Portraits of the thirty-eight known patients Sigmund Freud treated clinically—some well-known, many obscure—reveal a darker, more complex picture of the famed psychoanalyst.
Everyone knows the characters described by Freud in his case histories: “Dora,” the “Rat Man,” the “Wolf Man.” But what do we know of the people, the lives behind these famous pseudonyms: Ida Bauer, Ernst Lanzer, Sergius Pankejeff? Do we know the circumstances that led them to Freud’s consulting room, or how they fared—how they really fared—following their treatments? And what of those patients about whom Freud wrote nothing, or very little: Pauline Silberstein, who threw herself from the fourth floor of her analyst’s building; Elfriede Hirschfeld, Freud’s “grand-patient” and “chief tormentor;” the fashionable architect Karl Mayreder; the psychotic millionaire Carl Liebmann; and so many others? In an absorbing sequence of portraits, Mikkel Borch-Jacobsen offers the stories of these men and women—some comic, many tragic, all of them deeply moving. In total, thirty-eight lives tell us as much about Freud’s clinical practice as his celebrated case studies, revealing a darker and more complex Freud than is usually portrayed: the doctor as his patients, their friends, and their families saw him.
Everyone knows the characters described by Freud in his case histories: “Dora,” the “Rat Man,” the “Wolf Man.” But what do we know of the people, the lives behind these famous pseudonyms: Ida Bauer, Ernst Lanzer, Sergius Pankejeff? Do we know the circumstances that led them to Freud’s consulting room, or how they fared—how they really fared—following their treatments? And what of those patients about whom Freud wrote nothing, or very little: Pauline Silberstein, who threw herself from the fourth floor of her analyst’s building; Elfriede Hirschfeld, Freud’s “grand-patient” and “chief tormentor;” the fashionable architect Karl Mayreder; the psychotic millionaire Carl Liebmann; and so many others? In an absorbing sequence of portraits, Mikkel Borch-Jacobsen offers the stories of these men and women—some comic, many tragic, all of them deeply moving. In total, thirty-eight lives tell us as much about Freud’s clinical practice as his celebrated case studies, revealing a darker and more complex Freud than is usually portrayed: the doctor as his patients, their friends, and their families saw him.
256 pages | 20 halftones | 6 1/4 x 9 1/4 | © 2021
History: General History
Psychology: Counseling and Guidance
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Excerpt
As the research of historians Henri Ellenberger and Albrecht Hirschmüller has established, the reality was quite different. Bertha Pappenheim’s treatment had in fact been a veritable ‘ordeal’ for Breuer, as he wrote later to his colleague the psychiatrist August Forel. The treatment had never shown any real progress and as early as the autumn of 1881 Breuer was thinking of placing Bertha in another clinic, the Bellevue Sanatorium run by the psychiatrist Robert Binswanger in Kreuzlingen, Switzerland. Moreover, as we know from a letter sent on 31 October 1883 by Freud to his fiancée Martha Bernays, Mathilde Breuer had become jealous of her husband’s interest in his attractive young patient and rumors had begun to circulate. So, when Breuer terminated the treatment in June 1882, it was not because Bertha Pappenheim had recovered (in mid-June she was still suffering from a ‘slight hysterical madness’), but because he had decided to throw in the towel and transfer her to Bellevue. She was admitted there on 1 July 1882 after having ‘travelled’ briefly to visit relatives in Karlsruhe.
Founded in 1857 by Ludwig Binswanger (the grandfather of Ludwig Binswanger Jr, the promoter of existential psychoanalysis), the Bellevue Sanatorium was a renowned institution. Located in an idyllic park on Lake Constance the sanatorium hosted, with discretion and for a high fee, the elite of the mentally ill. It was a place where, as the Viennese novelist Joseph Roth wrote in The Radetzky March, ‘spoiled lunatics from rich homes receive onerous and cautious treatment, and the staff is as caring as a midwife.’ There was an orangery, chaises lounges, a bowling alley, an outdoor kitchen, tennis courts, a music room and a billiard room. One could also go hiking and horse riding nearby (Bertha took advantage of this daily). Bellevue patients stayed in comfortable villas scattered throughout the park.
Bertha Pappenheim had a two-room apartment and brought with her a lady companion who spoke English and French. Indeed, she was still partly ‘aphasic’ in German and plagued by more or less the same symptoms as before. In addition to her addiction to chloral hydrate, she was now also addicted to morphine due to Breuer’s efforts to calm her painful facial neuralgia. Her stay in Kreuzlingen lasted four months and brought little progress as far as her neuralgia and her dependence on morphine were concerned. The register at the time of Bertha’s release on 29 October 1882 mentions that she was ‘improved’, but a letter she sent to Robert Binswanger on 8 November tells a different story: ‘As for my health here, I can tell you nothing which is new or favorable. You will realize that to live with a syringe always at the ready is not a situation to be envied.’
Breuer declined to resume treatment when Bertha returned to Vienna in early January 1883 after a detour in Karlsruhe. From 1883 to 1887 Bertha was readmitted to Breslauer’s clinic three times. Each time the diagnosis by doctors was the same: ‘hysteria’. This is confirmed by the correspondence between Freud and his fiancée Martha Bernays. Bernays knew Bertha personally (Bertha’s father had been her legal guardian after the death of Bernays’s own) and Freud kept her informed of her friend’s condition. On 5 August 1883 he wrote: ‘Bertha is once again in the sanatorium in Bertha Pappenheim in riding costume during her stay at the Bellevue Sanatorium. Gross-Enzensdorf, I believe [Inzersdorf, in fact]. Breuer is constantly talking about her; says he wishes she were dead so that the poor woman could be free of her suffering. He says she will never be well again, that she is completely shattered.’ In two letters to her mother, dated January and May 1887, Martha wrote that her friend Bertha continued to suffer from hallucinations in the evening. Thus, five years after the end of Breuer’s treatment and multiple stays at clinics, Bertha Pappenheim had still not recovered.
Founded in 1857 by Ludwig Binswanger (the grandfather of Ludwig Binswanger Jr, the promoter of existential psychoanalysis), the Bellevue Sanatorium was a renowned institution. Located in an idyllic park on Lake Constance the sanatorium hosted, with discretion and for a high fee, the elite of the mentally ill. It was a place where, as the Viennese novelist Joseph Roth wrote in The Radetzky March, ‘spoiled lunatics from rich homes receive onerous and cautious treatment, and the staff is as caring as a midwife.’ There was an orangery, chaises lounges, a bowling alley, an outdoor kitchen, tennis courts, a music room and a billiard room. One could also go hiking and horse riding nearby (Bertha took advantage of this daily). Bellevue patients stayed in comfortable villas scattered throughout the park.
Bertha Pappenheim had a two-room apartment and brought with her a lady companion who spoke English and French. Indeed, she was still partly ‘aphasic’ in German and plagued by more or less the same symptoms as before. In addition to her addiction to chloral hydrate, she was now also addicted to morphine due to Breuer’s efforts to calm her painful facial neuralgia. Her stay in Kreuzlingen lasted four months and brought little progress as far as her neuralgia and her dependence on morphine were concerned. The register at the time of Bertha’s release on 29 October 1882 mentions that she was ‘improved’, but a letter she sent to Robert Binswanger on 8 November tells a different story: ‘As for my health here, I can tell you nothing which is new or favorable. You will realize that to live with a syringe always at the ready is not a situation to be envied.’
Breuer declined to resume treatment when Bertha returned to Vienna in early January 1883 after a detour in Karlsruhe. From 1883 to 1887 Bertha was readmitted to Breslauer’s clinic three times. Each time the diagnosis by doctors was the same: ‘hysteria’. This is confirmed by the correspondence between Freud and his fiancée Martha Bernays. Bernays knew Bertha personally (Bertha’s father had been her legal guardian after the death of Bernays’s own) and Freud kept her informed of her friend’s condition. On 5 August 1883 he wrote: ‘Bertha is once again in the sanatorium in Bertha Pappenheim in riding costume during her stay at the Bellevue Sanatorium. Gross-Enzensdorf, I believe [Inzersdorf, in fact]. Breuer is constantly talking about her; says he wishes she were dead so that the poor woman could be free of her suffering. He says she will never be well again, that she is completely shattered.’ In two letters to her mother, dated January and May 1887, Martha wrote that her friend Bertha continued to suffer from hallucinations in the evening. Thus, five years after the end of Breuer’s treatment and multiple stays at clinics, Bertha Pappenheim had still not recovered.