Reply to 13 April 2000 LRB article by Mikkel Borch-Jacobsen: "How a Fabrication Differs from a Lie"
Snelling, D. (2000) ''In a cool and scientifically objective spirit: perverting reason and truth in the Freud Case'.
David Snelling is a contributor to "The Analytic Freud" (Routledge, 2000), and author of a forthcoming book on the philosophy of psychoanalysis
In On the History of the Psychoanalytic Movement Freud tells us how in the early days his ideas met with indifference and hostility from his medical and scientific colleagues, and asserts that such a response arose from “affective” rather than intellectual grounds: was a resistance not unlike that met with from patients in analysis.
Subsequently, this suggestion has been turned against psychoanalysis by those hostile to it, who have taken it as evidence that psychoanalysis attempts to put itself beyond criticism by besmirching the motives of the critics. Criticism is to be dismissed as resistance, therefore has no rational purchase.
Of course, Freud did not mean this. The irrational basis of the kind of criticism he was trying to identify is exhibited in the form and texture of the arguments, which distinguish it from what he calls the “cool and scientifically objective spirit” of genuine criticism. Thus later, in the New Introductory Lectures, he tells us that “there was no violation of logic, and no violation of propriety and good taste, to which the scientific opponents of psychoanalysis did not give way”. Such deviations from accepted standards of rational discussion, if they fall into a sufficiently distinct pattern to be unified under a name, deserve to be given one. The most appropriate name available would seem to be Freud-bashing.
Freud-bashing has become a new industry. In his recent book Open Minded Jonathan Lear speculates as to why this should be so. He sees it as signalling “a culture which wishes to ignore the complexity, depth and darkness of human life”. But there is a more basic task to be performed in getting to grips with this phenomenon. The aims and tactics of the bashers have to be systematically examined, in part so that Freud-bashing can be clearly identified and distinguished from fair criticism, but also in order to uncover the presuppositions of this kind of thinking and make plain its flaws.
Freud-bashing plunges the ad hominem argument down to new depths. Freud was a liar. Freud was a cheat. Freud was a thief (of ideas, if nothing else). On one account, Freud was even a would-be murderer. In fact the easiest sign of the Freud-basher to spot is resort to abusive language. Borch-Jacobsen uses the words “lie”, “liar”, and their derivatives in connection with Freud 19 times in the course of his short article, insisting that Freud “lied through his teeth”, and dubbing him “the Great Liar”. Apart from its rhetorical effect, such abuse has another role. Freud-bashing requires that the very worst construction be put on everything Freud did. This tendency reaches its furthest extreme in the writings of Frederick Crews, for whom Freud is clearly the very Devil. In the mind of Borch-Jacobsen, as of Crews, Freud is ruthless, efficient and single-minded in perpetrating his wickedness; the archetypal comic-book villain. No allowances can be made in Freud’s case for the emergence of ordinary human flaws within a complex pattern of motives, no shades of grey between the stark black and . And yet these writers are professors of literature.
Another favourite tactic is to quote the conclusions of other bashers as if they unchallengeably establish their claims, much in the way that journalists writing on these matters so often cite the “facts” about Freud unearthed by these “experts” (which include the speculations, such as the murder charge mentioned above, of that eccentric autodidact—or, for those who prefer, “maverick researcher”—Peter Swales; speculations Borch-Jacobsen is happy to invoke).
Hence Borch-Jacobsen feels licensed baldly to state: “No, Anna O.’s ‘talking cure’ never was the ‘great therapeutic success’ later vaunted by Freud. No, Breuer in no way denied the role of sexuality in the neuroses. No, Freud was not as intellectually isolated as he claimed, and the reactions of his colleagues were far from being unfavourable at the beginning. On the contrary, many of them—notably his friend Fliess—had a deep interest in sexuality, including infantile sexuality...” and so on. Such claims rest on selective and biased use of the evidence. Borch-Jacobsen discusses Anna O.’s case and Breuer’s view of sexuality and the neuroses in his article, after an examination of Freud’s attempt to pioneer the medical application of cocaine. I shall reply at length only to the cocaine charges, though fully convinced that the other criticisms can be rebutted in similar detail, given space. But I want to begin with a few passing remarks on the last issue mentioned in the list above, Freud’s professional isolation.
Freud’s views on infantile sexuality were unacceptable to his medical colleagues because of his claim that the causes of hysteria were to be found in the sexual life of childhood—a very specific claim, not about the existence infantile sexual life itself, but its aetiological significance. As is familiar, this claim took two forms: the earlier version proposed that the causative factor was childhood abuse or “seduction”; the later held that infantile sexual phantasy was to blame—infantile sexuality proper. As has been shown by the hero of an earlier wave of Freud-bashing, Jeffrey Masson, in The Assault on Truth, the first version met with a chilling reception when Freud publicised it in his paper The Aetiology of Hysteria, delivered to his assembled Viennese colleagues in 1896. Yet Freud’s next step— his move to the second, phantasy-based aetiology—meant, in the words of Paul Robinson in his book Freud and His Critics, that he “abandoned the seduction theory only to embrace an idea that was even more offensive to the prejudices of his culture”. In fact, belief in the aetiological significance of infantile sexual phantasy was and is unique to psychoanalysis. If Freud’s isolation lessened as the years went by, it was solely because the numbers of analysts grew.
Citing Fliess to show that Freud was not isolated would seem a joke in other, less virulently anti-Freudian company. Freud turned to Fliess with the intensity he did because Fliess was the only person willing to listen: not a senior colleague learned in mental diseases but an ear, nose and throat man with unorthodox views outside his specialism, views in which he connected the sexual organs with the nose and claimed we all possess a basic bisexual constitution, as well as promoting odd numerological notions. A case of one outsider being consoled by another.
Successful Freud-bashing requires that very close attention be paid to details. These may be details of psychoanalytic theory, of the history of psychoanalysis, or of Freud’s biography. Slanted interpretation of such details can then be made in the knowledge that very few readers will have the time or opportunity to check them. So, Borch-Jacobsen, following Israëls, takes up the pre-psychoanalytic “cocaine episode”, arguing that Freud claimed therapeutic success in the use of cocaine in treating morphine addiction when he knew full well that this was not so. Here at once we plunge into a mass of obscure detail. Unfortunately, I cannot spare the reader the task of looking into it again.
There are three main charges made against Freud here. First, in July 1884, Freud published an article in which he claimed that he had cured a morphine addiction despite already knowing, as letters uncovered by Israëls purportedly reveal, that the treatment was a failure. At the same time, he stated that cocaine use had been suspended after ten days. Secondly, Freud published a second article on cocaine in 1885, in which he repeated the first claim and added that no cocaine habituation had set in, although he knew by this time that the patient (his friend Fleischl-Marxow) had become a cocaine addict. Thirdly, he published yet another article (in 1887, though Borch-Jacobsen doesn’t give the date) where he attacks a critic (Erlenmeyer) who had failed to replicate his results, on the grounds that this opponent had used injections instead of oral doses of cocaine; this despite Freud’s own advocacy of injections in his 1885 paper.
Decision on these issues is clouded by the fact that Freud was at the time attempting to use cocaine extensively in a variety of applications, and seems to have put it to two separate uses in Fleischl’s case: as a means of morphine withdrawal and as an analgesic. Further distinction needs to be drawn between use of morphine for pain control and its addictive abuse. It seems that Freud began in May 1884 by attempting to rid Fleischl of his addiction using orally administered cocaine, and that he had some initial success. Even the letter that Borch-Jacobsen quotes against Freud at this point says: “With Fleischl things are so sad that I cannot enjoy the cocaine successes at all” (my emphasis). The reason why Fleischl was using morphine in the first place was to alleviate severe incurable pain caused by diseased nerves resulting from an infected hand. He considered his situation to be so bad that he was planning to shoot himself. No one involved—Freud, Fleischl or the other doctors on the case—would have expected the cocaine intervention to affect the real malady, the nerve damage. It is this malady which, it seems clear, occasioned Freud’s sadness; already in 1883 Freud had written: “[Fleischl] is not the sort of man you can approach with words of empty consolation. His state is precisely as desperate as he says”.
But Fleischl’s medicinal use of morphine had given rise to an addiction which had become an independent problem. One has no reason to doubt Freud’s good faith in reporting a positive short-term improvement in tackling the morphine abuse. But a resurgence of the original malady prompted another physician on the case, Billroth, to attempt an operation. Fleischl returned to morphine use—in response to Billroth’s recommendation, on Borch-Jacobsen’s own admission—to control post-operative pain.
On the issue of Fleischl’s newly-acquired cocaine addiction, Borch-Jacobsen tells us that “after Freud gave him cocaine injections in January 1885 in an attempt to fight the pain [Fleischl] started injecting himself with ‘enormous doses’ of that substance (1 gram per day)”, with the implication that Freud caused the abuse of cocaine injections by administering the “first shot”. But this is to argue post hoc ergo propter hoc. Freud’s injections were directly into the affected nerves, and intended to have a local analgesic effect. And, as is indicated by the event which is the focus of Jones’s discussion of the “cocaine episode”, the discovery by Carl Koller of cocaine’s value as a local anaesthetic in eye operations, such an intervention was entirely justifiable. There is no disputing that Freud introduced Fleischl to cocaine in 1884. But this does not make him solely responsible for Fleischl’s later abuse of it.
In fact, Borch-Jacobsen’s argument undermines itself. Given that Freud administered the injections to what remained of Fleischl’s hand in January 1885, and that this pre-dated Fleischl’s cocaine addiction, as Borch-Jacobsen admits in insinuating that the injections caused the addiction, Freud might plausibly be thought justified in stating only two months later, in March 1885, in the spoken version of the paper published in August of that year, that there was “no cocaine habituation”. This might also be thought to justify the statement by Jones in his biography, which Borch-Jacobsen quotes dismissively, that “This [i.e. March 1885] was before Fleischl had suffered from cocaine intoxication” (about which see more below).
What, then, of the letters of July and October 1884 unearthed by Israëls and gleefully cited by Borch-Jacobsen, in which Freud remarks on Fleischl’s “large” consumption of cocaine? We must remember that Freud had no reason to believe at this time that cocaine was not the wonder drug he hoped it would be, and no reason to regard Fleischl’s use of it as sinister, or as indicating an addiction. In fact, as Borch-Jacobsen himself tells us, it was not until June 1885 that Fleischl suffered from what Jones is almost certainly referring to in his remark on “cocaine intoxication”, i.e. a cocaine psychosis. And Freud had no reason to think in August, when his March statements were repeated in print, that the later abuse by injection resulting in “intoxication” in June was directly caused by his original cocaine intervention by oral administration, which had occurred thirteen months previously. Jones adds that in a reprint of Freud’s original 1884 article which appeared in December of that year Fleischl himself contributed a note commenting on “his own good experiences” in using cocaine to withdraw from morphine, though Borch-Jacobsen gives no credence to this sort of patient report because, he believes, “it so happens” that all Freud’s patients had an irrational tendency to find his theories “acceptable”.
The issue of cocaine injections, which provides the third target for Borch-Jacobsen’s attack, is also more complicated than he allows. In his July 1884 paper Freud reports that the patient (Fleischl) received three tenths of a gram of cocaine per day orally during his withdrawal treatment. In his paper of August 1885 he says the dose should be about four tenths of a gram, i.e. roughly the same amount, again administered orally. But then he says, two sentences later, that “I have no hesitation in recommending the administration of cocaine for such withdrawal cures in subcutaneous injections of 0.03–0.05 g per dose”, i.e. doses of approximately one tenth the quantity of the oral dose. This statement has no additional support: no cases are cited, and there is no further discussion. We are left to speculate, either that Freud extrapolated a safe injection dose for morphine withdrawal from his experience administering cocaine orally to Fleischl, or, with Jones, that Freud had administered such injections himself (cf. Jones’s biography, vol. 1, p.105) although there is evidence, from the account in the analysis of Freud’s Irma dream in The Interpretation of Dreams, that this was not the case. But there may be another explanation, for which we must turn to an examination of the final charge against Freud, that in 1887 he condemned Erlenmeyer for using injections, despite having advocated them himself in 1885.
Let us look carefully at what Freud says in his 1887 article, Craving for and Fear of Cocaine, in response to Erlenmeyer’s two attacks of July 1885 and May 1886. Freud says that Erlenmeyer committed “a serious experimental error”, in that he did not administer the recommended effective dose of “several decigrams per os” (actually, as we have seen, 3–4 dg). He continues: “Erlenmeyer had given minimal amounts injected subcutaneously and thus obtained, from a dosage, ineffective over a long period, a transient toxic effect” (my emphasis).
So Erlenmeyer used too small a dose in his injections, according to Freud. But do we not find that in his 1885 article Freud proposes the injection of doses of only one tenth of his recommendations for oral administration given only a line or two before? Borch-Jacobsen is contemptuous of Jones’s suggestion that Freud’s behaviour may be determined by unconscious factors; but here is a blatant inconsistency between two statements which stand side by side, and, to use a phrase Borch-Jacobsen uses elsewhere, Freud “seems not to have noticed”: the surest sign of unconscious determination. Let me give a tentative reconstruction of what may have happened.
Erlenmeyer’s first critical article appeared, as I have said, in July 1885. At this time Freud would have been correcting proofs of his March paper for publication in August. As I have already pointed out, the statement about the use of injections stands out like a foreign body in the text. Is it possible that Freud unconsciously incorporated into his paper a conclusion using data from Erlenmeyer’s, which he would have been reading at the time: a conclusion which converts Erlenmeyer’s negative assessment into a positive one? The existence of the original manuscript of the March version would settle the matter. Short of that, a look at Erlenmeyer’s article, and at his dosage records there, would provide some evidence.
In the absence of such evidence we only have a speculation. But since the critics freely avail themselves of the right to speculate and second-guess Freud’s motivation, some speculation on the other side might be ventured. Borch-Jacobsen admits that his reading of events make it difficult plausibly to reconstruct Freud’s motives so as to fit that reading. We have to think either that Freud was “recklessly”, “insanely” prepared to risk exposure by the many people who knew the truth on these issues, “especially Erlenmayer” (sic); or that he suffered from some massive tendency to self deception, through which he “convinced himself of his imaginary success”, “hallucinated his theories”, “dreamed up his clinical data” and engaged in “magical behaviour”. Exactly which theory of psychopathology supports these psychobabblings Borch-Jacobsen does not say. He does say that “such complete indifference to reality is staggering”. Indeed; so staggering as to be wholly inexplicable without such a theory. Unfortunately for him the best one available is psychoanalysis.
So let us put such speculations, pro and anti, aside for now. For anyone who is prepared to take an unprejudiced view of the psychoanalytic conception of the mind, there is a more satisfactory approach to these issues. Let us conjecturally accept that in 1887 Freud tried to put the blame on Erlenmeyer for the use of cocaine injections which he had himself advocated in 1885. This putting the blame on someone else falls into the pattern found in the dream of Irma’s injection, in which Freud’s colleague Otto is blamed for infecting their patient “Irma” with an injection from a dirty needle. Curiously, a core argument in Masson’s assault on Freud, the assertion that Freud transferred the blame for Fliess’s bungled operation on Emma Eckstein onto Emma herself, also fits the pattern, and also ties in with the Irma dream, as Max Schur showed in his original discussion of the issue. Freud’s analysis of that dream revealed a host of associations around the themes of guilt and blame, failed treatments and damaged patients. This is clearly what Jones is alluding to in speaking of unconscious determination of the injection theme. Freud does emerge as flawed in this view, which is the one adopted by Jones in his discussion of the “episode”; but the flaws have their roots in the unconscious; Freud resorts to the infantile response of “it’s not me, it’s him!” when certain sensitive areas are intruded upon. This infantile response is itself the clue to the unconscious determination at work. What psychoanalysis offers is a way of taking such determination into account in our understanding of what people do, Freud included. It also holds out the hope of diminishing the grip that such determination has on our lives. It is just this that the bashers, for whatever unconscious motives of their own, cannot stand.
My discussion has drawn upon The Cocaine Papers, edited by Robert Byck, Stonehill Publishing Company 1974, now regrettably out of print, to which the interested reader is referred.
Copyright © 2001 The British Psychoanalytical Society (incorporating the Institute of Psychoanalysis) London