Sigmund Freud Believed his Patients at First

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Sigmund Freud Believed his Patients at First

My two main sources for the information in this post are:
“Freud and the Seduction Theory: A challenge to the foundations of psychoanalysis:” Jeffrey M, Masson, The Atlantic Magazine, February 1984.
“Assault on Truth: Freud’s Suppression of the Seduction Theory.” Jeffrey Moussaieff Masson, 1984.

I have wanted to write this post for a long time but I postponed it for the day when I could research it properly, with all the footnotes in place. Finally, I have admitted that day is unlikely to come, so decided to write a less-than-perfect post and get it off my mind.

It’s the sad story of Sigmund Freud and his best friend and colleague, Wilhelm Fliess. It’s also the sad story of the difficulty in breaking through denial about child sexual abuse, both individually and societally.

Freud’s wrote to Fleiss for over ten years. His letters have been preserved, but all of Fleiss’s letters to Freud have been destroyed. These letters show Freud’s thinking during the 1890’s when he was developing the “seduction theory” and how he later came to disbelieve his hypothesis and decided that his patients had been fantasizing sexual abuse by their fathers because they really wished to displace their mothers and have their fathers all to themselves sexually.

Wilhelm Fleiss was a medical doctor and a nose and throat specialist. He held the controversial theory that masturbation caused neurotic symptoms and that there was a link between the nose and the genitals. Thus if the nose was cauterized or operated on, the urge to masturbate would subside and the symptoms would disappear.

Freud, a neuropsychologist, held the equally if not more controversial belief that the stories his patients were telling him were true and that they had been sexually abused in childhood, usually by their fathers. He called this the “seduction theory,” meaning that the adult had seduced (or assaulted) the child, not that the child had seduced the adult. He stated that he believed them because of the emotions they showed while recounting the assaults and by the fact that their symptoms got better after they talked about their childhoods.

Freud also believed Fleiss’s theory. How he could believe both at once is beyond me, but he did.

Many of those letters were about a patient they shared, Emma Eckstein. I’m going to skip over that, except to say the Fliess persuaded Freud to let him operate on her nose, and he botched the operation and she almost bled to death. He never admitted his mistake, and Freud came to believe that Emma’s hemorrhage was a symptom of her neurosis, not an error on Fleiss’s part, thus remaining loyal to his friend.

Not long after this, Freud repudiated his original belief that his patients had been sexually abused in childhood. Here is part of the letter he wrote Fleiss describing his change of heart:

“And now I want to confide in you immediately the great secret of something that in the past few months has gradually dawned on me. I no longer believe in my neurotica [theory of the neuroses]. This is probably not intelligible without an explanation; after all, you yourself found what I was able to tell you credible. So I will begin historically [and tell you] from where the reasons for disbelief came. The continual disappointment in my efforts to bring any analysis to a real conclusion; the running away of people who for a period of time had been most gripped [by analysis]; the absence of the complete successes on which I had counted; the possibility of explaining to myself the partial successes in other ways, in the usual fashion – this was the first group. Then the surprise that, in all cases, the father, not excluding my own, had to be accused of being perverse – the realization of the unexpected frequency of hysteria, with precisely the same conditions prevailing in each, whereas surely such widespread perversions against children are not very probable.”

This sounds to me much like the arguments of the False Memory Syndrome Foundation proponents. The patients’ accounts are too similar, the accusations too bizarre, it must be fantasies and lies. These women come from good families and incest is exceedingly rare, perhaps one in a million families.

What really grips my attention, though, is Freud’s stating, “… in all cases, the father, not excluding my own, had to be accused of being perverse…” How many people have said, “not me – I had a happy childhood.” “Not my family.” “Not my father.” And later, “Oh shit, it did happen to me.”

Freud went on to say,

“What would you say, by the way, if I told you that my brand-new theory of the early etiology of hysteria was already well known and had been published a hundred times over, though several centuries ago?. . . But why did the devil who took possession of the poor things invariably abuse them sexually and in a loathsome manner? Why are their confessions under torture so like the communications made by my patients in psychological treatment?”

He is talking about the Inquisition. My guess is that he believed that the women accused of being witches stated they were sexually assaulted by the devil, not by their fathers. And yet, he says that their accounts are very similar to what he heard from his patients.

He continues:

“Imagine, I obtained a scene about the circumcision of a girl. The cutting off of a piece of the labia minora (which is still shorter today), sucking up the blood, following which the child was given a piece of the skin to eat.

“I dream, therefore, of a primeval devil religion whose rites are carried on secretly, and I understand the harsh therapy of the witches’ judges.”

And here I say to myself, “Aha! Others have said that this is the first time that ritual abuse survivors have broken through their denial and spoken publicly. And yet I have long thought that the first wave of public acknowledgment of Satanic ritual abuse was during the Inquisition.” Here is Freud disagreeing with me, yet agreeing in almost the same breath. For he says that his patients were fantasizing, and yet one had a deformed labia, evidence that the abuse she described was true, and this makes him fantasize about a primitive devil religion.

There is more to this story, though.

Fleiss had children, and one of them, Robert, became an analyst. He, like Freud, believed his patients. Unlike Freud, he did not recant. In 1959 he published “Erogeneity and Libido: Addenda to the theory of Psychosexual Development of the Human.” In a footnote he wrote:

“In the first volume of his [Freud’s] biography Jones gives a description of my father that enables the psychiatric reader to make his own diagnosis. Some of these readers, perhaps defending themselves against acknowledging the above mentioned incidence [incest] in their own families, may therefore be tempted to dismiss what I have observed as a form of projection. For their benefit: following Freud’s advise to the analyst to re-enter analysis, I have clarified the picture of my father in two expert and thorough analyses, the last in middle age with Ruth Mack Brunswick: and I have had an extended conversation with Freud himself about his onetime friend.”

The description Jones gave of Wilheim Fleiss suggested he was a child molester, and Robert Freud hints in this passage that he was abused by his father. This would have happened about the time that Freud stopped believing his patients. If what I surmise is true, we have two close friends, one who is incesting his son and one who was incested by his father, but is still amnesic for that part of his childhood. Very interesting.

I’ll end with something that does not call for interpretation or conjecture. When Freud was talking about incest, he was rejected by his colleagues and others who read his papers. Sixty years later, Robert Fleiss was also rejected for believing his clients. In the 1980’s, when Jeffrey Masson edited Freud’s letters and included material on Freud’s belief in child sexual abuse, he too was rejected. (Believing that he had been pushed out of the field, he wrote books about animals and became an animal activist.) And to this time, many therapists who work with survivors of extreme child abuse are rejected.

We have come a long way, but the road to acceptance is still long and lonely.



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