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The Talking Cure

Seamus O’Mahony

Becoming Freud: The Making of a Psychoanalyst, by Adam Phillips, Yale University Press, 192 pp, $25, ISBN 978-0300158663

Adam Phillips occupies a unique place in British intellectual life. He works four days a week as a private psychoanalyst, and spends one day a week (Wednesdays) writing. These Wednesdays have been extraordinarily productive, as he has now produced seventeen books, and is the general editor of a new English translation of the collected works of Sigmund Freud. Phillips’s books are mainly essay collections, written through the sometimes opaque and distorting prism of classic Freudian psychoanalytic theory. He read English at Oxford, but in his twenties, inspired by the writings of the psychoanalyst Donald Winnicott (the subject of his first book in 1988), he trained as a psychoanalyst, undergoing the full Freudian himself. He worked as a child psychologist in the NHS for over seventeen years, but became disillusioned with the bureaucracy and set himself up in private practice in Notting Hill. He has had famous patients, such as Hanif Kureshi and Will Self (can you imagine the free-association?); Self famously moaned that his long analysis with Phillips was a waste of time.

As well as famous patients, Phillips has famous admirers: Alain de Botton proclaimed him “the finest essayist working in Britain” and admitted that Phillips was the only writer to whom he had ever written a fan letter. John Banville has described him as “an Emerson of our time”. Adam Mars-Jones proclaims him as “the closest thing we have to a philosopher of happiness”. The only dissenting voice is that of Theodore Dalrymple: writing under his own name (Anthony Daniels), he reviewed Phillips’s On Flirtation for the British Medical Journal in 1995: “Paragraph after paragraph conveyed little or no sense to me, and I could detect no difference in meaning when I converted some of his affirmative sentences into their negatives. The author, despite being a literary critic as well as psychoanalyst, uses language imprecisely and with little regard for aesthetic considerations. His style is often so barbarous that his meaning can only be glimpsed, as through a glass darkly.”

Becoming Freud is a short biography of Freud, taking us up to the age of fifty, by which time he had written The Psychopathology of Everyday Life and Interpreting Dreams, and established the foundations of psychoanalysis. Freud lived a further thirty-three years, dying in exile in London, and Becoming Freud is in part a speculation on what might have happened had he died at fifty. The book was commissioned by Yale University Press, and is one of a series of “Jewish Lives”. We are repeatedly told by Phillips that Freud distrusted biography, and Phillips is equally sniffy about the genre. This book is therefore short on biographical “fact”, and long on Phillips’s exposition of the ideas. Freud has been the subject of several lengthy biographies, most notably by his disciple the Welsh psychoanalyst Ernest Jones, and more recently by the equally devoted cultural historian Peter Gay. Phillips devotes a substantial chunk of this book to debunking biography, with the result that of the 162 pages, only fifty or so are devoted to what might be called biography; the majority of the book is essentially Phillips’s own retelling of Freudian theory.

Phillips recounts the bare facts – almost contemptuously ‑ over the first three pages, before settling down to a Freudian demolition of the notion of biography: “The facts of a life – and indeed the facts of life – were among the many things that Freud’s work has changed our way of thinking about. Freud’s work shows us not merely that nothing in our lives is self-evident, that not even the facts of our lives speak for themselves; but that facts themselves look different from a psychoanalytic point of view.” He goes on: “Psychoanalysis would one day be Freud’s proof that biography is the worst kind of fiction; that biography is what we suffer from; that we need to cure ourselves of the wish for biography, and our belief in it … To have a sense of what someone was like after reading their biography is to have been willingly duped.”

The young Freud clearly saw himself as a man chosen by destiny, who would be the subject of not just one, but of many, biographies. In 1885, at the age oftwenty-nine, he wrote to his fiancée, Martha Bernays: “One intention, as a matter of fact, I have almost finished carrying out, an intention which a number of as yet unborn and unfortunate people will one day resent. Since you won’t guess what kind of people I am referring to, I will tell you at once: they are my biographers. I have destroyed all my notes of the past fourteen years, as well as letters, scientific excerpts and the manuscripts of my papers.”

This being a “Jewish Life”, Phillips devotes much of the book – rather too much – to an examination of the influence of Freud’s Jewishness on the development of his ideas. Born in 1856 in Freiberg in Moravia, in what is now the Czech Republic, Freud was the first child of the union of his father, Jacob, with his second (possibly third) wife. At the time of his birth, Freud had two half-brothers, already in their twenties. (Phillips does not mention it, but a substantial age difference between father and mother is a common feature in gifted people.) After a brief move to Leipzig, the family settled in Vienna when Sigmund was four. The Jews of Central Europe were then a vulnerable people: “Freud’s youth, that is to say, from the age of four, was that of an immigrant, a resident alien. And psychoanalysis is first and foremost a psychology of, and for, immigrants (people who can never quite settle); not a Jewish science as Freud feared, but an immigrant science for a world in which, for political and economic reasons, there will be more and more immigrants.”

The bourgeois Jews of fin de siècle Vienna “had finally found a culture in which they had a place – a place and a voice.” Although many Jews prospered in Vienna, it was still the city of the viciously anti-Semitic mayor Karl Lueger: “Freud like a lot of Viennese Jews of his generation had to be a kind of double agent ... indeed, to be a Jew of Freud’s class and aspiration involved these divided allegiances; the all-too identifiable Jew and the Viennese citizen had to coexist.”

Expanding on the theme of Jewishness, or rather, anti-Semitism, Phillips devotes several unconvincing pages to the Dreyfus affair, on the rather flimsy grounds that Freud referred to Dreyfus fleetingly in three of his books. Freud himself did not believe that his Jewishness had any influence on his psychoanalytic ideas. Responding to a rebuke from Ernest Jones about his belief in telepathy, he replied: “If someone should reproach you with my Fall into Sin, you are free to reply that my adherence to telepathy is my private affair like my Jewishness, my passion for smoking, and other things, and the theme of telepathy – inessential for psychoanalysis.” Phillips, who is Jewish himself, rather revealingly told the Paris Review: “Then I read Freud, who seemed to me to be a version of the Jewish family life that I knew. Here was a voice that felt very familiar to me – not that my parents spoke psychoanalysis at all.” What can they have discussed at the Phillips dinner-table?

Freud’s Jewishness had more immediate and practical consequences: as a medical student, and for a few years after qualifying as a doctor he had worked in the laboratory of the great physiologist Ernst Brücke; he might have lived out his career as a neuroscientist had Brücke not candidly advised the young Freud that as a Jew, academic advancement was all but closed to him and that he should instead go into private medical practice. Brücke was the first in a series of older male role models to whom Freud had an intense emotional attachment. In An Autobiographical Study , Freud observed: “In Ernst Brücke’s physiological laboratory, I found rest and full satisfaction – and men, too, whom I could respect and take as my role models: the great Brücke himself, and his assistants.” Freud’s search for such father figures reflected his intense disappointment with his own father. Jacob Freud had not only failed as a businessman, but he was unlettered, and for the young Sigmund, what was far worse: a coward. In Interpreting Dreams, Freud describes a story told to him by Jacob when he was a boy:

He told me a story to show me how much better things were now than they had been in his days. “When I was a young man,” he said, “I went for a walk one Saturday in the streets of your birthplace; I was well dressed and had a new fur cap on my head. A Christian came up to me and with a single blow knocked off my cap into the mud and shouted: “Jew! Get off the pavement.” “And what did you do?” I asked. “I went into the roadway and picked up my cap.”

The young Freud, bookish and sensitive, was appalled by his father’s lack of mettle, and chose instead a better role model from antiquity: “I contrasted this situation with another which fitted my feelings better: the scene in which Hannibal’s father Hamilcar Barca, made his boy swear before the household altar to take vengeance on the Romans. Ever since that time Hannibal had a place in fantasies.”

Freud was highly regarded by Brücke, and published several papers on neuroscience (he was interested particularly in eels and crayfish), and later claimed that it was the happiest period of his life. It was this Freud, the zoologist, the scientist, that his grandson, the painter Lucian, was proudest of. After Brücke let him go, Freud transferred his hero-worship to the celebrated French neurologist Jean-Martin Charcot. He spent several months with Charcot at the Salpêtrière Hospital in Paris in 1885 on a travelling fellowship, his application backed by Brücke. Charcot, part genius, part charlatan, was cultured and charismatic: “For Freud Charcot was the scientist as artist, a paradoxical person. A great neurologist who would quote Dante or Virgil, a doctor whose work artists and writers are intrigued by.” Freud ingratiated himself with the great man by offering to translate a collection of his lectures into German. Charcot staged famous public demonstrations at the hospital where, using hypnosis, he would induce bizarre displays in his (predominantly female) “hysterical” patients. These Bedlamesque events were eagerly attended by the Parisian beau monde, and the old Swedish fibber Axel Munthe gives us a vivid account of these exploitative medical circuses in his semi-fictional “memoir”, The Story of San Michele:

Some of them smelt with delight a bottle of ammonia when told it was rose water, others would eat a piece of charcoal when presented to them as chocolate. Another would crawl on all fours on the floor, barking furiously when told she was a dog, flap her arms as if trying to fly when turned into a pigeon, lift her skirts with a shriek of terror when a glove was thrown at her feet with a suggestion of being a snake. Another would walk with a top hat in her arms rocking it to and fro and kissing it tenderly when told it was her baby.

It had hitherto been regarded as a form of malingering, and thus under conscious control, but Charcot believed hysteria was “genuine”, the symptoms not under conscious control, physical (“organic”) in origin, and probably hereditary. Other French neurologists, such as Hippolyte Bernheim, correctly surmised that these manifestations were psychosomatic in origin. Freud, too, came to differ with Charcot, but to the end of his life, worshipped the Frenchman, keeping a bust of him in his study. So what exactly is “hysteria”? Now referred to as “conversion disorder” (the word “hysteria” has unfortunate misogynistic origins), it is a condition where the patient exhibits physical symptoms and behaviours – mainly neurological, such as paralysis, tics, and fits – for which there is no physical or “organic” explanation. There is a recognised association between hysteria and low IQ, and Munthe observed that many of Charcot’s hysterics were poor, illiterate rural women. One wonders therefore why so many nice, well-educated, middle class Viennese women developed the condition, requiring the attentions of Dr Freud.

Freud’s next intense male relationship was with Josef Breuer, fourteen years older than Freud, a Viennese physician, also Jewish. Unlike Brücke and Charcot, Breuer was modest and circumspect. Although able and highly regarded, he was unable to advance in his career as a hospital doctor, probably because of his race. With Breuer, Freud wrote his first major work, Studies in Hysteria, in 1895. This consisted of a series of case histories, most famously that of “Anna O”: “In 1880, her father had fallen ill and she began to experience bizarre and disturbing symptoms while she nursed him: she developed anaesthesias, spasms, deafness, absences, paralyses … Breuer discovered, led by her, that if he just let her speak her fantasies through what she called “the talking cure”, it began to alleviate her symptoms. The relief, though, was only temporary. By the time she was finally hospitalised by Breuer she was a morphine addict.” This is a recurring theme in Freud’s clinical practice: what we now euphemistically call “patient outcomes” were frequently disastrous.

Studies in Hysteria concluded that the condition was psychological in origin. This conclusion put Freud in opposition to Charcot, but he remained devoted to the great Frenchman. Freud eventually broke with Breuer. This pattern of behaviour is repeated throughout his long life: an initial intense male friendship/collaboration is followed inexorably by disagreement, then estrangement. Freud took what he needed from these relationships, and when they no longer served his purpose, he moved on. Next was Wilhelm Fliess, two years younger than Freud, an ear nose and throat surgeon and neuroanatomist. Their relationship, conducted mainly by letter, was intense. Freud described their occasional meetings as “congresses”. Unlike the sober, steady Breuer, Fliess (also Jewish) was dangerously charismatic.

Beginning in the early 1890s, Freud seems to have experienced a prolonged spiritual crisis, and what was to emerge at the end of this crisis was psychoanalysis. In his voluminous correspondence with Fliess, Freud developed his ideas of infantile sexuality, the Oedipus complex, the subconscious and the meaning of dreams. Shortly after moving into Berggasse 19, Freud wrote to Fliess: “Do you suppose that someday one will read on a marble tablet on this house: Here on July 24, 1895, the secret of the dream revealed itself to Dr. Sig. Freud?” Fliess had some ideas of his own, such as universal bisexuality and the male period (23 days, apparently). But Fliess’s strangest idea was his conviction that the nose was a sexual organ, an idea he expounded in The Relations between the Nose and the Female Sex Organs (1902). “It is not accidental”, writes Phillips, “that in this period Freud was so taken with the mixture of wackiness and hard science that was Wilhelm Fliess.” Phillips is suspiciously selective in this “biography”, and he excludes one eye-poppingly bizarre episode from Freud’s association with Fliess, namely the case of Emma Eckstein. I first encountered this story many years ago in A Social History of Madness (1987), by the late, great, medical historian Roy Porter:

Freud had a hysterical patient named Emma Eckstein. He attributed her neurosis to masturbation and, following Fliess’s ‘reflex nasal neurosis’ theory, saw the nose as the source of her masturbatory activity. The usual treatment recommended by Fliess and Freud was a dose of cocaine to the nose, but in this case Freud agreed to let Fliess carry out anti-masturbatory nasal surgery.
The operation was carried out in February 1895. Its result was almost fatal. Thanks to a gross surgical bungle, Fliess unknowingly managed to leave half a metre of gauze stuck up her nasal cavity. When that was finally removed, Emma haemorrhaged violently, ‘had no pulse, and almost died’. Unable as ever to stomach blood, Freud fled the room. Emma did not die, but she recovered very slowly. Freud’s reaction was instructive. He wrote repeated letters of reassurance to Fliess ... Fliess was not to blame for what had happened, Freud now argued, precisely because it was all Emma Eckstein’s fault. It was her hysterical reaction, her ‘longing’, her attention-seeking need to provoke a crisis which had caused the haemorrhage … she bled out of longing.

How’s that for “wackiness”? Fliess too was eventually discarded, and in an intense period from 1898 to 1905, Freud wrote the books which made him famous. He saw himself firmly in the tradition of Darwin, and had no doubts that psychoanalysis was a science. (He was at pains, however, to stress that it was not a Jewish science.).What seems to have inspired him was his own experience, and he extrapolated from this an entire Grand Unifying Theory of the Human Psyche. So, for example, Freud’s feelings towards his father and mother became everybody’s experience – the Oedipus complex. Freud’s own dreams formed the basis for the interpretation of all our dreams. “He discovered psychoanalysis in his sleep,” observes Phillips with awe. Freud’s self-analysis formed the basis of all subsequent psychoanalyses. Freud’s, being the fons et origo of analysis, was the only allowable case of self-analysis. All subsequent analysis would have to be carried out by those trained by Freud, who would in turn train the next generation, and so on in an unbroken apostolic succession. Bryan Appleyard observed how Freud’s theories were stated in a “curiously unchallengeable way”, rendering any scientific analysis or debate virtually impossible. Phillips repeatedly refers to Freud “discovering” the Oedipus complex, or the meaning of dreams, as if he was describing JJ Thomson’s discovery of the electron. What Freud did, as Phillips points out, was to invent a whole new profession – psychoanalysis. Starting in 1902, he held informal meetings of like-minded Jewish doctors (“the Wednesday Society”), which in 1908, had become the altogether grander Vienna Psychoanalytic Society.

Freud’s ideas quickly became part of the modernist conversation, appealing to intellectuals and Marxists: “Words like id, ego, superego, repression would soon be common currency, so contagious was this new language for the heart and soul and conscience of modern people.” Just as Darwin’s ideas explained so much, so too, apparently, did Freud’s:

Once Freud discovered, through analysing his own dreams, his “single” idea everything fell into place: “A single idea of general value dawned on me,” he wrote to Fliess. “I have found in my own case too, the phenomena of being in love with my mother and jealous of my father, and I now consider it a universal event in early childhood.” This single idea – so ordinary and obvious until Freud elaborated it in his own way – contained, as we shall see, many ideas (it could explain rivalry, ambition, jealousy, envy, pride, authority, religion, communism, scarcity, abjection, success, failure, mourning, and murder, among other things).

In its blanket acceptance that Freud’s “single idea” could explain everything from rivalry to murder, “among other things” this assertion by Phillips is truly remarkable.

Many Freudian psychoanalysts, including Phillips, concede that psychoanalysis is not a science, and argue that it was a mistake on Freud’s part to make such claims: “To my mind,” wrote the psychiatrist Anthony Storr, “Freud’s wish to be thought a scientist, and his reluctance to admit that he abandoned this role at an early stage in his career, have had an unfortunate effect. If no one had ever claimed that psychoanalysis was a science, dispute about its status would not have been so intemperate.” Phillips himself does not claim scientific validity for psychoanalysis. In a 2001 New Statesman profile, he remarked: “I read psychoanalysis as poetry. So I don’t have to worry about whether it is true or even useful, but only whether it is haunting or moving or intriguing or amusing.” The profile concluded: “In Phillips’s view, the main requirement of therapy is that it be interesting.”

Freud was at heart a literary man. When Havelock Ellis described him as an artist rather a scientist, Freud bristled, regarding this as an attempt to discredit his work. After his training in “hard” science with Brücke, Freud, in Studies in Hysteria, admitted to some doubts about the scientific validity of the work: “Like other neuropathologists I was trained to employ local diagnoses and electro-prognosis, and it still strikes me 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.”

As a clever schoolboy, Freud’s passions were archaeology, classical history, languages and literature. He had a particular fascination with Don Quixote, so much so that, as a teenager, he went to the trouble of learning Spanish so he could read the book in the original Castilian. Freud did not have a vocation for medicine: “Neither at that time, nor indeed in my later life, did I feel any particular predilection for the career of a doctor. I was moved, rather, by a sort of curiosity, which was, however, directed more towards human concerns than towards natural objects.” Why, then, did he study medicine? He claimed that he was inspired to do so by “the doctrines of Darwin”, but I wonder if there is a more prosaic explanation, namely, that becoming a doctor was what was expected of a bright Jewish boy. At the age of seventy he wrote:

After forty years of medical activity, my self-knowledge tells me that I have never really been a doctor in the proper sense. I became a doctor through being compelled to deviate from my original purpose; and the triumph of my life lies in my having, after a long and roundabout journey, found my way back to my earliest path … I scarcely think, however, that my lack of a genuine medical temperament has done much damage to my patients.

I wonder whether Emma Eckstein or the Wolf Man read that passage, and if they did, what they thought. Freud, like many doctors before and after him, lacked the philanthropic instinct. “learning and teaching”, observes Phillips, “were often very much more to Freud’s taste than helping and healing”. Freud, like Jonathan Miller (who cheerfully admitted to his lack of philanthropy), may have initially decided to study medicine with intellectual and scientific ambitions, but was forced into clinical practice by the need to provide for Martha and his family.

Freud was first and foremost a writer, and he wrote beautifully. Phillips, however, does not write quite so beautifully. His prose induced in me a profound lassitude, a sort of torpor. Long sentences with sub-clause after sub-clause are followed by shorter ones. Without verbs. Sometimes without meaning. Here is a random example: “But what Freud was interested in in these crucial years was not just the all-too-familiar, all-too-human imperious urgency of sex, but how the body becomes (in both senses) its languages; how culture is the translation, to use one of Freud’s favoured analogies, of the body’s unconscious, forbidden desire, the desire a person believes he can’t afford to acknowledge. Freud was not returning sexuality to its “rightful share,” but working out what that share might be.”

This is odd, because Phillips talks beautifully. In an interview with the Paris Review in 2012, he is engaging, wry, witty; his views are clearly expressed and refreshingly unpredictable. Talking to The Guardian, he makes no great claims for psychoanalysis: “I would say to people, if you’re curious, try it out. There are plenty of other treatments in the culture and something else may work for you, it may be aromatherapy, but this is what psychoanalysis is like, give it a go. But that’s all. To make too much of a case for it beforehand is to make a false promise.” Reading this interview I was reminded of Christopher Hitchens, who, early in his career was advised by Simon Hoggart to “write more like you talk”.

Freud’s ideas have taken quite a kicking over the last twenty-five years, most notably fromFrederick Crews (read his 1993 piece in The New York Review of Books). While Darwin’s Great Idea has been backed up by decades of scientific observation, Freudian psychoanalysis is now regarded as having all the scientific validity of, say, aromatherapy (also recommended by Phillips). But even if Freudianism is no longer quite the cultural force it once was, Freud remains an intellectual figure as important as Darwin, Marx and Einstein. It is a pity that pretty much all the biographies of him have been written by his disciples, and Phillips’s book, though mercifully short, is unfortunately also in this tradition.

What if Freud had died at fifty, in 1906? “Psychoanalysis,” concludes Phillips, “would have been very different, but it would have been sufficiently complete.” So, we would have missed out on his structural theory of the mind, the pleasure principle, the death-drive and “elaborated metapsychology”. But the chief work of the post-1906 older Freud was to become the Master, the founder of the psychoanalytic movement. The history of this movement is strangely reminiscent of that of the early Christian Church, with doctrinal disputes and schisms, “more obsessed by enforcing its own rules of theory and practice than by wondering what rules are being used for”. By the time of his death, Freud had established “a thriving new profession”.

Freud’s fellow Viennese, the priest and social philosopher Ivan Illich, argued in his 1975 polemic Medical Nemesis that healthcare had become a “monolithic world religion” “Medicalization,” he wrote, “led people to see themselves as bundles of diagnoses.” Curiously, Illich neglected to point the finger at his fellow Austrian, for more than anyone, Freud (“We are all sick”) created the notion of universal human psychopathology, and thus, the need for “therapy”.

How did an obscure Viennese private physician, treating “nervous” patients, persuade the world that his childhood, his dreams, his “self-analysis” contained universal truths, truths which explained the human psyche? Whether he was right or wrong is irrelevant: what is remarkable is that his ideas, so “curiously unchallengeable” became so globally accepted. “As an idea,” observes Bryan Appleyard, “psychoanalysis has been fabulously successful. It has become, in our age, a pervasive orthodoxy of self-knowledge.” Just what was it about Sigmund Freud that was so persuasive?


Seamus O’Mahony is a consultant physician and a regular contributor to the Dublin Review of Books.