Freud, p.21
Freud, page 21
Callousness toward the sick wasn’t limited to those selected for display. Charcot suborned some female patients to spy on others and report back about faked symptoms. “I had there the best possible police,” he wrote of two such spies, “that of women over women, for you are aware that if women enter into any plot among themselves they very seldom succeed.”49
Again, any patient, at any unannounced moment, could be pricked with a pin to test for dissimulation of anesthesia or subjected to a demeaning experiment such as the “dermagraphism” described above. More ambitiously, the Iconographie crew undertook to freeze catalepsy on film by administering shocks while patients were arrayed before the camera. One famous image shows six stupefied women, their arms held out in statuesque recoil, a moment after they were startled by the crashing sound of a gong that was struck in an adjacent room. The response, if genuine, was epileptoid, but Charcot regarded it as a proof of hysteria.50
Charcot and his staff were also much concerned with observing and measuring secretions that might yield knowledge of hysteria’s dark interior operations. That project was largely focused on the various fluids, especially vaginal ones, exuding from patients in states of pathological somnolence or rigidity. Peremptory stripping, genital prying, and the collecting of samples for analysis were therefore a routine occurrence within the wards.51 And the Iconographie didn’t hesitate to report on what was observed, such as the “voluminous breasts, hairy armpits, and pubic region” of the much-photographed Augustine.52
Searching for hysteria’s hieroglyphs below the waist, the Salpêtrière’s inquirers attached correspondingly less importance to what was being expressed through vocal cords. Thus, when patients railed against the early sexual abuse and emotional torment that must have contributed to their illness, Charcot paid no attention to their complaints. “You can see how hysterics scream,” he told one Tuesday seminar. “One might say that it is much ado about nothing.”53
Among all of the Salpêtrière’s means of maintaining dominance and compelling desired behavior, the most pervasive was the administration of drugs. Patients were doped with ether, chloroform, ethyl valerate, morphine, and/or amyl nitrite to start or stop attacks and to test whether alleged paralyses and contractures would persist under an enforced relaxation of muscles. Augustine received every one of those drugs, and both she and Blanche Wittmann developed a desperate craving for ether.54 Charcot’s assistant D.-M. Bourneville, having discovered that Augustine indulged in erotic reverie when subjected to ether, was especially fond of inducing that state in her and then insisting that she write out her fantasies. Augustine was reluctant to do so, but her craving for the drug overcame her inhibition.
Drugs were employed in the wards on a daily basis as a means of repaying obedience or, alternatively, of securing orderly behavior. Patients who balked at continuing to perform illustratively in lectures could expect to be rendered submissive through forced drugging. A narcotized patient, dependent on the authorities for her next fix, was unlikely to withhold compliance, much less to incite her wardmates to rebellion.
When things went smoothly in Charcot’s Salpêtrière, it functioned less as a hospital than as a center of propaganda and a site for dehumanizing experiments. But when the subjects balked, they found themselves treated like felons in a dictator’s prison. The nominally therapeutic showers, baths, and “faradizations” then became means of reprisal, submitting the uncooperative to prolonged chilling or ramped-up electricity. The ovarian compressor also doubled, when necessary, as an instrument of discipline. And the Salpêtrière had its own version of “the hole”—namely, the insane ward, into one of whose cells a straitjacketed Augustine was carried, and then handcuffed to the wall, after an attempted escape. Until she fled for good in 1880 by recruiting an accomplice and disguising herself as a male visitor, Augustine was approaching the condition of the debased aliénées whom Pinel had once encountered in the same hospital.
And then there was “Célina,” whose fits had usually been arrested through ovarian compression:
When the attacks persisted, however, and in an effort to calm her blatant sexuality, her doctor cauterized her cervix. This operation, which was all the more painful to the patient because she also suffered from vaginismus…, was repeated four times.… They then treated her with ether, to which she became addicted.55
The burning of her cervix and the disabling of her mind with ether, like the fastening of Augustine to a wall, must have served as a lesson to her watchful sisters: be hysterical in the correct manner!
Charcot’s Salpêtrière had indeed become a vast laboratory, not for the elucidation of hysteria but for the inadvertent demonstration of everything that can go wrong when egotism, ambition, hierarchical authority, and unchecked power are “scientifically” brought to bear on a helpless population of unfortunates. A week’s visit had been more than enough for Delboeuf to grasp the foolishness and sadism of the enterprise. His stay overlapped with that of Freud, who would be on hand for over four months. Now we will see how Freud—reputedly the most thoughtful and observant of psychologists—responded to the same body of evidence.
12
Attachment Therapy
1. INITIATION
On October 13, 1885, Freud arrived in Paris and took up residence in a hotel in the Latin Quarter, expecting to remain in the city for three months. As things turned out, he stayed, with a Christmas-season absence in Wandsbek, until February 28, 1886—and even then he didn’t go straight home, instead passing two more weeks among pediatric neurologists in Berlin. Still another visit to his fiancée intervened before he returned to Vienna on April 4.
Earlier in Vienna, Freud had felt relatively comfortable in his university, in its hospital, and in a tight-knit, mutually solicitous Jewish community, including his own needy but always affectionate and supportive family. In Paris, however, he was going to be an unknown outsider armed only with a letter of introduction from Moriz Benedikt—a “fairly crazy person,” as he confided in a Brautbrief of July 1, 1885, who “is extremely unpopular with us at home.” And Freud would be bidding for recognition in a language that he had begun to study only shortly before arriving—a language in which, as he wrote to his future sister-in-law Minna Bernays after more than six weeks in Paris, he couldn’t say “du pain” clearly enough to make himself understood.1 “My heart is German provincial,” the same letter confessed, “and it hasn’t accompanied me here.”2
In Paris, Freud’s usual headaches and indigestion were exacerbated by a heightened sense of anonymity, helplessness, and “laziness,” his term for a depressive paralysis of will. Typical was his report to Martha of October 31:
Again today I am not yet completely well. Not a continuous nausea; but after lunch a miserable feeling of dizziness, an overheated head, sleepiness, and irritability. At the same time, I am always so hungry that I struggle not to eat twice or three times as much, and, as I mentioned, it is quite different from my Viennese condition, which involved a weariness that lasted all day and no specific stomach symptoms.
Freud’s own explanation of such sharpened torment was that it resulted from the thwarting of his drive for professional success—a frustration that Paris, vibrant but withholding, seemed to amplify. His health in general, he felt, and hence his ability to settle down, stood at risk if the pressure to achieve were to continue much longer. The cure that he pondered was, once again, to renounce all scientific aspirations and to resign himself to mediocrity. Thus the keynote of his initial phase in Paris was surrender to intimidation, a feeling of having been overwhelmed in advance of any effort.
That feeling had two main focuses, Charcot and the city itself. Both of them loomed in Freud’s imagination as all-powerful without needing to make room for his drab foreign self. Understandably, then, he was in no rush to present his meager credentials at the Salpêtrière. Instead, he spent most of his first week taking long walks, frequenting museums and theaters, and moping over his isolation—“not a word of German, no familiar faces, no jokes, no signs of affection all day long.”3 His anonymity in the bustling streets must have struck him as a foretaste of the cold reception awaiting him at the mammoth asylum.
It was natural, then, for the lonely stranger to console himself with a good deal of cocaine, which never seems to have been in short supply. Before he left Paris at the end of February 1886, the drug would play an important role in steadying his nerves for social interaction. In the early stage of his visit, it must have appealed to him as his only reliable comfort. References to his use of cocaine crop up frequently in the Paris Brautbriefe, and many of his reported thoughts, deeds, and mood swings bespeak its influence.
It was in Paris, for example, that Freud underwent his first known hallucinatory experiences. In The Psychopathology of Everyday Life (1901), attempting to distance himself from “spiritualism,” he would make the following remarkable disclosure:
During the days when I was living alone in a foreign city—I was a young man at the time—I quite often heard my name suddenly called by an unmistakable and beloved voice; I then noted down the exact moment of the hallucination and made anxious enquiries of those at home about what had happened at that time. Nothing had happened.4
“Quite often,” we see, Freud was undergoing auditory hallucinations in Paris; and instead of immediately recognizing their unreality, he had had to make “anxious enquiries” by mail to be sure that Martha hadn’t spoken to him from 600 miles away. Hallucinations are a common result of cocaine intoxication.
Not even cocaine, however, could prevent Freud from deciding that the French were a cold, arrogant, and dishonest folk. Yet little by little, Paris melted the hostility of its unhappy critic. In its sheer antiquity, monumentality, and variety, the city he couldn’t expect to impress was itself the most impressive thing he had seen. The medieval and Roman ruins at the Musée de Cluny and the Assyrian and Egyptian remains at the Louvre helped to imprint on him an archaeological conception of the past. Attending migraine-inducing plays at the cramped and stuffy Comédie Française and the Porte St. Martin in the hope of improving his French, reading Victor Hugo’s Notre-Dame de Paris, and repeatedly visiting the great cathedral itself and the Louvre, he soon began to feel less like a bewildered alien and more like an intellectual tourist whose horizons were being broadened.
Paris was also opening Freud’s eyes to a side of life that he still found rather alarming: uninhibited behavior. In the mid-1880s, unabashed candor about the body and its needs was the best-known trait of the city whose international icon wasn’t yet the Eiffel Tower but the Folies Bergère. It is easy to picture how Freud’s agitation must have been heightened by the daily parade of saucy faces and swaying hips that he witnessed during his strolls. And sex for hire was both legal and ubiquitous in Paris. Freud apparently told Marie Bonaparte, late in life, that he hadn’t entered his marriage as a virgin.* Perhaps, then, at twenty-nine he did learn a thing or two about copulation, thus beginning to catch up with other European men of his generation.
2. OVERAWED
Freud mustered enough courage to enter the Salpêtrière on October 19, 1885. But out of nervousness, no doubt, he had left Benedikt’s letter of introduction back in his hotel. Charcot was on duty, but Freud thought it advisable to delay presenting himself until the following day. When he did so, his fear of a curt reception was allayed at once. Benedikt’s letter, he perceived, was all Charcot needed to accept him as a legitimate visitor who ought to be accorded the usual privileges.
Freud’s first description of Charcot to his fiancée was an evocative vignette:
At ten o’clock M. Charcot arrived, a big man of fifty-eight, wearing a top hat, with dark, strangely soft eyes (or rather, one is; the other is expressionless and has an inward cast), long wisps of hair stuck behind his ears, clean shaven, very expressive features with full protruding lips—in short, like a worldly priest from whom one expects a ready wit and an appreciation of good living.†
Freud’s medical apprenticeship in Austria had taught him to assume that any learned mentor will project an air of stern authority. Imagine his surprise, then, at finding Charcot to be relaxed, urbane, droll, and forthcoming in the presence of subordinates and others. “Altogether,” he wrote after their first meeting, “the atmosphere is very unconstrained and democratic. Charcot lets fall in passing such an abundance of the shrewdest remarks, asks many questions, and is always so polite as to correct my miserable French.”5 That this show of openness was itself a display of power—that of a ruler who can afford to be cordial because no one would dare to contradict him—did not occur to Freud, nor would it do so later.
In the Brautbriefe a month later, we find Freud wholly possessed both by Charcot’s self-presentation and by his science. Now he is ready to defend the Frenchman against all doubters. Interestingly, however, this new loyalty has only reinforced his own defeatism. Charcot’s dazzling accomplishments have shown him the futility of lesser efforts:
Charcot, who is one of the greatest of physicians, a brilliant and prudent man, is simply ripping away all of my opinions and purposes. After many of his lectures I go away as I do from Notre Dame, with new feelings about perfection. But he assails me; when I go away from him I no longer have any desire to work at my own silly things; I’ve been lazy for three days now without making self-accusations about it.… I can’t say whether the seed will ever bear fruit, but I know for certain that no other man has had a comparable effect on me.… When I get home I feel quite resigned and say to myself: the great problems are for men between fifty and seventy; for us young people there is life itself.6
Why was Freud so demoralized? The reason he gave Martha was incoherent. If no one besides men between the ages of fifty and seventy could solve major problems—already an absurd supposition—that must have been because those achievers had devoted themselves to a field of inquiry when they were no older than Freud and had kept at it for decades. The apparent lesson would be to buckle down now in the hope of becoming Charcot’s peer, or at least his worthy colleague, with the passage of time.
But Freud, we remember, wanted fame and wealth in the short run. He seemed to feel, bizarrely, that what he craved was already the property of another. Instead of emulating Charcot’s dedication, he was inclined to step aside and become an armchair Charcotian—or, rather, a Charcot acolyte, staying as close to the great man as possible, hanging on his every word, and hoping to attract his notice.
Now that Freud was fully aware of Charcot’s psychological interests, he felt especially lukewarm toward the neuroanatomical project—microscopically studying diseased brain tissue from dead children—that Charcot’s assistants, under the master’s obliging direction, had set up for him in the hospital’s laboratory for pathology. Indeed, he would abandon the work altogether after a couple of desultory months. Explaining his decision to Martha on December 3, he provided no fewer than seven reasons for having quit, from a stomach catarrh and insufficient space to “the very healthful effects of calmness” and “the impossibility of lunching near the Salpêtrière.” The inconveniences were real enough, but Freud’s capitulation, so unlike Charcot’s early perseverance in far more trying circumstances, marked the chasm between their temperaments.
Freud’s one obsessive desire was to draw Charcot’s favorable attention to himself. Nothing was worse than the thought that he was doomed to remain insignificant in the master’s eyes. “My well-being is really quite poor overall,” he wrote on November 12, 1885,
and I am so terribly afraid of doing anything, and unhappy about all the little hindrances. I think now I am beyond the worst of it, but the whole month has been a loss, and I must make good use of the next two if I want to finish a project. The French are still very arrogant and inaccessible, and I am not so pleased with Charcot anymore, either. He never speaks a word to me or any other foreigner, and one feels so cramped and isolated.
Appalled by such mewling, the levelheaded Martha reminded her betrothed that he was privileged to have been given this free time for self-development in a foreign capital. Rebuked, on November 17 he made an attempt to be philosophical. “Charcot is an extraordinary person,” he grudgingly reflected, “whether he is speaking to me or not.”
Two days later Freud was in better spirits, and he managed to tell Charcot of a clinical project he had in mind—a joint venture with Pierre Marie, who had been Charcot’s chef de clinique, or master assistant, at the time he was delegated to accommodate the visitor. In fact, as we learn from an earlier letter, it was Marie who had proposed the idea to Freud.7 Although we don’t know the specifics, Marie’s intention was to offer Freud an opportunity to relate his anatomical studies to observation among the Salpêtrière’s hysterics.8 Charcot immediately authorized the step. Here, then, it might be supposed, was the moment when Freud began his transition from neurology to clinical psychology.
Freud, however, dreaded the forthcoming task. “In my disheartened and sullen state,” he wrote on November 12, “I’ve considered that this new work will hold me here longer and put me into even greater unrest and agitation.” And a week later he reported, “It looks as though Marie wants to withdraw, so I don’t know what I will be able to accomplish.”9 For whatever reason, one of Charcot’s most influential lieutenants had changed his mind about working with the newcomer.
