Freud - Complete Works (410 page)

  
¹
‘When we survey the contents of this
document’, writes Dr. Weber in his report, ‘and
consider the mass of indiscretions in regard to himself and other
persons which it contains, when we observe the unblushing manner in
which he describes situations and events which are of the most
delicate nature and indeed, in an aesthetic sense, utterly
impossible, when we reflect upon his use of strong language of the
most offensive kind, and so forth, we shall find it quite
impossible to understand how a man, distinguished apart from this
by his tact and refinement, could contemplate taking a step so
compromising to himself in the public eye, unless we bear in mind
the fact that . . .’ etc. etc. (402.) Surely
we can hardly expect that a case history which sets out to give a
picture of deranged humanity and its struggles to rehabilitate
itself should exhibit ‘discretion’ and
‘aesthetic’ charm.

Psycho-Analytic Notes On An Autobiographical Account Of A Case Of Paranoia

2412

   With this object in view I shall
now mention a further small piece of the case history to which
sufficient weight is not given in the reports, although the patient
himself has done all he can to put it in the foreground. I refer to
Schreber’s relations to his first physician, Geheimrat Prof.
Flechsig of Leipzig.

   As we already know,
Schreber’s case at first took the form of delusions of
persecution, and did not begin to lose it until the turning-point
of his illness (the time of his ‘reconciliation’). From
that time onwards the persecutions became less and less
intolerable, and the ignominious purpose which at first underlay
his threatened emasculation began to be superseded by a purpose in
consonance with the Order of Things. But the first author of all
these acts of persecution was Flechsig, and he remains their
instigator throughout the whole course of the illness.¹

   Of the actual nature of
Flechsig’s enormity and its motives the patient speaks with
the characteristic vagueness and obscurity which may be regarded as
marks of an especially intense work of delusion-formation, if it is
legitimate to judge paranoia on the model of a far more familiar
mental phenomenon - the dream. Flechsig, according to the patient,
committed, or attempted to commit, ‘soul-murder’ upon
him - an act which, he thought, was comparable with the effort made
by the devil or by demons to gain possession of a soul and may have
had its prototype in events which occurred between members of the
Flechsig and Schreber families long since deceased (22 ff.). We
should be glad to learn more of the meaning of this
‘soul-murder’, but at this point our sources relapse
once more into a tendentious silence: ‘As to what constitutes
the true essence of soul-murder, and as to its technique, if I may
so describe it, I am able to say nothing beyond what has already
been indicated. There is only this, perhaps, to be added . . . (The
passage which follows is unsuitable for publication.)’ (28.)
As a result of this omission we are left in the dark on the
question of what is meant by ‘soul-murder’. We shall
refer later on to the only hint upon the subject which has evaded
censorship.

  
¹
‘Even now the voices that talk with
me call out your name to me hundreds of times each day. They name
you in certain constantly recurring connections, and especially as
being the first author of the injuries I have suffered. And yet the
personal relations which existed between us for a time have, so far
as I am concerned, long since faded into the background; so that I
myself could have little enough reason to be for ever recalling you
to my mind, and still less for doing so with any feelings of
resentment.’ (‘Open Letter to Professor
Flechsig’, viii.)

Psycho-Analytic Notes On An Autobiographical Account Of A Case Of Paranoia

2413

   However this may be, a further
development of Schreber’s delusions soon took place, which
affected his relations to God without altering his relations to
Flechsig. Hitherto he had regarded Flechsig (or rather his soul) as
his only true enemy and had looked upon God Almighty as his ally;
but now he could not avoid the thought that God Himself had played
the part of accessory, if not of instigator, in the plot against
him. (59.) Flechsig, however, remained the first seducer, to whose
influence God had yielded (60). He had succeeded in making his way
up to heaven with his whole soul or a part of it and in becoming a
‘leader of rays’, without dying or undergoing any
preliminary purification.¹ (56.) The Flechsig soul continued
to play this role even after the patient had been moved from the
Leipzig clinic to Dr. Pierson’s asylum. The influence of the
new environment was shown by the Flechsig soul being joined by the
soul of the chief attendant, whom the patient recognized as a
person who had formerly lived in the same block of flats as
himself. This was represented as being the von W. soul.² The
Flechsig soul then introduced the system of
‘soul-division’, which assumed large proportions. At
one time there were as many as forty to sixty sub-divisions of the
Flechsig soul; two of its larger divisions were known as the
‘upper Flechsig’ and the ‘middle Flechsig’.
The von W. soul (the chief attendant’s) behaved in just the
same fashion (111). It was sometimes most entertaining to notice
the way in which these two souls, in spite of their alliance,
carried on a feud with one another, the aristocratic pride of the
one pitted against the professorial vanity of the other (113).
During his first weeks at Sonnenstein (to which hr, was finally
moved in the summer of 1894) the soul of his new physician, Dr.
Weber, came into play; and shortly afterwards the change-over took
place in the development of his delusions which we have come to
know as his ‘reconciliation’.

  
¹
According to another and significant
version, which, however, was soon rejected, Professor Flechsig had
shot himself either at Weissenburg in Alsace or in a police cell at
Leipzig. The patient saw his funeral go past, though not in the
direction that was to be expected in view of the relative positions
of the University Clinic and the cemetery. On other occasions
Flechsig appeared to him in the company of a policeman, or in
conversation with his wife. Schreber was a witness of this
conversation by the method of ‘nerve-connection’, and
in the course of it Professor Flechsig called himself ‘God
Flechsig’ to his wife, so that she was inclined to think he
had gone mad. (82.)

  
²
The voices informed him that in the course
of an official enquiry this von W. had made some untrue statements
about him, either deliberately or out of carelessness, and in
particular had accused him of masturbation. As a punishment for
this he was now obliged to wait on the patient (108).

Psycho-Analytic Notes On An Autobiographical Account Of A Case Of Paranoia

2414

   During this later stay at
Sonnenstein, when God had begun to appreciate him better, a raid
was made upon the souls, which had been multiplied so much as to
become a nuisance. As a result of this, the Flechsig soul survived
in only one or two shapes, and the von W. soul in only a single
one. The latter soon disappeared altogether. The divisions of the
Flechsig soul, which slowly lost both their intelligence and their
power, then came to be described as the ‘posterior
Flechsig’ and the ‘"Oh well!" Party’.
That the Flechsig soul retained its importance to the last, is made
clear by Schreber’s prefatory ‘Open Letter to Herr
Geheimrat Prof. Dr. Flechsig’.

   In this remarkable document
Schreber expresses his firm conviction that the physician who
influenced him had the same visions and received the same
disclosures upon supernatural things as he himself. He protests on
the very first page that the author of the
Denkwürdigkeiten
has not the remotest intention of
making an attack upon the doctor’s honour, and the same point
is earnestly and emphatically repeated in the patient’s
presentations of his position (343, 445). It is evident that he is
endeavouring to distinguish the ‘soul Flechsig’ from
the living man of the same name, the Flechsig of his delusions from
the real Flechsig.¹

  
¹
‘I am accordingly obliged
to admit
as a possibility
that everything in the first chapters of my
Denkwürdigkeiten
which is connected with the name of
Flechsig may only refer to the soul Flechsig as distinguished from
the living man. For that his soul has a separate existence is a
certain fact, though it cannot be explained upon any natural
basis.’ (342-3.)

Psycho-Analytic Notes On An Autobiographical Account Of A Case Of Paranoia

2415

   The study of a number of cases of
delusions of persecution has led me as well as other investigators
to the view that the relation between the patient and his
persecutor can be reduced to a simple formula.¹ It appears
that the person to whom the delusion ascribes so much power and
influence, in whose hands all the threads of the conspiracy
converge, is, if he is definitely named, either identical with some
one who played an equally important part in the patient’s
emotional life before his illness, or is easily recognizable as a
substitute for him. The intensity of the emotion is projected in
the shape of external power, while its quality is changed into the
opposite. The person who is now hated and feared for being a
persecutor was at one time loved and honoured. The main purpose of
the persecution asserted by the patient’s delusion is to
justify the change in his emotional attitude.

   Bearing this point of view in
mind, let us now examine the relations which had formerly existed
between Schreber and his physician and persecutor, Flechsig. We
have already heard that, in the years 1884 and 1885, Schreber
suffered from a first attack of nervous disorder, which ran its
course ‘without the occurrence of any incidents bordering
upon the sphere of the supernatural’ (35). While he was in
this condition, which was described as ‘hypochondria’
and seems not to have overstepped the limits of a neurosis,
Flechsig acted as his doctor. At that time Schreber spent six
months in the University Clinic at Leipzig. We learn that after his
recovery he had cordial feelings towards his doctor. ‘The
main thing was that, after a fairly long period of convalescence
which I spent in travelling, I was finally cured; and it was
therefore impossible that I should feel anything at that time but
the liveliest gratitude towards Professor Flechsig. I gave a marked
expression to this feeling both in a personal visit which I
subsequently paid him and in what I deemed to be an appropriate
honorarium.’ (35-6.) It is true that Schreber’s
encomium in the
Denkwürdigkeiten
upon this first
treatment of Flechsig’s is not entirely with out
reservations; but that can easily be understood if we consider that
his attitude had in the meantime been reversed. The passage
immediately following the one that has just been quoted bears
witness to the original warmth of his feelings towards the
physician who had treated him so successfully: ‘The gratitude
of my wife was perhaps even more heartfelt; for she revered
Professor Flechsig as the man who had restored her husband to her,
and hence it was that for years she kept his portrait standing upon
her writing-table.’ (36.)

  
¹
Cf. Abraham, 1908. In the course of this
paper its author, referring to a correspondence between us,
scrupulously attributes to myself an influence upon the development
of his views.

Psycho-Analytic Notes On An Autobiographical Account Of A Case Of Paranoia

2416

   Since we cannot obtain any
insight into the causes of the first illness (a knowledge of which
is undoubtedly indispensable for properly elucidating the second
and severer illness) we must now plunge at random into an unknown
concatenation of circumstances. During the incubation period of his
illness, as we are aware (that is, between June 1893, when he was
appointed to his new post, and the following October, when he took
up his duties), he repeatedly dreamt that his old nervous disorder
had returned. Once, moreover, when he was half asleep, he had a
feeling that after all it must be nice to be a woman submitting to
the act of copulation. The dreams and the phantasy are reported by
Schreber in immediate succession; and if we also bring together
their subject-matter, we shall be able to infer that, at the same
time as his recollection of his illness, a recollection of his
doctor was also aroused in his mind, and that the feminine attitude
which he assumed in the phantasy was from the first directed
towards the doctor. Or it may be that the dream of his illness
having returned simply expressed some such longing as: ‘I
wish I could see Flechsig again!’ Our ignorance of the mental
content of the first illness bars our way in this direction.
Perhaps that illness had left behind in him a feeling of
affectionate dependence upon his doctor, which had now, for some
unknown reason, become intensified to the pitch of an erotic
desire. This feminine phantasy which was still kept impersonal, was
met at once by an indignant repudiation - a true ‘masculine
protest’, to use Adler’s expression, but in a sense
different from his.¹ But in the severe psychosis which broke
out soon afterwards the feminine phantasy carried everything before
it; and it only requires a slight correction of the characteristic
paranoic indefiniteness of Schreber’s mode of expression to
enable us to divine the fact that the patient was in fear of sexual
abuse at the hands of his doctor himself. The exciting cause of his
illness, then, was an outburst of homosexual libido; the object of
this libido was probably from the very first his doctor, Flechsig;
and his struggles against the libidinal impulse produced the
conflict which gave rise to the symptoms.