Freud: It is, on the contrary, obvious that a single case history, even if it were complete and open to no doubt, cannot provide an answer to all the questions arising out of the problem of hysteria . . . It is not fair to expect from a single case more than it can offer. And anyone who has hitherto been unwilling to believe that a psychosexual aetiology holds good generally and without exception for hysteria is scarcely likely to be convinced of the fact by taking stock of a single case history.17
Michael Sherwood: This situation is almost unique: in perhaps no other field has so great a body of theory been built upon such a small public record of raw data.18
The problem, though, is not that Freud published so few of these ‘observations’, since one observation, if it is well executed, can revolutionise an entire discipline. (Ian Hacking,19 quite rightly, points out that Michelson and Morley’s famous experiments on the Earth’s motion relative to ether – in which we see an anticipation of the theory of relativity – were comprised of Michelson’s observations made in the space of a few hours on the days of 8, 9, 11 and 12 July 1887.) What is problematic about Freud’s observations is the fact that he was the only one who had access to them, contrary to the demands of publicity which have characterised science since the seventeenth century. As Steven Shapin has shown,20 this demand is an entirely integral aspect of the ‘Scientific Revolution’, not to mention the modern sciences among which psychoanalysis is supposedly situated. For Boyle and his colleagues at the Royal Society, only an experiment visually certified by multiple competent and credible witnesses was sufficient to establish a fact: a matter of fact, around which a consensus could be made. The experiments of Boyle, Hooke and Oldenburg, for this reason, were carried out in a public location (a laboratory in the halls of the Royal Society), and they were open to their peers, who were called upon to sign the official report. As for colleagues who lived far away, they were furnished with detailed experimental protocols so that they could reproduce the experiment themselves, and thus, in their turn, be witnesses to the matter of fact.
This ideal of direct observability and possible replication – whether ultimately realised or not – is one of the traits that most efficiently distinguishes modern science from the initiatory and secretive practices that preceded it, and it continues to define the scientific ethos, whatever the field. Thus, even during Freud’s time, any doctor or researcher could attend Charcot’s patient demonstrations or Bernheim’s hypnosis sessions, both to verify the authenticity of the phenomena they described, and to train in their techniques. It was after a visit to the Salpêtrière, for example, that Delbœuf became convinced of the artefactual nature of Charcot’s grande hystérie and grand hypnotisme.21 Likewise, it was after their return from a visit to Bernheim’s clinic in Nancy that Forel, Freud and several others began practising ‘suggestive psychotherapy’ in their clinics or private offices.
Bernheim: The many French and foreign colleagues who have done me the honor of visiting my clinic have been able to appreciate that my greatest concern has been not to go beyond the limits of the most scrupulous observation, and not to cross beyond the frontiers of demonstrable truths. Those of my colleagues who retain some doubts, either because they have not seen my cases or because they know about them incompletely, display a wise and scientific skepticism. But if they are willing to visit my clinic they will find here the continuing demonstration of the facts I report.22
At the beginning of the twentieth century, this ease of access to clinical materials and training techniques (which is to say, of reproducibility) naturally continued to characterise the majority of European clinics in which psychotherapy was practised. This is especially true at the Burghölzli clinic, where psychoanalysis, as we have seen, was taught just like any other medical technique. Researchers who came there for an internship could have on-the-job training in the new techniques by witnessing analytic interviews with patients, by undergoing analysis with Jung, Riklin or Maeder, or again by collectively analysing their dreams and slips of the tongue during the meals they took together.
Bleuler, 1910: The doctors of the Burghölzli have not only interpreted one another’s dreams, they have paid attention for years to those complex indicators which have been offered: mistakes, slips of the pen, a word written over the line, symbolic actions, the humming of unconscious melodies, acts of forgetting, and so on. In this manner we have got to know one another, and have mutually obtained an integrated portrait of our character and our conscious and unconscious strivings.23
Again: in 1909 the title of Jung’s lectures for the summer semester was ‘Course in Psychotherapy with Demonstrations’,24 making clear the open nature of the teaching being done in Zurich.
In Vienna, however, things were done much differently. Owing to the confidentiality that Freud’s private clientele demanded, no one was allowed to come into his office to verify de visu the exactitude of his observations or to learn the finer points of his technique. To be honest, though, this obstacle wasn’t insurmountable. Freud quite easily could have asked his patients for their permission to have a colleague witness the sessions and, undoubtedly, it would have been obtained on the condition that this colleague also respect medical confidentiality (which went without saying: the observations doctors published at this time never revealed the names of the patients, even when aliases were used). It was in this way, for example, that Breuer had asked Krafft-Ebing to observe his patient Bertha Pappenheim;25 and there was nothing extraordinary about this. Even the first analysts found it completely natural to allow their colleagues to attend analysis sessions.
Ernest Jones, on Otto Gross: He was my first instructor in the practice of psychoanalysis and I used to be present during his treatment of a case.26
Ferenczi, 5 February 1910: I believe I have found a recruit of some importance for our cause in the person of a young student. His name is . . . Vajda . . . Currently, I am undertaking an experiment with him. I have chosen . . . an exemplary case of anxiety hysteria, and I am analyzing the patient in Vajda’s presence, three times a week. He acts as my ‘secretary.’ And the arrangement works! This is not without interest for the teaching of psychoanalysis.27
Angelo Hesnard: We remember our astonishment when, during our first research studies in collaboration with some of Freud’s disciples, we attended several . . . interviews between the analyst and analyzed, during which the former was practically silent for hours at a time, while the second, orienting his reverie little by little in a personal direction, naturally, and sometimes without any intervention by the doctor, yielded confidences of perfect transparency.28
Freud, however, strongly insisted that the delicate nature of his patients’ confidences meant that such ‘scientific uses’ of ‘their admissions’ were entirely out of the question.
Freud: The presentation of my case histories remains a problem which is hard for me to solve . . . If it is true that the causes of hysterical disorders are to be found in the intimacies of the patients’ psycho-sexual life, and that hysterical symptoms are the expression of their most secret and repressed wishes, then the complete elucidation of a case of hysteria is bound to involve the revelation of those intimacies and the betrayal of those secrets. It is certain that the patients would never have spoken if it had occurred to them that their admissions might possibly be put to scientific uses; and it is equally certain that to ask them themselves for leave to publish their case would be quite unavailing . . .29 I am aware that – in this city, at least – there are many physicians who (revolting though it may seem) choose to read a case history of this kind not as a contribution to the psychopathology of the neuroses, but as a roman à clef designed for their private delectation. I can assure readers of this species that every case history which I may have occasion to publish in the future will be secured against their perspicacity by similar guarantees of secrecy, even though this resolution is bound to put quite extraordinary restrictions upon my choice of material.30
It will be remarked that here Fr
eud speaks of the necessity of hiding his patients’ identities from the public, which is an entirely legitimate concern. But why expand this embargo to include those colleagues bound by professional secrecy? It’s one thing to protect a patient’s privacy from the public; it’s something else to shield their analyses from any peer evaluation or ‘case presentation’. No one, in fact, would push the principle of medical confidentiality to such an extreme, and apply it in such a rigid manner, as Freud and his successors did.31 Psychoanalysis is a strange, confidential science, in the sense that the direct and public presentation of the matter of fact is quite literally forbidden, tabooed and scandalised. From this point of view, Freud’s private office was indeed closer to the laboratory of the ancient alchemists, where a “secret art” was practised, than to the open and transparent space of the modern laboratory. No one penetrated his lair; no one saw the ‘transmutations of psychological values’ achieved by the scientist; and thus no one would know how to reproduce them independently. Freud is the sole witness to what transpired behind the padded doors of 19 Berggasse, and of his cases we know only what he wanted to tell us in his case histories. For the rest of us, all we know about his method of working comes from the sparse technical writings that he left us.
Freud: I have as a rule not reproduced the process of interpretation to which the patient’s associations and communications had to be subjected, but only the results of that process. Apart from the dreams, therefore, the technique of the analytic work has been revealed in only a very few places . . . Before the technical rules, most of which have been arrived at empirically, could be properly laid down, it would be necessary to collect material from the histories of a large number of treatments.32
Strachey: An examination of the list of Freud’s technical writings . . . will show that after [the publication of the Studies on Hysteria in 1895], apart from two very sketchy accounts dating from 1903 and 1904, he published no general description of his technique for more than fifteen years . . . The relative paucity of Freud’s writings on technique, as well as his hesitations and delays over their production, suggests that there was some feeling of reluctance on his part to publish this kind of material. And this, indeed, seems to have been the case, for a variety of reasons . . . Behind all his discussions of technique, however, Freud never ceased to insist that a proper mastery of the subject could only be acquired from clinical experience and not from books. Clinical experience with patients, no doubt, but, above all, clinical experience from the analyst’s own analysis.33
One of the most immediate consequences of this ‘secretist’ practice was the elevation of Freud’s case histories to the status of paradigms for analytic practice (the term Paradigma is often used by Freud himself).34 Insofar as third-person observation of an analysis was out of the question, those who wanted to be trained in analysis were forced to fall back on Freud’s case histories and/or put themselves on the master’s couch (as the observed, not as observers). Even today, analysts in training learn psychoanalysis not by observing a senior practitioner’s analyses, but by studying Freud’s case studies, and by making a didactic analysis with an analyst who learned the same way. As a result, climbing back up the chain we always find ourselves with Freud and his canonical case histories – endlessly copied and ‘confirmed’ by successive generations of analysands/analysts. In this respect, it is not exactly accurate to say, as Sulloway has,35 that the non-scientific character of the new technique Freud developed is marked by the fact that his peers couldn’t replicate it. On the contrary, there are undoubtedly few domains where the replication has been so well cultivated and with so much success. In other sciences, practitioners rarely take the time to repeat experiments that have already been conducted, and when they do attempt to do so the replication is almost never perfect, owing to the inadequate transmission of the ‘implicit knowledge’ necessary to make the equipment work.36 What is replicated in psychoanalysis, however, is not the experiment itself, but Freud’s report of it – which is obviously quite different. Those who accept this report as the thing itself certainly have little difficulty finding the phenomena it describes wherever they look: it’s simply a matter of reciting it, and having it recited to them. But for the more sceptical, if they want to verify the accuracy of the report, they will have about as much luck catching their own shadow. In several cases, when Freud’s colleagues tried to apply the psychoanalytic method to see for themselves, they ended up with much different observations and reports.
Adolf Friedländer: In my ‘Brief Remarks on Freud’s Doctrine relative to the Sexual Etiology of the Neuroses,’ and in an address before a medical society in Frankfurt, I have reported that in order to be impartial I have decided to apply Freud’s psychoanalytic method in several cases. The results were not of a nature to change my [critical] views.37
Janet: If the psychoanalytical method means, at any cost, and with aid of the most improbable and most ridiculous interpretations, the discovery of sexual fixed ideas, it is clear that the authors I have quoted, and I myself, have not practised psychoanalysis. Are we to blame for that? The very thing we are discussing is the justification for pushing this method of sexual interpretation to an extreme . . . Who is entitled to insist upon us using a method which is discredited by our own observations?38
Forel: I now intend to briefly provide three examples of psychoanalyses, two of them practiced by myself, and one by Frank. The question of knowing if, in the first case, sexual anaesthesia is a purely individual and innate trait or if it is caused by a Freudian ‘repression’ wasn’t resolved by the analysis; the woman remained as frigid as before. For the Freudian School, every case of this type concerns repression. But such a supposition is completely arbitrary and I contest its validity.39
Here we touch upon another consequence of Freudian secrecy: the necessity of taking Freud at his word. As the philosopher Frank Cioffi aptly remarks, psychoanalysis is a testimonial science,40 based on the veracity of its founder. With Freud as the sole witness to the phenomena invoked by the theory, it is extraordinarily important that his case reports and clinical observations be absolutely reliable. If they aren’t – if, for example, it turns out that Freud let himself be influenced by preconceived ideas, personal considerations or the desire to contradict an adversary – then the entire edifice would be threatened. We would no longer have clinical ‘data’, only biases. This is why, from very early on, the Freudian legend doubled as a personality cult. Freud, Jones thus tells us, was a man of ‘absolute honesty’ and ‘flawless integrity’;41 a man who was ready to sacrifice friendships and theories upon the altar of Science. (Jones, with some difficulty, concedes that the murky Swoboda–Weininger scandal, in which Fliess caught Freud red-handed in a lie, was the exception which proved the rule: ‘It was perhaps the only occasion in Freud’s life when he was for a moment not completely straightforward.’42) This personality cult may seem a harmless accessory, but it corresponds to a profound epistemological necessity. If it wasn’t possible for Freud to lie, it’s simply because, in the absence of the thing itself, we have only the witness’s good faith to rely upon.43 As Lacan might have said: the Freudian field is structured by a symbolic pact with the founding Father, whose Word, which his sons constantly return to, is the sole guarantor of their practice. This is what explains, for example, why the question of knowing whether Freud cheated on his wife with his sister-in-law is so significant for psychoanalysts. In any other scientific discipline, such a preoccupation with the vulgar details of the founder’s biography would seem trivial and inappropriate; but not in psychoanalysis, where such questions stir up a tide of polemics and erudite commentaries.44 They go directly to the reliability of the Witness of the Unconscious: how could we believe someone whose soul and desire weren’t pure? Here again, it’s Lacan who sums it up. Lacan: What is it that makes us say at once that . . . alchemy, when all is said and done, is not a science? Something, in my view, is decisive, namely, that the purity of soul of the operator was, as such, and in a
specific way, an essential element in the matter. This remark is not beside the point, as you may realize, since we may be about to raise something similar concerning the presence of the analyst in the analytic Great Work, and to maintain that it is perhaps what our training analysis seeks. I may even seem to have been saying the same thing myself in my teaching recently, when I point straight out, all veils torn aside, and in a quite overt way, towards that central point that I put in question, namely – what is the analyst’s desire?45
Narrating the unconscious
Was the founding analyst’s desire pure? Let’s suppose for a minute that it was. Let’s suppose, in other words, that we could respond negatively to Frank Cioffi’s famous question: ‘Was Freud a liar?’46 Would his case histories, because of this, be any more reliable? By no means. It is essential to understand that a written report is not a simple ‘observation’ of reality. All narration, as sincere as it may be, implies a selection, a montage, a ‘configuration’47 and a ‘retrodiction’48 of events from the narrator’s point of view (this is what we could call, in honour of Kurosawa’s beautiful film, the Rashomon effect). This is the reason why Boyle and his colleagues at the Royal Society were so insistent that experiments and observations be made in public. In their eyes, only a convergence of multiple testimonies was capable of correcting the errors of individual witnesses.
The Freud Files Page 22