Ideas: A History from Fire to Freud

The fourth charge against Freud is by far the most serious but stems from the case of Anna O. It is that the entire edifice of psychoanalysis is based on clinical evidence and observations that are at best dubious or flawed, and at worst fraudulent. Perhaps the single most important idea in psychoanalysis is Freud’s conclusion that infantile sexual wishes persist in adults, but outside awareness, and can thus bring about psychopathology. ‘At the bottom of every case of hysteria,’ he reported in 1896, ‘there are one or more occurrences which belong to the earliest years of childhood but which can be reproduced through the work of psychoanalysis in spite of the intervening decades.’ What is strange about this is that, although in 1896 he had never before reported a single case of sexual abuse in infancy, within four months he was claiming that he had ‘traced back’ unconscious memories of abuse in thirteen patients described as hysterical. Allied to this was his argument that the event or situation that was responsible for a particular symptom could be revealed through his technique of psychoanalysis, and that ‘abreacting’ the event – reliving it in talk with the associated emotional expression – would result in ‘catharsis’, remission of the symptom. He became convinced that this was, in his own words, ‘an important finding, the discovery of a

caput Nili

[source of the Nile] in neuropathology . . .’

³⁹

But he then went on to add – and this is what has brought about the great revision – ‘these patients never repeat these stories spontaneously, nor do they ever in the course of a treatment suddenly present the physician with the complete recollection of a scene of this kind’. For Freud, as he presented his findings, these memories were unconscious, outside the patient’s awareness, ‘traces are never present in conscious memory, only in the symptoms of the illness’. His patients, going into therapy, had no idea about these scenes and, he confessed, they were ‘indignant as a rule’ when they were told. ‘Only the strongest compulsion of the treatment can induce them to embark on reproducing them’ (the early circumstances of abuse). As Allen Esterson and others have shown, Freud’s techniques in the early days were not those of a sensitive analyst sitting quietly on a couch, listening to what his patients had to say. On the contrary, Freud would touch his patients on the forehead – this was his ‘pressure’ technique – and he would insist that something would come into their heads – an idea, image or memory. They were made to describe these images and memories until, after a long stream, they would alight on the event that caused the (supposed) hysterical symptom. In other words, say the critics, Freud had very fixed ideas about what lay at the root of various symptoms and rather than passively listen and let the clinical evidence emerge from observation, he forced his views on his patients.

It was out of this unusual approach that there came his most famous set of observations. This was that the patients had been seduced, or otherwise sexually abused, in infancy, and that these experiences lay at the root of their later neurotic symptoms. The culprits were divided into three: adult strangers; adults in charge of the children, such as maids, governesses or tutors; and ‘blameless children . . . mostly brothers who for years on end had carried on sexual relations with sisters a little younger than themselves’.⁴⁰ The age at which these precocious sexual experiences were alleged to have taken place occurred most commonly in the third to fifth year. To this point, what the critics chiefly argue is that Freud’s allegedly ‘clinical’ observations are no such thing. They are instead a dubious ‘reconstruction’, based on symbolic interpretation of the symptom. It is necessary to repeat that a close reading of Freud’s various reports shows that patients never actually volunteered these stories of sexual abuse. On the contrary they vehemently denied them. Invariably, it was Freud who ‘informed’, ‘persuaded’, ‘intuited’ or ‘inferred’ these processes. In several places he actually admitted to ‘guessing’ what the underlying problem was.