In the meantime, other experiments were taking place at the Burghölzli in the field of experimental psychopathology on associations. These were inscribed in a more general tendency to utilise the methods of the new scientific psychology in psychiatry. The psychiatrist Gustav Aschaffenburg, a student of Wundt, had applied the latter’s work on verbal associations to psychopathological research. This drew the interest of the Burghölzli psychiatrists, notably Jung and Franz Riklin. It was hoped that the association experiment could provide a quick and reliable means of differential diagnosis. Despite grand promissory claims in print by Bleuler, this project was an abject failure. Experimenters failed to differentiate sexes, let alone make fine diagnostic discriminations. Jung and Riklin salvaged the operation by linking failures to respond and failed reaction times to Freud’s account of repression. The stimulus words, they claimed, could be regarded as indicators of affectively stressed complexes.
The linkage was fateful. Jung claimed that psychoanalysis was a difficult art, and that what was lacking was a basic framework. This could be provided by the association experiment, which could facilitate and shorten psychoanalysis.105 However, what was described as psychoanalysis strictly along Freud’s lines included hypnosis and the recollection of traumatic sexual memories, from the time of the Studies on Hysteria and the defunct seduction theory. Visibly, news of changes in Freud’s theories were slow to reach the Burghölzli. Jung, together with Forel and most contemporaries, did not realise that Freud’s method had radically changed – and for good reason, since Freud had not clearly indicated his rupture with Breuer and his abandonment of the seduction theory.106
Jung: At last in one of the latest sessions, came the narration of an event which in every respect had the significance of Freud’s youth trauma.107
In paper after paper, the Burghölzli researches replicated Freud’s abandoned theories. Association experiments, followed by abreaction, were throwing up a series of childhood sexual traumas. In other words, the Burghölzli psychiatrists were replicating and providing proof for theories which Freud had already abandoned. The situation was paradoxical. Freud had finally found an echo in mainstream psychiatry, but it was for theories which he had given up. Scientific replication, which was supposedly the source of reliable consensus, had led to the uncontrollable proliferation of simulacras. Freud, as one sees in his first exchanges with Jung and Abraham, had a delicate damage limitation exercise on his hands.
At any rate, Bleuler and Jung’s advocacy of Freud (and before them, that of Forel) brought psychoanalysis far greater visibility in German-language psychiatry. The Burghölzli became the hotbed of psychoanalysis, and foreign visitors, such as Ernest Jones, Sándor Ferenczi and Abraham Brill, streamed to it, as it was the only institution where one could learn how to practise psychoanalysis. Psychoanalysis was treated not as a separate discipline, requiring specific training or authorisation to practise, but as an auxiliary technique in medicine and psychiatry. Visitors to the Burghölzli were able to hear lectures on the subject, attend staff meetings where patients were subjected to analytical questioning, and have some sessions of analysis with figures such as Jung, Riklin and Maeder. The Burghölzli utilised an open model of instruction, similar to the one that Bernheim had established at Nancy for the teaching of hypnosis.
Furthermore, Jung and Riklin’s reformulation of the association experiment into a tool for clinical experimentation appeared to present psychoanalysis in a contemporary experimental manner. It was publicly demonstrable, complete with statistics, measurements down to the millisecond and sophisticated laboratory equipment such as the pneumograph. The association experiment had thus all the paraphernalia and trappings that were being increasingly taken as the hallmarks of science in psychology. Compared with this, Freud’s sole apparatus of the couch seemed a relic of the hypnotic era. If one wanted to find out about psychoanalysis, the first destination of choice was therefore not Vienna, but Zurich. This brought several problems with it, at least from Freud’s point of view. Indeed, it fostered a situation in which a growing number of psychiatrists started getting interested in psychoanalysis without being in direct contact with him. In addition, and more worryingly, if psychoanalysis could easily be practised and tested, it could also as easily be disproven.
When a theory achieves greater visibility, it inevitably attracts discussion and contradiction. From 1906 onward, a series of debates about psychoanalysis took place in psychiatric congresses, which lasted until 1913. It is striking that, despite invitations, Freud himself did not take part. Aloof disengagement and deputised representation were to be Freud’s style. He delegated the task of defending his theories to his followers and, withdrawing behind a haughty silence, which his contemporaries viewed as a refusal of debate.
Jung, 29 August 1953: He never risked himself in a congress and never defended his cause in public! . . . This always made him afraid! America was the first and only time! . . . He was too touchy!108
May 1906, Baden-Baden: a congress of the South West German Neurologists and Psychiatrists. Gustav Aschaffenburg, Professor of Psychiatry at Cologne and former student of Wilhelm Wundt, presented a paper on the ‘Relations of sexual life to the development of nervous and mental illnesses’. After considering the work of Leopold Löwenfeld and Willy Hellpach, Aschaffenburg turned his attention to Freud. Löwenfeld had noted that at the present time, since Freud alone was the master of the psychoanalytic method, there was no way to test his results. Aschaffenburg maintained, on the contrary, that this could be done through the association experiment. Referring to Jung’s recent work, he argued that psychoanalysis was not fundamentally different from the association experiment, and a consideration of the latter demonstrated that Freud interpolated a sexual meaning into harmless processes. Against this explanation Aschaffenburg acknowledged that one had to consider the objection that patients confirmed Freud’s interpretations. Daily experience showed that patients often expressed foolish explanations for events and accepted them from others. The power of influence – particularly when Freud himself was convinced of the correctness of his conceptions and that his patients were hysterics – was enough to explain why this happened.
Gustav Aschaffenburg: Freud lets the person whom he examines associate freely and this continues until, from time to time, he thinks that he has discovered a precise index, and then he draws his patient’s attention to this and gets him to associate further starting from this new point of departure. But most patients who go to see Freud already know in advance where he wants to go and this thought immediately evokes complexes of representations connected to the sexual life . . . But if the sexual trauma always appears with him as the final result of his psychoanalyses, there is in my view only one possible explanation: that Freud as much as his patients is a victim of an auto-suggestion.109
Thus an objective evalution of the analytic procedure was quite possible. Aschaffenburg’s evaluation was resoundingly negative.
Aschaffenburg: Freud’s method is incorrect for most cases, dubious for many, and unnecessary for all.110
Freud did not reply to Aschaffenburg’s critique. Instead, it was answered in print by Jung. Jung began by writing that he was replying to Aschaffenburg’s ‘very moderate and careful criticism’ so as not to throw out the baby with the bath water. His line of defence was quite simple. First, he modified Freud’s ‘principles’ ‘with the understanding of the author’ to the statement that an indefinitely large number of cases of hysteria stem from sexual roots.111 Secondly, he argued that the only way to disprove this was to use Freud’s method. If he wanted to substantiate his criticisms of arbitrary interpretation and auto-suggestion, this was all Aschaffenburg had to do.
Jung: As soon as Aschaffenburg meets these requirements, that is to say, publishes psychanalyses with totally different results, we will have faith in his criticism, and then the discussion of Freud’s theory can be opened.112
Jung’s reply appeared in the Müncher medizinische Wochenschrift in Octo
ber. The following month, there was a meeting of the South West German Psychiatrists in Tübingen. Two Swiss psychiatrists and former students of Forel, Ludwig Frank and Dumeng Bezzola, spoke on the analysis of psychotraumatic symptoms. Their interest in Breuer and Freud’s cathartic method had been encouraged by Forel and his close collaborator Oskar Vogt.113 Frank continued to develop it. Encouraged in this by Forel and Vogt, they both shared an interest in Breuer and Freud’s cathartic method, which Frank had continued to develop under the name psychanalysis (Psychanalyse). Frank’s presentation was induced by Aschaffenburg’s critique at the congress in Baden-Baden, to which he objected, just like Jung, that only those who had practised psychanalysis were entitled to pass judgment on it. Based on his own experience, Frank presented a series of cases which, he claimed, demonstrated the effectiveness of the original Breuer–Freud method.
The support which Bezzola and Frank could provide Freud and the Burghölzli team was sizeable, since they could call on Forel and had numerous emulators in Forel’s school (Karl Graeter, R. Loÿ, Charles de Montet, Philipp Stein, W. Warda,114 etc.). Here were psychiatrists from across Europe who were replicating psychoanalysis and producing independent confirmations of it – exactly what was needed, in principle, to create a consensus around Freud’s theories. However, the problem was that the psychanalysis of which Frank spoke was no less dissimilar to Freud’s method than Jung and Riklin’s first association experiments.
Above all, it was a psychoanalysis without the ‘o’. Freud’s first use of the word psychoanalysis was in a paper published in French in the Revue neurologique.115 His French neologism, psychoanalyse, appears to have been directly modelled on the word psychotherapy.
Freud: I owe my results to a new method of psychoanalysis [d’une nouvelle méthode de psychoanalyse], Josef Breuer’s exploratory procedure . . . By means of that procedure – this is not the place to describe it – hysterical symptoms are traced back to their origin, which is always found in some event of the subject’s sexual life appropriate for the production of a distressing emotion.116
Curiously, Freud provided no definition, justification or extended description of the term, but simply retroactively applied it to what he had been content to describe in the previous year as a method of psychotherapy. Pierre Janet was later to complain that Freud had simply appropriated his work and that his psychoanalysis was nothing but a copycat name for his own psychological analysis (analyse psychologique).
Pierre Janet: They [Breuer and Freud] spoke of psychoanalysis where I had spoken of psychological analysis. They invented the name complex, whereas I had used the term psychological system . . . They spoke of catharsis where I had spoken of the dissociation of fixed ideas or of moral disinfection. The names differed, but the essential ideas I had put forward . . . were accepted without modification.117
Thus, for Janet, psychoanalysis was nothing but a copycat name for his own psychological analysis. Forel and his students, on the other hand, noted that Freud’s term was a barbarism which indicated an ignorance concerning the correct formation of words from Greek roots.118
Dumeng Bezzola to Jung, 1 May 1907: One speaks of psychoanalysis, as if the apostrophising was not as appropriate as with other compounds. Who says psychoiatry, psychoasthenia, etc.?119
Forel: I write ‘psychanalysis’ like Bezzola, Frank and Bleuler, and not ‘psychoanalysis’ as Freud does, according to the rational and euphonic derivation of the word. On this subject, Bezzola remarks for good reason that one writes ‘psychiatry’ and not ‘psychoiatry’.120
In addition, this psychanalysis relieved of its ‘o’ was a Breuerian psychanalysis. Frank and Bezzola reproached Freud for having abandoned the essential element of the cathartic method – hypnosis – without a convincing explanation. Hence, Frank recommended a type of hypnoanalysis combining interpretation and the induction of a hypnoid state. (Thus, before Lacan’s return to Freud, there had already been a return to Breuer in the history of psychoanalysis.)
Ludwig Frank: The original Breuer–Freud method which Freud later abandoned was analysis under hypnosis. I use this method most often and have studied it in the course of the years and it appears to me to be valuable.121
Bezzola likewise proposed a ‘modification of the Breuer–Freud procedure’, which he called ‘psychosynthesis’. He placed the patient in a relaxed position with closed eyes and, instead of Freudian associations, collected direct sensory impressions. In this regard, he found Jung’s association complexes of great heuristic value. Introductory hypnosis as well as Freud’s procedure of interpretation was unnecessary, since the self-observation of neurotic sensations could by itself bring about the experience corresponding to the hypnoid state.
Bezzola to Jung, 1 May 1907: Like psychoanalysis, it is another modification of the Breuerian method. The principle of healing (discovered by Breuer) remains the same.122
Finally, just like Breuer, Frank and Bezzola refused to follow Freud in his unilateral insistence on sexuality, however enlarged.
Frank: Freud has abandoned this method [the cathartic method] since many years. It is very much to be regretted that he has not given the grounds for this. His new method of treatment through interpretation and the limitless enlargement of his concept of sexuality have provoked in the discussion such a violent opposition to everything promoted and accomplished by Freud that there is a danger that also Breuer’s method of treatment and valuable developments by Freud [an allusion to the pressure method described by Freud in the Studies on Hysteria] will become forgotten and overlooked . . . It seems to me that Freud no longer takes account in his method of interpretation, at least in a great number of cases, of the important role of the hypnoid state in their genesis, to which he himself had drawn attention.123
Frank also noted that he had found that he couldn’t lead all cases back to a sexual cause, and he also thought that it wasn’t necessary to look for one if the treatment was successful. Clearly, the psychanalysis and psychosynthesis that Frank and Bezzola advocated against Aschaffenburg were rivals to Freud’s psychoanalysis. These new allies were in fact competitors.
In the discussion following Frank and Bezzola’s presentations, the psychiatrist Alfred Hoche expressed his profound scepticism regarding Freud’s new method.
Hoche: Certainly there is much that is new and good in Freud’s teaching of the psychoanalysis of hysteria; unfortunately the good is not new and the new is not good. That only good can come from medico-therapeutic effect of a deepened analysis of psychic phenomena and an intensive entering into the particular individuality of a single case, that for the patient to become clear about latent oppressing things and thus come to an expression where understanding is available, can be a relief, and even a solution. All this is not new. But the frequency with which the specifically sexual factor should play the main role according to Freud and others is not good. What have we then heard today? That doctors who have applied psychotherapy with interest and energy have succeeded in eliminating in a suggestive manner a series of subjectively tormenting conditions. That this is possible, we have known for a long time, but it does not need the label of a special method, which comes with the pretension of indicating something completely new. He who reads the Freudian ‘Fragment of a hysteria-analysis’ without prejudice will only put it down shaking his head. For my part, I must confess that it is for me wholly incomprehensible how anyone can take the train of thought produced there seriously. Still less do I understand it, if we – those present – are reproached that we are not at all in a position to be spoken with as long as we have not likewise utilized this ‘method’. Such a reproach misfires, since we take the whole presupposition to be invalid. It therefore borders on comic relief when the opposition to Freudian ideas is set in parallel with the resistance of contemporaries to Copernican views, as happened in private discussions.124
In response, Jung, who was also present, reiterated Frank’s (and his own) view that one could not assert that Freud was wrong without having empl
oyed psychanalysis. To this, the psychiatrist Max Isserlin replied that he had attempted to replicate Jung’s experiments, and whilst he had confirmed Jung’s thesis that emotionally stressed complexes led to lengthened reaction times, he had found no data which established a standardisation of these complexes in the sense of Freudian theory, i.e., sexual traumata. Finally, Robert Gaupp cautioned against Hoche’s views as being too harsh. Whilst he was opposed to the exaggerations of the Freudian teaching, Bleuler and his school had the right to the unprejudiced verification of their experimentally established positions.
In the published version of his paper, Bezzola added an appendix in which he protested Hoche’s complete identification of his views with Freud’s theory of neurosis. He had not stressed his differences in his paper, he wrote, out of respect for the stimulation he had received from Breuer and Freud’s Studies on Hysteria.
Bezzola: Freud analyses symbolism and interprets it according to the causative experience. He constructs and suggests this. I let it be put together by the patient himself through primary sensations and movement impulses. I let it be directly experienced. With Freud the doctor works under the control of the patient, with me the patient works under the control of the doctor. With me the danger of false interpretation is excluded, because I avoid every suggestion, except those for relaxation.125
The Freud Files Page 8