I found Breger's biographical insights into Freud interesting, specifically how Freud's personality and circumstances affected his theory. This is a similar psycho-historical approach taken by Atwood and Stollorow in "Faces in a Cloud", which I reviewed here last year. I actually found Breger's insights fresher and more pertinent.
I had often heard a feminist critique of psychoanalytic theory that Freud was sexist and came from a repressive Victorian culture in Vienna at the turn of the century. Interestingly, Breger noted that not everyone in Vienna was as sexually repressed as was Freud at that time.
With respect to Freud's sexism, Breger quoted Freud 's letter to his fiancée, Martha Bernays, "It seems a completely unrealistic notion to send women into the struggle for existence in the same way as men. Am I to think of my delicate sweet girl as a competitor? The position of woman cannot be other than what it is: to be an adored sweetheart in youth and a beloved wife in maturity." Breger reported that after they were married, Freud forbade Martha to follow her religious observances and rituals that she grew up with.
Breger also quoted some of Freud's grim views of sex within marriage from "Civilized Sexual Morality and Modern Nervous Illness" (1908): "satisfying sexual intercourse in marriage takes place only for a few years; and we must subtract from this, of course, the intervals of abstention necessitated by regard for the wife's health. After these three, four or five years, the marriage becomes a failure. Fear of the consequences of sexual intercourse first brings the married couple's physical affection to an end; and it usually puts a stop as well to the mental sympathy between them. The spiritual disillusionment and bodily deprivation to which most marriages are thus doomed puts both partners back in the state they were in before their marriage, except for being the poorer by the loss of an illusion"
The most interesting story to me was the collaboration between Joseph Breuer and Freud to answer the question of What is Hysteria? and Breuer's development of the talking cure. I had read Ernest Jones' biography of Freud 30 years ago and was astonished to learn from Breger how Jones distorted the history and facts of the case of Anna O and the collaboration between Breuer and Freud to favor Freud's theory of repressed sexuality as the cause of hysteria.
Breger carefully reviewed the case as described by Breuer and Freud in their landmark work, Studies on Hysteria, and brought in other sources as well. Breger contrasted Breuer's technique of listening and helping the patient express affect to Freud's penchant to intellectualize the materialize and then make interpretations meant to dispel the neurotic symptom.
Also, Breuer thought sexuality was one emotional experience among many in hysterics whereas Freud made it the centerpiece of his theory of Hysteria and of psychology in general. After originally crediting Breuer with the development of the talking cure, the basis of psychoanalytic technique, Freud later minimized Breuer's contribution. Freud accused Breuer of missing the centrality of repressed sexuality in the Anna O case, even suggesting in a letter to a friend that Anna O had developed a hysterical pregnancy with "Dr. Breuer's baby."
Breger wrote, "Freud's distorted version of the case, and Jones' further elaboration of it, attempt to portray Breuer as a coward and Freud as a hero. These stories emphasize that the older, more experienced doctor presumably did not have the courage to face up to his patient's sexuality, whereas Freud not only did so with his patients, but placed sexuality as the center of his theory of neurosis. But Freud's version of what happened is simply not true."
Breger repeatedly asked why Freud was so intent on focusing so much on sexuality, moving away from trauma, loss, or death as significant factors in the genesis of psychopathology. This was the central thesis of Breger's book, that Freud was seeking "undying fame." Freud wrote in a letter to Fliess, "The expectation of eternal fame was so beautiful as was that of certain wealth, complete independence, travels, and lifting the children above the severe worries that robbed me of my youth. Everything depended upon whether or not hysteria would come out right."
After his self-analysis, Freud moved further from his belief in the importance of real traumatic experiences in the pathogenesis of neurotic symptoms and more toward the role of fantasy, instincts, and his theory of the Oedipus Complex. Breger believed that Freud erred in abandoning the role of reality and also by embracing the single cause of the Oedipus constellation as universal for all patients.
Like Joe Weiss, Breger emphasized the case specific nature of the causes of psychopathology and also the importance of real trauma versus wishes and fantasies. Breger wrote, "There were many causes of the neuroses, but they were always something real, not Oedipal or any other kind of fantasy, and each person should have been understood as a unique individual in a specific familial-social context."
Finally, Breger's story of Freud was the story of betrayal and broken relationships. Of Freud's personal family relationships, Breger wrote, "He was prone to powerful jealousy of potential rivals (for his fiancée, Martha Bernays), including a previous suitor, her mother, and her older brother Eli, a generous and outgoing former friend of Sigmund's. He picked fights with both her mother and Eli over trivial matters and insisted that Martha side with him, tearing her away from her beloved family members, who were now, in his words, 'enemies.'"
In his professional life, after being supported and mentored by Breuer, he later soured on the relationship and broke it off. Similarly, he later broke with his friend Wilhelm Fliess and members of his inner psychoanalytic circle, Alfred Adler, Wilhelm Stekel, Carl Jung, Otto Rank, and Sandor Ferenczi. "Those who disagreed with orthodox doctrines or came up with new ideas were blacklisted," wrote Breger, "not given referrals - which Freud largely controlled - and their reputations were tarnished with lies and slander."
"A Dream of Undying Fame" was eye opening in many ways and beautifully written. Like the Double Helix, the story of Watson and Crick's discovery of the structure of DNA, Breger's book is a satisfying tale of intellectual discovery and human relationships. It was written by a seasoned clinician whose humanistic view of psychotherapy is quite congenial with our own.
Steve Foreman
