Freud stared at Breuer with great intensity as he told this tale—a look Breuer knew. It was Freud’s total-recall look: he was not only contemplating and registering everything but recording it as well; six months hence, he would be able to repeat this conversation with perfect accuracy. But Freud’s demeanor changed abruptly when Breuer described his final proposal.
“Josef, you offered him WHAT? You are to treat this Herr Müller’s migraine, and he should treat your despair? You can’t be serious! What does this mean?”
“Sig, believe me, it was the only way. If I had tried anything else, poof!—he’d be on his way to Basel. Remember that excellent strategy we planned? To persuade him to investigate and reduce his life stress? He demolished that in minutes by utterly eulogizing stress. He sang rhapsodies about it. Whatsoever does not kill him, he claims, makes him stronger. But the more I listened and thought about his writings, the more I was convinced he fancies himself a physician—not a personal one but a physician to our entire culture.”
“So,” Freud said, “you snared him by suggesting he begin to heal Western civilization by starting with a single specimen—you?”
“That’s true, Sig. But first he snared me! Or, that homunculus you claim is active in each of us snared me with his pitiful plea of ‘Help me, help me.’ That, Sig, was almost enough to make me a believer in your ideas about there being an unconscious part of the mind.”
Freud smiled at Breuer and enjoyed a long draw on his cigar. “Well, now that you’ve snared him, what next?”
“The first thing we’ve got to do, Sig, is get rid of this term ‘snare.’ The idea of snaring Eckart Müller is incongruous—like catching a thousand-pound gorilla with a butterfly net.”
Freud smiled more broadly. “Yes, let’s drop ‘snare’ and just say that you’ve got him in the clinic and will see him daily. What’s your strategy? No doubt he’s busy designing a strategy to help you with your despair, starting tomorrow.”
“Yes, that’s exactly what he said to me. He’s probably working on it this very moment. So it’s time for me to plan as well, and I hope you can help. I haven’t thought it through, but the strategy is clear. I must persuade him he is helping me—while I slowly, imperceptibly, switch roles with him until he becomes the patient and I, once again, the physician.”
“Exactly,” Freud agreed. “That’s precisely what must be done.”
Breuer marveled at Freud’s ability always to sound so sure of himself, even in situations where there was no certainty whatsoever.
“He expects,” Freud continued, “to be your doctor of despair. And that expectation must be met. Let us lay plans—one step at a time. The first phase obviously will be to persuade him of your despair. Let’s plan this phase. What will you talk about?”
“I have no concerns about it, Sig. I can imagine many things to discuss.”
“But really, Josef, how are you going to make that believable?”
Breuer hesitated, wondering how much of himself to reveal. Still, he answered, “Easy, Sig. All I have to do is tell the truth!”
Freud looked at Breuer in astonishment. “The truth? What do you mean, Josef? You have no despair, you have everything. You’re the envy of every doctor in Vienna—all Europe clamors for your services. Many excellent students, like the promising young Doctor Freud, cherish your every word. Your research is remarkable, your wife the most beautiful, sensitive woman in the empire. Despair? Why, Josef, you’re atop the very crest of life!”
Breuer put his hand on Freud’s. “The crest of life! You’ve put it just right, Sig. The crest, the summit of the life climb! But the problem with crests is that they lead downhill. From the crest I can see all the rest of my years stretched out before me. And the view doesn’t please me. I see only aging, diminishment, fathering, grandfathering.”
“But, Josef”—the alarm in Freud’s eyes was almost palpable—“how can you say that? I see success, not downhill! I see security, acclaim—your name attached in perpetuity to two major physiological discoveries!”
Breuer winced. How could he admit to having wagered his whole life only to find that the final prize was, after all, not to his liking? No, these things he must keep to himself. There are things you don’t tell the young ones.
“Let me just put it this way, Sig. One feels things about life at forty that one cannot know at twenty-five.”
“Twenty-six. On the far side of twenty-six.”
Breuer laughed. “Sorry, Sig, I don’t mean to be patronizing. But take my word that there are many private things I can discuss with Müller. For example, there are troubles in my marriage, troubles I’d prefer not to share with you, so you don’t have to keep things from Mathilde and hurt the closeness you two share. Just believe me: I shall find much to say to Herr Müller, and I can make it convincing by sticking largely to the truth. It’s the next step I worry about!”
“You mean what happens after he turns to you as a source of help for his despair? What you can do to lessen his burden?”
Breuer nodded.
“Tell me, Josef, suppose you could design the next phase in any way you wish. What would you like to happen? What is it one person can offer another?”
“Good! Good! You prod my thinking. You’re magnificent at this, Sig!” Breuer reflected for several minutes. “Though my patient’s a man—and not, of course, a hysteric—still, I think I’d like him to do exactly what Bertha did.”
“To chimneysweep?”
“Yes, to reveal everything to me. I’m convinced there’s something healing in unburdening. Look at the Catholics. The priests have been offering confessional relief for centuries.”
“I wonder,” said Freud, “whether the relief comes from the unburdening or from the belief in divine absolution?”
“I’ve had as patients agnostic Catholics who still benefited from going to confession. And on a couple of occasions in my own life, years ago, I experienced relief from confessing everything to a friend. How about you, Sig? Have you ever been relieved by confession? Ever unburdened yourself fully to anyone?”
“Of course; my fiancee. I write Martha every day.”
“Come now, Sig.” Breuer smiled and put his hand on his friend’s shoulder. “You know there are things you can never tell Martha—especially Martha.”
“No, Josef, I tell her everything. What couldn’t I tell her?”
“When you’re in love with a woman, you want her to think well of you in all ways. Naturally, you’re going to keep things hidden about yourself—things that might present you in a bad light. Your sexual lusts, for example.”
Breuer noted Freud’s deep blush. Never before had he and Freud had such a conversation. Probably Freud had never had one.
“But my sexual feelings involve only Martha. No other woman attracts me.”
“Then let’s say before Martha.”
“There was no ‘before Martha.’ She is the only woman I have ever craved.”
“But, Sig, there must have been others. Every medical student in Vienna keeps a Süssmädchen. Young Schnitzler seems to have a new one every week.”
“This is exactly the part of the world I want to shield Martha from. Schnitzler is dissolute—as everyone knows. I have no appetite for such dalliance. Nor time. Nor money—I need every florin for books.”
Best to leave this topic quickly, Breuer thought. I have learned something important, however: I now know the limits of what I can ever hope to share with Freud.
“Sig, I’ve gotten us off the track. Let’s go back five minutes. You asked what I want to happen. I’m saying that I hope Herr Müller will talk about his despair. I hope he’ll use me as a father confessor. Maybe that in itself will be healing, maybe bring him back into the human fold. He’s one of the most solitary creatures I’ve ever met. I doubt he’s ever revealed himself to anyone.”
“But you told me he’s been betrayed by others. No doubt he trusted and revealed himself to them. Otherwise, there could be no betrayal.”
Breuer thought about his words for a few moments and then added, “You know, Sig, I treat all patients this way, so this should pose no problem in my future work with Herr Müller. But there’s my past duplicity with him—that he might view as betrayal. Yet I can’t undo it. I wish I could cleanse myself and share everything with him—my meeting with Fräulein Salomé, the conspiracy among his friends to steer him to Vienna, and, above all, my pretense that it is I, myself, and not he who is the patient.”
Freud shook his head vigorously. “Absolutely not! This cleansing, this confession, would be for your sake and not for his. No, I think if you really want to help your patient, you will have to live with the lie.”
Breuer nodded. He knew Freud was right. “All right, let’s take stock. What do we have so far?”
Freud responded quickly. He loved this type of intellectual exercise. “We have several steps. First, engage him by disclosing yourself. Second, reverse the roles. Third, help him disclose himself fully. And we have one fundamental principle: to retain his trust and avoid any semblance of betrayal. Now, what’s the next step? Suppose he does share his despair, then what?”
“Maybe,” Breuer replied, “there doesn’t have to be a next step? Perhaps simply revealing himself would constitute such a major achievement, such a change in his way of life, that it would be in itself sufficient?”
“Simple confession isn’t that powerful, Josef. If it were, there’d be no neurotic Catholics!”
“Yes, I’m sure you’re right. But perhaps”—Breuer took out his watch—“this is as much as we can plan for now.” He signaled the waiter for the check.
“Josef, I’ve enjoyed this consultation. And I appreciate the way we confer—it’s a honor for me to have you take my suggestions seriously.”
“Actually, Sig, you’re very good at this. Together we make a good team. Yet I can’t imagine a great clamor for our new procedures. How often do patients come along who require such a Byzantine treatment plan? In fact, I’ve felt today that we were not so much devising a medical treatment as planning a conspiracy. You know whom I’d prefer as a patient? That other one—the one who called for help!”
“You mean the unconscious consciousness trapped inside your patient.”
“Yes,” said Breuer, handing the waiter a florin note without checking the tally—he never did. “Yes, it’d be a lot simpler to work with him. You know, Sig, maybe that should be the goal of treatment—to liberate that hidden consciousness, to allow him to ask for help in the daylight.”
“Yes, that’s good, Josef. But is ‘liberation’ the term? After all, he has no separate existence; he’s an unconscious part of Müller. Isn’t integration what we’re after?” Freud seemed impressed with his own idea and pounded his fist softly upon the marble table as he repeated, “Integration of the unconscious.”
“Ach, Sig, that’s it!” The idea excited Breuer. “A major insight!” Leaving the waiter a few copper Kreuzer, he and Freud walked onto Michaelerplatz. “Yes, if my patient could integrate this other part of himself, that would be a real achievement. If he could learn how natural it is to crave comfort from another—surely that would be enough!”
Walking down the Kohlmarkt, they reached the busy thoroughfare of the Graben and parted. Freud turned down Naglergasse toward the hospital, while Breuer strolled through Stephansplatz toward Backerstrasse 7, which lay just beyond the looming Romanesque towers of the Church of Saint Stephen. The talk with Sig had left him feeling more confident about meeting tomorrow morning with Nietzsche. Nonetheless, he had a worrisome premonition that all this elaborate preparation might be only illusion—that Nietzsche’s preparation, not his own, would govern their encounter.
CHAPTER 14
NIETZSCHE WAS INDEED PREPARED. The following morning, as soon as Breuer completed his physical exam, Nietzsche took control.
“You see,” he told Breuer, displaying a large new notebook, “how well organized I am! Herr Kaufmann, one of your orderlies, was kind enough to purchase this for me yesterday.”
He rose from his bed. “I also ordered another chair for the room. Shall we move over to them and begin our work?”
Breuer, silently bemused by his patient’s grave assumption of authority, followed the suggestion and took a seat next to Nietzsche. Both chairs faced the fireplace, in which an orange blaze crackled. After warming himself for a moment, Breuer rotated his chair so that he could more easily see Nietzsche and persuaded Nietzsche to do the same.
“Let us begin,” Nietzsche said, “by establishing the major categories for analysis. I’ve listed the issues you mentioned yesterday when you asked for my help.”
Opening his notebook, Nietzsche showed how he had written on a separate page each of Breuer’s complaints, and read them aloud: “ ‘One, general unhappiness. Two, besieged by alien thoughts. Three, self-hatred. Four, fear of aging. Five, fear of death. Six, urges toward suicide.’ Is that complete?”
Taken aback by Nietzsche’s formal tone, Breuer did not enjoy hearing his innermost concerns condensed to a list and described so clinically. But, for the moment, he responded cooperatively. “Not quite. I have serious trouble relating to my wife. I feel unaccountably distant from her—as though I were trapped in a marriage and a life not of my own choosing.”
“Do you consider that one additional problem? Or two?”
“It depends on your unit definition.”
“Yes, that is a problem, as is the fact that the items aren’t on the same logical level. Some may be a result, or a cause, of others.” Nietzsche leafed through his notes. “For example, ‘unhappiness’ may be a result of ‘alien thoughts.’ Or, ‘urges toward suicide’ may be either a result or a cause of death fears.”
Breuer’s discomfort grew. He did not like the direction this exchange was taking.
“Why do we need to establish a list at all? Somehow the whole idea of a list makes me uncomfortable.”
Nietzsche looked troubled. His air of confidence was obviously tissue-thin. One demurral from Breuer, and his whole demeanor changed. He responded in a conciliatory tone.
“I thought we could proceed more systematically by establishing some priority of complaints. To be frank, however, I’m not certain whether to begin with the most fundamental problem—let us for the moment say, fear of death—or the least fundamental, or most derivative, one—let us say arbitrarily, invasion by alien thoughts. Or should we begin with the most clinically urgent, or life-threatening, one—let us say, suicidal urges. Or with the most troublesome problem, the one that most disturbs your everyday life—let us say, self-hatred.”
Breuer’s uneasiness grew. “I’m not at all sure this is a good approach.”
“But I’ve based it on your own medical method,” Nietzsche replied. “To the best of my recollection, you asked me to talk in general about my condition. You developed a list of my problems and then proceeded systematically—very systematically, as I recall—to explore each in turn. Is that not true?”
“Yes, that is the way I do a medical examination.”
“Then, Doctor Breuer, why do you resist such an approach now? Can you suggest an alternative?”
Breuer shook his head. “When you put it this way, I’m inclined to agree with your suggested procedure. It’s just that it seems forced or artificial to speak about my innermost life concerns in tidy categories. In my mind, all the problems are inextricably intertwined. Also, your list seems so cold. These are delicate, tender things—not so easy to talk about as back pain or skin rashes.”
“Do not mistake awkwardness for callousness, Doctor Breuer. Remember, I am a solitary person, as I warned you. I’m not accustomed to easy and warm social exchange.”
Closing his notebook, Nietzsche stared out the windo
w for a moment. “Let me take another approach. I recall your saying yesterday that we must invent our procedure together. Tell me, Doctor Breuer, have you had any similar experience in your practice from which we can draw?”
“Similar experiences? Hmm. . . there’s no real precedent in medical practice for what you and I are doing. I don’t even know what to call it—maybe despair therapy or philosophic therapeutics, or some name yet to be invented. It’s true that physicians are called upon to treat certain types of psychological disturbance: for example, ones that have a physical basis, like the delirium of brain fever, the paranoia of brain syphilis, or the psychosis of lead poisoning. We also take the responsibility for patients whose psychological condition damages their health or threatens life—for example, severe involutional melancholia or mania.”
“Threatening to life? How so?”
“Melancholics starve themselves or may commit suicide. Manics often exhaust themselves to death.”
Nietzsche did not respond, but sat silent, staring at the fire.
“But obviously,” Breuer continued, “these are far removed from my personal situation, and the treatment for each of these conditions is not philosophic or psychological but instead some physical approach, such as electrical stimulation, baths, medication, enforced rest, and so on. Occasionally, with patients who have an irrational fear, we must devise some psychological method to calm them. Recently I was called to see an elderly woman who was terrified of going outside—she had not left her room in months. What I did was to speak to her kindly until she trusted me. Then, each time I saw her, I held her hand to increase her sense of safety and escorted her a little farther out of her room. But this is commonsense improvisation—like training a child. Such work hardly requires a physician.”
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