and girls 43 9 Freud’s letter to Marie Bonaparte was written a day after Oscar Rie’s death, on August 18, 1931, and is reported by Schur (1972). Oscar Rie had responded to Freud’s announcement concerning the treatment of infantile nervous diseases in 1886. He later became Freud’s assistant and the pediatrician to Freud’s children (Mühlleitner, 1992, p. 271). Rie collaborated with Freud in studies on brain palsy in children (Freud & Rie, 1891; Freud, 1893). 10 Jones (1953, p. 232) wrote that Freud’s training took place at the Kaiser Friedrich Krankenhaus, but this hospital was in fact founded four years later, in 1890. The hospital was founded on the initiative of a Berlin Committee presided by Rudolf Virchow, with Baginsky being appointed its director as well as the physician responsible for the department of internal and infective medicine. This erroneous conclusion has appeared in all subsequent works – including the recent book by Tögel, Freud und Berlin (2006). The error, in Tögel’s case, was due to an unintentional distraction (personal communication by the author). 11 The winter semester lasted from October 16, 1885 to March 15, 1886. The paid lessons were held on Mondays, Wednesdays, and Fridays, from 1 to 2 p.m.; and the lessons free of charge on Saturdays, from 6 to 7 p.m. The vacation courses started on March 22. At that time Baginsky was a member of the board of professors and in charge of the vacation course [Feriencurse]; this position enabled him to employ the title of “Professor” (in his 1886 “Report on my studies in Paris and Berlin,” Freud, in fact, refers to Baginsky as a “Professor”). 12 The request to hold lessons at the Institute for Sick Children was presented to the Council of Professors on October 28, 1886 by Dr. Richard Wittelshöfer (Lecturer in Surgery), Dr. Eduard Schiff (Lecturer in Dermatology and Syphilis), and Dr. Sigmund Freud (Lecturer in Nervous Diseases). The proposal received a negative response on March 3 of 1887. Nevertheless, Freud held courses on nervous illness of children during the summer semesters of 1887 and 1888 at the Institute for Children’s Diseases and, in 1892 and 1893, in a locale not indicated in the announcement (Gicklhorn & Gicklhorn, 1960). Under the guidance of Kassowitz the institute developed a rich scientific activity and, beginning in 1890, published a series named Beiträge zur Kinderheilkunde aus dem I. Öffentlichen Kinder-Krankeninstitut in Wien. Between 1886 and 1892 Freud collected 275 observations on children who suffered from cerebral palsy who were under the age of ten; it provided him with the clinical material for nine publications between 1888 and 1900, including three monographs. The most famous was published in 1897, in the prestigious series Spezielle Pathologie und Therapie, directed by Nothnagel. In the same year, Nothnagel supported Freud’s ambition to be appointed and receive the academic title of Professor (Freud’s wish remained unfulfilled until 1902). Freud left the Kassowitz Institute in 1896 with his post being taken over by Emil Redlich. It was later assumed by Julius Zappert in 1898 (Bonomi, 2002a). 13 Adolf Baginsky was born on May 22, 1843 in Ratibor. He studied medicine in Berlin with Virchow and Traube, and in Vienna for one year. He received his degree in Berlin, in 1866, and was appointed “Privatdocent” in pediatrics [Kinderheilkunde] on December 7, 1882; he presented a lecture on “The relationship of pediatrics to general medicine” [Das Verhältnis der Kinderheilkunde zur gesamten Medizin] on that occasion. He would later become Professor Extraordinarius (December 3, 1892), with his application to Ordinarius being rejected on January 29, 1897. The commission of the Faculty of Medicine

44 The castration of women and girls decided on January 15 of 1897 that the division of the chair in Kinderheilkunde, already assigned to Heubner in 1894, was useless (Bonomi, 2002b). Baginsky made important contributions in various fields, including the field of aphasia (cf. Eilig, 2005), a field in which Freud (1891) himself made an important contribution. 14 In his 1914 essay “On the history of the psycho-analytic movement,” Freud says that Chrobak sent him a woman patient to whom he could not give enough time, owing to his new appointment as a university teacher. After 18 years of marriage the woman was a virgin, her husband being impotent, and Freud remembers Chrobak’s taking the man aside and saying: “The sole prescription for such a malady is familiar enough to us, but we cannot order it. It runs: ‘Rx Penis normalis dosim repetatur’.” Likely Freud refers to this woman patient in his letter to Fliess of February 4, 1888 (cf. the editorial notes).

2

Between body and psyche The nerves

And the legs began to join in the conversation Throughout much of history the medical understanding of the body was mainly based on the ancient theory of humors, according to which a body was either too dry or too humid, too cold or too hot, but never “too nervous.” Up until the middle of the eighteenth century patients never suffered from a case of the “nerves” and it was only in the second half of that century that the idea that tissues might become “excitable” grew fashionable. It led human beings to begin to view themselves as a bundle of nerves. Suddenly, in the midst of modernity, when the pianoforte was created, humans began to be diagnosed as suffering from bad “nerves.” In the first half of the nineteenth century, the various discoveries of the spinal cord as relay between the central and the peripheral nervous system allowed for new representations of the human body and the diagnosis of new disorders. The notion of “spinal irritation,” which flourished among English surgeons and apothecaries and reached a climax in popularity around 1850, brought into being the idea that many different afflictions of the body were caused by an invisible but real sickness of the spine. In Europe, young women began to respond to psychic pain with fantastical paroxysms and health spas began to appear throughout the land promising to cure the new maladies. The diagnosis of an irritable spine was soon replaced by the more sophisticated notion of a “reflex neurosis.” That notion was based on the discovery of the reflex arc by Marshall Hall (in 1832) and was also called upon to explain how the irritation of genital organs, as well as the reflex arc’s propagation through the abdominal ganglions, provoked spasms and convulsions, as well as the typical hysterical bolus. It was in this way that hysteria, the most ancient of all the maladies, received an altogether new explanation which combined traditional wisdom with scientific advancement. The main symptoms of hysteria shifted from paroxysms to paralysis, or better, to an ample spectrum of disturbances ranging from spastic contractures, flaccid paralysis, joint pains, to difficulties in walking and standing. Medicine has been a therapeutic practice since its inception. In the course of the nineteenth century, however, it evolved into a discipline primarily

46 Between body and psyche: the nerves aimed at knowledge and knowing, and through that shift, grew into a science. Brain localization became the imprimatur of science among academics. The theory of reflex neurosis, however, remained an irreplaceable tool in the hands of the physicians whose living depended on their capacity to provide therapeutic solutions to symptoms and diseases. Moreover it paved the way to the notion of “cerebral unconscious” introduced by the gynecologist Thomas Laycock (1840, p. 107) in a treatise on women’s diseases, while explaining the brain as subjected to “the law of reflex action” (cf. Gauchet, 1992, p. 44), an idea which was further developed in his 1845 article titled “On the reflex function of the brain.” The deep connection between the research on the influence of the uterus and the ovaries on the automatic action of the brain and the mesmeric wave which around 1850 spread in Edinburgh, Glasgow, and London has been emphasized by Gauchet (1992, pp. 46–47). A further step would be accomplished by Pierre Janet (1889), who would replace the explanation of catalexis based on the reflexes or “physiologic automatisms” – supported by Haidenhain, Maudsley, and Despine, among others – with an explanation based on “psychological automatism,” namely, with ideational phenomena which are so embryonic that they do not reach awareness. Sigmund Freud studied medicine from 1873 to 1881 and was appointed “Privat-dozent” in neuropathology four years later, in 1885. During these years he toiled in the laboratory of physiology directed by Ernst Brücke, as well as in the laboratory of Theodor Meynert, where he researched the anatomy of the medulla oblongata and the effects of lesions on the nerve fibers. Freud liked this type of scientific investigative research work and, for a long time, was reluctant to realize that his academic aspirations could not be fulfilled by it. In 1886, when he “became a therapist against his will,” as he would later put it, hysteria remained mainly a malady composed of physical symptoms. These included motor spasms, paroxysms, paralysis, or sensory anesthesia, paresthesias, or hyperesthesia. The notion of “neurosis,” however, was rapidly changing. In the course of his shift from the body to the psyche, Freud, starting in 1886, made use of a “pressure technique” for several years. Freud’s technique consisted in applying pressure directly on the patient’s forehead in order to help him or her recall the traumatic event and thereby reach the nucleus of the pathogenic organization (Breuer & Freud, 1895, pp. 110, 112 fn. 2, pp. 275–276, 281, 294–295, 301; Freud, 1896b, pp. 177–178). Freud’s pressure technique is usually seen as a residue of his use of hypnosis in therapy. In Freud’s mind, however, it was also associated with pressure on the ovaries, and the nasal mucous membranes, as well as other hysterogenic spots which were commonly employed either to help release or help impede an attack of hysteria.1 The hallucinatory phase of the attack, which was characterized by the “attitudes passionnelles,” had a sexual component and often consisted in a complete re-enactment of the trauma (Freud, 1888, pp. 42–43). The shift from body to mind was itself recorded in the Studies on Hysteria, a text which Freud co-wrote with his mentor Joseph Breuer between 1893

Between body and psyche: the nerves 47 and 1895. Anna O., one of the main patients featured and discussed in the text, was treated by Breuer between 1880 and 1881; the four woman patients whose cases Freud presented in the text had all been treated by him a decade later. In the case of Anna O. the body remained the main vehicle for the expression of her emotions: she suffered from a contracture of her right arm and from many other somatic “conversions” as well. Freud’s 1889 treatment of Frau Emmy von N. initially consisted in providing her with massages which were combined with electric baths; her treatment with time shifted to a cathartic method of psychotherapy. A pivotal turn, however, occurred in the case of Fräulein Elisabeth von R. When Freud first visited her in 1892, her main symptoms were physical pains which were caused by walking and standing. The focus of her pain was a fairly large area of the anterior surface of the right thigh, where the skin and muscles were also particularly sensitive to pressure and pinching. Paradoxically, the patient, said Freud, responded to a “prick of a needle . . . with a certain amount of unconcern.” Freud’s treatment approach set out in a traditional manner: Treatment proceeded on the assumption that the disorder was of this mixed kind. We recommended the continuation of systematic kneading and faradization of the sensitive muscles, regardless of the resulting pain, and I reserved to myself treatment of her legs with high tension electric currents, in order to be able to keep in touch with her. (Breuer & Freud, 1895, p. 137) Only later did Elisabeth von R.’s painful legs begin to “join in the conversation” (p. 147). Realizing that her pain reached its climax while she was reporting the essential and decisive part of what she had to communicate, Freud decided to use the patient’s reports of her pains “as a compass” to help her move forward with the production of her story. Introducing the case history, Freud remarked: I have not always been a psychotherapist. Like other neuropathologists, I was trained to employ local diagnoses and electro-prognosis, and it still strikes me myself as strange that the case histories I write should read like short stories and that, as one might say, they lack the serious stamp of science. (p. 159) Since hysteria was somatically localized in the female genital organs, this is likely what he had in mind while writing that he “was trained to employ local diagnoses.” Similarly, the reference to the electrotherapy on the leg muscle opens a window on the practice of electric stimulation of genital organs (Starr & Aron, 2011).

48 Between body and psyche: the nerves In the other three case studies featured in the Studies on Hysteria, the embodiment of psychic pain was marginal or quasi-symbolic, as in the case of Frau Cäcilie M., whose violent pain in her right heel was traced back by Freud to her being afraid that she might not “find herself on a right footing” (p. 178). Thanks to the psychology of the time, the emphasis on the body began to move slowly into the background.

From spinal concussion to psychic shock The shift from the body to the mind or psyche which is recorded in the Studies on Hysteria is the end of a process which had started about 15 years earlier, and which was marked by the great success of the notions of psychic trauma in the 1880s. This notion took shape from the encounter of the successful notion of “spinal irritation” with one of the most powerful symbols of modernity, the railway. This encounter generated the notion of “railway-spine,” coined in 1866 by the British surgeon John E. Erichsen in his influential medical textbook On Railway and Other Injuries of the Nervous System to describe a post-traumatic condition caused by railway incidents. The condition described by Erichsen (1866) was just a chronic inflammation of the spinal cord membrane (chronic myelitis) due to spinal concussion, but he emphasized the violent character of the railway incident, the momentum of the person injured, and the unique degree of psychological shock suffered by the helpless victim (p. 9), ambiguously implying a connection between the psychological experience of unprecedented violence and chronic damage of the nervous system. The disruption of the nervous system was further emphasized in the new edition of his book, published in 1875, in which he advanced the idea that that a condition of “mental or moral unconsciousness” could be caused by the terror of the accident (p. 195). Erichsen was still sticking to a medical-surgical model, but in the ensuing debate the idea that the “nervous shock” alone could provoke the same collapse came to the fore. In 1883 Herbert W. Page took this step, claiming that the same shock on the nervous system could be inflicted “by fright and by fright alone” (p. 162). In the early 1880s this idea was in the air, and together with the ongoing debate on castration, hysteria, and suggestion, contributed to the emergence of the notion of “psychic trauma.” The first opponent of castration, who claimed that the general healing effect attributed to the operation was caused by suggestion, was James Israel, a surgeon at the hospital for the Jewish Community in Berlin and the author, in 1880, of the article “Ein Beitrag zur Würdigung des Werthes der Castration bei hysterischen Frauen” [Contribution to a discussion of the value of castration in hysterical women]. The article presents Israel discussing the reasons and effects of an “apparent castration” [Scheincastration]. A young lady who suffered pains in her ovaries, vomiting, and headaches, asked for Israel to operate on her after eight different physicians had each recommended that she undergo the procedure (!). Israel was against

Between body and psyche: the nerves 49 castration but, since the patient stood resolute in her decision, he simply simulated performing the desired operation. The effect was immediate: when she woke up, her symptoms were all gone. However, because of the coverage in the press, the patient recognized what had occurred and felt betrayed; her symptoms soon all reappeared. At this point she was operated on by the much more “reliable” Dr. Hegar, who accused his colleague, Dr. Israel, of lacking professional ethics. Among physicians, the technique of “apparent castration” fell immediately into disgrace and even the great Charcot spoke against it. Nevertheless, the idea that the healing effect of castration was mainly due to psychic suggestion would re-emerge in the years which followed. In an 1883 article on hysteria, Carl von Liebermeister stated that castration, the extirpation of the clitoris, and similar operations should be rejected. In order to obtain the same psychic effects, he recommended milder means, such as cauterization of the clitoris, extraction of blood from the vagina, and so forth. These means were seen by him as equivalent to hypnotism and shocks. The general function of the brain, in other words psychology, was beginning to replace the reflex neurosis theory; the fulcrum of this change was the notion of psychic shock. In 1883, Franz Riegel, who held the Chair of Medicine at the University of Giessen, published an article on hysteria in children based on a specific clinical fact: in some hysteric children, boys in particular, certain symptoms of paralysis and contractures appeared and disappeared as a result of strong psychic excitement. According to the author, the cause of this kind of paralysis was rooted in the imagination and had to be considered hysteric if it was not associated with pains in the ovaries, or other similar factors able to stir up the malady by reflexes (the inflammation of bowels, loins, or the womb, for example). For these reasons the required therapy had necessarily to be geared toward the “psychic” world of the patient rather than his or her soma; the cauterization of the clitoris or similar procedures, for instance (p. 471). What did the author mean by “psychic”? The treatment developed by Riegel, faradization, was one of the most successful therapies in those years. It featured electric shocks, which, in this case, were administered on the child’s legs. The treatment was geared towards bodily symptoms but the mechanism through which it operated was conceived as a psychical one, according to the nature of the symptoms. In other words, the body was manipulated in order to reach the mind. The same view underlined the use of a classic therapeutic tool, the so-called ferrum candens [white-hot iron] (p. 463) still being used at the time to treat symptoms of hysteria. In this initial and therefore still naïve moment of transition from the body to the mind, there were no inhibitions in describing the violence of the remedies: only a violent shaking of the body was able to produce a lasting “psychic impression”; in the same spirit, physicians did not hesitate in resorting to traumatic manipulations of the genitals. Since the beginning,

50 Between body and psyche: the nerves the attack on the genitalia was aimed at causing a psychic effect on the mind: the “operation,” as circumcision was often called, was threatened to little onanists precisely because they were unable to “keep in mind” the prohibition against touching their genitals. When doctors acted on the body, they were doing so as a way of accessing the mind: what the child was unable to remind him- or herself of had to be impressed on the body. A scar on the body functioned as a reminder for the mind. The new idea of nervous shock and psychic trauma which spread around 1880 was proof that it was possible to switch from the body to the mind and from the mind to the body in a smooth and easy fashion. A further step was accomplished in another article dealing with hysteria in children. Written by a docent of psychiatry at the University of Vienna named J. Weiss (1884), it explained the appearance and disappearance of symptoms on the basis of the pathologic excitability of the nervous system, with the author arguing that the “sudden recoveries” he had achieved with his patients had been a product of “psychic shock” (p. 460). A paradigmatic case history concerned a ten-year-old girl who grew sick after a strong fright but immediately recovered after a second strong fright was produced on purpose by the psychiatrist (pp. 456–457). The ancient founding principle of medicine, the identity between the cause and effect of evil, was now returning through the idea that the symptomatic effects of a shock could, in principle, be healed by a second shock. From this moment on the shift from surgical operations on the genitals to the psychological theory of fright was extremely rapid. For a certain period psychic shock and manipulation of the genitals were unavoidably intermingled. This link was severed by Charcot. In the academic year 1884–1885, Charcot provided the famous demonstration of the psychic mechanism of the hystero-traumatic paralyses, which Freud would praise as a cornerstone in the new explanation of the malady. As Freud (1893a) explained, Charcot “succeeded in proving, by an unbroken chain of argument, that these paralyses were the result of ideas which had dominated the patient’s brain at moments of a special disposition. In this way, the mechanism of a hysterical phenomenon was explained for the first time” (p. 22). This last sentence obscures the fact that the psychological explanation replaced the one based on the reflex theory and that paralyses of the legs, together with pains as well as difficulties in standing or walking, were usually interpreted as a consequence of shocking genital manipulations and the lasting irritation of the genital nerve.

The dissolution of the notion of psychic trauma The success of the notion of psychic trauma (Strümpell, 1884, 1888, 1892, 1893; Möbius, 1888, 1890, 1894; Janet, 1889, 1893/184; Breuer & Freud, 1895) was bound to its ambiguity, which, in turn, was bound to the ambiguities embedded in the discourse on the “nerves.” When these ambiguities, which basically concerned the relationship between mind and body, were

Between body and psyche: the nerves 51 resolved, the notion of psychic trauma also began to decline. After Charcot’s demonstration of the psychic mechanism of the hystero-traumatic paralyses, the same logic was applied to explain an increasing number of features. In the ensuing years the psychological explanation was extended to explain spasms, neuralgias, and hallucinations, anesthesias, hysterical attacks, tics, vomiting and anorexia, and other symptoms, progressively eroding the distinction between traumatic hysteria – or, according to other authors, such as Hermann Oppenheim (1889), “traumatic neurosis” – and simple or common hysteria. The psychological understanding of the symptoms of hysteria, based on the connection with the provoking trauma, led to a rapid transformation of the notion of hysteria. As Pierre Janet phrased it in an important article, the first part of which appeared in 1893: “the definitions of hysteria have changed and have become psychological” (p. 422). The transformation was completed that same year when Möbius claimed that all hysterical symptoms and phenomena were ideogenic, and Strümpell proposed that we consider the traumatic neurosis as hysteria, that is, as a purely psychic disorder. Once it was severed from sexuality the term “hysteria” no longer had a definite clinical meaning. One year later, in 1894, Robert Sommer proposed that we abolish it and that we instead use the newly coined term “psychogenic.” According to his definition, this qualification applied to all disorders which had been caused by representations and could be cured by representations. Sommer – a collaborator first of Wilhelm Wundt, the founder of experimental psychology in Germany, and then of Conrad Rieger – illustrated the question with the case history of an 11-year-old boy who had developed a psychogenic headache by combining the memory of a real injury (he had hit his head when he was five years old) with the sensation of pain. The triumph of the notion of psychic trauma was also beginning to dissolve; indeed, and as a consequence of the fading of the distinction between traumatic neurosis and common hysteria, the notion of trauma now began to progressively lose its explanatory power in favor of psychological motives. The fatal blow was provided by Strümpell a year later, in 1895, when he introduced the idea that in traumatic neurosis the most powerful representations were “Begehrungs-Vorstellungen,” representations determined by longings or wishes (Strümpell, 1895, p. 1137). In the reconstruction of the debate on psychic trauma among German neurologists and psychiatrists, provided by the historian of medicine Esther Fisher-Homberger (1975), the author demonstrates how in the span of a few years the psychological explanation of post-traumatic symptoms resulted in the dissolution of the cause-and-effect connection between trauma and symptoms. The shift from physical causes to psychological motives gave way to the notion that the victim’s unspoken wishes played a crucial role either in the onset of the post-traumatic symptoms or in their fixation. Traumatic neurosis was identified with hysteria and was renamed “pension-neurosis,” apparently because the long-term neurosis was not caused by an incident but by the unspoken wish for a pension, an element which contributed to

52 Between body and psyche: the nerves the long-term effect of the condition. The view emerged circa 1895 that individuals affected by traumatic neurosis would improve if only the right to compensation had not existed. In short, the etiological weight of the incident became uninfluential and the relevance of the shock and the fright which it produced was downplayed; factors such as the medical theory, the juridical system, social care, and the personality of the victim were now all held responsible for the patient’s morbid condition. The final dissolution of the notion of psychic trauma was made explicit by Robert Gaupp in his 1898 article “Zur Kritik der Verwendung des Begriffs ‘Trauma’ in der Ätiologie der Nervenkrankheiten” [Criticism of the usage of the notion of “trauma” in the etiology of nervous disorders]. In it the author arrives at the conclusion, which emerged slowly during the previous years, that the causal link between incident and symptoms was “thought” but not “real.” As Ludwig Bruns described it, hysteria did not obey physical but rather psychological laws (Fisher-Homberger, 1975, p. 127). At this point also the notion of traumatic neurosis introduced by Hermann Oppenheim in 1889 began to be ridiculed and soon disappeared from public debate. It reappeared, however, shortly after the beginning of World War I.2 The psychological turn was intimately connected with the new expansion of the theory of degeneration. Charcot’s famous demonstration of the psychic mechanism of the hystero-traumatic paralyses played an ambiguous role in this. While presenting an accidental event (trauma) as the determining cause of the symptom, Charcot was also assuming that the predisposition consisted of the same degeneration of the nervous system that characterized hypnotizability, later described by Janet (1889) as “désagrégation psychologique” (a term translated into English as “dissociation”). In short, the occasional trauma had a certain effect because the person affected by it had a psychopathic constitution due to heredity. Though many authors objected to this, still they were influenced by the idea of degeneration. For instance, Möbius objected that hysteria per se was not an expression of degeneration. According to him hysteria was in fact not defined by the symptoms but by the ideogenetic mechanism, which could be seen operating in both normal and degenerate persons. Yet, he also suggested that the sexual abnormalities traditionally ascribed to hysteria were to be understood as symptoms of degeneration. In other authors the idea of degeneration played a much heavier role, merging with the extension of the theory of natural selection to the organic, social, and intellectual development of peoples, also called “racial hygiene.” It is difficult today not only to understand how deeply the theory of degeneration influenced medicine, psychiatry, and the cultural life at the turn of the century, but also how “Freud’s introduction of psychoanalysis was intimately involved with a refutation of degenerationism” (Spiegel, 1986). While Freud embraced the psychological change he did not accept certain aspects of the emphasis on the brain, such as the stress on heredity, as is apparent in his criticism of Charcot (Freud,

Between body and psyche: the nerves 53 1893a). In a desire to distance himself from degenerationism Freud, for a certain period, between 1892 and 1895, was tempted to revive the old theory of reflex neurosis. This allowed him to explain the “acquisition” of the neurosis by means of sexual habits, mainly masturbation.

The storeys of hysteria When Breuer and Freud embraced the psychological explanation of hysteria, the process of the psychologization of trauma had managed to reach its apex; the two men, however, failed to completely embrace the rising view that hysteria consisted merely of ideogenic, psychically determined symptoms. Hysteria, according to them, was not a “psychosis” but a “neuropsychosis” or “psycho-neurosis.” Despite the fact that Freud and Breuer indeed accepted the psychological concept of hysteria they were reluctant, as Pierre Janet (1893/1894) was, to fully embrace the many consequences stemming from the ongoing process of the psychologization of trauma as expressed in the works of Möbius and Strümpell. According to them hysteria was an “objective” malady grounded on the “nervous system.” In other words, hysterics were not just players in a comedy. In their preliminary communication of 1893, “On the psychical mechanism of hysterical phenomena,” Breuer and Freud not only claimed that hysterics suffered “mainly from reminiscences” (p. 6) but took pains to explain the obstruction caused by ideas (memories) as an increase in the sum of excitation of the nervous system which had failed to discharge.3 In the theoretical section of their report, Breuer likened the structure of hysteria to a “building of several storeys” in which it was necessary to “distinguish the plans of the different floors” and “the various kinds of complication in the causation of the symptoms.” Breuer added the following: If we disregard them and try to carry through an explanation of hysteria by employing a single causal nexus, we shall always find a very large residue of unexplained phenomena left over. It is just as though we tried to insert the different rooms of a many-storeyed house into the plan of a single storey. (p. 245) At the top of the building there stood the complex of ideogenic symptoms, while at the bottom rested the “abnormal excitability” of the nervous system. “The basis of hysteria,” he explained, “is an idiosyncrasy of the whole nervous system” with “the complex of ideogenic, psychically determined symptoms” being “erected on it as a building is on its foundations” (p. 244). The postulate of an abnormal excitability of the nervous system was necessary to explain how an idea might be converted into a somatic phenomenon. As Breuer pointed out in the same theoretical section, ideas (“mnemic images”) can never “attain the character of objective existence

54 Between body and psyche: the nerves which is the mark of hallucinations” without excitation of the perceptual apparatus (Breuer & Freud, 1895, p. 187). The most vivid and intense memory of a physical pain cannot produce an actual pain. Only an abnormal degree of excitability of the perceptual organ can change an idea of a sense perception into an actual perception. Since hallucinations of pain are often present in hysteria, the question was now: How was it that an apparatus concerned with sensations of pain could become abnormally excited? At the time of the Studies on Hysteria, the only answer to this question was still based on the old reflex theory. Given the fact that excitability could arise under the irradiation of peripheral stimuli – for instance, headaches arising from “insignificant changes in the nose” – and that “ovarian neuralgia” depended “on states of the genital apparatus” (p. 189), Breuer arrived at the conclusion “that the old ‘reflex theory’ . . . should not be completely rejected.” As he went on to explain, “I venture to put forward the highly unmodern heresy that even motor weakness in a leg may sometimes be determined by a genital affection, not psychically, but by direct reflex action” (p. 241). Published in early 1895, Studies on Hysteria still reveals the old reflex neurosis theory at work at the basement of the theoretical building of hysteria. As we recall, this was the very same theory which had enabled Romberg to define hysteria as a reflex neurosis originating from the genitals. This model would be radically modified by Freud in just a few years. Whereas Breuer embraced a multifactorial view of the etiology of the neuroses, Freud, starting in 1893, began to endorse the idea of a single factor, the sexual one. Freud’s approach had become, according to his own definition, “mono-ideistic.” In his view the causes of the “abnormal excitability” of the nervous system were sexual noxae, masturbation in particular (if practiced, it produced neurasthenia; if given up, it led to hysteria). Freud identified other factors, all tied to sexual life, to explain mental illness. He viewed the use of condoms and the interruption of coitus, for example, as contributing to mental illness. He also became convinced that masturbation was the specific cause of the lack of nervous energy (neurasthenia) and that unconsummated excitation was the cause of nervous anxiety. From this point of view, Freud was living within the conceptual space marked by the “great fear” of the morbid consequences of masturbation (Stengers & Van Neck, 1984). At the same time, and as Arnold Davidson (1987b, pp. 275–276) has pointed out, he turned a creeping anxiety into a conceptual mutation, providing a foundation for a new conceptual space. Davidson arrived at his conclusion in light of the phenomenon of perversion, but it applies to the notion of reflex neurosis as well.4 Freud embraced the reflex neurosis theory without much reservation in 1893. As we shall see, he managed to do so through a variant which had been elaborated by Wilhelm Fliess. Freud began to change the reflex theory into a psychological theory around 1895 (his “Project for a scientific psychology,” written then (Freud, 1895c), reveals his first attempts and

Between body and psyche: the nerves 55

Beitrage z u r Lehre

Geschleehts - U nterschieden. D r . P . J . M o b iu s in L e ip z ig . Heft 3 /4 .

O bcr d ie W irk u n g e n d e r C a stra tio n .

.

'w-df

rm

Dr. P. I, -Mofiius in Leipzig. ,

K..

i

.

> a- ■»

Alle R ech te vorbehaiten.

‘

r

d

’?■ ~k

Halfe a. £ S. V e r la g vom -C arl M arhold. 1903.

Figure 2.1 Front page of Paul Möbius’s (1903) book Über die Wirkungen der Castration [On the Effects of Castration].

failures with regard to this important shift). His effort to outline a theory of the psychic apparatus was once again picked up by him in the famous seventh chapter of his book on dreams, where Freud (1900) claimed that “Reflex processes remain the model of every psychical function” (p. 537). The model, however, was now a mere abstraction and served mainly to illustrate how the pleasure principle and wish fulfillment functioned.

The deracination of psychoanalysis from the medical context In Über die Wirkungen der Castration [On the Effects of Castration], published in 1903, Paul Möbius, the main proponent of the purely ideogenic approach to the symptoms of hysteria, remarked that, whereas the history of castration

56 Between body and psyche: the nerves as a social practice was very ancient, physicians only began to be interested in the effects of castration after 1870 (p. 24). According to him, research on the effects of castration was essential to the study of sexual differentiation and development. Freud (1905) would significantly list Möbius among the authors who had contributed to the modern view of sexuality in his Three Essays on the Theory of Sexuality (p. 135, footnote). But while Möbius (1903) stated in his work that “If before men were castrated often, while women exceptionally, now the castration of women is so frequent that the cases of busy operators are hundreds, while the castration of men is relatively rare” (p. 22), Freud avoided being explicit about this question. In contrast to Breuer, who, as we will later see, openly spoke against this practice, Freud’s voice is here strangely silent: neither in his public nor private writings can the founder of psychoanalysis be seen to offer any direct or explicit statement on the question. Yet, from the very beginning he opposed the genital localization of hysteria, i.e., the theoretical premise and justification for castration. In his “Report on my Studies in Paris and Berlin,” Freud (1886a) not only praised Charcot for having contradicted this widespread prejudice (p. 11) but, in his famous presentation held at the Medical Society in Vienna on October 15, 1896, he went on to claim that, according to Charcot’s modern views, no connection between hysteria and the genital organs existed (Jones, 1953, p. 252). In his 1888 article on “Hysteria,” Freud questioned “whether changes in the genitals really constitute so often the sources of stimulus for hysterical symptoms” (p. 55), and, noting that the part of the body affected by a trauma could become the locus of hysteria, warned his readers against those “surgeons, whose intervention in such conditions can do nothing but harm” (p. 50). Recalling this warning later, Freud would write in his Studies on Hysteria that “the expectation of a sexual neurosis being the basis of hysteria was fairly remote from [his] mind.” Fresh from his experiences with Charcot in Paris, he “regarded the linking of hysteria with the topic of sexuality as a sort of insult [Schimpf] – just as the women patients themselves do” (Breuer & Freud, 1895, pp. 259–260; italics added). Similarly, in his 1896 paper on “The aetiology of hysteria,” Freud wrote that Charcot and Breuer, the two investigators who had helped to open up his work on hysteria, had each had “a personal aversion” [Abneigung entgegen] to this idea “which he originally shared” (Freud, 1896c, p. 199; translation slightly modified). Freud failed to explain why linking hysteria with sexuality had been experienced by him as a sort of insult. The German term which Freud called upon (Schimpf) itself connotes the idea of a reproach: “schimpfen,” in German, means to scold and also implies blame, outrage, shame, and stigma. It should be noted, however, that Freud had added “just as the women patients themselves do.” This presents Freud identifying with stigmatized female patients, an identification which I would argue functioned to fuel his opposition to the medical establishment.

Between body and psyche: the nerves 57 My fundamental thesis (Bonomi, 1994a, 1994b) is that Freud encountered the reality of the circumcisions which many medical professionals performed on young girls during the course of his pediatric training and was profoundly and deeply impacted by it. We can surmise that it served to stir memories of his circumcision, and, further, that his abhorrence towards the sexual factor involved a reactive formation to his memories. Tellingly, the only place where Freud openly expressed his contempt for male circumcision was in “The Taboo of Virginity.” The horror of blood and cyclic bleedings, Freud noted in that essay, had not “been strong enough to suppress practices like the circumcision of boys and the still more cruel equivalent with girls (excision of the clitoris and labia minora)” (Freud, 1918b, p. 197). It is important for us to take stock of the fact that Freud’s description of female circumcision as being “more cruel” than male circumcision not only points to the overlapping of the two genders but suggests that the origin of his powerful aversion to circumcision had been powerfully conditioned by these cruel acts against young females. After his studies in Paris and Berlin, Freud opposed the gynecological treatment of hysteria and went on to embrace the teaching of Charcot, arguing, as he did in his famous presentation to the members of the Medical Society in Vienna on October 15, 1886, that there was no connection between the disease and the genital organs. Commenting on the fact that his innovations were being rejected by established and respected authorities in his field, Freud (1925a) wrote in his “An Autobiographical Study” that he then found himself “forced into the Opposition” (p. 16), making use of the very same wording which he had employed to describe his stigmatization as a Jew. While a student at the University of Vienna, Freud reported, he had somehow been expected to feel inferior to his nonJewish classmates because of his ethnic origins. As Freud (1925a) put it: I have never been able to see why I should feel ashamed of my descent or, as people were beginning to say, of my “race” . . . These first impressions at the University, however, had one consequence which was afterwards to prove important; for at an early age I was made familiar with the fate of being in the Opposition and of being put under the ban of the “compact majority.” (p. 9) The phrase “compact majority” was a citation by Freud from Ibsen’s play of 1882, An Enemy of the People. In it, the story of one man’s struggle to do the right thing and to speak the truth in the face of extreme social pressure and against the opinion of the masses is recounted. Freud (1926d) went on to use the same wording in his address to the B’nai B’rith, as he informed his brethren of the role that his identity as a Jew had played in his work (p. 272). The fact implicitly presents Freud equating the representation of the hysteric woman with his own condition and status as a circumcised Jew.

58 Between body and psyche: the nerves This condensation helped turn Freud’s endorsement of the sexual factor into a mission. I am using the term mission here in light of Erich Fromm’s contention that Freud’s mission was that of establishing a movement for the ethical liberation of man, a new secular movement based on science and meant for an elite few (Fromm, 1959). The movement was then to slowly help guide man into a new age. I am also suggesting here that the inner articulation of Freud’s mission grows more understandable if only we realize the close connection between Freud’s position against the castration of hysteric women and his rebellion against stigmatizing Jews. Myths, whether intrapsychic or shared by a group, typically render some contingent element, idea or event, absolute while also effacing its historical context. This holds true with regard to the foundation of psychoanalysis; the disappearance of the context from its narration has served to turn the Freud enterprise into a myth. One of Freud’s most startling claims was his contention that in the “sexual aetiology in the neuroses” he had engaged and taken up a “fight for a new and original idea” (Freud, 1914, pp. 12–13). The absurdity of this claim has been highlighted by Henry Ellenberger in his The Discovery of the Unconscious (1970) as well as by Frank Sulloway in Freud, Biologist of the Mind: Beyond the Psychoanalytic Legend (1979). Recently, Mikkel Borch-Jacobsen and Sonu Shamdasani (2012) have made another important contribution towards demythologizing the Freud myth. In their book The Freud Files: An Inquiry into the History of Psychoanalysis, the authors present a long list of the statements Freud made concerning the origins of psychoanalysis and proceed to offer evidence which serves to contradict Freud’s claims. For these authors, the disappearance of the founding context remains the main factor at work in the construction of the Freud myth. As they state: “Deracinated, psychoanalysis became a discipline apart, cordoned off and protected from the refutation of some of its founding presuppositions” (p. 23). Even though I agree with this dimension of their critique of Freud, I think that historians of psychoanalysis should not limit themselves to highlighting the edges of the cut (the “deracination”) but should strive to construct, restore, and render more intelligible the original context which provides the Freud enterprise with its meaning in the first place. The central assumption guiding my present work is that the medical practice of the castration of women and the circumcision of girls provides us with an important missing piece, one which allows us to restore and to better understand the historical context and soil upon which the complex texture of the foundation of psychoanalysis was built. Remarkably, this piece of the puzzle has been penned out by historians of psychoanalysis when pondering and reflecting on the origins of psychoanalysis. A crucial point, for me, is the fact that the pre-Freudian sexual etiology of the neuroses was closely associated with castration and, more generally, with stigma, reproach, and punishment. Freud, I wish to argue, managed to transmute all of this into something new. Its novelty consists, first and foremost, in

Between body and psyche: the nerves 59 a new way of handling the intrinsic connection between sexuality, guilt, and punishment. Viewed from this angle, Freud managed to introduce a break with traditional systems of dealing with this crucial knot (religion, education, and medical manipulation). In doing so, he managed to successfully establish an altogether new discipline, one which has forever changed human intellectual history and how humans view and conceive of themselves. How Freud succeeded in all this remains to be explored.

Notes 1 Freud’s last reference to this technique is found in a letter that he wrote to Fliess on June 12, 1895. In it, he refers to pressure on a spot of the mucous membrane in order to “elicit” and “remove” a nervous tic. 2 I have described and discussed the process of the psychologization of trauma in detail in previous publications (Bonomi, 2000, 2007). 3 The reference to the increase in the sum of excitation of the nervous system was omitted from the Preliminary communication, later published in the Studies on Hysteria. 4 Arnold Davidson proposed that the psychological change in the understanding of hysterical symptoms corresponded to the transition from the anatomicopathologic explanation of the abnormalities of sexual life to the psychiatric explanation of perversions, which occurred during the period between 1870 and 1905. This transition passed through three structural (chronologically blurred) stages: (1) genital localization; (2) cerebral localization; and (3) the purely functional concept of the sexual instinct. It resulted in a structural change of the meaning of “sexuality.” Sexuality, as Davidson convincingly argued, emerged as a basic category of human experience and a privileged object of psychological knowledge only thanks to it being divorced from “sex,” that is, from the genital organs (Davidson, 1987a, 1987b, 1990).

7KLVSDJHLQWHQWLRQDOO\OHIWEODQN

Part 2

Withstanding trauma

7KLVSDJHLQWHQWLRQDOO\OHIWEODQN

3

A gynecological scandal

Freud, Fliess, and the theory of the nasal reflex neurosis To Breuer and Freud the causal relation between the psychical trauma and the hysterical phenomenon had “an important practical interest.” The doctor’s ability to reawaken the memory and revive as vividly as possible the initial psychical process which had served to set the symptoms in motion, they argued, allowed for its disappearance. The spasms, the neuralgias, and the hallucinations “re-appear once again with the fullest intensity and then vanish for ever. Failures of function, such as paralyses and anaesthesias, vanish in the same way” (Breuer & Freud, 1895, pp. 6–7). This claim was, however, overly optimistic, for it was not easy to reconvert the bodily symptoms into memories. Moreover, the permanence of the cure was indeed overstated. Finally, a crucial limitation of the “talking cure” consisted in its being addressed only to symptoms and not to the deeper causes. Freud’s collaboration with Wilhelm Fliess aimed at filling this gap. While collaborating with Breuer in the practice of psychotherapy, Freud began to research the etiology of the neuroses with Fliess, a well-established physician and nose and throat specialist who lived in Berlin and who became, in these crucial years, the closest friend and interlocutor of Freud. In 1892, Freud’s initial step consisted in his assuming that the “abuse” (misuse) of the sexual function – typically masturbation – was always and in all cases the ultimate cause of neurasthenia. But the essential element of this collaboration was that Freud embraced the theory of the nasal reflex neurosis endorsed by Fliess. The nasal localization of the neurosis became so significant for Freud precisely because it not only provided an anchorage on the nervous system but also offered him an alternative to the genital localization which was associated with blame, outrage, shame, and stigma. The view that the reflexes irradiating from the nasal mucous membrane were a cause of neurosis was controversial but not new. Indeed, it was rather widespread in the 1880s, when many physicians and gynecologists endorsed the idea of a special connection between the sexual organs and the nose (cf. Sulloway, 1979; Moscucci, 1990; Shorter, 1992). The theory was first introduced by Friedrich Voltolini, a laryngologist from Breslau, who, in 1871, treated a case of asthma by removing nasal polyps. Arthur Hartmann,

64 A gynecological scandal of Berlin, had supposedly cured a case of epilepsy by performing nose surgery on the patient in 1882. In 1883, Moritz Rosenthal, a professor at the University of Vienna and a neuropathologist who attended Freud’s 1886 lecture on male hysteria, supposedly found a connection between a clogged nose and nervous irritation in the stomach (Freud referred to him in his May 29, 1884 letter to Martha). Prior to that, Rosenthal had recommended excision of the clitoris as an intervention which would help to stop bouts of hysterical vomiting. In the same year John Noland Mackenzie, a surgeon in Baltimore, formulated the theory of the mutual influence between the nose and the genitals, based on the similarity between the mucous membranes of the nose and the sexual organs. The sneezing orgasm, seen as the product of the excitation of nasal tissues, was often seen as a cause of acute rhinitis; similarly, excessive masturbation was seen at the time as the cause of chronic disturbances and, by reflex, of disorders in other parts of the body as well. Similar views were embraced in 1884 by Wilhelm Hack, a professor in Freiburg, and, in 1888, by Joseph Joal, in France, who supposedly alleviated the menstrual cramps of a woman by cauterizing the turbinate bone in her nose, thus “proving” the existence of reflexes between the organs and the ovaries. The idea of a correlation between nose and genitalia was in large part based on the romantic notion of “vicarious menstruation” (nosebleeds were a typical example of such vicarious menstruation), which remained dominant in late Victorian medicine. The idea of “menstrualia vicaria,” at the root of the notion of a bisexual disposition and based on the tradition of Galen, was rediscovered in the seventeenth century (Pomata, 1992). According to this view, men also experienced menstruation through nosebleeds. When the modern idea of a “nervous system” was introduced, this tradition was revived thanks to the reflex neurosis theory which flourished in the nineteenth century; it has continued to influence medical theory till today.1 In 1893 Wilhelm Fliess published a book entitled Neue Beiträge zur Klinik und Therapie der nasalen Reflexneurose [New Contributions to the Clinical Treatment of the Nasal Reflex Neurosis]. Fliess had been widely assisted by Freud in articulating his ideas on the relationship between the nose and the nervous system. Fliess’s theory not only stressed the sexual etiology of neurosis but also endorsed the “galvanokaustische Behandlund” [electric cauterization] of the nose as a treatment for neurasthenia. In the opening pages of his book, Fliess explained that he had only become interested in the matter recently and, further, that it had been suggested to him by a friend. The friend in question was Sigmund Freud who, in his dialogue and exchanges with Fliess, conceived the research on the etiology of the neuroses as a common project between them. Freud would later summarize his many years of collaboration with Fliess by saying that he had presented his friend with the formula of sexuality only to receive the formula of bisexuality in exchange (Masson, 1985, p. 4). At Easter 1893, Freud helped Fliess to prepare a paper on nasal reflex neurosis for a symposium. Freud thoroughly commented and offered

A gynecological scandal 65 feedback on the manuscript. Fliess attempted to argue that a number of symptoms might be eliminated by anesthetizing certain spots on the nose with cocaine. The causes of neuroses, he also argued, were the traditional sexual noxae, and especially masturbation.2 Fliess went further, however, claiming that the physician could diagnose the presence of masturbation in a patient by merely examining the anatomy of his or her nose. The practice was seen by him as a cause of nosebleeds in men and menstrual bleeding and pain in women. If the patient gave up the practice, he argued, it was possible to curtail the negative impact that the bad habit exercised on the patient’s nervous system. Fliess also endorsed treating the nose, in both men and women, directly with cocaine or local cauterization. In Die Beziehungen zwischen Nase und weiblichen Geschlecthsorganen [The Relationship Between the Nose and the Female Sexual Organs] Fliess (1897) gave full expression to the idea that the mucous membrane of the nose served as an intermediate link between the noxious stimuli (masturbation) and all other symptoms of neurasthenia (pp. 108–109). Traces of these ideas can be found being discussed by the two men in the complete edition of Freud’s letters to Fliess, as well as in the supplementary editorial notes found in the German edition of the text (unfortunately lacking in the English edition of the book). For instance, in April 1893, Freud drew a comparison with the work of Alexander Peyer,3 a Swiss urologist who, in 1889, invented a device which could be applied on the urethra to help stop nasal bleeding in chronic masturbators (cf. Shorter, 1992). In 1890, in the article “Über Magenaffektionen bei männlichen Genitalleiden” [“On stomach disturbances in male genital illnesses”], Peyer also advanced the following piece of wisdom: it was well known that certain pains in the stomach could be eliminated by gynecological operations. Peyer now found the same connection in men, and, on the basis of 300 case histories, arrived at the conclusion that nervous disturbances of the stomach originated, via reflex, from the male genital organs. Its main causes, he stipulated, were sexual abuse, masturbation, and coitus reservatus (the same noxae identified by Freud). The basis in anatomical pathology was seen by Peyer as the product of inflammation of the mucous membrane of the prostatic part of the urethra, or chronic urethritis. The result was a neurasthenia sexualis, a condition which was to be treated locally, on the genitals (Peyer, 1890, p. 3170, p. 3202ff). In his comments on the draft of Fliess’s paper on nasal reflex neurosis in April of 1893,4 Freud not only drew a comparison with Alexander’s Peyer’s work but rejected his solution because the “urethra postica” could itself have been “a reflex organ.” Peyer had treated the nasal bleeding of a chronic masturbator by acting upon his urethra. Fliess, however, had healed the same symptom by inserting a sound in the nose and clearing it. Evidently the identification between genitals and nose was not limited to the mucous membranes and bleeding, but included catarrh as well. The shift from the urethra to the nose elicited Freud’s enthusiasm, to the point of his encouraging Fliess to praise the advantages of the new

66 A gynecological scandal localization and to endorse the possibility of surgical treatment on the nose as a means of achieving a cure. The goal of the operation was to enlarge the corpora cavernosa by removing or reducing the turbinate bone. The many comments and suggestions offered by Freud were integrated by Fliess into the final version of his presentation.

A difficult case (Nina R.) In the spring of 1893, while contributing to the theory of the nasal localization of the neurosis, Freud met a number of difficulties during his treatment of Nina R. His patient, a 24-year-old woman who suffered intense pain in her left leg, presented a mixed clinical picture. She suffered from anorexia, as well as from hysteric and phobic symptoms, including anxiety, headaches, facial cramps, vaginal paresthesias, dysmenorrhea, and chronic leucorrhea. The case material was not published by Freud and was reconstructed by Albrecht Hirschmüller (1978b), who, following a suggestion by Ellenberger, found a file with its case history in the hospital where Nina R. had received treatment (he arrived just in time to save it from destruction!). The material in the file included a detailed self-description by the patient which was addressed, in 1889, to Professor Krafft-Ebing. It also included notes taken by Freud in 1891, when the patient had first entered treatment for a few months (treatment at that time consisted of “hydrotherapy, mineral water with arsenic, bromine salts, and hypnotic suggestion”). Finally, it also included the anamnesis written by Freud in 1893 as well as various other documents related to her case and treatment. This same patient was again treated by Freud for a short period of time in 1893; her conditions worsened and Freud asked Carl Fleischmann, the doctor who assisted in the birth of Freud’s children,5 to provide the patient with a gynecological examination. The gynecologist found an excrescence and a leucorrhea; since these factors appeared to be related to her anorexia, she underwent curettage in June of that year. Ten days later Freud and Breuer referred her to the Bellevue Sanatorium in Kreuzlingen. In her self-description report of 1889, the patient already associated her disgust with food to the pains she felt in her abdomen (according to Krafft-Ebing, these were caused by her left ovary). She also spoke of her compulsion to masturbate since early childhood and of her struggles to control the practice. In Freud’s anamnesis, written in 1893 for the doctors in Kreuzlingen, it was suggested that the patient’s symptoms had set in after she gave up masturbation, as often occurred with women. At the time, Freud distinguished hysteria and neurasthenia on the basis of masturbation: whereas neurasthenia was directly caused by masturbation, hysteria was seen as a consequence of ceasing the practice – caused, as it were, by the fact that the accumulation of the nervous excitation was no longer discharged through the orgasmic climax.

A gynecological scandal 67

Figure 3.1 Belle Vue resort (1892). (Courtesy of IMAGNO brandstätter images.)

The doctors at Bellevue diagnosed the patient in July 1893 as suffering from hysteria. The famed Sanatorium was founded by Ludwig Binswanger Senior who, after his death in 1880, was replaced by his son Robert. The institution enjoyed the reputation of being “one of the best and most modern private sanatoria for nerve and mood illnesses” in all Europe (Hirschmüller, 1978a, p. 152). Anna O., the patient who had helped to found the “talkingcure,” had been referred there by Joseph Breuer soon after he ended her treatment and her symptoms returned. Freud, too, referred many of his own patients in crisis to the facility. In June 1893 Freud also began to scientifically research (the only time he ever did) the relationship between reflexes and enuresis nocturna in children. The research was carried out at the children’s hospital, where Freud had been working since 1886, and focused on the hypertonia of the legs (the classic symptom of the irritation of the “genital nerve”). Freud apparently wanted to investigate the urethral localization of the neurosis suggested by Peyer and its possible relation with the classic pains in the legs. He wrote in fact a paper titled “Über ein Symptom, das häufig die Enuresis nocturna der Kinder begleitet” (On a symptom which often accompanies the enuresis nocturna of the child) which he sent to Fliess on November 27 (Freud, 1893b). The result of the research was that in half of the cases a strange reflex set in when the legs of the child were spread apart and suddenly released. In the

68 A gynecological scandal accompanying letter, Freud endorsed the idea that anxiety was “a physical consequence of sexual abuse” (in this context “abuse” meant misuse), an element that was never missing in “mixed neurosis,” that is, in real patients encountered in everyday clinical practice.

Breuer’s opinions on the subject of female castration In January of 1894 Freud wrote Robert Binswanger for information about the condition of Nina R. It seems that the vaginal catarrh reappeared and that Nina’s condition deteriorated. This led the doctors at the hospital to recommend castration. On March 12, 1894 Breuer replied that he did not consider the procedure legitimate. Despite the fact that vaginal catarrh was a cause of irritation and had to be cured, Breuer argued that it was unnecessary to remove the uterus and the ovaries to do so. After Binswanger replied, Breuer wrote again to the director of the institution on March 23, this time in order to explain, in a long and detailed letter, his point of view on castration. Breuer’s opinions on the subject of female castration were based on his personal experiences with patients. He was highly cautious about the procedure and viewed himself as a “heretic” with respect to the practice which, as Breuer noted in his report, had grown into an “epidemic.” Gersuny, a surgeon close to Breuer and Freud, had warned him against the abuse and dangers of female castration. He had performed surgery on many women and had observed, on multiple occasions, that they often triggered psychosis. In many others, the entire hysterical syndrome reappeared only a short while after the procedure was performed. Moreover, since the neurasthenic picture was prevailing over the hysterical symptoms, Breuer argued that he could not see any reason for the surgical procedure in such patients. Castration, he protested, was a “gynaecological scandal”! The dangers of such “epidemics” among surgeons were illustrated by Breuer with the following story. He had once found in a patient an ovary that was bigger than the other; since the ovary was associated with persisting pains, Krafft-Ebing recommended castration. When the patient was operated on, it was found that the bigger ovary had only cystic degeneration and no direct relationship whatsoever with the hysterical symptoms; the other ovary was in fact also affected by the same cystitis. Instead of accepting the lack of connection between the ovary and the presenting symptoms, the surgeon decided to remove the second ovary as well, apparently in order to respond ahead of time to the possible objection that a lack of success might have been due to the incompleteness of the operation. Breuer tried to stop the surgeon and to save at least one of the patient’s ovaries during the procedure. The “professional conscientiousness” of the other physician, however, prevailed. This kind of medical reasoning was paradigmatic of the medical establishment at the time: if a doctor opposed the castration of a female patient,

A gynecological scandal 69 he risked being blamed and charged with not being conscientious enough. In a period when the removal of ovaries was so fashionable that it grew into an “epidemic,” and despite the fact that the consequences for the patient were devastating, it was dangerous for doctors to deviate from accepted and standard procedures. Breuer, a man of high ethical standards, decided to terminate his apology against castration, adding that, if Binswanger insisted, he was ready to leave the question up to Hegar, the famous gynecologist who invented the technique used to remove the ovaries. Breuer, however, was apparently not content with stepping back from the affair, as evidenced by a personal parapraxis: he “forgot” to mail the letter which he then found in a drawer only a few days later! This time the “scandalous letter” was finally mailed. Here, then, is the rest of the story: a few months later, probably after another relapse, Hegar was asked by Binswanger to visit the patient. On September 4, 1894, he answered that he was “inclined to admit the patient, also when the prospect of a healing only by the treatment of the genital disturbance would not be expected. [The genital disturbance] appears to be so important that it would be difficult to reach the goal [of healing] without its elimination or at least its partial relief through other means.”6 Nina R. was transferred from Bellevue to the clinic directed by Hegar in Freiburg in October 1894. He immediately performed a gynecological examination as well as curettage under anesthesia. Since tuberculosis came to the foreground, however, the expected castration failed to take place because the tuberculosis had to be treated first. The record stops here and we do not know whether Nina R. recovered from tuberculosis and if she was castrated following her recovery. The story, however, was not completely over, since Nina R. had a younger brother who suffered from neurosis. He was sent to Wilhelm Fliess to undergo an operation on his nose in July of 1895. Freud and Fliess discussed his case history in their correspondence in mid-July of that year. It was only a few days later that Freud experienced his dream of Irma’s injection, which provided multiple references to the relationship between the nose and the human sexual organs.

Libido and anxiety Between 1892 and 1895 Freud developed the concept of “psychic mechanism” into a theory of the psychological processes involved in the formation of hysteric and phobic symptoms; moreover, he achieved an uncommon capacity to work his way through the clinical material, at least judging by the case histories that he published in the Studies on Hysteria (Breuer & Freud, 1895). Yet, he also became more and more pessimistic with regard to psychic treatment. He also isolated a clinical picture which corresponded to panic attack, considering it as something that could not be dealt with by psychological analysis.7

70 A gynecological scandal In 1894 Freud went through a long period of depression, which sometimes was accompanied by cardiac symptoms and panic attacks. Freud’s psychosomatic state, which included dyspnea, a stuffed nose, and frequent migraine headaches, was described by him as follows in a letter that he wrote to Fliess on April 19, 1894: The most violent arrhythmia, constant tension, pressure, burning in the heart region; shooting pains down my left arm; some dyspnea, all of it essentially in attacks extending continuously over two-thirds of the day; the dyspnea is so moderate that one suspects something organic; and with it a feeling of depression, which took the form of visions of death and departure in place of the usual frenzy of activity. The organic discomforts have lessened during the past two days; the lypemanic mood persists, having the courtesy, though, to let up suddenly (as it did last night and at noon today) and leave behind a human being who looks forward with confidence again to a long life and undiminished pleasure in resuming the battle. The attempt to understand these attacks supported his speculations on anxiety neurosis. In his draft How Anxiety Originates, of June 6, 1894, Freud came to the conclusion that the accumulated physical sexual tension was transformed into anxiety: dyspnea and palpitations, both subsidiary paths of the coitus, served then “as the only outlets for the excitation” (Masson, 1985, p. 81). Whereas in hysteria a psychical excitation passes into the somatic field, here we have the deflection of somatic sexual excitation from the psychical field. The two situations, Freud concluded, were “combined extremely often” (p. 82). In contrast with the psychic mechanism of obsession, which is based on the substitution of a mnemic and ideational content, Freud now found that in phobias “substitution is no longer the predominant feature . . . psychological analysis reveals no incompatible, replaced idea in them” (Freud, 1894b, p. 80). Anxiety, in this case, “is not derived from any memory” (p. 81) and is solely depended on the accumulation of sexual tension. Initially Freud traced back phobias to the “strangulated affect” which is produced by distressing events. Within the abreaction model, discovering the traumatic event and liberating the associated affect lead to the resolution of the phobia. Between 1894 and 1895, Freud reconsidered the question and listed phobias, or at least a great number of them, in the “actual neuroses.” In a footnote to The Neuro-Psychoses of Defense, Freud (1894a) asserted that: The group of typical phobias, of which agoraphobia is a model, cannot be traced back to the psychical mechanism described above; on the contrary, the mechanism of agoraphobia differs from that of obsessions proper, and of the phobias that are reducible to them, in one

A gynecological scandal 71 decisive point. There is no repressed idea from which the anxiety affect might have been separated off. The anxiety of these phobias has another origin. (p. 57)8 The theory of the somatic origin of anxiety was further developed by Freud in his paper “On the grounds for detaching a particular syndrome from neurasthenia under the description ‘anxiety neurosis’” (Freud, 1894c). Freud’s central thesis in that work was that the affect of anxiety did not originate in a repressed idea, and was “not further reducible by psychological analysis, nor amenable to psychotherapy” (Freud, 1894c, p. 97; italics added). Freud considered it the “somatic counterpart to hysteria” (p. 14), that is, the somatic basis of the paresthesias, hyperesthesias, and pains typical of hysteria. The clinical picture drafted by Freud corresponded to the current, modern-day psychiatric formulations of “panic disorder.”9 The article on anxiety neurosis was published in January 1895 and was critically reviewed by Leopold Löwenfeld. According to the German psychiatrist, anxiety was a derivative of fright, the psychological fear of something, and appeared immediately or shortly after a psychical shock. In his “A reply to criticisms of my paper on anxiety neurosis,” Freud (1895a) admitted that in phobias “anxiety is linked to a definite ideational or perceptual content” just as sexual tension is produced by the arousal of libidinal ideas (p. 133). Freud, however, felt that this was not the case when anxiety attacks took “the form of vertigo, palpitation, dyspnoea, trembling, sweating, and so on.” This type of anxiety was in his view generated by an “excitatory sexual process . . . which, after the lapse of a definite and often constant interval of time, is followed by the anxiety attack. This [excitatory] role is played, in abstinent women, by menstrual excitation” (p. 132). Freud’s reply to Löwenfeld was written in May and published two months later, in July. It was shortly thereafter – on July 24, 1895 – that Freud dreamt his famous dream of Irma’s injection, a dream that marks the beginnings of psychoanalysis, and in which there appears the chemical formula of this excitatory sexual process, printed in bold heavy type. Here is the dream, as it was reported, four years later, in The Interpretation of Dreams (Freud, 1900): A large hall – numerous guests, whom we were receiving. – Among them was Irma. I at once took her on one side, as though to answer her letter and to reproach her for not having accepted my “solution” yet. I said to her: “If you still get pains, it’s really only your fault.” She replied: “If you only knew what pains I’ve got now in my throat and stomach and abdomen – it’s choking me” – I was alarmed and looked at her. She looked pale and puffy. I thought to myself that after all I must be missing some organic trouble. I took her to the window and looked down her throat, and she showed signs of recalcitrance, like women with artificial dentures. I thought to myself that there was really no need for her to do

72 A gynecological scandal that. – She then opened her mouth properly and on the right I found a big white patch; at another place I saw extensive whitish grey scabs upon some remarkable curly structures which were evidently modelled on the turbinal bones of the nose. – I at once called in Dr. M., and he repeated the examination and confirmed it. . . . Dr. M. looked quite different from usual; he was very pale, he walked with a limp and his chin was clean-shaven . . . My friend Otto was now standing beside her as well, and my friend Leopold was percussing her through her bodice and saying: “She has a dull area low down on the left.” He also indicated that a portion of the skin on the left shoulder was infiltrated. (I noticed this, just as he did, in spite of her dress.) . . . M. said: “There’s no doubt it’s an infection, but no matter; dysentery will supervene and the toxin will be eliminated.” . . . We were directly aware, too, of the origin of the infection. Not long before, when she was feeling unwell, my friend Otto had given her an injection of a preparation of propyl, propyls . . . propionic acid . . . trimethylamin (and I saw before me the formula for this printed in heavy type) . . . Injections of that sort ought not to be made so thoughtlessly. . . . And probably the syringe had not been clean. (p. 107) Freud was deeply struck by the vividness of the formula which appeared to him through his dream. The chemical substance was trimethylamin, a substance related to female sexual metabolism. Analyzing the dream, Freud (1900) indicated that the formula involved an allusion “to the immensely powerful factor of sexuality” (p. 116). Freud reported that the chemical formula also alluded to a friend who “had a special knowledge of the consequences of affections of the nose and its accessory cavities,” describing the friend as a man who had “drawn scientific attention to some very remarkable connections between the turbinal bones and the female organs of sex” (p. 116). Freud was of course referring to Wilhelm Fliess. According to Anzieu (1986a, p. 141), Freud’s dream of Irma’s injection stood as a reenactment of “another medical scene, one which took place just a few months earlier, in February, when Fliess visited Vienna,” namely, the surgical operation, by Fliess, on Emma Eckstein’s nose.

Freud and Hegar Emma Eckstein became Freud’s patient towards the end of 1894. Since Freud and Fliess agreed that Emma should undergo surgery on her nose, she was undoubtedly also examined by Fliess, her surgeon. Her nasal operation occurred in Vienna, on or about February 23, 1895. According to Masson (1984), her surgery ultimately involved an effort to cure the patient of the somatic consequences of her habitual masturbation. This fits in with what we’ve learned about the theory of the nasal reflex neurosis. We should

A gynecological scandal 73 not, however, underrate the fact that Freud made his decision to allow Fliess to operate on Emma during a period of growing pessimism about what psychotherapy was able to achieve. The theory of the somatic origin of anxiety, the revision of the theory of phobias, the belief that in many situations the affect of anxiety was “not further reducible by psychological analysis, nor amenable to psychotherapy” (Freud, 1894c, p. 97), created an atmosphere which facilitated the decision to intervene surgically on a patient who was being treated through talk therapy. When Freud arrived at his decision to have Fliess operate on Emma, he felt mostly pessimistic and was depressed about the possible therapeutic effects of psychical treatment. There is also another factor to be taken into account. Freud likely resented the fact that, in October 1894, his former patient, Nina R., was transferred to the gynecological clinic directed by Alfred Hegar. This led Freud to a close confrontation with the ideas and theory of the famous gynecologist. For sure he read and reviewed his last book, on The Sexual Instinct, and, probably, he re-read Hegar’s main work, Der Zusammenhang der Geschlechtskrankheiten mit nervösen Leiden und die Castration bei Neurosen [The Relationship of Sexual Illness to Nervous Diseases and Castration in Neuroses], which was published in 1885. The practice of removing the ovaries for psychiatric reasons began to spread in earnest only after the publication of this study. The only scholar who has apparently consulted Freud’s personal copy of Hegar’s study – found at the Sigmund Freud Memorial Collection at New York State Psychiatric Institute Library, it is today accessible to everyone – is Stephen Kern, who found numerous marginal notations in the text. To quote Kern (1975, p. 314, fn.): Freud underlined Hegar’s statement that there has been very little work on the effect of ovulation on the rest of the body (p. 4). Freud put question marks beside the following propositions: that a calm temperament is produced by castration (p. 5), that nervous illness causes functional disturbances of the genital apparatus (p. 49), and that castration will remove neurotic symptoms which are manifested in sexual pathology (p. 56). According to Kern, Freud read Hegar’s book on castration “when he was most actively pursuing Fliess’s theories about sexual substances” (p. 314). Given that there is no reason for us to assume that Freud had not been well acquainted with this milestone in the treatment of hysteria since 1885–1886, we can surmise that Freud consulted Hegar’s book again in October of 1894, when Nina R. was transferred from Kreuzlingen to the gynecological clinic run by Hegar; or perhaps just before, on the occasion of the “gynaecological scandal” lamented by Breuer. Freud might have also turned to the text when Nina R. was first hospitalized, a period when Freud was busy elaborating the theory of the somatic origins of anxiety.

74 A gynecological scandal There is clear evidence to support the fact that Freud read Hegar when he pondered and decided to refer Emma to Fliess for nasal surgery. A review of Hegar’s 1894 book Der Geschlechtstrieb [The Sexual Instinct] was published in the Wiener klinische Rundschau on February 3 of 1895; it was written by Sigmund Freud (Freud, 1985b). Despite the fact that Hegar’s book was dull and insignificant and that Freud seldom took time to read such texts, Freud not only read the text carefully but also decided to write a review of it, no doubt owing to his interest in the views of the highest authority on female castration. In his review Freud remarkably made use of the very same witticism found in his analysis of the Irma dream, a witticism in which Freud (1900) expressed “derision at physicians who are ignorant of hysteria” (p. 114). Commenting on Hegar’s low estimation of the sexual instinct, Freud remarked that, in the copy of the text which he had purchased, he came across a marginal gloss, written by a previous reader of Hegar’s text. The note, found in the section where Hegar reflected on the notion of free love, read: “Mr. Hegar simply forgets – the sexual instinct” (Freud, 1895b). Freud, for his part, would not forget “the immensely powerful factor of sexuality” in his Irma dream. Indeed, there is an even closer connection between Hegar’s method (the castration of women), Fliess’s method (the operation on the nose), and the Irma dream at work. Freud’s derision, directed at physicians who were ignorant of hysteria, has usually been interpreted by scholars as involving an act of aggression against Josef Breuer. While Breuer was initially critical of Fliess’s nasal localization theory, something that contributed, in 1894, to an estrangement and tensions between Freud and his older colleague, the record supports that Breuer, during the initial months of 1895, had actually referred several female patients to Fliess in Berlin for him to operate on their nose; among them was Breuer’s 13-year-old daughter Dora (Hirschmüller, 1986). On May 25, 1895, three months after the Emma incident, Freud wrote Fliess to say: Breuer . . . is not recognizable. . . . He has accepted the whole of your nose [theory] and is promoting enormous reputation for you in Vienna, just as he has become fully converted to my theory of sexuality. He is indeed an entirely different fellow from the one we were accustomed to. In July of the same year Breuer also referred Nina R.’s younger brother to Fliess for nose surgery. Fliess wrote Freud requesting information and advice about the young man and his family. Freud answered him on July 13, just ten days before dreaming his Irma dream. All of this suggests that Freud’s trust and confidence in Fliess and his controversial nasal theories were not shaken. Freud, the record suggests, still felt completely confident in Fliess and his friend’s talents as surgeon and “healer” in the summer of 1895. Freud’s reply to Fliess also suggests that, in connection with the series of successful operations on boys and girls, the memory of the castration

A gynecological scandal 75 recommended by Hegar had been reawakened. The opening scene in the Irma dream is staged in the summer resort in the outskirts of Vienna where Freud had traveled for a summer vacation with his family. The dream, as we know, opens with a birthday celebration. Martha, Freud’s wife, was due to turn 34 years old in a few days, on July 26. The name of the resort where Freud dreamt his dream as the night of July 23 gave way to the morning of the 24th was Belle Vue. This, however, was also the name of the sanatorium in Kreuzlingen where Nina R. had been advised to undergo a castration the previous year, a place where Breuer and Freud referred some of their patients for hospitalization and intensive treatment. Bellevue as such simultaneously served to refer Freud to the reception hall of a birthday celebration as well as the name of the hospital where he referred his patients in crisis for intensive treatment and examination. All these facts prefigured and helped to shape the various double scenes found circulating within the text of Freud’s complex and important dream. It is also the premise for the peculiar visual character of the series of dreams which Freud dreamt and analyzed in The Interpretation of Dreams, a series which attests to a progressive effort on his part to visualize something which was first announced when he opened up and looked down to examine Irma’s mouth. As Anzieu (1986b) has indicated, the “beautiful view [belle vue]” was “the point of departure” for Freud’s self-analysis (p. 219).

Premonitions Before turning to the incident, we have to take stock of two other elements. The first is cocaine. Freud considered the applications of cocaine a cure for his stuffed and swelled nose, which was also treated by Fliess with electric cauterization. Just a decade earlier Freud had been a regular consumer of cocaine and, in early 1895, had resolved to ingest cocaine nasally “which one should not really do,” as he noted in a letter to Fliess on January 24 of that year. The positive effect was immediate: “In the last few days,” wrote Freud, “I have felt quite unbelievably well, as though everything had been erased – a feeling which in spite of better times I have not known for ten months.” The feeling of well-being did not last long, however. Fliess’s visit to Vienna in February 1895 was also connected with cocaine. He had arranged a series of demonstrations in Chroback’s gynecological clinic in Vienna to show that it was possible to eliminate, or at least diminish, labor pains during birth by using cocaine on the lower turbinate bone and the so-called tubercola septi of the nose.10 On that occasion, Fliess also inserted a drill in the nose of Freud, or performed some other surgical maneuver. His surgical intervention on Freud’s nose was followed by purulent secretions. Then, just before returning back to Berlin, Fliess operated on Emma Eckstein’s nose. The second element to be taken into account is paranoia. In January 1895, besides reviewing Hegar’s book, Freud formulated his theory of

76 A gynecological scandal paranoia (Draft H).11 As he would later clarify: “The determining element of paranoia is the mechanism of projection involving the refusal of belief in the self-reproach” (Masson, 1985, p. 168). The phenomenon of paranoia provides us with an important bridge for grasping Freud’s understanding of the unconscious. In everyday life we are accustomed to our internal states being betrayed to other people by the expression of our emotions; however, if we are not in contact with our own thoughts and emotions, because direct access to the internal states is somehow hindered, then paranoia, with its overvaluation of what people might know about us, appears. Freud concluded that paranoia involved an abuse of the mechanism of projection for the purpose of defending the ego from something that we cannot admit to ourselves (Masson, 1985, pp. 109–112). Freud produced his theories on this subject at a time when he found himself troubled by Fliess’s medical recommendation and treatment suggestions. Most probably, Freud was not in touch with his thoughts and feelings on the matter then, as indicated by the fact that he had resumed the habit of using cocaine through nasal ingestion. There is another element which leads us to further ponder the matter. Shifting from paranoia to obsessive ideas, Freud associated gynecological treatments with a love affair. Discussing the general mechanism of substitution, he remarked that, in cases when an old maid kept a dog or an old bachelor collected snuffboxes, the former is finding a substitute for her need for a companion in marriage and the latter for his need for – a multitude of conquests. Every collector is a substitute for a Don Giovanni Tenorio, and so too is the mountaineer, the sportsman, and such people. These are erotic equivalents. Women know them too. Gynecological treatment falls into this category. There are two kinds of women patients: one kind who are as loyal to their doctor as to their husband, and the other kind who change their doctors as often as their lovers. (Masson, 1985, p. 110) It is unusual, if not rare, to find Freud explicitly referring to gynecological treatment.12 The fact that the latter included massages and electric stimulation renders its link to a love affair perfectly understandable. Yet, they also included curettage (like the one performed on Nina R.) as well as castration. What seems particularly striking, and in my view dissociated, is that this type of treatment was being fantasized by Freud as an erotic equivalent as he contemplated and endorsed the plan of allowing Emma to undergo surgery on the “genital spot” on her nose by Fliess. Even more revealing is perhaps the fact that all of these themes would serve to form the essential plot of Freud’s Irma dream. Freud’s reflections on paranoia, substitutions, and gynecological treatments are all found, in their essential form, in a draft which Freud enclosed

A gynecological scandal 77 in a communication which he wrote and sent to Fliess on January 24, 1895 (Draft H). In his letter, Freud wrote to say: Now only one more week separates us from the operation or at least from the preparations for it. The time has passed quickly, and I gladly avoid putting myself through a self-examination to ascertain what right I have to expect so much from it. My lack of medical knowledge once again weighs heavily on me. But I keep repeating to myself: so far as I have some insight into the matter, the cure must be achievable by this route. I would not have dared to invent this plan of treatment on my own, but I confidently join you in it. The passage presents Freud either referring to his own operation or, perhaps more likely, to Emma’s pending nasal surgery; it is as though the same undue expectations, doubts, and premonitions applied to both Freud and Emma. Our inability to distinguish between doctor and patient would continue on in the letters which Freud wrote to Fliess during the month of March. Those letters not only present Freud reporting to Fliess on Emma’s bleedings but also on Freud’s own condition and “case history.” Freud’s communications to Fliess as such serve to anticipate one of the central themes found in his Irma dream, namely, the mimesis between doctor and patient. Freud’s epistles to Fliess at the time also serve to announce the collapse of every difference – between male and female, doctor and patient, subject and object, me and you, inner and outer, fantasy and reality. Freud’s discovery of the Unconscious as a system would emerge from it, as would his effort to disentangle himself from this symmetrical world by restoring his masculine and professional status and emotionally detaching and withdrawing from Fliess. Freud’s effort was in large measure successful as a result of a long and demanding period of self-analysis. What was restored through it in time led Freud to found an altogether new system of thinking, one based on a single difference: castration or “having the phallus.” The idea of castration, which prior to the Emma incident had been closely related to a precise medical practice, would be uprooted by Freud from the fin de siècle treatment of hysteria. It was then elevated to a transcendental rule – one beyond time, history, and culture.

The incident Emma Eckstein’s nose was operated on on February 22 or 23, 1895. The operation was probably aimed at enlarging the corpora cavernosa by removing the turbinate bone. Emma’s condition worsened in the days following her operation. She began to experience pains, persistent swelling, and purulent secretion. She soon began to hemorrhage. Since Fliess was no longer in Vienna, Freud was forced to call on another surgeon, Robert Gersuny,

78 A gynecological scandal the same doctor who had warned Breuer against the practice of castration. Gersuny inserted a drainage tube; the patient, however, failed to improve. This led Freud to call yet another specialist, Ignaz Rosanes, who intervened surgically on the patient on March 6. Rosanes, much to his surprise, found a long piece of iodoform gauze which Fliess had left inside Emma’s nasal cavity during surgery. The patient began to experience massive bleeding as Rosanes removed the foreign body and nearly bled to death when the doctor removed the long piece of gauze which Fliess had carelessly left behind. Freud was overwhelmed with emotions and waited two days, until March 8, to write and inform Fliess of what had happened with Emma: the fetid odor was very bad. . . . The next moment came a flood of blood. The patient turned white, her eyes bulged, and she had no pulse . . . In the meantime – that is, afterward – something else happened. At the moment the foreign body came out and everything became clear to me – and I immediately afterward was confronted by the sight of the patient – I felt sick . . . She had not lost consciousness during the massive hemorrhage; when I returned to the room somewhat shaky, she greeted me with the condescending remark, “So this is the strong sex.” I do not believe it was the blood that overwhelmed me – at that moment strong emotions were welling up in me. So we had done her an injustice. A number of recurrent elements can be found in the letters which Freud wrote to Fliess just after the Emma incident. Expecting that the operation would be a harmless procedure, Freud found himself upset with Emma’s paleness, the fetid odor, and the patient’s persistent bleeding. He soon began to give up all hope for the poor girl and also felt guilt-ridden that they had done Emma “an injustice.” Freud seems to have been particularly bothered by his realization that his intention to do his “best for this poor girl was insidiously thwarted and resulted in endangering her life.” In the months which followed the unpleasant incident, Freud would repeatedly come to examine the cavity of his patient’s mouth and nose; a similar scene was of course enacted in the specimen dream a few months later, in July of 1895, when Freud found himself peering down and examining Irma’s throat and grew scared by what he saw. The conjunction between the two scenes led Schur (1966), and Masson (1984) after him, to conclude that the Irma in Freud’s dream was undoubtedly none other than Emma Eckstein.

Emma Eckstein’s interminable analysis We don’t know much about Emma Eckstein, yet what we know of her is sufficient to acknowledge her as one of the patients who most influenced Freud during the crucial period when he labored to establish and found psychoanalysis. According to Appignanesi and Forrester (1992), Emma was

A gynecological scandal 79 the chief patient who led Freud to formulate his wish-fulfillment theory of the psyche, the patient who played a part “at each of the stages of development” of his theory (p. 133). Emma (1865–1924) was born in Vienna to a well-known bourgeois family. Her father had invented a process for manufacturing parchment and thereby established the family fortune. He died in 1881 after a chronic and debilitating neurosyphilis (Lynn, 1997). Two of her siblings were associated with the socialist party and she herself was active in the Viennese women’s movement.13 She suffered from severe pain in her legs when standing or walking, symptoms which appeared to be of a hysterical nature. Her treatment with Freud lasted about three years and was one of the most protracted of Freud’s early cases, second only to his treatment of “Mr. E” (Oscar Fellner), which lasted from 1895 to 1900 (Davis, 1990). During this period Emma became friendly with Freud and with members of his family, especially Martha’s sister, Minna Bernays, who had been living with the Freud family since 1896. Freud was also acquainted with one of Emma’s brothers and mentions him in the first edition of The Psychopathology of Everyday Life (Freud, 1901b), and, anonymously, in later editions as well. The material where Emma’s brother is mentioned concerns Freud’s treatment of forgetting names. Material related to Emma’s brother is also treated by Freud in the second chapter of his text, which treats “the forgetting of foreign words.” All of this helps reveal not only the close relationship between the Freud and Eckstein families but Freud’s tendency to identify with Emma as well.14 Emma Eckstein ended her treatment with Freud before the end of 1897 and apparently began to treat and attend patients herself using Freud’s treatment techniques soon after. This fact technically made her the first analyst Freud ever trained. Freud was proud of Emma and, on December 12, wrote Wilhelm Fliess to say that she had been “doing very well.” Emma Eckstein wrote a two-page article on education in 1899 which appeared in a socialist magazine, and, in 1904, published a 38-page pamphlet entitled Die Sexualfrage in der Erziehung des Kindes [The Question of Sexuality in the Raising of Children]; the piece was mainly devoted to the dangers of masturbation in childhood. Drawing from her personal history and from the stories of her patients, Emma described how daydreams invaded the life of young girls and went on to stress the need to combat the solitary vice by establishing an alliance with the healthy part of the child. Following Freud’s teaching, she viewed masturbation as a substitute for withdrawn love. During that period she often borrowed books from Freud’s library, among them the well-known treatise on masturbation by Rohlender as well as Havelock Ellis’s book on the sexual instincts. In his open letter “The sexual enlightenment of children,” Freud (1907) quoted from Emma Eckstein’s 1904 pamphlet in approving fashion (p. 137). In the Library of Congress in Washington there is a file containing 14 letters, which Freud and Emma exchanged (cf. Masson, 1985); these letters

80 A gynecological scandal reveal that their relationship became stormy in 1905 and that Freud at that time refused to take Emma back into treatment. The last of these 14 letters was written by Freud in 1906 and was prompted by a dream he had about her. Emma began a second analysis with Freud three years later, in 1909–1910, in the period when Freud had in analysis her nephew Albert Hirst (1887–1974). This time the analysis was less successful than the previous one. Indeed, it was abruptly interrupted and Emma went on to spend much of the rest of her life bedridden or resting on a couch. She died in 1924, at the age of 59, of a cerebral hemorrhage. This part of Emma’s story was briefly narrated by Freud in 1937, in “Analysis terminable and interminable,” where Emma’s name is not revealed. The coincidences are so striking, however, that it is patently obvious that Freud, as Masson correctly inferred, could only have been referring to Emma Eckstein. In “Analysis terminable and interminable,” Freud noted that Emma’s “second illness may have sprung from the same source as her first one which had been successfully overcome: it may have been a different manifestation of the same repressed impulses, which the analysis had only incompletely resolved.” A subject’s inability to walk was viewed by Freud as a sign of genital neurosis. Freud indicates that the severe pains in Emma’s legs “had defied many kinds of treatment.” He unfortunately failed to specify which types and whether Emma had been provided with gynecological treatments as well. The reasons why Emma was operated on her nose in February of 1895 are still not fully known. According to Fliess and Freud, menstrual pain was often a functional symptom caused by masturbation and was to be treated by removing the turbinate bone (Fliess, 1897). This led Masson (1984) to conclude that, in the case of Emma, the operation on her nose ultimately involved an attempt to cure the somatic consequences of her masturbation.

Transference and counter transference According to Appignanesi and Forrester (1992), Emma was the main instigator of the wish-fulfillment theory, which materialized precisely during the period when Freud was treating her. In the section in the Studies on Hysteria devoted to the technique of psychotherapy, Freud explained the patient’s transference to the physician with the example of a female patient of his who suddenly wished that Freud would kiss her: In one of my patients the origin of a particular hysterical symptom lay in a wish, which she had had many years earlier and had at once relegated to the unconscious, that the man she was talking to at the time might boldly take the initiative and give her a kiss. On one occasion, at the end of a session, a similar wish came up in her about me. She was horrified at it, spent a sleepless night, and at the next session, though she did not refuse to be treated, was quite useless for work. After I had discovered the obstacle and removed it, the work proceeded further;

A gynecological scandal 81 and lo and behold! the wish that had so much frightened the patient made its appearance as the next of her pathogenic recollections and the one which was demanded by the immediate logical context. (Breuer & Freud, 1895, pp. 202–203) Freud wrote this material in early 1895. According to Appignanesi and Forrester, the patient in question was none other than Emma Eckstein, and the way in which Freud dealt with this delicate situation was, in their view, paradigmatic of the style necessary to neutralize the participation of the analyst in the analytic situation and to allow a patient’s “wish” to emerge as a solipsistic entity: The aplomb with which Freud dealt with such a desire on the part of a patient . . . was secured by regarding the mental image of Dr Freud kissing his patient as quite definitively the patient’s affair. This image had nothing to do with him; this image was strictly a consequence of the patient’s wish. If Freud hadn’t been quite clear that the patient was wishing this, and that is why she imagined the man taking the initiative and kissing her, then he would have found himself implicated in the kissing scene. In other words, being clear that the patient was wishing this, allowed him to be sure it was the patient, not the analyst, who produced the transference phenomenon. Hence the recognition of the transference required that Freud perceive that an important section of the “ideas” that hysterics repressed were wishes rather than any other sort of mental acts . . . The concept of transference and wish formed a couple, an interdependent pair of concepts: it is implausible to think that one could have one without the other. The crucial importance of the concept of wish-fulfillment in Freud’s thought is derived from the concept of transference and the daily practice of dealing with it, more than the abstract demand of his theoretical schema. What we do see in the early months of 1895 is the emergence of the concept of wish: in the context of Emma’s dream psychosis, then of simple wish-fulfilling dreams, of transference wishes in which Freud was implicated by Emma and other patients in imagined erotic scenes, and then, in the summer of that year, in the general thesis that dreams are wish-fulfillments, and the general theory that the operations of the mind are only ever set in motion because of wishful states. Emma herself supplied him with the clinical material to back up this account. (Appignanesi and Forrester, 1992, pp. 135–136) These comments are indeed correct and on target. I am also inclined to think that the man in the original kissing scene, re-enacted by Emma during her treatment with Freud, was her father Albert, who died in 1881, the year Emma turned 16 years of age. What we see in the early months of 1895 is not only the emergence of the concept of wish but also Freud’s

82 A gynecological scandal being overwhelmed by emotions during the chaotic scene of Emma’s massive hemorrhage. More generally, the degree to which Freud was involved in Emma’s treatment in many ways challenges the solipsistic notion of transference. The Irma dream too, I would claim, successfully challenges many aspects of the simple formula that dreams are wish-fulfillments. In his 1984 article “Freud’s Irma dream and the origins of psychoanalysis,” Ronald Langs came to the conclusion that the central theme of Freud’s paradigm dream was “Freud’s own unconscious awareness of his counter-transferences (pathology) in his relationship with Irma and his other patients – a topic that Freud did not specifically introduce until 1910” (p. 606). I continue to quote the author: Freud seems to be struggling intensely with the unconscious idea that there is something sick or destructive about the psychoanalytic process and the manner in which it provides patients with symptom alleviation. This latter theme is greatly accentuated by the final element of the dream which alludes to a therapeutic injection from a dirty syringe. It is here that some of the unconscious and unresolved sexual implications of the psychoanalytic procedure – an instinctualized representation of its penetrating qualities – are represented in thinly disguised form. To the last, Freud represents medical procedures as harmful to patients and methods of cure as the cause of their illness. (pp. 606–607) Freud’s concern with possibly doing harm to his patients appears to be particularly represented through the trimethylamin chemical formula found beating at the heart of his dream. Freud associated the formula with the chemistry of sexual processes and the role that sexual desire played in producing Irma’s symptoms. Yet, and as Langs suggests, the “concept of sexual countertransference, strongly symbolized in the contaminated injection, is entirely overlooked” by Freud. The Irma dream thus appears as paradigmatic of Freud’s invoking “the concepts of intrapsychic fantasies and transferences as a defense against the realization of existing counter-transferences and of interactionally determined unconscious perceptions” (p. 608). The fate of the Irma dream, according to Langs, spans the entire history of psychoanalysis; it does so not only because it is a paradigmatic representation of the sense of guilt which exists in most analysts (Searles, 1966) but, secondly, because the prevailing reaction to the sense of guilt has been directed towards defending and generating, again and again, the “false applications of the concept of transference.” Langs’s hope was that his reanalysis of the Irma dream would provide all of us “with the strength to understand the destructive aspects of psychoanalytic and psychotherapeutic practices and to revise our technical procedures accordingly” (p. 612). In spite of the many articles which have appeared on Freud’s Irma dream, we must admit that not much progress has been made toward achieving this

A gynecological scandal 83 goal. One of the reasons for it is that Irma was not Emma Eckstein, as Schur, Masson, Langs, and many other scholars had assumed. There are a number of factors which challenge their erroneous conclusion, among which stands a footnote in Freud’s own dream book where he remarked that the sound of the word “Ananas” bore a remarkable resemblance to that of Irma’s “family name” (Freud, 1900, p. 115). Following these hints, Anzieu reached the conclusion in his 1959 edition of his study of Freud’s self-analysis that the patient’s name must have been “Anna,” and, further, that the Irma in his dream must have been Anna Hammerschlag Lichtheim, a family friend and a young widow at the time Freud had his dream, as was the case with the Irma in his dream (Freud, 1900, p. 93). Siegfried Bernfeld appears to have arrived at the same conclusion even earlier but did not publish his finding. Further clarifying information was provided by Franck Hartman (1983), who indicated that when Marie Bonaparte questioned Freud directly about the names he had chosen for his children, he responded by informing her that he had named his youngest daughter Anna in honour of Irma: “Irma’s name was Anna, hence Anna.”15 A number of prominent psychoanalytic scholars have considered the fact that Irma was not Emma as offering proof that Freud’s dream of Irma’s injection had not been influenced by the Emma Eckstein incident. Kurt Eissler (1985), founder and former director of the Freud Archives, suggested that Freud was probably no longer upset by the incident three months after it occurred: “for all practical purposes the excitement about that terribly upsetting incident should have calmed down at the time of the dream” (p. 110). Eissler (1985) further explains: “After all, [Freud] had been successful. Emma had been rescued . . . Why should he have been so preoccupied with this episode several weeks later? More importantly, what could there have been in the event per se that could have led to such an eminently creative outcome?” (p. 121). In a similar vein, noting that the Eckstein nasal operation by Fliess was not as catastrophic as it has generally been assumed, Uwe Henrik Peters (1989, p. 840) has underscored that Emma, as a hysteric, used her nosebleeds as a means of opposing her therapist and achieving a symbolic triumph and victory over him. These observations and comments are not at all ill founded; and yet the thesis that the incident resulting from Fliess’s botched surgery of the patient was not relevant to the Irma dream transcends the reading of any one particular element in the dream. According to Thomä (1987), this thesis is the expression and product of a hagiographical attitude. It is, in my view, much more than that. The way in which we deal with the not yet fully clear relationship between the Emma Eckstein incident on March 6 of 1895 and the Irma dream four and a half months later reflects our way of dealing with dreams in general, indeed our very understanding of the relationship between analyst and patient as well as our idea of psychoanalysis itself. The elaboration of these ideas is the subject of the following chapter.

84 A gynecological scandal

Notes 1 See, for instance, the chapter “Reflex neurosis from disturbed pelvic mechanism” published in the 1907 book The Abdominal and Pelvic Brain, by Byron Robinson. The idea of an “abdominal brain,” which was later abandoned as a superstition by scientific medicine, remained in use only among practitioners in the field of reflexology, massage, and acupuncture. The idea of a “visceral brain” has more recently been rediscovered by contemporary neuroscientists. 2 According to Ernst Kris (1950), editor of the first edition of Freud’s letters to Fliess, the faulty discovery (that cocaine acted directly on the central nervous system), was due to Freud, an assertion for which I am unable to find any proof. On the contrary, in a letter which Freud penned to Fliess on September 14, 1893 the experiment is attributed to Fliess. 3 In his letter to Fliess, Freud mistakenly wrote “Preyer” rather than “Peyer.” The mistake was noted by the editors in the earlier edition and in the German new edition of Freud’s letters to Fliess. In the letter, Freud was attempting to refer Fliess to the work of (Alexander) Peyer. Masson (1985, p. 46) mistakenly suggests that Freud was referring Fliess to William (his name was not William but Wilhelm) Preyer, the famous child psychologist. 4 Draft C of April 1893, in Masson (1985), p. 44, and especially Draft C/2, added by Schröter in the 1986 German edition of the letters to Fliess (Freud, 1986, pp. 36–39). 5 Carl Fleischmann assisted in the births of Ernst (April 6, 1892), Sophie (April 14, 1893) and Anna Freud (December 3, 1895). I think, but I am not sure, that he was not a relative of Ludwig Fleischmann, the important Viennese pediatrician (who was head of the first pediatric department of the General Hospitals) who, in 1878, published the article “Über Onanie und Masturbation bei Säugligen” in the Wiener Medizinische Presse. 6 The letter, found by Hirschmüller but not published by him in his article of 1978 (Hirschmüller, 1978b), was partially published in Bonomi (1994b), p. 75. 7 Analyzing the question in detail, Compton (1992) came to the conclusion that “These discussions of phobias by Freud are essentially prepsychoanalytic, that is, they antedate the discovery of dynamic unconscious mentation” (p. 214). Freud would discard the toxicological theory of anxiety only three decades later, in 1926, when anxiety was no longer traced to the transformation of libidinal energy into fear, but recognized as the signal that the ego was under the impact of perceived threats (Freud, 1926a) – a thesis which remains rather close to Löwenberg’s criticism of the somatic origin of anxiety. 8 For a discussion of this problem, see Spira (1991). In a letter dated January 29, 1908, Karl Abraham wrote to Freud: “In your first essay on anxiety neurosis, you say that the affect in the phobias of anxiety neurosis cannot be fought by way of psychotherapy. Do you still hold the same opinion?” Freud’s response, on February 16, 1908, was not very clear. 9 Commenting on the clinical picture drafted by Freud, Compton (1992) wrote: “The panic disorder patient is said to be afraid of the occurrence of another panic attack. In addition, in the first paper delineating the anxiety neurosis (1894), Freud put together a clinical syndrome centered around: (1) general irritability; (2) chronic, generalized anxious expectation; (3) anxiety attacks. The latter consist of a feeling of anxiety which may or may not be accompanied

A gynecological scandal 85

10

11

12

13

14

15

by an ‘interpretation’ (that is, an assignment of some danger significance to a situational element) and by any or all of the following: (a) disturbances of the heart action; (b) disturbances of respiration; (c) sweating; (d) tremor and shivering; (e) ravenous hunger; (f) diarrhea; (g) vertigo; (h) ‘congestions’; (i) paraesthesias (pp. 94–95). This list is almost identical to that which comprises the criteria for a ‘panic attack’ in DSM-III-R (p. 238)” (p. 211). In the Wiener klinische Wochenscrift of February 24, 1895 it was announced that the decisive observations would soon be published. But, two days later, in the Wiener allgemeine Zeitung of February 26, in the article “A new medical discovery,” which included an interview with Fliess, it was reported that Dr. Fliess “has not yet been able to form a conclusive opinion about the significance of the discovery he has made” (cf. Masson, 1985, p. 113; and the editorial notes by Schröter in the 1886 German edition of the text). The article continues with, “Dr. Fliess, by the way, is returning to Berlin today,” which probably refers to when the article was written. February 24 was a Sunday, and it is likely that Fliess left on that day. The surgical operation of Emma occurred on Friday 22 or on Saturday 23. In a letter to Fliess of March 8, Freud wrote that the operation occurred 14 days before. Masson (1985) pp. 107–112. The mechanisms of paranoia are discussed by Freud in Draft K. According to Haynal (1996), Freud derived his theory of paranoia “from the understanding of his own relationship with Fliess” (p. 160). On this question, see also Mahony (1979a). As far as I know, Freud, in his work, refers to “gynecological treatment” only on two other occasions: in his paper “On the grounds for detaching a particular syndrome from neurasthenia under the description ‘anxiety neurosis’” (Freud, 1894c, p. 103), published on January 15, 1895, and in a paper which dealt with erotic transference “Observations on transference-love” (Freud, 1915, p. 161). Most of what is known about Emma Eckstein is based on the documents provided by Jeffrey Moussaieff Masson (1984) in The Assault on Truth (Chapter 3: “Freud, Fliess, and Emma Eckstein,” pp. 55–106, and “Appendix A. Freud and Emma Eckstein,” pp. 233–250). To quote Freud (1901b): “There came to my consulting-room one day a young man who was the younger brother of a woman patient. I had seen him countless times and used to refer to him by his first name. When I wanted to speak about his visit I found I had forgotten his first name . . . The analysis of the episode showed me that I had drawn a parallel between the visitor and my own brother . . . The external link between the thoughts concerned with my own and with the other family was made possible by the chance fact that in both cases the mothers had the same first name of Amalia” (pp. 23–24). The brother in question was most probably Friedrich Eckstein (1861–1939). Freud would refer to him in “Civilization and its discontents” (1930), p. 72. The exchange is narrated by Princess Bonaparte in her diary, entry of November 16, 1925 (Hartman, 1983, p. 559).

4

The significance of Emma Eckstein’s circumcision to Freud’s Irma dream

The crisis of the canonic narration of the origins of psychoanalysis For a long time we believed that we knew how psychoanalysis originated: Freud stood as a solitary hero who had single-handedly discovered the sexual etiology of the neurosis, infantile sexuality, and the Unconscious. All three of these facets were part of the same grand discovery, all made possible by Freud’s abandonment of the seduction theory in September of 1897. Self-analysis was the undisputed fulcrum of his entire achievement, the heroic achievement when Freud acquired access to a new psychology after liberating himself from the neurological prejudice initially found in his theoretical approach, a bias reinforced by his close collaboration with Wilhelm Fliess and Freud’s endorsement of his reflex neurosis theory at the time. Ernest Jones (1953) described this momentous shift in the opening volume of his biography of Freud: The passage from physiology to psychology meant far more than a merely intellectual exchange of outlook: it betokened a reaching towards depths of his own being that had for many years been covered over. The struggle must have been titanic. (p. 314) This superficial and simple-minded view of the “passage from physiology to psychology” was strongly challenged in the 1970s from within and outside official psychoanalysis. Distinguished scholars such as Robert Holt (1985), George Klein (1976), and Roy Schafer (1976), in a momentous choral effort, came to the conclusion that Freudian metapsychology had been fatally infiltrated by outdated physiological notions and hidden biological assumptions stemming from the period of Freud’s studies in medicine. At the same time, the idea that Freud was an original thinker who singlehandedly founded and discovered psychoanalysis was seriously challenged by historians of medicine and science as well. Henri Ellenberger’s The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry (1970) convincingly argued that the sexual theory of the neuroses, as well

Significance of Emma Eckstein’s circumcision 87 as the very idea of unconscious and unconscious motivation, had been around long before Freud. A further blow was dealt by Frank Sulloway who, in Freud, Biologist of the Mind: Beyond the Psychoanalytic Legend (1979), undermined the very idea of a “passage from physiology to psychology” in Freud while arguing that the discovery of infantile sexuality, promoted by Freud, was already well on its way to gaining acceptance. After the canonic narrative was challenged, an attempt to integrate historical research into a comprehensive view was offered by George Makari. In his book Revolution in Mind; The Creation of Psychoanalysis, Makari (2009) replaced the concept of “discovery” with the idea of “creation.” Freud, in that text, is no longer seen as a hero who struggled against himself to establish psychoanalysis but, rather, as an author who had produced an overreaching synthesis. To quote Makari (2008): “Sigmund Freud did not so much create a revolution in the way men and women understood their inner lives. Rather he took command of revolutions that were already in progress” (p. 5). The reading presented by Makari is compelling but incomplete, if only because the question of Freud’s self-analysis was overlooked in what he offered in his reading – a clear sign that the crisis has not yet been overcome.

The place of the Irma dream in relation to self-analysis Freud’s self-analysis has in large part lost its foundational status within our field. This has occurred, I would argue, mainly because of our failure to tap the hidden meaning of Freud’s founding dream, his dream of “Irma’s injection.” Freud presented his specimen dream and his interpretation of it in the second chapter of The Interpretation of Dreams for didactic purposes, in order to illustrate how analysts should proceed when trying to gain access to the thoughts underlying the manifest text in a dream. In his analysis of his dream Freud introduced us to the systematic use of free association, which was to be applied to the key elements within the dream to arrive at its truth; hence the reason why the Irma dream became “the most interpreted dream of all time” (Blum, 1996, p. 515). Yet, and despite this, we still fail to understand just how and why this dream, of all dreams, became the starting point of everything for Freud. Freud dreamt his Irma dream in the summer of 1895. Five years later, he dared imagine that a tablet honouring his dream and his interpretation of it would one day be placed outside the Hôtel Bellevue, the building in the outskirts of and overlooking the city of Vienna where he had dreamt his dream. As he wrote to Fliess on June 12, 1900: “Do you suppose that someday a marble tablet will be placed on the house, inscribed with these words? – ‘In this House, on July 24th, 1895 the Secret of Dreams was Revealed to Dr. Sigm. Freud.’ ” Between 1895 and 1900, the Irma dream precipitated Freud’s shift from medicine to psychology, survived the collapse of the seduction theory,

88 Significance of Emma Eckstein’s circumcision fertilized his systematic self-analysis, inspired the method of deciphering dreams, and helped paved the way to the Freudian Unconscious. During this crucial period Freud’s theory went through two dramatic shifts: first the formulation of the seduction theory, which was later followed by its abandonment, a turn which contributed to Freud’s discovery of psychic reality. The Irma dream is thus a major element of continuity during a period in Freud’s life which was characterized by a number of dramatic twists and turns; anyone who desires to interpret the origins of psychoanalysis is as such required to face the riddle behind the “revelation” from which psychoanalysis was itself born. Let us bear in mind that a “revelation,” especially the revelation of a secret, is typically unexpected, sudden, and traumatic, and, further, that the slow, active, and systematic application of a method was the consequence rather than the cause of this revelation. We might speculate that psychoanalysis was engendered as a product of Freud’s need to achieve control of his dream and, further, that his self-analysis, as well as his theories, was the product of an immense intellectual and emotional effort by him. On the one hand we find that Freud’s dreams were saturated with scientific formulas, abstract notions, and typographic elements, and, on the other, that his production of theory was permeated by visceral sensations and oneiric visions. The Irma dream was undoubtedly the starting point of this immense effort by Freud and makes it appear as if Freud had only experienced one and only one dream during the most creative and crucial period in his life. The dreams Freud dreamt during the course of his self-analysis might well seem to be repetitions, inversions, and recapitulations of words, scenes, or themes already present and at work within the Irma dream, his “Traummunster” – its entire unfolding reminding us of a musical fugue built on a theme which is presented at the beginning and then developed in the course of the composition before finally being recapitulated. The Irma dream is no different, for it serves to introduce and puts into play the exposition of a theme which continually recurs and returns throughout the course of Freud’s self-analysis and beyond. How is that possible? And what exactly is a recursive dream? Psychoanalysis has already presented us with answers to these questions: repetitive dreams always involve an attempt to secure a new solution to a trauma and are a response to a traumatic collapse. The idea that the Irma dream harbored a traumatic core was proposed by Didier Anzieu (1986a), the most respected scholar of Freud’s self-analysis. In his magnificent study of Freud, Anzieu describes Freud’s specimen dream as a “post-traumatic act of repetition aimed at reparation” (p. 143). The structural relationship between Freud’s founding dream, the damage suffered by Emma Eckstein as a child, and the creation of psychoanalysis will in my view be better understood in light of Sándor Ferenczi and his conception of trauma, particularly his notion of “traumatic progression.”

Significance of Emma Eckstein’s circumcision 89 In his revolutionary paper on the “Confusion of tongues between adults and the child,” Ferenczi noted “the surprising rise of new faculties after a trauma, like a miracle that occurs upon the wave of a magic wand, or like that of the fakirs who are said to raise from a tiny seed, before our very eyes, a plant, leaves and flowers.” This blossoming and emergence of new faculties were, according to him, outlets for mortal terror. The latter, Ferenczi (1933) added, appears to “possess the power to waken up suddenly and to put into operation latent dispositions which, uncathected, wait ... in deepest quietude for their development” (p. 165). Might the Irma dream be explained in such a fashion? Did the mortal terror memorialized in the founding dream of psychoanalysis serve to unleash an immense intellectual effort by the dreamer that culminated in the birth of a new science and an altogether new system of thinking?

Initiation, conversion, and inspiration One of the best-known and most detailed interpretations of Freud’s Irma dream was presented by Erik Erikson in 1954. Erikson’s reading of the dream recognized Freud’s most famous oneiric production as the carrier of “the historical burden of being dreamed in order to be analyzed, and analyzed in order to fulfill a very special fate” (p. 7). Erikson’s statement remains cryptic and enigmatic. In what follows, I will try to provide my own reading and translation of it. Irma was a female in treatment with Freud who was far from being the “standard good and amenable patient” (Freud, 1900, p. 109, fn.). Freud, for his part, was a doctor who was at times unable to maintain an appropriate medical presence and clinical distance from his patients. While he would have indeed preferred Irma to have been a more cooperative patient, the fact is that she was not. Recalcitrant to treatment as she was, Freud decided to stay up late into the night in order to write out her case history. In doing so, he found himself annoyed at having to justify and explain why his treatment of Irma had not fulfilled expectations. This is a situation that every psychotherapist has experienced at least once. In such situations our therapeutic alliance is broken and we are cut off from our visceral sensations, or overwhelmed by them, such that we become unresponsive and unable to focus and listen, making the clinical work difficult, if not impossible. If luck visits us, we might dream a dream which helps us to reconnect to ourselves and to re-engage and resume our clinical work with the patient. The Irma dream is a dream of this kind; it is one of those dreams produced to help restore the analytic space, the only difference being that it was dreamt by Freud in a period when the analytic space itself had not yet developed proper roots. The analytic space was in a way itself created by this dream and did so through the representation of the violation of boundaries. These facts might lead us to view the Irma dream as the “totem and taboo” of analytic space itself.

90 Significance of Emma Eckstein’s circumcision The Irma dream presents us with a patient who bursts into the private life of her analyst, a woman who complains of pains in her “throat and stomach and abdomen” and causes an embarrassing situation at a delicate moment in Freud’s life – indeed, the worst possible one for him. The dream, let us recall, opens as Freud is celebrating his pregnant wife’s birthday. Freud, not expecting such an invasion of his private space, is obviously upset by the intrusion. He takes Irma aside and, after initially hesitating, looks down to examine her throat. He immediately becomes scared and confused, unable to understand or to grasp the meaning of what he sees. The scene was recognized by Erikson (1954) as the fertilizing moment of the discovery of the Unconscious. According to him, Irma’s oral cavity stood as a symbol for a “woman’s procreative inside.” As such, it served to arouse “horror and envy,” and, in the same stroke, to symbolically fertilize Freud’s Unconscious (p. 45). The act of peering down to examine Irma’s throat, of glimpsing the inside of a female patient, was seen by Erikson as the moment of Freud’s “initiation, conversion, and inspiration,” the instant when Freud was transformed into a hero who would come to be regarded by mankind “with pity and terror, with ambivalent admiration and ill-concealed abhorrence” (p. 47). Taking Erikson’s emphasis on the horror from which psychoanalysis originated as a starting point, Lacan (1954–1955) was led to describe the scene in the dream when Freud looks down to examine Irma’s throat in the following way: There’s a horrendous discovery here, that of the flesh one never sees, the foundation of things, the other side of the head, of the face, the secretory glands par excellence, the flesh from which everything exudes, at the very heart of the mystery, the flesh in as much as it is suffering, is formless, in as much as its form in itself is something which provokes anxiety. (p. 154) We typically utilize the function of vision to gain control and mastery and do so by inspecting, localizing, and defining cause and effect; this attempt to impose our will and to gain control, however, is always likely to collapse and dissolve. Such an unexpected sudden happening is the central experience staged in the Irma dream. The horrendous discovery of the flesh one never sees is the prototype of what Lacan named the “real,” i.e., what escapes both the imaginary and the symbolic registers of meaning. For many scholars, the horror of the Irma dream lies at the root of psychoanalysis itself, a horror which Freud introjected by virtue of dreaming the dream. This might render psychoanalysis a product born of a poisoning infiltration. Whereas Erikson read the Irma dream as an injection of “horror feminae” and (pro)creation, Lacan sensed a deeper “horror vacui” and a confrontation at work within it. This confrontation seems to have been necessary, argues Lacan, for a new system of thought to come

Significance of Emma Eckstein’s circumcision 91 into being. What Freud encountered in the dream through Irma’s mouth, according to him, was a truth which served to generate and produce an altogether new and radical system of thinking. According to both Erikson and Lacan, the most important feature of the Irma dream resided in the fact that it was not a nightmare. While the dream could have indeed been nightmarish, it was not. Freud’s capacity to see was restored after the initial visual shock he encountered and he of course did not wake up but continued dreaming. What maintained the dream and allowed Freud to continue dreaming was the trimethylamin chemical formula which suddenly appeared to him in his dream in bold type. As Erikson noted, Freud, in the end, managed to “see” and what he saw in the dream then was a “formula” printed in bold or “heavy type” (p. 27). Freud’s initial surprise and visual shock were thus overcome and conquered by the sudden revelation of a novel doctrine and a new belief; this, oddly enough, is something that often occurs in the case of paranoiacs and to those who go on to found and establish a new religion. Erikson himself described Freud’s ability to regain and recover the function of sight within his dream as a “conversion.” Lacan, for his part, was led to recognize the function of the Word (la parole) through it, a new solution to the problem which materialized, for Freud and for us, through the founding dream of psychoanalysis.

The incident The magisterial readings of the Irma dream which Erikson and Lacan each offered remain unsurpassed. Erikson’s interest in the dream appears to have been triggered by the initial appearance of Freud’s letters to Fliess, published in abridged form in 1950 (1954 in the English translation) under the title The Origins of Psychoanalysis. This first version of Freud’s letters (edited by Marie Bonaparte, Anna Freud, and Ernst Kris) was the subject of heavy censorship by Anna Freud and featured her decision to remove all references to Emma Eckstein, Freud’s patient and the woman whose nose was operated on by Fliess on February of 1895, five months before Freud dreamt his Irma dream. Erikson and Lacan were unfamiliar with the dramatic outcome of the operation on Emma’s nose and were each ignorant of the fact that her condition worsened and that she nearly bled to death a few weeks after her operation. Freud attended the patient every day for several weeks following her surgery, living through the swelling, the fetid odor, and the visual shock of her infection and hemorrhaging. When Emma nearly bled to death, Freud nearly fainted. If we consider that neither Erikson nor Lacan knew what had happened to Emma, the emphasis which Erikson places on the visual shock as well as Lacan’s description of the invisible flesh as the “foundation of things” strikes us as an expression of the feelings of clairvoyance that we, as analysts, value and praise so highly in our practice.

92 Significance of Emma Eckstein’s circumcision Let me briefly digress here in order to gloss the significance of clairvoyance in relation to traumatic experiences which are kept secret by our patients. According to Ferenczi, clairvoyance is the main feature of the traumatic progression which characterizes the “wise baby.” What is a “wise baby”? Oedipus is a typical wise baby, a human being who, despite having suffered a trauma, nevertheless still manages to find the solution to a great and difficult riddle. As Ferenczi noted, however, the wise baby is at the same time a subject who is forced to grow wise. In the case of Oedipus, he became wise by virtue of the very events which had come to impact him early on in his life but remained hidden and secret from him. The immense intellectual effort and the sudden rise of new cognitive faculties and abilities such as clairvoyance are often the product of experiences which are unbearable, hidden, and secret. Other children are often forced to grow wise by becoming the therapists and psychiatrists of disturbed adults in their lives; it also includes patients who are in the habit of trying to guess the “thoughts and emotions that go on in their analyst’s mind” (Ferenczi, 1933, p. 161). Erikson and Lacan’s clairvoyance with regard to the Irma dream was perhaps of this kind. Despite the fact that they were each ignorant of the Emma incident, both men managed to partially touch on this truth as they attempted to decipher the meaning of Freud’s founding dream. About them we can say what Ferenczi once pointed out about common neurotic patients: “they show a remarkable, almost clairvoyant knowledge about the thoughts and emotions that go on in their analyst’s mind” (Ferenczi, 1933, p. 161).

The split between traumatic and psychic reality Paradoxically, the disclosure of the Emma incident decreased our very capacity to see its meaning for the dream. The incident was first revealed by Max Schur in his 1966 article “Some additional ‘day residues’ of the specimen dream of psychoanalysis,” where the material on Emma which had been left out when the initial edition of Freud’s letters to Fliess was published in 1950 now appeared for the first time. The material concerned three letters from Freud to Fliess between 1895 and 1897. The first related to the Emma incident in February of 1895; the second dealt with Freud’s initial attempt to formulate a psychological theory about Emma’s bleedings (April–May 1896); the third concerned two scenes which Emma produced during her analysis which were striking and revealing: one of these scenes was suggestive of the medieval theory of demonic possession, the second concerned a “scene about the circumcision of a girl” (January 1897). This last scene, Schur pointed out, predated Freud’s abandonment of the seduction theory and his shift toward psychic reality in September of 1897. Let us now shift our focus to the links between the Emma incident and Freud’s Irma dream. The Emma incident was caused by a surgical error. Emma, we know, was operated on her nose by Wilhelm Fliess in February of 1895, with Fliess

Significance of Emma Eckstein’s circumcision 93 forgetting to remove a piece of gauze from her nasal cavity during surgery. According to Schur, Irma was Emma, and the fault which was memorialized in Freud’s dream was none other than the one which Fliess’s surgical malpractice had created. Schur, however, failed to consider Freud’s relationship with Emma as a factor which played a role in either the operation, treated by him casually and as a mere external factor, or in the dream. The only transference which Schur took into account when pondering the meaning of the Irma dream was that of Freud’s towards Fliess. According to him, the Irma dream was the expression of Freud’s need to preserve his relationship with Fliess by exonerating him of any blame: “It was the need to exculpate Fliess from responsibility for Emma’s nearly fatal complications that was probably the strongest (immediate) motive for the constellation of this dream” (Schur, 1966, p. 104). Fliess was indeed a central transference figure in Freud’s life at the time, a subject who commanded powerful internal loyalties from Freud. As Schur (1972) noted in his posthumously published book, the catastrophic outcome of Fliess’s operation on Emma dealt a blow to Freud’s trust in him. It gave rise to powerful feelings of ambivalence which, after they were repressed, would slowly return and marked the course of his self-analysis. According to Schur, Freud’s self-analysis was itself the expression of the painful and difficult dissolution of his transference to Fliess. Despite the fact that the stress on Fliess as a father-and-brother transference figure indeed sheds light on Freud’s self-analysis, Schur appeared unable to realize that the figure of the “father” and “brother” had been a screen (both obstacle and protection) which served to block Freud’s fundamental identification with a traumatized/traumatizing female figure. In the Irma dream, the encounter with the traumatized female body may be witnessed in the horrible vision which overwhelmed and terrified Freud in the dream before it was quickly dismissed and brushed aside by him. Freud in fact stepped back immediately from the scene in order to enlist and call on the help of father and brother figures. Unable to tolerate what he saw and witnessed in the dream, Freud looks to be reassured and calmed by a father figure (Breuer) before being backed up by brother figures (the trio of doctors who work with him at the children’s hospital), each of whom steps in to take command of the situation and perform a medical examination on Irma. Why was Irma’s body so frightening to Freud? And why are the male figures in the dream so clumsy in the performance of their task? We simply don’t know. What we do know is that female figures would in time emerge as symbols of sexuality and death for Freud during the course of his self-analysis; I think here of Freud’s dream of the “Three Fates” (Freud, 1900, p. 203) as well as the dream of his “Self-dissection of the pelvis” (pp. 452–455) – the dream which brought Freud’s self-analytic journey to an end and allowed the frightening female body to finally be represented by him. Split in two, emotionally eviscerated, and horribly

94 Significance of Emma Eckstein’s circumcision castrated, Freud was now no longer afraid. The female body, glimpsed and examined by Freud in the horrible vision which appeared to him through his Irma dream, had finally become his own body; as Erikson (1954) put it: “The dreamer, in experimenting with traumatic reality, takes the outer world into the inner one,” with Freud making an “autoplastic experiment of an alloplastic problem” (pp. 31–32).1 If we consider that in Freud’s case this process lasted four years and took the form of a regressive journey which led him back into his earliest memories, we realize that the Irma dream functioned as the interface between his outer and inner world, and, further, that the meaning of his dream for the history of psychoanalysis is best secured if both of these aspects are weighed and pondered. Erikson’s attempt to read the specimen dream by focusing on earlier crises in Freud’s life2 must as such be complemented with an effort to take into account the trauma memorialized within the dream. The disclosure of the Emma incident presented us with this possibility. It never came to fruition, however. After Freud’s previously censored letters to Fliess were published in unabridged form, our capacity to keep together the outer and the inner world was compromised by the material reality of the operation which Fliess performed on Emma’s nose. Significantly, Schur felt that Erikson’s effort to interpret the dream had been unduly intrusive. Schur, the man who had first published the shocking excerpts on the Emma incident, proudly assured us that he had deliberately and personally refrained from providing us with any reinterpretation of the dream’s possible deeper sources. The meaning Schur intended through his statement seems clear: We are not allowed to be clairvoyant or to grow into wise babies who struggle to secure speculative knowledge about the origins of Freud’s founding dream or psychoanalysis. Our desire to explore the catastrophic collapse which fertilized Freud’s Unconscious and generated a new science must be held back and kept in check. Such a renunciation reveals a lack of confidence in psychoanalysis – the same lack of confidence shown by those who, like Kurt Eissler (1985), declared the case closed and settled once they were able to “prove” that the Irma in Freud’s dream was not Emma Eckstein but someone else. Only our ability to secure the deeper meaning circulating in Freud’s Irma dream will allow us to obtain the knowledge of the origins of psychoanalysis that we seek. It is precisely our ability to resume and continue on in our journey that will help us to secure the possible deeper meaning of Irma’s terrifying cavity in the dream; that, and perhaps a strange idea put forth by Erikson himself, is what will allow us to inhabit and secure new analytic ground with regard to Freud’s Irma dream. As Erikson (1954) noted, the collapse which the Irma dream memorialized was ultimately overcome by means of “a religious rite of conversion or confirmation” (p. 30). A double influence, Jewish and Catholic (p. 36), resonates and vibrates within it. Speculating even further on the visual trauma which broke through the Irma dream, Erikson decided to fill in the gap by

Significance of Emma Eckstein’s circumcision 95

Figure 4.1 Giulio Romano, Circumcision, 1520 ca, The Louvre. (Photo © RMN-Grand Palais (Musée du Louvre)/Gérard Blot.)

reporting the dream of a woman patient of his which consisted of nothing more than the image of a word which itself carried and contained a play on words in a variety of languages. The solution of the multilingual riddle rested on a shocking image, the painting of the “Circumcision of Christ” which the patient had admired in the Louvre museum in Paris (p. 18). Erikson would obviously not have dared to fill the gap in this precise manner if he himself had not already been convinced at some level of the affinity between the theme found in the painting and the trauma which the Irma dream itself memorialized.

The medical scenario and the castration of women Fliess’s malpractice during Emma’s nasal surgery offers us just one piece of the puzzle. An important question which must be raised here is the following: Why did Freud encourage and allow Emma to undergo surgery on her nose? We might expect that psychoanalytic scholars would have carefully investigated the possible medical rationale for the procedure after the Emma débâcle became known. Indeed, the Irma dream is itself largely in part about physicians, hospitals, scientific theories, medical remedies, diseases, and their

96 Significance of Emma Eckstein’s circumcision diagnosis. Investigators, however, have by and large not ventured to treat these themes in relation to Freud’s founding dream. Why?3 Two decades ago, on the occasion of the conference 100 Years of Psychoanalysis, I decided to entitle my contribution to the proceedings: “Why have we ignored Freud the ‘paediatrician’?” (Bonomi, 1994a). I had no answer to this question then and still don’t have one today. What I feel more certain about today, however, is that if we are to successfully transcend the split between fantasy and reality we must necessarily consider the role that another medical practice which has been ignored by psychoanalytic scholars up to now might have played in the affair. I am referring to the practice of female castration. Notwithstanding the masculine connotations that the term carries, the word “castration,” during the years when Freud studied medicine as well as during the period when he was founding psychoanalysis, referred mainly to a surgical procedure to treat the nervous, psychical, and “moral” disturbances in women. Freud, like his mentor Josef Breuer, opposed this practice. Despite this, several of their patients were nevertheless sacrificed on the altar of medicine. Was Emma Eckstein advised to undergo a genital treatment as a child, and/or an ovariectomy as an adult? The symptoms she displayed appear to strongly support that Emma indeed suffered from hysteria, a condition which, as noted, was in those days often treated by gynecologists. Did Freud try to save his patient from undergoing a gynecological treatment? Did he attempt to do so, moreover, by recommending that Emma undergo an operation on her nose, a procedure that he likely viewed then as essentially harmless? Did the surgery and near-fatal bleeding incident which followed play a role in Freud’s subsequent reformulation of his theory of hysteria? It is important for us to note that Freud only began to develop a new theory to explain hysteria soon after his Irma dream. Hysteria, according to Freud in 1895, was the product of a sexual shock which the patient had experienced in childhood. This traumatizing element, argued Freud, was itself accessible to psychological investigation and treatment – in other words, to intellectual deconstruction and emotional working through. Freud’s new theory was based on the same elements as the old one. Seduction, for instance, was now defined by him in terms of an “actual excitement of the genitals” (Freud, 1896a, p. 152). The “sensations and paraesthesias of the genital organs,” however, were now traced back by him to “the sensory content of the infantile scenes, reproduced in a hallucinatory fashion, often painfully intensified,” as Freud wrote (1896b, p. 214). Strictly speaking, Freud added nothing new to traditional medical knowledge; yet, the consequences of his theoretical position were far reaching inasmuch as the “causes” for hysteria now shifted from the world of anatomy to the living world of meanings. By assuming that the genital sensations typical of hysteria were mnemic symbols of forgotten sexual abuses, Freud presented us with a new and revolutionary way of dealing

Significance of Emma Eckstein’s circumcision 97 with the same genital paresthesias which were the target of gynecological manipulations. Prior to the Emma incident, Freud viewed the treatment of hysteria through gynecological manipulation as a form of substitutive treatment (Draft H, Masson, 1985, p. 110). After the Irma dream – a dream about substitutes and substitutions – he managed to achieve a fundamental advancement from the manipulation of substitutes to the analysis of substitutions, severing the final thread with traditional medicine in the process. This shift allowed Freud to establish psychoanalysis as an independent field charged with a new responsibility: withstanding the psychic consequences of sexual shock while refraining from offering manipulative or suggestive responses to patients in treatment. Freud never again abandoned this basic principle, a principle which was forever to guide the “talkingcure,” in favor of palliative remedies. One of the long-term consequences of Emma’s operation and the bleeding incident which followed was that it helped Freud to establish the notion of analytic space as a working concept. The fact that the starting point of the dream concerned an act of intrusion by a doctor upon the body of a female patient (Emma) and that the Irma dream itself opened with an invasion by a patient of Freud’s private space might bring us to recognize that one of the forces at work in the dream involved the reactive formation towards the experience of being violated and intruded upon. In this dream, the “injection” emerges as a symbol of all possible intrusions upon the body and of an invasion of psychical space. The establishment of the inviolability of the boundaries of what will be a safe analytic space thereby becomes the product of a defensive overreaction by Freud to the intrusion theme. Ultimately, we can find here the origins of Freud’s great concern for boundaries, his idiosyncratic allergy to every kind of influence, including the idea and principle of neutrality. This is yet another reason for the need to explore the origins of the reactive formation from which the standard technique itself originated.

The gap Kurt Eissler and Harold Blum – the first the founder and former director of the Freud Archives, the second its present director – each came to the conclusion that the operation on Emma’s nose was a displaced form of, and substitute for, castration, circumcision, or clitoridectomy. As Eissler (1997, p. 1303) noted: “Inasmuch as ovariectomy as an intended cure for hysteria was performed with some frequency in late-nineteenth-century Vienna, the removal of a little bone must have appeared to Freud as innocuous.” Blum (1996) for his part proposed that Fliess’s operations on the nasal cavity were “similar to mutilating procedures of the genitals, to preclude and punish masturbation” (p. 519). Both Eissler and Blum, however, failed to make use of the connection between Emma’s surgery and castration in their respective interpretations of the Irma dream. They did not make use of it either to help bridge the gap between the pre-analytic treatment period in the history

98 Significance of Emma Eckstein’s circumcision of psychoanalysis and the period when psychoanalysis was itself founded by Freud, or even to throw light on the relationship between Emma’s body and Irma, the patient who appeared to Freud in his founding dream. Like Emma, Irma too apparently suffered from an ailing and damaged body. The main idea which Didier Anzieu (1986a) identified for us about the figure of Irma in his monumental reconstruction of Freud’s self-analysis is that the examination which Freud performed on her throat in the dream memorialized “a gynaecological examination in disguise” and was “a substitute for it” (p. 145). Anzieu considers it a symbolic exploration of the mother’s uterus which had likely occurred as a result of the fact that Martha Freud was five months pregnant at the time Freud dreamt his dream. Anzieu, however, did not go further than this and he too failed to establish a link between his “gynaecological” interpretation of the dream and a surgical procedure which had likely been performed on Emma’s genitals as a child. Instead, he offered the hypothesis that Freud, in real life, had been in conflict about his wife’s pregnancy and that he perhaps also entertained the fantasy of her undergoing an abortion. Freud’s participation in a medical world which had so often responded to female hysteria with a systematic assault on the female genitalia was as such ignored by Anzieu. In his excellent reconstruction of Freud’s self-analysis, Anzieu makes use of the word “castration” more than 60 times. Not once, however, did he employ the term according to the prevalent meaning operating during the years when psychoanalysis was being established, that is to say, as referring to the extirpation of the ovaries in women who suffered from hysteria. Castration to Anzieu meant only symbolic rather than actual or real castration. This shift in meaning with regard to the word has been so deeply incorporated into the psychoanalytic mental space that it is difficult to convince an audience of psychoanalysts today that in everyday medical language during the time when Freud began to practice medicine in Vienna “castration” was associated with a real and actual medical procedure performed on women. We therefore face the following paradox. On the one hand, the nasal surgery performed by Fliess on Emma Eckstein has been acknowledged as a substitute for female castration and circumcision by a number of respected psychoanalytic scholars and, on the other, Freud’s examination of his patient’s throat in the Irma dream has been recognized as “a gynaecological examination in disguise, a substitute for it.” The gap between these two sides is so wide that it seems nearly impossible for us to bridge the two and bring material and psychic reality together.

A dream of male domination As most commentators on Freud’s Irma dream have noted, Martha Freud’s final pregnancy appears to have played an important role in her husband’s dream of Irma’s injection. The “hall” in which the guests are being received

Significance of Emma Eckstein’s circumcision 99 (the German word empfangen means both “to receive” and “to conceive” in the sexual sense of the term) in the dream, the white patch which Freud encounters in Irma’s throat, her “pale and puffy” appearance, as well as her “choking” and the “pains” in her “abdomen” all combine to suggest a landscape in which the phases of conception, pregnancy, and giving birth are condensed into a single scene. Anzieu (1986a) qualified it as the scene of a “maculate conception” (p. 146), an expression which suggests an allusive contrast with the “immaculate conception.” One element which remains absolutely certain in relation to the scene is that Freud and Martha had been experiencing a diminished sex life in 1895 and, further, that they had previously each agreed on having no more children. Martha, however, became pregnant for a sixth time in 1895. As Anzieu noted, Freud must have “felt guilty” about his wife’s “unwanted pregnancy” (p. 141). The role of the marital crisis in Freud’s life around the time of his Irma dream has been identified and commented upon by other scholars. According to Elms (1980), Freud was distressed by the inadequate methods of contraception and viewed fellatio as an alternative to traditional sexual gratification. Eissler (1985) found this hypothesis so convincing that he based his re-reading of the Irma dream upon it. Reconsidering the text of Freud’s dream, he found that certain words and sentences in it alluded to the “most ominous” circumstances of his wife’s unwanted pregnancy (p. 123). For instance, the sentence “I took constant pains to be sure that the syringe was clean” appears to suggest, Eissler noted, that despite the fact of Freud’s careful and constant worry that he would impregnate his wife, this time “the syringe” had indeed been “contaminated and Martha became pregnant” (p. 123). Similarly, the sentence “She opened her mouth properly” appears to hint at the possibility that Martha had “refused to grant him oral gratification, which would have averted pregnancy” (p. 124). Eissler obtained further evidence for his reading (i.e., that Martha’s pregnancy was at the core issue of Freud’s Irma dream) from Freud’s assertion that “sexual megalomania” had stood behind his dream. As we know, Freud wrote to Karl Abraham on January 9, 1908 regarding the meaning of the “trimethylamin” formula to say that “sexual megalomania” was hidden behind the dream while adding: “the three women, Mathilde, Sophie and Anna, are the three godmothers of my daughters, and I have them all!” Freud’s statement to Abraham reveals the logic hidden behind some of the material encoded within his dream, material which undoubtedly helped to shape its intricate plot. Despite the fact that the “Irma” which appeared to Freud in his dream condenses and combines multiple identities and stories, the evidence suggest that, whereas the main story line in the dream involves Emma, the person who is visually represented in the dream was Anna Hammerschlag, future godmother of his daughter Anna (Anzieu, 1986a, p. 134).4 This fact has been called on by psychoanalytic scholars, Eissler among them, to undermine the significance of the Emma Eckstein incident to Freud’s Irma dream. Freud’s allusion to

100 Significance of Emma Eckstein’s circumcision sexual megalomania, argues Eissler (1985), “would make no sense in connection with Emma Eckstein, but might be the upshot of sexual abstinence enforced by his wife’s pregnancy” (p. 124). Paradoxically, the point in the dream which Eissler viewed as most remote from the Emma incident is its closest point of connection. The birth of Anna Freud, whom Freud decided to name in honor of Anna Hammerschlag four and a half months following his “Irma/Anna dream,” fell on Tuesday, December 3, 1895. If we go back on the calendar nine months we arrive at the date of Tuesday, March 5, 1895. Anna Freud’s conception and Freud’s unplanned impregnation of Martha in all likelihood occurred between March 5 and March 12, 1895, that is to say, precisely when the Emma Eckstein incident materialized and intruded on Freud’s life. It was on March 8, 1895 that Freud wrote to Fliess to inform him of the Emma incident and to report to him that a second emergency operation had been performed on Emma just a few days earlier and in response to her nearly bleeding to death. The overlapping match between the “incident” and the “maculate conception” is truly uncanny.5 The fact is particularly true if only we consider Harold Blum’s position (1996) that the guilt which the Irma dream memorializes flowed back to a “sadistic assault on the mother figure” (p. 523) and a “hostile attack on the pregnant mother” (p. 531). Did Freud ever take notice of and reflect on the contiguity between the Emma incident and his impregnation of Martha? We simply don’t know. What we do know is that Freud, in the next few years, would follow Fliess in calculating the “critical dates” which linked together conception, birth, and death, and, further, that one of the first things he did after receiving Fliess’s manuscript on the “relationship between the nose and the female sexual organs” [die Beziehungen zwischen Nase und weiblichen Geschlechtsorganen] was to calculate the interval between the return of Martha’s menstrual periods (February 29, 1896), the birth of his daughter Anna (December 3, 1895), and the first movements of the fetus which Martha had been carrying (July 10, 1895). According to Eissler (1985), Freud at that time “stood in the shadow of a very severe self-reproach, having necessarily judged his wife’s sixth pregnancy to have been the result of a lack of sexual control on his part” (p. 124). Eissler also noted that Freud, in response to Fliess announcing his new solution for the prevention of conception in May of 1895, had replied: “For me you come too late by a few months.” Freud’s statement anticipates the many self-reproaches which surfaced in the Irma dream and Freud’s associations to them. Freud’s need to discharge the high level of anxiety he must have felt for having placed Emma’s life in danger at the time renders his lack of sexual control then somewhat understandable. However, the humiliation he also experienced then might help to clarify the link between the two scenes. When Emma was operated on for a second time in February of 1895 as a result of her massive hemorrhage she managed to remain on the scene

Significance of Emma Eckstein’s circumcision 101 and not lose consciousness. Freud, however, was overwhelmed by a powerful upsurge of emotions, walked away from the scene, went into another room, and nearly fainted. When he returned to the room where Emma had nearly bled to death she greeted him with an ironic and condescending remark: “So this is the stronger [starke] sex” (Masson, 1985, p. 117). Glossing the Irma dream in light of Emma’s statement, Patrick Mahony (1977) wrote: “it is as if Freud . . . vengefully works out Emma’s remark about females as the strong sex and he fabricates a dream of male domination” (p. 97). The material which was to give rise to the dream four and a half months later began to coalesce with the Emma incident, when Freud engaged in unprotected sex with his wife to affirm his masculine organ. If, moreover, Eissler’s hypothesis is correct, Freud’s frustrated attempt to have his wife serve him with oral sex would itself also function to inscribe and graft the two scenes together.

Beyond the pleasure principle What makes it particularly difficult to bridge the gap between the Emma incident and the Irma dream is that Freud’s entire interpretation of it revolves around a fantasy of “substitution,” read by him only from “the point of view of wish-fulfilment” (Freud, 1900, p. 119). His focus neglects to take into account the “return of unmastered traumatic sensory impressions which struggle for solution,” identified by Ferenczi (1930–1932) as the “traumatolytic function of the dream” (p. 240).6 Freud certainly had good reasons to emphasize the formula of trimethylamin and the sexual megalomania which he claimed had stood behind the dream. Verbal patterns, however, are not all that function within a dream. The most prominent characteristic of trimethylamin, a chemical substance associated with the vagina, is its foul-smelling odor. Smelling like rotting fish as it does, trimethylamin serves to introduce the idea that the female genitals are repellent. According to David Lotto (2001), the trimethylamin formula in Freud’s Irma dream functioned as a highly condensed symbol for “the conflict between misogynist thoughts and deeds and the guilt they generated – as well as a reminder of those shameful parts of himself that he characterized as feminine: the passive, castrated Jewish victim” (p. 1310). Contending that “the primary source of guilt in the Irma dream” was Freud’s misogyny, Lotto detected throughout Freud’s self-analysis clear evidence of “a sequence in which he acts badly toward a woman” (pp. 1306–1307). Lotto concluded that Freud struggled during his whole life with strong misogynist impulses, and, further, that the Irma dream was “part of an ongoing reparative process in a man engaged in battle with the darker aspects of his inner life” (p. 1310). Peering down into Irma’s throat, Freud was struck by the resemblance of the three curly structures to the female genitalia, and, further, was also frightened by the necrosis on his patient’s membranes. These necrotic

102 Significance of Emma Eckstein’s circumcision spots were indeed linked by Freud to his medical errors which in turn gave rise to harsh self-reproaches in him. They were, however, soon separated from the incident and displaced into a remote past. According to Robert Langs (1984, pp. 606–607), Freud’s worries and concerns in the Irma dream touch “more broadly upon the issue of whether or not psychoanalytic procedures could be dangerous and harmful to patients even to the point of bringing about their death.” A similar concern appears to break through in the medical examination performed on Irma in the dream, carried out by pediatricians in a hospital for children. At a certain point, Freud (1900) experienced the sensation that Irma was herself a child. To recall his words: “In the further course of the dream the figure of Irma acquired still other meanings, without any alteration occurring in the visual picture of her in the dream. She turned into one of the children whom we had examined in the neurological department of the children’s hospital” (p. 292). Freud here seems to come quite close to grasping the “nightmare” and trauma which Emma had experienced as a child. Did Freud, in the course of his progressive telescoping of the pain affecting his patient’s body – her throat, stomach, and abdomen – ever manage to glimpse the mortal terror that his patient Emma might have endured as a child as a result of her possible circumcision?

The cut Anzieu (1986a) has proposed that the Irma dream as a whole epitomizes the transformation of the carnal body into a symbolic body. This, he argues, was triggered by “the body of the crime from which [Freud] must exculpate himself” (p. 155). Anzieu argues that this “body of the crime,” around which the discovery of the Unconscious itself revolved, was “the desired body of the unpossessed mother.” Anzieu is I think partly correct, if only because the body in question was that of a hysteric Jewish woman who had likely endured castration (circumcision) during her early years. In his book On Freud’s Jewish Body: Mitigating Circumcisions, Jay Geller (2007) devotes several pages to Freud’s identification with Irma’s body. Geller associates circumcision with the nose, arriving at the conclusion that the Irma dream “betrayed the process by which Freud was generating apotropaic defenses against the ongoing trauma of his own Jewishness [Judentum] as lived and ascribed” (p. 94). In his view, the emotional source of the shock that Freud experienced when he was confronted with Eckstein’s massive nasal hemorrhaging served to tap into his “femininization” and relationship with Fliess. In this regard, Geller speaks of Freud’s “Jewish and gender-coded identification with Irma” (p. 91), reflected, he argues, in the perilous assimilation between Freud’s body and his female patient. Remarkably, Geller arrived at his conclusion without ever noticing that Emma Eckstein’s body had likely been scarred by a procedure which

Significance of Emma Eckstein’s circumcision 103 resembled an actual circumcision. In a letter that he wrote to Fliess on January 24, 1897, we find Freud writing the following: Imagine, I obtained a scene about the circumcision of a girl [eine Szene von Mädchenbeschneidung]. The cutting off [Abschneiden] of a piece of the labium minor (which is even shorter today), sucking up the blood, after which the child was given a piece of the skin to eat. This child, at age 13, once claimed that she could swallow a part of an earthworm and proceeded to do it. An operation you once performed was affected by a hemophilia that originated in this way [Unter der so begründeten Hämophilie hat einmal eine Operation von dir gelitten]. (Masson, 1985, p. 227) Freud does not explicitly state that the patient was Emma Eckstein. The context and his wording, however, strongly suggest that it was. Emma was affected by interminable bleedings after nasal surgery with Fliess. Emma, according to Freud, had been a bleeder since childhood. Freud interpreted her bleedings as a product of hysteria and did so for several reasons, among them the fact that Emma had engaged in compulsive self-mutilating and self-cutting behaviors and, as stated, because she “always has been a bleeder” (Masson, 1985, p. 186). Why, we may ask, was Emma a “bleeder”? Why did she so often cut herself? Were her re-enactments the products of fantasy or of a real trauma? Emma suffered from severe physical pains in her legs and had problems walking throughout most of her life. Her leg pains were associated with genital paresthesia and forced her to remain confined to bed or lying on a couch for long periods of time. Her analysis with Freud had a positive and beneficial effect on her condition and she was able to engage in a more normal life for several years. However, she experienced a relapse and developed masochistic fantasies and a traumatophilia. As Freud (1937) reported in Analysis Terminable and Interminable, Emma began to compulsively reenact her fantasies and underwent a “complete hysterectomy” “twelve or fourteen years after her analysis ended” (p. 222). The continuity between the circumcision scene and her complete hysterectomy years after her treatment with Freud ended is striking and uncanny. If we consider that Freud (1937) in that context had also indicated that the patient’s relapse and second illness had “sprung from the same source as her first one” (p. 222), we might easily reach the conclusion that her genital trauma was not as insignificant as might appear from Freud’s passing remarks concerning the shortening of her labium minus. Max Schur (1966) identified the patient which Freud mentioned in his letter to Fliess of January 24, 1897 as Emma Eckstein, commenting that Emma was “one of the first patients who offered Freud a clue to the crucial realization that what his patients had described to him as actual seduction episodes were fantasies” (p. 114). Schur’s conclusion has never been rejected; nor has

104 Significance of Emma Eckstein’s circumcision it been worked on, glossed, or elaborated any further, despite the fact that Freud, in January of 1897, still considered hysteric fantasies as grounded on real trauma. Indeed, it is important for us to note that Freud, in the passage, associates his patient’s hysteric circumcision fantasy with an actual and real cut on her external genitals, the traces of which had faded during the course of time but were nevertheless still recognizable in her body. Jeffrey Masson, the editor of Freud’s letters to Fliess, glossed Freud’s letter of January 24, 1897 and the passage in his controversial The Assault on Truth: Freud’s Suppression of the Seduction Theory (1984). He was, however, unable to make up his mind on whether the scene involving the circumcision of a girl mentioned by Freud had been real or fiction. Lisa Appignanesi and John Forrester (1992) describe this scene, as well as the preceding one in which “the diabolus sticks needles into her fingers,” as “fantastic scenes from [Emma’s] inner life, in the no-man’s land between fantasy and memory, resonating with the sadistic acts and fantasies of a former historical epoch” (p. 137). Wilcocks (2000) for his part raised the following perceptive question: “How on earth . . . did Freud know that one half of the vaginal lips of Emma was shorter than the other half?” (p. 102). There is no doubt that Freud, in his letter to Fliess, had been referring to a real cut on the external genitals of one of his female patients at the time, supported by his report of the existence of a disparity in the lengths of his patient’s labia lips. Those who contend that Freud had been referring to a fantasy on the part of his patient (but whose fantasy, Freud’s or Emma’s?) must necessarily explain the reason for their conclusion. Emma herself was likely unaware of the circumstances surrounding her castration and was most likely even confused about the cut in her genitals. Domestic accidents which occur at a very early age can at times function as the somatic basis for fantasies, as Freud himself discovered during the course of his self-analysis. Between the age of two and three he had climbed up on a stool which tipped over, its corner striking him behind the lower jaw. The injury caused a considerable loss of blood and some stitches had to be put in by a surgeon. In October of 1897, Freud discovered that the event had functioned as the basis for an oedipal fantasy of punishment (castration) for his incestuous wishes (Anzieu, 1986a, p. 243). The same probably occurred with Emma. There are, however, a number of important differences, the implications of which are far reaching. 1

2

In Freud’s case the injury occurred on his jaw, while in the case of Emma it was on her genital area. It strikes me as obvious that the scar on Freud’s jaw only became symbolic of castration for him as a result of the scene which Emma presented him during analysis in January of 1897. It is unlikely that an injury to the vaginal lips can be caused by a domestic accident. The locus morbi is so protected and hidden that we can only assume that an injury to this part of a woman’s body is intentional rather than the product of an accident. Obviously, we cannot exclude

Significance of Emma Eckstein’s circumcision 105

3

4

5

6

7

the possibility that the injury had been self-inflicted given Emma’s history of habitual masturbation. If we consider the medical context, however, we cannot ignore that the cutting of the labia minora (together with the excision of the clitoris and the surgical closure of the labia majora, usually known as “infibulations”) was a medical procedure, which was often performed between 1860 and 1885 in an effort to “cure” masturbation in female children. Emma was born in Vienna during this time, in 1865. The first pediatric department in a General Hospital in Vienna had been established in 1872, and was headed by Ludwig Fleischmann (1841–1878), a respected pediatrician and surgeon in Vienna (Tragl, 2007, p. 306). In 1878, the same year he died, Fleischmann published in the Wiener medizinische Presse a paper where he openly recommended that habitual masturbation in girls should be treated with the scarification or amputation of their clitoris and, further, that, in the case of small children, it should be treated with the “cauterization of the Labia or of the entrance of the vagina” (p. 49). This kind of medical procedure, I wager, was likely the cause of the anomaly in Emma’s vaginal lips which Freud reported in his letter to Fliess on January of 1897. I will return to examine the methods and ideas used by the pediatricians operating in Vienna between 1860 and 1885 in more detail in the next chapter. Emma’s childhood trauma was symbolically tapped into as a result of the operation which Fliess performed on her nose in 1895, the year she turned 30. Reacting to the surgical incident on the basis of her core fantasy, Emma could not fail but to unconsciously experience the surgical procedure as a reactivation of an earlier surgical intervention and the genital wound which resulted from it. Freud played an active role in Emma’s retraumatization. The fact that her operation (the removal of the turbinal bone) had been intended as a “cure” for the consequences of her habitual masturbation presents Freud behaving no differently than Emma’s father, the man most likely responsible for bringing Emma to a surgeon to cure her of her masturbation. Given the strong transference which Emma had developed on her analyst, we might further surmise that Freud was seized in the repetition of his patient’s trauma by unconsciously becoming the seducing and traumatizing object of her internal world. This might very well be the source of Freud’s sentiment that he had damaged Irma, feelings which, in his case, managed to speak and break through his Irma dream just months after undergoing her nasal surgery with Fliess. While it is true that Freud had been deeply puzzled by his thoughts and feelings on the matter, he was nevertheless unable to understand their logic in terms of a countertransferential enactment, despite his feeling that Irma had herself been “one of the children whom we had examined in the neurological department of the children’s hospital”

106 Significance of Emma Eckstein’s circumcision

8

(Freud, 1900, p. 292). Freud, the evidence suggests, simply truncated and blocked this particular line of thought, avoiding and derailing the subject by switching to the “immensely powerful factor of sexuality” (p. 116), a factor which Freud in time associated with the unsatisfied and demanding sexuality of widows. Finally, we might surmise that the sensation of having turned into the traumatizing object of his female patient remained particularly unbearable to Freud. Rather than acknowledging the fact, Freud instead reacted by unconsciously identifying with Emma’s traumatized self. Freud’s autoplastic reaction is I think particularly confirmed by his interpretation of the necrotic spots which he encountered when examining Irma’s throat in his dream. Freud, as we know, interpreted these as pointing back to his own state of health at the time. His doing so is partly explained by the fact that his own nose had been operated on by Fliess just prior to his performing surgery on Emma. Thus, if Emma failed to fully and unambiguously break through the Irma dream it was because her own body had somehow managed to morph with Freud’s; his patient’s nightmare became Freud’s own. From this point of view, the significance of the Irma dream for the origins of psychoanalysis might in the end boil down to it simply being the expression of the analyst’s introjection of the psychic reality of a patient who had been traumatized.

The preconscious understanding of a patient’s trauma is rooted in the uneasy and challenging participation of a process in which the analyst is contaminated, imbued, and sometimes flooded by his patient’s dissociated experiences. The analyst is then forced to become the “container” (Bion, 1962) in which these unrecognized visceral sensations are temporarily stored. As Franco Borgogno (2011) described with remarkable clarity, since the patient lacks “the stomach for digesting un-digestible and un-assimilable experiences,” the analyst must host the latter in his/her own stomach until the patient develops a stomach of his or her own. In Freud’s specimen dream, the abuse which Emma suffered and endured as a child was memorialized in Irma’s painful sensations in her throat, stomach, and abdomen. Crucial here is that Freud was infiltrated by Irma’s pains, and, further, that this infiltration in time slowly turned him into his own patient, initiating a process whose terminal point was Freud’s dream of him self-dissecting his own pelvis, a definitive point of Freud’s analytic initiation. A perhaps more important point to highlight here is that Freud himself failed to note that his own body, dissected (i.e., “analyzed”) by him in his dream, had transformed into the container of the visceral sensations of his own patients.

Emma’s masculine fantasy There are several elements which suggest that Emma’s genital paresthesias were associated with unconscious phallic fantasies. They did not escape

Significance of Emma Eckstein’s circumcision 107 Freud’s attention. An important clue, in this regard, is Freud’s first allusion to a woman’s penis. It surfaced in direct association and connection with the “scene about the circumcision of a girl” which Freud had extracted from his female patient in January of 1897. Freud was not acquainted at that time with the phallic fantasies of his female analysands and how they viewed and fantasized the male organ. In his letter of January 24, 1897, however, he formulated the idea that the broomstick which witches are often portrayed riding upon was most likely “the great Lord Penis” (Masson, 1985, p. 227). Another clue may be isolated in the fact that, 40 years after the incident, Freud decided to base his position on what analysis is able and not able to achieve by appealing to his treatment of Emma and what he, in light of her case, described as the impossible task of convincing a woman to give up on her wish for a penis. “At no other point in one’s analytic work,” Freud (1937) wrote on that occasion: does one suffer more from an oppressive feeling that all one’s repeated efforts have been in vain, and from a suspicion that one has been “preaching to the winds”, than when one is trying to persuade a woman to “abandon her wish for a penis on the ground of its being unrealizable” (p. 252) These elements not only appear to substantiate the idea that the sensorial hallucination of a penis had played a crucial role in Eckstein’s clinical profile (the genital paresthesias) but also suggests the need for us to reconsider her fantasy of having a penis as a “witness to the history of the origin of the illness” (Freud, 1896c, p. 192). Beyond a mere intrapsychic denial of her vagina, we might consider Emma’s phallic fantasy a symptom, a memorial of her trauma which, as such, embodied her hope to have her genitals and trauma recognized by her analyst. I am here relying on and affirming the principle that repetition fulfills a useful function and involves an attempt “to bring about a better solution than was possible at the time of the original shock” (Ferenczi, 1931, p. 238). Penis envy might in fact operate as a disguise for “the good sex organ” (Torok, 1964) and fantasized penises may at times indeed serve to organize sensations in the genital area. In the case of Emma, however, her hallucinations might well be viewed as an attempt on her part to restore the underlying representation of a vagina which had been violently and traumatically damaged by male doctors.

The moment of bliss Emma’s fantasy of having a penis might itself help to shed light on the interpersonal dynamic of her retraumatization. Freud’s desire to have a less masculine and more submissive female patient in his Irma dream appears to lie at the heart of his most famous oneiric production. The fantasy of taking

108 Significance of Emma Eckstein’s circumcision possession of the magic penis of the woman might itself offer us important clues into the meaning behind Freud’s preoccupation with not “doing harm” to Irma. Freud’s position might then shed light on the “deflowering fantasies” that, following his Irma dream, became a focal point of Freud’s own self-analysis. Let me provide a brief overview of this important subject. A crucial component of Freud’s self-analysis revolved around the scene in the meadows with flowers in which he and his nephew John (both boys were about three years old at the time, making John more of a cousin than a nephew) had behaved in “cruel fashion” towards John’s younger sister, Pauline (Freud, 1900, p. 483; pp. 423–425; Masson, 1985, p. 262). Frank Hartman (1983, p. 559) was one of the first to call attention to the significance of this scene from Freud’s childhood in relation to the Irma dream, presenting it as a proof of “the importance of the repetition of infantile conflict in the discovery of psychoanalysis.” The Emma Eckstein incident in his view stood merely to replay his cruel (“grausam”) treatment of Pauline at the age of three, with Fliess being cast in the role of John and Emma playing the role of the victim (Pauline). Hartman’s interpretation soon gained acceptance among Freud scholars, most likely because it offered a straightforward and simple analogy between the two scenes. The meadow childhood scene back in Freiberg in the spring of 1859 became the central memory around which Freud built his disguised autobiographical paper on “screen memories” (Freud, 1899; Bernfeld, 1946). In it, Freud’s sexual aggression towards his niece Pauline is framed around the romantic language of “flowers” and screened by the action of him aggressively “snatching away” a “little girl’s bunch of flowers” (Freud, 1899, p. 310). The scene also served to represent the prototype of Freud’s memory of bliss which, after being articulated by him in the language of chemistry in the Irma dream, was then transposed into the language of “flowers” in his dream of the Botanical Monograph, dreamt by him in March 1898, nearly three years after his Irma dream. Freud’s language and description, according to Anzieu (1986a, p. 292), had been modeled on a simple equation: “flower = female genitals.” Anzieu (1986a) presented us with the following account of Freud’s associative paths: I would contend that the present action in the [Botanical Monograph] dream – opening a folded plate on which a flower is “reproduced” – represents an intellectualization of a past, carnal action – opening the folded “flower” of a little girl, in other words her sexual organs, whose purpose is, precisely, to “reproduce”, and where the little boy imagines he can see the results of castration. The reproductive functions of the human body are often explained to small children through the analogy of botanical examples. (pp. 286–287)

Significance of Emma Eckstein’s circumcision 109 Anzieu is here able to detect the disturbing presence of a fantasy of “castration” at work within the scene. The same disturbing presence is evoked by an important association which Freud (1900) himself provided: the plastic memory of himself at the age of five when, together with his three-year-old sister Anna, he blissfully pulled a book apart “to pieces (leaf by leaf, like an artichoke …)” (p. 172). According to several commentators, Freud’s memory was tied to his blissful moment of “defloration,” while the image of “pulling the book to pieces” successfully conveys the idea of a destructive action which resonates with the verb “schockieren – to shock, to offend, and to disgrace” – itself associated with the German “Artischocke” (Mautner, 1991, p. 283). Freud’s fantasies and ruminations on the female genital organs bear the mark of the impact of Emma Eckstein. The symbolic meaning of defloration was later clarified by Freud (1918b) in his essay “The taboo of virginity,” where he associates the hymen with the female’s inborn illusion of having a penis and the rupture of the magic membrane with a form of symbolic castration which triggers her wish to castrate a man in order to keep his penis to herself (p. 204). Despite the fact that Freud’s “defloration fantasies” were rooted in his own life and history, I tend to think that they were over-determined by his unconscious concern with Emma’s retraumatization, an event which ultimately represented an attack on her magic protective shield (the phallic magic membrane). On a more general level, the assault on the imaginary phallus functions as an unconscious factor motivating men to treat hysteric women by castrating them. If only we examine the issue more closely, we realize that the practice emerged precisely during a time when the emancipation of women started, indeed during a period when the modern myth of the “femme fatale” began to surface in Western culture. The “femme fatale,” as Eddy de Klerk (2003c) has pointed out, is a “phallic woman,” a woman who takes revenge on men by placing them in a powerless, threatened, and dependent position in order to make them feel what she herself has been made to experience. Remarkably, this was also how Freud himself seems to have experienced the Emma Eckstein incident. While Freud identified with castrated female patients, the one who had been ultimately castrated was not Emma but Freud himself. This reversal of roles was part of an ongoing shared fantasy between Freud and Emma. The fantasy which they unconsciously shared may be seen in Emma’s reaction to Freud’s near-fainting spell in response to her bleeding incident in February of 1895. Circling back to an earlier point, when Freud returned to the room where Emma had been recuperating from her massive bleeding, she responded by greeting him with the remark: “So this is the stronger sex.” The impregnation of Martha in early March of 1895, as well as the fantasy of sexual grandiosity which Freud enacted through his Irma dream, were both reactions by him to the powerless, threatened, and dependent position in which he felt himself caught during and after the Emma incident.

110 Significance of Emma Eckstein’s circumcision In Freud’s self-analysis this position was revived through his ruminations on the true “femme fatale” in his life: the Roman Catholic nanny whom Freud described in his letter to Fliess of October 1897 as his sexual “initiator.” Freud had no clear recollection either of his seductress, nor of the specifics of the abuse he suffered; he did, however, experience various dreams where he found himself sexually aroused, trapped, and unable to move (“glued to the spot”) as well as mistreated, scolded, and humiliated. These paralyzing feelings, which were characterized by a blend of erotic arousal and sensations of impotence, were reawakened and stirred in Freud by his preconscious understanding of the infantile abuse which Emma had suffered and endured when young. It is important to underscore, in this regard, what several authors (Schur, 1972, p. 124; Grigg, 1973, p. 112; Mahony, 1977, p. 77) have previously emphasized, namely, that Freud sometimes qualified his childhood seductress as his “Amme” [wet nurse] – although Freud was presumably breast-fed by his mother – and that, as Freud himself noted, “Amme” is “Emma” spelled backwards (Freud to Jung, June 6, 1907; see also Vitz, 1988, p. 7). Moving away from the analytic situation and fantasizing about his Roman Catholic nanny enabled Freud to commit to and enter a systematic selfanalysis. His unconscious identification with Emma Eckstein, however, remained immured within the psychoanalytic corpus as an inaccessible enclave – a “State within a State, an inaccessible party” (Freud, 1939, p. 76).

The enclave If only we dig deeper into Emma’s scene, we are struck by the fact of its similarity to the Jewish ceremony of circumcision. The event traditionally takes place on the eighth day of life of the child and is exclusively meant for boys. In the orthodox tradition, the ceremony is known as the brith milah, with the ritual of circumcision always being performed by a man, a mohel, who, after cutting and removing the foreskin at the tip of the boy’s organ, applies his mouth to the child’s penis in order to suck up the initial drops of blood produced by the cutting. The ceremony is then followed by a celebratory meal. The scene which Freud obtained from Emma was obviously modeled on this ceremony. Freud himself was struck not by the mutilation or by the content of his patient’s fantasy but by the ritual pattern which it encoded. In his letter to Fliess of January 24, 1897, he associated the scene which Emma presented him with to the idea of a “primeval sexual cult, which once was – perhaps still is – a religion in the Semitic East (Moloch, Astarte).” Freud then writes that perverse actions “are always the same – meaningful and fashioned according to some pattern that someday will be understood.” Freud’s brilliant anticipation of the metapsychological idea of a deep structure of the Unconscious which was homologous to religion (Freud, 1901b, p. 258) diverts our attention from Emma and the possible meaning operating in Emma’s fantasy. If we attempt to grasp why her genital trauma

Significance of Emma Eckstein’s circumcision 111 had been reshaped to match the ritual of circumcision, a ritual from which girls are obviously excluded, we arrive at the following possible reconstruction. As a child, Emma must have found herself confused about her genitals and the fact that they had been injured and cut. She then likely developed the fantasy that she too, like her brothers and male cousins, had received and experienced a brith milah. By turning her trauma into an active fantasy, by enabling and making her genital mutilation thinkable, Emma’s masculine fantasy materialized as an attempt aimed at mastering her trauma. Two months after Freud obtained the brith milah scene from Emma he developed the idea that fantasies issued from things which had been heard but only understood subsequently (Masson, 1985, pp. 234, 239). In his draft “The architecture of hysteria” Freud further maintained that fantasies were psychic façades which were produced in order to bar access to memories and thereby preserve them: They are manufactured by means of things that are heard, and utilized subsequently, and thus combine things experienced and heard, past events (from the history of parents and ancestors), and things that have been seen by oneself. They are related to things heard, as dreams are related to things seen. In dreams, to be sure, we hear nothing; but we see. (Masson, 1985, p. 240) This passage helps us to better appreciate the role that the words brith milah might have played in the construction of Emma’s fantasy. It also sheds light on the mechanisms by which this same fantasy had made its way into Freud’s Irma dream – it clearly involved a shift from an acoustic to a visual code. The notion that in dreams “we hear nothing but we see” anticipates not only the theory that in dreams words are represented as things but also reminds us of the trimethylamin formula which helped to restore Freud’s capacity to see in the dream. Remarkably, and as Eddy de Klerk pointed out, the trimethilamine formula itself appears to be “an anagram, a nearly literal transcription, of ‘brith milah’ ”.7 Privately, Freud viewed his Irma dream as the moment when “the secret of the dream” had been “revealed” to him. In The Interpretation of Dreams, he wrote that “the dream-content seems like a transcript of the dreamthoughts into another mode of expression, whose characters and syntactic laws it is our business to discover by comparing the original and the translation” (Freud, 1900, p. 277). These and other factors give plausibility to de Klerk’s hypothesis that Emma’s nasal surgery served as an unconscious reminder of Freud’s own traumatic brith milah; the fantasy and sexual grandiosity inscribed in and carried by the word trimethylamin thus appears to be built upon a phallic wound. De Klerk never published his fascinating hypothesis, essentially because he lacked a persuasive model to explain how a bodily memory trace might

112 Significance of Emma Eckstein’s circumcision have connected with a verbal representation. After reading my work on the relevance of castration and circumcision for the origins of psychoanalysis, however, he entrusted me with his intuition. Before further expanding on this point, I wish to briefly review how the topic of Freud’s circumcision has been treated and addressed in the psychoanalytic literature. De Klerk belonged to a small but heterogeneous group of scholars who came to realize that circumcision functioned in Freud’s work as a crypt or hidden script. In 1993, Sander Gilman published a book filled with many interesting observations about circumcision and nineteenth-century medicine. Gilman found a rich literature which considered circumcision “as a remnant of the early Jewish idol or phallus worship” (Gilman, 1993, p. 58). He also noted that “in seeing the act of circumcision as ‘primeval’, Freud placed it at the root of Western civilization” (p. 83). Gilman proceeded to point out that “the debate about the impact of circumcision on the communal psyche was also closely related to Freud’s discussion of the trauma theory in the late 1890s” (p. 87). Finally, he noted that “by moving hysteria to the realm of the incestuous,” Freud had effectively eliminated “the trauma of circumcision” (p. 89). Other authors have found the trauma of circumcision reverberating within the flow of some of the most important dreams Freud reported during his self-analysis. Wendy Colman (1994) suggests that Freud as a child was likely left ridden with conflict as a result of witnessing the circumcision of his younger brother Julius, who died just six months after the ceremony. In her view, Freud’s affective response to the events of Julius’s circumcision and death came to impact his later dreams and his theoretical views on the castration complex. The fact that Freud was never able to fully retrieve the emotions that he experienced as a result of Julius’s sudden death influenced his ability to adequately conceptualize the castration complex (p. 622). Franz Maciejewski (2002) for his part traced the clinical material in Freud’s self-analysis back to the trauma of his circumcision, interpreting it as the “primal scene [Urszene] of the bad treatment” Freud had reported to Fliess in his letter of October 3–4, 1897 (p. 47). Eddy de Klerk (2003a, 2003b, 2004, 2008) integrated both aspects of the equation, proposing that Julius’s circumcision and death functioned to remind Freud of his own circumcision. In a later work, Maciejewski (2006) identified the event of Julius’s circumcision at the center of a primal scene which haunted and never ceased to impact Freud. Both de Klerk and Maciejewski placed heavy emphasis on the fact that Freud appears to have decided not to have his male children circumcised. Each read Freud’s dream of the self-dissection of his pelvis as a representation of his trauma, viewing his circumcision as not only a trauma in his life but as “a crypt of the repressed sufferings of the young Oedipus” (Maciejewski, 2002, p. 28). De Klerk’s contribution was developed around the assumption that a neonatal circumcision without the benefit of anesthesia is necessarily experienced by the infant as catastrophic and traumatic. De

Significance of Emma Eckstein’s circumcision 113 Klerk supported his position with clinical research and analytic vignettes. Maciejewski’s methodology, on the other hand, is mainly sociological. He works and proceeds on the assumption that neonatal circumcision is, in contradistinction to initiation rites during puberty, a cultural “memotechnique” aimed at reproducing a painful memory trace in the body. Expanding on Derrida’s (1996) suggestion that we consider a bodily memory trace an “archive,” Maciejewski found that it represents a second archive of psychoanalysis, one which underpins the primacy of the phallus and castration. Despite the fact that many of his interpretations are profoundly interesting and thought provoking, Maciejewski ultimately arrived at a rather disappointing conclusion. Picking up on Derrida’s remark on the irreducible literalness of circumcision in Freud’s text, Maciejewski (2002) found that the ultimate content of this secret archive is “the fact of circumcision [Tatsache der Bescheidung] as the traumatic central event of Jewish socialization and ethnogenesis” (p. 309). Jay Geller (2007), who has followed on and expanded on Gilman’s research, has responded by objecting that circumcision in Freud’s work is not a mere “fact” but a “dispositive.”8 These authors all share in the idea that the mark of circumcision in Freud’s work is a memory without memory which returns everywhere, to employ Derrida’s phrasing (1996). These same authors, however, ignore the social and cultural relevance of the medical cure/punishment for masturbation; de Klerk, to be fair, does come close to doing so by virtue of associating the disavowal of the traumatic element of circumcision with the neurological notion that infants fail to suffer pain – a misconception which began in 1872 with Flechsig’s discovery of the partial myelination of the neurons of the newborn baby. This idea in fact persisted for an entire century (Cope, 1998; Fitzgerald, 1998). The consequences of this selective inattention are many, the principal one being that these contributions on the subject of the hidden script in Freud’s texts are obsessively and defensively fixated on the male genital organ, as if contamination with the female gender was somehow forbidden. This might be one of the reasons why Emma’s “circumcision scene” has remained a residue even within the psychoanalytic literature. Yet, circumcision is in my view scarcely understandable if the phenomenon is isolated and cut off from the male imitation of the “wound” which the female body itself embodies, a fact which renders the human physical body a symbolic body and transforms the “wound” in the flesh of the female body into a “symbolic wound” (Bettelheim, 1954). The script of the original “contamination” was implicitly revived by the notion that men “menstruated” through their noses – an idea which had a long history before it resurfaced through Fliess’s theory of the nasal reflex neurosis. Moreover, Freud’s rejection of the Jewish ceremony of circumcision had been “contaminated” from the beginning by the horror which the medical practices of castration and circumcision of females (women and girls) must have produced in him during his early years as a medical

114 Significance of Emma Eckstein’s circumcision doctor. The crucial question is when and how circumcision became the hidden signifier of a traumatic inscription within the Freudian corpus.

The inscription We know that Freud was impacted by a painful psychic impression the day before he dreamt his Irma dream; it was then deflected on Irma in the form of a damaging injection. He felt annoyed by a reproach, a statement regarding Irma’s “incomplete cure,” and decided to stay up late into the night to write up a report of his treatment of Irma, essentially in order to offer a self-justification of his treatment performance. Writing the report was itself a painful exercise, both mentally and physically. Freud, we know, had been suffering from rheumatism at the time he dreamt his Irma dream, and, that night, felt particularly bothered by pain in his left shoulder [Schulter]. In the dream, these pains managed to reappear and were reflected in Irma’s body. Freud, in his dream, immediately turns to say to her: “If you still get pains, it’s really only your fault [Schuld].” Apparently, Freud jettisoned the painful reproach which had been directed at him and cast it in the direction of his patient. However, later on, in the course of the medical examination performed on Irma in the dream, her pains were isolated to a portion of her skin [Hautpartie] which had been infiltrated; it was immediately felt by Freud on his own left shoulder. In his book On Freud’s Jewish body, Jay Geller (2007, p. 91) has convincingly associated the word “Hautpartie” with circumcision. Here we arrive at an important and crucial passage in Freud’s dream. As Patrick Mahony (1977, p. 91) noted, the German word for shoulder [Schulter] “phonologically incorporates Schuld” (guilt, pronounced Schult in German). Ultimately, the unacceptable reproach ended up being placed, by Freud himself, upon his shoulders. The person from whom Freud had received the painful impression and reproach regarding Irma’s incomplete cure was his medical colleague and friend Oscar Rie (“Otto,” in Freud’s account of the dream). Freud was so upset with “Otto” in the dream that his annoyance was quickly displaced towards the gift that Rie had brought with him when he came to visit, a bottle of pineapple liqueur (“Ananas”). Freud, however, detected a strong smell of fusel oil (“amyl”) when the bottle was popped open. Freud found the odor so disturbing that he immediately decided to rid himself of the gift. In the dream, moreover, the responsibility for Irma’s pains was revengefully thrown back on Otto, who was dismissed by Freud as the “impure” one who had thoughtlessly injected Irma with a dirty syringe. The smell of amyl led Freud to recollect the whole chemical series (propyl, methyl, and so on), a series which accounted for the “preparation of propyl . . . propyls . . . propionic acid . . . ” which had been injected into Irma’s body. The substitution of “amyl” (the painful impression) with “propyl” (the injection) is the crucial point and knot in the dream. It is the juncture where Freud loses and then regains his masculine status. This substitution

Significance of Emma Eckstein’s circumcision 115 becomes more intelligible if only we consider yet another layer of meaning and deeper level of reproach. Oscar Rie (Otto) had just come from visiting Anna Hammerschlag’s family. Anna was Freud’s patient and the main figure condensed in the figure of “Irma” in his dream. Freud fancied that his friend Otto had been “siding” against him under the influence of his patient’s relatives. Otto’s reproach must have been felt by Freud as directly coming from Professor Hammerschlag, his former Hebrew teacher and a friend of his father Jacob, as well as his patient’s father. During the night the reproach directed at Freud by Otto for failing to “cure” his patient turned into an admonishment, with Freud feeling he had failed to fulfill his medical duties. We could well surmise that Professor Hammerschlag’s complaint against Freud, coming as it did from an authoritative and paternal figure who served as an agent of Jewish tradition, served to reawaken a much more substantial reproach in Freud. More deeply, Freud must have widened his self-reproach to include the fact of his having drifted away from Judaism and his failure to fulfill his religious duties to his father Jacob. Freud’s self-reproaches thus tapped into a central conflict in his life. It concerns his problematic and conflictive relationship with his Jewish ancestry and the religion and legacy of his forefathers. The theme cannot be examined in this context. Suffice it to say, however, that it was only after the death of his father Jacob that Freud opened up to the prospects of filial piety and, secondly, that it was only with his father’s death that he entered self-analysis and his lifelong journey back home (Rice, 1990). Seen from this angle, the Irma dream presents an all-too-clear expression of Freud’s rebellion against his Jewish heritage. Freud still felt himself entitled to make his own choices and pretended to be his own father. The weight of his self-reproaches, however, began to slowly turn the tide. Freud’s revolt, his conflicts and vacillations with regards to his origins, speak most powerfully through the fact that he had failed to fulfill some of the most important duties an observant Jewish father demands from a son. Unlike Jacob, Freud failed to present his male children with a Hebrew name and, more crucially, had failed to circumcise them as well, symbolically keeping his sons from entering into the covenant. The accusation that he had failed to cure the daughter of his former Hebrew teacher (the incomplete cure) reverberates in Freud’s failure to inscribe God’s Name on the organ of generation through the practice of milah, the very event when Jewish male children are offered their Hebrew names (the incomplete ceremony) and symbolically enter into covenant with the God of Israel. Freud failed to consciously notice this particular line of reproach involving his failure to live up to his duties as a Jew when analyzing his Irma dream. Instead, he reacted with the revengeful fantasy of a super complete cure for widows (the “sexual megalomania”). Freud clearly felt the weight of the blow, however. His failure to fulfill his religious duties as a son was thus quickly turned towards Rie, a fellow Jewish doctor, who is scolded by

116 Significance of Emma Eckstein’s circumcision Freud as a “disbeliever” (Erikson, 1954, p. 31). Despite the fact that Freud responded to Otto’s reproach as “non arrivé,” it nevertheless came to be inscribed in the dream through displacement and condensation. The most crucial inscription can perhaps be found in the word “amyl,” the signifier of the painful impression which Freud had received. The word, remarkably enough, encodes and nearly reproduces the reverse sound of “milah,” the Hebrew word for “cut.” Traumatic memories are easily associated with odors, and the smell of “amyl” might have well condensed many traumatic memories and paralyzing visceral emotions of impotence bound to the primordial “cut” which Freud had received by virtue of having entered the Jewish covenant through circumcision. In the dream, the signifier “amyl” is replaced by a chain of signifiers which, associated with pleasurable memories, reveals an attempt by Freud to dispel impotence, overcome isolation, and restore his masculine position. Erikson (p. 26) found the association of “propyl” with the Greek word propylon, and the verbal vicinity of “propionic” to “priapic–phallic” particularly enlightening (p. 26). Freud himself remarked, in a letter to Fliess written in the spring of 1898, that “Priapus stood for permanent erection, a wish fulfilment representing the opposite of psychological impotence” (Masson, 1985, p. 308). The precise meaning of the Priapus fantasy was more fully disclosed by Freud in his text “The taboo of virginity.” Appealing to St. Augustine, Freud (1918b) there reported on a custom which supposedly once existed in the Roman marriage ceremony in which a young virgin wife was required to “seat herself on the gigantic stone phallus of Priapus” to sacrifice her hymen (p. 204). The operative model for the substitution here is obviously a chief element within Freud’s own family romance, the replacement of his Jewish mother (Amalia) with the “Roman Catholic” nanny who cared for him during his early days in Freiberg. The meaning of the replacement of “amyl” with the “propyl” series thus appears to be the substitution of the Hebrew ceremony of circumcision with the Roman marriage ceremony, and, through and beyond it, of the Hebrew “milah” (cut) with the rupture of the hymen; a cut which, in Freud’s self-analysis, would come to be associated with the moment of “bliss” which brought pleasure and justified life itself. The “triumph of wish-fulfilment” (Freud, 1913c, p. 299) was however affected by a death anxiety which functioned as a prelude to Freud’s own discoveries and observations on castration anxiety. At a verbal level the conjunction between bliss and shock, defloration and castration, potency and impotency was hinted at by Freud’s stress on the reversibility of words. For instance, Freud transferred the verbal quality of the name “Anna” (doubly inscribed in “Ananas”) to the name “Otto,” also a palindrome. His doing so implicitly calls attention to reading words not only left to right, but in right-to-left Hebrew fashion; hence the double reading of “Emma,” which, once metamorphosed into “Amme,” is fused with a series of crucial and key

Significance of Emma Eckstein’s circumcision 117 names (Anna, Emma, Nana, Amalia) and primal fantasies in Freud’s life (Vitz, 1988, p. 181). The names, and the series, are tucked away and lost in the Freudian box. They might, however, well serve to present us with the key that might help us to unlock the navel [Nabel] of Freud’s dream, identified by him as “unplumbable” (Freud, 1900, p. 111). Throughout his professional life, Freud (1916–1917) repeatedly reminded us of the magical power of words. In his Introductory Lectures on Psycho-Analysis, for example, he wrote: Words were originally magic and to this day words have retained much of their ancient magical power. . . . Thus we shall not depreciate the use of words in psychotherapy and we shall be pleased if we can listen to the words that pass between the analyst and his patient. (p. 17) In the specimen dream this acoustic scenario was evoked by Irma’s resistance to open her mouth properly and, secondly, by the medical examination performed on her by a trio of doctors who percuss and auscultate her body. When one of the doctors examining her finds “that a portion of the skin [Hautpartie] on the left shoulder was infiltrated,” Freud (1900) was struck not only by the fact that he felt it in his own body, but also by the “ambiguous wording” and “unusual phrasing” regarding the infiltration (p. 113) – as though a piece of the talking-cure had been made inaccessible to verbal communication. Freud was prone to recognize the “active” and “masculine” influence that his words could exercise on his patients. He however lacked the inclination to recognize that he himself might turn into the “passive” and “feminine” recipient of his patient’s words. The important association “propyl–Propylaea” offered by Freud (1900) as a specimen of displacement (pp. 293–294) might allow us to here fill in a gap. Freud’s association, given Emma’s family name, itself presents a “most ambiguous wording.” Eckstein means “cornerstone” and, as such, serves to point directly to architecture, religion, and even foundations and founding rituals. The term “propylaea” is not only used to refer to the ceremonial gateway to Greek temples but, oddly enough, is also “a word given to the labia majora surrounding the vaginal orifice” (Anzieu, 1986b, p. 145). The bridge connecting these two meanings thus serves to bring the realm of architecture and anatomy together; it also functions to tie and bridge the body with a sacred place of worship. Indeed, and even more deeply, it also serves to transform a mutilated body into a sacred temple. It is as though, rather than analyzing it, Freud has appropriated and made Emma Eckstein’s brith milah fantasy his own fantasy. Freud too turns to the Jewish ceremony of circumcision, where the most vital part of the body, the penis, is consecrated to God, as the model for the “consecration” of a woman, questioning this ancient Hebrew ritual at its most delicate point, namely, the division between the sexes and the split between pure and impure.

118 Significance of Emma Eckstein’s circumcision Freud’s irreverence draws our attention to another side of his longstanding habit of distancing himself from his origins and heritage (milah), a movement which can itself be witnessed in the “universalism” which he adopted as his work progressed and developed. Freud’s desire for the universal can perhaps be best seen, in his dream of dreams, in the “Roman Catholic” resonance present in his bold chemical formula. Visually speaking the formula is “a system of triads, to each element of which is linked a subtriad, all stemming from one central point (N)” (Richardson, 1983, p. 69). The word “Catholic” itself not only means “universal” but is also intimately tied to the name which Freud personally selected to present and introduce us to his dream girl: “Irma” means “universal”. Indeed, “Irma = Emma,” as both derive from the German “ermen” (whole, universal).9 The architectural element at play within the Irma dream too, the “propylaea,” points towards classical Greece as the cradle of universal culture, absorbing into and within itself and beyond all differences in race, gender, and religions, any and all possible “temples.” While the model and template are indeed Hebrew (milah), in Freud’s founding dream they are transformed into a scientific formula (trimethylamin) which hints at a universal function.

Conclusions In his remarkable interpretation of Freud’s specimen dream, Erikson (1954) managed to grasp that Martha Freud’s physical fertilization and pregnancy had been duplicated in the spiritual fertilization which Freud, as founder and father of psychoanalysis, had experienced. The “mouth” which Freud opened to examine his patient’s buccal apparatus in the dream stood not only as a symbol for a woman’s procreative inside but of the dreamer’s Unconscious as well. To cite Erikson (1954): wir empfangen: we receive, we conceive, we celebrate a birthday. That a man may incorporate another man’s spirit, that a man may conceive from another man, and that a man may be reborn from another, these ideas are the content of many fantasies and rituals which mark significant moments of male initiation, conversion, and inspiration; and every act of creation, at one stage, implies the unconscious fantasy of inspiration by a fertilizing agent of a more or less deified, more or less personified mind or spirit. (pp. 46–47) Freud’s “feminine yielding,” the convergence of womb and mind, the possibility that a male subject may incorporate the spirit of another, as well as the intellectual birth of the notion of bisexuality, are all ideas which fundamentally helped to contribute to our understanding of the founding dream of psychoanalysis. An important point which Erikson overlooked in

Significance of Emma Eckstein’s circumcision 119 his analysis of the dream, however, was that Freud’s homosexual submission to Fliess had been intertwined with his identification with Emma, and, further, that what most powerfully served to fertilize Freud’s Unconscious in the summer of 1895 was the reproach which had materialized in light of the “bad treatment” which Emma had once received. The fate of the Irma dream, according to Langs (1984), spans the entire history of psychoanalysis. It does so not only because it is a paradigmatic representation of the sense of guilt which exists in most analysts (Searles, 1966) but because the prevailing reaction to the sense of guilt was in the service of defence. In my tentative reconstruction and interpretation of Freud’s dream I have tried to argue that Freud’s guilt above all consisted in the incorporation of the psychic reality of his patient. Doing so entailed Freud’s unconscious participation in the processes of repetition and, eventually, retraumatization. The medicalization of Emma’s treatment, the severity of the incident which followed as a result of her botched operation, as well as the intensity of the feelings of guilt Freud felt all combined to prevent him from acknowledging his having done harm to his patient, something that is always specific to the work of analytic treatment, a process which features the tendency to repeat as a main therapeutic factor in the cure. The interpretation of Freud’s dream which I have presented here allows us to better grasp that the dreamer’s “Jewish and gender-coded identification with Irma” (Geller, 2007, p. 91) had been the product of the transformation of Freud’s visceral body into the passive recipient of Emma’s trauma. We might therefore wonder whether the underlying guilt immortalized in Freud’s dream had been the “crime of introjection” itself (Abraham, 1963; Abraham and Torok, 1978). Freud’s “feminization” might itself be an expression of his difficulties in withstanding trauma as well as of his inability to function and serve as a container for Emma. Freud, as far as we know, never owned up to and took responsibility for the role he played in Emma’s suffering and retraumatization. The Irma dream, to be sure, well captures his desire to cleanse his person of any and all guilt. Freud’s analysis of Emma – his most important patient at the time – concluded in 1897 and quickly opened the door to Freud becoming his own “most important patient” (Masson, 1985, p. 279). Despite the fact that Freud was cognizant of his identification with Emma, during those years his ideas on identification had been mainly based on the model of hysterical identification. The latter, in Freud’s view, consisted of an unconscious inference (a form of “assimilation on the basis of similar aetiological pretension”) which enabled patients to express, through their symptoms, their experiences as well as those of other people in order to suffer on their behalf (Freud, 1900, p. 149). If we apply this logic to Freud’s transference neurosis, we realize that in many of his enactments and unconscious formations – in dreams, daydreams, parapraxis, and fantasies – Freud not only managed to relive and dramatize Emma’s traumatic experience but to unconsciously suffer on her behalf. It is important to remind ourselves of

120 Significance of Emma Eckstein’s circumcision the fact that Emma had been the first analyst personally trained by Freud and, further, that Freud’s legacy entails more than a transmission of knowledge and of tools from one generation to another. An important and crucial element which helped to facilitate Freud’s identification with Emma was the similarity of their reactions to the trauma which they had each lived and experienced as children. In Emma’s case, her trauma was dramatized and spoken through her hallucination of having a penis and the fantasy that the organ had been cut – her brith milah fantasy. In Freud’s case, the apotropaic reversal of impotence into sexual grandiosity and megalomania (“trimethylamin”) was linguistically encoded within the body of a formula which itself hinted at Roman Catholicism. It symbolized and functioned as a memorial of the trauma which Freud had endured at the hands of his Catholic Nanna [Amme]. As Velikovsky (1941) had long ago read and deciphered the formula in Freud’s founding dream: “Tri – three; amin; Amen – belief in the trinity” (p. 492, fn.). Applying the schema of hysterical identification, we unavoidably reach the conclusion that Emma’s brith milah fantasy was not only well understood by Freud at an unconscious level but that it also functioned as a model for the trimethylamin formula itself. Seen from this angle, the revelation which the specimen dream discloses was indeed an abstract thought, one consisting of an “unconscious inference” which tapped back into the dreamer’s personal childhood trauma. In short, Emma’s reaction to her circumcision functioned as an unconscious reminder to Freud of the sexual abuse he had suffered at the hands of his Catholic caretaker as a child. At a performative level, however, Freud appropriated Emma’s brith milah fantasy, and, in this way, managed to fulfill his wish of having a “good and amenable patient,” re-enacting the same fantasy which undergirded the operation on her nose: through it, Freud once again managed to “snatch away” her imaginary penis. Relating Freud’s fantasy back to his Catholic Nanny, we now see that it also carries the mark of his identification with the aggressor. What Freud ultimately repeated through it was the fantasy of an abused child. It led him to become as powerful as his aggressor by taking possession of her “Three-Amen” formula – the signifier of her imaginary phallus – with the unbearable sensations of impotence being split off and projected toward his traumatized patient. A deeper point to emphasize here is the fact that Freud’s hysterical identification with Emma might itself not be sufficient to accurately describe the role she played in the unconscious process from which psychoanalysis itself originated. The fact that Freud’s symbolic body – his body as experienced by him in dreams and unconscious fantasies and now marked by the sign of castration – underwent a sudden transformation itself recalls the process of an “identification of the ego with the abandoned object,” which Freud (1917, p. 249) himself had described in “Mourning and melancholia.” The process of mourning itself, however, seems inadequate to describe the psychic alteration which the founder of psychoanalysis had endured.

Significance of Emma Eckstein’s circumcision 121 This psychic alteration, present in the Irma dream through the pregnancy theme, was interpreted by Erikson as the product of an unconscious fantasy of being fertilized by a man, which led to the incorporation of his “spirit.” Erikson’s insight becomes more effective if we assume that the process of incorporation was no mere fantasy but a real process and that the fertilizing agent was Emma’s masculine fantasy, namely her psychic reaction to the trauma she had endured. A more important and crucial point is that in Freud’s dream the signifier of Emma’s trauma was immured in the trimethylamin formula; inscribed within it as a “mute word” (Derrida, 1976). Indeed, we might well wonder whether the process of psychic alteration present during the birth of psychoanalysis might be seen to consist in the “endocryptic identification” that Nicholas Abraham and Maria Torok (1978) described and identified in their work (p. 142). The silent invisible bond between Freud and Emma is perhaps best found in “Analysis terminable and interminable,” a text written by Freud (1937) while in the midst of his meditations and reflections on Moses (Freud, 1939). While struggling with the “evidence afforded by circumcision,” described by him in his book on Moses as a precious “key-fossil” [Leitfossil] (p. 39), Freud was led to reflect on the role that the “bedrock” [gewachsene Fels, “growing rock”] of castration played in any and all psychoanalytic treatment. In that context, Freud suddenly decided to circle back to his beginnings as an analyst in order to ponder, for the last time, the sediments of his treatment of Emma Eckstein – a concrete specimen of a petrified life and a literal cornerstone [Eck-stein] of psychoanalysis.

Notes 1 There are various elements which suggest Freud’s final dream in his self-analysis as a replay or new version of his founding dream, among them the duplication of the “preparation of propyl…” [Propylpräparat] (Freud, 1900, p. 107) presenting itself to him in the dream in the form of a “dissection [Präparation] of the lower part” of his body, his “pelvis and legs” (p. 452). The “horrible vision” of Irma’s body in Freud’s founding dream thus returned to him at the end of his self-analysis as a horrifying and unsettling vision of his own eviscerated body. 2 For Erikson the Irma dream stood as an adaptive or regressive response to a conflict or life crisis in Freud’s life at the time of his dream, when his ego was in similar fashion impaired and endangered as it was the day before Freud dreamt his dream (Levine, 1998, p. 38). 3 Erikson (1954) himself admitted that he had not been “sufficiently familiar with the history of medicine to fully comprehend the anatomical, chemical, and procedural connotations which the body parts and the disease entities mentioned in the dream had in Freud’s early days” (p. 27). 4 See also Freud’s first account of his Irma dream in his “Project for a scientific psychology,” where he wrote: “R. has given an injection of propyl to A.” The letter “R.” is an obvious reference to “Rie,” the “A.” a reference to “Anna” (Freud, 1895c, p. 341)

122 Significance of Emma Eckstein’s circumcision 5 I am indebted to Mario Beira for this observation and insight. Beira was inspired to calculate the date when Freud impregnated his wife Martha with Anna, their last child, when reading an earlier draft of this manuscript and emailed me to inform me what his calculations had uncovered. 6 Elaborating further on Freud’s (1920) revision of traumatic dreams, and realizing that day and life residues were “repetition symptoms of trauma,” Ferenczi (1930–1932) proposed that “a more complete definition of the dream function would be: Every dream, even an unpleasurable one, is an attempt at a better mastery and settling of traumatic experiences” (p. 238). 7 On July 24 of 2009 Eddy (Adrian) de Klerk wrote me to say: “When I began to read Freud ‘sub specie circumcisionis’, I was startled to find that the keyword in the Irma-dream ‘trimethylamin’ can be read as an anagram, a nearly literal transcription, of ‘brith milah’ (Hebrew for circumcision). Try it and you will find that nearly all of the letters and sounds of brith milah are present in ‘trimethylamin’, except for the initial ‘b’ in the phrase. It may be just a sheer coincidence, a speculation on my part; but perhaps maybe not. Anzieu once said that a nearly perfect likeness is a complete one for the unconscious.” Eddy de Klerk and I collaborated for a year on a rereading of Freud’s self-analysis “sub species circumcisionis” and planned to write a paper together on the Irma dream. Our plan was sadly cut short by his death on June 17, 2010. 8 The term “dispositive” was introduced by Foucault in his interview of 1977 “The confession of the flesh.” According to Geller (2007), circumcision became, in the central European cultural imagination, “both an apotropaic monument and a floating signifier that functioned as a dispositive, an apparatus that connected biblical citations, stories, images, phantasies, laws, kosher slaughterers [Schochets], ethnographic studies, medical diagnoses, and ritual practices, among other deposits in that noisome landfill called Europe, in order to produce knowledge about and authorize the identity of Judentum – and of the uncircumcised” (p. 11). 9 Cf., among others, http://www.behindthename.com/name/irma. I owe this insight and connection to Mario Beira.

Part 3

Topography of a split

7KLVSDJHLQWHQWLRQDOO\OHIWEODQN

5

The savior of children

A remarkable curly structure Emma Eckstein began her “talking cure” treatment with Freud during the final months of 1894.1 Did Freud perform a complete medical examination on his patient then? And, if so, did he inspect her external genitals? Let us suppose for the sake of argument that Freud, who was after all a physician, indeed did. How, if at all, was he impacted by the anatomical disparity between Emma’s vaginal lips? His concern for Emma’s vaginal lips was undoubtedly overshadowed by the catastrophic outcome of the operation performed by Fliess on her nose in February of 1895. During the months which followed the surgery Freud no doubt regularly asked Emma to open her mouth in order to inspect her oral cavity and monitor her recovery. Freud’s feelings of alarm began to decrease a few months later, in May, as Emma improved and resumed her capacity to ambulate. In July, as Freud enjoyed a period of vacation, the old situation resurfaced through his dream of Irma’s injection. Irma failed to open her mouth in the dream at first. According to Freud (1900), she was recalcitrant, “like women with false teeth.” This reminded him of a disillusionment he had experienced some time before. He was examining a woman who at a first glance “seemed a picture of youthful beauty, but when it came to opening her mouth she had taken measures to conceal her plates.” According to Freud, this led him “to recollections of other medical examinations and of little secrets revealed in the course of them” (p. 109). Then, and as he peered down his patient’s open mouth, Freud went on to report that he saw some “remarkable curly structures” (p. 107) which reminded him of “the female organ of sex” (p. 117). He also saw a “white patch” and “extensive whitish grey scabs” which reawakened unpleasant memories, all bound to cocaine. Freud had been a regular consumer of cocaine during the early days of his medical career. Freud’s habit was apparently discontinued but returned during the days when he decided to follow Fliess’s advice to operate on Emma Eckstein’s nose. He had in fact resolved to keep his nose under the cocaine brush. Freud felt an immediate positive effect:

126 The savior of children “In the last few days,” he reported to Fliess on January 24, 1895, “I have felt quite unbelievably well, as though everything had been erased – a feeling which in spite of better times I have not known for ten months.” Freud’s feelings of well-being did not last long, however. Providing Fliess with a clinical report on his own state of health, Freud wrote his friend on March 4, 1895 to say: “This morning I once again wanted to die (relatively) young.” Cocainization helped Freud to overcome his feelings of depression and poor energy but also worked against him. On April 20, he wrote Fliess to say: “I pulled myself out of a miserable attack with a cocaine application.” Less than a week later, on April 26, he wrote Fliess again, this time to report: “I put a noticeable end to the last horrible attack with cocaine.” Less than two months later, on June 12, Freud was able to openly admit: “I need a lot of cocaine.”2 It was just shortly thereafter that he experienced his Irma dream, a dream which among other things must have reminded Freud of the serious damages which cocaine, a chemical substance, had caused him. The trimethylamin formula which appeared through his Irma dream had itself been a remnant of this magical drug. The reason why Freud was so deeply struck by Fliess’s communication on the role of trimethylamin in sexual metabolism was because he himself had already come across the formula years earlier. In his 1884 article Über Coca, his first work, Freud was to remark, immediately after writing down the chemical formula for cocaine, that an oil had been extracted from the coca leaf which “has a smell reminiscent of trimethylamin” (Byck, 1974, p. 54). The odor itself pointed towards the female genitalia. Cocaine itself was also associated for Freud with severe self-reproaches. Reflecting on what he encountered as he peered down Irma’s mouth in the dream, Freud (1900) wrote: The scabs on the turbinal bones recalled a worry about my own state of health. I was making frequent use of cocaine at that time to reduce some troublesome nasal swellings, and I had heard a few days earlier that one of my women patients who had followed my example had developed an extensive necrosis of the nasal mucous membrane. I had been the first to recommend the use of cocaine, in 1885, and this recommendation had brought serious reproaches down on me. The misuse of that drug had hastened the death of a dear friend of mine. (p. 111) In what follows, I will attempt to explore the nature and origins of Freud’s self-reproaches, associated with what he saw as he looked into Irma’s throat. As we shall see, Freud’s self-reproaches form the starting point of the interplay between accusation and self-defense, dynamics which appear and persist throughout Freud’s self-analysis.

The savior of children 127

I am not guilty At the age of 28 Freud had come across material which described cocaine as a substance which was capable of reviving exhausted soldiers, rendering them “strong and capable of endurance.”3 He managed to procure a sample of the drug and began to investigate its effects on himself. Experiencing a sudden exhilaration, Freud thought he had found a remedy for his depleted sense of energy and virility. Instead of inducing a pathological state, as morphine did, cocaine increased feelings of well-being. Freud believed that the drug was not habit forming and that it helped to boost one’s mood and to improve a depressed state to a more normal and better-functioning level. In his first cocaine paper, published in July 1884, Freud wrote that the substance operated through “the abolition of depressing elements of wellbeing” and explained that “the euphoria of health and well-being” which the drug produced was “nothing more than the normal state of the healthy brain surface that ‘knows nothing’ of its own organs” (p. 301; translation by Bernfeld, 1953, p. 587). As Jones (1953, p. 92) explained, besides lowering and dispelling his depression, cocaine also provided Freud with “an unwonted sense of energy and vigour. Depression, like any other neurotic manifestation, lowers the sense of energy and virility: cocaine restores it.”4 According to Bernfeld, Freud extracted from the effect of the alkaloid “an important and highly optimistic insight; the depression of the normal status of well-being must be due to the interference of an unknown central agent, which can be removed chemically” (Bernfeld, 1953, p. 600). The entire matter was well summed up by Jones (1953) when he wrote that Freud had found “a magical drug” in cocaine (p. 89). The misuse of that drug had served to hasten the death of Ernst Fleischl von Marxow (1846–1891), a close friend and one of two assistants to Brücke at the Physiological Institute where Freud worked from 1876 to 1882. Fleischl contracted an infection at the age of 25 as a result of his research into pathological anatomy at the Institute and had to undergo one surgical operation after another to treat his infection: “His life became an unending torture of pain and of slowly approaching death, yet his mutilated and aching hand performed experimental work of technical perfection” (Bernfeld, 1953, p. 585). In order to alleviate the intolerable nerve pain he felt, Fleischl began to use morphine and became addicted to the substance. In the summer of 1884 cocaine appeared to be a promising, harmless drug, with many possible uses: a forceful invigorant, a powerful weapon against the need for food and sleep, as well as an “antidote” against morphine. In March of 1885, when discussing the treatment of morphinists before the Psychiatric Society, Freud boldly pronounced: “I would . . . advise without hesitation . . . to give cocaine in subcutaneous injections” (Bernfeld, 1953, p. 607). Seeing cocaine as a harmless medication with promising clinical applications, Freud began experimenting

128 The savior of children with it on colleagues, patients, and friends, among them Fleischl, who became dependent on and addicted to the drug. Freud attempted to cure his friend’s addiction by substituting morphine for cocaine. What he thought was a harmless substitution, however, was not: beginning in 1885 the physical and mental condition of Fleischl von Marxow resembled an alcohol delirium, with sensorial and paranoid hallucinations. Freud initially succeeded in relieving the physical pain (trigeminal neuralgia) which his friend and colleague felt by injecting cocaine directly into the nerve. He hoped to do the same for the neuromata; unfortunately “no good seems to have come of it . . . in April Freud had sat up all night with him . . . It was the first of many such nights he passed in the following couple of months” (Jones, 1953, p. 100). According to Jones, Fleischl was “by this time taking enormous doses of cocaine” which “led to a chronic intoxication, and finally to a delirium tremens with white snakes creeping over his skin” (p. 101). Fleischl, the “first morphine addict in Europe to be cured by cocaine,” in turn became the first cocaine addict in Europe, or certainly “one of the first” (Bernfeld, 1953, p. 601). Freud’s treatment of Fleischl grew increasingly difficult as the alarm on cocaine as a dangerous and poisonous drug began to spread throughout Europe. Freud, however, was unable to see or admit to the dangerous signs. The cocaine affaire had transformed into a nightmare by 1886, with Freud being charged as the one who had “started it all.” In the course of 1886 cases of cocaine addiction and intoxication were reported from all over the world and the drug was now being described as “the third scourge of humanity.” As Jones (1953) explained: “The man who had tried to benefit humanity, or at all events to create a reputation by curing ‘neurasthenia’, was now accused of unleashing evil on the world. Many must at least have regarded him as a man of reckless judgement” (p. 104). Siegfried Bernfeld, a leading scholar of Freud’s life and the origins of psychoanalysis, considered Freud’s research on cocaine as “his first attempt to break out into full independence,” an anticipation of his capacity to pursue his way completely alone against the “compact majority.” Freud was only able to achieve this goal in the late 1890s (Bernfeld, 1953, p. 581). Yet cocaine, “the first topic that he [Freud] himself – independent of others – chose in order to gain scientific distinction, failed him, and even threatened the independence which . . . he was just then attempting to establish” (p. 611). A similar crisis was precipitated a decade later by the Emma Eckstein incident: Freud failed to accept established medical practice at the time and refused to trust the pre-existing wisdom and established rules of his profession. He was in fact challenging them by supporting a completely new therapeutic plan of action (the removal of the turbinal bone in the nose). And what was the result? Could Freud rely on his capacity to make his own choices or those which his father and teachers had made for him? Were the options he rejected better than his own choices? The intensity

The savior of children 129 of self-reproach which broke and spoke through in Freud’s associations to his Irma dream in the summer of 1895 suggests that the confidence which he had placed in himself and his choices had been deeply compromised. Erikson (1954) spoke, in this regard, of Freud’s mid-life crisis. In 1887 Freud defended himself against the reproaches which followed his recommendations and endorsement of the use of cocaine. In his paper “Craving for and fear of cocaine,” published in the leading Viennese medical weekly at the time, Freud claimed that he had not advocated the harmful needle. A decade later, in the Irma dream, the cause of the infection was represented by this same harmful needle. According to Bernfeld (1953, p. 610), the dirty needle which appeared in the Irma dream pointed directly to the accusation that Freud “had not discovered a helpful remedy but rather a tempting poison, [and] that he and his work on cocaine amounted to nothing.” Bernfeld noted that, while Freud systematically denied having recommended the administration of cocaine via injections, he failed to include a paper where he had offered precisely this recommendation in the list of publications he had submitted when he applied for the position of “Professor extraordinarius” at the University of Vienna. A signifier of Freud’s denials and omissions, the “injection” managed to return and spoke through his Irma dream. Bernfeld was unfamiliar with the Emma incident; otherwise he might have pinpointed an analogy between the Fleischl incident and the botched operation on Eckstein: both had been meant as “harmless substitutions” (cocaine for morphine, and the operation on the nose for castration) and each turned out to be a damaging solution and a regrettable choice. Bernfeld (1953) explained Freud’s “wish to help Fleischl,” as a “defense against, and reaction to, his unconscious death wishes” (p. 610). Bernfeld offered this particular line of interpretation on the basis of Freud’s non vixit dream. Dreamt in October 1898, the dream was partly triggered by the inauguration of a monument to honor Fleischl at the University of Vienna. Freud decided to discontinue his position as a teaching assistant at the Physiological Institute in July of 1882 where Joseph Paneth became his successor. Unhappy about “the prospects of slow advancement and uninhibited by any emotional attachment to Fleischl, Paneth had repeatedly and openly expressed death wishes against Fleischl, the man who blocked his way.” Paneth’s egotism and ambition had horrified Freud. Yet, and as Bernfeld (1953) explained, Freud too, until 1882, “had been in the same position; he, too, had wanted to become an assistant, and in his case also, Fleischl had stood in the way” (p. 610). Commenting on the non vixit dream, Freud himself wrote: “to be sure, I myself had cherished even more intensely the same wish.” This adds yet another layer to the long list of self-reproaches which piled up in Freud’s case, self-reproaches which had indeed managed to break through his Irma dream.

130 The savior of children According to Bernfeld, Freud’s attempts to alleviate Fleischl’s pain by prescribing him cocaine were indeed partly due to his unconscious ill wishes against his friend and colleague. These were the very same ill wishes that Freud himself, during the course of his self-analysis, had traced back to the birth of his younger brother Julius, who died just a few months after he was born. In the well-known letter which Freud wrote to Fliess on October 3, 1897, Freud openly confessed to his friend that he had greeted the arrival of his younger brother Julius “with adverse wishes and genuine childhood jealousy; and that his [Julius’s] death [had] left the germ of [self-]reproaches in [him].” Bernfeld aligned Freud’s frustrated wish to secure an academic position at the University with his childhood desire for his unavailable mother: on both occasions someone stood in the way and blocked his goal. With regard to the childhood situation, we must note that Amalia went on to have five more children (Anna, Mitzi, Dolfi, Pauli, and Alexander) after Julius. Could the “pale and puffy” figure of Irma be seen as a double of the dreamer’s pregnant mother? Did Irma’s reluctance to open her mouth properly in the dream serve as a reminder to Freud of the unavailability of his mother Amalia, a woman who seemed to always be pregnant and thus unavailable to him? The feeling of being denied access in time grew into a fundamental theme which Freud explored during the course of his self-analysis. In his founding dream, the pains that Irma experienced in her body became a cause of great alarm for the dreamer. Freud, in the dream, immediately felt guilty but yet rejected any and all responsibility for Irma’s pain. I am reminded here of the only dream which Freud reported from his childhood in his dream book, namely, his dream of his “dead mother,” an anxiety dream he had had at the age of nine and a half, precisely when his mother had been pregnant with Alexander.5 In Freud’s dream his beloved mother Amalia was carried by two or three bird-beaked figures which, Freud (1900) fancied, “must have been gods with falcons’ heads from an ancient Egyptian funerary relief” (p. 583). Freud’s highly vivid dream derived from images he had encountered when reading the Philipsson Bible with his father as a child. This unusual Bible presented both the Hebrew text of the Old Testament as well as a German translation of the text. The book included cultural commentaries and background information on ancient history and material on comparative religion. It was illustrated by over 500 wood engravings, a truly shocking thing in a Hebrew Bible, as Judaism forbids representations and images in relation to the Bible. Freud awoke from his Egyptian dream crying and in such an anxious and agitated state that he ran from his bed into his parent’s bedroom to awaken them. The boy only grew calm when he saw his mother’s face, as though he had needed “to be reassured that she was not dead” (p. 584). According to Freud, the anxiety he experienced in his dream traced back to his childhood fantasies relating to sexual intercourse. Was the injection

The savior of children 131 given to Irma modeled on the pointed beaks of the tall and strange figures carrying his mother’s corpse? Anzieu (1986a), while commenting on the way in which the dream of the dead mother had been introduced by Freud, realized that the same latent content found at work in Freud’s dream of Irma’s injection could be found in this dream as well: “I am not guilty” (p. 294). Freud, let us note, had defended himself against the reproaches which followed his recommendations on the use of cocaine in the very same way, namely, by denying he had recommended the harmful needle. Fleischl had been infected in Brücke’s laboratory and it was only the amputation of his right thumb which had kept him from an even earlier death. The continued growth of neuromata,6 however, required one operation after another. Fleischl was affected by what is typically known as a phantom-limb phenomenon. A phantom limb is the sensation that an amputated or missing limb is still attached to the body, with the accompanying phantom pain being defined as a persistent painful feeling of the presence of the missing body part. When a limb is amputated, the severed nerve endings become inflamed and, according to the leading theorists at the time, it was inflammation of the periphery which caused the sensations in the brain which gave rise to the false perception. When the sensations grew highly painful, surgeons were often forced to perform a second amputation to remove the inflamed nerve endings and provide the patient with temporary relief from the phantom pain. Freud was so deeply moved by Fleischl’s suffering that, on one occasion, he wrote: I admire and love him with an intellectual passion, if you will allow such a phrase. His destruction will move me as the destruction of a sacred and famous temple would have affected an ancient Greek. I love him not so much as a human being, but as one of Creation’s precious achievements. (Jones, 1953, p. 99) Freud’s emotional enmeshment with Fleischl is strikingly similar to his entanglement with Emma Eckstein. Emma experienced a genital mutilation and was affected by genital paresthesias. She also suffered from her own peculiar and unique “phantom limb” (the quasi-hallucination of her having a penis). In reproaching himself for the damage he had caused Fleischl, Freud was also indirectly speaking of the pain, suffering, and damage he had caused Emma, implicitly acknowledging the relationship and resemblance between the two subjects and scenes. Fleisch died in 1891, three years before Freud began to treat Emma in 1894. The return of the unpleasant memories associated with Fleischl’s tragic and painful death presents an unconscious attempt by Freud to make sense of the Emma incident. Indeed, it links flesh (Fleischl) and stones (Eckstein) together for Freud. Even the image of the destruction of a sacred and famous temple managed to speak and broke through the Irma dream, all captured by the image of the

132 The savior of children “propylaea,” a term which pointed both to the ceremonial gateway of Greek temples and to the labia, an anatomical part of the body.

A plea on behalf of my own rights Freud associated cocaine not only with self-reproach but also with selfdefense. The interplay between accusation and defense, which in the Irma dream is only hinted at, spoke through the dreams which visited Freud after. I am thinking, in particular, of his Botanical Monograph as well as his Count Thun dream. In those dreams the accusations that Freud and his work had amounted to nothing were balanced with yet another story which featured cocaine. Analyzing the dream of the botanical monograph, Freud recalled that he had once written something in the nature of a monograph on a plant (a dissertation on the coca plant) where he had drawn attention to the anesthetic properties of cocaine. Indeed, in the final paragraph of his 1884 paper Über Coca, after remarking that cocaine possessed the ability to anesthetize the skin and mucous membranes, Freud brought his text to a close with the following prophetic remark: “Some additional uses of cocaine, based on its anaesthetic property, will probably be developed in the future” (Freud, 1884; translation by Bernfeld, 1953, p. 588). Freud’s paper was so well received that it was reprinted in pamphlet form, and with an addendum written by him, in February of 1885. In March, he delivered yet another successful lecture. The tide, however, was “beginning to turn” (Jones, 1953, p. 102). The public was split right down the middle between those who were for and those who were against the wide use of cocaine. In July Freud was criticized by Erlenmeyer, but then Obersteiner warmly defended him, as did others. In August of 1885 Dr. Guttmacher, the inventor of coca-leaf cigars, published in the Wiener medizinische Presse a eulogistic article on Parke’s universal panacea, in which the author said that “Dr. Freud’s prophecy” about the local applications of cocaine had now been more than fulfilled. How? Freud had come close to discovering the anesthetizing properties of cocaine, in particular its ability to numb the eye, in the summer of 1884. Instead of following through with his insight and completing the work, however, he decided to go on vacation, entrusting Leopold Königstein with experimenting on the possible anesthetic properties of the drug on the human eye. Königstein, however, was not aggressive enough in his research and was beaten to the task by Karl Koller. Koller’s discovery was universally acclaimed and he was soon declared a “benefactor of mankind.” According to Freud, the great opportunity of his life had been missed. Rather than seeing the matter through, he had traveled to visit his fiancée, whom he had not seen for over a year. His decision to travel out of Vienna on vacation prevented him from carrying out the necessary scientific investigation and achieving a major discovery which might have helped him to receive instant

The savior of children 133 fame. As Freud (1900) noted in The Interpretation of Dreams, he had not been “thorough enough to pursue the matter further” (p. 169). Just a few months later, on April 5, 1885, while in the midst of the Fleischl nightmare, Freud’s father contacted him to tell him that there was something wrong with one of his eyes. Koller examined Jacob and diagnosed him as suffering with glaucoma. Königstein operated the next day: Shortly after Koller’s discovery, my father had in fact been attacked by glaucoma; my friend Dr. Königstein, the ophthalmic surgeon, had operated on him; while Dr. Koller had been in charge of the cocaine anaesthesia and had commented on the fact that this case had brought together all of the three men who had had a share in the introduction of cocaine. (Freud, 1900, p. 170) The memory of a possibly great triumphant moment appeared to Freud through his Count Thun dream, where the reference to cocaine, the substance which had helped his father to successfully undergo surgery for glaucoma, was associated by him with the enumeration of his achievements and successes. Freud’s successes all functioned to challenge the severe pronouncement which Jacob Freud had once vocalized against his son. Jacob’s harsh words that “the boy,” his son Sigismund, would “come to nothing” were forever seared in Freud’s mind. As Jones (1953) described it: “Freud must have been proud to have helped his father and to have proved to him that he had after all amounted to something” (p. 95). There are two points which strike me as overdetermined. The first concerns the unilateral glaucoma which, in Freud’s dreams, memories, and fantasies, was replicated and emphasized through a series of figures, all of whom suffered from blindness in one eye. This reminds us of the anatomical difference found between Emma’s vaginal lips. The second is the peculiar stress which Freud placed on the anesthetic properties of cocaine. Psychoanalytic scholars have been perplexed by Freud’s contention that he had been quite close to discovering the anesthetic application of cocaine for eye surgery. When the English translation of Fritz Wittels’s biography of Freud appeared in 1924, however, Freud protested about how the cocaine story had been presented by Wittels.7 When the opening volume of Freud’s official biography by Jones (1953) appeared, Albert Hirst, Emma Eckstein’s nephew, was so disappointed with Jones’s views on the role of cocaine in Freud’s life that he wrote first to Freud’s daughter Anna and then directly to Jones. According to Hirst, “Freud had considered the cocaine story one of his triumphs” (Roazen, 1995, p. 6) and Jones had “completely misunderstood” what had happened (p. 7). When Jones, who based his own reconstruction on Karl Koller’s account, responded to Hirst he reaffirmed that in his view Freud later distorted the story as compared with how it could be reconstructed from contemporary records. It turns out that neither Bernfeld nor Jones had

134 The savior of children relied on Freud’s version in their historical reconstructions. According to Jones, Freud’s self-reproach for not having vigorously pursued his research on the anesthetic property of cocaine was “somewhat misplaced,” since “surgical application” had been a theme completely “foreign to his interests” (Jones, 1953, p. 90). Freud’s feelings of self-reproach for his failure to discover the anesthetic properties of cocaine were carefully and judiciously examined by Bernfeld (1953). He arrived at the following conclusion: there is no indication that Freud would have invented local anesthesia even if he had devoted himself to the study of cocaine with thoroughness and concentration. Freud’s thoughts were not on surgery. . . . he wanted to be ‘a good doctor’, one who relieves pain and restores the patient to normal well-being. He did not wish to be the dreaded surgeon, who cuts and hurts cruelly. (pp. 593–594; emphasis added) When writing on Freud’s interest on the anesthetic qualities of cocaine, Bernfeld and Jones each struggled with the intrusion of disturbing thoughts about surgeon and surgery. The intrusion of foreign and alien thoughts occurs quite often to those of us who read and study Freud. Typically the reader focuses on the manifest and surface level of Freud’s discourse, but then, quite often, there is a second level to his discourse which interferes with the surface level. This deeper level typically manages to break through as small fragments or puzzling elements which fail to fit within the discursive framework and render Freud’s discourse particularly incoherent or confusing. In this case the intruding alien is the image of the “dreaded surgeon, who cuts and hurts cruelly.” The same element informs the enigmatic daydream which Freud experienced the day after he dreamt and analyzed his dream of the botanical monograph, a dream which Freud explicitly envisaged as a continuation of the self-justifications which had been staged in his Irma dream. Once analyzed, Freud noted, both the Irma and botanical monograph dreams turned out to have been “a plea on behalf of my own rights” (Freud, 1900, p. 173). In his daydream Freud fantasized that he would travel to Berlin if he ever suffered from glaucoma in order to be operated on, incognito and in Fliess’s home, by a surgeon recommended to him by his friend. The surgeon, who would have no idea of Freud’s identity as he performed the operation, “would boast once again of how easily such operations could be performed since the introduction of cocaine” (Freud, 1900, p. 170). Examining the possible meaning of Freud’s unusual and peculiar fantasy, Grinstein (1961) attempted to shed light on “the castration significance” of Freud’s fantasy (p. 487). Recalling that Fliess had been the person upon whom Freud had transferred many of the feelings which had been reawakened during the process of his personal analysis, Grinstein wrote:

The savior of children 135 The fantasy of being operated on by a surgeon whom Fliess recommended is tantamount to Freud’s submitting to surgery by Fliess himself, since Fliess was after all a surgeon too, who had in reality operated on Freud on two occasions. Dynamically this was equated to his being castrated by Fliess. (p. 487) Grinstein (1961) traced the “evil thoughts and fantasies” punishable by castration in the daydream back to Freud’s “forbidden incestuous feelings toward his sister Anna” (p. 501) and, beyond it, to Freud’s repressed sexual desire for his mother. We might add that Freud had been identifying with Emma Eckstein, symbolically adopting her position and stepping into her shoes, as indicated in other dreams that he had. We might even speculate that Freud’s uncanny daydream had served to anticipate the self-dissection of the pelvis featured in the final dream of Freud’s self-analysis, a dream in which the castration which his former female patient had endured was replicated on Freud’s own body. One important element which remains unexplained, however, is that Freud felt proud of the fact that cocaine was being used a local anesthetic. Freud’s biographers have failed to acknowledge and to follow him on this point, if only because surgery had been “foreign to his interests” (Jones, 1953, p. 90). This discrepancy marks the initial point of a growing bifurcation between “facts” and “fantasies,” biography and phenomenology, in the reconstruction and interpretation of Freud’s life and his desire.

An additional use of cocaine In order to grasp the subjective meaning that the anesthetic use of cocaine had for Freud, it might be useful to focus on a specific use of the drug never mentioned by him. This application of cocaine was described by Maximillian Herz in October of 1885, in an article entitled “Über Hysterie bei Kindern” (On hysteria in children). Published in the Wiener medizinische Wochenschrift, Herz explained that the cause of hysteria in children might occasionally be due to local illnesses, general illnesses or perhaps even psychic trauma. These local causes, Herz (1885) argued, concerned mainly the “urogenital” parts, consisting in “phimosis, agglutination of the prepuce with the glans, inflamed and stretched clitoris, etc” (p. 1308). Exploring and pondering possible forms of therapy, Herz noted that onanism and masturbation had to be obviously struggled against and, further, that it was necessary to treat the phimosis, the smegma under the prepuce, the inflamed and long clitoris, as well as every other kind of vaginal stimulus. In a seven-year-old girl who engaged in the practice of onanism for a month, Herz found that her bad habit had originated in response to a bodily secretion, a vaginal “catarrh” (leuchorrea: “whitish patch”) (p. 1403). Since hygienic measures were not sufficient to put

136 The savior of children an end to her habit, Herz came up with a possible new solution: he succeeded in quickly curing the girl of her habit by applying a 10 percent solution of cocaine on the entrance of her vagina on a twice-a-day basis (p. 1403). As Herz (1885) explained: Obviously, anaemia and chlorosis have to be confronted with adequate measures . . . , the same has to be done in every possible way with regard to onanism and masturbation, which, according to Jacobi, are frequently the cause of hysterical fits. I will here mention only in passing the well-known fact that the stimulation of the genitals – in the form of phimosis, of the smegma accumulated under the prepuce etc., or in girls of the extended and inflamed clitoris – provide the occasion for onanism, masturbation, and every kind of vaginal stimuli, which must be cleared. In a case of the latter kind, concerning a weak female child age seven who had been practicing onanism for several months, . . . I have found that the cause of the habit was a vaginitis due to the catarrh and a tickle . . . the treatment based on surveillance, baths, and astringents introduced in the vagina, which lasted for several weeks, failed to reach the desired goal; only when I combined the treatment with the brushing on the entrance of the vagina with a 10% solution of cocaine on a twice a day basis did the tickle, the stimulation and the onanism cease immediately. (p. 1403) Maximilian Herz (1837–1890) was the director of the third pediatric department in the Vienna General Hospital. The first two departments were established in 1872 and were headed by Ludwig Fleischmann (1841–1878) and Alois Monti (1839–1909). The third was established in 1880 and was closed after Herz passed away in 1890 (Tragl, 2007, pp. 306–307). Herz, Fleischmann, and Monti had all received their medical degrees from the University of Vienna (Herz in 1861, Fleischmann in 1865, and Monti in 1862). They all went on to specialize in pediatrics. Herz spent some time in London, where he became a lecturer at the University in 1872. Alois Monti, who was of Italian origin, became associate professor in pediatrics in 1881 and full professor (Ordinarius) in 1887. Fleischmann died very young, in January of 1878, after he contracted rheumatism and suffered endocarditis. His article “Über Onanie und Masturbation bei Säugligen” [On onanism and masturbation in babies], which appeared in the Wiener medizinische Presse in 1878, was published posthumously. This group of pediatricians held important positions at the Vienna General Hospital when Emma Eckstein was a child. If her parents consulted a physician because of her masturbation it was likely a member of this group at the institution that they had turned to. These physicians were all moreover connected with Adolf Baginsky (1843–1918), Freud’s mentor in the field of pediatrics, who took his degree in medicine in 1866 at the

The savior of children 137

AR C HI Y FtJR

KINDERHEILKUNDE HERAUSGEGEBEN VON

Dr. A. B A G IN SK Y , 'J l M f Prlyatdooent an der DnlyersltSt Berlin.

Dr. M. HEKZ, Privatdoeent der Wiener Hocbschnle.

Dr. A. MONTI, Profeeaor der Wiener Hocbscbule.

F t t N F T E R BAND.

Wi.j.FA. 37 % h-S. y

.

'I ^ S V STUTTGART.

V E R L A G VO N F E R D I N A N D ENKE. 1884.

Figure 5.1 Cover of the journal Archiv für Kinderheilkunde, edited by Baginsky, Herz, and Monti (1884).

University of Berlin. Baginsky also studied medicine in Vienna for a year. While in Vienna he no doubt became personally acquainted with the future leading pediatricians in that city. When Baginsky founded the most important pediatric journal of the era in 1880, the Archiv für Kinderheilkunde,8 Alois Monti and Maximilian Herz became co-editors of the journal (Fleischmann had passed away two years earlier). Herz was thus associated with Baginsky when he announced his successful treatment of masturbation with the local application of cocaine in 1885. In his 1885 article, Herz also praised the etiologic classification of hysteria in children which had been devised by a student of Baginsky (Samuel

138 The savior of children Schäfer) in a doctoral dissertation which was published a year earlier, in 1884, in Baginsky’s own pediatric journal. The thread which connected Herz and Baginsky allows us to arrive at two specific conclusions. Freud had probably settled on Baginsky as his mentor in the world of hysteria and masturbation in children mainly because of the article by Herz. The second is that Freud, whose professional identity was at that time very much bound to cocaine,9 was perhaps hoping that the application of cocaine as a local anesthetic would gain acceptance within pediatric circles as a substitute for treating masturbation in children by circumcision. If so, Freud must have been bitterly disappointed. This form of treatment, as far as I’ve been able to ascertain, was soon dropped and was no longer mentioned or discussed, either in the pediatric journal which Baginsky edited or in other European journals. On the contrary, at the end of the century Hermann Rohlender still advocated the removal of the prepuce without anesthesia as a method of treatment for male masturbation. Similar surgical measures were also being recommended for female masturbators (see Chapters 1 and 4). Did Freud apply cocaine locally on the mucous membranes of the external genital organs of children, managing to “save” a number of female children from the treatment interventions which pediatrician, gynecologists, and sexologists were actively recommending during the decade that Freud worked at the children’s hospital in Vienna? From 1886 to 1896, as we know, Freud regularly worked three days a week at the Öffentliches Kinder-KrankenInstitut [Public Institute for Children’s Diseases] directed by Kassowitz. Despite the fact that Freud himself would later minimize this serious commitment to his work with children, the fact that his clinical work with them took place during the crucial years when he broke from the approach taken from the medical establishment suggests that it played an important role in laying down the essential patterns of the then emerging discipline of psychoanalysis. We might even wonder whether the “Trinitarian” pattern which informed Freud’s Irma dream, beginning with “the three curly structures in Irma’s throat” (Freud, 1900, p. 117) was not itself a product of the three days which Freud spent every week working with children. This leads us to ponder whether Freud (1900), in his Irma dream, had experienced the shadowy impression that Irma had herself been a child – indeed “one of the children whom we had examined in the neurological department of the children’s hospital” (p. 292). Freud, however, failed to pursue this particular line of thought when interpreting his Irma dream.

A tabooed word Looking down Irma’s throat Freud saw a white patch. The white patch reminded him of a diphtheritic membrane and triggered memories of a serious illness which his eldest daughter, Mathilde, had suffered almost two years earlier. Mathilde became seriously ill in 1893, with Freud fearing

The savior of children 139 that he might lose his daughter. Freud was then naturally led to recall the fear he had experienced during those anxious days (p. 111). This in turn reminded him of an unpleasant incident which had occurred with one of his female patients, a woman also named Mathilde. Freud had been responsible for a severe toxic state in his patient (Mathilde), produced as a result of his repeatedly prescribing sulfonal (regarded as a harmless remedy at the time) for her. As Freud (1900) recalled: My patient – who succumbed to the poison – had the same name as my eldest daughter. It had never occurred to me before, but it struck me now almost like an act of retribution on the part of destiny. It was as though the replacement of one person by another was to be continued in another sense: this Mathilde for that Mathilde, an eye for an eye and a tooth for a tooth. It seemed as if I had been collecting all the occasions which I could bring up against myself as evidence of lack of medical conscientiousness. (pp. 110–111) The substitution of one Mathilde for another Mathilde arrived to represent the apex of Freud’s self-reproaches, exposing the death of his patient in Freud’s mind as a crime which required punishment by the death of his daughter with the same name – a horrible sacrifice. The case history of Freud’s patient Mathilde, whose last name was Schleicher, has been reconstructed by Albrecht Hirschmüller (1989) on the basis of various clinical files. Born in 1862, Mathilde was hospitalized by Freud in Dr. Wilhelm Svetlin’s clinic on October 29, 1889 because of a psychotic crisis with erotic content.10 She was discharged from the facility seven months later, on May 25, 1890. Freud continued to treat her with sulfonal until the first signs of intoxication appeared. She died just a few months later, on September 24, 1890, at the age of 27 and before the scientific community had realized that sulfonal was toxic. Reflecting on the meaning of this unpleasant event, Hirschmüller found that the serotherapy for diphtheria had been discovered only a year before Freud dreamt his dream. Prior to 1895 diphtheritic septicemia almost always had a mortal outcome. It was only with the introduction of Behring’s serotherapy that the mortality rate for the disease was cut by half. Attempting to reconstruct Freud’s emotions and thoughts, Hirschmüller wondered whether Freud had identified with Behring, “the saviour of thousands of children.” Was Freud hoping to liberate mankind of a plague by means of a great discovery? This is a relevant question, one which addresses many important but puzzling pieces in Freud’s self-analysis. According to Hirschmüller, after the conference in Vienna held by Behring in 1894, the debate on the pros and cons of serotherapy became highly polarized. A year later, in 1895, we find that newspapers were either in favor of or critical of the therapy,

140 The savior of children alternatively described in the press as either a “great conquest” or a “Jewish fraud.” The debate and differences of opinion eventually reached Freud’s own pediatric milieu. When his daughter Mathilde really did fall ill with septic diphtheria in March of 1897 (Masson, 1985, p. 232), Freud did not allow serotherapy to be dispensed to her as a mode of treatment; Oscar Rie and Kassowitz were likewise “against the injections recommended by Behring” (p. 235). There is an important element which Hirschmüller has overlooked when reflecting on the diphtheria knot which links Freud’s treatment of Mathilde Schleicher with his fears regarding his daughter’s infection. Behring had not been the only person who had “recommended the injection.” Besides Behring, there was another well-known figure involved in the struggle to cure diphtheria, namely, Adolf Baginsky, Freud’s mentor in the field of pediatrics. Diphtheria had become one of Baginsky’s main interests by 1886 and Freud decided to write a review of a study on diphtheria a year after (Freud, 1887), just shortly after he had completed his training with Baginsky. Baginsky had dreamt of an “Infektions-Pavillon” [infections building] – the first of its kind in the world – since opening the Berlin pediatric hospital Kaiser Friedrich in the early 1890s. He had hoped to isolate and to successfully treat children suffering from diphtheria and had been personally involved in researching the antitoxin treatment. Later on he was the first to adopt Behring’s serotherapy as a mode of treatment for diphtheria. In the highly charged debate on the pros and cons of the serum, Baginsky was its main supporter, resisting and challenging even the authority of Virchow, who sided against it.11 The rescue fantasies which Hirschmüller picked up on as he explored and reflected on the debate regarding the pros and cons of the serum therapy of diphtheria can itself be found embedded in the so-called “seduction theory” which Freud developed just shortly after his Irma dream. It was, however, also anticipated in Freud’s specimen dream, where the attack which Irma endured was treated and seen by him as the byproduct of an infection. The dream contained two principal scenes. In the first, Freud guides Irma to the window to examine and look down her throat. In the second, the examination is repeated in a hospital setting, where Freud is aided by Otto and Leopold, his two assistants at the neurological department at the Kassowitz Institute, a children’s hospital in Vienna (Freud, 1900, p. 112). Otto was Oscar Rie, Freud’s friend and colleague, but also the pediatrician of Freud’s own children. Interpreting the dream, Freud associated the scene at the hospital with his habit of examining children undressed. This line of inquiry was quickly cut short by him, however, saying that he “had no desire to penetrate more deeply at this point” (p. 113).12 Freud quickly changed the subject and began reflecting on the subject of diphtheria, a severe infective disease which presented Freud with a signifier of a taboo. In his dream Freud noted that the sound of the word “dysentery” [Dysenterie] was not far removed from the word “diphtheria” [Diphterie] – “a word of ill

The savior of children 141 Die

Smmit1n>nipil kl»f-rrrn-l’i (•‘ill *ck kINat*-1krjal anl^a .•

j ■ ■ - i nf i j y U ' l iiliT . l i n i l .} iit- r iiiili.

AA'V'- ’'01/ lii'tiin ism V r r li i K v i’ ii A u g u s t 11i r.s ■■Inv :i M. NW. I’MH -t-n IJailn AH,

Figure 5.2 Front page of Adolf Baginsky’s (1895) monograph The Serum-Therapy of Diphtheria after the Observations in the Children Hospital Kaiser- und Kaiserin Friedrich in Berlin.

omen which did not occur in the dream” (p. 114). Freud’s original German text reads: “welcher genannt wird Name ††† im Traum nicht,” which, to correct Strachey’s mistranslation, may be more accurately rendered by “a word (or name – Name) which ††† is not named in the dream.”13 The three crosses – an exorcizing sign chalked on the inside of doors in peasant houses to help ward off danger – anticipates the exorcizing function of the trimethylamine chemical formula in his Irma dream, helping to dispel the horrid spectacle found in the open mouth which materialized in his founding dream (the three curly structures – female genitalia). Did the triple cross surface in Freud’s text as a specific reminder, symbol, and signifier which helped him to magically ward off frightening feelings, fantasies, and memories stirred up in his mind by Emma Eckstein’s circumcision? A number of authors have proposed that Freud had placed his associations on Mathilde (“this Mathilde for that Mathilde, an eye for an eye and a tooth for a tooth”) into his dream book only after his daughter experienced a second bout of severe illness between March and April of 1897 (see, for instance, Hamot, 2006–2007). It was only then that his daughter Mathilde had come down with diphtheria, an illness which occurs in humans only

142 The savior of children once. If so, the circumcision scene which Emma had produced for Freud as her analysis neared its end in 1897 must have been fresh in his mind. Recall that Freud had first shared details of Emma’s circumcision scene with Fliess in January of 1897.

Infection Baginsky’s successful struggle against diphtheria duplicated, moreover, his less glorious struggle against masturbation in children: both were viewed by him as “infectious” diseases.14 Baginsky’s fight against “infections” was itself associated with the notion that doctors were priests, an idea found at work just under the surface of the Irma dream itself. In this context we might recall that, on February 25, 1895, two or three days after Fliess had operated on Emma’s nose, Baginsky delivered an important lecture on “Die hygienischen Grundzüge der Mosaischen Gesetzgebung” [“The hygienic foundations of mosaic constitution”]. Modernization implied secularization and the translation of religious discourse into scientific language. Just as Christian Darwinists presented the idea of original sin as an anticipation of modern scientific knowledge, Baginsky considered Mosaic law an anticipation of modern hygiene. According to him the ritual provisions of Mosaic law were based on the physiology of the human organism, thus representing basic hygienic sanitary norms. He traced Moses back to the world of Egyptian priests and considered them “sanitary officials” whose functions were equal to those of modern doctors, the most important of these being the prevention, isolation, and elimination of infection and diseases. In pre-scientific days the causes of diseases were attributed to a devil or to an animal spirit which, once it made its way into the patient’s body, had to be removed, destroyed, neutralized, or discharged to cure the patient. The theme of infection has provoked uncontrolled fears and irrational reactions since time immemorial, becoming emblematic of obscure superstitions that have slowed the progress of scientific knowledge. The theme of infection was itself deeply enmeshed with the Jewish question, as Sander Gilman has effectively argued in Freud, Race and Gender (1993, pp. 60–70). In nineteenth-century medical literature the issue of syphilis was often debated in connection with circumcision. Circumcision was on the one hand seen as prophylaxis against the disease but, at the same time, also viewed as a source of infection to the newborn infant through the ritual of metsitsah, the sucking on the penis by the mohel (male circumciser) to facilitate the stopping of the blood flow issuing from the cut on the male organ after circumcision. As Gilman (1993) noted, the debate on the transmission of syphilis by this ritual “raged in Vienna during the mid-nineteenth century as vociferously as anywhere else in Europe” (p. 67). In the extensive debate, the locus of transmission of syphilis shifted from the mouth of the mohel to the instruments used to perform the ritual. The result was that “more and more Jews were refusing to have their children circumcised” (p. 67).

The savior of children 143

Yerlag von Friedrich Vieweg & Sohn in Braunschweig.

Die hygienischen Grundziige der m osaisclien Gesetzg ebung. V ortrag, gehalten fur einen wohlthatigen Zweck am 25. Februar 1895, in der Aula des Friedrich-W erder’schen Gymnasiums in Berlin. Yon

Dr. Adolf B agi ns ky,

a. o. P r o f e a s o r a n d e r T J a i r e r s i t a t B e r l i n .

Z w e i t e A u f l a g e * _ gr. 8- gefcu P reis 50 ^

Figure 5.3 Advertisement of Baginsky’s (1895) lecture on “The hygienic foundations of Mosaic constitution.”

In most European countries the ritual was reformed but, as Gilman noted, the practice of metsitsah remained associated with “the feminization of the male Jew and his absolute position as one at risk for a sexually transmitted disease” (p. 69).15 Concern about infection deeply informed Freud’s early theory of sexual etiology of neuroses, itself modeled on the brand new germ theory (Carter, 1980). Searching for the specific causative agents of infectious diseases, Robert Koch identified, in 1882, the tubercle bacillus, thus defining the method of determining the causative agent of an infection. Following Koch’s famous three postulates for isolating a specific infectious agent, Freud, by 1895, began believing that neurosis, like an infectious disease itself, must have a specific cause in the sexual life of the subject (Makari, 1998, 2008). Freud introduced this scientific model while discussing anxiety neurosis (Freud, 1895a) and further developed it in the context of his so-called seduction theory (Freud, 1896a). According to this theory the causative agent of hysteria was the repressed memory of a sexual abuse which the hysteric subject had suffered during his or her early years. Between 1895 and 1896 Freud equated the research for this causative agent (the repressed memory) with the medical examination of scabs on the genitals, no doubt positioning himself in as a syphilidologist in the process. The rational motivation for this peculiar fantasy, which in the Irma dream was displaced from the genital up to the throat, was his distrust of investigative procedures which featured anamnesis. Patients, according to Freud, were simply not reliable when questioned about sexual matters. Freud thus dreamt of a second method of arriving at the etiology of hysteria which would be as reliable as the one employed by the syphilidologists who did not have to depend “on the statements of their patients” (Freud, 1895a, p. 129) to arrive at their conclusions. Instead, they proceeded by examining the female genitalia directly, its shape, and the crust found at its margins,

144 The savior of children a fact which then provided them with the possibility “of penetrating” from the symptoms “to a knowledge of their causes” (Freud, 1896c, pp. 191–192). Despite all attempts at rationalizing his concern about infection, either by adopting the method defined by Koch or by imagining himself peering into the female genitalia in search of the causative agent of hysteria, the unconscious roots of Freud’s concern broke through in the founding dream of psychoanalysis Freud’s Irma dream is undoubtedly deeply informed by the theme of hygiene – the “unclean” injection given to Irma spoke directly to this fact. The allusions present in Freud’s Irma dream did not escape the attention of his first followers. Karl Abraham, who met Freud for the first time in December 1907, wrote him on January 8, 1908 to ask: I should like to know whether the interpretation of the paradigm dream in the Interpretation of Dreams is incomplete on purpose (“Irma’s injection”). I think that trimethylamin leads to the most important part, to sexual allusions that become more and more distinct in the last lines. Surely everything does point to the suspicion of syphilitic infection in the patient? The spot in her mouth = plaque, the infection, the injection of trimethylamin, which has been carelessly given, the dirty syringe (!!). The entire pediatric scenario in Freud’s dream is moreover reminiscent of the controversial use of circumcision in the treatment of masturbation in children. The theme of circumcision was itself a highly loaded and potentially troubling theme when tackled by a Jewish scientist or writer. Freud must have felt that it was simply better for him to avoid the theme altogether. His keeping the topic secret and hidden, however, did not involve a rational choice by him, if only because his decision had been informed and determined by powerful unconscious factors. A result of Freud’s analysis of his specimen dream was that his use of free association led him to unearth a large number of self-reproaches. Freud, in his analysis of his dream and as we saw, blamed himself not only for the agony and death of his friend Ernst Fleischl but also for poisoning his patient Mathilde, to be punished with the death of his own daughter Mathilde. How was Freud able to endure this mountain of self-reproaches? One possible strategy for coping with his anxiety was to keep his feelings private and secret, a stratagem often employed by paranoiacs and founders of a religion. One such secret was Freud’s belief that he had once been a “saviour of children.” Rescue fantasies, Freud would later claim, are the essential element found in all “family romances.” The anesthetic use of cocaine on the mucous membranes was itself part and parcel of Freud’s own rescue fantasies. Freud was of course the man who claimed that what is repressed is typically viewed as dirty and incompatible with the ego; here, however, we manage to find traces of those little secrets which were not dirty, reproachful, or incompatible with his ego (the fantasy of saving female children from circumcision).

The savior of children 145 What managed to escape Freud’s scrutiny in this instance, however, was his powerful identification with suffering children, children who either sick, impotent, or had endured some traumatic and traumatizing event.

The Altar of Sacrifice Freud’s sensitivity towards the suffering of children spoke and broke through at the time of his pediatric training with Baginsky. On March 10, 1886, after visiting the Royal Museum in Berlin and seeing the fragments of the Pergamon Altar of Sacrifice, he wrote his future wife Martha to say: What appeals to me more than the stones, however, are the children in the clinic . . . As long as their brains are free of disease[s], these little creatures are really charming and so touching when they suffer. I think I would find my way about in a children’s practice in no time. The stones to which Freud referred in his letter were “fragments representing the battle between the gods and the giants,” tense dramatic scenes of the Pergamon Altar of Sacrifice, the largest, in both dimension and conception, still preserved from the ancient world. In the second century bc the altar was famous for its colossal sculptures, a physical representation of the legendary struggle of gods and giants which consolidated the new Olympic order – the Gigantomachy, as Lucius Ampelius referred to it in his Liber Memorialis. The stones of the Pergamon Altar had been found in 1872 and excavated during the course of the archeological campaign of the Berlin Royal Museum. The stones, and the scenes of the mythological battle which had been found engraved upon them, had a deep impact on fin de siècle German culture. Jacob Burckhardt, the author of the famous Griechische Kulturgeschichte [History of Greek Civilization], the first volume of which was posthumously published in 1898, considered the emasculation of Uranos by his son Kronos, which marked the beginnings of the mythological battle, the original sin from which the misery and evil of mankind had originated. References and allusions to the Greek gigantomachy and the horrible emasculation, later repeated on Kronos by his son Zeus, sustained Freud’s theoretical speculations regarding the ruthlessness of the relation between fathers and sons in primeval human society. It also informed his meditation and position on castration. Freud referred to the Uranos/Kronos myth directly in The Interpretation of Dreams (1900, p. 256, p. 619), The Psychopathology of Everyday Life (1901b, p. 198, p. 218), and in several other works as well. The Greek myth of the dethronement of Kronos offered evidence which Freud, in Totem and Taboo (1913a), translated into the story of the murder of the despotic primal father. Freud later developed the myth to argue on behalf of the idea that unconscious fantasies of castration were part of the phylogenetic heritage.

146 The savior of children As Freud argued in The Question of Lay Analysis, since the child repeats “the history of his race in an abbreviated form” during his mental development, the same archaic factors which were dominant during the early or primeval days of human civilization could now be detected in the mental life of the child (Freud, 1926c, p. 212). It was indeed by appealing to the Greek myth of Kronos that Freud framed and presented his vigorous defense of lay analysis. It is “mythology” itself, he argued, that “may give you the courage to believe psycho-analysis.” “If you have felt inclined to suppose that all that psycho-analysis reports about the early sexuality of children is derived from the disordered imagination of the analysts,” Freud (1926c) wrote, “you must at least admit that their imagination has created the same product as the imaginative activities of primitive man, of which myths and fairy tales are the precipitate” (p. 212). The founding myth of Greek cosmogony was tellingly enough still in Freud’s mind when, while taking a break from writing Moses and Monotheism at Christmas 1937, he wrote his unfinished note on the “Splitting of the ego in the process of defence” (Freud, 1938a). In his note, Freud recognized that the ego can be split in two and, further, that the rift “never heals” but “increases as time goes on.” He illustrated and reinforced his point by once again commenting on a theme which never ceased to occupy his mind and interests, namely, the tremendous feelings of fear which the threat of castration had produced in a three-year-old child. Freud’s line of argument was severed, however, at the precise juncture where he had switched from the case history to the Greek myth. “At this point,” he wrote, “it is impossible to forget a primitive fragment of Greek mythology which tells how Kronos, the old Father God, swallowed his children and sought to swallow his youngest son Zeus like the rest, and how Zeus was saved by the craft of his mother and later on castrated his father” (p. 278). Why, after having invoked this mythological fragment, was Freud unable to proceed and advance his argument any further? The Pergamon Altar of Sacrifice is famous for esthetic reasons as well. The main difference from the classical period, emblematic of harmony and perfection in the representation of the human body, is that in the Pergamon sculptures the traumatic moment of pain, agony, and death is for the first time fully represented in art. In the letter which Freud wrote to Martha in March of 1886, the shift from stones to children was itself informed by this dramatic element. Shortly thereafter, the endless series of mutilations which his friend Ernest von Fleischl had endured was associated by Freud with the destruction of a sacred and famous Greek temple, as though the very stones themselves were now beginning to speak the language of trauma. We might, however, question whether the metaphor of the moving destruction of a temple had been erected atop another event, namely, the destruction of the temple of Solomon in Jerusalem, a historical event largely repressed and displaced by Freud given his estrangement from Judaism.

The savior of children 147 As is well known, and as Freud himself recalled in Moses and Monotheism: “Immediately after the destruction of the Temple in Jerusalem by Titus, the Rabbi Jochanan ben Zakkai asked permission to open the first Torah school in Jabneh” (Freud, 1939, p. 115). It was therefore via words and letters that the transmission of Judaism was guaranteed after the destruction of the Temple. Pergamon is itself associated with manuscripts: the word parchment (Latin: pergamena; German: Pergament) derives its meaning from the name of this Greek city (now in Turkey). Herodotus informs us in his Histories (v. 58) that the name the Ionians of Asia Minor used to refer to books was diphtherai (skins) and, further, that this same word was in turn adopted by Hellenized Jews to describe the biblical scrolls. Was it because of its association with the biblical scrolls that Freud decided to write and present the word “diphtheria” with a triple cross? The image of a Greek temple spoke through the Irma dream as well. The fact is hinted at by the “Propylaea” element found at work within the dream, a memorial of the genital mutilation which Emma had suffered as a child. Could the diphtheritic membrane, conflating anatomy and destiny in the founding dream of psychoanalysis as it does, be interpreted as referring to a temple, a book, as well as a piece of skin all at once?

Notes 1 The start date of Emma’s treatment is critical. We know that Fliess visited Vienna in late December of 1894 and that he likely performed a medical examination on Emma then, most probably in response to a request from Freud. The two men likely discussed a plan of treatment for Emma (the removal of her turbinal bone) at the time. 2 The cocaine brush was “completely put aside” by Freud with the event of his father’s death in October of 1896. According to Jurgen von Scheidt (1973, p. 421), Freud’s self-analysis was the result of a “protracted unconscious effort to come to grips with cocaine’s euphoria.” Freud, in his view, was never a cocaine addict, his use of cocaine having functioned in the service of his ego. According to Linn (2002, p. 1152), however, Freud did become an addict to the drug, as his “extraordinary denial of the growing number of reports about the dangers surrounding its use” appears to imply. 3 Freud’s letter to Martha Bernays dated April 21, 1884. 4 Jones (1953) no doubt had the following passage, found in a letter which Freud wrote to his fiancée Martha on June 2, 1884, in mind: “Woe to you, my Princess, when I come. I will kiss you quite red and feed you till you are plump. And if you are forward you shall see who is the stronger, a gentle little girl who doesn’t eat enough or a big wild man who has cocaine in his body. In my last severe depression I took coca again and a small dose lifted me to the heights in a wonderful fashion. I am just now busy collecting the literature for a song of praise to this magical substance” (p. 92). 5 Freud (1900) indicated that he had experienced his dream when he had been seven or eight years old, but apparently dreamt his dream later, in the autumn of 1865. See Rosenfeld (1956, p. 98), Anzieu (1986a, p. 297) and Blum (1990, p. 32).

148 The savior of children

6

7 8 9

10

11

12

Freud’s dream was thus likely tied to his mother’s final pregnancy, the conception and subsequent birth of Alexander Freud on April 19, 1866. Amalia was about two months pregnant when her father died and no physical signs yet appeared of her being pregnant. Freud, however, might have heard of his mother being pregnant from family members. A neuroma (plural neuromata) is a tumor, a mass growing from a nerve which usually consists of nerve fibers. Pain radiating from the lesion to the periphery of the affected nerve is usually intermittent but may become continuous and severe. The pain experienced may be due to a painful phantom. On this question the reader is referred to the article by Gordon Grant, “Methods of treatment of neuromata of the hand,” which appeared in the Journal of Bone and Joint Surgery in 1951. Grant’s piece opens with the following statement: “The neuroma is the normal product of repair of the proximal end of a divided somatic nerve. Amputation is commonly followed by temporary sensitivity of the end bulbs of the severed nerves and by phantom limbs sensation. In the majority of patients these symptoms gradually fade . . . In a hapless minority of patients the syndrome does not recede. The hypersensitivity of the neuroma increases, bizarre phantom-limb symptoms persist” (p. 841). Freud to Wittels, August 15, 1924 (E. L. Freud, 1960, p. 350). The journal itself had been founded as a continuation of another journal, the Zentral-Zeitung für Kinderheilkunde, which Alois Monti had edited and published in Berlin since 1877. See, for instance, Freud’s fortuitous encounter in Paris with America’s leading ophthalmologist, Hermann Knapp, who greeted Freud as the man who had helped introduce cocaine to the world. Freud’s encounter with Knapp is recounted in a letter Freud wrote to Martha Bernays on February 10, 1886. The intensity of the erotic transference was associated with the hypnotic treatment which Freud provided Mathilde. According to Hirschmüller, the association motivated Meynert’s criticism of Freud and of the use of hypnosis in treatment in general. During a year-long period (from March 15, 1894 to March 15, 1895) Baginsky tested the serum with severely sick children. On April 20, 1895, he published and made public his results in a book entitled Die Serumtherapie der Diphterie nach den Beobachtungen im Kaiser-und Kaiserin-Friedrich Kinderkrankenhaus in Berlin [The Serum-Therapy of Diphtheria after the Observations in the Children Hospital Kaiser- und Kaiserin Friedrich in Berlin]. In the study Baginsky (1895b) reported that, after the introduction of the antitoxin therapy, the mortality of children affected by diphtheria had been reduced from 48.2 percent to 15.6 percent (see also Werner, 1990). Three years later a more complete and comprehensive study, entitled “Diphterie und diphteritischer Croup” was published in the journal Specielle Pathologie und Therapie, directed by Nothnagel. This was the very same book series where Freud’s work on the Infantile Cerebral Paralyses was published in 1897. In The Interpretation of Dreams, Freud asserted, in rather dogmatic fashion, that “Psychoanalysis is justly suspicious. One of its rules is that whatever interrupts the progress of analytic work is a resistance” (Freud, 1900, p. 516). Had Freud, by cutting off the associative thread bearing on the children’s hospital and his habit of examining children completely undressed, managed to cordon off an entire set of important thoughts and memories?

The savior of children 149 13 I was alerted to Strachey’s textual mistranslation by Mario Beira. It is well known that Freud appealed to the sign of the three crosses in other contexts. The three crosses had appeared already in his juvenile correspondence with Silberstein, and then on three separate instances in his letters to Fliess. On November 5, 1899: “I would have liked to write to you about the sexual theory, because I have something that is plausible and confirmed in practice; it is only that I do not yet have the slightest idea what to do with the ††† female aspect, and that makes me distrust the whole thing” (Masson, 1985, p. 382). On May 8, 1901, while referring to his text The Psychopathology of Everyday Life, he wrote: “The essay is entirely without structure and contains all sorts of forbidden ††† things” (p. 441). Finally, on April 26, 1904: “my ††† studies of hysteria and the dream, which so far have been labeled disgusting!” (p. 461). In Freud’s letters to Jung, these three crosses again appeared three times, in association with “sexuality” (on January 1, 1907), the “unconscious” (on August 27, 1907), and as he commented on Schreber’s memoirs on December 18, 1910 (McGuire, 1974, p. 19, p. 79, p. 380). In Freud’s letters to Ferenczi they appear only once, on January 19, 1910. Revealingly enough, Jung decided to call on this same sign to refer to Freud’s “dangerousness” (see his letter to Freud of November 2, 1907). Abraham himself associated the three crosses with Freud’s reputation within professional circles (see his letter to Freud of May 23, 1913). It reveals how Freud himself grew into an uncanny and taboo subject in time. 14 In a passage in his Handbook of School Hygiene, previously quoted, Baginsky (1877) wrote: “Every onanist represents a threat to [those who are] pure, because the imitation of onanism is infectious and masturbation tends to spread more than other evils” (p. 467). 15 Gilman (1993) convincingly argued that “The linked dangers of sexuality, syphilis, and madness were constantly associated with the figure of the male Jew. . . . Central to the definition of the Jew was the image of the male Jew’s circumcised penis, damaged, or incomplete, and therefore threatening the wholeness and health of the male Aryan. The damaged penis represented the potential ravages of sexually transmitted disease” (p. 61). The Jewish body, according to him, became the object “about which the debates over the meaning and source of health and disease were held” (p. 69).

6

The cornerstone

The object of the sacrifice is to give strength and stability to the building. But sometimes, instead of killing an animal, the builder entices a man to the foundation stone, secretly measures his body, or a part of it, or his shadow, and buries the measure under the foundation stone; or he lays the foundation stone upon the man’s shadow. . . . In these cases the measure of the shadow is looked on as equivalent to the shadow itself, and to bury it is to bury the life or soul of the man, who, deprived of it, must die. Thus the custom is a substitute for the old custom of immuring a living person in the walls, or crushing him under the foundation stone of a new building, in order to give strength and durability to the structure. (Frazer, 1890, p. 144)

Stones, pillars, and rocks When Herman Nunberg delivered an elegant presentation on “The synthetic function of the ego” before the members of the Vienna Psychoanalytic Association in the late 1920s,1 it led Freud to recall a painting by Moritz von Schwind, The Legend of the Bishop and the Devil. Painted in 1855, it portrays a bishop and a devil laboring to build a chapel atop a hill. While the devil is featured pushing a cart loaded with heavy stones up the hill, the bishop is represented standing in front of the building under construction merely praying to the Lord. “I myself,” Freud reportedly said to Nunberg, “seem to be the devil who does the hard work, while you make a magic gesture, and everything falls into place” (Roazen, 1975, p. 328). According to Hanns Sachs, Freud also said: Mine was the devil’s lot. I had to get the stone out of the quarry as best I could and was glad when I succeeded in arranging them willy-nilly so that they formed something like a building. I had to do the rough work in a rough way. Now it is your turn and you may sit down in peaceful meditation and so design the plan for a harmonious edifice, a thing I never had the chance to do. (as quoted by Roazen, 1975, p. 328)

The cornerstone 151

Figure 6.1 The Legend of the Bishop and the Devil (ca. 1854) by Moritz von Schwind, Monaco, Schack-Galerie München, Bayerische Staatsgemaeldes-ammlungen. (Courtesy of Foto Scala, Firenze/BPK, Bildagentur für Kunst, Kultur und Geschichte, Berlin.)

While Freud appears to have always viewed psychoanalysis as a building perpetually under construction, he nevertheless also felt that its structure rested upon a rock-solid foundation. Freud was here implicitly relying on an ancient way of viewing the world and its origins. The laying of the corner or foundation stone of a temple or important building in a city was typically seen as symbolically replicating the creation of the cosmos itself. According to the Genesis story, it was out of chaos and after the dark waters were divided that the earth was created, a solid rock which floated over an abyss of nothingness. This conception of the origin of the world provided justification for ceremonies of bloody sacrifices, all offered in an effort to pacify a deity: the threshold beneath which the sacrificial blood was shed, it was believed, prevented the chaos from welling up and breaking out into

152 The cornerstone the world. Was the psychoanalytic edifice itself the product of a cosmogonist battle with a Leviathan or merely the willy-nilly result of Freud’s labors and rough work? Freud’s self-ironic comment on his difficult and ground-breaking labors when founding psychoanalysis serves to recall the legend of the building of Solomon’s ancient Jewish Temple in Jerusalem. During the early phase of the project a huge stone was reportedly dug out and delivered from the quarry by the workers. The laborers were unable to pinpoint the precise place within the building where this large stone was to be placed and the stone was soon discarded as useless and forgotten. Whenever a corner or headstone was needed to fill a particular space or gap in the building, however, a laborer always managed to recall the stone which had been rejected as possibly helping to fit the space and help join the two sides of a wall together. Memory of this incident was apparently recalled through a well-known biblical passage: “The stone which the builders rejected has become the chief cornerstone” (Psalm 118:22), words which Peter later invoked in the New Testament to describe Jesus Christ (1 Peter 2:6–8). According to various biblical commentators, the two walls which joined and came together at an angle symbolized the spiritual unity binding Jews and Christians together, indeed the living and the dead, and the two sexes, male and female, as well. In his presentation Nunberg (1931) underscored the assimilative, binding, and creative function of the ego, proposing that what was “originally felt to be painful and alien” incites “the ego to increased synthetic activity, the result being that what it rejected at the outset it now under certain conditions assimilates and converts into an integral part of itself” (p. 131). The idea might have led Freud to recall the story of the rejected stone which, après coup, transformed into the cornerstone. Freud is said to have presented Nunberg with a lithograph reproduction of von Schwind’s painting after his presentation (Roazen, 1975, p. 328); the word lithograph itself means a written (graphéin) or incised stone (litho). Freud often pushed his closest pupils into further exploring certain subjects by presenting them with small gifts which then prompted them to recharge and deepen their interest in the theme.2 The difficult process of digging out the stones which Freud then utilized to begin building the psychoanalytic edifice was mainly carried out by him in 1897. It was at the beginning of that year that Emma Eckstein produced her circumcision scene during analysis. Emma’s analysis appears to have come to an end shortly thereafter. We don’t know exactly when – my guess, perhaps my fantasy – is that Freud and Emma agreed to terminate the analysis just before Freud left for Nuremberg to meet with Fliess during the Easter weekend of 1897. We can speculate that Emma’s struggles against masturbation had come to the foreground during the final phase of her analysis and, further, that she provided Freud with important clinical material relating to this topic during this final phase.3

The cornerstone 153 Easter Sunday in 1897 fell on April 18. Freud had of course traveled to Nuremberg to meet with Fliess for their congress then. This fact suggests that his final or closing session with Emma might have taken place on Good Friday, April 16, that is to say, and as my friend Mario Beira has brought to my attention, on the 39th anniversary of little Julius’s burial back in Freiberg. Freud’s little brother died on April 15, 1858 (a Thursday) and the boy, speculates Beira, was likely buried the very next day (Friday, April 16), as Judaism forbids burials on the Sabbath. The fact that Freud opened his analytic practice years earlier in Vienna on an Easter Sunday, Beira speculates, and that Emma and Freud each had mothers named Amalia further strengthens the connections for why Freud might have decided to terminate Emma’s treatment on a Good Friday. Emma, as we know, went on to become the first analyst personally trained by Freud to practice psychoanalysis. It was just a few months later that Freud decided to abandon his so-called seduction theory. His initial steps in that direction were taken in April– May 1897, when the idea of the existence of an “architecture of hysteria” occurred to him (Drafts L, M, and N). In his letter to Fliess of May 2, Freud wrote to indicate that he had “now gained a sure inkling of the structure of hysteria.” Freud also reported that he had managed to successfully isolate three structural elements – memory fragments, impulses, and fantasies (protective fictions) – and concluded that the psychic elements [Gebilde] on which the architecture of hysteria rested, the repressed elements, were no longer “memories” but “impulses that derive from primal scenes [Urszene].” Freud viewed this new insight – it marked a shift towards a drive psychology – as “a great advance.” I reconstruct that the final phase of Emma’s analysis led Freud to gain a new understanding of his patient’s “masturbation fantasies” [Onanierphantasien] (Masson, 1985, p. 239). It was just a few months later, in September, that Freud wrote to inform Fliess that he no longer believed in his previous theory. It was only a month later, in October, that his initial intuition on the general value of the Oedipus myth came to him. The passage concerning the circumcision scene which Freud reported in his letter of January 24, 1897 was left out when an abridged version of Freud’s letters to Fliess was first published in 1950. A segment of Freud’s description of the scene was initially published by Max Schur in his 1966 article “Some additional ‘day residues’ of the specimen dream of psychoanalysis.” Commenting on the material relating to Emma’s scene, Schur suggested that the scene anticipated Freud’s abandonment of his seduction theory. He wrote: The use of the word “scene” here and in the two previous letters is very significant. We know from Freud’s correspondence with Fliess that he still believed in the “seduction etiology” of hysteria. However in the published portion of this letter and the preceding ones he clearly describes what he later called fantasies. This holds true for Emma’s “scenes.” It would therefore seem that Emma was one of the first patients who

154 The cornerstone offered Freud a clue to the crucial realization that what his patients had described to him as actual seduction episodes were fantasies. As we know, this realization opened the way to the discovery of early infantile sexuality and its manifestations in infancy. (p. 114) While Schur’s conclusion appears to me to be correct, his argument concerning the relationship between Emma’s scene and actual events in her life does not. Schur’s position that “scenes” are always and necessarily a product of a subjective mental construction remains vague. A more relevant question for us concerns whether Emma’s labia lips were truly cut and injured as a result of surgical circumcision. Despite Freud’s explicit remark on the anatomical disparity of Emma’s labia lips, Schur maintained that Emma had not been circumcised but had merely imagined and fantasized the scene she had presented Freud. Freud’s theoretical shift and discarding of his old theory have been reviewed and discussed in detail by numerous psychoanalytic scholars. The question of the existence of a possible connection between Emma’s circumcision scene and the shift in Freud’s thinking, however, has been ignored and kept entirely out of the debate. Various elements suggest that Freud’s theoretical turn had indeed been informed and influenced by the scene which Emma had presented him; the scene itself helped to position memories of punishment for childhood masturbation at the center of Freud’s new conception of psychic life. An essential trait of the “architecture of hysteria” was identified by Freud in May of 1897. It concerned the conflation of the “motives of libido and of wish fulfillment as a punishment” in the formation of symptoms (Masson, 1985, p. 251). Freud had apparently realized that the memory of punishment had been used by Emma in her struggle against the sexual impulse and, further, that her seduction fantasy had been “intended to cover up the auto-erotic activity of the first years of childhood, to embellish it and raise it to a higher plane” (Freud, 1914, p. 17). In Emma’s case, Freud perhaps failed to come to a definitive conclusion about the actual role her father had played in her symptoms and illness. As Freud (1906) indicated in his first public account of his theoretical shift, however: it was no longer a question of what sexual experiences a particular individual had had in his childhood, but rather of his reaction to those experiences – of whether he had reacted to them by “repression” or not. It could be shown how in the course of development a spontaneous infantile sexual activity was often broken off by an act of repression. (pp. 275–276) While scenes of seduction might or might not have taken place in Emma’s case, it was now the “repression” of the sexual impulse which emerged as the “cornerstone” of the psychoanalytic edifice for Freud. Freud often

The cornerstone 155 invoked this concept to theorize his creation. The word which Freud mainly called upon to do so was “Grundfeiler,” quite literally foundation pillar (Freud, 1906, p. 273; 1914, p. 16; 1923c, p. 247; 1924b, p. 196; 1925a, p. 30; 1926a, p. 96). Freud also invoked the words “Grundstein” (Freud, 1913b, p. 170), “Angelpunkt” (Freud, 1916–1917, p. 131), and “Eckstein” (Freud, 1933, p. 104) to do so. The last of these was the word which Luther employed in his German translation of the Bible to refer to the cornerstone concept (Ephesians 2:20; 1 Peter 2:6) – “akrogoniaios lithos” in the Septuagint translation, “lapis angularis” in the Latin. Freud’s new thesis was that repression, and his conception of it, was the foundation pillar on which the entire edifice of psychoanalysis now rested. At the same time, Freud also identified “the appreciation of the importance of sexuality and of the Oedipus complex” (Freud, 1923c, p. 247) among the fundaments. Yet, certain basic problems, not taken into account by Freud during his analysis of Emma, were to resurface time and time again. In a paper entitled “A Child is being beaten,” Freud (1919a) would years later maintain that, in the case of a fantasy which found its outlet in masturbatory acts, a convergence between a girl’s love impulse for her father and her sense of guilt could be found. The transformation of the forbidden libidinal excitation into punishment, Freud further noted, made the “essence of masochism” understandable for the first time (p. 189). Masochism itself, let us recall, stood as the core and central element of the troubling and disturbing scenes which Emma presented to Freud for analysis in January of 1897. As Freud (1933) indicated in his New Introductory Lectures on Psycho-Analysis, however, his libido theory was itself unable to explain the puzzling problem of masochism. Discussing the relationship of anxiety with instinctual life, Freud maintained that his conclusions in favor of a death instinct were based on the phenomena of sadism and masochism. As Freud wrote: Both phenomena, sadism and masochism alike, but masochism quite especially, present a truly puzzling problem to the libido theory; and it is only proper if what was a stumbling-block for the one theory should become the cornerstone [Eckstein] of the theory replacing it. (p. 104) Freud must have had the biblical concept of a cornerstone in mind when crafting the above passage. The fact that he had invoked the notion of a “stumbling-block” [Stein des Anstosses] – rendered as skandalon in the Septuagint – in the passage suggests as much. While Freud often called on the concept of “cornerstone” in his writing, the passage cited is the only instance I can find where he used the word “Eckstein.” Since this context is highly evocative of the symptom matrix which Emma had presented to Freud during the crucial year when he labored to provide psychoanalysis with its foundation, we might well wonder whether Freud had somehow

156 The cornerstone arrived to envision Emma as his “cornerstone” patient – indeed, the foundation stone to his new building – during those years. The idea of a “foundation stone” surfaced in Freud’s work again in “Analysis terminable and interminable,” a text written by him 40 years after Emma’s initial analysis with him had ended (Freud, 1937). Freud’s conclusion in that text, as we know, was that the castration complex was ultimately based on a biological “bedrock.” Significantly enough, Hermann Nunberg’s essay on “Circumcision and problems of bisexuality” (1947) was an attempt to shed light on this supposedly impenetrable “bedrock” and to pinpoint its psychological, historical, and religious underpinning.

The chief cornerstone Shortly after Emma produced her circumcision scene in analysis we find Freud concerning himself with the subject of anti-Semitism. This came about as a result of two dreams dreamt by Freud. One was his dream “Uncle with a yellow beard,” a dream which had been triggered by a visit Freud had received from a friend, Leopold Königstein, in February of 1897. Königstein’s academic promotion, it turns out, had been blocked by antiSemitic elements within the Ministry of Education (Freud, 1900, p. 137). The second dream which led Freud to the topic of anti-Semitism was the fourth dream in his “Rome series.” The dream in question had been triggered by a language conflict between the Germans and the Czech in Prague at the time. The conflict managed to surface through Freud’s dream and his associations to its latent content. Freud lived as a small child in an area where Czech was regularly spoken and, while analyzing his dream, he had been reminded of his early days back in Freiberg where he often heard the Czech language spoken. Freud actually understood some Czech as it had been spoken by his Catholic nanny. Freud was also led to recall his German-nationalist phase during the days when he attended the University of Vienna as he analyzed his dream. The main memory which Freud’s dream reawakened, however, stemmed from another critical period in his life, namely, his school days, when Hannibal became his favorite hero. Recalling this period in The Interpretation of Dreams, Freud (1900) explained that when he, in the higher classes, began to understand for the first time what it meant to belong to an alien race, and anti-Semitic feelings among the other boys warned me that I must take up a definite position, the figure of the Semitic general rose still higher in my esteem. To my youthful mind Hannibal and Rome symbolized the conflict between the tenacity of Jewry and the organization of the Catholic Church. And the increasing importance of the effects of the anti-Semitic movement upon our emotional life helped to fix the thoughts and feelings of those early days. (p. 196)

The cornerstone 157 Reconstructing the political context in which Freud had developed his ideas during the course of 1897, McGrath (1986) concluded that both of Freud’s dreams showed “that the political events of early 1897 were able, because of his sensitized state, to call up the unresolved hopes and conflicts of his childhood and early adolescence” (p. 182). Freud’s Rome–Prague dream was in McGrath’s view tied to issues relating to anti-Semitism.4 Freud’s dream must have occurred in April of 1897, immediately after the promulgation of the language ordinances. It was during this same period, it turns out, that Karl Lueger, the leader of the Christian Social Party, took office as mayor of Vienna.5 Lueger’s popularity had been closely tied to anti-Semitic propaganda. Lueger’s victory represented a real political setback for Jewish-German liberals such as Freud. As McGrath (1986) points out, Lueger’s electorate victory must have been particularly disappointing “since it occurred in a context that seemed to threaten Freud’s career hopes and to betray his basic interest as both a German and a Jew” (p. 184). Anzieu (1986a, p. 183), after performing a detailed analysis of all four of Freud’s dreams relating to Rome between December of 1896 and January of 1897, proposed an altogether different timing for Freud’s Rome–Prague dream. In the final analysis, it seems that both the January and April 1897 dates are plausible for when Freud dreamt his dream. Freud’s concerns about anti-Semitism, to be sure, reflected not only the political events of early 1897 but also his emotional reaction to the circumcision scene which Emma had presented him. It was probably in April of 1897 that Freud dreamt his Norekdal dream. Freud had received a manuscript from a medical colleague in which the importance of a physiological discovery had been overestimated and treated in an overly emotional manner by the writer. Freud went to bed that night after reading the manuscript to dream a sentence which pointed back to the very text he had read: “It’s written in a positively norekdal style.” Freud (1900) provided the following explanation and analysis of his peculiar dream: There could be no doubt that it was a parody of the [German] superlatives “kolossal” and “pyramidal”; but its origin was not so easy to guess. At last I saw that the monstrosity was composed of the two names “Nora” and “Ekdal” – characters in two well-known plays of Ibsen’s [A Doll’s House and The Wild Duck]. Some time before, I had read a newspaper article on Ibsen by the same author whose latest work I was criticizing in the dream. (p. 296) The Norekdal dream strikes me as perhaps the most condensed, obscure, and baffling of all the dreams dreamt by Freud. According to Grinstein, the theme of the two Ibsen plays in the dream might relate to the deception perpetrated by women who fail to tell the truth and lie.6 Neither Grinstein

158 The cornerstone (1980) nor Anzieu (1986a), however, was able to provide a plausible date for Freud’s Norekdal dream. Following Wittels,7 Ulrike May (2003) reconstructs that the medical colleague who had sent Freud the manuscript was Isidor Sadger, a student of Freud between 1895 and 1898. Sadger, as we know, later became a member of the Vienna Psychoanalytic Society. May (2003) suggests that the manuscript sent by Sadger was an article he wrote on Paul Flechsig’s discoveries on brain localization. Sadger’s article was eventually published in the Deutsche Revue in April of 1897. It appeared under the title “Das Wunder vom denkenden Eiweiss” [The miracle of the thinking protein].8 Paul Flechsig became famous for his studies on the pyramidal trunk and the process of myelinization. In 1894, at the beginning of his rectorship at Leipzig University, he had delivered a lecture which caused quite a stir owing to its crude materialism. The “architecture of the brain,” Flechsig argued in his lecture, mirrored the “structure of the mind” (May, 2003, p. 128). In his article, Sadger had praised Flechsig’s discoveries about the brain with terms such as “incredible,” “extraordinary,” “enormous,” “amazing,” and “colossal.” Indeed, he went on to compare Flechsig with Moses. To quote Sadger (1897, pp. 98–99): The Bible tells us of a strange event concerning Moses. When he came down from Sinai where he had received God’s word, with the two tablets in his hands, there was such luminosity and radiance in his face that the children of Israel and yes, even his own brother, recoiled in awe and fright. This radiance of Moses has not been extinguished to the present day . . . This radiance, I venture to say, would have suffused Flechsig’s face when he finally succeeded in finding the evidence for our thinking organs. They represent the golden stairway on which he will ascend to immortality. (as quoted in May, 2003, p. 127) According to May, the passage comparing Flechsig to Moses’s radiance as he descended from Sinai carrying the two tablets of the law is likely one of the passages which Freud must have had in mind when writing of the overemotional manner and the overestimation of a physiological discovery by a colleague. Indeed, eight years later, in a letter to Jung, Freud described Sadger as a “congenital fanatic of orthodoxy, who happens by mere accident to believe in psychoanalysis rather than in the law given by God on Sinai-Horeb” (McGuire, 1974, p. 130). The word “pyramidal” in Freud’s Norekdal dream seems to have operated as a “switch point” in the text where many lines of thoughts came together and crisscrossed in condensed fashion. It might not be out of place for us to recall here that Freud had at one time described his book on dreams as his “Egyptian dream book” (letter to Fliess of August 27, 1899). The process of interpreting dreams, according to Freud, was completely

The cornerstone 159 “analogous to the decipherment of an ancient pictographic script such as Egyptian hieroglyphs.” In both cases, Freud (1913b) wrote in a later work: there are certain elements which are not intended to be interpreted (or read, as the case may be) but are only designed to serve as “determinatives”, that is to establish the meaning of some other element. The ambiguity of various elements of dreams finds a parallel in these ancient systems of writing; and so too does the omission of various relations, which have in both cases to be supplied from the context. (p. 177) A brilliant micro-analysis of the phoneme “ek” in Freud’s Norekdal dream was provided by Per Roar Anthi (1990).9 The fact that Ibsen’s literary figures were woven into the text of the dream in a markedly abbreviated and disguised manner, Anthi (1990) noted, suggests that the dream itself must have been a highly “distorted expression of unconscious ideas not easily available to Freud” (p. 142). Anthi focused on the two associations which Freud offered on his dreams: the words “kolossal” and “pyramidal.” He assumed that Freud, on the basis of his neurological knowledge, must have “related the word pyramidal with the pyramidal nervous system” (p. 147). Anthi moved beyond the field of anatomy, however, to link the subject to Freud’s interest in archeology. In this regard the most vital phonetic unit found in the two words dreamt by Freud is indeed the “ek” signifier found at the heart and center of the puzzling word which appeared to him through his dream. According to Anthi, the names Nora and Ekdal functioned as screen figures behind which hid the identity of another person in Freud’s life, namely, Emma Eckstein. To quote Anthi (1990): In spite of the repressive forces, the syllable Eck-, the first cohesive phonetic unit of the patient’s surname Eck-stein, has forced itself through and attached itself to the name Ekdal via the letter formation Ek- in Ek-dal, as Eck- and Ek- have a similar sound picture. The next syllable in her name, -stein, which in German literally means stone, is not so easy to derive. We must make a detour through Freud’s associations [to] kolossal and pyramidal in order to see how the word -stein has been subjected to disguises. . . . The characteristic hallmark of a pyramid is its apex which forms a common corner where all the sloping sides of the pyramid meet. As Eckstein in German just means cornerstone, we immediately comprehend how the identity of this patient has in fact been hidden in the associations pyramidal and kolossal which obviously refer to the idea “pyramid” and their unmistakable basic pattern of Eckstein. (p. 147; emphasis added) The word “pyramidal,” a concrete application of an architectonic metaphor for the nervous system, is thus a nodal point of intersection in the

160 The cornerstone dream where various associative lines meet in a single point or corner. As May (2003) notes, the neurological term “pyramidal” can be traced back to Flechsig. This same term also serves to condense Freud’s interest in archeology. The essential contribution offered by Anthi when interpreting Freud’s dream consists in his having identified the phoneme “ek” at the center of the word norekdal as the precise angle (“Eck”) in which anatomy and archeology joined and met; the signifier indeed points in the direction of Eckstein, Freud’s most important patient at the time. There are at least two other elements which support Anthi’s interpretation. The first is Freud’s ideas on the “architecture of hysteria” in May 1897. The second is the position which Freud’s Norekdal dream occupies in The Interpretation of Dreams (Freud, 1900). Freud decided to introduce his Norekdal dream immediately after his analysis of “The work of condensation” in the Irma dream. His analysis thus supports that Irma indeed stood as a “collective figure” in his dream. The fact that Freud offered a detailed analysis of the function which the word “propylaea” played in his dream (pp. 294–295) – itself a “nodal” or “switch point” which linked human anatomy (the labia) with architecture – supports this line of interpretation and reading. Freud for his part explained that the work of condensation in dreams was to be seen at its clearest when it handled “words and names.” The latter, Freud contended, are “frequently treated in dreams as though they were things, and for that reason they are apt to be combined in just the same way as are presentations of things.” Freud then added: “Dreams of this sort offer the most amusing and curious neologisms.” He then proceeded to emphasize his point by way of his Norekdal dream (pp. 295–296). All of these facts serve to validate and support Anthi’s textual analysis and hypothesis that the name which had been treated as a thing by Freud through his dream, indeed as a corner or angle (“Ecke”), was the name “Eckstein,” German for “cornerstone.” The observation helps to further disclose just how Freud, during the period when he labored to found psychoanalysis, had entertained the fantasy that Emma Eckstein operated as the “cornerstone” of the intellectual edifice which he labored to construct at the time. It also suggests that Emma’s position in Freud’s psychic economy issued from her cut or excised labia, to wit, her circumcision. Freud’s emotional response to Emma’s genital wound, which he appears to have completely brushed aside, if not repressed, seems to have been powerful and riddled with conflict. As noted, an inscribed stone which serves to symbolically mark the origin and foundation of a building is known in architecture as a cornerstone or foundation stone.10 Metaphorically a cornerstone is a concept which provides the basic tools for understanding or manipulating a larger intellectual edifice. It is the fundamental assumption from which something is begun and developed, calculated, or explained. Besides its meaning in architecture and its metaphoric meaning, the idea of a cornerstone carries other symbolic meanings as well. In the Jewish tradition the foundation stone, or

The cornerstone 161 rock, is considered the navel of the world. In the Greek-Christian tradition, however, it is viewed as symbolic of Jesus Christ, a figure whom the Apostle Paul described as the “head of the corner” or “chief corner.”11

The sacrifice The theme of sacrifice was deeply reworked by authors such as Clay Trumbull (1885) at the end of the nineteenth century. His study on the “blood covenant” became extremely influential at the time. William Robertson Smith (1889–1890), who assumed the existence of a single archaic protoreligion which stood as the common root of both Christian and Jewish rituals, and James Frazer (1890), who in The Golden Bough (first published in 1890) attempted to identify a single pattern which undergirded fertility rites, human sacrifices, world mythologies, and religious beliefs, also reworked and developed the theme. In Freud’s case we find that the theme of sacrifice had stood at the center of his lifelong work on unconscious psychic reactions. Freud maintained Smith’s idea that sacrifice involved “an act of fellowship” between the deity and his worshippers and that, psychologically speaking, it featured a renunciation or act of self-punishment carried out in order to help restore the bond with a powerful parental figure, an oedipal father. It should be noted that Freud’s own examples often hinted towards an omnipotent mother figure.12 Freud likely interpreted Emma’s circumcision scene as involving some form of sacrifice by her which aimed to restore her bond with her father. This can be inferred from the fact that Freud, when reporting the scene to Fliess in his letter of January 1897, proceeded to link the material in Emma’s scene to the figure of “Moloch,” the ancient Ammonite god associated with child sacrifices and votive offerings. Freud, however, added a further detail: “In hysteria,” he said, “I recognize the pater [father] in the high demands made in love.” Human sacrifices and the offering of children to appease an angered omnipotent deity were ubiquitous in primeval times. In the Old Testament (II Kings 23:10, Isaiah 57:5, Jeremiah 19:5), and in the Western psyche in general, they were mainly associated with the worship of Moloch – a metallic idol with a wide open-mouth inside which newborn babies were sacrificed into flames. We might recall that the Hebrew word for hell, Gehinna, itself derived from the “Valley of Hinnom” (Ge Hinnom), where fire sacrifices to Moloch were practiced. Indeed, in the popular imagination the portal to Hell, as Arlow (1955) indicated, is often depicted by the image of a mouth, with Hell itself described as “yawning for its victims who must inexorably pass into its mouth or through its jaws” (p. 69). Freud’s reference to the Semitic idol is thus particularly significant here as it directly connects Emma’s circumcision to the biblical narrative. As far as I know, Freud never again referred to Moloch after his January 1897 letter to Fliess. The fact that ritual infanticide was often used by non-Jews to fuel anti-Semitic propaganda and that the idea of

162 The cornerstone

Figure 6.2 Moloch with child. Illustration contained in the work by Johann Lund Die alten jüdischen Heiligthümer, Gottesdienste und Gewohnheiten, edited by Heinrich Muhlius, Hamburg, 1711. (Courtesy of Universitätsbibliothek Frankfurt am Main/Digitale Sammlungen Judaica, http://sammlungen. ub.uni-frankfurt.de/freimann/content/pageview/3818249.)

bloody sacrifices to Moloch inspired intellectuals and philosophers during the nineteenth century to equate Judaism with Molochism (Rose, 1990, pp. 251–262) is sufficient to suggest that these unpleasant associations remained a central reason why Freud never referred to Moloch in his published work.13 Freud, however, often referred to Kronos, the Greek equivalent of the Semitic idol. In a well-known passage in The Interpretation of Dreams, while attempting to justify his son’s rebelliousness, Freud (1900) was led to depict the despotic power which the figure of the father held by writing:

The cornerstone 163 The sanctity which we attribute to the rules laid down in the Decalogue has, I think, blunted our powers of perceiving the real facts. We seem scarcely to venture to observe that the majority of mankind disobeys the Fifth Commandment. Alike in the lowest and in the highest strata of human society filial piety is wont to give way to other interests. The obscure information which is brought to us by mythology and legend from the primaeval ages of human society gives an unpleasing picture of the father’s despotic power and of the ruthlessness with which he made use of it. Kronos devoured his children, just as the wild boar devours the sow’s litter; while Zeus emasculated his father and made himself ruler in his place. (pp. 256–257) Freud’s passage would have been more logical and convincing were he to have referred to Moloch, the biblical symbol of the “primaeval ages of human society,” rather than Kronos. By recasting his views against the sacrificing of children within the framework of the Greek battle for civilization, Freud was apparently distancing himself emotionally from unpleasant thoughts associated with Moloch. The theme appears to have been so loaded and conflict-ridden for Freud that he in fact committed an error when writing about it. As Freud later realized, he had mistakenly carried his thoughts on the emasculation of the father “a generation forward; [for] according to Greek mythology it was Kronos who committed it on his father Uranus” (Freud, 1901b, p. 218). Reviewing his mistake and lapsus, Freud explained that “where an error makes its appearance a repression lies behind it – or more correctly, an insincerity, a distortion, which is ultimately rooted in repressed material” (p. 218). He then associated this material to Jacob Freud, his dead father (p. 219). Freud committed a similar error in The Psychopathology of Everyday Life, in the context of analyzing the castration fantasies of a young boy.14 Freud was apparently only able to truly understand the hidden logic of his own mistake years later, when Sándor Ferenczi committed a lapsus similar to his own. Commenting on a manuscript which Ferenczi had sent to him, Freud wrote: “Isaac just as nice. Analogous to my mistake in telling the story of Kronos’ castration by Zeus, put forward against mythology, only now explains this mistake to me (Interpretation of Dreams)” (Freud to Ferenczi, November 21, 1909; emphasis added). Ferenczi’s manuscript is unfortunately missing and we have no access to the actual material informing Freud’s remark. The fact that Freud gained insight into his mistake in relation to material bearing on the biblical figure of Isaac, Jacob’s father, is highly revealing. It serves to directly transport us to the theme of “sacrifice.” It also suggests that, despite his having couched his thoughts and fantasies in Greek garb, Freud was nevertheless still being unconsciously oriented and guided by the biblical narrative.15 In the latter the overcoming of the primeval custom of child sacrifice was explained by the legend of Isaac, more particularly, through the scene

164 The cornerstone of his near-sacrifice, the Akedah (Hebrew word for binding). Isaac was brought by his father Abraham to Mount Moriah at God’s command to be sacrificed. After he was bound on the sacrificial altar and as Abraham prepared to carry out the deed, an angel of God appeared and restrained Abraham from proceeding. To replace the human sacrifice, circumcision is then introduced as a sign and token of the covenant between God and Abraham: rather than the individual, it is now a part of the body, the genitals, that is now symbolically sacrificed (Schlossman, 1966). In his book on Moloch and the practice of sacrificing children in Western religions, Martin Bergmann (1992, 2007) argues that the struggle against sacrificing children stood as a driving force in the development of Western religions, indeed as an influential element in the human collective psyche. Bergmann argued that Moloch, or a similar god under another name, was the original deity of the Israelites. The abolition of the practice of sacrificing children, he argues, marked the evolution of an omnipotent and irascible god into a more loving and predictable deity. This discontinuity was itself memorialized in the stories bearing on Abraham’s near-sacrifice of his son Isaac (Genesis 22) and in the story of the killing of Egyptians’ firstborn children just prior to the Exodus from Egypt (Exodus 11:5). As Bergmann (1992) phrased it: “It was the unique destiny of the Israelites to bind this omnipotent and irascible god into a god able to enter in a contract with a particular group of tribes. Following the covenant, God became more reasonable and more predictable” (p. 3). Bergmann went on to add: “From now on Yhwh will spare the life of the firstborn and will be content to have him circumcise” (pp. 100–101). Circumcision was therefore “a memorial to, a replacement for, and a prevention of the sacrifice of the child” (p. 104). Following James Frazer and other authors, Bergmann argues that children were originally sacrificed during Passover. In the Jewish tradition this holiday in time became a celebration of the renunciation of child sacrifice and of human sacrifice in general. Passover (in Hebrew Pesach, which literally means the act of passing over) commemorates the day on which the Angel of Death passed over the houses of the Jews and spared the life of the firstborn Jewish child living in the home; the firstborns of the Egyptians, however, were not protected but were slain (Exodus 12). The averted infanticide, notes Bergmann (1992, p. 91), resurfaced through Christ’s crucifixion. The sacrifice of Isaac, which according to Jewish tradition occurred at the time of Passover, thus prefigures the sacrificing of Christ, God’s chosen son. While Judaism emphasized that the sacrifice of Isaac had been averted, the Apostle Paul, in his letter to the Galatians, argued that Christians were ultimately the descendants of the sacrificed and resurrected Isaac. Instead of men sacrificing their sons, God had sacrificed his own son for the sins of men. In the new covenant, circumcision was replaced by the ritual commemoration of God’s son through the Eucharist. Within this new symbolism, circumcision now lost its function to acquire a

The cornerstone 165 new metaphoric meaning. In the discourse of Paul the token in the flesh transformed into a figure of speech: “circumcision of the heart” (Romans 2:28–29). As Bergmann (2007) indicated: “After this displacement of the sacrifice from men to God, circumcision was no longer necessary. God was no longer seen as needing human sacrifice” (p. 113). It was in January of 1897, the very year when Freud had managed to extract “the stone out of the quarry as best he could,” that the scene of Emma’s circumcision scene appeared. As I read and interpret it, it served to trigger fantasies and thoughts relating to the sacrifice of children during the early stages of human society for her analyst. Freud, however, abandoned the biblical narrative in order to help him land in classical Greece. As noted, it then allowed him, in October 1897, to install the Oedipus legend as providing the key to an understanding of childhood sexual desire. These two moments in Freud’s meditation are not completely disconnected. Like Isaac, Oedipus himself was a child who came close to being sacrificed. Both children, as we know, survived, but not before being emotionally impacted and traumatized by the scene. Isaac was brought to Mount Moriah to be sacrificed while Oedipus was bound and exposed to die on Mount Cithaeron, his pierced foot remaining a visible mark of his trauma and near-death. In his study on Isaac and Oedipus (1954) Erich Wellisch compared Oedipus with Isaac and went on to examine the Oedipus myth in light of infanticide (the primal crime of humanity). Several other authors, among them Max Sugar (2002) and Kalman Kaplan (2002), later pinpointed the essential similarity and common themes binding the two legends together. Both legends are centered and revolve around the themes of filicide, patricide, guilt, punishment, and expiation. Sugar (2002) speculated that Isaac had been guilty of incest with his mother and went on to suggest that his later blindness should be interpreted as an upwardly displaced equivalent of castration (p. 696). He viewed the Isaac myth as a more positive and hopeful variant of the Oedipus myth. In Freud’s narrative the story of the near-sacrifice of Isaac was completely bypassed by him. Freud apparently never imagined or saw Oedipus as a replacement figure for Isaac. Despite the similarities between the Oedipus and Isaac legends, there is an important difference to be found between Oedipus’s tragic destiny and Isaac’s providential salvation. The discrepancy appears to be rooted in the very difference between Greek tragedy and the Bible story. As Wellisch explained, ancient Greek philosophy “has not the vision of salvation” (p. 115) and the gods of the Greek Pantheon are indifferent to the destiny of man. This indifference, which in Freud’s meditation is strongly idealized and assimilated into his desire for scientific objectivity, stood as an important element behind his sympathy for, and preference for, Greek mythology. Indeed, throughout his entire work Freud again and again rejected the very idea of salvation. He certainly had solid motives for doing so. The deeper point, however, is that his insistence on and appeal to rational motives led him to disavow

166 The cornerstone and to never acknowledge his own rescue fantasies. Despite his disavowal, Freud’s rescue fantasies came to play an important and essential role in his founding of psychoanalysis. Freud never ceased struggling against the very brutal “Moloch” associated with Emma’s circumcision scene. In Totem and Taboo, the highest expression of Freud’s founding myth, we find Moloch resurfacing in displaced fashion, namely, through the brutal father of the primeval horde who is dethroned and emasculated by a band of brothers (Freud, 1913a). The struggle against the sacrifice of children stood as a driving force not only in the development of Western religion but also in the foundation of psychoanalysis. It remained an element which was marginalized and never fully integrated. The fantasy of rescuing a child, which patently informed Freud’s “seduction theory,” was not lost when he abandoned his seduction theory. It survived, in disguised fashion, through Oedipus’s tragic rebelliousness. Indeed, I would argue that it served to turn psychoanalysis into a mission.

The navel of the world Other elements must be explored if we are to successfully pinpoint the connections between Freud’s unconscious reaction to Emma Eckstein’s circumcision, his use of the cornerstone concept, and its associations with the idea and concept of a foundation rock, stone, or pillar in the building of psychoanalysis. The worship of natural rocks, stones, and pillars is to be found in all primitive religions. In his Lectures on the Religion of the Semites, William Robertson Smith (1889–1890) proposed that stones originally held the function of helping to mark the place where blood sacrifices were performed. Stones, he argued, were rendered sacred by the sacrificial blood which had been poured over them. Sacred stones were thus “at once idol and altar” (p. 213). The sacred stone which marked the center of the world was called omphalos (“navel” in Greek). In primeval times the navel was perhaps associated with a sacred stone because the newborn baby’s umbilical cord was severed with a stone. The presence of the navel in the human body, we may perhaps surmise, prompted fantasies and speculations which were then preserved in legends and myths. The most famous omphalos stone was found in Delphi, the site of the most renowned sanctuary and oracle in ancient times. The site was identified by Zeus as he sought to find Gaia’s navel, Gaia being his “Grandmother Earth.” The name of Delphi itself derives from delphys, meaning “womb.” According to the legend, in order to prevent dethronement by his children, Kronos devoured them as soon as they were born. His last son, Zeus, was however rescued from this destiny by his mother, who replaced the baby with a stone. Believing that it was Zeus, Kronos then swallowed the

The cornerstone 167 stone. This stone in turn became the omphalos stone which was worshipped in the sanctuary at Delphi. According to other legends, the site of the sanctuary in Delphi was the place where the chthonic serpent Python, a child of Gaia, was killed by Apollo. Python was slain beside the rock cleft where the Sybil sat on her tripod. Its body then fell into this fissure and became the guardian of the omphalos, the sacred navel stone and mid-point of all earth. Since fumes arose from Python’s decomposing body, the priestess, who was named Pythia (after the name of the serpentine dragon Python) fell into a trance and in a state of frenzy induced by vapors began to prophesize and delivered oracles. In The Interpretation of Dreams Freud alluded to the “navel of the world” at the beginning of his journey into the unknown. Commenting on his Irma dream, Freud (1900) referred to the “navel” of the dream as the entry point for all interpretation: “This,” he said, “is the dream’s navel, the spot where it reaches down into the unknown” (p. 525). Sian Morgan (1995) found an allusion to the oracle at Delphi in Freud’s passage. It referred to the priestess who interpreted dreams as she peered down a cleft in the earth, just as Freud peered down Irma’s throat: “The navel is the omphalos. The omphalos at Delphi marked the shrine to the earth goddess, where in mythology a dragon or python held sway” (p. 167). In support of her thesis, Sian Morgan noted that Freud’s associations to the navel of the dream via “the three women” all came together through Irma, the central figure in his most important dream. These “three women” remind us of Pythia, priestess of Delphi, who not only sat on a tripod when carrying out her function but whose position was typically represented by three different women who each took turns prophesying. Freud would in a later dream identify these three women with the Three Fates. A further concordance between the oracle of Delphi and Freud’s Irma dream can be found in the theme of intoxication or poisoning which appears in Freud’s dream. While Pythia pronounced her oracles as she was intoxicated by vapors rising up from below – scientists believe that the gas oozing from the fissure was ethylene – Freud’s Irma dream had itself been instigated by the aroma of amyl emitted as he opened a spoiled bottle of pineapple liqueur (Ananas) which he had received as a gift from Otto, a friend and medical colleague. The “amyl” was transformed through the dream work first into “propyl” and then into “trimethylamin” and its formula. The formula, we might say with Lacan, was itself the oracle which had been delivered and presented through Freud’s most important dream. Freud’s passing allusion to the “navel of the world” in his founding dream is dense and packed with implications. For starters, it appears to announce a “womb-fantasy” (Freud, 1918a, p. 101) which, in the following years, would lend to Freud’s discovery of the Unconscious the dimension of a legendary descent into the hellish depths of Mother Earth’s belly, which is typically and often portrayed being undertaken by a hero in

168 The cornerstone search of a magic object, a loved figure, or simply in order to gain a higher form of knowledge or enlightenment. Freud’s descent into the infernal region was notoriously inspired by Aeneas’s quests for a homeland following the destruction of Troy. In Virgil’s poem, Aeneas fails to regain his lost homeland but he settles in Italy. His doing so helped set the stage for the foundation of Rome, through which Troy’s glorious past would arrive to be revived. In Freud’s case, the lost and refound homeland was undoubtedly the ancient and Holy City of Jerusalem. Freud’s quest for his lost homeland was revived by the death of his father Jacob in October 1896. His analysis of the Irma dream, when all is said and done, remained an analysis of an isolated dream; after the death of his father Jacob, however, Freud’s dreams and his analysis of them acquired the necessary continuity which helped transform them into a systematic commitment. It was soon after, between December 1896 and January 1897, that Freud experienced his series of dreams on Rome. A precise reconstruction of the thoughts and emotions which Freud harbored at the time is of course impossible. Anzieu (1986a) helped to fill a number of the gaps in the best way he could, comparing Freud to Aeneas, the mythic founder of Rome in Virgil’s poem Aeneid: Like Aeneas, Freud has lost his father; and the work of mourning, which enables him to recover the image of the dead man deep within his psyche, no doubt reminds him that the reason Aeneas went down into the underworld was to consult his father, Anchises. . . . Anyone wishing better to understand the internal processes that were at work within Freud between November 1896 and Easter 1897 would be well advised to read Book VI of the Aeneid carefully. (p. 176) Anzieu’s recommendation and description might appear far removed from Freud’s daily life. In December of 1896, however, Virgil’s Aeneid was so heavily in Freud’s mind that, while drafting a new plan for a book on the neuroses, he decided that the section on the formation of symptoms would be preceded by the motto “Flectere si nequeo superos, Acheronta movebo” [If I cannot bend the Higher Powers, I will move the Infernal regions], a statement found in Virgil’s Aeneid. After abandoning his plan for the book he decided to retain the motto as an epigraph to The Interpretation of Dreams. There is a specific element which floats to the foreground when we align and compare Freud’s descent into the Unconscious with Aeneas’s descent into the infernal region. In both cases the mystical trip is imagined as a journey into the barathrum (abyss) of the maternal body which starts out before an open mouth. In Virgil’s Aenid the entrance into Hell is indeed depicted as a wide-open and yawning mouth: “There was a cave profound and hideous, with wide yawning mouth, stony, fenced by a black lake, and

The cornerstone 169 the gloom of woods.” In Freud’s case, it was of course Irma’s own mouth that functioned as a gateway to the unknown. We cannot but think here of the image of Moloch’s open and yawning mouth, inside which children were to be thrown and sacrificed into the fire.16 The allusion to the “navel of the world” found in Freud’s initial dream resurfaced in Freud’s final dream, namely, his dream of the self-dissection of the pelvis. In this dream, after having performed the bloody sacrifice on his own body, we find Freud setting out on a perilous journey which had been inspired by the imaginative novels She and Heart of the World by Rider Haggard, both of which dealt with perilous journeys into the interior or “womb of the earth.” In Haggard’s second novel the “Heart of the World” is the name of a lost city and of a pyramid located at its center (the “pyramid of the Temple of the Heart”). The “Heart” is also the Holy Sanctuary within the pyramid and, finally, of the talisman which had been severed in halves. The hero of the novel has received half of it as heritage from his dead father, and the entire novel consists of a perilous search for “that which was lost” – the other half of the Heart talisman. When the severed halves of the Heart are set in their place upon the altar in the Holy Sanctuary, the Heart opens up like a flower to reveal a red jewel shaped like a human eye and a small plate of dull gold, covered with hieroglyphics. In his comments about the novel, Grinstein (1980, pp. 412–413) noted that the union of the two halves of the heart talisman was symbolic of a mystic marriage ceremony; the opening of the heart, like a flower, hints at a woman’s defloration while the vigilant eye represents the forbidding superego which brings destruction and death to those who violate the taboo. I would add that the heart talisman functions as a sacred omphalos stone and that the symbolism displayed in the novel’s narrative – featuring pyramids, sanctuaries and “severed halves” – might shed light on the thoughts behind Freud’s Norekdal dream. It suggests that Emma’s cut labia, after having elicited Freud’s repulsion, eventually transformed into “idol and altar,” if not the very cornerstone of his fantasy world. We might surmise that the fact that blindness featured so heavily in Freud’s fantasies and dreams issued from the intensity of his desire to “see” Emma’s genitals, a forbidden pleasure in looking which then resurfaced as a focal point of his self-analysis.17 In Freud’s work the theme of the two severed halves which strive for reunion would arrive to resurface in Beyond the Pleasure Principle. Appealing to Plato’s Symposium, Freud (1920) recalled the myth of the Androgyne, the original “man–woman” being which Zeus decided to cut “in two ‘like a sorbapple which is halved for pickling’. After this splitting was performed, ‘the two parts of man, each desiring his other half, came together, and threw their arms about one another eager to grow into one’.” (pp. 56–57). Freud introduced this myth in order to illustrate his idea of the instinct as involving a compulsion “to restore an earlier state of things” (p. 56). The myth of the Androgyne was reported in more complete form by Herman Nunberg (1947) in his essay on “Circumcision and problems

170 The cornerstone of bisexuality.” Nunberg opined that the introduction of this primordial cut introduced the idea of, and made it necessary to heal, human beings. What he offers in relation to this part of the myth, left out by Freud, must be quoted at length as it helps us to circle back to the navel symbolism. According to the myth, it was the god Apollo who was designated to heal and repair this primordial and original cut: Then Apollo turned their faces about, and pulled their skin together from the edges over what is now called the belly, just like purses which you draw close with a string; the little opening he tied up in the middle of the belly, so making what we know as navel. . . . Now, when our first form had been cut in two, each half, in longing for its fellow, would come to it again; . . . “Each of us, then, is but a tally of a man, since everyone shows like a flatfish the traces of having been sliced in two; and each is ever searching for the tally that will fit him.” (Plato, Symposium, as quoted by Nunberg, 1947, p. 149) Plato’s myth of the Androgyne may indeed be viewed as involving a fantasy which features the navel, the omphalos, the scar of a cut which is simultaneously real, imaginary, and symbolic. The navel, a concrete and visible scar in the human body, might thus perhaps be seen as lying at the origins of the metaphor of the “cut,” a fact which attests to the incompleteness of our being and our desire for reunion, wholeness, and integrity. The cut in question was perhaps originally the cut which must necessarily be performed on the umbilical cord for a living being to enter life, the prototype and model of all “symbolic wounds” performed in initiation rites, including circumcision. Indeed, commenting on Plato’s myth of the Androgyne, Nunberg found that it was strikingly similar to the system of fantasies which one of his patients who had been circumcised at the age of five had produced during analysis. The severed foreskin in these fantasies represented the lost female part of the man which was then sought in the outer world. Incest fantasies and marriage ceremonies, Nunberg argued, represented a symbolic way of regaining the lost foreskin in order to help heal the wound. Even the very manner in which the wound was treated in the Symposium, argued Nunberg, serves to remind us of circumcision. This poses an interesting problem as the Greeks did not circumcise themselves or their children: “How then, is it possible that Plato, a Greek, used a circumcision phantasy, personified in a hermaphroditic figure split in two, as a basis for the origin of sexes?” (p. 150). Nunberg raises an important question indeed. It enables us to overcome the particularity of circumcision by exposing the original symbolic structure replicated in the rite of circumcision. According to Nunberg, Plato derived his myth on the creation of man from the idea, ubiquitous in ancient mythologies, that the ancestor of all human beings had been a bisexual creature who had been split in two, a man and a woman, and whose goal

The cornerstone 171 became the reunion of the two severed halves. The creation myth found in the book of Genesis can itself be treated under this framework. According to the Bible, the first woman, Eve, had been formed from a rib taken from Adam’s side. Adam, in short, was originally an androgynous creature. Reviewing various myths, and relating them to the fantasies which his circumcised patients had shared with him, Nunberg argued that the castration trauma could be mastered by projecting femininity into the outside world and by mobilizing the heterosexual libido – the desire to unite both sexes into a single unit. Nunberg’s concluded that if the prepuce symbolized the feminine part of man then “the restoration of the unity of both sexes in the myth may signify the restoration of the penis as it appeared before circumcision” (p. 152). This dynamic, which obviously applies to the cut on Emma’s vaginal labia, illustrates the fantasies that the trauma which she endured might have aroused and mobilized in Freud. Nunberg speaks in this regard of a “nullification of the circumcision” (p. 153). Freud formulated this same principle in more general terms, labeling and indexing it under the rubric of the “pleasure principle.” He was many years later forced to recognize the existence in the human psyche of a compulsion to repeat which stood as more fundamental and primary than the pleasure principle (Freud, 1920, p. 22). Indeed, we may surmise that Freud, during the course of Emma’s analysis, had been confronted with both of these phenomena and tendencies since, as Nunberg (1947) pointed out, circumcision was without doubt a trauma which released and unleashed “a tendency in the ego to repeat it in one way or another and to form reactions to it” (p. 146).

Notes 1 Nunberg (1931) later presented a paper on the topic at the Eleventh International Congress in Oxford in July of 1929. 2 In Nunberg’s case, I wonder if somehow he felt encouraged to research and write on the topic of circumcision. Indeed, the opening sentence of Nunberg’s paper on “Circumcision and problems of bisexuality” (1947) refers to the foundation stone concept – “the ‘bedrock’ where psychology rests on biological foundations” (p. 145). 3 In her 1904 article Die Sexualfrage in der Erziehung des Kindes [The Question of Sexuality in the Raising of Children], Emma Eckstein devoted considerable attention to the theme of masturbation and to the fantasies accompanying the act (see Masson, 1984). 4 The anti-Semitic theme behind this dream was disclosed by Freud (1900) himself in another passage in The Interpretation of Dreams, where, analyzing his “Count Thun” dream, he reconnected his surprise at his German-nationalist attitude with his recollection “of a piece of anti-Semitic provocation during a railway journey in the lovely Saxon countryside” (pp. 212–213). The episode was described by the 27-year-old Freud (1960) in his letter to Martha of December 16, 1883. When he opened a window on the train, several people asked him to close it, “there came a

172 The cornerstone

5

6

7

8

9 10

shout from the background: ‘He’s a dirty Jew!’ – And with this the whole situation took a different color. My first opponent also turned anti-Semitic . . . I was not in the least frightened of that mob. [I] asked the one to . . . step up and take what was coming to him. I was quite prepared to kill him, but he did not step up . . . I settled down boldly beside it [the window] . . . I held my own quite well, and used the means at my disposal courageously” (p. 78). Lueger was elected Mayor several more times and was voted into office for a fifth time by the populace on March 31, 1897. The Emperor finally gave in and sanctioned his election two weeks later, on April 16, 1897. He was sworn into office four days later, on April 20, 1897 and remained in office as Mayor for 13 years, until his death at the age of 65 in March of 1910. According to Grinstein (1980), Freud’s Norekdal dream was possibly informed by the image of the “guilty woman.” Reviewing Ibsen’s two plays, Grinstein (1980) found that: “Both plays contain the common element of the woman living a lie” (p. 218). In each case “one character takes it upon himself to expose the deception perpetrated by the woman” (p. 219). In A Doll’s House, for instance, Torvald rants at Nora: “All these years – she who was my joy and pride – a hypocrite, a liar . . . I ought to have foreseen it” (p. 213). Grinstein concludes that this stood as the fundamental theme of Freud’s Norekdal dream and went on to link the criticism leveled against Freud by his medical colleagues for his views on the cause of hysteria. In his biography of Freud, Fritz Wittels (1924) suggests that the medical colleague who had sent Freud the manuscript was his own uncle, Isidor Sadger. Wittels describes Sadger’s manuscript as “an essay extolling Flechsig’s works” which Freud considered “bombastic” (p. 76). Since Freud spoke of a manuscript, we can safely assume that he had likely received Sadger’s text in advance; May (2003) suggests between February and April of 1897. Sadger published a total of six articles on Ibsen between 1894 and 1898, with only one of these manuscripts matching Freud’s account. It was an article which was published in a newspaper, Nette freie Presse, in two parts (on February 2 and February 4 of 1896). In it, the names Nora and Ekdal appear in various instances. For chronological reasons, May believes that the article on Ibsen which Freud read might be “Ibsen’s ‘John Gabriel Borkman’,” which appeared in April 1897. This piece did not appear in a newspaper and the name Ekdal is not mentioned in it (the name “Nora” appears just once). May did not arrive at a definitive conclusion regarding the article on Ibsen by Sadger which supposedly triggered Freud’s dream. Anthi proposed an altogether different date and context for Freud’s Norekdal dream. While he was most likely mistaken on that point, the fact remains irrelevant as far as the validity of his structural micro-analysis is concerned. Webster’s online dictionary offers the following account of the cornerstone concept: “The cornerstone (or foundation stone) concept is derived from the first stone set in the construction of a masonry foundation, important since all other stones will be set in reference to this stone, thus determining the position of the entire structure. Over time a cornerstone became a ceremonial masonry stone, or replica, set in a prominent location on the outside of a building, with an inscription on the stone indicating the construction dates of the building and the names of architect, builder and other significant individuals. The rite of laying a cornerstone is an important cultural component of western architecture and metaphorically in sacred architecture generally.”

The cornerstone 173 11 The Book of Isaiah offers: “Behold, I lay in Zion for a foundation a stone, a tried stone, a precious corner stone, a sure foundation: he that believeth shall not make haste” (28:16). This verse has generated various interpretations by scholars. The passage from Psalm 118 cited at the start of this chapter was most likely originally spoken by David and later attributed to Jesus; it is cited in the New Testament on at least six different occasions (Matthew 21:42, Mark 12:10, Luke 20:17, Acts 4:11, Ephesians 2:20, and Peter 2:7). 12 Freud broached the subject, for instance, when he broke a little marble Venus sculpture by accident. Freud immediately realized that his clumsiness and subsequent accident stood as a “sacrificial act.” As he explained, his eldest daughter had been gravely ill and the destruction of the beloved marble object represented a “thank-offering” for her recovery (Freud, 1901b, p. 169). This episode, which was incorporated by Freud into the second edition of The psychopathology of everyday life, reminds us of the way in which Mathilde’s diphtheria was treated by Freud in the Irma dream. 13 As noted by James Frazer (1894), since his earlier editions of The Golden Bough, Moloch was identified with Israel. This association was employed by Max Horkheimer and Theodor Adorno (1947) in the context of their analysis of antiSemitism. To quote from their Dialectic of Enlightenment: “The Jews as a whole are charged with practicing forbidden magic and bloody rituals. Disguised as an accusation, the subliminal craving of the indigenous population to revert to mimetic sacrificial practices is joyously readmitted to their consciousness. Once the horror of the primeval age, sent packing by civilization, has been rehabilitated as a rational interest through projection onto the Jews, there is no holding back. It can be acted out in reality, and the evil which is acted out surpasses even the evil content of the projection. The popular nationalist fantasies of Jewish crimes, of infanticide and sadistic excess, of racial poisoning and international conspiracy, precisely define the anti-Semitic dream, and fall short of its realization” (p. 153). 14 On that occasion Freud elided a father’s name (Tarquinius Priscus, the fifth King of Rome) in favor of a son, Tarquinius Superbus (p. 198). Freud realized his mistake only after the second edition of his dream book was published in 1904. 15 We don’t know exactly which aspect of the Isaac legend allowed Freud to finally grasp the unconscious logic secretly guiding his error. Perhaps it concerned the story of the deception of the aged and blind Isaac by his son Jacob. The biblical Jacob, said the Bible, dressed himself up to look like his slightly older twin brother (Esau) and presented himself to his aging and blind father Isaac in an attempt to trick him and secure his blessing. Freud (1900) too once fantasized receiving the blessing of a blind and aged father and did so as he dreamt of his father’s problems with glaucoma and imagined being operated on in disguised or “incognito” (pp. 170, 216–217). Freud’s “incognito fantasy” appears to have been at bottom informed by the Jacob story in the Bible. 16 I for one wonder whether a Moloch fantasy was behind Freud’s selection of the “moving dream” which he reported in the very opening page of the seventh and final chapter of The Interpretation of Dreams. This “metapsychological” chapter was introduced by the dream of a man who had fallen asleep in a room adjacent to the one in which the lifeless body of his child lay in a bed. One of the candles had fallen to the bed, with the resultant fire burning the child’s lifeless body. Freud (1900) reports that it was at that point that the father dreamt that the child had walked up to him to say: “Father, don’t you see I’m burning?” (p. 509).

174 The cornerstone 17 In his letter to Fliess of October 3, 1897, Freud speculated that his “libido toward matrem” was awakened when, journeying with her from Leipzig to Vienna at the age of three, he had “an opportunity of seeing her nudam” (Masson, 1985, p. 268). The sexual pleasure in looking – “Schaulust” in German, which was rendered by Strachey with the neologism “scopophilia,” later turned into “scoptophilia” – and its repression were discussed by Freud in several works. In his article “The psycho-analytic view of psychogenic disturbance of vision” Freud (1910f) proposed an explanation of psychogenic visual disturbance based on the talion punishment: “Because you sought to misuse your organ of sight for evil sensual pleasures . . . you should not see anything at all any more” (p. 217). Freud composed this article as a contribution to a Festschrift in honor of Leopold Königstein, an ophthalmologist and a good friend, between March and April 1910, that is, in the period of Emma Eckstein’s second analysis with him (see Chapter 9 of the present work).

7

A bisexual monster

A window on the unconscious Commenting on the motto Flectere si nequeo superos, Acheronta movebo [‘If I cannot deflect the will of Heaven, I shall move Hell], chosen by Freud as an epigraph to The Interpretation of Dreams, Carl Schorske (1973) noted that these words from Virgil’s Aeneid were spoken by an infuriated Juno who, after having failed to keep Aeneas from settling in Italy and establishing Rome, summons from Hell a Fury, Allecto, who was portrayed by Virgil as “a gorgonlike phallic female ‘alive with black and writhing snakes,’ a bisexual monster” (p. 56). Anzieu (1986a) suggested that this bisexual monster represented “the persecutory anxiety which in his own case Freud never succeeded fully in elucidating” (p. 178). In this chapter I will attempt to reconstruct the appearance of the theme of bisexuality in Freud’s work, tracing the theme back to his emotional and intellectual struggle with Emma Eckstein’s phallic fantasies and thereby to the genesis of The Interpretation of Dreams. According to Freud, dreams provided a window on the unconscious. Freud experienced a dream around October 30 of 1897 which itself featured a window. He had seen in the window of a bookshop a new volume in a series of monographs on great artists, world history, and famous cities which he had been in the habit of buying. The opening title in the new series bore the title “Famous speakers” or “Speeches” and was itself devoted to “Dr. Lecher.”1 During those days the Austrian Parliament had been required to pass legislation by a certain date in order to help renew commercial and economic relations between Austria and Hungary, the two halves of the Empire which had broken or split apart from each other. Because of hostilities between the Czechs and the Germans, the German-language faction set out to block the passage of this legislation. In the turmoil, Dr. Lecher had spoken non-stop for 12 hours, all supposedly without repeating himself. According to Mark Twain it had been “the longest flow of unbroken talk that ever came out of one mouth since the world began.” For 12 hours the orator “stood there, undisturbed by the clamour around

176 A bisexual monster him, and with grace and ease and confidence poured out the riches of his mind, in closely reasoned arguments, clothed in eloquent and faultless phrasing” (McGrath, 1986, p. 223). Freud’s dream itself recalled his Prague–Rome dream of early 1897 and the political aspirations towards freedom in Freud’s Hannibal fantasy during his school days. Yet, as proposed by Carl Schorske (1973): The brilliant, lonely, painful discovery of psychoanalysis, which made it possible for Freud to overcome his Rome neurosis . . . was a counterpolitical triumph of the first magnitude. By reducing his own political past and present to an epiphenomenal status in relation to the primal conflict between father and son, Freud gave his fellow liberals an ahistorical theory of man that could make bearable a political world spun out of orbit and beyond control. (p. 59) According to McGrath, a student of Schorske, the Dr. Lecher dream was the first of Freud’s “political dreams to which he gave an openly counterpolitical interpretation” (p. 227). It is not easy to understand what Freud was unable to voice then, however, since he had just recently arrived at a symbolically meaningful decision. Just a month earlier, in September, he had joined the B’nai B’rith (literally “sons of the covenant”) Society in Vienna, a Jewish fraternal lodge whose fortnightly meetings Freud attended on a regular basis after he became a member. As a new member, Freud was required to give a speech before the members of the society. Freud opted to give a speech “On dream interpretation,” which he did on December 7 of 1897. Freud’s identification with Lecher, the non-stop speaker and obstructionist of the Austrian Parliament, betrays a deeper conflict bearing on the function of opening or keeping one’s mouth shut – the very image present in Freud’s most famous dream, to wit, Irma’s hesitation to open her mouth properly. The oral theme can itself be found inscribed in the very name of the orator (Lecher) – it suggests “delicious” (Lecker) in German as well as the gesture of “licking” in the French language (lécher). The name also neatly taps into Freud’s daughter Anna and her dream of strawberries.2 Anna’s strawberries dream was mentioned by Freud in his letter to Fliess of October 31, 1897 where we find Freud also writing: “Under the influence of analysis my cardiac symptoms are now very frequently replaced by gastrointestinal symptoms.” Not given the chance to talk, an oral function (mouth) had now regressed to a bodily function. In Freud’s Lecher dream the speech which had been suppressed was now being voiced through the image of a monograph on famous “Speakers” or “Speeches.” It was in my view the first oneiric representation of Freud’s dream book, the depository of what Freud had been unable to verbalize.

A bisexual monster 177 A few months later, on March 5 of 1898, Freud wrote to Fliess to report that had managed to complete a section of his book on dreams. Fliess promptly replied that he had envisioned the book “lying finished” before him. On the night when Freud received his response from Fliess he went to sleep to dream he had written a monograph on a certain plant (Freud, 1900, p. 169). Just the previous morning Freud had seen a recently published book, a monograph of the genus “Cyclamen,” in the window of a local book shop. Freud worked relentlessly on his book on dream interpretation during the next two and a half years. It was finally completed and published by him near the end of 1899 under the title Die Traumdeutung.

The inhibition What exactly was it that Freud had been unable to put into words? The cause of Freud’s inhibition is not altogether clear. He had certainly experienced a sort of psychic collapse in the summer of 1897: “I have never before even imagined anything like this period of intellectual paralysis,” he wrote to Fliess on June 22 of 1897. “Incidentally, I have been through some kind of neurotic experience, curious states incomprehensible to Cs. [consciousness], twilight thoughts, veiled doubts.” It was precisely at that exact moment, in my view, that Freud became his own “patient.” As he explained to Fliess less than two months later, on August 14: “The chief patient I am preoccupied with is myself.” He then explained that the analysis was “more difficult than any other,” while adding: “It is, in fact, what paralyzes my psychic strength for describing and communicating what I have won so far.” We know that Freud developed a “transference neurosis” towards Fliess which undergirded and fostered his self-analysis. An important piece of the transference surfaced in Freud’s analysis of his non vixit dream, where Fliess is portrayed as a reincarnation and revenant of John (Freud, 1900, p. 425), Freud’s nephew and playmate during his childhood years back in Freiberg. In this context Freud (1900) was reminded of a “dispute about some object” between the two children. “Each of them,” he wrote, claimed to have got there before the other and therefore to have a better right to it. . . . On the evidence of the dream, I may myself have been aware that I was in the wrong (“I myself noticed the mistake”). However, this time I was the stronger and remained in possession of the field. (p. 483) In real life the “dispute” Freud had been unable to voice concerned the idea of a universal bisexual constitution of human beings, an idea which Fliess had proposed during their Easter meeting in Nuremberg on April 18 of 1897. Later, in one of Freud’s last communications to Fliess, his letter of August 7, 1901, he wrote: “You remember my telling you years ago, when

178 A bisexual monster you were still a nose specialist and surgeon, that the solution lay in sexuality. Several years later you corrected me, saying that it lay in bisexuality — and I see that you are right.”

Bisexuality In January of 1897 Freud had reported Emma’s circumcision scene in the context of a group of three letters which featured clinical material and bold ideas Freud had hoped to personally discuss with Fliess in three months, during their upcoming Easter congress in the spring. Their meeting took place on April 18, not in Rome, as Freud had wished, or in Prague as planned, but in Nuremberg instead. In the course of the meeting Freud presented Fliess with other clinical material, in particular the recurrent dreams of gigantic snakes which one of his female patients, Emma Eckstein most likely, had been experiencing. It was while discussing the clinical significance of these snake dreams that Fliess introduced the idea that “undercurrents in a woman might stem from the masculine part of her psyche” (Masson, 1985, p. 465). Fliess had developed this idea with his theory that repression stood as a product and consequence of the bisexual constitution of human beings. As Freud (1919a) described it: “To put the theory briefly: with men, what is unconscious and repressed can be brought down to feminine instinctual impulses; and conversely with women” (p. 201). Freud found Fliess’s theory highly attractive “on account of its bold simplicity” (p. 200). He had been deeply impacted by the idea of bisexuality as the true cause and primal motive force of repression and immediately adopted a modified version of it, founding his new architecture of hysteria on “repression” while maintaining that “the element essentially responsible for repression is always what is feminine” (Masson, 1985, p. 246). In spite of his vacillations and variable metapsychologies, Freud would till the end keep and embrace this simple formula and idea. As we know, in “Analysis terminable and interminable,” he concluded that the “repudiation of femininity” stood as the biological bedrock of the psychic field (Freud, 1937, p. 252). Freud (1905, p. 220) held this factor as decisive after he became acquainted with the notion of bisexuality. Yet, he repeatedly repressed the fact that the concept and importance of bisexuality were originally introduced by Fliess, a symptomatic “memory disturbance” which haunted Freud throughout his relationship with his friend from Berlin. The entire topic was affected by tensions which would slowly surface during the course of Freud’s self-analysis and became the point which led to the break between the two men not long after the publication of The Interpretation of Dreams. Freud’s pretension to have a better right to the idea of inborn bisexuality grows more understandable once we take stock of the fact that it appears to have been inspired by the phallic snake dreams which Emma Eckstein had most likely presented him during analysis. As Freud would come to later explain to Fliess in a letter:

A bisexual monster 179 at that time I was already familiar with the references in the literature in which the idea of bisexuality is used to explain inversion. You must admit that a resourceful mind can on its own easily take the step from the bisexual disposition of some individuals to extending it to all of them, though this step is your novum. (Masson, 1985, p. 466) This passage suggests that the masculine fantasy reported by his female patient was interpreted and recognized by Freud at a clinical level but that it had not yet been theoretically elaborated by him. In this delicate phase Freud still had the opportunity to trace the phallic dreams and fantasies reported to him by Emma back to the genital mutilation which she had likely endured during childhood. The universal theory advanced by his friend, however, prevented this possibility, serving to distance Freud from his early interest and concern with traumatic experiences and memories. This was the very moment when Freud and Fliess had together joined to “rob” Emma’s fantasy, just as Sigismund and John had robbed Pauline back in Freiberg – when the two boys “as though by mutual agreement,” fell on Pauline and snatched “away her flowers” (Freud, 1899, p. 311). After their meeting in Nuremberg, Freud generalized the clinical material he encountered when analyzing Emma by developing the psychobiologic theory that a woman’s sensation of having a penis was rooted in human anatomy and, more specifically, in “the male genital zone” found in girls, to wit, her clitoris (Freud to Fliess on November 14, 1897). Since the clitoris can be viewed from the embryological point of view as a little penis, Freud (1905) assumed that a girl’s sexuality was of “a wholly masculine character” (Freud, 1905, pp. 219–221). Ultimately, this led Freud (1923a) to formulate his theory of the primacy of the phallus, the idea that, for both sexes, “only one genital, namely the male one, comes into account” (p. 142). In Freud’s reconstruction of the female child’s psyche, the child initially expects that her tiny penis will grow as large as that of a boy’s. When the wish fails to materialize, argued Freud (1924a), the child arrives at the conclusion that she once possessed a big penis which had been cut off (p. 178). In other words, the genital mutilation which Emma endured had now morphed into a universal biotrauma.

Bilaterality Fliess took steps to recast his theory of inborn bisexuality after his meeting with Freud in Nuremberg; he now placed it within a broader theory of bilateral symmetry in which left-handedness was associated with sexual inversion. According to this theory, the right side of the human body correlated with the dominant biological sex; in feminine men and masculine women it was the left side which became dominant (Fliess, 1906, pp. 438–439). Fliess presented his “Bi-Bi” theory (bisexuality-bilaterality) at a private “congress” which the two men held in Breslau during Christmas of 1897.3

180 A bisexual monster Freud had apparently failed to reveal the true identity of the female patient who had inspired Fliess to develop his theory during their Easter meeting in Nuremberg. It was shortly after their meeting on April 27–28, however, that Freud experienced his “secerno” dream. He had received a telegram with the address where Fliess had been staying while on vacation in Italy; the address, however, was vague and unintelligible, difficult to read and decipher. The key word in Freud’s dream, secerno, was associated by him with Italy. Freud also saw it as being linked to his feelings of anger towards Fliess, anger which stemmed from Fliess “having kept his address [in Italy] secret . . . for so long” (Freud, 1900, p. 316). Commenting on “secerno,” Anzieu (1986a, p. 218) noted that the word “means ‘I hide’ or ‘secret’ in Italian.” Freud wrote to Fliess immediately after, on April 28, 1897, and noted that the dream managed to bring together “all the annoyance with you that is unconsciously present in me.” This annoyance resurfaced during their 1897 Christmas meeting in Breslau, a meeting which occasioned the first overt disagreement between the two men. Fliess apparently became annoyed at Freud’s reluctance to accept his new theory of left-handedness and, even more so, with Freud’s inability to express and articulate his objections (cf. Masson, 1985, pp. 465–466). Freud, who had experienced feelings of clumsiness and paralysis, attempted to clarify his position only a few days later, on January 4 of 1898. As he explained to Fliess in a letter, he had no aversion to his theory of bisexuality. Freud embraced the emphasis which Fliess had placed on bisexuality from the beginning and considered the concept to be an important one for his research and concerns, for his notion of “defense” in particular. Freud’s objection, which he was indeed unable to adequately articulate and voice, concerned the permeation of bisexuality and bilaterality and the absurd conclusion which Fliess drew in relation to each half of the sex organs. As Freud explained to his friend: I should no doubt have been able to turn the doubt I felt into an objection; or, rather, been able to seize upon it (the idea) when you yourself said that each of the two halves probably contains both kinds of sex organs. But where, then, is the femininity, for instance, of the left half of a man if it carries a testicle (and the corresponding lower male/female sexual organs) just like the right one? Your postulate that for all results male and female must unite is already satisfied, after all, in one half! (Masson, 1985, p. 292) Freud, moreover, had the impression that Fliess considered him to be partially left-handed but was not aware that he had a preference for the left hand. Despite this, Freud appears to have indeed suffered from a right–left spatial disorder and from problems with lateralization. “Years ago,” he wrote, “I had two left hands.” He then continued explaining his

A bisexual monster 181 disorder, which he was able to compensate for by quickly making a few writing movements with his right hand. Didier Anzieu (1986a) was led to wonder how it was that Freud became a “genius instead of a dyslectic?” (p. 206). It is incorrect to oppose genius and dyslexia; the fact that those who suffer from the disorder are forced to invent new coding strategies can itself serve as a factor which promotes creativity and attempts to find divergent and novel solutions to problems. Freud’s description of his spatial difficulties, when coupled with his verbal idiosyncrasies, might indeed lead us to suspect that he had managed to successfully compensate for his apparently mild dyslexia. Dyslectic children do not understand why they suffer from difficulties performing tasks which come so naturally and easily to others. They thus view themselves as different from other children, as “clumsy” and “unable to do anything,” as Freud himself recalled his childhood nanny back in Freiberg describing him. Moreover, directional confusion is also the reason for changing the sequence of numbers (as in Freud’s absurd dreams), letters in words (milah can morph into amyl; brith milah can transform into trimethylamin) and for reversing entire words (Emma may easily transform into Amme). Right–left confusion disorder, however, affects a much larger population and is not necessarily a sign of directional dyslexia. As Anzieu (1986a) noted, Freud had several “mothers” (Amalia, his biological mother, as well as his Czech Catholic nanny). As frequently happens “in a multilingual context or in situations where moving houses disrupts the child’s emotional, sociocultural and linguistic environment,” the codes that are imposed in such cases are often “scrambled, resulting in writing and learning difficulties” (p. 206). We may well wonder whether Freud’s right–left confusion disorder and clumsiness were somehow bound up with the conflicting rules of encoding and decoding alphanumeric symbols. A close reading of Freud’s communications reveals that words were for the most part encoded by him in left-to-right (Catholic) fashion but in right-toleft (Hebrew) fashion as well. Freud most likely did not suffer from dyslexia. It is possible, however, that the impact of emotional trauma led him to experience focal confusion between codifying rules for attachment, language, and sex. Significantly, in his dreams and parapraxis, the issue of clumsiness and inhibition regularly surfaced in association with “ambiguous wording” – starting with infiltration of the “Hautpartie” (piece of skin) which, given its “unusual phrasing,” caught Freud’s attention when analyzing his Irma dream. In his letter to Fliess, while reflecting on his aversion to Fliess’s conception of left-handedness, Freud felt it could have indeed rested on unconscious motives rather than on the subject of left-handedness per se (Masson, 1985, pp. 292–293). We might expand on this point by remarking that the right–left dichotomy turns the world into an extension of the carnal body and the psyche into the sediment of the lively experience of an external space, thereby functioning as a universal fixation point of political tensions and psychic conflicts.

182 A bisexual monster Indeed, the right–left dichotomy embodies the strong–weak, good–bad, right–wrong distinction. It serves to structure the polarized manner of thinking which characterizes discourse about sexuality (masculine–feminine), law (licit–illicit), religion (pure–impure), agency (active–passive), attitudes (authoritarian–permissive), and political thinking (Domhoff, 1969).

My son the Myops The objection which Freud was unable to voice in Breslau came to inform the first in a series of “absurd dreams” dreamt by him. Known by scholars as “My son the Myops,” it likely dated from the first day of January in 1898.4 The dream material can be divided into three distinct parts. The first features a preliminary short dialogue between Freud and a university professor, associated with worries and concerns about children; it is followed by a second segment, not recounted by Freud, and a third and final segment which is the main material reported and analyzed by Freud in some detail in his dream book. The dream opens by declaring that something had occurred in Rome and that it became necessary “to remove the children to safety.” The scene in the dream, Freud (1900, p. 441) reported, actually unfolded “in front of a gateway, double doors in the ancient style (the ‘Porta Romana’ at Siena …)”. We are thus once again standing before and facing the very gate which marked the locus of Freud’s clumsiness and paralysis. The “double doors” in Freud’s dream served to recall the double two-lip structure of the female labia, symbolic exit and entry point for all humans. A disturbingly sad segment follows in the dream. In it, Freud finds himself sitting by the edge of a fountain, depressed and “almost in tears,” when a female figure, an attendant or a nun, suddenly brings out two boys and hands them over to their father, who, Freud relates, was not himself. Freud notes, however, that the older of the two boys being handed over was clearly his oldest son, Jean-Martin. The woman, who stood out in the dream because she sported a red nose, asked Jean-Martin, the older boy, to kiss her goodbye. This female figure (attendant or nun) appears to tie directly back to Freud’s Catholic nanny, his Amme, and to linguistically connect with Emma (Amme in reverse) as well. Freud (1900) explains: The boy refused to kiss her, but, holding out his hand in farewell, said “Auf Geseres” to her, and then “Auf Ungeseres” to the two of us (or to one of us). I had a notion that this last phrase denoted a preference. (pp. 441–442) It is rare for us to find a genuine description of suffering in Freud’s work. It is certainly found here. The peculiar pairing of the nonsensical words which Freud dreamt (Geseres–Ungeseres) suggests that Freud had this time

A bisexual monster 183 failed to completely side with Greek or Latin and that he had inched closer to Hebrew, this time while dreaming of Rome. This subtle shift by Freud towards the language of Scripture opened the way and quickly gave birth to a symbolic space which then allowed Freud to express feelings bearing on trauma and related sensations. These feelings of pain and suffering were expanded by Freud in his associations with the fountain on whose edge he found himself sitting while nearly weeping. Freud’s associations with the fountain were with the Old Testament, to the 137th Psalm found within it, to be specific: “By the waters of Babylon we sat down and wept.” Freud next informs us that he decided to take action to consult “philologists” about his dream. The word “Geseres,” they informed him, was “a genuine Hebrew word” which “derived from a verb ‘goiser,’ the word was best translated, they told him, by ‘imposed sufferings’ or ‘doom’” (Freud, 1900, p. 442). What events might Freud have possibly been alluding to with the word? And why were the tragic events which had occasioned his weeping associated with Rome? What exactly was the threat on the horizon which threatened the children and which had brought Freud nearly to tears in his dream? Why exactly was the task of traveling so difficult, if not impossible, for Freud in his dream? Other questions arise for us as well: why would the German “Auf Wiedersehen” [farewell] transform, in the dream, into a painful “see you– not see you again”? All the emotional elements in Freud’s peculiar dream appear to gel and condense around this mysterious and painful goodbye and the unusual wording surrounding a separation and farewell. Freud seems to have been deeply struck, puzzled, and troubled by the unusual wording and peculiar phrasing in his dream. He tells us that his “Myops” dream had been constructed “on a tangle of thoughts provoked by a play which I had seen, called Das neue Ghetto [the New Ghetto]” (p. 442). He further indicated that it was this play, a theatrical production which touched on “the Jewish problem” and thereby Freud’s concerns as a Jew “about the future of one’s children,” that had triggered his sad and peculiar dream. Freud’s preoccupation with the future of his children, his worries with personal and intellectual freedom as a Jew, and his wish to see Vienna free of anti-Semitism, have all been carefully scrutinized by Peter Loewenberg (1970) and Alexander Grinstein (1980) in relation to his dream. Immanuel Velikovsky (1941) recognized in Freud’s dream the expression of a persistent doubt about remaining a Jew and of becoming a Christian, as well as a deep concern about the future and safety of his children. The fountain on whose edge Freud found himself sitting on in Siena as he nearly collapsed into tears in his dream itself served to recall a baptismal font.5 The themes of “bilaterality” and “bisexuality” feature as important and key elements in Freud’s dream as well. While explaining his views on bilateral symmetry in Breslau during their Christmas meeting in the spring of 1897, Fliess had begun a sentence with the words: “If we had an eye in the middle of our foreheads like a Cyclops.” Freud wanted to object to the absurd conclusions which issued from Fliess’s theories on bilaterality,

184 A bisexual monster theories which led Freud to confusing thoughts about the right and left sides of the human genitals. Freud, however, was unable to freely communicate, vent, or otherwise open his mouth to Fliess about his thoughts and feelings on the matter. In the dream, however, the one-eyed Cyclops somehow became “Myops.” Many of Freud’s associations during his analysis of his Myops dream were organized around this verbal knot in particular. According to Marthe Robert (1976) and Avner Falk (1978), Freud’s dream reveals an effort on his part to deal with conflicts relating to “bilaterality.” It also tapped into his conflicts with Judaism and his unconscious attraction to Christianity. We will come back to this important point in the chapters to follow. The Geseres–Ungeseres opposite pairing in Freud’s Myops dream was traced back by Wendy Colman (1994, p. 615) and Franz Maciejewski (2002, pp. 50–53) to “beschnitten–Unbeschnittensein” (circumcised–uncircumcised). Colman picked up and recombined, in an unusual and creative manner, several fragments of Freud’s dream. For instance, she linked the name of the Cyclops Polyphemus, one of multiple elements condensed into the word “Myops,” to its literal meaning. In Greek Polyphemus means “manyvoiced, also much spoken of.” She then wondered whether Freud might have feared “putting voice, or many voices, to something he sees or knows?” (p. 612). Her observation might shed light on Freud’s decision to investigate the etymological origins of the “Geseres,” and the “Geseres–Ungeseres” opposition and dichotomy found in his dream. As noted, Freud (1900) proposed several meanings for the word “Geseres,” among them “imposed sufferings,” “doom,” and “weeping and wailing” (p. 442). Colman (1994) dug deeper into the possible Hebrew meaning of this unusual word, however. The word “Geseres,” according to her, is best understood as the plural of geserah. A “geserah,” she notes, is a very strict ordinance or edict developed and imposed by rabbis to reinforce the religious law of the Talmud . . . Each geserah functions as a prohibition, and appears to be based on unreasoned judgement. Furthermore, the word geserah is associated with persecution, following its use with a story of a massacre of Jews in Russia in 1648. . . . Used in this way, geserah embodies a history of sentences imposed by rulers that signified doom through impending torture or disaster for the Jews. It is symbolic of decrees often associated with Passover, a holiday that occurs in April, the month of [Freud’s younger brother’s] Julius’ death. The Hebrew verb Freud actually refers to, “goiser,” means to cut, fell, or clip. (p. 613)6 Similarly, the one-eye theme appears to be connected to the experience of a visual shock. Was Freud a conflict-ridden witness to a shocking and traumatic scene? Colman (1994) answers in the affirmative and points to

A bisexual monster 185 the circumcision scene involving Freud’s younger brother Julius. According to her, the affective resonance of the traumatic scene of Julius’s circumcision came to color Freud’s dreams as well as his theoretical writings on the topic of castration. Freud’s inability to fully conceptualize and think through the castration complex, argues Colman (1994), was partly a product of his having repressed Julius’s circumcision, an event which Freud had either personally witnessed or heard about as a very young child. Julius was circumcised in October of 1857, when Sigismund was still a toddler, under two years of age. According to Colman, however: When conceptualizing his theory Freud became stymied in his own minor observation of women as humans without penises, and was unable to explore the strength of his experience of seeing actual penile mutilation. (p. 622) Franz Maciejewski (2002) devotes several pages to the Myops dream in his book on Freud while suggesting that we interpret the Cyclops in Freud’s dream as a symbol for a “big and undamaged penis” (p. 50). The “red nose” on the female attendant or nun who hands Freud’s first-born son over to a father in the dream, he argues, appears to point in the direction of a “bleeding genital” (p. 52). In his view, many of Freud’s dreams and fantasies seem to trace back to the traumatic event of his own circumcision in Freiberg. Maciejewski’s observation is in my view only partly on target. It is certainly insufficient to account for the specific symbolic articulation and material found circulating in Freud’s Myops dream. Commenting on the “Geseres–Ungeseres” dichotomy and plot in the dream, Freud indicated that, during a walk with Fliess at their Easter congress in the spring of 1897, a little girl had come up to him and asked him the way “to a particular street.”7 Freud responded by saying he felt “obliged to confess” that he did not “know the way” as he was not a resident of the city. He then remarked: “It is to be hoped that when she grows up that little girl will show more discrimination in her choice of the people whom she gets to direct her.” Shortly thereafter, as he walked through the streets of the city with Fliess, Freud caught sight of a door plate inscribed with the words: “Dr. Herodes. Consulting hours: …” “Let us hope,” Freud (1900) remarked, “that our colleague does not happen to be a children’s doctor” (p. 443). Freud’s words on Dr. Herodes seem to tap directly back into the theme of aggression toward children via King Herod, responsible for the massacre of the Holy Innocents. They also signal in the direction of pediatricians and Freud’s own early pediatric work and experiences with children. Freud’s allusion to the famed King of Judea who, alarmed at the prospect of a usurper after he had received news of the birth of Jesus, ordered all children under the age of two in Bethlehem and its vicinity to be slaughtered, is obvious. This raises a number of questions, among them: Why should a children’s

186 A bisexual monster doctor (pediatrician) be the subject of such a gruesome and violent fantasy by Freud? Why the need on his part to rescue and protect children? And who exactly is it that must be rescued and protected from harm? Was it Freud the child, his own children, perhaps each and every child in the world?8 Freud’s insinuations and allusions are most complex in this context. The pediatric line of thought appears to have crossed over and blended with the meaning underlying the word “Geseres.” In analyzing his dream, Freud was led to recall the son of a friend of his who was attacked by a disease of the eyes which, according to the doctor, was of no danger as long as it remained on one side, but would turn into a serious matter if it crossed over to the other eye. The child’s eye infection eventually cleared up in the one eye but shortly thereafter crossed over and appeared in the previous good eye. The boy’s mother, in panic, sent for a doctor who, after examining her child, shouted at her: “Why are you making such a ‘Geseres’? If one side has got well, so will the other” (p. 443). The school desk of that very boy, Freud tells us, was later handed over as a gift for Freud’s eldest son, Jean-Martin, to use. “The construction of the desk,” Freud noted, “was also intended to save the child from being short-sighted and one-sided; hence the appearance in the dream of ‘Myops’ (and, behind it, ‘Cyclops’) and the reference to bilaterality” (p. 444). Freud then adds: “My concern about one-sidedness had more than one meaning.” Maciejewski speculatively and creatively links shortsightedness to circumcision. The link might be further strengthened by the fact that the theme of a “construction of the desk” was a topic which had much interested Adolf Baginsky. He had discussed it in his Handbook of School Hygiene: well-built school desks, he argued in his text and to push his hygienic agenda forward, helped to keep children from falling into the habit of masturbating. Myopia itself was obviously a consequence of the bad habit, with circumcision being both a remedy and a punishment for it. The massacre of the Holy Innocents around the time of Christ’s birth, on the other hand, appears to suggest a reference by Freud to the cruel practice of medical circumcision on children. Freud’s reference, however, might be more specific in this instance. Freud’s dream thoughts were in large part triggered by Fliess’s ideas on bilaterality and, more specifically, by the image of the two halves of the human sex organ. Had this topic of conversation somehow led Freud to thoughts of Emma’s external genitals and their deformation, to wit, the fact that one of her labia lips was cut and shorter than the other? The fact that Freud’s dream came to him around the time of the one-year anniversary of his patient Emma having presented him with the scene and her circumcision fantasy during analysis suggests to me that her own peculiar bilateral asymmetry had managed to trigger an entire line of thought for Freud. Among other things it led him to thoughts regarding the practice of medical circumcision of children to treat their habit of masturbation, a cruel and barbaric practice which had deeply impacted Freud at the beginning

A bisexual monster 187 of his professional life in 1886. It must have also led him to thoughts of his own decision to not circumcise his oldest son, Jean-Martin, a choice which served to bind Freud’s rescue fantasies with his revolt against his father and the religion of his ancestors. Finally, the Myops dream must have also served to trigger thoughts for Freud about his own myopia and his unilaterality when it came to decisions regarding sexual matters and his defiance of his father. Ultimately, the painful conflict Freud was unable to resolve in either direction related to his fantasy of rescuing children, on one side, and his desire to reconcile himself with his father, Jacob, on the other. Freud’s own division was unquestionably also reflected in his own ruminations and dreams about being blind in one eye – an asymmetry which itself bore the mark of Emma’s anatomic peculiarity and was perhaps also symbolic of his own position as witness to her castration and childhood trauma. As in the Irma dream, Freud’s dissent had transformed into dysentery, with tragedy being substituted by comedy. In closing, we should recall how Freud decided to bring his own interpretation of his “absurd” dream to an end: In every epoch of history those who have had something to say but could not say it without peril have eagerly assumed a fool’s cap. The audience at whom their forbidden speech was aimed tolerated it more easily if they could at the same time laugh and flatter themselves with the reflection that the unwelcome words were clearly nonsensical. The Prince in the play, who had to disguise himself as a madman, was behaving just as dreams do in reality; so that we can say of dreams what Hamlet said of himself, concealing the true circumstances under a cloak of wit and unintelligibility: “I am but mad north-north-west: when the wind is southerly, I know a hawk from a hand-saw!” (p. 444) Freud, ever the hawk, had certainly managed to place the fool’s cap upon his own head as a result of his ever-soaring theoretical flights.

Notes 1 Freud (1900), pp. 268–269. Dr. Lecher had delivered a speech on October 28–29. McGrath (1986, p. 220) had indicated that Freud’s dream must have occurred soon after, most probably a few days later, on or about October 29 or 30. 2 In The Interpretation of Dreams the “Dr. Lecher” dream had been narrated by Freud (1900, p. 268) just after he had recalled his little daughter Anna’s dream of strawberries. Nineteen months old at the time, Anna experienced an attack of severe vomiting and had to be kept away from food during the day. Her nurse attributed her indisposition to her having eaten an excessive amount of strawberries. According to Freud, Anna’s dream provided clear and unmistakable evidence that dreams were at bottom nothing but the fulfillment of a wish (Freud, 1900, p. 130; 1901a, pp. 643–644; Masson, 1985).

188 A bisexual monster 3 Breslau itself played an important role in Freud’s childhood memories. When his family moved from Freiberg to Vienna and Freud saw his mother “nudam,” the train passed through the station in Breslau. The gas flames Freud saw at the station quickly reminded him “of spirits burning in hell,” as he informed Fliess in a letter on December 3, 1897. Freud in the letter added that his own fear of travel and related anxiety was somehow bound up with the event in Breslau. 4 Anzieu (1986a) reports that Freud must have experienced his “My son the Myops” dream between the final week of December 1897 and the first four days of January of 1898. I am proposing January 1 as it celebrates and observes the “feast of the Circumcision of Christ,” a holiday which symbolically serves to tie and unite, via the theme of circumcision and the topic of Freud’s dream, the two religions which most impacted Freud: Judaism and Christianity. 5 The idea that Freud might have entertained converting to Christianity was quickly dismissed by Jones (1955, p. 17). The thought, however, no doubt kept returning to him in disguised form. Kennett Grigg (1973) attempted to ground the religious question of Freud’s oedipal striving by emphasizing the role that his first years in Freiberg, and his experiences with his Catholic nursemaid, then played in his life. Thus, in a paper which he entitled “All roads lead to Rome,” he proposed that the religious reference to Judaism and Catholicism in Freud’s Myops dream “probably indicates the conflicts between the negative and the positive oedipal strivings” (p. 117). 6 Robert Kramer (personal communication) has suggested to me that yet another meaning of “goiser” can be seen to derive from Yiddish: he decrees = er iz goyzer; he decreed = er iz goyzer geven. 7 As Freud (1900) wrote: “I remembered how, during the previous Easter, my Berlin friend and I had been walking through the streets of Breslau, a town in which we were strangers” (p. 443). While Freud and Fliess did actually meet in April of 1897 (during Easter), their meeting did not take place in Breslau but in Nuremberg; it was during that meeting that the two men discussed material which Freud had sent to Fliess just a few months earlier, in January of 1897. It was precisely during this time period that Fliess arrived to formulate his theory of inborn bisexual disposition. Freud’s lapsus, his mistakenly writing “Breslau” rather than “Nuremberg,” is certainly an interesting and most revealing parapraxis. 8 Freud’s associating and linking Dr. Herodes to a “children’s doctor” is indeed so striking that when I wrote “Why have we ignored Freud the ‘paediatrician’? The relevance of Freud’s paediatric training for the origins of psychoanalysis” (Bonomi, 1994a), I used it as an epigraph to the article.

8

The crossroad

The muddy street As we saw, in the first edition of The Interpretation of Dreams, Freud (1900) decided to adopt as a motto a line from Virgil’s Aeneid. In the second edition of his dream book, however, he decided to weave a second motto into the body of his text: “The interpretation of dreams is the royal road [via regia] to a knowledge of the unconscious activities of the mind” (p. 608). Aron and Starr (2013, p. 262) have advanced a perceptive observation about this second motto which I shall attempt to gloss here: the road from which Jacob Freud was forced off by an aggressive anti-Semite was eventually transformed by his son Sigmund into the “royal road” of psychoanalysis. In his preface to the second edition of The Interpretation of Dreams, written in the summer of 1908, Freud indicated that his dream book carried a subjective significance for him and that it represented a portion of his own self-analysis. The book, Freud now realized eight years after it was first published, had stood as a “reaction” to his own father’s death, “the most important event, the most poignant loss, of a man’s life,” to quote from Freud’s own preface (p. xxvi). Jacob Freud passed away on October 23, 1896 and it was after that event that Freud’s desire to visit Rome began to surface more powerfully in his dreams and fantasies. Freud’s Rome dream series, dreamt by him between December 1896 and January 1897, reawakened many memories for him and served to throw Freud into self-analysis. One memory which Freud recalled during his self-analysis involved an event which led him to experience a great deception at the age of “ten or twelve.” It led to a turning point in Freud’s relationship with his father Jacob. Assuming that Sigismund was now mature enough to handle and make sense of the anecdote which his father shared with him, Jacob related the story of an incident which had occurred years earlier. It concerned an episode in which Jacob had been forced to cede ground to a hostile and threatening anti-Semitic gentile and to step off the paved sidewalk into a muddy street. Jacob was apparently wearing religious garb in observance of the Jewish Sabbath while walking through town. Jacob was sporting a

190 The crossroad “new fur cap,” which immediately identified him as an observant Jew. A Christian walked up to him and with a single blow knocked his cap from his head to the ground while shouting: “Jew! Get off the pavement!” (Freud, 1900, p. 197).1 By sharing his story Jacob had probably wanted to emotionally prepare his son for the humiliations, challenges, and prejudices which he was bound to experience while living in a Christian world as a Jew. Jacob most probably related the episode to his son just before full civil equality had been granted to Austrian Jews in 1869, the year Sigismund turned 13. When Freud recalled his father’s fur-cap incident during the course of his selfanalysis many years later, he failed to appreciate the truly human dimension at the heart of Jacob’s story. Freud mainly recalled having felt ashamed of his father’s passive and meek response to the aggressive actions of the anti-Semite. When he asked his father how he had responded to the gentile’s hostile act, Jacob meekly replied: “I went into the roadway and picked up my cap.” Freud’s relationship with his father was never the same after hearing this story from Jacob. In The Interpretation of Dreams Freud wrote that the incident had impressed him as exhibiting “unheroic conduct on the part of the big, strong man who was holding the little boy by the hand.” Freud continued: I contrasted this situation with another which fitted my feelings better: the scene in which Hannibal’s father, Hamilcar Barca,2 made his boy swear before the household altar to take vengeance on the Romans. Ever since that time Hannibal had had a place in my phantasies. (p. 197) Serving to further unfold the leitmotif of his family romance, to wit, the fantasy of substituting his Jewish mother Amalia for his Roman Catholic nanny, the ten or 12-year-old boy repudiated his father Jacob, whom he now perceived as weak, and began holding up Hannibal, the bold Semitic general who had stood up to the more powerful Romans, as his ego-ideal. This helped Freud to forge his own individual character and masculine position: unlike his father, Freud would never cede ground nor allow himself to be pushed off the path he traveled. As Aron and Starr (2013) observed: “Freud saw himself as a defiant Jewish hero taking a stance against the anti-Semitic majority. In stark contrast to the behaviour of his unheroic father, Freud prided himself on his courage in his confronting the anti-Semitic threat” (p. 261). Exploring the meaning of Freud’s Hannibal fantasy, Aron and Starr (2013, p. 262) identified the muddy road where Jacob was forced off by an anti-Semite with the “royal road” of psychoanalysis evoked by Freud in the second edition of his dream book. The fact that Freud decided to introduce the image of the royal road [via regia] while in the process of tracing the subjective meaning of his dream book as his personal reaction to his father’s death strongly supports the thesis that the

The crossroad 191 path to which Jacob had been denied access and free passage had indeed been transformed by his son into his own “royal road.” Following a suggestion by Richard Armstrong (2005), who traced one of the meanings of Freud’s “royal road” [via regia] back to the King’s highway in the Bible, the ancient trade route which stretched across the Sinai, Aron and Starr recalled that the via regia mentioned in the Old Testament (Numbers 20:17) was a street from which the Israelites themselves had been barred and not allowed passage by the King of Edom. Aggressively confronted by the Edomites, Armstrong concluded that the Israelites, like Freud’s father, had been barred and “knocked off the road.” Finally, the road metaphor may also be seen to apply to the Oedipus myth, the fatal crossroad where Oedipus, instead of passively accepting being forced and pushed off the road by a stranger he encountered by chance at the place “where three roads met,” responded aggressively and killed King Laius, his biological father. In sum, and to quote Aron and Starr (2013): “Freud was identified with Oedipus, who, unlike the Israelites – and unlike his unheroic father Jacob – would not be pushed off the road” (p. 262). The “universal application” of the Oedipus myth, let us recall, was discovered by Freud while in the midst of his self-analysis. To recall Freud’s letter to Fliess of October 15, 1897: A single idea of general value dawned on me. I have found, in my own case too, [the phenomenon of] being in love with my mother and jealous of my father, and I now consider it a universal event in early childhood, even if not so early as in children who have been made hysterical. (Similar to the invention of parentage [family romance] in paranoia – heroes, founders of religion.) If this is so, we can understand the gripping power of Oedipus Rex, in spite of all the objections that reason raises against the presupposition of fate; and we can understand why the later “drama of fate” was bound to fail so miserably. (Masson, 1985, p. 272) This Greek myth would slowly come to be adopted and embraced by Freud as the core element of psychoanalytic theory during the next few years. Freud had introduced his via regia motto in the summer of 1908 and it was shortly thereafter that the idea of the “nuclear complex of the neuroses” surfaced in his work (Freud, 1909b, p. 206 fn.). It was in 1910, the very year when the International Psychoanalytic Association was established, that the notion of the “Oedipus complex” was first coined by Freud (1910a, p. 47; 1910e, p. 170). Per aspera ad astra: the humble and muddy street into which Jacob’s fur cap had been knocked off had indeed been transformed by his son into the “royal road” of psychoanalysis itself.

192 The crossroad

The fate of the one royal road To further help complete the picture, we need to take stock of a metaphoric transformation found embedded within the very notion of a “royal road.” It was in the work of Philo Judaeus, a contemporary of Jesus who lived in Alexandria, that the ancient via regia was first transformed into the road which led to knowledge of God, and later, under the Greek church fathers, into the orthodox manner of faith, the “one royal road” which kept to the straight and narrow path and avoided all heresy (Armstrong, 2005, pp. 249–250; see Philo, 1854, p. 371). A similar transformation can be detected in Freud’s own royal road. During the period when psychoanalysis transformed into a collective and institutionalized movement, Freud composed Totem and Taboo (1913a), presenting the myth of the castrating father who is revered by the son as a god. Freud then traced it back to an event whose memory had proved indestructible despite every effort by mankind to erase it: the murder, dismemberment, and cannibalistic incorporation of the primal father, an event endlessly commemorated, Freud argued, through festivals and religious ceremonies. All of communal life, claimed Freud, was built upon this unique and singular event, with its memory having been powerfully repressed yet unconsciously transmitted from one generation to another. According to Freud, law, religion, morality, civilization, and the Oedipus complex itself all derived and issued from it. The recognition of the Oedipus complex now became for Freud (1905) “the shibboleth that distinguishes the adherents of psycho-analysis from its opponents” (p. 226, footnote added in 1924). The “one royal road” of psychoanalysis ultimately turned out to be a place impacted by endless conflicts between orthodoxy and heresy, a crossroad where the tragic fate of Oedipus Rex was time and time again reenacted (Roustang, 1976), a muddy street into which all those who had been identified as “opponents” of the psychoanalytic movement, usually by Freud himself, were forced off the road paved by Freud, at times with a single blow. Tellingly enough, this was the fate suffered by those early pioneers of the psychoanalytic movement who had entered into a close relationship with Freud. I am here thinking of Carl Gustav Jung, Otto Rank, and Sándor Ferenczi in particular, each seen by Freud, at one time or another, as a “son” or an heir. History tells us that each of these intimate collaborators in time became an “opponent” and, further, that this transpired precisely when each attempted to question and move beyond the oedipal theory of the castrating father. Jung (1912), for his part, discovered in the depths of the Unconscious the “threatening mother imago,” and a similar turn characterized the crisis which threatened the unity of the psychoanalytic movement in 1924. The main cause of this crisis was the publication of Otto Rank’s The Trauma of Birth (1924), a work dedicated by Rank to Freud and written in

The crossroad 193 order to help set trauma free from the imaginary primeval scenario into which it had been confined by Freud. Rank, by publishing his book, was attempting to ground the phenomenon of trauma back in concrete actual life. In this work the “ubiquity of the ‘castration complex’” (p. 20) was recast by him in terms of the infant’s ambivalence about separating from a powerful and engulfing mother. Accordingly, the primary task of clinical work was now reformulated by him in terms of liberating patients from their unconscious and conflicted attachment to their mother imago. Freud was so impressed by Rank’s thesis at first that he described it as the most important progress in the field since the discovery of psychoanalysis itself (Falzeder & Brabant, 2000, p. 131). Freud was unable to read the manuscript completely through, however, and turned away from it. He ultimately withdrew his support from Rank whom he had once considered and described as his son. Identified by Freud as an opponent during the course of the 1924 crisis and cast into the role of a heretic, Rank was thus pushed off the road by father Freud with a powerful single blow (Lieberman, 1985; Rudnytsky, 1991, 2002; Bókay, 1998; Leitner, 1998; Lieberman & Kramer, 2012). He had little choice but to resign from the psychoanalytic movement two years later, in 1926. Freud was apparently unable to accept or conceive that the child’s attitude toward the mother was ambivalent from the start. The mother–son bond was in fact viewed by him as “the most perfect, the most free from ambivalence of all human relationships” (Freud, 1933, p. 133; see also 1921, p. 101, fn; 1930, p. 113). In a series of lectures delivered in New York in 1926, presentations which were largely ignored by the psychoanalytic community at the time, Rank took steps to reformulate and sharpen his theory in light of Freud’s own personality and position regarding the figure of the mother. I will here rely on the reconstruction that Robert Kramer (1995) has furnished us. It was Rank’s essay of 1926 “The genesis of the guilt-feeling” that marked the precise moment of the birth of modern object-relations theory. In his work, Rank traced the kernel of the superego back to the “strict mother” (Rank, 1996, p. 134), arriving at the conclusion that the “origin of the castration complex is thus really pre-Oedipal” (p. 137). In his 1926 essay on “The genesis of the object relation,” Rank proposed that the original relation of the ego to the object was twofold, and that at the Oedipus stage the boy makes “his father bad, in order to keep his picture of the good mother clear” (pp. 142–143). According to Rank, the unmitigated division between a loving mother and a castrating father found at the heart of Freud’s work was the product of a cleavage. Acknowledging the profound emotional ambivalence which permeates the mother–son bond, Rank argued, was simply too painful for Freud. As Rank indicated during his initial lecture in New York in 1926 (Foundations of a Genetic Psychology), Freud was simply unable to envision and recognize the “bad mother”:

194 The crossroad The “bad mother” he has never seen, but only the later displacement of her to the father, who therefore plays such an omnipotent part in his theory. The image of the bad mother, however, is present in Freud’s estimation of woman, who is merely a passive and inferior object for him: in other words, “castrated”. When he recently deprived woman even of a superego, which embraces the higher ethical and social abilities, he quite overlooked the enormous share the mother and the child’s relation to her have on the development of the ego and its higher capabilities. (Rank, 1996, p. 101) A similar point was later made by Ferenczi in 1932 in his diary. Due to its heterodoxy, the text was published 53 years later. Discussing Freud’s “castration theory of femininity” – the theory that girls are born with the feeling that they have a penis, a feeling they must renounce if they are to grow into full “females” – Ferenczi noted that the founder of psychoanalysis neglected the possibility that masculinity (in girls) might take place “for traumatic reasons.” He then added that the author of this theory, that is to say, Freud may have a personal aversion to the female-oriented sexuality in women: idealization of the mother. He recoils from the task of having a sexually demanding mother, and having to satisfy her. At some point his mother’s passionate nature may have presented him with such a task (the primal scene may have rendered him relatively impotent). (Dupont, 1985, p. 188) Ferenczi then advanced the thesis that Freud had most likely constructed a theory in which the father castrated the son who then revered the father as a god in reaction to the humiliation and castration which Freud must have experienced at the hands of his own mother. As Ferenczi concluded: “In his conduct, Fr[eud] plays only the role of the castrating god, he wants to ignore the traumatic moment of his own castration in childhood; he is the only one who does not have to be analyzed” (Dupont, 1985, p. 188).

The crossroad Let us circle back to the years when psychoanalysis was being founded. Despite the fact that Freud managed to avoid being pushed off the road, he often did find himself “glued” to a spot, endlessly circling the same crossroad or intersection during his self-analysis. Without examining all the specific details here, we can trace the general map of Freud’s psychic landscape if only we take stock of the fact that his “royal road” had been forged by him in relation to his desire to travel to and enter Rome, a fantasy which took on more urgency for him following the death of his father Jacob. The motto “All roads lead to Rome” had itself surfaced in

The crossroad 195 the third dream of Freud’s Rome series (Freud, 1900, p. 195); the idea of a “crossroad” can itself be found at the heart of his fourth dream, his “street-corner dream” of January 1897. Freud’s fourth Rome dream has been interpreted by scholars as the most important crossroad of his self-analysis. To Anzieu (1986a), who dedicated several pages of his study to examining and interpreting this dream, the essential and important element within it remained the “street corner” itself, interpreted by him as the place where two or three systems merged, intersected, and joined. While the third dream in the Rome series “describes a mythical journey into his mother’s pregenital belly” (p. 205), the fourth dream marks a sudden transition “from a dream of syncretic amalgamation with his mother’s breast to a much later relationship with his mother, one that began when she taught him to read and write German” (p. 205), as though skipping an intermediate step. This suggests that Freud’s own mother probably spoke little to no German. According to Theodor Reik, who met and conversed with her in Vienna, Amalia Freud spoke to members of her family in Yiddish.3 Commenting on the German posters in Freud’s street-corner dream, Anzieu went on to say: Freud learned to speak several languages because he had several “mothers” . . . His real mother language – real because it was a unique language, because it was that of his actual mother, and because it was taught to him by her – did not really crystallize in his mind until he started learning to read and write. (p. 206) This is the point in his narrative where Anzieu also came to ask himself: “Why did Freud become a genius instead of a dyslectic?” Anzieu correctly grasped that something, connected with the experience of losing the breast and the infant’s capacity to fill that void by syllabifying and speaking, had been missing for Freud. Anzieu, however, failed to explore this important point any further in his study. He considered the jump from the earliest image of the body to an abstract mental space as a sign of Freud’s genius rather than as a mark of trauma, censorship, or traumatic progression – to recall a Ferenczian notion which fits well with Freud’s brilliant discoveries. While we are used to imagining Ferenczi as a “wise baby” who became wise as a result of the traumas he had experienced, we should also realize that Freud too was traumatized as a child and that he managed to overcome his inhibitions and grew “wise” by developing a vision which led him to see further and leap far ahead of his contemporaries. To Anzieu, Freud’s street-corner dream signals not the direction of a gap but towards a new geometrical mental space born as a result of various systems joining together. The key element in Freud’s dream is thus its switch or central point of intersection, namely, the “street corner” itself. Its architectural layout presents us with a triangular and oedipal structuring

196 The crossroad of mental space. We might say that Freud’s peculiar way of overcoming his paralyzing inhibition was to transform himself into an intelligent and brilliant Oedipus. Freud’s street-corner dream itself eventually helped to pave the way towards his discovery of the universal application of the Oedipus legend in October 1897. His dream as such not only served to foreshadow the famous and fatal crossroad of the Greek legend but arrived to name Freud’s own private crossroad, the place where the codes themselves were mixed and the “tongues” scrambled – to recall the notion of a “confusion of tongues” which Ferenczi (1933) had introduced. Anzieu, for his part, rightly envisioned the street corner in Freud’s dream as the very symbolic space where two religions (Catholic and Jewish) intersected and three languages (German, Czech, and Yiddish) converged, all part of Freud’s early experiences in Freiberg before his family moved to Leipzig and later resettled in Vienna (p. 200). Freud’s trilingualism or “polyglottism” back in Freiberg, in Anzieu’s view, merged with the other patterns to match “the logic of the triply ternary formula for trimethylamin . . . which features in the Irma dream” (p. 201). Anzieu, moreover, came to view the corner in Freud’s dream as a complement to the Rosetta stone, the famous stone whose trilingual inscriptions (hieratic Egyptian, demotic Egyptian, and Greek) made it possible for us, as a result of Champollion’s discovery, to decipher Egyptian pictographic script. Freud’s conception of dreams as a rebus, a cryptogram, or a picture puzzle, argued Anzieu (1986a), was related to the successful deciphering of the Rosetta stone, a discovery which Anzieu envisioned as having contributed to helping Freud “see the preconscious as a system of associative chains that added verbal presentations . . . to unconscious thing-presentations” (p. 202) and which presented him with a template for interpreting dreams. Freud himself summarized his theoretical position in his dream book in a now famous and well-known passage which speaks directly to the topic at hand: The dream-thoughts and the dream-content are presented to us like two versions of the same subject-matter in two different languages. Or, more properly, the dream-content seems like a transcript of the dream-thoughts into another mode of expression, whose characters and syntactic laws it is our business to discover by comparing the original and the translation. (p. 277) Lacan’s famous thesis that the Unconscious “is structured like a language” was undoubtedly inspired by this same bilingual cornerstone. Anzieu (1986a, p. 202), for his part, argued that his former analyst’s thesis appears to be unsupported by Freud’s work and the material which surfaced from his self-analysis. It is interesting to note, however, that Anzieu arrived at a conclusion quite similar to Lacan’s own by proposing that Freud’s fourth

The crossroad 197 dream in his Rome series resonated with the very moment when Freud, like Moses, had received the “Tables of the Law of the unconscious”: Like Moses guided by God, Freud, secretly guided by his dead father in the work of mourning, goes up on to the hill and sees Rome, i.e. the twofold original love he received from a young German mother and another woman, who spoke Czech. He will never in his lifetime be able to repossess that love; he will, however, manage to recall it and to understand the role and meaning of the traces he still has of his infantile experiences; above all, he will, before he dies, find the time, strength, and acuity of mind to make his mark, like Moses, as a lawgiver. The German posters [in the street-corner dream] will turn out to be the Tables of the Law of the unconscious. (pp. 203–204) While I find Anzieu’s interpretation and reading of Freud profoundly inspiring, I also find that it is allusive, vague, and overly metaphoric. He failed to grasp, for instance, that the word “trimethylamin” may itself be read as involving a direct transcription of brith milah while the corner [Ecke] in Freud’s “street-corner” [Strassen-ecke] dream itself presents us with a pictographic representation of “Eck-stein” (corner-stone). More importantly, perhaps, is Anzieu’s failure to realize that Freud had dreamt his street-corner dream in January of 1897, precisely during an intense and crucial moment of his analysis of Emma Eckstein, his chief patient at the time. Freud’s Rome dreams were indeed closely related to his analysis of Emma. As I anticipated in previous chapters, her circumcision scene served to trigger his street-corner dream. The circumcision scene itself thus helped to mark an important “crossroad” in the history of psychoanalysis, functioning, I would argue, as the corner [Ecke] where Emma’s analysis and Freud’s own self-analysis intersected and criss-crossed. It functioned, in short, much akin to a cornerstone, allowing two walls to join, meet, and come together.

Beyond the myth of an isolated mind All of this raises a number of important questions about the epistemological status of Freud’s self-analysis and the structure of the mental space which Freud dreamt and envisioned. Freud’s self-analysis has typically been seen as the basis for his insights into the significance of infantile sexuality as well as a main feature and determinant of why he discovered the Oedipus complex. According to Ernst Kris, Freud’s personal conflicts with his father Jacob led him to a fateful distortion, namely, the idea that “seduction by adults,” typically fathers, was responsible for neuroses. But then self-analysis imposed itself on the struggling man and served “the function of liberation from suffering as well as from fateful error” (Kris, 1954, p. 181). As Kris explained: “In the interpretation of his own dreams, Freud had made a fateful step;

198 The crossroad from self-observation and self-experimentation he had proceeded into a new and definite direction, to systematic self-analysis” (p. 183). In the process, Freud’s ego functions emerged “from involvement in intense conflict to full and supreme autonomy” (p. 181).4 This thesis, advanced during the golden age of psychoanalysis, when ego autonomy was valued as the axis upon which psychoanalysis itself was built, was presented in such hagiographic fashion (Jones, 1953, pp. 351–352; Eissler, 1971, pp. 306–307), however, that various critics interpreted them as “legends” to be demystified or deconstructed (Borch-Jacobsen & Shamsadani, 2012). There is, however, a central point where Freudians and critics of psychoanalysis seem to meet and agree: each side takes it for granted that the method used by Freud had been that of self-observation [Selbst-Beobachtung] or “introspection” – an old psychological concept absorbed by psychoanalysts without any serious attempt to define its suppositions, working principles, or hypotheses. Grossman’s (1967) work on this theme as far as I know involves the only attempt at examining, defining, and addressing the topic. Unfortunately, however, it fails to deal with or otherwise successfully examine the important question, foundational to be sure, of Freud’s self-analysis and its status. Despite the fact that “the myth of an isolated mind” (Storolow & Atwood, 1992) found at the heart of traditional Freudian psychoanalysis has been systematically and vigorously challenged by numerous analytic scholars who have embraced the view that humans are intersubjectively connected from the beginning (Fairbairn, 1944; Sullivan, 1964; Greenberg & Mitchell, 1983; Aron, 1996; Mitchell, 1997; Aron & Starr, 2013), Kris’s reading of Freud’s self-analysis as a triumph of ego autonomy has remained largely unquestioned, even by members working within a relational framework. As far as I know, the only author to have explicitly rejected the idea that Freud’s self-analysis was based on introspection was Patrick Mahony (1994). In his work, Mahony underscores the importance that the process of creative writing has played within the body of Freud’s speculative theorizing and does so to creatively read and interpret Freud’s texts. On many occasions Freud remarked that the dreams he had dreamt were at first unintelligible to him and that he was then forced to write them down again and again in an attempt to help him decipher their hidden meaning. Freud at times also argued that his dream book had been directly presented him by his unconscious (Masson, 1985, p. 305). Such a method is well reflected in the importance that inscriptions, transcriptions, and translations play in both the single interpretation and Freud’s general theory of dreams. Freud, Mahony (1994, pp. 104–105) noted: hyperinvested the inscriptions of his dreams, association and his analysis of them, a praxis which expanded to include his screen memories, parapraxes, transient symptoms and interaction with patients. It is quite to the point that also around this time Freud saw an uncanny resemblance between his compositional practice and that of an

The crossroad 199 inspired Biblical writer; hence, while scorning the arbitrary devaluations made by his predecessors, Freud claimed that he was closely attending to dreams as if they were “Holy Writ.” (Freud, 1900, p. 514) In contrast to introspection, Freud’s “writing cure” (as Mahony baptized the practice in light of and while glossing the idea and project of a “talking-cure”) helped to expose and enact unconscious contents and fantasies. The bulk of Freud’s revolutionary book on dreams – its first edition was nearly based exclusively on his own dreams – indeed involved a “truly performative” act (p. 110) by him. If we question the source of Freud’s fantasies, we are necessarily led to conclude that they were to a large extent the product of his interactions with and daily handling of his patients. Extending Breuer’s method, Freud created a regressive setting where his patients were not only invited to recollect their childhood experiences but led to revive and relive them as well. Freud, since the beginning, envisaged the logic of his treatment method as providing his analysands with the opportunity of repeating and reliving something from their past which had traumatized them. Freud, however, did not expect that its repetition and reliving in treatment might itself be traumatic or that he himself, as analyst, would be so deeply impacted by his patient’s conscious and unconscious communications during the process. We can surmise that Freud must have at times felt overwhelmed by his patient’s conscious and unconscious communications and, further, that his own childhood traumas were reactivated during the process. Writing down his dreams and analyzing them, recording his fantasies and elaborating his theoretical speculations, functioned to a large extent as a relief valve and drainage device which helped Freud to continue on in his work and to reflect on his challenging and novel approach to treatment. This situation is particularly true with regard to those patients of Freud whom he treated for an extended period of time during the time frame when he himself was undergoing self-analysis. We know of only three such cases. Two were males; the other, and only female of the group, was Emma Eckstein. There are many reasons for us to accept that many of the dreams and fantasies concerning the female body which Freud experienced during his self-analysis had been a product of his treatment of Emma. In Freud’s mind there was “a profound link between dreams and the maternal body” (Mahony, 1994, p. 111). Mahony (1994) suggests that Freud composed his dream book in a dreamlike state with the text itself also being “a dream to a certain extent” (p. 111). Freud’s meta-dream, Mahony argues, was itself closely associated with the female genitals: “In the clearest terms Freud explained the investigation in his book as a journey through nature – both in landscape, symbolic of the female genitalia, and woods, generally symbolic of the mother” (p. 111). The maternal body was strongly idealized by Freud as the perfect body of

200 The crossroad a Sleeping Beauty which triggered nostalgic feelings and oedipal fantasies in him. It was no doubt also experienced by Freud as a paralyzing Medusa head (Erickson, 1954) – “the terrible symbol of the female genital region” (Ferenczi, 1923; Freud, 1922, 1923b). How did Emma’s fantasies and reports to Freud about her genitals and their injury impact him?

I = she The circumcision scene which Emma presented Freud undoubtedly functioned to provoke powerful emotions in him, reawakening two memories in particular which we find in the two associations to his street-corner dream. One involved an old Czech nursery rhyme which Freud managed to trace back to his first years of life in Freiberg and associated with his Czech and Roman Catholic nanny. The other was the Hannibal fantasy of his school days and his masculine desire to exact revenge on Catholic Rome for their persecution and crimes against the Jewish people. In Freud’s psychic geography, “Rome” stood as the intersection of these two memories. Freud began to travel progressively further south into Italy in 1895, visiting Italian cities in search of artistic beauty. By 1896, however, his deepest desire was to visit and enter Rome. Freud even experienced the fantasy of meeting with Fliess in the city on an Easter Sunday. Freud, however, was unable to fulfill his desire and fantasy. The insistence of these two fantasies left Freud symbolically paralyzed and glued to the spot, unable to make his way further south to enter Rome. In December of 1897, while recalling his street-corner dream, Freud wrote Fliess to report that his “longing for Rome” was “deeply neurotic.” “It is connected,” said Freud, “with my high school hero worship of the Semitic Hannibal, and this year in fact I did not reach Rome any more than he did from Lake Trasimeno” (Masson, 1985, p. 285). Commenting on his street-corner dream, Freud (1900) indicated that he had “actually been following in Hannibal’s footsteps. Like him, I had been fated not to see Rome” (p. 196). It took another five years for Freud to overcome his neurotic dread and to finally set foot in the Eternal City. The sensation of being “glued to the spot” was experienced by Freud in a number of his dreams. In one of these his feelings of being blocked involved a missing hat. Freud experienced this dream in May of 1898; the event which had triggered his dream involved his housemaid, a woman who, according to Freud, was a “genius at putting things away” and had apparently “hidden” his hat (p. 337 fn.). In Freud’s dream the one who was being charged with dishonesty was Freud himself – as though the dream had been repeating a crucial and important element which had surfaced in his self-analysis, to wit, his identification with his nanny, the woman who was discovered stealing from the Freud family and sent to prison for it. This very theme surfaced through an important dream dreamt by Freud. Known as his “bad treatment” dream, it was discussed and presented by Freud to Fliess in a letter he wrote to him on October 3 and 4, 1897. Two weeks later,

The crossroad 201 on October 15, 1897, Freud re-examined and rethought his initial interpretation of the dream and concluded: “The correct interpretation is: I = she” (Masson, 1985, p. 271). If we consider that Freud, in that very same letter, also identified with Oedipus, the masculine and phallic hero of the Greek saga, we realize that his statement regarding his nanny had been both striking and remarkable. At the very least it helped to introduce a twofold pattern modeled on bisexuality: one masculine and explicit, the other feminine and implicit in Freud’s drama of fate. Freud’s “dishonesty” dream was staged in a private sanatorium where he had held a position as a consultant. In other words, the dream replicated the medical scenario of the Irma dream itself. The theme, moreover, was reminiscent of the horrendous gaping hole staged in that dream. As Freud (1900) noted in his dream book, “gaps” in dreams are “the genital apertures of the women” with the statement “there’s something missing” describing “the principal feature of the female genitalia” (p. 333). This time, however, the body which had to undergo an examination was not that of his female patient, but Freud’s own. This is yet another declination of the “I = she” equation which supports the thesis that Freud had not only indeed identified with Irma but, behind her, Emma Eckstein as well. In the dream “something” was indeed “missing” and Freud was being charged with dishonesty. He was therefore forced to undergo questioning and an “examination” (in both medical and scholastic sense) as he was being accused of having “appropriated the missing article.” After Freud was brought into a large hall – it had machines in it which reminded him “of an Inferno with its hellish instruments of punishment [Strafaufgabe]” – he was then told he could proceed. Freud (1900), however, was unable to find his “hat” and thus unable to leave the large hall with the “hellish instruments of punishment” (p. 336). In this dream it is his missing hat which appears as signifier for Freud’s paralysis. Commenting further on the dream and its material, Freud wrote: “‘I am far from having done my duty, so I must not go yet.’ – Birth and death were dealt with in it” (p. 337 fn.). Employing a religious term which takes us back to Freud’s Irma dream and its Roman Catholic “solution,” Freud (1900) was also led to remark: “That I could go was a sign of my absolution [Absolution]” (p. 337). Evidently the obvious association between his unfulfilled duties and his father’s story of having his hat hurled into the street was vigorously avoided by Freud. In 1911, and in papers written afterwards, Freud (1916a) discussed the symbol of the hat in relation to dreams as “a symptom by means of which obsessional neurotics succeed in causing themselves continual torments” (p. 340). The symptom in question involved the reluctance by certain men to remove their hat when greeting someone in the street, a habit which, as Freud explained, was rooted in the castration complex. The hat, according to Freud, stood as a symbol for the male genitalia.5 Grinstein (1980, p. 278)

202 The crossroad and Anzieu (1986a, p. 322) each arrived at the conclusion that the missing hat in Freud’s “dishonesty” dream signaled in the direction of castration, to wit, the lack of the male genitalia. Only Wendy Colman (1994, p. 616), a woman, was able to identify the possibility that the removal of a hat by a man might be also seen as symbolic of the removal of the foreskin during brith milah. Freud’s dream was in her view entangled with and hinted towards the topic of ritual circumcision. Both interpretations are plausible and legitimate, yet an important difference remains: castration is not real but symbolic while circumcision is a real actual life event in the life of all male Jews; “castration,” moreover, erases the Jewish difference while “circumcision” opens up to a specifically Jewish scenario which allows us to enter into dialogue with Freud’s personal history.6 Colman in fact reconstructs this personal scenario, surmising that little Sigismund must have been impacted by the circumcision and death of his younger brother Julius, a trauma which later furnished the unconscious motivation for Freud’s conceptualization of the castration complex. Since Julius’s circumcision occurred when Freud was 17 months old (Julius was born in October of 1856 and died six months later, in April 1857) we must question the possible impact of Julius’s circumcision on Freud. Freud’s mother gave birth to another boy, Alexander, when Freud was ten years old. Freud likely participated in Alexander’s brith milah ceremony and retained an active memory of the event and its accompanying rituals. Alexander’s circumcision scene most likely included metsitsah b’peh, the oral suctioning of the blood on the infant’s penis by the mohel to help restore normal blow flow to the glans resulting from the cut to the tip of the organ. As Eastern Jews, Freud’s parents belonged to a social class and milieu which practiced the unreformed form of the ritual which included metsitsah (Gilman, 1993, pp. 67–70). I am stressing this particular aspect of the ceremony because the element in the scene presented him by Emma which most impressed Freud not only related to the mouth but reproduced and hinted at this specific detail of the ritual. After sucking up the blood, wrote Freud in his letter of January 24, 1897 to Fliess, “the child was given a piece of the skin to eat.” Two weeks later, on February 11 of 1897, Freud penned a rather chaotic letter to Fliess which reveals him struggling with powerful fantasies which had most likely surfaced as a result of this specific detail in Emma’s narrative. In the letter Freud comes to wonder about the exact moment when oral disgust sets in on children7; he then describes hysterical symptoms based on identification, focusing on symptoms where perverse action upon the mouth is memorialized. Freud then suddenly added: “Unfortunately, my own father was one of these perverts and is responsible for the hysteria of my brother (all of whose symptoms are identifications) and those of several younger sisters” (Masson, 1985, pp. 230–231). The brother in question was of course Alexander, born in April 1866, just a month before Freud turned ten years of age.

The crossroad 203 The material discussed by Freud in his letter suggests that Emma’s circumcision scene had served to awaken a very disturbing fantasy related to fellatio for Freud. Did the scene presented by Emma reawaken Freud’s memories related to Alexander’s brith milah? It might be useful to recall that, as indicated by Moisés Tractenberg (1989), in both the brith milah and the Christian Eucharist the believer is called upon to identify, painfully and regressively, with either the circumcised child or the crucified Christ. Moreover, according to Tractenberg, during the brith milah ceremony the regression of the adults and the enactment of the devouring fantasy assume the disturbing aspect of a maniacal defense in which these adults (or boys) manage to relive their own circumcision. It then culminates in the fantasy of incorporating the genital potency of the newborn child (p. 461). We also know that Freud was at the time struggling with the fantasy that he himself, besides Alexander, had been sexually abused by his father. Freud, let us recall, was in the process of mourning his father Jacob, who had died less than four months earlier, when he wrote his letter. Since fantasies of incorporation are typical of the process of mourning, Freud’s fellatio fantasy itself offers us a direct clue into how Freud’s self-analysis intersected, criss-crossed, and merged with his treatment of Emma.

Freud’s reaction to Emma’s circumcision scene: an overview We are now in a better position to identify a number of conclusions, all tentative, which may help us orient and organize our investigation. The scene which Emma presented Freud served to trigger a sexual fantasy of fellatio that was associated with: (1) the oral sucking of the penis by the mohel after circumcision; (2) Alexander’s brith milah; and (3) the fantasy that his father Jacob had been a pervert. The distressing idea that Jacob Freud had been a sexual pervert was definitively dropped and dismissed by Freud seven months later, when he abandoned his “theory of the father.”8 Three weeks later, on October 15, 1897, Freud arrived at the conclusion that his sexual fantasy had all along been informed by what he would later identify as the Oedipus complex. Apparently his masculine identification with the phallic hero of the Greek saga involved a flight not only from his passive and feminine fellatio fantasy but from memories associated with the Hebrew ceremony of brith milah and his Jewish identity. As several authors have pointed out, Freud managed to dissociate himself from his Jewish identity by virtue of embracing the Oedipus myth. Feldman (1993; quoted in Aron & Starr, 2013, p. 281) proposes that Freud, by embracing a phallic narrative of a Greek drama, had placed distance between himself and the Bible story. According to Boyarin (1997), Freud’s adoption of a Greek narrative stood as a direct byproduct of his repressing his subjective experience as “castrated” and “circumcised,” that is to say, as a

204 The crossroad feminized Eastern European Jew who lived his life in context of the fin de siècle invention of the normative notion of heterosexuality. As Boyarin (1997) sees it, it all stood as a “family romance of escape from Jewish queerdom into gentile, phallic heterosexuality” (p. 215). By choosing and siding with a Greek vision of the world over a Hebrew biblical framework, Freud was at least downplaying, if not outright denying, his position as son to Jacob Freud. He was now fantasizing himself as “Oedipus, son of Laius” (p. 250). Like Feldman and Boyarin, Aron and Starr (2013) propose that Freud’s adoption of the Oedipus myth rather than a Jewish narrative to found psychoanalysis originated from his own defensiveness about Jews being passive, feminine, and homosexual. This move, which was intertwined with Freud’s negative attitude towards Eastern European Jews, marked the place of a dissociation, not only because of Freud’s inability to recognize “that he and his family were Eastern Jews” (p. 239) but also because he was “disavowing his own vulnerability, passivity, dependence, and femininity” by doing so. Freud’s disavowal, according to these authors, was then “unconsciously embedded in his psychoanalytic theories” (p. 258). A crucial point to emphasize here in light of Gilman (1992, 1993), who has written extensively on the fin de siècle anti-Semitic perception of the Jewish body, is that all these authors pinpoint circumcision as the privileged signifier which is invoked to characterize male Jews as “feminine” and “primitive”; again, and as the argument is presented, Freud took active steps to dissociate himself from this particular and unique Jewish marker of Judaism.9 The authors in question (Gilman, Boyarin, Aron, and Starr) all view Freud’s discovery of the Oedipus complex as intimately connected to his attempt to dissociate himself from circumcision, a privileged signifier of the male Jew according to Freud himself. Freud was born of Galician Jewish parents in Moravia and grew up in the second district of Vienna, precisely where most unacculturated Eastern European Jews who had moved to Vienna following Austria’s democratic reforms in the 1860s resided. In contrast to Western European Jews, who in the course of the process of modernization were increasingly secularized and integrated into German culture, Eastern Jews were viewed by most Viennese as vulgar, crude, and uncivilized. As anti-Jewish intolerance intensified, Western Jews desired to distance themselves from the Ostjuden community. This included Freud, who typically made it a point of dissociating from traditional or “primitive” and “barbaric” rituals and Eastern European Jews who, in both the Jewish and non-Jewish imagination, exemplified the racial anti-Semitic stereotypes projected by members of the dominant society on all Jews. The oral suctioning of the infant’s penis by the mohel during circumcision, as we saw, was a standard practice which Eastern Jews followed in particular. According to Gilman (1993), the practice stood at the center of an intense debate “about the retention of circumcision as a ritual practice that was carried on in Jewish communities in Europe from the middle of the

The crossroad 205 century.” As Gilman explained, the debate was “over whether circumcision was ritually necessary and whether it was safe” (p. 67). It was in this way that the practice of metsitsah “became a dividing line between the practices of Viennese Jewry and the tradition of Eastern Jewry” (p. 68).10 Freud’s family was not only of Eastern European origins but he himself went on to receive private tutoring in Hebrew as a child, first at home from his father and then with Professor Hammerschlag. Freud’s student years in Vienna and his time at the Gymnasium eventually exposed him to a diverse education. Freud was taught Greek and Latin in school, something that helped him to begin distancing himself from his family’s Eastern European Jewish origins. As is well known, in his final self-analytic essay, “A disturbance of the memory of the Acropolis,” Freud (1936) himself singled out his education in Greek history as a specific example of how he had managed to surpass his father Jacob and to travel further than him. As my friend Elizabeth Roudinesco (2014) has observed in her most recent book, for Freud, as with many of his male Jewish contemporaries in Vienna, the fact of surpassing one’s father was not only necessary but required. They had to do so, moreover, by embracing a new culture while at the same time not betraying the memory and identity of their Jewish ancestors. Quoting Roudinesco: Forging his destiny in this way, Freud joined the history of the sons of the Jewish bourgeoisie, members of the commercial working class of the Austro-Hungarian Empire who were forced to dejudeize themselves in order to become learned intellectuals. In order to continue to exist as Jews they had to adopt Greek, Latin or German culture. (pp. 28–29) Yet the point is that Freud was not just part of the new Jewish bourgeoisie, he was also in the very peculiar position of analyst of a woman whose childhood trauma, to wit her circumcision, dramatically impacted on Freud’s divided identities. My thesis, in this regard, is that the traumatic scene which Emma related to him during analysis served to reawaken conscious and unconscious memories bearing on the circumcision of his younger brother Alexander (and, behind it, of his dead brother Julius), and that by embracing the Oedipus myth, Freud not only managed to distance himself from these memories, a clear mark of his Eastern Jewish roots, but also to bury and preserve them within the Greek script of the phallic hero whose destiny is bound to castration.

Notes 1 Martin Bergmann (1995, p. 248) relates that, before the emancipation of the Jews in Germany, in 1809 Jews were prohibited from using public sidewalks and that if a gentile shouted “Mach mores Jud!” [“Jew show your manners!”] to a son

206 The crossroad

2

3

4

5

6 7

of Israel, the Jew had to respond by taking off his hat and bowing before stepping into an unpaved muddy road, often covered with horse manure (see also Goldfarb (2009), p. 23, p. 300). In the first edition of The Interpretation of Dreams Freud mistakenly wrote “Hasdrubal” (the name of Hannibal’s brother) rather than “Hamilcar” (the name of Hannibal’s father). Freud (1901b) interpreted his error by noting that “Hasdrubal was the name of Hannibal’s brother, as well as of his brother-inlaw and predecessor in command” (p. 218). There were in fact two individuals named “Hasdrubal” in Hannibal’s family, one the younger brother of his sister, the other her husband and the man who eventually replaced Hamilcar in the command of the troops when Hamilcar died. Freud was guilty of yet another error when reporting his mistake to Fliess in his letter of November 12, 1899, dating the letter “IX” (September) rather than November (“XI”), mistakenly placing the roman “I” before rather than after the “X.” Freud commented on his Hamilcar–Hasdrubal substitution while trying to explain his two other errors, as though they had issued from the same source and nucleus: the substitution of Marburg with Marbarch in his Hollthurn dream and his substituting Uranus with Kronos. According to Reik: “She [Amalia] did not speak in high German but Galician Yiddish” (Freeman, 1971, p. 80). Anzieu (1986a) himself was unsure what language Amalia actually used when talking to her son – earlier on in the same book he states that Freud’s mother “likely” taught her son German (p. 16). In his earlier paper, “The significance of Freud’s earliest discoveries,” Kris (1950) had no choice but to admit that Freud’s self-analysis “did not remain isolated; what he discovered in his patients he applied to himself and insight gained concerning himself facilitated further progress in therapy” (p. 114). Kris’s observation was unfortunately not developed further by him, with the interpersonal matrix of Freud’s self-analysis being swept aside by him in favor of the ideal of “ego autonomy.” See Freud’s paper from 1911, later incorporated by him into The Interpretation of Dreams under the title “A hat as a symbol of a man (or of male genitals)” (Freud, 1900, p. 362). Freud (1916b) later wrote: “the symbolic meaning of the hat is derived from that of the head, in so far as a hat can be regarded as a prolonged, though detachable head” (p. 339). Freud apparently here failed to realize that if the body can be viewed as a phallus (Lewin, 1933), a hat could easily be taken to represent the foreskin removed from the head of the penis during circumcision. Freud perhaps purposely avoided linking the hat symbolism directly to circumcision, instead preferring to present his followers with a more universal reading of the hat, one which managed to embrace both Judaism and Catholicism. To quote from Freud’s letter: “I had been meaning to ask you, in connection with the eating of excrement [by] [illegible words] animals, when disgust first appears in small children and whether there exists a period in earliest infancy when these feelings are absent. Why do I not go into the nursery and experiment with Annerl?” (Masson, 1985; p. 230). Freud was here referring to his daughter Anna, 14 months old at the time. This peculiar passage shows that Freud was struggling with a compulsion whose significance is not altogether clear (the idea of “incest” is a description rather than an explanation). Freud’s words in his letter lead me to think that Beira’s position on the name of the “Nana” who had seduced and abused Freud as a child being “Anna” might have indeed managed to hit the target.

The crossroad 207 8 Freud identified a number of reasons for his abandonment of his seduction theory, all pinpointed in his letter to Fliess of September 21, 1897. Among these Freud identified “the certain insight that there are no indications of reality in the unconscious, so that one cannot distinguish between truth and fiction that has been cathected with affect.” Accordingly, Freud added that “there would remain the solution that the sexual fantasy invariably seizes upon the theme of the parents” (Masson, 1985, pp. 264–25). 9 To quote Aron and Starr (2013): “Psychoanalysis was born of trauma, developed in the context of Freud’s strong identification as a Jew, living in a viciously antiSemitic milieu. Its development cannot be fully understood without attending to the traumatic impact of virulent anti-Semitism surrounding Freud and his followers, in which the Jewish body was the target of anti-Semitic ridicule and disparagement. . . . The most salient visible characteristic marking the Jew as racially different was circumcision. . . . As European anti-Semitism intensified, circumcision, originally a signifier of religious difference, became the centerpiece of discussions about racial difference, including Jewish effeminacy, primitivity, degeneracy, and disease” (pp. xvi–xvii). 10 Metsitsah b’peh continues to be practiced among some Jews, with the controversy surrounding it having been addressed and discussed during a debate between all of the major candidates who ran for the office of mayor in New York City in the fall of 2013 (see Taylor, 2013).

9

The witch meta-psychology

The witch Freud viewed his “metapsychology” as a set of abstract assumptions, mainly biological, upon which his entire theory of psychoanalysis rested. When discussing the topic of analytic treatment in “Analysis terminable and interminable,” however, he came close to equating theorizing with fantasy, introducing the bewildering image of what he labeled “witch meta-psychology” in the process. Quoting Freud (1937): If we are asked by what methods and means this result is achieved, it is not easy to find an answer. We can only say: “So muss denn doch die Hexe dran!” [“We must call the witch to our help after all!” Goethe, Faust] – the witch meta-psychology. Without metapsychological speculation and theorizing – I had almost said “phantasying” – we shall not get another step forward. (p. 225) Freud’s words are significant in the history of psychoanalysis insofar as they suggest that his theorizing activity was influenced by unconscious fantasies – an idea which has come to inform my own effort to reconstruct and interpret the origins of psychoanalysis, its source, and subsequent development. In his essay, “The manifest and latent meaning of metapsychology,” Robert Holt (1982) traced this figurative turn in Freud’s thinking back to the image of the “bad mother,” which Freud’s “witchlike Nana” (nurse), the woman who cared for him as a young child in Freiberg, must have represented for him. Freud likely developed the fantasy of having two mothers – his real and loving mother and his “Amme” (wet-nurse) – while living in Freiberg as a small child. About his “prehistoric old nurse,” Freud (1900) once wrote: “Her treatment of me was not always excessive in its amiability, and her words could be harsh if I failed to reach the required standard of cleanliness” (p. 248). Freud found himself recalling his Nana during the course of his self-analysis; his initial memory of his Nana broke through in September–October 1897. According to Holt, Freud’s memory of her person had been anticipated in a

The witch meta-psychology 209 series of letters he penned to Fliess in January 1897; a letter wherein Freud fantasized and speculated about witches in particular. Judging from these letters, wrote Holt, it appears that the figure of the “witch” carried several unconscious meanings for Freud. The figure of the witch was not only viewed by Freud as a punitive phallic mother and the exciting projective embodiment of perverse desires which she enacted with the father-Devil but as the poor victim of loathsome sexual abuse as well. The figure of the “witch,” we recall, materialized for Freud in response to Emma having presented him with a number of scenes during analysis which triggered thoughts on witchcraft and demonic possession for him (letter to Fliess, January 17, 1897). It was in his next letter of January 24 of 1897 that Freud wrote: “The idea of bringing in witches is gaining strength. I think it is also appropriate. Details are beginning to abound. Their ‘flying’ is explained; the broomstick they ride probably is the great Lord Penis.” With this and other passages in mind, Holt (1982) speculated that a witch, as an adept in magic, had “the ‘omnipotence of thought’ and the power to accomplish such wonders as the transformation of human beings by means of words” – a description which appears to closely describe the “therapeutic work and role of the psychoanalyst” (p. 28). Commenting on the occupational hazard of psychoanalysis, Holt noted that an analyst “must listen all day to just the fantasies and wishes and fears that no one else would tolerate in conversation”: No matter how well analyzed a psychoanalyst may be, no matter how much desensitized by the daily repetition of talk about this infantile underworld, it can readily jar his or her equilibrium, stirring up unruly fantasies, occasionally even to the point where the analyst acts them out with the patient. (pp. 28–29) Holt’s observation acquires a supplementary precision once it is linked back to Freud’s countertransference during his analysis of Emma Eckstein. It turns out that the letters on which Holt relied to frame and advance his argument were mainly those which dealt with the circumcision scene which Emma had presented to Freud in January of 1897. Freud’s remark on the “witch metapsychology” squares with Freud’s own observation, discussed in a previous chapter, that he had received “the devil’s lot” while building the psychoanalytic edifice; the figures of the Devil and the witch, to be sure, each featured powerfully in the scenes which Emma presented to Freud in 1897 and in the bold speculations Freud then produced as a result of their impact on him.

The phallus Freud often claimed the investigations and hypothesis on human genitals which children produced were strikingly similar to the speculations

210 The witch meta-psychology generated by the most sophisticated scientists. At the same time, Freud also found that the attitude which children exhibit towards the sexual organs mimicked the same dynamics which primitive men exhibited toward them. In his essay on Leonardo, for example, Freud (1910b) proposed that the genitals, during the primeval stages of the human race, were “the pride and hope of living beings.” Freud then went on to say: “they were worshipped as gods and transmitted the divine nature of their functions to all newly learned human activities.” The sublimation of genital worship by primitive people in turn gave birth to innumerable divinities. When the connection between sexuality and the holy “fell into contempt,” however, primitive forms of genital worship survived in the “language, customs and superstitions of mankind” (p. 97). To support his thesis, Freud cited from a 1786 essay by Richard Payne Knight (1750–1824). Entitled A Discourse on the Worship of Priapus and its Connection with the Mystic Theology of the Ancients, the essay was one of the first studies to deal specifically with the connection between sexuality and religion. Knight’s text featured an account by Sir William Hamilton (1730–1803) of what remained of the worship of the Greek god Priapus in Isernia, near Naples. It dealt specifically with the apotropaic use of phallic amulets, a theme which greatly interested and inspired Freud.1 Freud, however, rarely referred to the worship of the phallic god Priapus in his work. One of the few instances when he did was in his essay on “The Taboo of Virginity” (Freud, 1918b) Freud also mentioned Priapus in a letter to Fliess on April 14, 1898, shortly after Easter. In his letter, Freud presented Fliess with a detailed description and account of the priapic statues he had seen in the museum at Aquileia, near Grado, which he had just visited with his brother Alexander. Implicitly alluding to the apotropaic significance of the worship of Priapus, he then concluded: “Priapus stood for permanent erection, a wish fulfillment representing the opposite of psychological impotence.” We find this same apotropaic function linguistically at work in the “propionic acid” which featured in the injection given to Irma in Freud’s founding dream. Erikson (1954), we recall, arrived at this same conclusion, finding that “propionic” [Propion] suggested “priapic–phallic” (p. 26). This same pattern had been powerfully reawakened in Freud after Emma presented him with her scenes in January of 1897. It was at that time, as we recall, that Freud was led to formulate the idea that the broomstick which witches are often portrayed straddling as they fly is the “great Lord Penis.” The image of the “great Lord Penis” in Freud’s communication helped bring together the activities of theorizing and fantasizing for him; it also marked the first appearance of the concept of the “phallus” in Freud’s work. Commenting on the image of the great Lord Penis in Freud’s passage, Luisa de Urtubey (1983) identified an essential ambiguity regarding the sexual role which the witch came to play within it, wondering whether she had been “united with the father’s penis during the course of copulation?” or been “in possession of a penis?” (p. 34).

The witch meta-psychology 211

Figure 9.1 Ancient and modern amulets from a plate of On the worship of Priapus in the Kingdom of Naples (1781).

These questions are perhaps best addressed in light of the circumcision scene which Freud reported to Fliess in the same letter. The oral incorporation of the penis figured as an essential and central feature of the scene. Freud not only remarked that “the child was given a piece of the skin to eat” following the cutting of the labia but that the girl “at age 13, once claimed that she could swallow a part of an earthworm and proceeded to do it” (Masson, 1985, p. 227). Freud’s description, which presents the girl challenging her male peers, reveals a reversal of roles as well as a movement from passive to active by her. The child, in this case Emma, is no longer seen as frightened but frightening. It also presents Emma as no longer a poor and passive victim of a hostile sexual aggression against her but as a girl endowed and empowered with phallic potency. Emma having orally incorporated the penis of the fatherDevil led Freud to see her as a “witch”; indeed, as a threatening phallic female figure who had managed to reverse her misfortune. The dynamic described by Freud is strikingly similar to the one found in “The taboo of virginity,” where Freud (1918b) maintained that a woman reacted to her defloration with feelings of resentment and with the “wish to castrate her young husband and to keep his penis for herself” (p. 205). Expanding on this theme, Karl Abraham (1920, 1924) argued that a woman reacted to her “wound” by fantasizing of robbing a man of his

212 The witch meta-psychology genital organ, by biting it off and devouring it. The process of introjection, as Freud described it, occurred through the oral incorporation of an object. The fantasy of swallowing the penis, he argued, itself featured a process of identification with the penis. This theme was widely discussed in analytic circles during the 1920s. Ferenczi (1926), for instance, spoke of a genitalization of the entire human body while Bertram Lewin (1933), in his study on “The body as phallus,” explained the regressive fantasy and desire to return to the mother’s womb as a product of a wish to incorporate the penis: “When the body represents a phallus,” Lewin said, “it means that a person has in fantasy eaten a phallus and identified himself with it” (p. 32). As noted, such fantasies were discussed, treated, and commented upon by Freud’s followers. Freud’s initial interest in the theme sprung directly from the circumcision scene offered him by Emma, a scene which in time led Freud to experience dreams wherein he clearly attempted to identify with the phallus.2 These dreams paved the way towards Freud’s identification with Oedipus, himself a phallic hero, as well as to his discovery concerning the deeper meaning of the Oedipus legend in 1897. The main point which I wish to stress here, however, is that the fantasies which Emma’s scenes awakened in Freud were experienced by him within an “as-if” space. They not only surfaced as a result of the analytic framework but revealed a profound continuity between fantasizing and theorizing – a dynamic emphasized by Freud himself when describing his “witch meta-psychology.” Freud appears to have been deeply and forever impacted by Emma’s circumcision scene. It soon led him to a new grand idea, an idea whose meaning becomes more understandable if only we realize that Emma had fashioned and reported her scene to Freud in the form of a religious ceremony, a brith milah event to be precise. As his letter to Fliess of January 24, 1897 reveals, Freud introduced Emma’s circumcision scene to Fliess with the following words: “I am beginning to grasp an idea: it is as though in the perversions, of which hysteria is the negative, we have a remnant of a primeval sexual cult, which once was – perhaps still is – a religion in the Semitic East (Moloch, Astarte).” This grand idea became the starting point of a new system of thought for Freud which would henceforth be slowly developed by him in several directions.3 Freud’s obscure statement appears to anticipate the convergence between neurosis and religion which he later theorized and presented in Totem and Taboo (Freud, 1913a). The continuity between this work and the hysteric scene offered him by Emma becomes more transparent once we realize that the latter featured a “totem meal.” In Totem and Taboo Freud (1913a) interpreted the totemic meal as involving a ceremony through which the memory of a single event had been preserved, reenacted, and transmitted from generation to generation. Freud advanced and proposed his hypothesis by appealing to the work of William Robertson Smith, whose Lectures on the Religion of the Semites were first published in 1889–1890. In Moses and Monotheism, Freud (1939) described

The witch meta-psychology 213 Robertson Smith as a “man of genius” and, further, noted that it was Smith’s work in particular which had provided him with “valuable points of contact with the psychological material of analysis and indications for its employment” (p. 132). Did Emma’s circumcision scene present Freud with a clear instance of such “psychological material”? Smith had researched the connection between primeval human sacrifices and the modern Christian rite of Holy Communion in his work. He naturally assumed the existence of a single archaic proto-religion as the common root of both Christian and Jewish rituals. In Totem and Taboo, Freud (1913a) described Robertson Smith’s reading of the origin and meaning of the ritual of sacrifice as being “of decisive interest” for his own work. Smith’s central contribution consisted in his having prospected the sacrifice at the altar as the essential feature of religions and arguing that the original meaning of the sacrifice was reducible to “an act of fellowship between the deity and his worshippers” (p. 133). The cannibalistic consummation of the flesh and blood of the totem was itself paradigmatic of this act of fellowship. “By incorporating parts of a person’s body through the act of eating,” Freud pointed out, “one at the same time acquires the qualities possessed by him” (p. 28). The main difference between Freud and Robertson Smith on this topic was that Freud deduced the original meaning of totemism from the vestiges remaining of it in childhood. The totem, according to Freud, was merely a father in disguise. “Thus,” he concluded, “we can trace through the ages the identity of the totem meal with animal sacrifice, with theanthropic human sacrifice and with the Christian Eucharist, and we can recognize in all these rituals the effect of the crime by which men were so deeply weighed down but of which they must none the less feel so proud” (pp. 154–155). The ritual of the metsitsah, a cannibalistic element featured in some forms of the brith milah ceremony, is strikingly absent from these rituals; this despite the fact of it supporting the very thesis which Freud wished to advance. In fact, and as Hermann Nunberg (1947) indicated in his groundbreaking article on circumcision and the problems of bisexuality: “Orthodox Jews, at the circumcision ceremony, usually name their son after their deceased father” (p. 168). Nunberg then proceeded to observe that the son not only stood as a “reincarnation of his father’s father” but that the “sucking blood from his penis at the circumcision ceremony” was a “relic of the totem meal” (p. 172). Nunberg’s observation squares with Freud’s own idea that cannibalism represented “an attempt to ensure identification with [the father] by incorporating a piece of him” (Freud, 1939, p. 82). The essential clinical point advanced by Nunberg (1947), however, was that the trauma of circumcision “released forces aimed at overcoming its effects. All of the phantasies, thoughts and habits, served a single purpose: preservation of the phallus” (p. 154). A similar point was underscored by Moisés Tractenberg (1989). Expanding on an idea originally introduced by Angel Garma, Tractenberg proposed

214 The witch meta-psychology the brith milah ceremony as “a manic ritual” (p. 461) through which the adult participants felt “the need to exhibit joy on reliving the pain of their own circumcision, which is reproduced projectively in the circumcision of the child.” Tractenberg added that “the bris meal or repast” following the ceremony symbolized “the oral-cannibalistic incorporation of the prepuce (equivalent to a filicidal-parricidal totem meal) and of the child’s life instinct through the fantasized incorporation of its genital potency” (p. 461). This same goal, argued Tractenberg, is achieved through all ceremonial meals, when men typically celebrate by drinking and toasting with wine.

An exquisite breakfast Many of Freud’s ideas on the Unconscious, I have realized over time, were in large part the product of his psychic reaction to Emma’s childhood (circumcision) trauma. Freud experienced a dream in July of 1899 which epitomized his own personal journey into the unknown. In the opening scene of the dream we find Freud’s body lying on a surgical table and split into two. His pelvis was being dissected. Peering down into the lower part of his body in the dream, Freud looks down to see his pelvis completely eviscerated. This scene replicates the act of peering down Irma’s mouth in his founding dream. Unlike the Irma dream, however, Freud was now no longer frightened by what he saw. Indeed, Freud is now numb to the scene. The dreamer sets out on a long journey and, in the dream, eventually arrives at a hut or “wooden house” which he then enters to find an open window. In order to bring his journey to an end Freud is obliged to successfully cross a chasm; when he realizes that what was required to make his crossing possible was the body of two children he suddenly wakes up in a state of “mental fright” (Freud, 1900, p. 453). Commenting on the dream’s final scene, Freud argued that it revealed the fulfillment of a wish. The wooden house, he said, “was also, no doubt, a coffin, that is to say, the grave.” The fact that it reminded him of an Etruscan grave near Orvieto he had once visited led Freud to draw the following conclusion: “The dream seems to have been saying: ‘If you must rest in a grave, let it be the Etruscan one.’ And by making this replacement, it transformed the gloomiest of expectations into one that was highly desirable” (pp. 454–455). The Etruscan grave surfaces here as a concrete embodiment of the “navel of the world,” something Freud sought and yearned for since his Irma dream; the central wish which his dream helped fulfill appears to have been directly related to his fantasy of taking possession of his mother’s womb. The grave was located in a burial city (necropolis) which Freud visited accompanied by his younger brother Alexander4 on September 9 of 1897, a month before announcing to Fliess his discovery of the universal application of the Oedipus myth. The fact that Freud was accompanied by his younger brother Alexander when visiting the Etruscan necropolis near Orvieto gives rise to a number

The witch meta-psychology 215 of questions. Why exactly was this place so meaningful to Freud? Was Freud somehow reminded of the novels She and Heart of the World by Rider Haggard, both of which dealt with perilous journeys into the “womb of the earth” in search of something missing, as he walked through the streets of the Etruscan necropolis with his brother? Most importantly, was Freud somehow reminded of the only dream which he reported from his childhood in his dream book, his dream of his “dead mother,” during his visit? Could the Etruscan grave Freud visited while on vacation with his brother be viewed as a duplicate, within his own imagination, of the funerary relief in his Egyptian dream? I have previously indicated that Freud dreamt his Egyptian dream at the age of nine and a half, when his mother Amalia was pregnant with Alexander. Freud’s visit to the Etruscan necropolis, we can surmise, must have reawakened memories of his longed-for pregnant mother. It also tapped into a bundle of feelings, fantasies, and thoughts which in Freud’s case paved the way towards his discovery of the Oedipus complex soon after. It was not by chance that Freud’s feelings of oedipal triumph and the punishment which he expected as a result, whether during his visit to the Etruscan necropolis or while standing atop the acropolis in Athens (Freud, 1936), each featured his brother Alexander accompanying him on his trip and standing by his side. It was while visiting the necropolis near Orvieto that Freud purchased the first objects of what would grow into his immense collection of antiquities.5 A few months later, on the night of May 10, 1898, Freud (1900) experienced the only dream he reported in The Interpretation of Dreams which featured his brother Alexander. In it the two brothers suddenly came under attack from the sea while inside a castle and grew frightened at the sight of a warship. Their fear dissipated, however, when another ship materialized and, as Freud and his brother called out in one voice: “That’s the breakfast ship!” [Frühstücksschiff] (p. 464). The breakfast ship was small and cut or severed in the middle. It greatly resembled the class of objects which had attracted Freud’s interests when he visited “the museums in the Etruscan towns.” The items, made of black pottery, were the toilet set of an Etruscan lady which Freud claimed resembled modern “breakfast sets” (p. 465). The strange object in Freud’s dream, he deduced, meant “a black ‘toilette’, i.e. mourning dress, and made a direct reference to a death” (p. 466). According to Freud, it reminded him of “the funeral boats in which dead bodies were placed and committed to the sea for burial.” Since the breakfast ship was broken in the middle, Freud naturally concluded that it represented “the return after a shipwreck [‘Schiffbruch’, literally ‘ship break’]” (p. 466). Freud’s dream, expressing the feeling of having survived a maritime catastrophe, led him to think of Schiller’s couplet Erwartung und Erfüllung [Expectation and Fulfillment]: “With thousands of masts, the young man crisscrosses the ocean/Safe on his ship, the old man quietly sails into port.”

216 The witch meta-psychology Freud, however, only cited half of Schiller’s couplet when reporting and analyzing his dream. Scholars have interpreted the broken and cut-off ship in Freud’s dream as pointing in the direction of a direct assault upon the genitals, perhaps a fantasy of a destructive defloration (Anzieu, 1986a, p. 318) or a scene of castration associated with a homosexual encounter between men of different ages (Cotti, 2007, p. 172). A more specific situation was more likely in circulation in the dream, namely, the event of Alexander’s circumcision. The ship which had been “cut off short where it was broadest in the middle” (p. 465) in this instance resembled and represented a circumcised penis. The Etruscan lady in a black mourning dress pointed towards Amalia’s mourning of her son Julius, the boy who died just a month before Freud celebrated his second birthday in Freiberg. Memory of Alexander’s brith milah had most likely served to remind Freud of Julius’s death, thereby blending the image of a circumcised penis with the death of Julius, the child whose life had tragically been cut short. Despite the naval attack and gloomy expectation of an impending death, Freud described his breakfast ship dream as the “most vivid and beautiful dream” he had experienced during “the last few years” (p. 546). What rendered the dream so beautiful, Freud explained, was the hallucinatory clarity and vividness of the colors in it as well as the memory of a delicious breakfast which he had enjoyed with his brother while traveling on a little steamer in the lagoon and canals of Grado (Adriatic Sea) during their Easter holiday vacation. Freud arrived in Aquileia, in Istria, with his brother on the morning of April 10, an Easter Sunday. The two men immediately set out to visit the archeological museum in the city. Freud provided a detailed description of the priapic statues he found in the museum four days later, in his letter to Fliess of April 14 of 1898. After visiting the museum in Aquileia the two brothers then boarded a small steamer ship in order to travel through the canals in the city and reach the lagoons in Grado. It was while on the deck of the small ship that Freud and his brother enjoyed their delicious breakfast, consuming their provisions and “a choice Istrian wine” (Masson, 1985, p. 308) as the vessel made its way. Freud’s breakfast ship dream thus recalled this exceptional joyful moment in his life, a moment in which Freud and his brother Alexander found themselves celebrating and experiencing “the most cheerful joie de vivre” (p. 466).

An incorporation dream Schiller’s saying that “hunger and love are what moves the world” acquired a central position in Freud’s system precisely around this time. Hunger and love each appeared to Freud as drives with different aims: the first strove to preserve the ego (the individual) while the second aimed after objects (Freud, 1930, p. 117). Freud was far from thinking that objects could be incorporated into the ego. Nevertheless, while analyzing his dream of the

The witch meta-psychology 217 Three Fates in the fall of 1898, Freud (1900) suddenly realized that hunger and love each appeared to “meet at a woman’s breast” (p. 204). Freud’s dream of the Three Fates was a “hunger dream” (1900, p. 233). In the first part of his dream he found himself entering a kitchen in search of something to eat. Three women were standing in it; one of them was the hostess of the inn and was twisting something about in her hand, as though she was making Knödel [dumplings]. She answered that I must wait till she was ready. . . . I felt impatient and went off with a sense of injury . . . (p. 204) In the second half of the dream Freud sees himself trying on an “overcoat” [Überrock] with fur, except that it was too long for him. He then attempts to try on another overcoat, this one featuring a Turkish design. A stranger, however, comes up to him and tries to prevent him from putting on this second coat by claiming it was his. The argument between Freud and the man about the coat was somehow resolved and they end up making peace and being friendly to each other. The crucial element in this dream of Freud’s is the sense of injury which he felt as the dream opened. It reawakened a memory for Freud of one of the first lessons taught to him by his mother. Once, at the age of six, he had stepped into the kitchen at home feeling hungry. His mother, however, told her son that he needed to wait to eat and, rather than making dumplings, proceeded to rub the palms of her hands together in order to show him the “blackish scales of epidermis [skin]” which her rubbing had produced. “My astonishment at this ocular [ad oculos] demonstration,” Freud explained, “knew no bounds” and led him to think of the feeling which Shakespeare’s words “Thou owest Nature a death” (p. 204) expressed.6 Shakespeare’s words as quoted by Freud can be viewed as embodying the expression of a deprived or damaged ego which Freud tries to restore in his dream. The damage itself is represented by the lack of a maternal container (the skin), while the restoration of the ego takes the appearance of a desire for a new skin (the overcoat). Yet the meaning of both the damage and the skin appears to be overdetermined. The fact that Freud’s dream led him to memories of “the most revolting sexual punishments” (p. 208) led Anzieu (1986a) to offer the following reading of Amalia’s kitchen lesson to her son: “masturbation (rubbing Knödel in one’s hands) is dangerous, one can die of it.” Amalia’s ocular demonstration, Anzieu argued, must “have symbolised other lessons, which Freud intentionally omits to mention” (p. 366). These “lessons” which Freud failed to report were in my view related to the numerous memories of “sexual punishments” which he had witnessed while working as a pediatrician – I am referring to the then-prevailing efforts to “cure” masturbation and hysteria which I have described in the initial section of this book.

218 The witch meta-psychology The scene in the kitchen triggered feelings in Freud which were similar to the ones he had experienced as a result of his Irma dream: his desire for a more amenable and cooperative female figure, for example. His feelings of impatience in the dream matched the feelings Freud had felt when Irma failed to open her mouth properly at first in his dream. The feeling of being injured in turn duplicated the “horrible discovery” Freud made as he peered down Irma’s throat in his dream. The three curly structures in the mouth, symbolic of the female sexual organ, now took the appearance of the three women in the kitchen. Freud immediately recognized them as the Three Fates, the three forms taken by the figure of the mother in the course of a man’s life, as put by Freud (1913c, p. 301) in a later work, mother, lover, and death – the last of these being Atropos, the “inevitable” one who cut the thread of life. Even the blackish epidermis (Latin for skin) which his mother’s “ocular demonstration” had produced signaled toward the piece of skin which had been infiltrated [Hautpartie] in Freud’s Irma dream; indeed, the very concept of destiny which surfaced in association with the word diphtheria, a taboo word deriving from diphtera, Greek for leather or skin. All of the signifiers at work here point to the possibility that the repressed “ocular demonstration” secretly celebrated in Freud’s dream tapped directly back into Emma Eckstein’s “revolting sexual punishment.” In short, Freud’s feelings of being deeply injured are unconsciously represented by him by his appealing to images and sensations which Emma had evoked in him from the very start of her treatment, and in particular to her missing “piece of skin.” Freud’s secret identification with his circumcised female patient becomes more apparent in the second part of his dream, as Freud searched for a replacement for his own missing “piece of skin” in the form of an overcoat. Commenting on this material in Freud’s dream, scholars have usually emphasized the homosexual component which it appears to suggest (cf. Grinstein, 1980, p. 169). According to Anzieu (1986a), the overcoat with fur represents the mother’s body and specifically female genitals; the stranger is the father who makes it clear that he is the possessor of his mother’s body. Freud giving up the “overcoat” he desires represents his submission to his father and, ultimately, his “passive position” towards him (p. 366). Scholars have failed to realize, however, that Freud was being moved by the desire to find a replacement for a piece of skin which had been destroyed, and that the lack of a maternal container is to be unconsciously equated with his lost and missing foreskin (prepuce). Seen from this angle, Freud’s “hunger dream” appears to be a dream of incorporation, dreamt by him in order to magically help fill a void in his own ego (symbolized by the piece of skin which was missing from his own body).7 In Freud’s associations to the dream, his desire is enacted by his gnawing and cannibalizing an entire series of individuals because of their names – Mr. Knödl becomes Knödel [dumplings], von Fleischl becomes Fleisch [meat], and so on – as though names were a second skin. As Freud observed while reflecting on the sensitivity humans typically feel about their

The witch meta-psychology 219 names: “we seem to have grown into [our names] like our skin” (Freud’s emphasis, p. 207). All these fantasies on names and skin appear to hint at the incorporation of Emma’s circumcision scene. Just as the paradigmatic punishment for her shameful genital frictions had turned Emma into an “Eckstein”, a cornerstone, now it was Freud’s turn to be excited and ashamed because of his name, so close to “Freude”, ‘joy’ in German. The precise meaning of Freud’s imaginary joy can be further clarified by the following links and associations. The dumplings [Knödel] reminded Freud of a certain Herr Knödl, a man once guilty of plagiarizing. This suggested the idea of “appropriating whatever one can, even though it belongs to someone else” (p. 205) to Freud. The same “appropriating” idea returned to Freud just shortly after, in his non vixit dream, when his childhood memory of a “dispute about some object” with John back in Freiberg was fashioned by him to help screen off an imaginary dispute with Fliess regarding the priority of the discovery of inborn bisexuality. As we recall, Fliess’s discovery and grand new idea had been directly inspired by Emma Eckstein’s phallic dreams. Ultimately, the object incorporated by Freud was Emma’s imaginary phallus – the nullifier of her/his castration.

A persisting “memory disturbance” Freud denied that dreams offered a window into the future.8 His interpretation of his “hunger dream” as a “fatal dream,” however, turned out to be prophetical. Freud became involved in a public dispute over plagiarism regarding matters of inborn bisexuality just a few years later. His friend Fliess complained that he had been plagiarized by Otto Weininger and accused Freud directly of having passed on his ideas to Weininger through Hermann Swoboda, one of Freud’s pupils. Freud interpreted Fliess’s accusations as an instance of paranoid thinking. As Jones (1953) observed, however, Freud had in the end to admit that “he must have been influenced by his wish to rob Fliess of his originality” (p. 346). In his detailed reconstruction of this intricate and much-discussed issue, Schröter (2003) came to the conclusion that the accusations of plagiarism leveled by Fliess against Freud indeed revealed a paranoid pattern detected by Freud. If we take into account the fact that the relationship between the two men cooled down immediately after Freud published The Interpretation of Dreams, however, we must naturally wonder whether Freud’s reference to plagiarism in his “hunger dream,” when coupled with his inhibitions and memory disturbances relating to the discovery of inborn bisexuality, did not provide Fliess with sufficient factors to trigger his feelings of paranoia towards Freud. Consider Freud’s own report of one of his memory disturbances in The Psychopathology of Everyday Life: One day in the summer of 1901 [it was actually in 1900] I remarked to a friend . . . “These problems of the neuroses are only to be solved

220 The witch meta-psychology if we base ourselves wholly and completely on the assumption of the original bisexuality of the individual.” Fliess had replied to Freud then: “That’s what I told you two and a half years ago at Br. [Breslau] when we went for that evening walk. But you wouldn’t hear of it then.” It is painful to be requested in this way to surrender one’s originality. I could not recall any such conversation or this pronouncement of my friend’s. . . . Indeed, in the course of the next week I remembered the whole incident, which was just as my friend had tried to recall it to me. (Freud, 1901b, pp. 143–144) Despite the fact that Freud recognized that the idea of bisexuality had been originally introduced by Fliess, he time and time again managed to repress the fact.9 The most spectacular enactment of Freud’s “memory disturbance” in relation to the same psychic constellation was his experience when he visited the Acropolis in 1904 (Freud, 1936). The sensation of estrangement and derealization which Freud felt as he stood atop the Acropolis with his brother Alexander would come to haunt him for the rest of his life. I will examine each of these important “incidents” in the second volume of this study. The point that I want to stress here is the overdetermined nature of Freud’s core “forgetfulness.” Only at an oedipal level did it concern his imaginary dispute with Fliess and his desire to rob him of his originality. More profoundly, the true object of Freud’s desire was Emma’s own magic phallus. Freud’s attempt at transforming his fantasy into theory would come to inform his essay on Leonardo da Vinci (1910b).

The fellatio fantasy It was during the period when Freud experienced his dream of the Three Fates that he also stumbled upon the figure of Leonardo da Vinci; the context when this occurred was deeply marked by Fliess’s belief that bisexuality was somehow connected to bilaterality. In a letter to Fliess on October 9 of 1898, Freud described the famed Italian artist as “the most famous left-handed person” in world history, presenting the artist as a case uniquely suited to Fliess’s theory of bilateral symmetry. Having the annoying impression that Fliess considered him to be “left-handed,” Freud offered Leonardo as a replacement for himself. Freud became interested in Leonardo again in the autumn of 1909. On November 11 of that year he wrote to inform Jung that he had recently learned from a young philologist that Oedipus had originally been a phallic demon and that his name simply meant “erection”.10 Since then, Freud added, “a noble spirit, Leonardo da Vinci, has been posing for me – I have been doing a little ψA [psychoanalysis] of him” (McGuire, 1974, p. 260). This same topic returned in a letter Freud sent to Jung ten days later, on November 21, 1909:

The witch meta-psychology 221 Oedipus, I believe I have told you, means swollen foot, i.e., erected penis. Quite by accident I recently hit on what I hope is the ultimate secret of foot fetishism. In the foot it has become permissible to worship the long-lost and ardently longed-for woman’s penis of the primordial age of infancy. Evidently some people search as passionately for this precious object as the pious English do for the ten lost tribes of Israel. . . . I do wish I could show you my analysis of Leonardo da Vinci. I am desperately sorry not to have you here. (McGuire, 1974, p. 266) It was just a week and a half later (on December 1) that Freud presented his ideas on Leonardo before the members of the Vienna Psycho-Analytical Society. His essay on homosexuality and left-handedness, his favorite, was completed only a few months later, in April of 1910. Freud’s work on Leonardo provided him with the framework to explain the most crucial and amazing elements found in genital worship, the one relating to “the long-lost and ardently longed-for woman’s penis” in particular. Archeology and mythology both teach us that in the primordial stage of mankind the phallus, the primal creative force of nature, can be often found as an attribute of a mother goddess. According to Freud (1910b), this fantasy is revived during the early stages of development of the male individual, when a child’s curiosity for sexual life is so strongly dominated by his interest in his genitals that he is unable to imagine that they could possibly be missing in other individuals. This belief is so firmly planted in the male child’s mind, said Freud, that it fails to be “destroyed even when he first observes the genitals of little girls” (p. 95). Despite the fact that the child’s perception tells him that what he is looking for is missing, he is incapable of admitting and affirming his actual perception. Indeed, the possibility of doing so strikes him “as an uncanny and intolerable idea” (p. 95) and is rejected. It is only when the child is threatened with castration that he is forced to conclude that “little girls too had a penis, but it was cut off and in its place was left a wound” (p. 95). But this “theoretical advance” gained under the impression of the threat of castration has a cost: from now on, the male child “will tremble for his masculinity” and, at the same time, will “despise the unhappy creatures on whom the cruel punishment has, as he supposes, already fallen” (p. 95). Freud will later argue that “the child believes that it is only unworthy female persons that have lost their genitals – females who, in all probability, were guilty of inadmissible impulses similar to his own. Women whom he respects, like his mother,” Freud (1923a) added, are imagined by the child as retaining a penis “for a long time” (pp. 144–145). During the course of his self-analysis, Freud found that the satisfaction which a child derives from sucking at the mother’s breast was the prototype of all future experiences of bliss. As Freud (1905) phrased it, it stood as the “innocent origin” of the “repulsive and perverted phantasy of sucking

222 The witch meta-psychology at a penis” (p. 52). A confusing aspect of Freud’s theory was the erasure of all differences in the condensation of breast and penis. According to him there was an unbroken continuity, if not a complete identity, found between breast and penis, with the mother being fantasized by the child as being endowed with the male organ. Indeed, it was the child’s desire for the mother’s penis which in Freud’s view marked the very apex of his or her erotic attraction towards the mother.11 An important attempt to theorize this very point informed Freud’s speculations on Leonardo da Vinci in 1910, a milestone in the construction of the symmetrical (right and left, positive and negative) structure of the Oedipus complex. As we know, Freud interpreted Leonardo’s autobiographic memory of being visited in his cradle by a bird of prey as a “vulture fantasy,” explaining it as signaling in the direction of a “sexual act in which the penis is put into the mouth of the person involved,” a “completely passive” fantasy which, said Freud (1910b), resembled “certain dreams and phantasies found in women or passive homosexuals (who play the part of the woman in sexual relations)” (p. 86). The origin of this repulsive passive fantasy, Freud argued, was of the most innocent kind and consisted in the child taking “the nipple of the mother or wet-nurse [Amme]” into his or her mouth (p. 87) and sucking at it. Freud argued that it was only when the child discovered that a woman did not possess a penis that his longing turned into its opposite and gave way to “a feeling of disgust” which, during puberty, could then “become the cause of psychical impotence, misogyny and permanent homosexuality” (p. 96). Typically, Freud explained, these subjects experienced a highly intense erotic attachment to their mothers which in time succumbed to repression: “The boy represses his love for his mother: he puts himself in her place, identifies himself with her . . . In this way he has become a homosexual” (p. 100). In the Leonardo essay Freud focuses on the modalities through which the memory of the woman’s penis – “the revered creation of primaeval phantasy” – had managed to be preserved through the memory of being visited in his cradle by a bird of prey. In Freud’s reconstruction, the sucking mother is turned into a vulture which had placed its tail into the child’s mouth – the Italian word for tail, coda, was interpreted by Freud as a substitutive symbol for the penis. According to Freud, Leonardo projected his fellatio fantasy into his painting “Madonna and Child with St. Anne.” The great Italian painter, Freud argued, had experienced “two mothers” during childhood, his actual biological mother (Caterina) and a stepmother (Albiera) who entered his life between the ages of three and five. In Freud’s view the two women had been condensed into a “composite unity” by Leonardo in his painting (p. 113). Freud’s argument derived from a single linguistic factor. He accepted the German word “Geier” [“vulture”] as a translation for the Italian word for bird or “nibio” [“kite”] and associated it with the hieroglyph for the Egyptian word for “Mutter” [mother], Mut, the vulture-headed Egyptian

The witch meta-psychology 223 goddess “usually represented by the Egyptians with a phallus.” This Egyptian goddess, said Freud, presented “the same combination of maternal and masculine characteristics as in Leonardo’s phantasy of the vulture” (p. 94). Freud’s readers were quick to point out that his argument rested on a fundamental misunderstanding; the translation of “Nibio” by “vulture,” it turns out, was wrong. Freud’s mistake, however, allows us to better pinpoint the subjective and unconscious sources of his unique interpretation of Leonardo’s autobiographical memory. Eva Rosenfeld (1956) has pointed out that Freud’s error (calling the kite a vulture and linking it with Egypt) functioned to bring “Freud’s own childhood dream of the beak-headed gods” (p. 98) into the picture. There are a number of other elements besides the image of Freud’s mother being carried to her bed by bird-beaked figures in Freud’s dream which suggest that Freud had projected his own fantasies when formulating his interpretation of Leonardo. Like Leonardo, Freud too enjoyed the care of “two mothers” as a child – his mother Amalia and his Catholic nana. A crucial point here, however, concerns the fantasies which the event of Alexander’s brith milah might have engendered for Freud at the age of ten. The act of seeing the mohel suck on Alexander’s penis during the circumcision ceremony might have led Freud to develop a fantasy relating to the act of fellatio. This oral fantasy might have in turn merged with fantasies and memories linked to the sexual seduction Freud experienced as a child at the hands of his Catholic nana, something that naturally led him to then confuse penis with breast. Other formal elements deserve to be identified and commented on here as well. St. Anne stood as a grandparent figure (she was Christ’s grandmother). In Leonardo’s painting we find the same generational matrix (the holy child, the mother, and the grandmother) present in Freud’s own brith milah scene, when Freud had received his grandfather’s name (Schlomo) from his father. Freud’s circumcision scene not only featured little Schlomo Sigismund, the newborn child, but his father (Jacob) and grandfather (Schlomo) as well. Leonardo’s great gift and talent for reverse writing appear to be significant as well. As Freud (1910b) noted, the great Italian genius not only “kept a diary” but “made entries in his small hand (written from right to left) which were meant only for himself” (p. 102). While true that Freud was not left-handed, he nevertheless symbolically mirrored Leonardo’s talent for reverse writing as a result of his early training in Hebrew. This suggests the need for us to pay special attention to Freud’s claim that the origins of the repulsive fantasy of having the mouth filled with the mother’s penis consisted in the child taking “the nipple of the mother or wet-nurse [Amme]” into his or her mouth (p. 87). The emergence of the word Amme in this context is not marginal, if only because it mirrored the name Emma for Freud.12 Freud’s speculation and interpretation of Leonardo’s painting thus appear to boil down to a writing code, fashioned in either Hebrew style (right-to-left) or left-to-right Catholic fashion.

224 The witch meta-psychology Indeed, the same link between the fellatio fantasy and Amme as Emma appears to signal in the direction of Emma and her holy scene. I will circle back to this point in the second volume of this study. As we shall come to see, one of Emma’s most important and revealing symptoms, through which she managed to displace her genital mutilation, concerned her breasts.

Do you believe that hysterical pain can be cured by the knife? Together with Leonardo, the unsettled Fliess question resurfaced for Freud in powerful fashion. In a letter to Ferenczi on January 10 of 1910, Freud decided to present his younger colleague with “a piece of analysis” which featured Fliess, identifying what he considered as the true “inner cause” of his break-up with his former friend. Freud was apparently intensively preoccupied with Fliess and even dreamt of him in the summer of 1910, a full six years after their last exchange in 1904. In the second half of the year Freud worked on the connection between homosexuality and paranoia and did so by analyzing the text which President Schreber published of his mental illness (Freud, 1911). Freud formulated a theory on Schreber which appears to have been a projection of his own homosexual conflicts, as experienced and lived by him in his relationships with Fliess. Freud himself was not sure he had managed to exclude his own complexes when treating Schreber’s text.13 This is how Mahony (1979a) was led to explain the appearance of “Fliess’s spectre” in Freud’s life in 1910: In all this drama, 1910 was a pivotal year with Fliess as a revenant, appearing with da Vinci in the spring, the Schreber [case] from the summer into the winter, and then influencing Freud not to have a Christmas meeting with Bleuler in Innsbruck, associated as it was with “horrid memories” of a private congress in 1899. (p. 88) Commenting on Freud’s increased interest in bisexuality, Mahony (1979a) noted that 1910 stood as “one of the most puzzling” years in “Freud’s life.” He added: “I confess that the available historical material clarifies but does not explain all” (p. 86). One fact in particular might help us to resolve the mystery. Fliess was not the only “revenant” to enter Freud’s life in 1910 for this was also the year when Emma Eckstein re-entered analysis with Freud. Freud’s treatment of Emma Eckstein appears to have ended on a positive note in 1897 with Emma then entering the profession and functioning as an analyst. Emma experienced a severe crisis 12 years later, however, during the period when Freud treated her nephew Albert Hirst.14 Relying on the text of an interview which Hirst granted Kurt Eissler in 1952, Lynn (1997) noted the following:

The witch meta-psychology 225 Freud also provided Albert Hirst with information about his aunt, Emma Eckstein, who for a time had been known as a famous and spectacular success for Freud. She suffered a relapse during Hirst’s second analysis. Hirst was so upset when she attempted suicide that he had to sit up to discuss it with Freud. (p. 81) Hirst was in analysis with Freud for a second time between the fall of 1909 and early 1910. There is evidence to suggest that Emma Eckstein herself re-entered analysis with Freud during this period as well.15 Freud produced far-reaching speculations on matters relating to fetishism during this period. In February of 1910, he boldly theorized a woman’s foot as “the substitute for the painfully missed, prehistorically postulated, penis of the woman.”16 Freud featured this new idea in his essay on Leonardo. To quote Freud (1910b) directly: the fixation on the object that was once strongly desired, the woman’s penis, leaves indelible traces on the mental life of the child . . . Fetishistic reverence for a woman’s foot and shoe appears to take the foot merely as a substitutive symbol for the woman’s penis which was once revered and later missed; without knowing it, “coupeurs de nattes” [perverts who enjoy cutting the hair of females] play the part of people who carry out an act of castration on the female genital organ. (p. 96) This passage becomes highly uncanny and disturbing once it is linked with Emma’s trauma, to wit, her surgical castration. It becomes even more disturbing when examined in light of Emma’s second slice of analysis. Emma’s second phase of treatment apparently ended when Dr. Dora Teleky found an ulcer or a collection of pus on Emma’s abdomen and removed it surgically. Freud is said to have become angry with Emma as a result of the surgery, dropped her as his patient, and resolved that he would never again involve himself with her. According to Lynn (1997): Freud told Hirst that he disagreed with Emma’s view of her later symptoms as organic. He also described his reaction to Emma’s having accepted treatment from another physician – he was angry, and he resolved that never again would he involve himself with her. Hirst asked Freud about childhood trauma in her case, but this was one matter Freud would not discuss. (p. 81)17 Dora Teleky (1879–1963), a former student of Freud, graduated from medical school in 1904 and, from 1907 to 1911, studied gynecology under Rudolf Chrobak and other well-known gynecologists.18 She went on to study

226 The witch meta-psychology urology under Otto Zuckerkandl between 1911 and 1914. Freud knew most of her teachers well and the fact might perhaps explain his emotional overreaction to the situation. Dora Teleky married Ernst von Brücke, the grandchild of Freud’s mentor, in 1930. The couple eventually left for the United States during the Anschluss. In his controversial book on Freud, Emil Ludwig (1957) cites from a letter which Dora Teleky had sent to him. Ludwig reported the following: Considerably later the patient [Emma Eckstein] returned, complaining of stomach pains. It seems she had been operated on by an outstanding Viennese doctor for abscesses in the uterus, but because of the pains wanted to see Dr. Freud again. “Dr. Freud ordered me to look at the patient,” writes Dr. Bruecke [Teleky]. “I saw that the abscesses still persisted, or that a fresh abscess had formed on the site of the incision. I made a new incision and at one stroke freed the patient of her pains. When I later told this to the master at his home he blew up. With biting scorn he asked me whether I actually believed that hysterical pain could be cured by the knife. Quaking, I objected that an obvious abscess must be treated. Despite the fact that the patient was cured of all complaints, Dr. Freud became so unfriendly to me that I was obliged to break off the discussion and leave him.” (p. 115) Freud also reacted to the surgical intervention on Emma by declaring that she would now never improve, which indeed turned out to be the case. He then dropped her as his patient for good. Freud commented on this last phase of Emma’s treatment in 1937, in “Analysis terminable and interminable.” Freud did so, however, without revealing his patient’s identity. The coincidences are so striking, however, that it is patently obvious that Freud, as Masson (1984) and others after him correctly inferred, could only have been referring to Emma Eckstein. “An unmarried woman, no longer young,” Freud (1937) writes, had been cut off from life since puberty by an inability to walk, owing to severe pains in the legs. Her condition was obviously of a hysterical nature, and it had defied many kinds of treatment. An analysis lasting three-quarters of a year removed the trouble and restored to the patient, an excellent and worthy person, her right to a share in life. In the years following her recovery she was consistently unfortunate. There were disasters in her family, and financial losses, and, as she grew older, she saw every hope of happiness in love and marriage vanished. But the one-time invalid stood up to all this valiantly and was a support to her family in difficult times. I cannot remember whether it was twelve or fourteen years after the end of her analysis that, owing to profuse haemorrhages, she was obliged to undergo

The witch meta-psychology 227 a gynaecological examination. A myoma was found, which made a complete hysterectomy advisable. From the time of this operation, the woman became ill once more. She fell in love with her surgeon, wallowed in masochistic phantasies about the fearful changes in her inside – phantasies with which she concealed her romance – and proved inaccessible to a further attempt at analysis. She remained abnormal to the end of her life. (p. 222) It is not altogether clear just why and when Dora Teleky performed her medical incision on Emma. In her letter to Ludwig, Teleky herself reported that Emma “had been operated on by an outstanding Viennese doctor for abscesses in the uterus.” Freud, however, spoke of “a complete hysterectomy” in his account. It would be important to know the identity of the doctor who operated on Emma and, beyond this, whether the “outstanding” surgeon who had performed the operation was one of those gynecologists who had previously attempted to cure female hysterics by removing their ovaries (castration). Freud’s vigorous reaction to the situation would become more understandable should this have been the case. The clinical picture which Freud presented in his 1937 text about his former patient describes a woman who had acted out her masochistic fantasies with a male surgeon; they offer a description of a woman who had been impacted by a severe traumatophilia. This squares with Emma’s clinical picture and her childhood trauma as she described it to Freud. Moreover, we do not know whether Emma’s ovaries had been removed by the time she made her way back to Freud for a second attempt at analysis. In his description, Freud indicated that Emma’s severe leg pains had “defied many kinds of treatment,” perhaps suggestive of her having undergone further gynecological treatments. Besides Fliess’s near-fatal operation on her nose, had Emma experienced other surgical treatments during the course of her life? This might perhaps help explain Freud’s reaction to the minor incision which Teleky had performed on Emma – indeed, the logic behind Freud’s angry question to her: “Do you believe that hysterical pain can be cured by the knife?”

“I am Schreber” Freud’s description of Emma’s “romance” reveals several points of contact with his peculiar interpretation of Schreber’s delusional system. Schreber’s delusion, we recall, was understood by Freud as having been caused by an outburst of libido. Schreber’s Memoirs were first published in 1903. Freud, however, only became attracted to Schreber’s autobiographical account of his illness in the spring of 1910. He read the text for the first time that summer; most likely, I reconstruct, soon after his decision to drop Emma as his patient forever. Daniel Paul Schreber was a distinguished jurist and judge who, after having been promoted to the high office of Senatspräsident in Dresden,

228 The witch meta-psychology developed symptoms of severe paranoia. He suffered an acute attack of hypochondria and was treated in a Leipzig psychiatric clinic which Paul Emil Flechsig – the same radiant-Flechsig-Moses behind the Norekdal dream – directed during the mid-1880s. In 1893, after being appointed president of the high court, Schreber experienced a relapse which led to his being hospitalized at a psychiatric clinic where Professor Flechsig once again treated him. His condition grew worse, however, and he soon began believing that his body was being manipulated in a number of disturbing and revolting ways. Flechsig, his doctor, suddenly became his enemy and persecutor and Schreber’s delusions began to gradually take on a mystical and religious dimension. God himself, whom Schreber at first considered his ally in his struggle against Flechsig, became the instigator of a plot by which his soul was to be murdered, with his body then being transformed into a female. He could then be abused as a whore, all in order to serve a higher and holy purpose. Schreber’s emasculation, which was initially experienced by him as a persecution and a serious injury, was finally accepted by him in the service of this higher cause, to wit, the salvation of humanity. Like Christ, who willingly accepted his martyrdom in order to save mankind, Schreber now also saw himself as a universal redeemer. The “putrefaction of the abdomen” and the destruction of the internal organs played a central role in Schreber’s delusional system (cf. Freud, 1911, p. 17). According to Freud, the cause which triggered Schreber’s illness involved “an outburst of homosexual libido” which took as its object the figure of his doctor (p. 43), hence, Schreber’s “romance” with his “surgeon.”19 Thus, to use the very wording Freud had employed when writing about Emma, the “fearful changes in his inside” surfaced as a key element in Schreber’s emasculation and his transformation into a woman. This detail is not irrelevant, since Flechsig himself made use of surgical castration to treat nervous and mental disorders in women. Flechsig had in fact done so in the very same clinic where Schreber was hospitalized against his will. We know that Flechsig published an article entitled “Zur gynäkologischen Behandlung der Hysterie” [For the gynecologic treatment of hysteria] in 1884. In it, Flechsig mentions three cases in which he had performed castration on women. In his article, Flechsig also examined “the indications for the use of castration as a treatment of neuroses and psychoses.” Niederland (1984, p. 104) reconstructs not only that Schreber must have been familiar with Flechsig’s writings but that this presented us with a “kernel of truth” which explained Schreber’s great fear that he might be castrated after he was hospitalized in order to be treated by Flechsig. This line of thought presupposes the validity of Freud’s reading of Schreber’s delusional system, a system which has been convincingly criticized and challenged by Zvi Lothane (1992) in his book In Defense of Schreber. Freud was no doubt familiar with Flechsig’s work and his endorsement of the practice of female castration. Freud, however, turned a blind eye

The witch meta-psychology 229 to this element in the story, just as he also brushed aside the fact that Schreber’s father was a medical doctor who was well known for his crusade against masturbation (Niederland, 1984). Freud, in other words, treated the clinical material relating to Schreber exactly as he treated the material bearing on Emma Eckstein, namely, by dissociating it from trauma and an actual traumatic reality. The presence of Flechsig as persecutor played a primary role in eliciting Freud’s interest in Schreber’s Memoirs. Freud in fact composed his psychoanalytic notes on Schreber’s paranoia in part as an attempt to overcome his homosexual transference to Fliess. He admitted as much to Ferenczi. Freud and Ferenczi left together for Sicily at the end of August 1910 and were planning to collaborate on a text on Schreber. Their attempt at collaboration, however, failed, with the so-called “Palermo incident,” in September of 1910, creating the first serious breach in their relationship.20 Ferenczi attempted to overcome their impasse after the incident by informing Freud of his longing for “absolute mutual openness” between them (October 3, 1910). Freud’s reply, on October 6, was remarkably open and sincere: Not only have you noticed that I no longer have any need for that full opening of my personality, but you have also understood it and correctly returned to its traumatic cause. Why did you thus make a point of it? This need has been extinguished in me since Fliess’s case, with the overcoming of which you just saw me occupied. A piece of homosexual investment has been withdrawn and utilized for the enlargement of my own ego. I have succeeded where the paranoiac fails. . . . My dreams at the time were, as I indicated to you, entirely concerned with the Fliess matter. Analyzing Schreber’s delusional system, viewed by Freud as an attempt by Schreber at self-healing, had allowed Freud to withdraw a “piece of homosexual investment” and to successfully utilize it, as he said, for the “enlargement” of his “own ego.” Freud did so by casting Fliess in the role of Flechsig and identifying with Schreber. Freud’s identification with the mad judge suggests that he must have experienced his break with Emma as a catastrophic collapse. It also suggests that Freud had once again managed to reenact the pattern “I = she,” unconsciously adopting the role of his female patient in the process. We might in fact argue that, while Freud was intensively preoccupied in resolving his “homosexual” transference to Fliess, it was Emma who had once again disappeared from his phenomenal field as an external object. “I am Schreber, nothing but Schreber,” Freud wrote to Ferenczi on December 3, 1910. On December 18, he penned a letter to Jung to report that “his Schreber” was finally finished. Freud then added: The piece is formally imperfect, fleetingly improvised. I had neither time nor strength to do more. Still, there are a few good things in it,

230 The witch meta-psychology and it contains the boldest thrust at ††† psychiatry since your Dem. [entia] Pr.[aecox]. I am unable to judge its objective worth as was possible with earlier papers, because in working on it I have had to fight off complexes within myself (Fliess). It was in that same month of December that the “peace” which Freud had enjoyed during his “work on paranoia” was suddenly disturbed by the Adler affair, painful to him only because “the wounds of the Fliess affair” were reopened by it (Freud’s letter to Jung of December 22, 1910). In the course of the healing process the “putrefaction of the abdomen” had somehow transformed into simple “wounds.” It was shortly thereafter that Freud began work on a new manuscript, one which dealt with the origins of religion. Freud first announced this new project to Jung on February 12 of 1911. He did so with the following words: “For some weeks now I have been pregnant with a larger synthesis and hope to be delivered of it this summer” (emphasis added). This new child was baptized by Freud with a name: Totem and Taboo.

Notes 1 Freud apparently placed an order for Knight’s study in July 1909 and received the text five months later, in December (cf. his letters to Jung of November 11 and December 19, 1909). 2 I am thinking here of Freud’s “exhibitionist dream” which he reported to Fliess on May 31, 1897. In the dream Freud found himself traveling up a flight of stairs while wearing very few clothes. He notices a maidservant as he travels up the stairs and suddenly feels “excited” and “ashamed,” indeed “paralyzed” and “glued to the spot” all at once. I will discuss Freud’s dream in the second volume of this study. 3 The idea that neurosis was the “negative of perversion” was repeated by Freud on various occasions and contexts (Freud, 1905, p. 50, p. 165; 1906, p. 277; 1908a, p. 191; 1913b, p. 209). It stood as the most important point of continuity between his “theory of the father” and his later view of the neuroses as a product of infantile sexuality. Freud’s statement served to anticipate his later understanding and theorizing of religion as “the obsessional neurosis of mankind” (Freud, 1927). 4 Freud was also traveling with Felix Gattel; born in Europe, Gattel had settled and lived in America but decided to return to the continent to study with Freud in Vienna. 5 On this question, see the postcard which Freud sent to Martha on September 9, 1897. 6 Freud had misquoted Shakespeare’s Henry IV (Act 5, scene 1), erasing “God” in favor of “Nature” in the process. 7 I am here utilizing the term “incorporation” as opposed to “introjection,” according to the clinical observations and theoretical proposition formulated by Abraham and Torok (1972). 8 Freud (1900) initially insisted that dreams only provided knowledge of the past, for dreams “are derived from the past in every sense.” In the end, however, he was forced to recognize that the “ancient belief that dreams foretell the future

The witch meta-psychology 231

9

10

11

12

13

14

15

16

is not wholly devoid of truth,” since “by picturing our wishes as fulfilled, dreams are after all leading us into the future” (p. 621). An important expression of Freud’s symptomatic forgetfulness was his famous Signorelli slip in September of 1898. Freud’s act of forgetting then was both temporally and thematically connected to his dream of the Three Fates. I will discuss Freud’s Signorelli slip in the second volume of the present work. The young philologist was David Ernst Oppenheim (not to be confused with the Oppenheim who inspired Freud’s 1910 paper “The antithetical meaning of primal words”), was a member of the Vienna Psychoanalytic Society for a short period. He spoke to the members of the Society about the phallic significance of the name Oedipus on March 29, 1911. An initial attempt at disentangling this confusing condensation was offered by the Dutch psychoanalyst August Stärcke (1921a). In his paper on “The castration complex,” Stärcke argued that unconscious fantasies were repetitions of real situations and that mankind’s cannibalistic stage was experienced by all human beings who fed at their mother’s breast. “The mamma,” he noted, can “signify the mother as well as the breast” (p. 196). Ultimately it was the child’s feeling of the loss of the nipple in the mouth area which fed the fantasy of a “woman with a penis.” Despite the fact that Stärcke’s contribution was awarded an important prize, Freud (1924a, p. 175) remained skeptical about the actual effects of the withdrawal of the mother’s breast. In a letter Freud wrote to Jung on June 6 of 1907 and writing about an analysand who was in the habit of “inventing words,” Freud remarked that the patient “spent her childhood between her mother and her nurse, who stayed with her for many years.” Freud then added: “The mother’s name is Emma; turn it around: Amme” (McGuire, 1974, p. 59). Referring to his paper on paranoia, Freud wrote Jung on December 22 of 1910 to say: “this time I am not sure to what extent I have been able to exclude my own complexes, and shall be glad to accept criticism.” On this question, see Zvi Lothane (1992). Albert Hirst (1887–1974) was the son of Käthe Eckstein, Emma’s older sister. Albert had an initial brief analysis with Freud in 1903; a ten-month analysis followed in 1909–1910. His own sister, Ada, was for a short time also in analysis with Freud. Hirst was interviewed by Kurt Eissler in 1952. The transcripts (dated March 16 and March 30, 1952) are today at the Siegfried Bernfeld collection at the Library of Congress in Washington. Hirst was later interviewed by Paul Roazen in 1966 (Roazen, 1969, pp. 89, 214; 1978, pp. 350–351) who then used the material to craft the opening chapter of his book How Freud worked. First-hand accounts of patients (Roazen, 1995). Hirst began writing an autobiography in 1972 which he intended to publish. The manuscript, never published, can also be found at the Freud Archives in Washington. Masson (1984) discovered that Freud wrote a prescription for Emma Eckstein (boric acid for her vagina) in 1910 (May 24). Emma’s second analysis with Freud likely started between the autumn of 1909 and early 1910 and apparently came to an end in May or early June of 1910. The idea surfaced in a letter which Freud wrote to Karl Abraham on February 24, 1910. In it he discussed the topic of fetishism, reporting his old views. Freud also introduced a new idea which had come to him: “In addition, it must be emphasized that the female foot is probably the substitute for the painfully

232 The witch meta-psychology

17 18

19

20

missed, prehistorically postulated, penis of the woman. A substitute for the same thing seems to be the plait. Cutting off plaits thus stands for the castration of women, ‘making’ women, as it is through castration that one becomes a woman” (Falzeder, 2002, p. 106). On this point, see also Masson’s references to Albert Hirst (Masson, 1984). Dora Teleky was one of three students who audited Freud’s courses at the University of Vienna in 1900, 1903, and 1904. She was in fact the first woman to officially register for Freud’s courses at the University. Citing from a personal communication sent to him by Teleky, Emil Ludwig (1957) reported that “Freud had induced her, as the sole woman among eight or ten students, to relate a dream during class. ‘I innocently reported dreaming of climbing the Rax in the lowest spurs of the Viennese Alps.’” Freud, according to Teleky, publicly remarked: “How clear! The knapsack she carried on her back in the dream naturally means her uterus.” Teleky responded to Freud’s unsolicited and tactless interpretation by dropping his class at the university (p. 43). According to Freud (1911), Schreber’s feelings of persecution were the product of “struggles against the libidinal impulse.” The feminine fantasy which aroused such violent opposition, said Freud, had “its root in a longing, intensified to an erotic pitch, for his father and brother” (p. 50). In Freud’s reconstruction, Flechsig stood for Schreber as a substitute for his brother and God as a substitute for his father, whom he had lost at the age of 19. Ferenczi rebelled as soon as the two men sat down in Palermo to start the working on Schreber, when Freud began dictating to Ferenczi rather than engaging him in a collaborative work. The “Palermo incident” remained a defining event in their relationship, frequently alluded to by both men. Ferenczi presented his initial version of the event in a letter to Groddeck on Christmas of 1921. He also referred to it in his clinical diary, in his entry for August 4 of 1932. Freud, wrote Ferenczi then: “could tolerate his being a son only until he contradicted him for the first time (Palermo)” (Dupont, 1985, p. 248). This remark suggests that Ferenczi did not approve of Freud’s line of thinking and interpretation of Schreber.

10 The fatal skin

La Peau de chagrin Sigmund Freud died in London on September 23, 1939. The date commemorated the day when Freud, 42 years earlier, was required to have stopped reciting the Jewish prayer for the dead (Kaddish) for his father. Freud, however, failed to perform his religious duties for Jacob. Freud not only failed to recite Kaddish for his father but continued to distance himself from the religion of his ancestors after Jacob’s death. It was on the very day when Freud had been required by Jewish law to stop reciting Kaddish for Jacob (September 23, 1897), however, that Freud officially joined the B’nai B’rith Society in Vienna (Knoepfmacher, 1979b, p. 65). The father of psychoanalysis and self-described “completely godless Jew”1 appears to have been silently and unconsciously affirming his status as a son of the covenant [B’nai B’rith] by his decision to join the organization.2 The product of a physician-assisted suicide, Freud’s death in 1939 appears to have been a well-calculated and unconsciously timed event. Freud’s death, let us recall, came after he had summoned his doctor, Max Schur, in order to help remind him of a pact they had agreed to and established with each other years earlier, namely, that if his suffering ever became intolerable and senseless, Schur would help him bring an end to his life. Schur kept his promise, injecting his most famous patient with morphine on the very day when Freud had called on him to remind him of their earlier agreement and pact: September 21, 1939 (Schur, 1972). According to Mario Beira, September 21 stood as a symbolically charged date in the calendar for Freud as well, for it also marked the day when Freud, 42 years earlier, wrote Fliess in Munich to announce his decision to abandon his so-called seduction theory and discard his “theory of the father.” Freud’s announcement to Fliess then allowed him to drop his earlier charges against Jacob of having been a seducer and child molester, indeed of having been “responsible for the hysteria of my brother [Alexander] . . . and those of several younger sisters” (Freud to Fliess, February 8, 1897). There was yet another event at the end of Freud’s life, however, which was laden with heavy unconscious symbolic meaning for him. The last book Freud read before asking Schur to administer the fatal injection was

234 The fatal skin Balzac’s La Peau de chagrin. Balzac’s novel is about a young man named Raphael de Valentin who, while on his way to commit suicide in Paris, decides to stop at a small antique shop. The shop owner soon offers him a magical piece of animal skin. The object, a talisman, is able to grant any and all of Raphael’s wishes but shrinks a little each time that it does. Ignoring the warnings given him by the shopkeeper who had offered the magic skin, the novel’s hero decides to purchase the skin and soon begins “wishing for unlimited power, for wealth, for prestige, for having others at his feet, for vindictive triumph” (Portnoy, 1949). As his life draws to an end, however, Raphael finds himself in a decrepit and miserable state of despair. When Freud finished with the book he told Schur that it had been the right novel for him to read: “it is about shrinking and dying,” said Freud to his doctor. Schur, who had not read the novel, failed to grasp the meaning of Freud’s words. It was only later that he realized their deeper significance and logic, finding in Freud’s words a hidden reference to the death of his father Jacob Freud 43 years earlier. Jacob, in his last days, had himself been “steadily shriveling up,” as Freud wrote Fliess on September 29 of 1896, three weeks before Jacob passed away on October 23. According to Kollbrunner (2001), Freud’s words to Fliess in September 1896 anticipated the process of his later struggles with his cancer of the mouth, the very illness which brought so much pain and personal suffering to Freud. A letter written by Freud on August 2, 1923 to his brother Alexander confirms that Freud had indeed associated his own cancer of the mouth with Balzac’s novel early on: “My peau de chagrin (Balzac),” wrote Freud to his younger brother then, “has also become short, and it is precisely for that reason that I want to use the last morsels dearly, I want to see Rome once more and give Anna a great joy.”3 It was during the months following his letter to Alexander about the magic or fateful skin that Freud composed his essay on “The economic problem of masochism.” Circling back to the notion of fate or destiny, a recurrent theme in his work, Freud (1924c) wrote: The course of childhood development leads to an ever-increasing detachment from parents, and their personal significance for the super-ego recedes into the background . . . The last figure in the series that began with the parents is the dark power of Destiny which only the fewest of us are able to look upon as impersonal. (p. 168) Let us recall that the idea of “retribution on the part of destiny” materialized in the founding dream of psychoanalysis in connection with the white patch Freud encountered as he examined Irma’s mouth by the light of an open window. This scene, we note, triggered thoughts for Freud which were associated with “diphtheria” (a word derived from ‘diphtherai’: skin,

The fatal skin 235

Figure 10.1 Illustration of Balzac’s La Peau de chagrin, drawn by Adrien Moreau (1897). (Courtesy of Laboratorio fotografico del Gabinetto Viesseux.)

parchments, and biblical scroll). Freud, for his part, was to refer to this word as one of ill omen, as a word “which ††† is not named in the dream.” The three crosses – an exorcising sign chalked on the inside of doors in peasant homes to help ward off danger – anticipated the Three-Amen formula in Freud’s Irma dream, thus dispelling the horrid spectacle of Irma’s open mouth in the dream. We ourselves cannot help but to associate all this with Freud’s own mouth and its fate. Freud’s difficult battle with mouth cancer has struck many as indeed somehow bound to destiny and fate. The first to have entertained the thought, outside of Freud himself, appears to have been George Groddek who, on January 4, 1924, brought Freud’s attention to the fact that he was now 67 years old and that the number in question was found in an earlier figure to which Freud had associated in The Psychopathology of Everyday Life (Freud, 1901b).4

236 The fatal skin The idea of a “fated death,” which emerged during the years of Freud’s self-analysis as an obsessive symptom, would in time transform into a recurrent concern in Freud’s life and a constant theme in his work (Schur, 1972). The fact that Freud associated his cancer of the mouth with Balzac’s La Peau de chagrin suggests that he indeed had not viewed his illness as a simple product of his lifelong addiction to cigar smoking but, rather, as a direct message which issued from the dark power of destiny itself. It also allows us to situate the “leukoplakia” (literally, “white patches”) which Felix Deutsch had spotted on the mucous membranes of Freud’s oral cavity in 1923 into a broader symbolic context. I speak here in particular of that portion of skin which Freud felt had infiltrated his body during his Irma dream. The second surgery performed on Freud’s oral cancer had been so extensive that it required his surgeon to have to construct a prosthetic device to help separate the patient’s oral and nasal cavities and keep Freud’s mouth in place. Over the course of the next 16 years, Freud endured more than 30 operations to treat the proliferation of the cancerous lesions in his mouth, a condition which had indeed been exacerbated by his heavy smoking, a fixation and oral dependency which Freud was never able to conquer. According to Max Schur (1972), it led to a life of “endless torture” for Freud (p. 364). The fact that Freud’s life and suffering had been brought to an end by Schur by making use of a symbolically dirty and poisonous needle (Spritze), Beira argues, tapped directly back into the closing line of Freud’s most famous dream, his dream of Irma’s injection. A number of scholars who have researched and analyzed Freud’s life have been struck by the uncanny parallel to be found between the mouth as locus morbi in the Irma dream and the mouth cancer which surfaced years later. A number of these authors have attempted to isolate the possible unconscious meaning at work in this curious coincidence. The Irma dream, argued Hersh (1995), managed to present Freud with a preview of his own future. In a similar vein, Madelon Sprengnether (2003) has contrasted Freud’s masculine competence and phallic self-image with the helplessness and passivity which Irma exhibited in Freud’s founding dream. Irma’s helplessness, passivity, and victimization in the dream, argues Sprengnether, broke and spoke through the very image of her injured mouth – the “imagistic center” of Freud’s Irma dream. By diverting our attention from the dream’s most powerful spectacle – its scene of oral violation – the phallic interpretation which Freud presented served to “suppress the orally violated ‘feminine’ identification that runs, like a flashing subliminal message, through his dream” (p. 271). To quote Sprengnether further: “With a vicious irony and fatality, Freud’s disavowed identity with Irma returned to plague him in later life” (p. 271). Freud’s mouth would indeed eventually bear the burden of the image of his patient’s mouth in the dream; this fact, argues Sprengnether, offers “silent testimony to the legacy of trauma embedded in the [founding] dream of psychoanalysis” (p. 260). As Sprengnether adds: “It’s as though Freud’s dream had turned to nightmare – one in which he was condemned to play the role of Irma until he died” (p. 273).

The fatal skin 237 Commenting on Sprengnether’s perceptive reading of Freud’s Irma dream, Mario Beira (2012) wrote to her to share his view that the dream’s “imagistic center,” the mouth, was itself present in Freud’s name, to wit, the “Mund” [mouth] found in the second half of “Sigmund.” In his communication to Sprengnether, Beira also highlighted the fact that Freud dropped “Mund” from his name when designing the plaque that he, in a letter he sent to Fliess on June 12 of 1900, fantasized would one day come to adorn the place where he dreamt his dream: “Here, on July 24, 1895, the secret of the dream revealed itself to Dr. Sigm. Freud.” The progressive shrinking of the magic skin in Balzac’s novel can here be seen to match Freud’s own decision to shrink his Christian name, from Sigismund to Sigmund. The cut which Freud performed on his birth name, reminiscent of circumcision, thus appears to be structurally and symbolically connected to his existential act and decision to change his name from Sigismund to Sig..mund. Commenting on the attitude which people exhibit toward their names, we recall Freud’s own observation and remark in his dream book that people appear “to have grown” them into “like our skin” (p. 207). Returning to Balzac’s novel, we note that its title was translated into German as “Das Chagrinleder” [The Wild Ass’s Skin] and that it was also rendered into that language as “Die Schicksalshaut” [The Fatal Skin] and “Die tödlichen Wünsche” [The Mortal Wish]. The novel was published in English under the title The Magic Skin. As noted, Balzac’s novel centers around a talisman, a piece of skin which has the power to fulfill any and all wishes of the person who possesses it but shrinks a little each time a wish is granted to its owner. The more it shrinks, the closer its owner comes to death and the less time he has to live. According to Eddy de Klerk (2008, p. 299), the magic skin in Balzac’s novel must have reminded Freud of the piece of skin removed from the tip of his penis during his brith milah, the most symbolically important event during Freud’s first days. The hero of the novel, de Klerk also noted, had purchased the magic skin in a store which was owned by an old Jewish merchant. The magic parchment itself, we are told, bore the Seal [Signet] of Salomon, a name which matched “the same Hebrew name (Schlomo) which Freud received [soon] after his circumcision, but later rejected” (p. 299). Interesting here as well is that the ancient biblical texts are traditionally written on animal skin. Attempting to expand on the symbolic field which arises from the connection between magic skin and wish fulfillment, Eddy de Klerk (2008) observed: The magic of the talisman obviously hints back to Freud’s first childhood, as the unlimited wish-fulfillment. But why is it that the owner of the talisman must also be punished for the fulfillment of his wishes? Through circumcision, the penis, as the place where sexual satisfaction

238 The fatal skin takes place, becomes a suitable symbol for the satisfaction of every wish. The fact is bound to a traumatic experience from the beginning. The possession and use of the talisman—i.e. foreskin—magically renovates the capacity of the intact penis to fulfill every wish. At the same time it also hints at the catastrophe of circumcision. We must not forget that Freud equated castration with death. The equivalence is not accidental and can perhaps be seen as an unconscious signal of the mortal terror which the newborn child must have experienced during the course of his circumcision. (p. 299) The piece of skin (foreskin) which Sigismund lost as a result of his circumcision, according to de Klerk, transformed into “a magic place of life and death” for Freud, a veritable “Schicksalshaut” [skin of destiny].5 Balzac’s novel also features material which tapped into a theme central to Freud’s life, his love for two women. As a child, Freud’s love and affection was channeled in the direction of two women (his mother and his Catholic nanny). This pattern continued into adulthood with Martha and Minna. As de Klerk reminded us while speaking of Balzac’s novel: “The hero [in the novel] oscillates between two loves. Finally there appears in the book the ambivalence towards the mother. While dying he bites the loved one on her breast” (p. 300). De Klerk’s observations deserve serious consideration. I would like to expand on his provocative reading of the material by way of two personal observations. Freud was in my view consciously aware of the connections which de Klerk pinpointed when glossing and interpreting Freud’s decision to turn to and read Balzac’s novel as his life drew to a close. Balzac’s text, moreover, appears to have been very much in Freud’s mind at the time of his Irma dream. During a period of rampant anti-Semitism, Freud had obviously been unable to freely discuss and examine the role which circumcision might have played in his inaugural dream and, by extension, in his founding of psychoanalysis. Freud’s hesitancy to speak freely on this subject might explain the deeper reasons for Irma’s reluctance to open her mouth properly in Freud’s dream. Traumas and the difficulties humans have about speaking about traumatic events are as we know structurally related to each other. Freud’s reluctance to broach the topic of circumcision early on in his career was undoubtedly tied to the rampant and virulent anti-Semitism which plagued Vienna at the time. It was also joined to Freud’s traumatic past and aversion towards Jewish rituals and ceremonies. Freud, moreover, had likely encountered the practice of female circumcision at the time of his pediatric training and was most likely shocked and scandalized by it. He most likely never felt fully free to denounce the practice, however, as some of the leading medical authorities in Vienna, and in Europe, vigorously endorsed it at the time. We can also surmise that Freud must have experienced similar feelings in relation to Jewish authority figures around

The fatal skin 239 him when he decided against having his male children circumcised. One such figure must have been Professor Samuel Hammerschlag, his childhood Hebrew teacher and father of Anna Hammerschlag, a patient he treated in 1895 and who appeared to him as the central figure in his Irma dream. My second observation concerns the moment when circumcision became symbolic for Freud of the “Schicksalshaut” [skin of destiny]. De Klerk traced the moment all the way back to the event of Freud’s actual circumcision. Despite the fact that the event situated the entire framework of the narrative in place, I am inclined to think that Freud’s circumcision only became meaningful to him après coup, that is to say, much after the event. The instances in Freud’s life which paved the way toward this above all included the circumcision of Freud’s two younger brothers (Julius and Alexander) as well as his encounter with the practice of female circumcision when he began to work directly with patients as a physician. There remains another crucial moment which served to link together these various and different instances and which led to the installation of a drama which eventually found representation in Freud’s fantasy of having symbolically murdered his father Jacob, an observant Jew. I speak of Freud’s decision not to circumcise any of his male children.

Freud’s alienation from Judaism Together with the Christian name that all Jewish children were required by law to receive from their parents after being born, Freud was also presented with a Hebrew name by his father when he was circumcised on May 13, 1856. Jacob settled on the name Schlomo for his newborn son. Jacob chose this Hebrew name for his son to honor his own father, Freud’s paternal grandfather Schlomo, who passed away just a few months prior to Freud’s birth in Freiberg. The Christian name which Jacob offered his son was of course Sigismund. According to Mario Beira, Jacob appears to have been affirming the Jewish and Hasidic tradition of naming with his choice of names for Freud. Jewish fathers who follow and honor that tradition typically settle on a Christian name for a child which squares, matches, or affirms the initial letter of the child’s Hebrew name, or vice versa. If so, Beira argues, the letter Shin (‫)ש‬, initial letter in Schlomo (‫)מלש‬, must have functioned as a key signifier in Freud’s unconscious. The letter Shin not only served to refer Freud back to the aleph of the Hebrew name he had received from his father but to the initial letter of the Christian name which Jacob presented him as well. This is because the letter S in the Latin alphabet corresponds to the letter Shin in Hebrew. The name Sigismund itself, if written in Hebrew, begins with Shin. This logic, claims Beira, makes it highly unlikely that Jacob presented the name “Moses” to his son Julius for a Hebrew name, something that Maciejewski

240 The fatal skin (2006) claims and calls upon to interpret Freud’s fascination with Moses. A more likely choice by Jacob for Julius was the name Joseph, a name which Beira argues would not only explain why Freud (1900) found it so “very easy to hide . . . behind people of that name” but why the name Joseph arrived to play such a “great part” in Freud’s “dreams” (p. 484, fn. 2). We think here of Freud’s “non vixit ” dream in particular (pp. 421–425). Jacob Freud indeed came from a Hasidic background and milieu and, judging from the evidence and while he might have indeed been a member of the Hebrew movement named “Haskala” (Bergmann, 1976), appears to have been a pious and religiously observant Jew who read the Bible and Talmud on a regular, if not daily, basis. Jacob appears to have tried to win his favorite son over to Judaism in a number of ways. He instructed young Sigismund on the art of reading, for example, by using the Bible as a basic text. Jewish scripture was indeed the main instrument which Jacob called upon to provide his son Sigismund with an education up until Freud began attending a formal school around the age of nine. We also know that Jacob decided to send his son, from age seven until about the age 13, to Samuel Hammerschlag – father of a woman who later became Freud’s patient and triggered his Irma dream – for private instruction in Hebrew and the Bible (Falk, 1978, p. 372). Freud possessed a natural gift for languages and handled Greek and Latin as well as a number of modern languages, including French, Italian, and Spanish, with ease. Jacob not only brought his son up to observe and respect Jewish tradition and customs but attempted to make sure that Sigismund would receive a solid introduction to Judaism and a working knowledge of the language of scripture (Leshon Hakodesh). Freud, however, would years later claim being unable to read any Hebrew (Schneider & Berke, 2000). In order to make better sense of all this contradictory and diverging information, Berke and Schneider (2003, p. 727) advanced the hypothesis that the founder and father of psychoanalysis suffered from a split in his personality, identifying and contrasting an overt Freud (who at times denigrated and distanced himself from his roots and origins) with a hidden or private Freud (knowledgeable of and fascinated by Jewish ideas and practices). Despite his father’s Hasidic background, Freud apparently never used his Hebrew name and took active steps to distance himself – beginning in his adolescence and continuing into his adult life – from Judaism and its accompanying rituals. Commenting on Freud’s aversion to Judaism, Falk (1978) wrote: Freud could not accept his father’s Judaism, as he could not accept his father. He . . . forgot his Hebrew, carefully avoided Jewish nationalism (and Zionism), and suppressed the inclination to espouse it. Only at the age of 70, in his address to the B’nai B’rith Society in Vienna, could Freud discuss his lifelong struggle with his Jewishness. (p. 374)

The fatal skin 241 Freud’s estrangement from the religion and belief system of his ancestors seems to have begun during his early adolescent years, a period when childhood fantasies are consolidated into a family romance. The starting point of Freud’s family romance appears to trace back to his fantasy of substituting his Jewish mother Amalia for his Roman Catholic nanny. According to a number of authors, the death of Julius Freud on April 15, 1858, when Sigismund was a month short of celebrating his second birthday, together with Amalia being pregnant with Anna, rendered his mother emotionally unavailable, fostering Freud’s attachment to the nanny who cared for him then and who had regularly brought him to Catholic church services in Freiberg with her. Wendy Colman (1994) proposes that Freud had been significantly traumatized by the event of the circumcision of his younger brother Julius during his “prehistoric” period back in Freiberg. His mother later gave birth to another male child, Alexander, on April 19 of 1866, just before Freud turned ten years of age. It was on the occasion of his brother’s circumcision eight days later (on April 26) that the newly arrived boy received his Hebrew and Christian names from his father: Efraim and Alexander (Klerk, 2008, p. 279). Alexander’s Hebrew name had been personally selected by Jacob to honour his own father’s father, his paternal grandfather Efraim. The child’s Christian name, however, was chosen by Sigismund Freud himself. Freud settled on the name Alexander for his brother and chose it in honour of the greatest military conqueror of the ancient world, the Hellenic hero Alexander the Great. We do not know what Christian name Jacob might have had in mind for his son Efraim. Beira informs me that the name Efraim, in Hebrew, is spelled aleph-peh-resh-yod-mem. Aleph, the initial letter of the Hebrew alphabet, corresponds to our A, opening letter in the Latin alphabet. Beira reconstructs that Freud selected Alexander for his brother in light of this fact. The name Alexander, he argues, came to Freud because Jacob had made it clear to Sigismund, and to other family members participating in the family council to help name the boy, that the child’s Christian name had necessarily to begin with the letter A in order to affirm aleph, the initial letter in Efraim: ‫ֶא‬, Freud’s naming of Alexander, Beira argues, must have served to remind Freud then that his two names (Schlomo and Sigismund) were each launched by the letter Shin.6 Freud, ten years old at the time, had obviously managed to gain a symbolic victory over his father Jacob by virtue of imposing his choice of a Christian name for his newly arrived brother. Freud reportedly recited the entire story of Alexander the Great’s Macedonian triumphs during the informal family gathering convened by Jacob to help pick out a name for his just-arrived son. It seems clear that Freud’s choice of a name for his brother then served to anticipate his future Hellenism and later imposition of a Hellenic identity over an underlying Jewish template.

242 The fatal skin Sigismund must have participated in Alexander’s brith milah ceremony soon after the boy was born and must have retained an active memory of the event. Given the importance which certain “impressions” played in Freud’s theory – Freud spoke of “a terrible storm of emotion” in relation to the sight of a girl’s genitals (Freud, 1925b, p. 252), for instance – we can safely assume that the ten-year-old boy must have been deeply impacted by the chastisement of his little brother’s penis, the Alexander whom he greeted, just a few days earlier, by presenting him with the name of a great Hellenic hero. It was not long after the event of Alexander’s circumcision that Freud experienced a great disillusionment and a turning point in his life. Freud reported that he must have been “ten or twelve years old” when Jacob disclosed an event in which he had been forced to cede ground to an anti-Semitic gentile and to step off the pavement into the muddy street. Sigismund’s relationship with his father, which had been close and intimate until then, changed forever. Further unfolding the leitmotif of his family romance, to wit, his fantasy of having substituted his Jewish mother Amalia with his Roman Catholic nanny, Freud now repudiated his father, “the big strong man” who had been holding “the little boy by the hand” when Jacob recounted his “unheroic conduct,” to wit, his failure to stand up to and challenge the aggressive anti-Semite. Freud responded to his dismay by turning to the Semitic Hannibal, a figure who helped to satisfy his need for a more pugnacious ego-ideal at the time. The Hannibal fantasy which Freud singled out in an effort to help him forge his individual identity was likely the product of a reaction. Freud’s turning to Hannibal might have involved his own “masculine protest,” a result of Alexander’s circumcision and the emotions and fantasies which Freud associated with the event. Freud’s period of adolescent rebellion began with his Hannibal fantasy. It was punctuated by his decision to change his name just a few years later. According to Klein (1987), since the name Sigismund had been an all too typical Christian name given to Jewish children at the time, with people constantly making Sigismund jokes, Freud decided to drop the name by shortening it to Sigmund. Freud’s decision has been seen by some as a sign of his growing ability at the time to affirm the naming tradition of his ancestors. It has also been viewed as a manifestation of an oedipal project and of his capacity to symbolically father himself. The fact that Freud had managed to symbolically surpass Jacob by presenting his brother Alexander with a Christian name might have served in Sigismund’s case to encourage him to take action on his own name only a few years later. Freud’s name change was not smooth, with the future founder of psychoanalysis exhibiting what Peter Gay (1988) has described as Freud’s “curious vacillations.” As Gay has indicated, Freud experimented and switched back and forth between the two names during his adolescent years. According to Jones, Freud had definitively changed his name by 1878, when he was 22 years old (Jones, 1953). The first movement toward enacting the name change, however, was traced back by Klein (1987) to “1869 or 1870”

The fatal skin 243 (p. 46), when Freud was 13 or 14 years of age. Thus, the name change was both thematically and chronologically connected to Sigismund’s symbolic victory over Jacob at the time of Alexander’s brith milah, as well as to his Hannibal fantasy and the construction of a new identity through a name change; as Freud (1913a) himself once observed: “A man’s name is a principal component of his personality, perhaps even a portion of his soul” (p. 112). Since Freud received his Schlomo and Sigismund names at the time of his brith milah, De Klerk (2008, p. 297) views Freud’s decision not to use his Hebrew name as an unconscious sign of protest by him against the ritual. Freud’s decision to shorten his name from “Sigismund” to “Sigmund” also stood, in De Klerk’s view, as a form of masculine protest by him against circumcision indeed as involving a displaced form of symbolic self-circumcision. Picking up on Freud’s later habit of signing himself off in his letters as “Sigm” – a practice which pushed the German “Sieg” [“victory” or “triumph”] into the foreground – de Klerk (2008) argues that Freud, by “giving his own name to himself,” had managed to emancipate himself “from his painful past and asserted himself as triumphant” (p. 298).7 Freud, as we know, traveled to Paris and Berlin from Vienna for his studies in 1885–1886. Once back in Vienna, he embraced the teachings of Charcot, affirming the non-connection between hysteria and the genital organs. When Freud’s first male child entered the world in 1889, Freud named him JeanMartin, in honor of the man who had challenged the genital localization of hysteria. Freud decided not to have Jean-Martin circumcised and, as far as we know, never presented his first-born son, or any of his children, with a Hebrew name. Would Freud have arrived at his decision had he not encountered the medical practice of circumcision during his early days as a physician? Freud’s decision to not circumcise his sons served to break a long family tradition in the family in which Judaism was transmitted from one generation to the other through ritual circumcision. When Freud’s second son was born in 1891, he named him Oliver, after Oliver Cromwell, the famed British military leader. His third son, Ernst, born a year later, was named by Freud in honour of Ernst Brücke, the great German scientist who had served as Freud’s mentor. Freud’s dissent from the medical establishment thus became entangled with his opposition to religion, paving the way for an inmixing of religion and medicine (priests and doctors) in his case. This inmixing, I argue, helped to give shape to Freud’s Irma dream in the summer of 1895. It also contributed, four years later, to the final dream Freud dreamt to bring the process of his formal self-analysis to an end, to wit, his dream of his self-dissection of the pelvis, a dream built around the metaphorical and literal meaning of “Brücke” (bridge) and thus the man after whom Freud had named his last son in 1892. In the final scene in his dream, when Freud fathoms he might be able to use the body of his two children as boards to help him pass over a chiasm, he suddenly wakes up from his dream in a state of panic and fear. The bridge between generations had in Freud’s case been broken, cut off by Freud’s decision not to leave his final son, named after Brücke (bridge), uncircumcised.

244 The fatal skin It becomes clear from Freud’s own naming practices that he felt himself entitled to pursue his own ideals, despite family or social pressures. Indeed, the ideals of independence and autonomy featured in Freud’s work as a highly valued goal. Yet, Freud’s antireligious feeling at times also featured an overreaction. During the first weeks of his marriage to Martha, for instance, he forbade her from lighting Sabbath candles on Friday evening, creating a situation which Martha, who had been raised in a religious and observant Jewish household, later identified as the only unpleasant experience of her marriage (Gay, 1987, p. 153; Rice, 1994, p. 251). We don’t know just how Martha reacted when she learned that her husband decided not to have their male children circumcised, keeping them from symbolically entering the Jewish covenant. Freud’s decision, to be sure, must have been deeply painful to his parents, his father Jacob in particular. As Rice (1994) aptly observed: “one can correctly surmise that [Jacob and Amalia] could not have been too happy at the absence of this crucial religious ritual in their grandchildren” (p. 252). The heavy emphasis which Freud placed on shame during the course of his self-analysis – I am referring to the memory Freud retrieved when he, at the age of seven or eight, urinated in his parent’s bedroom and his father, in a moment of anger, pronounced that his son would come to nothing (Freud, 1900, p. 216) – takes on added meaning in view of the disappointment which Jacob must have experienced when he learned that his favorite son had decided not to circumcise his male children. Jacob must have not only resented but experienced his son’s decision with disappointment and shame. The earlier situation, in which the son felt shame for the father’s unheroic behavior, had now been reversed; it was now the father, Jacob, who likely felt disappointment and ashamed of his son for his behavior. This framework helps to explain why Jacob, on the occasion of Freud’s 35th birthday in 1891, decided to present his son with a newly bound copy of the old family Bible which he, years earlier, had used to help his son master the art of reading. Jacob decided to take the old and tattered book and, rebinding with a new leather cover, presented it to his “dear son Schlomo” as a birthday present. Jacob’s gift was accompanied by a moving dedication written in Hebrew. In it, we find Jacob reminding his son of the fact that his grandfather (Schlomo) had been a Rabbi, as had also been the case with his great-grandfather, Ephraim.8 A careful and close reading of Jacob’s birthday dedication to Freud was presented by Emanuel Rice in his 1990 book Freud and Moses: The Long Journey Home, a study which amply and convincingly reveals the depth of Jacob’s religious sentiment, attachment, and faithfulness to Judaism. In his dedication Jacob called on the Hebrew phrase “shivray luhoth” to characterize his son’s decision to discard the Philippson Bible they had read together years earlier. According to Ostow (1989, p. 487), by using this phrase Jacob was suggesting that his son had shattered his

The fatal skin 245 Bible just as Moses had done with the original tablets. This is an important observation, for it might help to explain the origins of a number of Freud’s fantasies and, more importantly, a central source for his powerful identification with Moses. As Goodnick (1992, p. 345) has brought to our attention, Jacob, in his Hebrew dedication to his son, made use of “a verse with the term Shaddai, Almighty”. Jacob’s words to Freud in the dedication, argued Goodnick, were not simply meant as a “birthday acknowledgement” but were also “intended” as a “love offering” meant to help overcome and bridge “the hiatus of many years of psychological distance between father and son, based presumably on their different approaches to their heritage” (pp. 359–360). Might we not conclude from this that Jacob decided to present Freud with the gift of the Freud family bible and wrote the Hebrew dedication in order to help remind his son “Schlomo” of the duty which every Jewish father had been commanded by God to fulfill in relation to each and every son, namely, that of inscribing His name on the male organ of generation? The inscription in question, as noted, is produced through the practice of milah, the event during which every Jewish male child is presented with his Hebrew and Christian names to enter the ancient covenant which El Shaddai established with the Jewish people through Abraham.

The dissent The theme of not having fulfilled one’s duties was an important and central theme in Freud’s Irma dream. Freud (1900) viewed his founding dream as signaling in the direction of his struggles and battles against his “opponents” (p. 295). Read at a surface level, Freud’s opponents at the time of his dream were precisely those “physicians” who were “ignorant of hysteria” (p. 115); yet medicine, in Freud’s founding dream, had somehow come to be conflated with religion. Freud did not know whether the child that Martha carried at the time would be a boy or a girl when he dreamt his dream. Moreover, he had not yet selected a name for the child, his sixth and final.9 Freud, in this particular instance, was once again being forced to confront the consequences of his choices, choices which touched on matters relating to sex, language, and names. Freud’s decision to leave his sons uncircumcised, we can also assume, served to expose his conflicts with the figure of the father. During the following years it would be this very theme, bearing on the question of the “father,” which became the central focus and topic of Freud’s self-analysis. Despite the obvious displacement from religion toward the field of medicine found at work in the Irma dream, once the question is turned back in the direction of the innocent Dr. Rie, Freud’s reproaches against him become more transparent: Dr. Rie (Otto) is reprimanded by Freud as the one who was “unclean” – a reproach which unconsciously tapped back into

246 The fatal skin Freud’s decision to not circumcise his boys.10 Freud’s choice perhaps also likely led him to feel concern that he might be marginalized, isolated, and even shunned by his fellow Jews. Freud’s Irma dream, as Erikson indicated, opens in a convivial and joyful atmosphere. The feeling of “We-ness” and celebration is lost, however, as soon as Freud takes steps to examine Irma’s throat in the dream. It was at that precise moment that Freud’s feeling of isolation in the dream began to surface. The feeling of belonging was only re-established thanks to Freud’s displaced indignation against Oscar Rie, the impure one who was quickly cast by him into the role of a disbeliever (Erikson, 1954, p. 31) – thereby relieving Freud from any and all blame. The Irma dream indeed reveals Freud’s desire to exculpate and cleanse his person of any and all guilt. Not only was the accusation turned against the innocent Dr. Rie in the dream but the impurity was also magically eliminated via dysentery: “Dr. M. said: ‘It’s an infection, but no matter. Dysentery [Dysenterie] will supervene and the toxin will be eliminated’ ” (Freud, 1900, p. 106). The word “dysentery” linked a number of crucial words and key signifiers into a phonemic network which, beginning with “Rie,” proceeded to passed through “Diphte-Rie,” “Hyster-Rie,” and “Dysente-Rie” (diphtheria, hysteria, dysentery; cf. Mahony, 1977, p. 89). This secret verbal thread allows us to isolate the word dissent as an important structural element within Freud’s dream. Freud, as we know, deeply disliked and had a visceral aversion towards all religious ceremonies; holding nothing sacred except for the pursuit of truth, he refused to participate in any religious event. In Freud’s dream, an entire group of ideas and people are associated with Dr. Rie (the one “who did not understand me, who sided against me, and who made me a present of liqueur with an aroma of amyl”). This group is in the dream contrasted with a number of ideas associated with Wilhelm Fliess, the one “who did understand me, who would take my side, and to whom I owed so much valuable information, dealing, amongst other things, with the chemistry of the sexual processes” (Freud, 1900, p. 294). Trimethylamin, the signifier of the covenant with Fliess, is here opposed, as a sort of reactive formation, to “amyl,” the signifier of the painful impression which had contributed to triggering the dream. The word “amyl,” as previously indicated, presents us with the very same phonemes found in “milah,” the Hebrew word for “cut.”11

The sacred realm of the unconscious In his essay on “The antithetical meaning of primal words” Freud (1910d) noted that in Latin sacer meant both “sacred” and “accursed,” presenting “a complete antithesis in meaning without any modification of the sound of the word” (p. 159). In Totem and Taboo, he observed that among the ancient Romans the notion of sacer was the same as the Polynesian idea of taboo, while adding: “To us it means, on the one hand, ‘sacred’, ‘consecrated’, and

The fatal skin 247 on the other ‘uncanny’, ‘dangerous’, ‘forbidden’, ‘unclean’ ” (Freud, 1913a, p. 18). Freud discussed and treated this same idea in his Introductory Lectures on Psychoanalysis (1916–1917, p. 179), as well as in An Outline of Psychoanalysis (1938b, p. 169) and Moses and Monotheism (1939), where the antithetical meaning of the word was traced back by him to the ambivalence which in general dominates the [child’s] relation to the father. The Latin sacer, as Freud (1939) explained, “means not only ‘sacred’, ‘consecrated’, but also something that we can only translate as ‘infamous’, ‘detestable’ ” (p. 121). In the Irma dream this duplicity speaks through the horrible vision which the dream presented Freud through the disturbing image of Irma’s mouth as well as through the trimethylamin chemical formula which suddenly appeared to him in the dream in heavy type. Strangely enough, Freud decided not to present his readers with a visual representation of the formula. Glossing Freud’s omission, Patrick Mahony (1977) noted: “Since [Freud] had visualized that formula, it presents no problem with representability and so stands alone among all the elements in the staged dream. This extraordinary allusiveness of the reported dream is equally an elusiveness and indication of strong censorship” (p. 94). The first analyst who attempted to comment on the meaning of the trimethylamin formula in Freud’s dream was Jacques Lacan. Instead of N(CH3)3, Lacan decided to present his followers with an expanded version of the chemical formula, one which featured its threefold shape as well as the French chemical nomenclature for nitrogen, Azote or AZ, rather than N. This allowed Lacan to highlight not only the symbolic structure of the formula but its sacred or religious dimension as well: In Lacan’s view, A and Z stood for alpha and omega, the ever-present God who is “All-in-one.” In order to disarticulate the signifier from the signified, Lacan proposed that AZ could also be replaced by the N, the

c N

c

N N N N N N N

Figure 10.2 Image of the chemical formula for trimethylamin, as presented by Lacan in seminar 2.

248 The fatal skin opening letter of the word “Nemo,” (meaning “no one” in Greek) thereby supporting and advancing his own theoretical position on the ego. “Like the oracle,” said Lacan (1954–1955): The [chemical] formula gives no reply whatsoever to anything. But the very manner in which it is spelt out, its enigmatic, hermetic nature, is in fact the answer to the question of the meaning of the dream. One can model it closely on the Islamic formula There is no other God but God. There is no other word, no other solution to your problem, than the word. (p. 158) Lacan, who was raised in a deeply Catholic milieu, filtered Freud’s formula through a central element to Christianity, namely, the Incarnation. The idea that “the Word became flesh” (Gospel of John) is turned by Lacan into its opposite to interpret Freud’s dream: “The flesh (the horrible gap, the trauma, the cut) became word.” Remarkably, the graphic representation of the trimethylamin formula which appeared to Freud in bold type in his Irma dream upon closer inspection appears to itself embody the shape of the Hebrew letter Shin (‫)ש‬, perhaps the most symbolically meaningful letter in the Hebrew alphabet. The letter Shin not only partakes of a triadic shape, as does Freud’s chemical formula, but signals in the direction of God Almighty in Judaism, indeed towards the function of the Name and naming as well. The link between the trimethylamin formula in Freud’s dream and the letter Shin was first noted by Gérard Haddad (1981). In his book on the Talmudic sources of psychoanalysis, Haddad argued that the letter Shin, which appeared to Freud in his dream through the chemical formula, stood as a signifier for one of God’s names in particular, El Shaddai (He who stopped Abraham’s arm as he was about to sacrifice his son Isaac). The very idea of protection and being spared from death is itself associated with the mezuzah, the object which observant Jews place on the right doorpost of their homes. The mezuzah features the letter Shin on its outer casing. Beira informs me that the letter Shin came to be featured on the mezuzah as a result of an event which transpired much after the near-sacrifice of Isaac on Mount Moriah, namely, the first Passover and the blood of an unblemished lamb which the Jews in exile were commanded by God to place on the side posts and upper door post of their houses as a sign, in order to make the angel of death, who was executing judgment against the gods of Egypt, pass over their homes (Exodus 12:23). The letter appears

Figure 10.3 The letter Shin of (or in) the Hebrew alphabet.

The fatal skin 249 and is featured in the mezuzah in order to remind all those entering a Jewish home of El Shaddai, the God of the Covenant, to wit, His promise to protect the children of Israel. As we have seen in a previous chapter, the Isaac event and Passover tapped directly back into the long struggle against the sacrificing of children, a practice which, in Judaism, was replaced by circumcision. The notion that circumcision was introduced as a token of the covenant with Abraham was both rejected and dismissed by Freud (1939) in Moses and Monotheism as a “clumsy invention” (p. 45). As Leonard Shengold (1993, p. 70) observed: “Freud’s view dissociated circumcision from Father Abraham and also from Jacob by depriving them of their historical existence.” There is indeed a deep and striking continuity at work between the Irma dream, in which the symbol of the covenant with Abraham is suppressed and overwritten with a scientific formula and Freud’s last monumental work, and Moses and Monotheism (1939), a text where circumcision is dismissed by Freud as a fossil and the covenant between God and Abraham is effectively erased and dissolved by him. The deeper point, however, is that Freud did not dismiss circumcision in his work but replaced it with castration instead. By doing so, Freud appears to have taken steps to erase the covenant itself, coining and proposing a new symbol to replace and override the ancient practice of sacrificing children, this time a universal one. This helps us to circle back to the founding dream of psychoanalysis and its relationship with the theme of sacrificing children, a topic announced in Freud’s dream by the word Propylaea, the ceremonial gateway of Greek temples. Reflecting on the dream work of his founding dream, Freud (1900) realized that the word amyl fell under the influence of this Greek term, a crucial intermediate element which, by “means of simultaneous condensation and displacement” (Freud, 1900, p. 295; 1901a, p. 657) pushed the repressed element (amyl) in the direction of a line of signifiers (propyl . . . propyls . . . propionic acid) which contributed to the eventual emergence of trimethylamin within the dream. The Greek words Propyls and Propylaea refer to an anatomical part of the female body, the labia. Once translated into German, as Erikson (1954, p. 26) noted, it yields Vorhof, a word which opens and points to yet another line of association, namely, the words Vorname [name] and Vorhaut [foreskin]. These two words provide the piece of skin [Hautpartie] which infiltrated Freud’s body in his dream with a more precise meaning. In the end, it led Freud to identify with Irma and, behind her, Emma. Finally, referring to an anatomical part of the body and to the ceremonial gateway of Greek Temples as it does, the word Propylaea allows us to link flesh and stones and to align and associate the human body with a house, building, or architectural structure. The Irma dream, as we know, opens up in a large hall, a place designed for entertainment and secular festivity. The event being celebrated (a birthday) is suddenly replaced in the dream by a children’s hospital. In the second half of the dream the secular ceremony begins to take on religious overtones. In his formalistic analysis of this dream, Mahony (1977) noted

250 The fatal skin that certain linguistic aspects of the dream symbolized the “reversibility of the dream’s total structure,” thereby reinforcing the idea that the Irma dream presents us with an interesting instance of one of those dreams that “yield meaning if read backwards” (p. 89; cf. Freud, 1900, p. 328). Read forward, the Irma dream appears to narrate the story of Emma Eckstein’s nasal surgery and to reveal that the operation had repeated and reactivated the trauma which Emma had suffered as a child when she was circumcised. Read in reverse or backwards, however, the Irma dream seems to narrate the story of a brith milah (those of Alexander and of Julius and Freud himself) which, as with all circumcisions on Jewish male children, ends in a celebration and a festive banquet. What each of these readings ultimately appears to suggest is that Emma’s half-effaced labia had served to transport Freud back to his origins, to wit, his entry into the world and the event of his circumcision eight days later. Beira (2012), for his part, proposes that the shape of the Hebrew letter Shin (‫ )ש‬which is found embodied in the trimethylamin formula functioned in Freud’s case as a signifier for the initial name (Schlomo) he had received from Jacob at the time of his circumcision in Freiberg. It is of course important to recall that Jacob decided to address his son by “Schlomo” in the birthday dedication he penned to him thirty-five years later, in May of 1891. The fact that Jacob wrote the dedication in Hebrew and to bridge the hiatus between father and son strongly supports Beira’s line of interpretation. An important question to ask here is this: why would a name which Freud had abandoned return to him via a dream and a chemical formula whose shape itself embodied the initial letter of each of his names? I can’t help here but be reminded of an autobiographical passage which Freud inserted in his 1891 monograph On Aphasia. Discussing the final words which the speech apparatus produces just before a shock, words which the aphasic repeats again and again, Freud observed the following: I remember having twice been in danger of my life, and each time the awareness of the danger occurred to me quite suddenly. On both occasions I thought, “This is the end [of you]” [“Jetzt ist es aus mit dir”], and while otherwise my inner language proceeds with only indistinct sound images and hardly more intensive lip movements, in these situations of danger I heard these words as if somebody was shouting them into my ears, and at the same time I saw them as if they were printed on a piece of paper fluttering in the air. (Freud, 1891/1953, pp. 61–62) What Freud apparently experienced at the moment when Irma opened her mouth in the dream was a similar situation of peril. The action of opening Irma’s mouth, as I’ve more than once observed, suggests a double meaning, pointing towards the act of vocalization and speaking. Thus in the founding

The fatal skin 251 dream of psychoanalysis we find two of three elements present in the danger or peril situation described by Freud: the lip movement (Irma’s mouth) and the printed letters fluttering in the air (the formula of the trimethylamin). The only thing missing is the sound of the words. Freud, in his 1897 draft on “the architecture of hysteria,” had noted that in dreams we “hear nothing; but we see.” This stands in contrast with the scenes produced by hysterics, scenes which are “manufactured by means of things that are heard” (Masson, 1985, p. 240). The words which were in this instance visualized rather than heard by Freud through his dream were brith milah. Central to Freud’s dream and encoded through the word trimethylamin, they must have served to condense in Freud’s mind the genital mutilation and trauma which his patient Emma had suffered during childhood. In a short article published in 1939, Otto Isakower called our attention to the role which hearing, language, and words play in the formation of the superego. To help illustrate and highlight their link, Isakower referred us to the very same perilous situations which Freud had himself called upon in his work on aphasia. The link between utterances and the superego is clearer in the case of the Hebrew words brith milah, words which were highly significant for Freud in light of the duties, religious and otherwise, which he had failed to fulfill as a Jew and son of covenant. They also served as the starting point of his conflicts with Jacob, indeed the process of rapprochement and atonement with the figure of the father in general, a process which Freud, in Totem and Taboo, described as involving a “deferred obedience” (Freud, 1913a, p. 145). The German word used by Freud, Gehorsams, suggests a clear connection with the auditory sphere – the same link is implied by the etymology of the English word obey, which derives from the Latin ob + audire, to listen and hear. These passing observations are sufficient for us to see just why psychoanalysis was born with and out of this particular dream dreamt by Freud in the summer of 1895. Freud’s specimen dream serves to highlight and gives voice to a unique commandment, namely, that of remembering rather than repeating or acting out. Freud would come to underscore the value of this idea and principle time and again in his later work. The commandment and duty to remember, so central to Judaism itself, calls on each one of us to transform repetition and the drive into knowledge. The same commandment, central to psychoanalytic praxis as envisioned and dreamt by Freud, can also be seen operating in Freud’s own effort to replace religion with science; in Freud’s dream, the attempt is symbolized, if not captured, by the bold trimethylamin chemical formula which presented itself to Freud through his inaugural founding dream. This helps us to circle back to Freud’s final “novel,” to wit, Balzac’s La Peau de chagrin. At the start of the novel, we discover its hero planning to end his life by jumping from a bridge and drowning himself in the river Seine. While on his way to his suicide, however, Raphael finds himself attracted to a peculiar shop of antiquities. He enters the establishment to find a Jewish shopkeeper who soon begins to discuss “the great secret of human life with

252 The fatal skin him”. The great secret in the end boiled down to three simple words, words which Balzac wrote in capital letters in his novel: VOULOIR, POUVOIR, and SAVOIR. We could easily translate this mystic trio into the language of psychoanalysis: libido, wish fulfillment, and knowledge. Will or libido [vouloir], the shopkeeper explains, consumes us; power or wish fulfillment [pouvoir] destroys us, while knowledge [savoir] soothes and calms us. The hero of the novel, however, is, like Faust, tempted by the promise of an unlimited number of wish fulfillments and chooses the magic skin, thereby deciding his fate and the sad destiny and verdict inscribed in the peau de chagrin itself. The word chagrin, in French, not only means shagreen but misery as well; a similar double meaning can be found at work in Freud’s own magic word: “trimethylamin.” There remains one final detail which calls for analytic reflection. In Studies on Hysteria, published only a few months before Freud dreamt his Irma dream, Breuer ridiculed the idea of a single causal nexus of hysteria, comparing the idea to the attempt to insert “the different rooms of a manystoreyed house into the plan of a single storey” (Breuer & Freud, 1895, p. 244). This was exactly what Freud and Fliess were attempting to do when endorsing the thesis of a single etiological formula. What the Irma dream helps to show is that, through displacement and condensation, many rooms, storeys, and even buildings of different ages and types can stand together “all-in-one.” The trimethylamin formula which magically materialized within the heart of Freud’s dream can thus be heard as Freud’s own unconscious reply and attempt to join hands to Josef Breuer for, as Freud (1900) noted about the word “trimethylamin” in his dream, “So many important subjects converged upon that one word” (p. 117).

Notes 1 Discussing the relationship between psychoanalysis and religion, Freud wrote to Oskar Pfister on October 9, 1918: “Incidentally, why was it that none of all the pious ever discovered psycho-analysis? Why did it have to wait for a completely godless Jew?” Freud’s self-description was glossed and rendered famous by Peter Gay (1987). 2 I am grateful to Mario Beira for having drawn my attention to the interesting connections between these dates. We know that Jacob Freud died on October 23, 1896 and, further, that the prayer for the dead, in the Jewish tradition, is to be recited by the oldest son for his father for exactly 11 months, starting from the day of death (Kohler and Neumark, 1983, p. 384). Beira has not only brought these facts and revealing connections to my attention but also points out to me that Freud’s death in London in 1939 occurred on Yom Kippur, the most solemn day in the entire Hebrew calendar, the day when Jews are required to ask God for forgiveness for past sins they have committed against Him. 3 The letter, stored today in the Library of Congress in Washington, D.C, is discussed in The Correspondence of Sigmund Freud and Sándor Ferenczi, vol. 3, 1920–1933, p. 111 (Falzeder & Brabant, 2000).

The fatal skin 253 4 While correcting the proofs of his dream book Freud decided to leave all mistakes in his manuscript untouched and offered the number 2467 as an arbitrary figure to estimate the number of mistakes a careful reader would find in his text. Freud soon realized that his age at the time was 43 and that adding 24 to the number yielded 67, a figure which he then devised as the age of his own future demise. While Freud’s prediction failed to materialize, his doctor, Schur, would later observe that Freud’s mouth cancer first appeared in 1923, the year Freud turned 67. 5 According to de Klerk (2008), Freud’s fascination with Balzac’s novel also signaled back to his death wishes against Julius, the younger brother who had died in April of 1858, at the age of six months. Thanks to the talisman, the hero of the novel murdered an opponent in a duel. As a consequence of his wish being granted, however, the skin shrank a bit more, leading Raphael de Valentin to realize that his opponent’s magic death had at bottom involved a kind of selfmurder. In the same way, Freud struggled with guilt feelings throughout his life which issued from his having wished his younger brother (Julius) dead, if only because his wish had indeed been magically fulfilled. 6 The Hebrew alphabet contains no vowels, only consonants. The pronunciation of the letter aleph is strictly determined by the pronunciation mark offered to the letter just beneath it in a text. When presented with three dots in the form of a triangle (seghol), as in the case of Efraim, aleph is read as “e” rather than “a.” The name “Emma,” written in Hebrew, offers a clear instance of this rule. Beira also informs me that two Hebrew names often offered to girls named Emma are “Emunah” and “Amalia.” The name “Amalia,” it turns out, not only matched the name of Freud’s mother but the name of Emma’s mother as well: Amalia Eckstein, née Wahle, born in 1836. The fact that Freud and Emma each had mothers named Amalia, Beira argues, fed and strengthened the process of Freud’s unconscious identification with Emma. 7 Beira (2007) surmises that Freud’s decision to remove “is” from Sigismund to rename himself tapped back on “Israel,” the Biblical patriarch who had received this name from God as a new name during his famous wrestling match with the angel, a gesture which finally allowed the biblical Jacob to obtain the paternal blessing from the figure of the father he had sought for so long. Beira (1992) argues that Freud’s name change, if read to the letter, hints at both the primal murder of the father as well as the totemic meal which Freud had theorized in light of Goethe and the question of “the beginning” to bring Totem and Taboo to a close. 8 Jacob not only addressed his son in the dedication as his “dear son Schlomo” but signed himself off to him in the text as “Jacob son of Rabbi Sh(lomo) Freud.” Goodnick (1992) has offered the following commentary on Jacob’s words: “the title ‘Reb’ [Rabbi] (indicated by the letter ‫ ר‬before Jacob’s father’s initial ‫ שּ‬for Shlomo, Sigmund’s Hebrew name) is not a title of authority or spiritual leadership but one of courtesy applied to any fellow Jew. Yet in his earlier Hebrew recording of his own father’s death in the same Bible he writes ‘ha-Rav (= Rabbi) Shlomo son of ha-Rav Ephraim’. This may suggest that Jacob Freud was descended from a line of rabbinical scholars, whereas he himself became engaged from his early days in business pursuits” (p. 347). Jacob’s decision to address his son by the name “Schlomo” served to remind Freud of the very first name he had received from his father. The fact that Jacob then signed himself

254 The fatal skin off to him as the son of Rabbi Schlomo should be seen as involving an attempt by him to underscore the fact that they were bound together by their Jewish origins. It is important to notice that Jacob made use of a single letter, the letter Shin, to refer his son to the name in question. 9 Freud eventually settled on two possible names: Anna, in honour of the daughter of his former Hebrew teacher Samuel Hammerschlag, the “young lady” who appeared to him in his Irma dream, or Wilhelm, after Wilhelm Fliess, his best friend and interlocutor at the time. As his letter to Fliess of October 20, 1895 bears witness, Freud arrived at these two names as possible names for his sixth and final child three months after dreaming his Irma dream, six weeks before Martha eventually gave birth to a girl in early December of 1895. 10 While pondering the persistence and history of the ritual of circumcision in Moses and Monotheism, Freud (1939) remarked that those who had adopted the practice “felt proud of it.” According to him: “They feel exalted by it, ennobled, as it were, and look down with contempt on the others [those not circumcised], whom they regard as unclean” (pp. 29–30). 11 I for one wonder whether Freud’s intense relationship and feelings for Fliess were in part based on a common and shared aversion towards religion. De Klerk (personal communication dated September 3, 2009) informed me that Wilhelm Fliess eventually decided to break from the Jewish community and that the actual break occurred on November 4, 1926. De Klerk consulted many of the archives of the Jewish communities in Germany in the hope of finding Fliess’s Hebrew name and date of his circumcision. He found Fliess’s “day of dissent,” instead the date when Fliess formally broke away from and left the Jewish community: November 4, 1926. I state for the record that I have been unable to verify this information.

Bibliography

Note Where two dates are given, the later date refers to the publication date of the English translation. Abraham, K. (1920). Manifestation of the female castration complex. In: Selected Papers of Karl Abraham. London: Hogarth Press, 1927, pp. 338–369. Abraham, K. (1924). A short study of the development of the libido, viewed in the light of mental disorder. In: Selected Papers of Karl Abraham. London: Hogarth Press, 1927, pp. 418–501. Abraham, N. (1963). Le «crime» de l’introjection. In : N. Abraham and M. Torok (eds) L’écorce et le noyau. Paris: Aubier Flammarion, 1978, pp. 123–131. Abraham, N., & Torok, M. (1972). Mourning or melancholia: Introjection versus incorporation. In: The Shell and the Kernel. Chicago: University of Chicago Press, 1993, pp. 125–138. Abraham, N., & Torok, M. (1978). L’écorce et le noyau. Paris: Aubier Flammarion. English translation: The Shell and the Kernel. Chicago: University of Chicago Press, 1993. Anthi, P. R. (1990). Freud’s dream in norekdal style. Scandinavian Psychoanalytic Review, 13: 138–160. Anzieu, D. (1959). L’auto-analyse de Freud et la découverte de la psychoanalyse. Paris: PUF. Anzieu, D. (1986a). Freud’s Self-Analysis. New York: International Universities Press. Anzieu, D. (1986b). The place of Germanic language and culture in Freud’s discovery of psychoanalysis between 1895 and 1900. International Journal of Psychoanalysis, 67: 219–-226. Appignanesi, L., & Forrester, J. (1992). Freud’s Women. London: Virago Press. Arlow, J. A. (1952). The psychobiological origins of circumcision by C. D. Daly. Psychoanalytic Quarterly, 21: 437. Arlow, J. A. (1955). Notes on oral symbolism. Psychoanalytic Quarterly, 24: 63–74. Armstrong, R. H. (2005). A Compulsion for Antiquity: Freud and the Ancient World. Ithaca, NY: Cornell University Press. Aron, L. (1992). From Ferenczi to Searles and contemporary relational approaches Psychoanalytic Dialogues, 2: 181–190. Aron, L. (1996). A Meeting of Minds. Hillsdale, NJ: The Analytic Press. Aron, L., & Starr, K. (2013). A Psychotherapy for the People: Toward a Progressive Psychoanalysis. New York: Routledge.

256 Bibliography Baginsky, A. (1877 [1883, 1898–1900]). Handbuch der Schulhygiene zum Gebrauche für Ärzte, Sanitätsbeamte, Lehrer, Schulvorstände und Techniker. [Handbook of School Hygiene.] Berlin: Denicke. Baginsky, A. (1883 [1889, 1892, 1896]). Lehrbuch der Kinderkrankheiten für Ärzte und Studierende. [Handbook of Pediatrics for Doctors and Students.] Braunschweig: Verlag von Friedrich Wreden. Baginsky, A. (1895a). Die hygienischen Grundzüge der mosaischen Gesetzgebung. [The hygienic foundations of mosaic constitution.] Deutsche Vierteljaresschrift für öffentliche Gesundheitspflege, 27: 465–491. Baginsky, A. (1895b). Die Serumtherapie der Diphtherie nach den Beobachtungen im Kaiserund Kaiserin-Friedrich Kinderkrankenhaus in Berlin. [The Serum-Therapy of Diphtheria after the Observations in the Children Hospital Kaiser- und Kaiserin Friedrich in Berlin.] Berlin: A. Hirschwald. Baginsky, A. (1898). Diphterie und diphteritischer Croup. In: H. Nothnagel (ed.) Specielle Pathologie und Therapie. Vienna: A. Holder. Baginsky, A. (1901). Über Suggestion bei Kindern. Zeitschrift für Pädagogische Psychologie und Pathologie, 3/1: 96–103. Barker-Benfield, G. J. (1976). The Horrors of the Half-Known Life: Male Attitudes Toward Women and Sexuality in Nineteenth-Century America. New York: Harper & Row. Behrend, F. J. (1860). Über die Reizung der Geschlechtstheile, besonders über Onanie bei ganz kleinen Kindern, und die dagegen anzuwendenden Mittel. [On the stimulation of the sexual parts, especially on onanism in very small children, and the means to employ against it.] Jahrbuch für Kinderkrankheiten, 35: 321–329. Beira, M. (1992). Lacan, psico-análysis y el Dios de Moisés. In: Lacan en Estados Unidos, translation and selection of texts by Donna Bentolila-Lopez. Argentina: Homo Sapiens, pp. 119–138. Beira, M. (2007). Fidel Castro Ruz: una interpretación psicoanalítica. Introduction to Julia Miranda’s Diario para Uchiram: Cuba 1962–1969. Madrid: Verbum. Beira, M. L. (2012). Letter to Madelon Sprengnether (January 6, 2012). Unpublished manuscript. Bergmann, M. S. (1976). Moses and the evolution of Freud’s Jewish identity. Israeli Annals of Psychiatry and Related Disciplines, 14: 3–26. Bergmann, M. S. (1992). In the Shadow of Moloch: The Sacrifice of Children and its Impact on Western Religions. New York: Columbia University Press. Bergmann, M. S. (1995). The Jewish and German roots of psychoanalysis and the impact of the holocaust. American Imago, 52: 243–259. Bergmann, M. S. (2007). The taming of God’s aggression and the need for a loving God. Annual of Psychoanalysis, 35: 111–119. Berke, J., & Schneider, S. (2003). Repairing worlds: An exploration of the psychoanalytical and kabbalistic concepts of reparation and tikkun. The Psychoanalytical Review, 90: 723–749. Bernfeld, S. (1946). An unknown autobiographical fragment of Freud. American Imago, 4: 3–19. Bernfeld, S. (1949). Freud’s scientific beginnings. American Imago, 6: 163–196. Bernfeld, S. (1953). Freud’s studies on cocaine, 1884–1887. Journal of the American Psychoanalytic Association, 1: 581–613. Bernfeld, S., & Cassirer Bernfeld, S. (1952). Freud’s first year in practice, 1886–1887. Bulletin of the Menninger Clinic, 16: 37–49. Bertin, C. (1982). Marie Bonaparte: A Life. New York: Harcourt Brace.

Bibliography 257 Bettelheim, B. (1954). Symbolic Wounds: Puberty Rites and the Envious Male. New York: Collier Books, 1962. Bion, W. R. (1962). Elements of Psychoanalysis. London: Heinemann. Bloch, I. (1907). The Sexual Life of our Times. (English translation.) New York: Falstaff Press 1928. Blum, H. P. (1977). The prototype of preoedipal reconstruction. Journal of the American Psychoanalytic Association, 25: 757–785. Blum, H. P. (1990). Freud, Fliess, and the parenthood of Psychoanalysis. Psychoanalytic Quarterly, 59: 21–40. Blum, H. P. (1996). The Irma dream, self-analysis, and self-supervision. Journal of the American Psychoanalytic Association, 44: 511–532. Bókay, A. (1998). Turn of fortune in psychoanalysis: The 1924 Rank debates and the origins of hermeneutic psychoanalysis. International Forum of Psychoanalysis, 7: 189–199. Bonaparte, M., Freud, A., & Kris, E. (eds) (1950). Aus den Anfängen der Psychoanalyse. Briefe an Wilhelm Fliess, Abhandlungen und Notizen aus den Jahren 1887–1902. English translation: The Origins of Psychoanalysis: Letters to Wilhem Fliess, Drafts and Notes: 1887–1902. London: Imago, 1954. Bonomi, C. (1994a). Why have we ignored Freud the “paediatrician”? The relevance of Freud’s paediatric training for the origins of psychoanalysis. In: A. Haynal, E. Falzeder (eds) 100 Years of Psychoanalysis: Contributions to the History of Psychoanalysis. Special Issue of Cahiers Psychiatriques Genevois. London: H. Karnac (Books), pp. 55–99. Bonomi, C. (1994b). “Sexuality and death” in Freud’s discovery of sexual aetiology. International Forum of Psychoanalysis, 3: 63–87. Bonomi, C. (2000). La psicologizzazione del trauma. Nascita e tramonto della diagnosi di “nevrosi traumatica” (1870–1920ca). Teoria & Modelli, n.s., 5(1–2): 125–161. Bonomi, C. (2002a). Kassowitz Institute. In E. Erwin (ed.) The Freud Encyclopedia: Theory, Therapy, and Culture. New York: Routledge, pp. 301–302. Bonomi, C. (2002b). Baginsky Adolf. In E. Erwin (ed.) The Freud Encyclopedia: Theory, Therapy, and Culture. New York: Routledge, pp. 41–43. Bonomi, C. (2007). Sulla soglia della psicoanalisi. Freud e la follia del bambino. [On the Threshold of Psychoanalysis: Freud and the Insanity of the Child.] Turin: Bollati Boringhieri. Bonomi, C. (2009). The relevance of castration and circumcision to the origins of psychoanalysis. 1. The medical context. International Journal of Psychoanalysis, 90: 551–580. Bonomi, C. (2013). Withstanding trauma: The significance of Emma Eckstein’s circumcision for Freud’s Irma dream. The Psychoanalytic Quarterly, 82 (3): 689–740. Borch-Jacobsen, M., & Shamsadani, S. (2012). The Freud Files: An Inquiry into the History of Psychoanalysis. Cambridge: Cambridge University Press. Borgogno, F. (2011). The Girl who Committed Hara-Kiri and Other Historico-Clinical Essays (English translation). London: Karnac Books, 2013. Boyarin, D. (1997). Unheroic Conduct: The Rise of Heterosexuality and the Invention of the Jewish Man. Berkeley, CA: Stanford University Press. Brabant, E., Falzeder, E., & Giampieri-Deutsch, P. (1993). The Correspondence of Sigmund Freud and Sándor Ferenczi, Volume 1, 1908–1914. Cambridge, MA: Harvard University Press.

258 Bibliography Breuer, J., & Freud, S. (1895). Studies on hysteria. In: S. Freud, SE 2. Byck, R. (ed.) (1974). Cocaine Papers by Sigmund Freud. New York: Stonehill Publishing. Carter, K. C. (1980). Germ theory, hysteria and Freud’s early work in psychopathology. Medical History, 24: 259–274. Carter, K. C. (1983). Infantile hysteria and infantile sexuality in late nineteenthcentury German-language medical literature. Medical History, 27: 186–196. Charcot, J. M. (1890). Leçons sur les maladies du système nerveux. Oeuvres complètes vol. III, Paris: Lecrosnier et Babé. Colman, W. (1994). “The scenes themselves which lie at the bottom of the story”: Julius, circumcision, and the castration complex. Psychoanalytic Review, 81: 603–625. Compton, A. (1992). The psychoanalytic view of phobias – Part I: Freud’s theories of phobias and anxiety. Psychoanalytic Quarterly, 61: 206–229. Cope, D. K. (1998). Neonatal pain: The evolution of an idea. Newsletters, American Society of Anesthesiologists, September, 1–3. Cotti, P. (2007). Hunger and love: Schiller and the origin of drive dualism in Freud’s work. International Journal of Psycho-Analysis, 88: 167–182. Daly, C. D. (1950). The psycho-biological origins of circumcision. International Journal of Psycho-Analysis, 31: 217–236. Darby, R. (2003). The masturbation taboo and the rise of routine male circumcision: A review of the historiography. Journal of Social History, 36: 737–758. Darby, R. (2005a). A Surgical Temptation: The Demonization of the Foreskin and the Rise of Circumcision in Britain. Chicago: University of Chicago Press. Darby, R. (2005b). Pathologising male sexuality: Lallemand, spermatorrhoea and the rise of circumcision. Journal of the History of Medicine and Allied Sciences, 60: 283–319. Davidson, A. I. (1987a). Sex and the emergence of sexuality. Critical Inquiry, 14: 16–48. Davidson, A. I. (1987b). How to do the history of psychoanalysis: A reading of Freud’s three essays on the theory of sexuality. Critical Inquiry, 13 (2): 252–277. Davidson, A. I. (1990). Closing up the corpses: Diseases of sexuality and the emergence of the psychiatric style of reasoning. In G. Bools (ed.) Meaning and Method: Essays in Honour of Hilary Putnam. Cambridge: Cambridge University Press, pp. 295–325. Davis, D. (1990). Freud’s unwritten case. Psychoanalytic Psychology, 7: 185–209. Derrida, J. (1976). Fors: The anglish words of Nicolas Abraham and Maria Torok. English translation in: N. Abraham, & M. Torok (eds) The Wolf Man’s Magic Word: A Cryptonimie. Minneapolis: Minnesota University Press, 1986, pp. xi–xlviii. Derrida, J. (1996). Archive Fever: A Freudian Impression. Chicago, IL: University of Chicago Press. Domhoff, G. W. (1969). But why did they sit on the King’s right in the first place? Psychoanalytic Review, 56: 586–596. Dupont, J. (1985). The Clinical Diary of Sándor Ferenczi. Cambridge: Harvard Universities Press, 1988. Eckstein, E. (1904). Die Sexualfrage in der Erziehung des Kindes. [The Question of Sexuality in the Raising of Children.] Leipzig: Curt Wigand. Eilig, P. (2005). Baginsky on aphasia. Journal of Neurolinguistics, 18: 301–315. Eissler, K. R. (1971). Talent and Genius: The Fictitious Case of Tausk Contra Freud. New York: Quadrangle Books.

Bibliography 259 Eissler, K. R. (1985). A farewell to Freud’s interpretation of dreams. American Imago, 42: 111–129. Eissler, K. R. (1997). Preliminary remarks on Emma Eckstein’s case history. Journal of the American Psychoanalytic Association, 45: 1303–1305. Eissler, K. R. (2001). Freud and the Seduction Theory: A Brief Love Affair. Madison, CT: International Universities Press. Ellenberger, H. F. (1968). Freud’s lecture on masculine hysteria (October 15, 1886): a critical study. In: M. S. Micale (ed.) Essays of Henri Ellenberger in the History of Psychiatry. Princeton, NJ: Princeton University Press, 1993, pp. 119–135. Ellenberger, H. F. (1970). The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry. New York: Basic Books. Ellenberger, H. (1972). The story of Anna O.: A critical review with new data. In M. S. Micale (ed.) Essays of Henry Ellenberger in the History of Psychiatry. Princeton, NJ: Princeton University Press, 1993, pp. 254–272. Elms, A. C. (1980). Freud, Irma, Martha: Sex and marriage in the “Dream of Irma’s injection.” Psychoanalytic Review, 67: 83–109. Erichsen, J. E. (1866). On Railway and Other Injuries of the Nervous System. London: Walton & Maberly. Erichsen, J. E. (1875). On Concussion of the Spine, Nervous Shock, and Other Obscure Injuries of the Nervous System in their Clinical and Medico-legal Aspects. London: Longmans Green. Erikson, E. (1954). The dream specimen of psychoanalysis. Journal of the American Psychoanalytic Association, 2: 5–55. Fairbairn, W. D. (1944). Endopsychic structure considered in terms of object-relationships. International Journal of Psycho-Analysis, 25: 70–92. Falk, A. (1978). Freud and Herzl. Contemporary Psychoanalysis, 14: 357–387. Falzeder, E. (2002). The Complete Correspondence of Sigmund Freud and Karl Abraham 1907–1925. London: Karnac. Falzeder, E., & Brabant, E. (2000). The Correspondence of Sigmund Freud and Sándor Ferenczi, Volume 3, 1920–1933. Cambridge, MA / London: Harvard University Press. Feldman, Y. S. (1993). “And Rebecca loved Jacob,” but Freud did not. Jewish Studies Quarterly 1: 72–88. Ferenczi, S. (1920). Notes and fragments. In: Final Contributions to the Problems and Methods of Psycho-Analysis. London: Hogarth Press, 1950, pp. 216–218. Ferenczi, S. (1923). On the symbolism of the head of Medusa. In: Further Contributions to the Theory and Technique of Psycho-Analysis. London: Hogarth Press, 1950, p. 360. Ferenczi, S. (1924). Thalassa: A Theory of Genitality. London: Karnac Books, 1989. Ferenczi, S. (1926). Gulliver phantasies. In: Final Contributions to the Problems and Methods of Psycho-Analysis. London: Hogarth Press, 1950, pp. 41–60. Ferenczi, S. (1930–1932). Notes and fragments. In: Final Contributions to the Problems and Methods of Psycho-Analysis. London: Hogarth Press, 1950, pp. 219–279. Ferenczi, S. (1931). Child-analysis in the analysis of adults. In: Final Contributions to the Problems and Methods of Psycho-Analysis. London: Hogarth, 1955, pp. 126–142. Ferenczi, S. (1933). Confusion of tongues between adults and the child. In: Final Contributions to the Problems and Methods of Psycho-Analysis. London: Hogarth Press, 1950, pp. 156–167. Fichtner, G. (1989). Freuds Briefe als historische Quelle. Psyche, 43: 803–829. Fisher-Homberger, E. (1975). Die traumatische Neurose. Vom somatischen zum sozialen Leiden. Bern: Hans Huber.

260 Bibliography Fitzgerald, M. (1998). The birth of pain. Medical Research Council News, summer, pp. 20–23. Flechsig, P. T. (1884). Zur gynäkologicshen Behandlung der Hysterie. [For the gynecologic treatment of hysteria.] Neurologisches Zentralblatt, 19/20: 1–18. Fleischmann, L. (1878). Über Onanie und Masturbation bei Säugligen. [On onanism and masturbation in babies.] Wiener medizinische Presse, 19: 8–10, 46–49. Fliess, W. (1893a). Die nasale Reflexneurose. In: Verhandlungen des Kongresses für innere Medizin. 12 Kongress, pp. 348–394. Fliess, W. (1893b). Neue Beiträge zur Klinik und Therapie der nasalen Reflexneurose. [New Contributions to the Clinical Treatment of the Nasal Reflex Neurosis.] Leipzig: Deuticke. Fliess, W. (1897). Die Beziehungen zwischen Nase und weiblichen Geschlechtsorganen. [The Relationship Between the Nose and the Female Sexual Organs.] Leipzig: Deuticke. Fliess, W. (1906). Der Ablauf des Lebens. In: Grundlegung zur exakten Biologie. Leipzig: Deuticke. Fliess, W. (1925). Von den Gesetzen des Lebens. Frankfurt am Main: Campus Verlag, 1985. Frazer, J. G. (1890). The Golden Bough. A Study in Comparative Religion. New York: McMillan, 1894. Freeman, E. (1971). Insights: Conversations with Theodor Reik. New York: Prentice Hall. Freud, E. L. (ed.) (1960). Letters of Sigmund Freud 1873–1939. London: Hogarth. Freud, S. (1886a). Report on my studies in Paris and Berlin. SE 1: 5–15. Freud, S. (1886b). Observation of a severe case of hemi-anaesthesia in a hysterical male. SE 1: 23–31. Freud, S. (1887). Rezension von: Über schwere diphteritische Lähmungen und deren balneotherapeutische Heilung (Berlin, Aug. Hirschwald, 1887). Zentralblatt für Kinderheilkunde, 1: 250. Freud, S. (1888). Hysteria. SE 1: 37–59. Freud, S. (1891). Zur Auffassung der Aphasien. Leipzig: Franz Deuticke. English translation: On Aphasia: A Critical Study. New York: International Universities Press; 1953. Freud, S. (1893a). Charcot. SE 3: 7–23. Freud, S. (1893b). Über ein Symptom, das häufig die Enuresis nocturna der Kinder begleitet. [On a symptom which often accompanies the enuresis nocturna of the child.] Neurologisches Zentralblatt, 12: 735–737. Freud, S. (1894a). The neuro-psychoses of defense. SE 3: 43–61. Freud, S. (1894b). Obsessions and phobias: their psychical mechanism and their aetiology. SE 3: 69–82. Freud, S. (1894c). On the grounds for detaching a particular syndrome from neurasthenia under the description ‘anxiety neurosis’. SE 3: 85–115. Freud, S. (1895a). A reply to criticisms of my paper on anxiety neurosis. SE 3: 119–139. Freud, S. (1895b). Review of Hegar’s Der Geschlechtstrieb Wiener klinische Rundschau In: M. Solms (ed.) A previously-untranslated review by Freud of a book on the sexual instinct. International Review of Psychoanalysis, 1990, 17: 361–363. Freud, S. (1895c). Project for a scientific psychology. SE 1: 283–397. Freud, S. (1896a). Heredity and the aetiology of the neuroses. SE 3: 141–156. Freud, S. (1896b). Further remarks on the neuro-psychoses of defence. SE 3: 157–185. Freud, S. (1896c). The aetiology of hysteria. SE 3: 187–221. Freud, S. (1897). Die infantile Cerebrallähmung. In: H. Nothnagel (ed.), Specielle Pathologie und Therapie. Vienna: A. Holder.

Bibliography 261 Freud, S. (1899). Screen memories. SE, 3: 303–322. Freud, S. (1900). The interpretation of dreams. SE, 4–5. Freud, S. (1901a). On dreams. SE, 5: 629–686. Freud, S. (1901b). The psychopathology of everyday life. SE, 6. Freud, S. (1905). Three essays on the theory of sexuality. SE, 7: 123–246. Freud, S. (1906). My views on the part played by sexuality in the aetiology of the neuroses. SE, 7: 269–279. Freud, S. (1907). The sexual enlightenment of children (an open letter to Dr. M. Fürst). SE, 9: 129–140. Freud, S. (1909a). Analysis of a phobia in a five-year-old boy. SE, 10: 1–150. Freud, S. (1909b). Notes upon a case of obsessional neurosis. SE, 10: 151–318. Freud, S. (1910a). Five lectures on psycho-analysis. SE, 11: 1–55. Freud, S. (1910b). Leonardo da Vinci and a memory of his childhood. SE, 11: 57–138. Freud, S. (1910c). The future prospects of psycho-analytic therapy. SE, 11: 139–152. Freud, S. (1910d). The antithetical meaning of primal words. SE, 14: 155–161. Freud, S. (1910e). A special type of choice of object made by men. SE, 11. 163–176. Freud, S. (1910f). The psycho-analytic view of psychogenic disturbance of vision. SE, 11: 210. Freud, S. (1911). Psycho-analytic notes on an autobiographical account of a case of paranoia (dementia paranoides). SE, 12: 9–82. Freud, S. (1913a). Totem and taboo. SE, 15: 1–240. Freud, S. (1913b). The claims of psycho-analysis to scientific interest. SE, 13: 163–190. Freud, S. (1913c). The theme of the three caskets. SE, 12: 291–301. Freud, S. (1914). On the history of the psycho-analytic movement. SE, 14: 1–66. Freud, S. (1915). Observations on transference-love (further recommendations on the technique of psycho-analysis III). SE, 12: 157–171. Freud, S. (1916a). A connection between a symbol and a symptom. SE, 14: 339–340. Freud, S. (1916b). A connection between a symbol and a symptom. SE, 14: 339–340. Freud, S. (1916–1917). Introductory lectures on psycho-analysis. SE, 15: 1–240; SE, 16: 243–463. Freud, S. (1917). Mourning and melancholia. SE, 14: 243–258. Freud, S. (1918a). From the history of an infantile neurosis. SE, 17: 1–124. Freud, S. (1918b). The taboo of virginity. SE, 11: 193–208. Freud, S. (1919a). ‘A child is being beaten’: A contribution to the study of the origin of sexual perversions. SE, 17: 179–204. Freud, S. (1919b). The ‘uncanny’. SE, 17: 217–256. Freud, S. (1920). Beyond the pleasure principle. SE 18: 3–64. Freud, S. (1921). Group psychology and the analysis of the ego. SE, 18: 65–144. Freud, S. (1922). Medus’s head. SE, 18: 273–274. Freud, S. (1923a). The Ego and the Id. SE, 19: 1–66. Freud, S. (1923b). The infantile genital organization (an interpolation into the theory of sexuality). SE, 19: 139–146. Freud, S. (1923c). Two encyclopaedia articles. SE, 18: 233–260. Freud, S. (1924a). The dissolution of the Oedipus complex. SE, 19: 173–179. Freud, S. (1924b). A short account of psycho-analysis. SE, 19: 191–212. Freud, S. (1924c). The economic problem of masochism. SE, 19: 155–170. Freud, S. (1925a). An autobiographical study. SE, 20: 7–70.

262 Bibliography Freud, S. (1925b). Some psychical consequences of the anatomical distinction between the sexes. SE, 19: 243–260. Freud, S. (1926a). Inhibitions, symptoms and anxiety. SE, 20: 77–174. Freud, S. (1926b). Psycho-analysis. SE, 20: 259–270. Freud, S. (1926c). The question of lay analysis. SE, 20: 181–258. Freud, S. (1926d). Address to the Society of B’Nai B’Rith. SE 20: 271–274. Freud, S. (1927). The future of an illusion. SE, 21: 5–56. Freud, S. (1930). Civilization and its discontents. SE, 21: 57–145. Freud, S. (1933). New introductory lectures on psycho-analysis. SE, 22: 1–182. Freud, S. (1936). A disturbance of memory on the Acropolis. SE, 22: 237–248. Freud, S. (1937). Analysis terminable and interminable. SE, 23: 209–254. Freud, S. (1938a). Splitting of the ego in the process of defence. SE, 23: 271–278. Freud, S. (1938b). An outline of psycho-analysis. SE, 3: 139–208. Freud, S. (1939). Moses and monotheism: Three essays. SE, 23: 1–138. Freud, S. (1986). Briefe an Wilhelhm Fliess 1887–1904. (Herausgegeben von J.M. Masson, Bearbeitung der deutschen Fassung von M. Schröter). Frankfurt am Main: Fisher. Freud, S., & Rie, O. (1891). Klinische Studie über die halbseitige Cerebrallahmung der Kinder, Beiträge zur Kinderheilkunde, 3:14, 239, 241–2, 245, 325. 20:14, 18. Freud, S. (1893). Zur Kenntniss der cerebralen Diplegien des Kindesalters. (Beiträge zur Kinderheilkunde, Neue Folge, Heft III) Leipzig und Wien: Franz Deuticke. Fromm, E. (1959). Sigmund Freud’s mission. London: Allen & Unwin. Gauchet, M. (1992). L’inconscient cérébral. [The Cerebral Unconscious.] Paris: Seuil. Gaupp, R. (1898). Zur Kritik der Verwendung des Begriffs “Trauma” in der Ätiologie der Nervenkrankheiten [Criticism of the usage of the notion of “trauma” in the etiology of nervous disorders.] Zentralblatt für Nervenheilkunde und Psychiatrie, 21 [N.F. 9]: 388–393. Gay, P. (1987). Freud: A Godless Jew: Freud, Atheism, and the Making of Psychoanalysis. New Haven: Yale University Press. Gay, P. (1988). Freud: A Life for Our Time. New York: Norton. Geller, J. (2004). The psychopathology of everyday Vienna: Psychoanalysis and Freud’s familiars. International Journal of Psycho-Analysis, 85: 1209–1223. Geller, J. (2007). On Freud’s Jewish Body. Mitigating Circumcisions. New York: Fordham University Press. Gicklhorn, J., & Gicklhorn, R. (1960). Sigmund Freuds akademische Laufbahn im Lichte der Dokumente. Vienna: Urban & Schwarzenberg. Gilman, S. L. (1991). The Jew’s Body. New York: Routledge. Gilman, S. L. (1992). Freud, race and gender. American Imago, 49: 155–183. Gilman, S. L. (1993). Freud, Race and Gender. Princeton, NJ: Princeton University Press. Goldfarb, M. (2009). Emancipation: How Liberating Europe’s Jews from the Ghetto led to Revolution and Renaissance. New York: Simon and Schuster. Gollaher, D. L. (1994). From ritual to science: the medical transformation of circumcision in America. Journal of Social History, 28: 5–36. Gollaher, D. L. (2000). Circumcision: A History of the World’s Most Controversial Surgery. New York: Basic Books. Goodnick, B. (1992). Jacob Freud’s dedication to his son: A reevaluation. The Jewish Quarterly Review New Series, 82(3/4): 329–360. Grant, G. H. (1951). Methods of treatment of neuromata of the hand. Journal of Bone and Joint Surgery of America, 33: 841–848.

Bibliography 263 Greenberg, J. R. & Mitchell, S. A. (1983). Object Relations in Psychoanalytic Theory. Cambridge, MA: Harvard University Press. Grigg, K. A. (1973). “All roads lead to Rome”: The role of the nursemaid in Freud’s dreams. Journal of the American Psychoanalytic Association, 21: 108–126. Grinstein, A. (1961). Freud’s dream of the Botanical Monograph. Journal of the American Psychoanalytic Association, 9: 480–503. Grinstein, A. (1980). Sigmund Freud’s Dreams. New York: International Universities Press. Grossman, W. I. (1967). Reflections on the relationships of introspection and psycho-analysis. International Journal of Psycho-Analysis, 48: 16–31. Guttmacher, H. (1885). Parke’s universal panacea. In: R. Byck. (ed.) Cocaine Papers by Sigmund Freud. New York: Stonehill Publishing, 1974, pp. 121–150. Haddad, G. (1981). L’Enfant illégitime: Sources talmudiques de la psychanalyse. Paris: Hachette. Hamot, B. (2006–2007). Le rêve de l’injection faite à Irma visité par la Théorie mimétique. Available online at: http://www.rene-girard.fr/57_p_3172/l-heritage-de-freud.html (accessed September 30, 2014). Hartman, F. R. (1983). A reappraisal of the Emma episode and the specimen dream. Journal of the American Psychoanalytic Association, 31: 555–585. Haynal, A. (1996). What correspondence between Freud and Ferenczi? International Forum of Psychoanalysis, 5: 159–164. Hegar, A. (1878). Die Castration der Frauen vom physiologischen und chirurgischen Standpunkte aus. [The Castration of Women.] Leipzig: Breitkopf und Härtel. Hegar, A. (1885). Die Zusammenhang der Geschlechtskrankheiten mit nervösen Leiden und die Castration bei Neurosen. [The Relationship of Sexual Illness to Nervous Diseases and Castration in Neuroses.] Stuttgart: Enke. Henoch, E. H. (1881). Die hysterischen Affectionen der Kinder. Wiener medizinische Presse, 22: 916–918, 951–952, 980–982, 1006–1009. Hersh, T. R. (1995). How might we explain the parallels between Freud’s 1895 Irma dream and his 1923 cancer? Dreaming, 5: 267–287. Herz, M. (1885). Über Hysterie bei Kindern. Wiener medizinische Wochenschrift, 35/43: 1305–1308; 44: 1337-1342; 45: 1368-1371; 46: 1401–1405. Hirschmüller, A. (1978a). Physiologie und Psychoanalyse in Leben und Werk Josef Breuers. Bern: Hans Huber. English translation: Life and Work of Josef Breuer: Physiology and Psychoanalysis. New York: New York University Press, 1989. Hirschmüller, A. (1978b). Eine bisher unbekannte Krankengeschichte Sigmund Freuds und Josef Breuers aus der Entstehungszeit der ‘Studien über Hysterie’. Jahrbuch der Psychoanalyse, 10: 136–168. Hirschmüller, A. (1986). Briefe Josef Breuers an Wilhelm Fliess 1894–1898. Jahrbuch der Psychoanalyse, 18: 239–262. Hirschmüller, A. (1989). Freuds ‘Mathilde’: Ein weiterer Tagesrest zum Traum. Jahrbuch der Psychoanalyse, 24: 128–159. Hirschmüller, A. (1991). Freuds Begegnung mit der Psychiatrie. Von der Hirnmythologie zur Neurosenlehre. [Freud’s Encounter with the Psychiatry. From Brain Mythology to the Doctrine of the Nerves.] Tübingen: Edition Diskord. Hochsinger, C. (1938). Die Geschichte des ersten Öffentlichen Kinder-Kranken-Institutes in Wien während seines 150 jährigen Bestandes 1788–1938. Vienna: Verlag des KinderKranken Institutes. Holt, R. R. (1965). A review of some of Freud’s biological assumptions and their influence on his theories. In: N. S. Greenfield, & W. C. Lewis (eds) Psychoanalysis

264 Bibliography and Current Biological Thought. Madison: University of Wisconsin Press, pp. 93–124. Reprinted in Holt, R. R. (1985) pp. 114–140. Holt, R. R. (1982). The manifest and latent meanings of metapsychology. Annual of Psychoanalysis, 10: 233–255. Reprinted in Holt, R. R. (1985), pp. 15–33. Holt, R. R. (1985). Freud Reappraised: A Fresh Look at Psychoanalytic Theory. New York: The Guilford Press. Holt, R. R. (2002). Review of ‘Freud and the seduction theory: A brief love affair’ by K. R. Eissler. American Imago, 59: 483–488. Horkheimer, M. & Adorno T. W. (1947). Dialectic of Enlightenment. Philosophical Fragments. Edited by Gunzelin Schmid Noerr, translated by Edmund Jephcott. Stanford: Stanford University Press, 2002. Huschka, M. (1938). The incidence and character of masturbation threats in a group of problem children. Psychoanalytic Quarterly, 7: 338–356. Isakower, O. (1939). On the exceptional position of the auditory sphere. International Journal of Psychoanalysis, 20: 340–348. Israel, J. (1880). Ein Beitrag zur Würdigung des Werthes der Castration bei hysterischen Frauen. Berliner klinische Wochenschrift, April 26: 241–246. English translation: Contribution to a discussion of the value of castration in hysterical women. In: J. M. Masson (ed.) A Dark Science: Women, Sexuality, and Psychiatry in the Nineteenth Century. New York: Farrar, Straus and Giraux, pp. 139–145. Janet, P. (1889). L’automatisme psychologique. Essai de psychologie expérimentale sur les formes inférieures de l’activité humaine. [The psychological automatism. Essay of experimental psychology on the inferior forms of human activity.] Paris: Félix Alcan (reprinted by Éditions Odile Jacob, Paris, 1998). Janet, P. (1893/1894). Quelques définitions récentes de l’hysterie (I and II). Archives de Neurologie, 1893; 26(77): 1–29; 1894, 25(76): 417–438. Jolly, F. (1892). Über Hysterie bei Kindern. Berliner Klinische Wochenschrift, 34: 841–845. Jones, E.(1953). Sigmund Freud: Life and Work, vol. I. The Young Freud: 1856–1900. London: Hogarth. Jones, E. (1955). Sigmund Freud: Life and Work, vol. II. Years of Maturity 1901–1919. London: Hogarth. Jung, C. G. (1912). Psychology of the Unconscious: A Study of the Transformations and Symbolisms of the Libido. New York: Moffat, Yard, 1916. Kaplan, K. J. (2002). Isaac versus Oedipus: An alternative view. Journal of the American Academy of Psychoanalysis, 30: 707–717. Kern, S. (1973). Freud and the discovery of child sexuality. History of Childhood Quarterly, 1: 117–141. Kern, S. (1975). The prehistory of Freud’s theory of castration anxiety. Psychoanalytic Review, 62: 309–314. Klein, D. B. (1987). Jewish Origins of the Psychoanalytic Movement. Chicago: University of Chicago Press. Klein, G. (1976). Psychoanalytic Theory: An Exploration of Essentials. New York: International Universities Press. Klerk, A. de (2003a). Het trauma van Freuds besnijdenis. [The trauma of Freud’s circumcision.] Tijdschrift voor Psychoanalyse, 9(3): 136–152. Klerk, A. de (2003b). Repliek. [Rejoinder.] Tijdschrift voor Psychoanalyse, 9(4): 251–255. Klerk, A. de (2003c). The femme fatale and her secrets from a psychoanalytical perspective. In: H. W. van Os (ed.) Femmes Fatales – 1860–2010. Wommelgem, Belgium: BAI, pp. 43–53.

Bibliography 265 Klerk, A. de (2004). Kastrationsangst und di Beschneidung Neugerorener. Anmerkungen zu Franz Maciejewski: “Zu einer ‘dichten Beschreibung’ des Kleinen Hans. Über das vergessene Trauma der Beschneidung.” Psyche, 58/5: 464–470. Klerk, A. de (2008). Die Bedeutung der Kastrationsangst und der Beschneidung in Freuds Werk und Leben. [The significance of castration anxiety and circumcision in Freud‘s work and life.] In: G. Schlesinger-Kipp, & R-P. Warsitz (eds) “Die neuen Leiden der Seele”. Das (Un-)behagen in der Kultur. Deutsche Psychoanalytische Verein. Frankfurt/Main: Vertrieb Geber & Reusch; pp. 279–304. Knight, R. P. (1786). A Discourse on the Worship of Priapus and its Connection with the Mystic Theology of the Ancients to which is Added an Account of the Remains of the Worship of Priapus Lately Existing at Isernia in The Kingdom of Naples by Sir William Hamilton, K. B. London: T. Spilsbury, Snowhill. Knoepfmacher, H. (1979a). Zwei Beiträge zur Biographie Sigmund Freuds. Jahrbuch der Psychoanalyse, 11: 51–72. Knoepfmacher, H. (1979b). Sigmund Freud and the B’nai B’rith. Journal of the American Psychoanalytic Association, 27: 441–449. Kohler, K., & Neumark, D. (1983). Length of time for recital of kaddish (article originally published in 1913). In: W. Jacob (ed.) American Reform Responsa: Collected Responsa of the Central Conference of American Rabbis 1889–1983, New York: Central Conference of American Rabbis, pp. 383–385. Kollbrunner, J. (2001). Der kranke Freud. Stuttgart: Klett-Cotta. Kramer, R. (1995). “The ‘Bad Mother’ Freud has never seen”: Otto Rank and the birth of object-relations theory. Journal of the American Academy of Psychoanalysis, 23: 293–321. Kris, E. (1950). The significance of Freud’s earliest discoveries. International Journal of Psycho-Analysis, 31: 108–116. Kris, E. (1954). New contributions to the study of Freud’s The Interpretation of Dreams – A Critical Essay. Journal of the American Psychoanalytic Association, 2: 180–191. Krömer, R. (1896). Beitrag zur Castrationsfrage. [Contribution to the problem of castration.] Allgemeine Zeitschrift für Psychiatrie, 52: 1–74. Lacan, J. (1953). The function and field of speech and language in psychoanalysis. In: Écrits: A Selection, transl. A. Sheridan. London: Tavistock, 1977. Lacan, J. (1954–1955). The Seminar of Jacques Lacan. Book II. The Ego in Freud’s Theory and in the Technique of Psychoanalysis 1954–1955. In: J.s-A Miller (ed.) translated by S. Tomaselli, with notes by J. Forrester. Cambridge: CUP, 1988. Langs, R. (1984). Freud’s Irma dream and the origins of psychoanalysis. Psychoanalytic Review, 71: 591–617. Laqueur, T. (1990). Making Sex: Body and Gender from the Greeks to Freud. Cambridge, MA: Harvard University Press. Laqueur, T. W. (2003). Solitary Sex: A Cultural History of Masturbation. New York: Zone. Laycock, T. (1840). Treatise of the Nervous Diseases of Women: Comprising an Inquiry into the Nature, Causes and Treatment of Spinal and Hysterical Disorders. London: Longman. Laycock, T. (1845). On the reflex function of the brain. The British and Foreign Medical Review, 19: 298–311. Leitner, M. (1998). Freud, Rank und die Folgen. Ein Schlüsselkonflikt für die Psychoanalyse. Vienna: Turia & Kant.

266 Bibliography Levine, H. B. (1998). Erik Erikson’s dream specimen paper: A classic revisited. Psychoanalytic Study of the Child, 53: 25–42. Lewin, B. D. (1933). The body as phallus. Psychoanalytic Quarterly, 2: 24–47. Lieberman, E. J. (1985). Acts of Will: The Life and Work of Otto Rank. New York: Free Press. Lieberman, E. J., & Kramer, R. (eds) (2012). The Letters of Sigmund Freud and Otto Rank: Inside Psychoanalysis. Baltimore: Johns Hopkins University Press. Liebermeister, C. (1883). Über Hysterie und deren Behandlung. [On hysteria and its treatment.] Sammlung Klinischer Vorträge, 236: 2139–2158. Linn, L. (2002). Freud’s encounter with cocaine. Journal of the American Psychoanalytic Association, 50: 1151–1161. Loewenberg, P. (1970). A hidden zionist theme in Freud’s “My son, the myops dream.” Journal of History of Ideas, 31: 129–131. Lothane, Z. (1992). In Defense of Schreber. Hillsdale, NJ: Analytic Press. Lotto, D. (2001). Freud’s struggle with misogyny: homosexuality and guilt in the dream of Irma’s injection. Journal of the American Psychoanalytic Association, 49: 1289–1313. Löwenfeld, L. (1895). Über die Verknüpfung neurasthenischer und hysterischer Symptome in Anfallsform, nebst Bemerkungen über die Freud’sche ‘Angstneurose’. Münchener medizinische Wochenschrift, 42: 282–285. Löwenfeld, L. (1899). Sexualleben und Nervenleiden. Die nervösen Störungen sexuellen Ursprungs (2nd edn). Wiesbaden: Bergmann. Ludwig, E. (1957). Doctor Freud. An Analysis and a Writing. New York: Hellman, Williams & Company. Lynn, D. J. (1997). Sigmund Freud’s psychoanalysis of Albert Hirst. Bulletin of the History of Medicine, 71(1): 69–93. Maciejewski, F. (2002). Psychoanalytisches Archiv und jüdisches Gedächtnis. Freud, Beschneidung und Monotheismus. Vienna: Passagen Verlag. Maciejewski, F. (2006). Der Moses des Sigmund Freud. Ein unheimlicher Bruder. Göttingen: Vanderhoeck & Ruprecht. Mahony, P. J. (1977). Towards a formalist approach to dreams. International Review of Psycho-Analysis, 4: 83–98. Mahony, P. (1979a). Friendship and its discontents. Contemporary Psychoanalysis, 15: 55–109. Mahony, P. (1979b). The budding International Association of Psychoanalysis and its discontents. Psychoanalysis and Contemporary Thought, 2: 551–591. Mahony, P. J. (1994). Psychoanalysis – The writing cure. In: A. Haynal, & E. Falzeder (eds) 100 Years of Psychoanalysis. Contributions to the History of Psychoanalysis, Special Issue of Cahiers Psychiatriques Genevois. London: H. Karnac (Books), pp. 101–119. Makari, G. J. (1998). The seductions of history: Sexual trauma in Freud’s theory and historiography. International Journal of Psycho-Analysis, 79: 857–869. Makari, G. (2008). The Creation of Psychoanalysis. New York, NY: HarperCollins. Masson, J. M. (1984). The Assault on Truth: Freud’s Suppression of the Seduction Theory. New York: Farrar, Straus & Giroux. Masson. J. M. (ed.) (1985). The Complete Letters of Sigmund Freud to Wilhelm Fliess 1887–1904. Cambridge, MA: Harvard UP. Masson, J. M. (1986). A Dark Science. Women, Sexuality and Psychiatry in the Nineteenth Century. New York: Farrar, Straus and Giroux. Mautner, B. (1991). Freud’s Irma dream: a psychoanalytic interpretation. International Journal of Psychoanalysis, 72: 275–286. May, U. (2003). The early relationship between Sigmund Freud and Isidor Sadger: A dream (1897) and a letter (1902). Psychoanalysis and History, 5: 119–145.

Bibliography 267 McGee, J. M. (1882). Genital irritation as a cause of nervous disorders. Mississippi Valley Medical Monthly, 2. McGrath, W. J. M. (1986). Freud’s Discovery of Psychoanalysis: The Politics of Hysteria. Ithaca, NY: Cornell University Press. McGuire, W. (ed.) (1974). The Freud/Jung Letters. The Correspondence between Sigmund Freud and C. G. Jung. London: Routledge and The Hogarth Press. Merkel, F. (1887). Beitrag zur Casuistik der Castration bei Neurosen. [Contribution to the Study of Castration in the Neuroses.] Nuremberg: J. L. Stich. Mitchell, S. A. (1988). Relational Concepts in Psychoanalysis: An Integration. Cambridge, MA: Harvard University Press. Mitchell, S. A. (1997). Influence and Autonomy in Psychoanalysis. Hillsdale, NJ: The Analytic Press. Möbius, P. J. (1888). Über den Begriff der Hysterie. Zentralblatt für Nervenheilkunde, 2: 66–73 (reprinted in Möbius, P. J. (1894), pp. 1–7). Möbius, P. J. (1890). Über Astasie-Abasie. In: Schmidt’s Jahrbücher der in- und ausländischen gesammten Medizin, vol. 27, pp. 25–30. (reprinted in Möbius, P. J. (1894), pp. 8–19). Möbius, P. J. (1894). Über den Begriff der Hysterie und andere Vorwürfe vorwiegend psychologischer Art. Neurologische Beiträge, vol. 1. Leipzig: Ambr. Abel. Möbius, P. J. (1903). Über die Wirkungen der Castration. [On the Effects of Castration.] Halle a.d. S.: Verlag von Carl Marhold. Morgan, S. (1995). The dream of psychoanalysis: Irma’s dream, some commentaries, and a contemplation of its navel. British Journal of Psychotherapy, 12: 160–169. Morgan, W. K. C. (1965). The rape of the phallus. Journal of the American Medical Association, 193: 123–124. Moscucci, O. (1990). The Science of Woman: Gynaecology and Gender in England, 1800–1929. Cambridge, UK: Cambridge University Press. Moscucci, O. (1996). Clitoridectomy, circumcision and the politics of sexual pleasure in mid-Victorian Britain. In: A. H. Miller and J. E. Adams (eds) Sexualities in Victorian Britain. Bloomington: Indiana University Press, pp. 60–78. Mühlleitner, E. (1992). Biographisches Lexikon der Psychoanalyse. Tübingen: Edition Diskord. Niederland, W. G. (1984). The Schreber Case. Psychoanalytic Profile of a Paranoid Personality. Hillsdale, NJ: The Analytic Press. Nunberg, H. (1931). The synthetic function of the ego. International Journal of Psycho-Analysis, 12: 123–140. Nunberg, H. (1947). Circumcision and problems of bisexuality. International Journal of Psycho-Analysis, 28: 145–179. Oppenheim, H. (1889). Die traumatischen Neurosen nach den in der Nervenklinik der Charité in den letzen 5 Jahren gesammelten Beobachtungen. Berlin: Hirschwald. Ostow, M. (1989). Sigmund and Jakob Freud and the Philippson bible – (with an analysis of the birthday inscription). International Review of Psycho-Analysis, 16, 483–492. Page, H. W. (1883). Injuries of the Spine and Spinal Cord Without Apparent Mechanical Lesion, and Nervous Shock, in their Surgical and Medico-Legal Aspects. London: J. & A. Churchill. Peters, U. H. (1989). Irma – Emma – Martha – Anna. Einige zusätzliche Bemerkungen zu Ausführungen von K. R. Eissler und H. Thomä. Psyche, 43(9): 830–848. Peyer, A. (1890). Über Magenaffektionen bei männlichen Genitalleiden. [On Stomach Disturbances in Male Genital Illnesses.] Leipzig: Breitkopf und Härtel, pp. 3169–3202.

268 Bibliography Philo (1854). The Works of Philo Judaeus, vol. 1, translated from the Greek by C. D. Yonge. London: Henry G. Bohn. Pomata, G. (1992). Uomini mestruanti: Somiglianza e differenza fra i sessi in Europa in età moderna. [Menstruating men: gender similarities and differences in modern age Europe.] Quaderni Storici, N. S. 79(1): 51–103. Portnoy, I (1949). “The magic skin”: a psychoanalytic interpretation. American Journal of Psychoanalysis, 9(1): 67–75. Rank, O. (1924). The Trauma of Birth. New York: Dover Books, 1994. Rank, O. (1996). A Psychology of Difference. The American Lectures. Princeton, NJ: Princeton University Press. Rice, E. (1990). Freud and Moses: The Long Journey Home. New York: SUNY Press. Rice, E. (1994). The Jewish heritage of Sigmund Freud. Psychoanalytic Review, 81: 237–258. Rice, E. (2000). Freud and the Legacy of Moses: Richard J. Bernstein. Cambridge, England: Cambridge University Press, 1998. Richardson, W. (1983). Lacan and the subject of language. In: J. H. Smith and W. Kerrigan (eds) Interpreting Lacan (Psychiatry and the Humanities, Vol. 6). New Haven: Yale University Press, pp. 56–63. Riegel, F. (1883). Zur Lehre von den hysterischen Affectionen der Kinder. Zeitschrift für Klinische Medicin, 6/5: 453–471. Rieger, C. (1896). Über die Behandlung “Nervenkranker.” Schmidt‘s Jahrbücher der Medicin, pp. 251–252. Rieger, C. (1900). Die Castration in rechtlicher, socialer und vitaler Hinsicht. [Castration in Legal, Social and Vital Perspectives.] Jena: Gustav Fischer. Roazen, P. (1969). Brother Animal: The Story of Freud and Tausk. New York: Knopf. Roazen, P. (1975). Freud and his Followers. New York: Da Capo Press, 1992. Roazen, P. (1978). Reading, writing and memory: Dr. K. R. Eissler’s thinking. Contemporary Psychoanalysis, 14: 345–353. Roazen, P. (1995). How Freud Worked. First-Hand Accounts of Patients. Northvale, N.J.: Jason Aronson. Robert, M. (1976). From Oedipus to Moses: Freud’s Jewish Identity. Garden City, NY: Anchor/Doubleday. Robertson Smith, W. (1889–1890). Lectures on the Religion of the Semites. London: Adam and Charles Black, 1894. Robinson, B. (1907). The Abdominal and Pelvic Brain. Chicago: Frank S. Betz. Rohlender, H. (1899). Die Masturbation. Eine Monographie für Ärzte und Pädagogen. Berlin: Fischer. Romberg, M. H. (1840–1846). Lehrbuch der Nervenkrankheiten des Menschen. Berlin: Duncker, 2 edn. 1851. English translation: A Manual of the Nervous Diseases of Man. 2 vols. London: Sydenham Society (1853). Rose, P. L. (1990). German Question/Jewish Question. Revolutionary Antisemitism from Kant to Wagner. Princeton: Princeton University Press. Rosenfeld, E. M. (1956). Dream and vision – some remarks on Freud’s Egyptian bird dream. International Journal of Psycho-Analysis, 37: 97–105. Roudinesco, E. (2014). Sigmud Freud en son temps et dans le nôtre. Paris, Seuil. Roustang, F. (1976). Un destin si funeste. Paris: Minuit. Rudnytsky, P. L. (1991). The Psychoanalytic Vocation: Rank, Winnicott, and the Legacy of Freud. New Haven, CT: Yale University Press. Rudnytsky, P. L. (2002). Reading Psychoanalysis. Freud, Rank, Ferenczi, Groddeck. Ithaca, NY: Cornell University Press. Rycroft, C. (1984). A case of hysteria. Review of The Assault on Truth: Freud’s Suppression

Bibliography 269 of the Seduction Theory by Jeffrey Moussaieff Masson. The New York Review of Books, 31(6): April 12, 1984. Sadger, I. (1897). Das Wunder vom denkenden Eiweiss. [The miracle of the thinking protein.] Deutsche Revue, 22: 93–110. Schafer, R. (1976). A New Language for Psychoanalysis. New Haven, CT: Yale University Press. Schäfer, S. (1884). Über Hysterie bei Kindern. [On hysteria in children.] Archiv für Kinderheilkunde, 5: 401–428. Scheidt, J. von (1973). Sigmund Freud und die Cocaine. [Sigmund Freud and cocaine.] Psyche, 27: 385–429. Schlossman, H. H. (1966). Circumcision as Defense—A Study in Psychoanalysis and Religion. Psychoanalytic Quarterly, 35: 340–356. Schneider, S., & Berke, J. H. (2000). Sigmund Freud and the Lubavitcher Rebbe. The Psychoanalytic Review, 87(1): 39–59. Schorske, C. E. (1973). Politics and patricide in Freud’s interpretation of dreams. Reprinted in Annual of Psychoanalysis, 2 (1974): 40–60. Schröter, M. (2003). Fliess versus Weininger, Swoboda and Freud: The plagiarism conflict of 1906 assessed in the light of the documents. Psychoanalysis and History, 5: 147–173. Schur, M. (1966). Some additional “day residues” of the specimen dream of psychoanalysis. Reprinted in M. Kanzer and J. Glenn (eds) Freud and his Self-Analysis. New York: Jason Aronson, 1979, pp. 87–116. Schur, M. (1972). Freud: Living and Dying. New York: International Universities Press. Scull, A., & Favreau, D. (1986). The clitoridectomy craze. Social Research, 53: 243–260. Searles, H. (1966). Feelings of guilt in the psychoanalyst. Psychiatry, 29: 319–323. Shengold, L. (1993). “The boy will come to nothing!” New Haven, CT: Yale University Press. Shorter, E. (1992). From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era. New York: Free Press. Smidt, H. (1880). Über das Vorkommen der Hysterie bei Kindern. Jahrbuch für Kinderheilkunde und physische Erziehung, N.F., 15: 1–22. Sommer, R. (1894). Diagnostik der Geisteskrankheiten für praktische Ärtze und Studierende. Vienna: Urban & Schwarzenberg. Spiegel, R. (1986). Freud’s refutation of degenerationism: a contribution to humanism. Contemporary Psychoanalysis, 22: 4–24. Spira, D. S. (1991). The evolution of Freud’s conceptualization of phobias. Psychoanalytic Inquiry, 11: 376–394. Spitz, R. A. (1952). Authority and masturbation: some remarks on a bibliographic investigation. Psychoanalytic Quarterly, 21: 490–527. Sprengnether, M. (2003). Mouth to mouth: Freud, Irma, and the dream of psychoanalysis. American Imago, 60: 259–284. Stärcke, A. (1921a). The castration complex. International Journal of Psycho-Analysis, 2: 179–201. Stärcke, A. (1921b). Psycho-analysis and psychiatry. International Journal of Psychoanalysis, 2: 361–415. Starr, K. E., & Aron, L. (2011). Women on the couch: Genital stimulation and the birth of psychoanalysis. Psychoanalytic Dialogues, 21(4): 373–392. Stengers, J., & Van Neck, A. (1984). Histoire d’une grande peur: la masturbation. Brussels: Editions de l’Université de Bruxelles. Stolorow, R. D. & Atwood, G. E. (1992). Contexts of Being: The Intersubjective Foundations of Psychological Life. Hillsdale, NJ: Analytic Press.

270 Bibliography Strümpell, A. (1884). Über die Ursachen der Erkrankungen des Nerven Systems. Leipzig: F.C.W. Vogel. Strümpell, A. (1888). Über die traumatischen Neurosen. Berlin: Fischer. Strümpell, A. (1892). Über die Entstehung und die Heilung von Krankheiten durch Vorstellungen. Erlangen: Junge. Strümpell, A. (1893). Über die traumatischen Neurosen. Verhandlungen des Congress für Innere Medizin, Wiesbaden 1893, 12: 83–98. Strümpell, A. (1895). Über die Untersuchung, Beurteilung und Behandlung von Unfallkranken. Praktische Bemerkungen. Münchener medizinische Wochenschrift, 42: 1137–1140, 1165–1168. Sugar, M. (2002). Commonalities between the Isaac and Oedipus myths: A speculation. Journal of the American Academy of Psychoanalysis, 30: 691–706. Sullivan, H. S. (1964). The Fusion of Psychiatry and the Social Sciences. New York: W. W. Norton. Sulloway, F. J. (1979). Freud, Biologist of the Mind: Beyond the Psychoanalytic Legend. New York: Basic Books. Taylor, K. (2013). Mayoral rivals entangled in debate on city’s rules for a circumcision rite. New York Times, September 27, 2013. Thomä, H. (1987). Wer war Freuds “Irma”? Psyche, 41: 987–991. Tissot, S. A. D. (1760). English translation: A Treatise on the Diseases Produced by Onanism. New York: Collins and Hannay, 1832. Tögel, C. (2006). Freud und Berlin. [Freud and Berlin.] Berlin: Aufbau Verlag. Torok, M. (1964). The meaning of “penis envy” in women. In: N. Abraham & M. Torok (eds) The Shell and the Kernel (English translation). Chicago: The University of Chicago Press, 1993, pp. 41–73. Torok, M. (1968). The illness of mourning and the fantasy of the exquisite corpse. In: N. Abraham & M. Torok (eds) The Shell and the Kernel (English translation). Chicago: The University of Chicago Press, 1993, pp. 107–124. Tractenberg, M. (1989). Circumcision, crucifixion and anti-semitism – The antithetical character of ideologies and their symbols which contain crossed lines. International Review of Psycho-Analysis, 16: 459–471. Tragl, K. H. (2007). Chronik der Wiener Krankenanstalten. Vienna, Austria: Böhlau. Trumbull, H. C. (1885). Blood Covenant. A Primitive Rite and its Bearing on the Scripture. Philadelphia: John D. Wattles, 2nd° edition, 1893. Urtubey, L. de (1983). Freud et le diable. Paris: PUF. Velikovsky, I. (1941). The dreams Freud dreamed. Psychoanalytic Review, 28: 487–511. Vitz, P. (1988). Sigmund Freud’s Christian Unconscious. New York: Guilford Press. Warren, C. A. B. (2004). Genital surgeries and stimulation in nineteenth century psychiatry. In: M. T. Segal, V. Demos, & J. J. Kronenfeld (eds) Gendered Perspectives on Reproduction and Sexuality: Advances in Gender Research, vol. 8. Bingley, UK: Emerald Group Publishing, pp. 165–197. Weiss, J. (1884). Die infantile Hysterie. Archiv für Kinderheilkunde, 5: 451–461. Wellisch, E. (1954). Isaac and Oedipus: Studies in Biblical Psychology of the Sacrifice of Isaac. London: Routledge and Kegan Paul. Werner, E. (1990). Vom Kaiser- und Kaiserin-Friedrich-Kinderkrankenhaus zur Kinderklinik Universitätsklinikum Rudolf Virchow. Kinderarzt, 9: 1315–1322. Wilcocks, R. (2000). Mousetraps and the Moon: The Strange Ride of Sigmund Freud and the Early Years of Psychoanalysis. Lanham: Lexington Books. Wittels, F. (1924). Sigmund Freud: Der Mann, die Lehre, die Schule. Leipzig: E. P. Tal. English translation: Sigmund Freud, his Personality, his Teaching and his School. Translated by Eden and Cedar Paul. London: Dodd, Mead.

Index

Abraham 164, 245, 248, 249 Abraham, K. 42, 84, 99, 149, 211 Abraham, N. 119, 121, 144, 230, 231 akrogoniaios lithos (lapis angularis) 8, 155 Anna O. 47, 67 Anthi, P. R. 159, 160, 172 Anzieu, D., on the Irma dream 72, 75, 83, 88, 98, 99, 102, 104, 117, 122; Botanical monograph 108, 109; Dead mother 131, 147; Rome dreams 157, 168, 195–197; Norekdal dream 158; Bisexual monster 175; Secerno dream 180; Freud’s dyslexia 181, 206; My son the Myops 188; Dishonesty dream 202; Castle on sea 216; Three fates 217–218 Appignanesi, L., 78–81, 104 Arlow, J. A. 26, 161 Armstrong, R. H. 191, 192 Aron, L. 47, 189–191, 198, 203–206 Baginsky, A. xi, 30–36, 40, 43, 44, 136–138, 140–143, 145, 148, 149, 186 Baker Brown, I. 26 Balzac, H. xi, 234–238, 252, 253 Barker-Benfield, G. J. 24, 26 Behrend, F. J. 28 Beira, M. 122, 149, 153, 206, 233, 236, 237, 239–241, 248, 250, 252, 253 Beiträge zur Kinderheilkunde aus dem I. Öffentlichen Kinder-Krankeninstitut in Wien 43 Belle Vue resort 67 Bellevue sanatorium 66, 67, 69 Bergmann, M. S. 164, 205, 240

Berke, J. H. 240 Bernays, Martha 31, 33, 147, 148 Bernays, Minna 79 Bernfeld, S. 83, 108, 127–134, 231 Bertin, C. 5, 26 Bettelheim, B. 113 Binswanger, L. 67 Binswanger, R. 67–69 Bion, W. R. 106 bisexuality 12, 64, 118, 175, 178–180, 183, 201; and circumcision 156, 170, 171, 213; dispute on 219, 220 Bloch, I. 37 Blum, H. P. 87, 97, 100, 147 B’nai B’rith 57, 176, 233, 240 Bonaparte, M. 4, 5, 26, 31, 43, 83, 85, 91 Borch-Jacobsen, M. 58 Borgogno, F. 106 Boyarin, D. 203, 204 Breuer, J. 22, 42, 46, 47, 50, 53, 54, 56, 59, 63, 66–69, 73–75, 78, 81, 93, 96, 199, 252 brith milah 9, 10, 110, 117,120, 202, 203, 212, 213, 216, 223, 237, 242, 243, 250, 251; covenant 245; maniac ritual 214; milah/amyl 117, 181, 246; metsitsah 142, 143, 202, 205, 207, 213; mohel 4, 110, 203, 223, 142, 202–204, 223; totem meal 212–216; trimethylamin 8, 9, 111, 118,122, 197 Brücke, E. 17, 46, 127, 131, 226, 243 Cäcilie M. 48 Carter, K. C. 31, 143 Castration; apparent castration 48, 49; Breuer’s opinion 68–69;

272 Index cauterization of the labia 28, 29; crime against society 17; excision or scarification of the clitoris 19, 23–26, 28, 29; giuridical status 24, 25; infibulation 23, 105; removal of ovaries 18, 20, 22, 73, 97, 227; scientific study 56; therapy of hysteria 17, 19, 49, 68, 73, 98 cerebral unconscious 20, 46 Charcot, J. M. 2, 19, 2 1, 22, 31, 39, 42, 49–52, 56, 57 Chrobak, R. 39, 44, 225 circumcision; adaptive function 26; cure of masturbation 28; hygienic measure 26; memo-technique 28 Colman, W. 112, 184, 185, 202, 241 Compton, A. 84 Cope, D. K. 113 Cotti, P. 216 Daly, C. D. 26 Darby, R. 24, 27 Davidson, A. I. 54, 59 Davis, D. 79 Derrida, J. 113, 121 Mr. E (Oscar Fellner), 79 Eckstein, Amalia 253 Eckstein, Emma 4–13, 72, 91, 197, 199, 209; circumcision 9, 11, 96, 102–114, 117, 131, 136–138, 218; as “corner” [Ecke] 197; as “cornerstone” 8, 117, 121, 155, 159, 160, 166, 197, 219; as “stone” [Stein] 131; as Irma 72, 78, 79, 82–84, 88, 92–94, 99, 125; Emma/ Amme 110, 116, 231; first analysis 78, 79–82; and second analysis, 174, 224–226, 229, 231; masochistic fantasies 227; masturbation 79, 80; nose surgery 72, 75, 77, 80, 98, 109, 100, 128, 129, 250; phallic fantasies 106, 107, 109, 111, 175, 178, 179, 219; re-traumatization 105,106, 109, 250; wish-fulfillment theory 80 Eckstein, Albert 81 Eckstein,Friedrich 79, 85 Eckstein, Käthe 231 Eissler, K. R. 5, 37, 38, 83, 94, 97, 99–101, 198, 224, 231

electrotherapy 47, 49, 64 Elisabeth von R. 47 Ellenberger, H. F. 19, 22, 42, 58, 66, 86 Elms, A. C. 99 Emmy von N. 47 Erichsen, J. E. 48 Erikson, E. 89–95, 116, 118, 121, 129, 210, 246, 249 Fairbairn, W. D. 198 Falk, A. 184, 240 Falzeder, E. 2, 41 Favreau, D. 24, 26 Feldman, Y. S. 203, 204 femme fatal 109, 110 Ferenczi, S. 1, 9, 11, 26, 88, 89, 92, 101, 107, 122, 149, 163, 192, 194–196, 200, 212, 224, 229, 232, 252, 259, 260 Fichtner, G. 12 Fisher-Homberger E. 51, 52, 60 Fitzgerald, M. 113 Flechsig, P. T. 113, 158, 160, 172, 228, 229, 232 Fleischl von Marxow, E. 127–131, 133, 144, 146, 218 Fleischmann, C. 66, 84 Fleischmann, L. 29, 84, 105, 136, 137 Fliess, W. 70, 83, 84, 93, 97, 100, 108, 119, 126, 134, 135, 147, 177; bisexuality, plagiarism, and paranoia 178, 179, 219, 220, 229, 230; Breslau meeting with Freud 180–181, 188; dissent towards the Jewish community 254; nasal reflex neurosis theory 54, 63–65, 72, 74; nose operation of Emma Eckstein 5, 69, 74–78, 85; Nuremberg meeting with Freud 152, 153, 177–179, 185, 188 Forrester, J. 78–81, 104 Frazer, J.G. 150, 161, 164, 173 Freeman, E. 206 Freud, Alexander 11, 130, 148, 203, 205, 210, 214–216, 220; brith milah 202, 203, 223, 241, 242, 250; Christian name 241, 243; Jewish name 241 Freud, Amalia (born Nathanson) 130, 148, 153, 195, 206, 215, 216, 217, 244, 253

Index 273 Freud, Anna (daughter), 4, 83, 84, 91, 100, 257, 176, 187, 206, 234, 254 Freud, Anna (sister) 109, 135, 241 Freud, Jacob 115, 133, 163, 168, 187, 189–191, 194, 197, 203–205, 223, 233, 234, 239–245, 249–254 Freud, John 108, 177, 179, 219 Freud, Julius 112, 130, 239; brith milah 185, 202, 205, 239, 241, 250; death 153, 202, 184, 216, 241; Hebrew name 239, 240 Freud, Martha (née Bernays) 9, 75, 98, 99, 100, 109, 118, 122, 238, 244, 254 Freud, Pauline 108, 179 Freud, Sigmun, cancer 234–236, 253; circumcision: as cure/punishment 40; conflict with his father 250; decision to not have his son circumcised 3, 4, 239, 243; dismissal of the covenant between God and Abraham 249, 254; child therapist 31, 32, 33, 39, 43; contempt for the “excision of the clitoris and labia minora” in girls 57; cocaine 75, 76, 125–138, 147, 148; identification with: Catholic nanny 200, 201; Emma Eckstein 77, 79, 102, 106, 109, 110, 119, 120, 121, 135, 201, 218, 249, 253; Leonardo da Vinci 221–223; Oedipus 191, 201, 204; Schreber 227–229; death 233–236; dreams: Breakfast-ship (Castle on sea) 215; Botanical monograph 108, 132, 134; Count Thun 132, 133, 172; Famous Speakers 175; Dead mother with bird-beaked figures 130, 131, 215, 223; Dishonesty 201, 202; Hollthurn 206; Irma’s injection 7, 11, 69, 71, 72, 83–121, 125–148, 236, 245–252; My son, the Myops 182–188; non vixit 129, 177, 219, 240; Norekdal 157–160, 169, 172; Rome series: third dream 195; fourth dream (streetcorner dream) 156, 157, 195, 197; Three Fates 93, 167, 217–219, 231; Secerno 180; Self-dissection of the pelvis 17, 93, 112, 135, 169, 243; Hannibal fantasy 156, 176, 190, 200, 205, 242, 243; Jewish identity and

heritage 57, 190, 195, 204–206, 240; 203, 204, 233, 239, 240–246; name and change of name 223, 237, 243 250; pediatric training 31, 32; two mothers 116, 181, 190, 223, 241, 242; unconscious reaction to Emma Eckstein’s circumcision 11, 105, 106, 166, 205, 250 Fromm, E. 58 Gauchet, M. 20, 22, 46 Gaupp, R. 52 Gay, P. 242, 244, 252 Geller, J. 102, 113, 114, 119, 122 Gicklhorn, J. and R. 43 Gilman, S. L. 142, 143, 149, 202, 204, 205 Goldfarb, M. 205 Gollaher, D. L 24, 27 Goodnick, B. 245, 253 Grant, G. H. 148 Greenberg, J. R. 198 Grigg, K. A. 110, 188 Grinstein, A. 134, 135, 157, 169, 172, 183, 201, 218 Grossman, W. I. 198 Guttmacher, H. 132 Haddad, G. 11, 248 Hammerschlag, Samuel 115, 205, 239, 240, 254 Hamot, B. 141 Hartman, F. R. 83, 85, 108 Haynal, A. 2, 41, 85 Hegar, A. 18, 49, 69, 72–75, 260 Henoch, E. H. 29 Hersh, T. R. 236 Herz, M. 135, 136, 137, 138 Hirschmüller, A. 19, 22, 38, 42, 66, 67, 74, 84, 139, 140, 148 Hirst, A. 38, 80, 133, 224, 225, 231, 232 Hochsinger, C. 34 Holt, R. R. 86, 208, 209 Horkheimer, M. 173, 26 Huschka, M. 37 Irma: as Anna Hammerschlag 83, 99, 115, 121, 239; “universal” 118 Isaac 173; and Oedipus 165; sacrifice 163, 164, 165, 248, 249

274 Index Isakower, O. 251 Israel, J. 23, 48, 49 Jacob 163, 173, 174, 253 Janet, P. 46, 50–53 Jolly, F. 19–21, 36 Jones E. 19, 22, 30, 43, 56, 86, 127, 128, 131–135, 147, 188, 198, 219, 242 Jung, C. G. 149, 192, 220 Kaplan, K. J. 165 Kassowitz, M. 31, 32, 39, 140 Kassowitz Institute 32, 43, 138 Kern, S. 36, 73 Klein, D. B 242 Klein, G. 86 Klerk, A. de 3, 8, 109, 111–113, 237–239, 241, 243, 253, 254 Knight, R. P. 210, 230 Knoepfmacher, H. 233 Kohler, K. 252 Kollbrunner, J. 234 Koller, K. 132, 133 Königstein, L. 32, 132, 133, 156, 174 Krafft-Ebing, R. von 66, 68 Kramer, R. 188, 18, 39 Kris, E. 4, 91, 84, 197, 198 Krömer, R. 17 Kronos 145, 146, 163, 166; errors 163, 206; as replacement of Moloch, 162, 163 Lacan, J. 90–92, 167, 196, 247, 248 Langs, R. 82, 83, 102, 119 Laqueur, T. W. 23, 28, 41 Laycock, T. 46 Levine, H. B. 121 Lewin, B. D. 206, 212 Lieberman, E. J. 193 Liebermeister, C. 49 Linn, L. 147 Loewenberg, P. 183 Lothane, Z. 228, 231 Lotto, D. 101 Löwenfeld, L. 71 Ludwig, E. 226, 227, 232 Lynn, D. J. 79, 224, 225 Maciejewski, F. 3, 112, 113, 184, 185, 186, 239 Mahony, P. J. 85, 101, 110, 114, 198, 199, 224, 246, 247, 249

Makari, G. J. 22, 87, 143 Masson, J. M. 5, 6, 72, 78, 80, 83, 84, 85 masturbation 23–37, 63; diagnosis, causes and effects 34–36; nasal reflex neurosis 65, 80; seduction 28, 29, 30, 36; small children 28, 29 Mautner, B. 109 May, U. 158, 160, 172 McGee, J. M. 27, 267 McGrath, W. J. M. 157, 176, 187 Merkel, F. 18 Meynert, T. 21, 46, 148 Mitchell, S. A. 198 Möbius, P. J. 50, 51, 52, 53, 55, 56 Moloch, 110, 161–164, 166, 169, 173, 174, 212 Monti, A. 136, 137, 148 Morgan, S. 167 Morgan, W. K. C. 27 Moscucci, O. 26, 63 Moses 121, 142, 158, 197, 228, 245 Neumark, D. 252 Niederland, W. G. 228, 229 Nina R. 66–68, 73–76 Nunberg, H. 7, 26, 150, 152, 156, 169, 170, 171, 213 Oedipus 92, 112, 153, 155, 165, 166, 191–193, 196, 197, 201, 203–205, 212, 214, 215, 220–222, 231 Oppenheim, H. 51, 52 Ostow, M. 244 Page, H. W. 48 Peters, U. H. 83 Peyer, A. 65, 67, 84 Philipp, E. 3 psychic shock/trauma 48–52 psychogenic, ideogenic 51–53, 174 Rank, O. 192–194 Redlich, E. 43 reflex neurosis 20, 22, 45, 54, 63 Reichmayr, J. 3 Reik, T. 42, 195, 206 reversal of roles 106, 109, 211 Rice, E. 3, 13, 115, 244 Richardson, W. 118 Rie, O. 31, 43, 114, 115, 140, 262, 246 Riegel, F. 49

Index 275 Rieger, C. 24, 25, 42, 43, 51 Roazen, P. 133, 150, 152, 231 Robert, M. 184 Robertson Smith, W. 161, 166, 212, 213 Rohlender, H. 79, 138 Romberg, M. H. 20–22, 35, 36, 38, 39, 40, 54 Rose, P. L. 162 Rosenthal, M. 64 Rosanes, I. 32, 78 Rosenfeld, E. M. 147, 223 Roudinesco, E. 7, 205 Roustang, F. 192 Rudnytsky, P. L. 193 Rycroft, C. 5, 6 Sadger, I. 158, 172 Schafer, R. 86 Schäfer, S. 137 Scheidt, J. von 147 Schlossman, H. H. 164 Schneider, S. 240, 256 Schorske, C. E. 175, 176 Schreber, D. P. 149, 224, 227–229, 232 Schröter, M. 84, 85, 219, 262 Schur, M. 4, 5, 43, 78, 83, 92–94, 103, 110, 153, 154, 233, 234, 236, 253 Scull, A. 24, 26 Searles, H. 82, 119 Shamdasani, S. 58 Shengold, L. 249 Shorter, E. 20, 26, 63, 65 Smidt, H. 30, 43 Sommer, R. 51 Spitz, R. A. 23, 24, 42 Sprengnether, M. 236, 237 Stärcke, A. 21, 22, 38, 231 Starr, K. E. 47, 198, 203, 204, 206, 256 Stengers, J. 23, 36, 54 Stolorow, R. D. 198 Strümpell, von A. 50, 51, 53 Sugar, M. 165 Sullivan, H. S. 198

Sulloway, F. J. 19, 22, 37, 38, 42, 58, 63, 87 Swoboda, H. 219 Taylor, K. 207 Teleky, D. 225–227, 232 Thomä, H. 83 Tissot, S. A. D. 23 Tögel, C. 43 Torok, M. 107, 119, 121 Tractenberg, M. 203, 213, 214 Tragl, K. H. 105, 136 traumatic progression 9, 88, 92, 195 Trumbull, H. C. 161 Trimethylamin: anagram (brith milah) 8, 9, 111, 122, 181, 197, 251; embodiment of the letter Shin 11, 248; exorcizing function 141; foulsmelling odor of the vagina 101; immensely powerful factor of sexuality 72; syphilitic infection 144; magical drug 126; mute word 121; oracle 167, 247, 248; pictographic script 196, 247; revelation of a novel doctrine 91; scientific (universal) formula 118; sexual countertransference 82; sexual megalomania 99; signifier of the covenant with Fliess 246; Three-Amen formula 120 Urtubey, L. de 210 Van Neck, A. 23, 36, 54 Velikovsky, I. 120, 183 Vitz, P. 110, 117 Warren, C. A. B. 26 Weininger, O. 219 Weiss, J. 50 Wellisch, E. 165 Werner, E. 140 Wilcocks, R. 104 Wittels, F. 133, 148, 158, 172 Zappert, J. 43

Taylor* Francis eBooks

eBooks

from Taylor & Francis Helping you to choose the right eBooks for your Library

Add to your library's digital collection today with Taylor & Francis eBooks. We have over 50,000 eBooks in the Humanities, Social Sciences, Behavioural Sciences, Built Environment and Law, from leading imprints, including Routledge, Focal Press and Psychology Press.

k TRVA'- '

Free Trials Available

We offer free trials to qualifying academic, corporate and government customers.

Choose from a range of subject packages or create your own! Benefits for you

■ ■ ■ ■

Free MARC records COUNTER-compliant usage statistics Flexible purchase and pricing options 70% approx of our eBooks are now DRM-free.

Benefits for your user

■ Off-site, anytime access via Athens or referring URL ■ Print or copy pages or chapters ■ Full content search ■ Bookmark, highlight and annotate text ■ Access to thousands of pages of quality research at the click of a button.

eCollections

eFocus

Choose from 20 different subject eCollections, including:

We have 16 cutting-edge interdisciplinary collections, including:

Dependable

Development Studies

Economics

The Environment

Health Studies

Islam

Law

Korea

Middle East Studies

Urban Studies

For more information, pricing enquiries or to order a free trial, please contact your local sales team: UK/Rest of World: [email protected] USA/Canada/Latin America: [email protected] East/Southeast Asia: [email protected] India: [email protected]

www.tandfebooks.com

K M