The present book includes the most complete collection of interviews of Freud on record. It also brings a review of the main interpretations of Freud's personality. A detailed survey of Freud's work is given in chronological sequence taking into account the cultural and scientific movement of the time.
Freud's masters and those men who played an important role in the shaping of his thought are examined in the light of new data. Regarding Breuer, for instance, I utilized unpublished data provided by Breuer's family, notably the documents concerning the Breuer Foundation Breuer-Stiftung the very existence of which seems to have escaped the attention of other historians before now. Emphasis is laid on Moritz Benedikt as being one of the very important sources for Freud, whereas it is shown the Freud's relationship to Charcot was not that of disciple to master, but rather in the guise of an existential encounter.
A careful scrutiny of facts already known and inquiries in the Viennese archives convinced me that the usual version of Anna O. Much new material was discovered regarding Freud's sources, his relation- ships with some of his contemporaries, the context of his discoveries, and their impact. The reader will find in Chapter 8 a critical account of Alfred Adler's family background and life history, based on extensive research in the Viennese archives and inquiries among members of the Adler family and several of his earlier disciples.
It is shown that Adler's Jewish background was quite different from Freud's, which would explain the great differences in the attitudes of the two men in regard to the Jewish and Gentile worlds. It is shown also how Adler's family constellation was reflected in his later theories. Among other unfamiliar facts is the revelation of the pre-Freudian period in Adler's thought.
After prolonged research, I was able to find a copy probably the only surviving one of Adler's first publication, his Health Book for the Tailor Trade A series of articles published by Adler in a little-known Austrian periodical were also unearthed. A scrutiny of the booklet and articles shows that the main tenets of Adler's future system were already present in these early works, in other words that Adler's individual psychology cannot be considered as "a distortion of psychoanalysis," but as a return to and elaboration of the ideas Adler had developed during the six years of his pre-psychoanalytic period.
The evolu- tion of Adler's thought is related step by step and its various facets are illustrated with examples drawn from among his little known writings, including interviews given to newspapers or magazines. Several unknown sources of Adler are described-for instance, the works of Russian writers. Chapter 9 brings a great deal of fresh information about Carl Gustav Jung.
It begins with a description of his Swiss background and the extra- ordinary story of his grandparents. Memories of Jung's former schoolmate, Gustav Steiner recently published in the Basler Stadtbuch, a publication hardly known outside Basel. I was able to identify the young medium on whom Jung performed early experiments and to obtain new data about this episode. I definitely refute the current stereotype that Jung's system is merely a distortion of Freud's psychoanalysis.
It is shown that several of Jung's main ideas were already present in Jung's student days. Jung's self- experiment of to is related on the basis of published and un- published material and interpreted as an example of a creative illness.
The survey given of Jung's system is probably the most complete and all- encompassing of any that has been written to date: not only did I utilize the whole of Jung's published works, and the interviews he gave to news- papers and magazines, but I had access to the complete collection of Jung's unpublished lectures and seminars. The evolution of Jung's thought is described in its chronological sequence and progress. The account given of Jung's psychotherapy is also the most complete given to this date.
Various little-known aspects of Jung's thought are referred to, such as his philosophy of history and the extensive, unpublished commentaries he gave of Nietzsche's Zarathustra.
Hitherto unknown or overlooked sources of Jung's ideas are pointed out. It aims at giving a synthesis of the story of the birth and growth of the new dynamic psychiatric systems from to The origin and development of each system is shown year by year, in their interplay as well as in their relation- ships to other psychiatric and psychotherapeutic trends, and to the cultural and political background.
In this way it will appear to the reader that the growth of psychoanalysis and of the newer dynamic systems was not so much a revolution as a gradual evolution from the first dynamic psychiatry to the newer ones. The story of dynamic psychiatry is thus intermingled with that of events of the time: wars and political upheavals, literary and artistic movements, international congresses, sensational trials, and even psychiatric systems from 18 82 to The origin and development of each are emphasized, for instance Charcot's death and the publication of psychiatric books or literary works that caused a sensation.
Several episodes of these polemics are singled out, particularly the Zurich polemic of which has never been related by other historians before now ; it is shown that the meaning of these polemics to people of that time was somewhat different from the aspect they acquired in retrospect.
Attention is drawn to a variety of dynamic systems or psycho- therapeutic techniques that played a great role in their time but are more or less forgotten today. Throughout this whole chapter a great number of unknown or little-known data are offered to the reader. A short concluding chapter is devoted to classifying and defining the factors that caused and directed the evolution of dynamic psychiatry, namely, the socio-economic background; the succession of, and conflicts between, great cultural trends; the personality, family situation, life events, and neuroses of the founders; the phenomenon of "creative illness" in regard to Freud and Jung ; the role of the social class from which the founders drew their patients; the complex and ambiguous role of certain privileged patients mostly hysterical women ; the role of environment, colleagues, disciples, rivals, contemporary books and contemporary events.
A sojourn in England was made possible by a grant of the British Council, and a second research summer in Vienna and Zurich by a grant of the Direction of the Psychiatric Services in Quebec.
The latter also paid the salary of a secretary for the completion of the book. I also received encouragement and a generous allotment of time from the University of Montreal.
The Viscount du Boisdulier provided me with a great deal of information from family archives about his illustrious ancestor, the Marquis de Puysegur. Ignace Meyerson. Kathe Breuer gave me much information about her father-in-law, Dr. Joseph Breuer, and permission to utilize unpublished letters and other documents, among others, those of the Breuer Foundation.
Ernest Freud obligingly showed me the office and library of his father, as reconstructed in his home in Maresfield Gardens, London, and supplied information on various points. Eissler, director of the Freud Archive, gave the author valuable advice and kindly lent him the manuscript of his unpublished study on Freud's personality.
Alphonse Maeder, both in Zurich. The stark discrepancy between the currently accepted version of certain events and the relation given of the same by these two old-timers was one of the incentives which brought me to a more critical attitude in my investigations.
In my inquiries about Freud I was helped in the most generous way by Mrs. Renee Gicklhorn, in Vienna, who lent me the manuscript of her unpublished book on the so- called Wagner-Jauregg trial, as well as photocopies of several precious documents.
Reminiscenses about Alfred Adler were provided by Dr. Alexandra Adler and relatives in Austria, Germany and America. Hans Beckh- Widmanstetter introduced the author into the labyrinth of the Viennese archives, helped him in every possible way, pursued the research on his behalf afterwards, and gave him permission to utilize his unpublished study on Alfred Adler's childhood and youth. Ansbacher, of Burlington, Vermont. I had been personally acquainted with the late C. Jung and had interviewed him on all the points I found obscure in his teachings; I then wrote the draft of an account of Jung's theories, after reading which, Jung returned it to me with pencilled annotations.
Thanks are also due to Mr. Franz Jung, Dr. Meier, Miss Aniela Jaffe, and those who allowed me to read Jung's unpublished lectures and seminars. Information on various important points was provided by Dr. Charles Baudouin, Dr. Ludwig Binswanger, Dr. Oscar Diethelm, Dr.
Henri Flournoy, Dr. Eugene Minkowski, Dr. Jacob Moreno, Dr. Gustav Morf, Mrs. Olga Rorschach, Dr. Leopold Szondi, and many others.
Long as it is, this list is still incomplete and should at least include those students whose questions and remarks often incited me to look more closely at certain problems, thus confirming the truth of Rabbi Chanuna's sentence in the Talmud: "Much did I learn from my teachers, more from my colleagues, most from my students. Certain medical or philosophical teachings of the past, as well as certain older healing methods, offer a surprisingly high degree of insight into what are usually considered the most recent discoveries in the realm of the human mind.
For many years, accounts of cures performed among primitive peoples by medicine men, shamans, and the like aroused little attention among psychiatrists. Such accounts were regarded as queer stories, of interest only to historians and anthropologists. Medicine men were thought to be either grossly ignorant and superstitious individuals, able to cure only those patients who would have recovered spontaneously in any case, or dangerous impostors exploiting the credulity of their fellow men.
Today we have reached another, more positive evaluation. The develop- ment of modern psychotherapy has drawn attention to the mystery of the mechanism of psychological healing and shown how many of its details still puzzle us.
Why is it that certain patients respond to a certain type of cure while others do not? We do not know; therefore, anything that might shed light on such problems is welcome. Historical and anthropological research has brought forth important documents and revealed evidence of the use among primitive and ancient peoples of many of the methods used by modern psychotherapy, even though in a different form, as well as evidence of other subtle therapeutic techniques for which present-day parallels can hardly be found.
The study of primitive healing thus is of interest not only to anthropologists and his- torians as being the root from which, after a long evolution, psychotherapy developed but is also of great theoretical importance to the study of psychiatry as the basis of a new science of comparative psychotherapy. In this chapter we shall first discuss the discovery of primitive psycho- therapy and then present a survey of the main techniques of primitive healing that will lead to a comparison with modern psychotherapy.
We will conclude with a brief sketch of the evolution from primitive healing to present-day dynamic psychotherapy. The Discovery of Primitive Psychotherapy One of the first scientists to understand the scientific relevance of primi- tive healing was the German anthropologist Adolf Bastian It is worthwhile to summarize the account of that experience:. The medicine man bade his white patient to come to his lodge shortly after dusk and to bring with him his hammock and a few leaves of tobacco, which were put into a bowl of water placed on the floor of the lodge.
The treatment was performed in the presence of about thirty natives who had gathered there. There was no windm1. The patient was ordered to lie down on his hammock and to keep still.
A young native boy who spoke English lay down on another hammock and translated as much as he could of the words spoken by the medicine man and by the kenaimas demons or spirits. The medicine man began by conjuring up the kenaimas.
It was not long before these manifested their presence by all kinds of noises. Each of them spoke with its own voice. Some of them were sup- posed to fly through the air; the patient could hear the rustling of their wings and feel a draft on his face. He even felt the touch of one of them and was agile enough to bite off a few fragments, which he later found to be leaves of boughs that the medicine man must have been swinging through the air.
He could also hear the demons licking the tobacco leaves that were on the ground. The ceremony made a powerful impression on the patient, who gradually fell into a kind of hypnotic sleep. The ritual lasted for not less than six hours and was completed when the medicine man suddenly put his hand on the patient's face.
But when the latter arose, his head- ache had not vanished. The medicine man. As a proof of the cure he showed him a caterpillar. Bastian commented on the fantastic achievement of this man who. He insisted upon the necessity of collecting similar data because, he said, primitive medicine was rapidly disappearing, and these data would be of the greatest value for medicine as well as for ethnology.
A great deal of scattered data relating to primitive medicine had, of course, already been published at that time. The arduous task of collecting and organizing this data was attempted by Bartels on the basis of ex- tensive materiaJ.
Examples of these are the search for restoration of a supposedly lost soul, the extraction of the disease in the form of a foreign body obviously pro- duced through jugglery , the expulsion of evil spirits, and others. Bartels' compilation, however, was still only a mosaic of isolated facts drawn from widely different peoples.
Since his time, our knowledge of primitive medicine has greatly increased. We are now in a better position to distinguish the specific features of primitive medicine among the many peoples of the world. But we must not lose sight of the fact that our knowledge will always remain fragmentary.
Numerous primitive populations disappeared before any serious ethnological investigation could be conducted and of those that survived, many have retained only distorted remnants of their former customs and lore. Nevertheless, the data in our possession provide us with fairly accurate knowledge of the main features of primitive medicine, as can be seen, notably, in the books of Busch an 3 and Sigerist.
Clements distinguished five main forms of treatment that can be deduced from the disease theory through a "very simple cause-and- effect sort of reasoning.
Disease-object intrusion Extraction of disease-object 2. Loss of the soul To find, bring back, and restore the lost soul 3. Spirit intrusion a. Exorcism b. Mechanical extraction of the foreign spirit c. Transference of the foreign spirit into another living being.
Breach of taboo Confession, propitiation 5. Sorcery Counter-magic. For example, given the theory that disease results from the in- trusion of a disease-object, there is no reason why the treatment should consist of the extraction of the disease-object through mouth-sucking rather than through any of the other possible means.
However, a survey of the known facts shows that almost everywhere the disease-object is extracted only by this method. This peculiar fact brings us to the logical conclusion that we are dealing with a specific form of treatment that must have originated in one place and then spread to the rest of the world. As we shall see later, we can even attempt a reconstruction of the development of primitive medicine from the earliest prehistoric times to the present day.
As the many forms of primitive therapy became better known and reliable documents became available, psychiatrists began to show an interest in them. Charcot had been interested in psychopathological manifestations among primitive populations, and wanted to compare them with those of his hysterical patients in Paris. One of his associates, Meige, 6 gathered reports on possession and exorcism among the natives of Central Africa, and an African woman, who had arrived from her native land with severe hysterical symptoms, was examined and treated in Charcot's ward at the Salpetriere 7 In , Oskar Pfister commented on an account of a cure by a Navaho medicine man and attempted an interpretation in psychoanalytic terms.
Among anthropologists, Claude Levi-Strauss vigorously emphasized the basic identity of certain age-old concepts of primitive medicine to certain new concepts of modern dynamic psychiatry. The healer searches for the lost soul, brings it back, and restores it to the body to which it belongs. The disease theory is widespread, but not universal. It is prevalent among some of the most primitive populations of the earth, such as the Negritos of the Malay Peninsula, the Pygmies of the Philippines, the Australians, and, generally speaking, those peoples who belong to what Graebner and Schmidt called the Urkulturkreis.
However, this disease theory may also be found among populations of more advanced cultures. But even in one given area there are many local varieties regarding the concepts relative to the nature of the soul, the causes and agents of soul loss, the destination of the lost soul, and the curability of the disease. These two notions are combined in the theory that man bears within himself a kind of duplicate, a ghost-soul whose presence in the body is a prerequisite to normal life, but that is able to leave the body tem- porarily and to wander about, especially during sleep.
In the words of Frazer, "the soul of a sleeper is supposed to wander away from his body and actually to visit the places, see the persons, and perform the acts of which he dreams. It may get caught and detained by evil spirits during its wanderings, and may also leave the body in a waking state, especially after a sudden fright. Finally, it may also be forcibly removed from the body by ghosts, demons, or sorcerers.
Logically, then, the treatment of the disease consists in finding, bringing back, and restoring the lost soul. However, the techniques, as well as the disease theory, vary widely. Sometimes the lost soul remains in the physical world, either far removed from or close to the patient; sometimes it wanders into the world of the dead or the spirits.
The latter concept is found pre- dominantly in Siberia, where a cure can be performed only by a shaman, that is, a man, who, during his long initiation, has been introduced into the world of the spirits and is thus able to function as a mediator between that world and the world of the living.
Russian ethnologists have gathered many remarkable accounts of shamanism. One of them, Ksenofontov, states:. When a human being has lost his soul. Shamans contend to he able. They must often make a bargain with the spirits who have stolen the souL propitiate them and bring them gifts.
Sometimes they have to fight the spirits. Once they have recaptured the lost souL they bring it back and restore it to the deprived body. In other parts of the world, the healer need not go so far away, nor must he work himself into ecstasy. The technique may consist simply of con- jurations and other magical operations. This is the case with the Quechua Indians of Peru. We are indebted to Dr. Federico Sal y Rosas for a detailed study on the soul-loss disease among that population.
The Quechua word Jani designates the disease as well as the soul and the healing cure. The follow- ing is a summary of Sal y Rosas's account:. The Que chua Indians believe that the soul or perhaps part of it can leave the body, either spontaneously or through being forced.
The Susto disease can occur in two ways: either through fright caused, for instance, by thunder, the sight of a bull, a snake, and so on, or because of malevolent influences, not fol- lowing upon fright the latter being called "Susto without Susto". Among the malevolent forces that can produce the abduction of the soul, the influence of the earth is considered supreme. The Quechuas show a great fear of certain slopes and caves, and especially of the old Incan ruins.
Whether the Susto occurs following a fright or not, in both cases the power to be propitiated is the earth. How can the disease be designated as Susto when it was not preceded by a fright?
It may be diagnosed as such when an individual loses weight and energy and becomes irritable, has disturbed sleep and nightmares, and especially when he falls into a state of physical and mental depression called Michko. The matter is then clarified by a curandera. This woman will rub the body of the patient from head to toe with a live guinea pig in such a way that the animal dies at the end of the operation.
Then she will skin it and read her oracular diagnosis in the animal's blood, which is made to drip into a bowl of water, and from the lesions she discovers in the animal's organs. The healing ceremony begins with an operation called the Shokma, which is also performed by a curandera. The mixture is then collected and handed over to a male healer, a curiosa, who now performs the essential parts of the rites.
The curiosa comes to the patient's house at midnight, wraps the mixture in a piece of the patient's clothing, and prepares him to receive the absent spirit.
He then leaves the patient, who remains alone in the darkened house with the door open; he walks away, using the mixture to make a white line along the ground to enable the soul to find its way back; he goes either to the spot where the patient experienced his initial fright or to some dreaded place, such as an old grave or the ruin of an Incan fortress. There, using the mixture, he makes a cross on the ground, places himself at the center of the cross, and offers what remains of the mixture as a propitiatory sacrifice to the earth.
He then solemnly calls the lost soul, repeating his call five times. At the end of the fifth invocation, he must perceive a special noise that indicates the presence of the lost soul before he can return to the house of the patient, carefully following the white track. The patient must be asleep; the healer cautiously lifts the blanket over the patient's feet, this being the place where the soul supposedly re-enters the body accompanied by a special rustle that is audible to the healer. At this moment, the patient is expected to dream that his soul returns to his body in the shape of a tame animal.
The healer now leaves the house, either through another door or by walking backward. The patient's family is not allowed to return until the following morning, and in most cases, when they return, they find the patient cured. Sal y Rosas compiled statistics on patients, mostly children or adolescents afflicted with Susto, who underwent a medical examination. It was found that these patients belonged to two distinct groups: The first consisted of 64 emotion- ally disturbed individuals suffering from anxiety, depression, hysterical symp- toms.
The second group included patients afflicted with physical diseases such as tuberculosis, malaria, postdysentery colitis, malnutri- tion, anemia, and so on, all further complicated by emotional disturbances. A remarkable fact is the frequently successful outcome of the healing pro- cedure. With praiseworthy honesty. Sal y Rosas writes: "I have personally observed many cases of typical or even atypical Susto abruptly improve or re- cover completely after one or two sessions of Jani.
Such a success achieved by a humble rural curiosa or by a peasant woman, with their primitive and savage psychotherapy, contrasts with the failure of graduated physicians- among them the author of this article-in the cure of Susto. Among all primitive disease theories probably none is stranger to us than the idea of soul loss. Nothing is further from our principles of treatment than the restoration of a lost soul to a patient. And yet, if we ignore the cultural element and seek the roots of facts, we may find a common ground between those primitive concepts and ours.
Do we not say that our mental patients are "alienated," "estranged" from themselves, that their ego is impoverished or destroyed? Could not the therapist who gives psycho- therapy to a severely deteriorated schizophrenic patient by trying to es- tablish a contact with the remaining healthy parts of the personality and to reconstruct the ego be considered the modern successor of those shamans who set out to follow the tracks of a lost soul, trace it into the world of spirits, and fight against the malignant demons detaining it, and bring it back to the world of the living?
Intrusion and Extraction of the Disease-Object This theory maintains that disease is caused by the presence in the body of a harmful foreign substance, such as a piece of bone, a pebble, a splinter of wood, or a small animal. Certain peoples believe that disease is caused not by the object itself but by a special disease-essence contained in the object.
Sometimes, the harmful disease-object is believed to have been shot into the body by a sorcerer. This disease theory is widespread in America excepting the eastern Eskimos , very common in eastern Siberia, Southeast Asia, Australia, New Zealand, and in several other parts of the world. It has also left many traces in European popular medicine and folklore.
A striking fact is the connection between this disease theory and a peculiar kind of treatment: the medicine man uses his mouth to suck out the disease-object. Other methods, such as massage, are much less frequent. Yet, there is little doubt that these cures are often successful. It has also been pointed out that among certain populations the disease-object is of such a nature that a patient could not possibly believe that it had been extracted from his body. We face here a situation that frequently occurs in anthropology.
Freud, according to Ellenberger, was heir to the Protestant Seelsorge or "Cure of Souls", a practice that arose after Protestant reformers abolished the ritual of confession. During the 19th century, the idea of unburdening oneself by confessing a shameful secret was gradually transferred from religion to medicine, influencing Mesmer's animal magnetism, and eventually Freud.
Ellenberger argues that evaluating Freud's contributions to psychiatry is made difficult by a legend involving two main features that developed around Freud: the first being, "the theme of the solitary hero struggling against a host of enemies, suffering the 'slings and arrows of outrageous fortune' but triumphing in the end", and the second, "the blotting out of the greatest part of the scientific and cultural context in which psychoanalysis developed".
The first aspect rested on exaggeration of the anti-Semitism Freud encountered, as well as overstatement of the hostility of the academic world and the Victorian prejudices that hampered psychoanalysis. The second aspect led to Freud being credited with the achievements of others.
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