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Madness on the Couch

from Chapter One: The Gospel According to Freud

Freud is extraordinary. Of course he is full of fishy thinking and his charm and the charm of the subject are so great that you may easily be fooled . . . So hold on to your brains.
— Ludwig Wittgenstein

We possess the truth; I am as sure of it as fifteen years ago.
— Sigmund Freud

The man who convinced two generations of followers that diseases could be decoded, like hieroglyphics, looked conventional enough. Freud was nearly forty years old, well past the period of flaming youth, before he embarked on any of the work for which he is known today. He was a well-respected physician, a securely entrenched member of the middle class (as securely entrenched, at any rate, as a Jew in anti-Semitic Vienna could be), and the unchallenged head of a Victorian household that included a wife, a sister-in-law, and six children. Formal in his speech, meticulous in his dress, methodical in his habits, Freud hardly seemed a revolutionary.

He was a handsome man, five-foot-seven and of medium build, with brown hair, brown eyes, and a neatly trimmed beard. Though he was an affectionate father, the children were largely the province of his wife — she also handled such domestic chores as spreading the toothpaste on her husband's toothbrush — while Freud devoted himself to work. He was a therapist by trade but not by temperament; his ambition reached beyond soothing a handful of troubled Viennese. "We do analysis for two reasons," he once declared, " — to understand the unconscious and to make a living."

The world-weary tone was characteristic. Freud's true goal was discovering the laws of the mind, and patients were only a means to that end. Therapy was "not the main or even the essential aim of psychoanalysis. The chief aim of psychoanalysis is to contribute to the science of psychology and to the world of literature and life in general." When one ex-patient made the mistake of asking Freud to evaluate himself as an analyst, the great man grew testy. "I'm glad you ask," he replied, "because, frankly, I have no great interest in therapeutic problems."

This was no Norman Rockwell doctor with a heart as big as all outdoors and a kind word always at the ready. "In the depths of my heart," Freud once told his great friend Lou Andreas-Salomé, "I can't help being convinced that my dear fellow men, with a few exceptions, are worthless." It was a favorite sentiment. "I have found little that is 'good' about human beings on the whole," Freud declared on another occasion. "In my experience most of them are trash . . . If we are to talk of ethics, I subscribe to a high ideal from which most of the human beings I have come across depart most lamentably."

Still, there were bills to be paid. Six days a week patients arrived at No. 19 Berggasse, an apartment building in a respectably middle-class Viennese neighborhood. A butcher shop occupied the ground floor, Freud's office and the family apartment the second. Freud took a midday break to walk down the hall and join his family for lunch. He saw patients in a steady stream, the first at nine in the morning and the last perhaps as late as nine at night. (He put his patients on the couch, rather than in a chair, so that they did not see him. "I cannot put up with being stared at by other people for eight hours a day (or more)," he explained.)

Freud sat out of view behind the patient's head, jingling his keys or playing with his watch chain, and jumping in with opinions and interpretations, and even jokes, as they occurred to him. Quite often one of his beloved dogs was sprawled across the carpet. It was a less austere approach than later Freudians — or even Freud himself, in his advice to others — would deem acceptable. (When Freud's daughter Anna decided that she, too, would become an analyst, Freud bent a far more important rule. He chose to analyze her himself, a father taking on the task of probing such matters as the meaning of his daughter's sexual fantasies.)

In the interest of objectivity, psychoanalysts were not supposed to betray any reactions, neither approval nor disapproval, neither shock nor boredom. "The doctor should be opaque to his patients," Freud decreed, "and, like a mirror, should show them nothing but what is shown to him." The goal was "emotional coldness." "I cannot advise my colleagues too urgently," Freud wrote, "to model themselves during psycho-analytic treatment on the surgeon, who puts aside all his feelings, even his human sympathy, and concentrates his mental forces on the single aim of performing the operation as skillfully as possible."

Nor did Freud look for much more collaboration from his patients than a surgeon would. Analysis was, he said, "a situation in which there is a superior and a subordinate," and there was little doubt about which was which. Freud "was quite dogmatic, and did not like disagreement," an ex-patient recalled. "When I would protest about something, his interpretations, he used the Viennese dialect term, saying: 'You know a Schmarn about psychoanalysis.' It's hard to translate the word Schmarn, but a vulgar translation would be 'You know shit about analysis.' He said: 'You don't have the right to query my interpretation.' "

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