When Nietzsche Wept

by Irvin D. Yalom

  Surprised by Nietzsche’s sudden closure, Breuer looked at his watch and saw he had still another ten minutes available. But he offered no objection and left Nietzsche’s room feeling the relief of a schoolboy released early from class.

  Excerpts from Dr. Breuer’s Case Notes on Eckart Müller, 7 December 1882

  Patience, patience, patience. For the first time, I learn the meaning and the value of the word. I must keep in mind my long-range goal. All bold, premature steps at this stage fail. Think of the chess opening. Develop pieces slowly and systematically. Build a solid center. Don’t move a piece more than once. Don’t take out a queen too early!

  And it is paying off? The big step forward today was the adoption of first names. He almost choked at my proposal; I could barely suppress my laughter. For all his free-thinking, he is a Viennese at heart and loves his titles—almost as much as his impersonality! After my Friedrich-ing him repeatedly, he began to reciprocate.

  It made a difference in the atmosphere of the session. Within a few minutes, he opened the door a tiny crack. He alluded to having had more than his share of crises and of being forty when he was twenty! I let this pass—for now! But I must return to it!

  Perhaps, for the time being, it is best if I forget about my attempts to help him—best if I simply flow with his efforts to help me. The more genuine I am, the less I try to manipulate, the better. He is like Sig—he has the eyes of a hawk and sees through any dissembling.

  A stimulating discussion today, like the old days in Brentano’s philosophy class. At times I got swept up in it. But was it productive? I repeated for him my concerns about aging, mortality, and purposelessness—all the morbid meditations of mine. He seemed strangely intrigued by my old refrain of the lad of infinite promise. I’m not sure I entirely understand his point yet—if there is one!

  Today his method is clearer to me. Since he believes that my Bertha obsession serves to divert me from these .Existenz concerns, his intent is to confront me with them, to stir them up, probably to make me more uncomfortable. Hence, he prods sharply and offers no support whatsoever. Given his personality, that, of course, is not difficult for him to do.

  He appears to believe that a method of philosophic disputation will affect me. I try to let him know it does not touch me. But he, like me, keeps experimenting and improvising methods as he proceeds. His other methodological innovation today was to employ my “chimneysweeping” technique. It feels odd for me to be the sweeper rather than the overseer—odd, but not unpleasant.

  What is unpleasant and irritating is his grandiosity, which shines through repeatedly. Today he claimed that he will teach me about the meaning and value of life. Only not now! I’m not yet ready for it!!

  Friedrich Nietzsche’s Notes on Dr. Breuer, 7 December 1882

  Finally! A discussion worthy of my attention—a discussion that proves much that I have thought. Here is a man so weighed down with gravity—his culture, his state, his family—as never to have known his own will. So kneaded into conformity is he that he looks astonished when I speak of choice, as though I were speaking some alien tongue. Perhaps conformity particularly constricts the Jews—external persecution binds a people so tight together that the single one cannot emerge.

  When I confront him with the fact that he has allowed his life to be an accident, he denies the possibility of choice. He tells me that no one embedded in a culture can choose. When I gently confront him with Jesus’ mandate to break with parents and culture in pursuit of perfection, he declares my method too ethereal and changes the subject.

  It is curious how he had the concept in his grasp at an early age, but never developed the vision to see it. He was “the lad of infinite promise”—as are we all—but never understood the nature of his promise. He never understood that his duty was to perfect nature, to overcome himself, his culture, family, lust, his brutish animal nature, to become who he was, what he was. He never grew, he never shed his first skin: he mistook the promise to be the acquisition of material and professional objectives. And when he achieved these objectives without having ever quieted the voice that said, “Become yourself, ” he lapsed into despair and railed at the trick played on him. Even now he does not get the point!

  Is there hope for him? He at least thinks about the right issues and does not resort to religious deceptions. But he has too much fear. How do I teach him to become hard? He once told that cold baths are good for toughening the skin. Is there a prescription for toughening resolve? He has arrived at the insight that we are ruled not by God’s desire, but by time’s desire. He realizes that the will is powerless against the “thus it was. ” Do I have the ability to teach him to transform the “thus it was” into the “thus I willed it”?

  He insists on calling me by my first name, even though he knows it is not my preference. It is but a small torment; I am strong enough to permit him that little victory.

  Letter to Lou Salomé from Friedrich Nietzsche, December 1882

  Lou,

  Whether I suffer a lot is inconsequential compared to the question of whether or not, dear Lou, you will find yourself again. I’ve never dealt with so poor a person as you are:

  unknowing but sharp-witted

  rich in using up what’s known

  without taste but naïve in this shortcoming

  honest and just in small matters, out of stubbornness usually

  On the larger scale, the entire stance toward life—dishonest

  without any sensitivity for giving or taking

  without spirit and incapable of love

  in affect always sick and near to madness

  without thankfulness, without shame toward benefactors

  in particular

  undependable

  not well behaved

  crude in things of honor

  a brain with the first signs of a soul

  character of the cat—the predator clothed as a house pet

  nobleness as reminiscence of familiarity with nobler people

  a strong will, but not a large object

  without diligence and purity

  cruelly displaced sensuality

  childish egoism as a result of sexual atrophy and delay

  without love to people but love to God

  in need of expansion

  crafty, full of self-restraint in reference to the sexuality of men

  Yours,

  F.N.

  CHAPTER 17

  THE NURSES AT THE LAUZON CLINIC rarely talked about Herr Müller, Dr. Breuer’s patient in room 13. There was little to say. To a busy, overworked nursing staff, Herr Müller was the ideal patient. During the first week, he had had no attacks of hemicrania. He made few demands and required little attention aside from the monitoring of vital signs—pulse, temperature, respiratory rate, and blood pressure—six times a day. The nurses regarded him—as had Frau Becker, Breuer’s nurse—as a true gentleman.

  It was clear, however, that he valued his privacy. He never initiated conversation. When called upon by the staff or other patients, he spoke amiably and briefly. He chose to take his meals in his room and, after his morning sessions with Dr. Breuer (which, the nurses assumed, consisted of massage and electrical treatments), he spent most of his day alone, writing in his room or, if weather permitted, scribbling notes while strolling around the garden. About his writing, Herr Müller courteously discouraged inquiries. It was known only that he was interested in Zarathustra, an ancient Persian prophet.

  Breuer was impressed by the discrepancy between Nietzsche’s gentle manner in the clinic and the shrill, often combative voice in his books. When he put the question to his patient, Nietzsche smiled and said, “It’s no great mystery. If no one will listen, it’s only natural to shout!”

  He seemed content with his life in the clinic. He told Breuer not only that his days were pleasant and pain-free, but also that their daily talks together were productive for his philosophy. He had always been contemptuous of philosophers like Kant and Hegel,
who wrote, he said, with an academic stylus solely for the academic community. His philosophy was about life and for life. The best truths, he always said, were bloody truths, ripped out of one’s own life experience.

  Before his connection with Breuer, he had never attempted to put his philosophy to practical use. He had casually dismissed the problem of application, claiming that those who could not understand him were not worth troubling with, whereas the superior specimens would find their way to his wisdom—if not now, then a hundred years later! But his daily encounters with Breuer were forcing him to take the matter more seriously.

  Nevertheless, these carefree, productive Lauzon days were not so idyllic for Nietzsche as they seemed on the surface. Subterranean crosscurrents sapped his strength. Almost daily, he composed enraged, longing, desperate letters to Lou Salomé. Her image incessantly invaded his mind and diverted his energy from Breuer, from Zarathustra, and from the sheer joy of luxuriating in days free of pain.

  Whether viewed from the surface or the depths, Breuer’s life during the first week of Nietzsche’s hospitalization was harried and tormented. The hours spend at the Lauzon taxed an already-burdened schedule. An invariable rule of Viennese medicine was that the worse the weather, the busier the physician. For weeks, a grim winter with unremitting gray skies, chilling blasts of northern wind, and heavy, soggy air sent patient after patient trudging in a steady stream into his examination room.

  December diseases dominated Breuer’s docket: bronchitis, pneumonitis, sinusitis, tonsillitis, otitis, pharyngitis, and emphysema. In addition, there were always patients with nervous diseases. That first week of December, two new young patients with disseminated sclerosis entered his office. Breuer especially hated this diagnosis: he had no treatment whatsoever to offer for the condition and dreaded the dilemma of whether to tell his young patients about the fate lying ahead of them: increasing disability, and episodes of weakness, paralysis, or blindness that could strike at any moment.

  That first week as well, two new patients appeared who had no evidence of organic pathology and who, Breuer was certain, were suffering from hysteria. One, a middle-aged woman, had, during the past two years, experienced spastic seizures whenever she was left alone. The other patient, a girl of seventeen, had a spastic disorder of the legs and could walk only by using two umbrellas as canes. At irregular intervals, she had lapses in consciousness when she shouted such strange phrases as: “Leave me! Get gone! I’m not here! It’s not me!”

  Both patients, Breuer believed, were candidates for the Anna O. talking treatment. But that course of treatment had taken too heavy a toll—on his time, his professional reputation, his mental equilibrium, and his marriage. Even as he was vowing never to undertake it again, he found it demoralizing to turn to the conventional, ineffective therapeutic regimen—deep muscle massage and electrical stimulation according to the precise, yet unvalidated guidelines Wilhelm Erb had worked out in his widely used Handbook of Electrical Therapeutics.

  If only he could have referred these two patients to another physician! But to whom? No one wanted such referrals. In December of 1882, there was, aside from him, no one in Vienna—no one in all of Europe—who knew how to treat hysteria.

  But Breuer was exhausted not by the professional demands upon him, but by the self-imposed psychological torment he was suffering. Their fourth, fifth, and sixth sessions had followed the agenda established in their third meeting: Nietzsche pressed him to confront the Existenz issues in his life, especially his concerns about purposelessness, his conformity and lack of freedom, and his fears of aging and death. If Nietzsche really wants me to become more uncomfortable, then, Breuer thought, he must be pleased by my progress.

  Breuer felt truly miserable. He was growing even more estranged from Mathilde. Anxiety weighed him down. He could not free himself of the pressure in his thorax. It was as though a giant vise were crushing his ribs. His breathing was shallow. He kept reminding himself to breathe deeply; but no matter how hard he tried, he could not exhale the tension that constricted him. Surgeons had now learned to insert a thoracic tube in order to drain a patient’s pleural fluid; sometimes he imagined plunging tubes into his chest and armpits and sucking out his Angst. Night after night, he suffered from dreadful dreams and severe insomnia. After several days, he was taking more chloral for sleep than was Nietzsche. He wondered how long he could continue. Was such a life worth living? Sometimes he thought about taking an overdose of Veronal. Several of his patients had endured suffering like this for years. Well, let them do it! Let them cling to a meaningless, miserable life. Not he!

  Nietzsche, supposedly there to help him, gave him little comfort. When he described his anguish, Nietzsche dismissed it as a trifle. “Of course you suffer, it’s the price of vision. Of course, you are fearful, living means to be in danger. Grow hard!” he exhorted. “You are not a cow, and I am no apostle of cud chewing.”

  By Monday night, one week after they had agreed upon their contract, Breuer knew that Nietzsche’s plan had gone seriously awry. Nietzsche had theorized that the Bertha fantasies were a diversionary tactic on the part of the mind—one of the mind’s “back alley” tactics to avoid facing the far more painful Existenz concerns clamoring for attention. Confront the important Existenz issues, Nietzsche had insisted, and the Bertha obsessions would simply fade away.

  But they did not fade! The fantasies overran his resistance with ever greater ferocity! They demanded more from him: more of his attention, more of his future. Again, Breuer imagined changing his life, finding some way to break out of his prison—his marital-cultural-professional prison—and to flee from Vienna with Bertha in his arms.

  One specific fantasy gathered strength. He imagined returning home one night to see a cluster of neighbors and firemen gathered in his street. His house is on fire! He throws his coat over his head and charges past restraining arms up the stairs into the burning house to save his family. But the flames and the smoke make rescue impossible. He loses consciousness and is rescued by firemen, who tell him his entire family have died in the fire: Mathilde, Robert, Bertha, Dora, Margarethe, and Johannes. Everyone praises his courageous attempt to save his family, everyone is aghast at his loss. He grieves deeply, his pain inexpressible. But he is free! Free for Bertha, free to escape with her, perhaps to Italy, perhaps to America, free to begin all over again.

  But will it work? Is she too young for him? Are their interests the same? Will love stay? No sooner did these questions appear than the loop began again: once more he is on the street, watching his house consumed in flames!

  The fantasy fiercely defended itself against interruption: once started, it had to be finished. Sometimes even in the brief interval between patients, Breuer would find himself in front of his burning house. If Frau Becker entered his office at this juncture, he pretended to be writing a note in a patient’s chart and motioned for her to leave him for a moment.

  While at home, he could not look at Mathilde without suffering paroxysms of guilt for having placed her in the burning house. So he looked at her less, spent more time in his laboratory doing research with his pigeons, more evenings at the coffeehouse, played tarock with friends twice a week, accepted more patients, and returned home very, very tired.

  And the Nietzsche project? He was no longer actively struggling to help Nietzsche. He took refuge in a new thought: maybe he could best help Nietzsche by letting Nietzsche help him! Nietzsche seemed to be doing well. He was not abusing drugs, he slept soundly with only a half gram of chloral, his appetite was good, he had no gastric pains, and his migraine had not returned.

  Breuer now fully acknowledged his own despair and his need for help. He stopped deceiving himself; stopped pretending he was talking to Nietzsche for Nietzsche’s sake; that the talking sessions were a ploy, a clever strategy to induce him to talk about his despair. Breuer marveled at the seductiveness of the talking treatment. It drew him in; to pretend to be in treatment was to be in it. It was exhilarating to unburden hims
elf, to share all his worst secrets, to have the undivided attention of someone who, for the most part, understood, accepted, and seemed even to forgive him. Even though some sessions made him feel worse, he unaccountably looked forward to the next with anticipation. His confidence in Nietzsche’s abilities and wisdom increased. There was no longer doubt in his mind that Nietzsche had the power to heal him—if only he, Breuer, could find the path to that power!

  And Nietzsche the person? Is our relationship, Breuer wondered, still solely professional? Certainly he knows me better—or, at least, knows more about me—than anyone in the world. Do I like him? Does he like me? Are we friends? Breuer wasn’t sure about any of these questions—or about whether he could care for someone who remained so distant. Can I be loyal? Or will I, too, one day betray him?

  Then something unexpected happened. After leaving Nietzsche one morning, Breuer arrived at his office to be greeted as usual by Frau Becker. She handed him a list of twelve patients, with red checks beside the names of those who had already arrived, and a crisp blue envelope on which he recognized Lou Salomé’s handwriting. Breuer opened the sealed envelope and extracted a silver-bordered card:

  11 December 1882

  Dr. Breuer,

  I hope to see you this afternoon.

  Lou

  Lou! No reservations about first names with her! Breuer thought, and then realized Frau Becker was speaking.

  “The Russian Fraulein strolled in an hour ago asking to see you,” explained Frau Becker, a frown creasing her usually smooth forehead. “I took the liberty of telling her about your heavy morning schedule, and she said she’d return at five. I let her know that your afternoon was just as heavily scheduled. Then she requested Professor Nietzsche’s Vienna address, but I told her I knew nothing about it, and she’d have to talk to you about that. Did I do the right thing?”