Freud - Complete Works (411 page)

  
¹
Adler (1910). According to Adler the
masculine protest has a share in the production of the symptom,
whereas in the present instance the patient is protesting against a
symptom that is already fully fledged.

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

2417

   I will pause here for a moment to
meet a storm of remonstrances and objections. Any one acquainted
with the present state of psychiatry must be prepared to face
trouble.

   ‘Is it not an act of
irresponsible levity, an indiscretion and a calumny, to charge a
man of such high ethical standing as the former
Senatspräsident Schreber with homosexuality?’ - No. The
patient has himself informed the world at large of his phantasy of
being transformed into a woman, and he has allowed all personal
considerations to be outweighed by interests of a higher nature.
Thus he has himself given us the right to occupy ourselves with his
phantasy, and in translating it into the technical terminology of
medicine we have not made the slightest addition to its
content.

   ‘Yes, but he was not in his
right mind when he did it. His delusion that he was being
transformed into a woman was a pathological idea.’ - We have
not forgotten that. Indeed our only concern is with the meaning and
origin of this pathological idea. We will appeal to the distinction
he himself draws between the man Flechsig and the ‘Flechsig
soul’. We are not making reproaches of any kind against him -
whether for having had homosexual impulses or for having
endeavoured to suppress them. Psychiatrists should at last take a
lesson from this patient, when they see him trying, in spite of his
delusions, not to confuse the world of the unconscious with the
world of reality.

   ‘But it is nowhere
expressly stated that the transformation into a woman which he so
much dreaded was to be carried out for the benefit of
Flechsig.’ - That is true; and it is not difficult to
understand why, in preparing his memoirs for publication, since he
was anxious not to insult the ‘man Flechsig’, he should
have avoided so gross an accusation. But the toning-down of his
language owing to these considerations did not go so far as to be
able to conceal the true meaning of his accusation. Indeed, it may
be maintained that after all it is expressed openly in such a
passage as the following: ‘In this way a conspiracy against
me was brought to a head (in about March or April, 1894). Its
object was to contrive that, when once my nervous complaint had
been recognized as incurable or assumed to be so,
I should be
handed over to a certain person
in such a manner that my soul
should be delivered up to him, but my body . . .
should be transformed into a female body, and
as such
surrendered to the person in question
with a view to sexual
abuse . . .’¹ (56). It is unnecessary to
remark that no other individual is ever named who could be put in
Flechsig’s place. Towards the end of Schreber’s stay in
the clinic at Leipzig, a fear occurred to his mind that he
‘was to be thrown to the attendants’ for the purpose of
sexual abuse (98). Any remaining doubts that we have upon the
nature of the part originally attributed to the doctor are
dispelled when, in the later stages of his delusion, we find
Schreber outspokenly admitting his feminine attitude towards God.
The other accusation against Flechsig echoes over-loudly through
the book. Flechsig, he says, tried to commit soul-murder upon him.
As we already know, the patient was himself not clear as to the
actual nature of that crime, but it was connected with matters of
discretion which precluded their publication (as we see from the
suppressed third chapter). From this point a single thread takes us
further. Schreber illustrates the nature of soul-murder by
referring to the legends embodied in Goethe’s
Faust
,
Byron’s
Manfred
, Weber’s
Freischütz
,
etc. (22), and one of these instances is further cited in another
passage. In discussing the division of God into two persons,
Schreber identifies his ‘lower God’ and ‘upper
God’ with Ahriman and Ormuzd respectively (19); and a little
later a casual footnote occurs: ‘Moreover, the name of
Ahriman also appears in connection with a soul-murder in, for
example, Lord Byron’s
Manfred
.’ (20.) In the
play which is thus referred to there is scarcely anything
comparable to the bartering of Faust’s soul, and I have
searched it in vain for the expression ‘soul-murder’.
But the essence and the secret of the whole work lies in - an
incestuous relation between a brother and a sister. And here our
thread breaks off short.²

  
¹
The italics in this passage are
mine.

  
²
By way of substantiating the above
assertion I will quote a passage from the last scene of the play,
in which Manfred says to the demon who has come to fetch him
away:

                                                               
. . . my past power

                                               
Was purchased by no compact with thy crew.

There is thus a
direct contradiction of a soul having been bartered. This mistake
on Schreber’s part was probably not without its significance.
- It is plausible, by the way, to connect the plot of
Manfred
with the incestuous relations which have repeatedly
been asserted to exist between the poet and his half-sister. And it
is not a little striking that the action of Byron’s other
play, his celebrated
Cain
, should be laid in the primal
family, where no objections could exist to incest between brother
and sister. - Finally, we cannot leave the subject of soul-murder
without quoting one more passage from the
Denkwürdigkeiten
: ‘in this connection Flechsig
used formerly to be named as the first author of soul-murder,
whereas for some time past the facts have been deliberately
inverted and an attempt has been made to "represent"
myself as being the one who practises
soul-murder . . .’ (23.)

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

2418

   At a later stage in this paper I
intend to return to a discussion of some further objections; but in
the meantime I shall consider myself justified in maintaining the
view that the basis of Schreber’s illness was the outburst of
a homosexual impulse. This hypothesis harmonizes with a noteworthy
detail of the case history, which remains otherwise inexplicable.
The patient had a fresh ‘nervous collapse’, which
exercised a decisive effect upon the course of his illness, at a
time when his wife was taking a short holiday on account of her own
health. Up till then she had spent several hours with him every day
and had taken her mid-day meal with him. But when she returned
after an absence of four days, she found him most sadly altered: so
much so, indeed, that he himself no longer wished to see her.
‘What especially determined my mental break-down was a
particular night, during which I had a quite extraordinary number
of emissions - quite half a dozen, all in that one night.’
(44.) It is easy to understand that the mere presence of his wife
must have acted as a protection against the attractive power of the
men about him; and if we are prepared to admit that an emission
cannot occur in an adult without some mental concomitant, we shall
be able to supplement the patient’s emissions that night by
assuming that they were accompanied by homosexual phantasies which
remained unconscious.

   The question of why this outburst
of homosexual libido overtook the patient precisely at this period
(that is, between the dates of his appointment and of his move to
Dresden) cannot be answered in the absence of more precise
knowledge of the story of his life. Generally speaking, every human
being oscillates all through his life between heterosexual and
homosexual feelings, and any frustration or disappointment in the
one direction is apt to drive him over into the other. We know
nothing of these factors in Schreber’s case, but we must not
omit to draw attention to a somatic factor which may very well have
been relevant. At the time of this illness Dr. Schreber was
fifty-one years old, and he had therefore reached an age which is
of critical importance in sexual life. It is a period at which in
women the sexual function, after a phase of intensified activity,
enters upon a process of far-reaching involution; nor do men appear
to be exempt from its influence, for men as well as women are
subject to a ‘climacteric’ and to the susceptibilities
to disease which go along with it.¹

  
¹
I owe my knowledge of Schreber’s age
at the time of his illness to some information which was kindly
given me by one of his relatives, through the agency of Dr.
Stegmann of Dresden. Apart from this one fact, however, I have made
use of no material in this paper that is not derived from the
actual text of the
Denkwürdigkeiten
.

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

2419

   I can well imagine what a dubious
hypothesis it must appear to be to suppose that a man’s
friendly feeling towards his doctor can suddenly break out in an
intensified form after a lapse of eight years¹ and become the
occasion of such a severe mental disorder. But I do not think we
should be justified in dismissing such a hypothesis merely on
account of its inherent improbability, if it recommends itself to
us on other grounds; we ought rather to inquire how far we shall
get if we follow it up. For the improbability may be of a passing
kind and may be due to the fact that the doubtful hypothesis has
not as yet been brought into relation with any other pieces of
knowledge and that it is the first hypothesis with which the
problem has been approached. But for the benefit of those who are
unable to hold their judgement in suspense and who regard our
hypothesis as altogether untenable, it is easy to suggest a
possibility which would rob it of its bewildering character. The
patient’s friendly feeling towards his doctor may very well
have been due to a process of ‘transference’, by means
of which an emotional cathexis became transposed from some person
who was important to him on to the doctor who was in reality
indifferent to him; so that the doctor will have been chosen as a
deputy or surrogate for some one much closer to him. To put the
matter in a more concrete form: the patient was reminded of his
brother or father by the figure of the doctor, he rediscovered them
in him; there will then be nothing to wonder at if, in certain
circumstances, a longing for the surrogate figure reappeared in him
and operated with a violence that is only to be explained in the
light of its origin and primary significance.

   With a view to following up this
attempt at an explanation, I naturally thought it worth while
discovering whether the patient’s father was still alive at
the time at which he fell ill, whether he had had a brother, and if
so whether he was then living or among the ‘blest’. I
was pleased, therefore, when, after a prolonged search through the
pages of the
Denkwürdigkeiten
, I came at last upon a
passage in which the patient sets these doubts at rest: ‘The
memory of my father and my brother . . . is as
sacred to me as . . .’ etc. (442.) So that
both of them were dead at the time of the onset of his second
illness (and, it may be, of his first illness as well).

    We shall therefore, I
think, raise no further objections to the hypothesis that the
exciting cause of the illness was the appearance in him of a
feminine (that is, a passive homosexual) wishful phantasy, which
took as its object the figure of his doctor. An intense resistance
to this phantasy arose on the part of Schreber’s personality,
and the ensuing defensive struggle, which might perhaps just as
well have assumed some other shape, took on, for reasons unknown to
us, that of a delusion of persecution. The person he longed for now
became his persecutor, and the content of his wishful phantasy
became the content of his persecution. It may be presumed that the
same schematic outline will turn out to be applicable to other
cases of delusions of persecution. What distinguishes
Schreber’s case from others, however, is its further
development and the transformation it underwent in the course of
it.

  
¹
This was the length of the interval between
Schreber’s first and second illnesses.

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

2420

   One such change was the
replacement of Flechsig by the superior figure of God. This seems
at first as though it were a sign of aggravation of the conflict,
an intensification of the unbearable persecution, but it soon
becomes evident that it was preparing the way for the second change
and, with it, the solution of the conflict. It was impossible for
Schreber to become reconciled to playing the part of a female
wanton towards his doctor; but the task of providing God Himself
with the voluptuous sensations that He required called up no such
resistance on the part of his ego. Emasculation was now no longer a
disgrace; it became ‘consonant with the Order of
Things’, it took its place in a great cosmic chain of events,
and was instrumental in the re-creation of humanity after its
extinction. ‘A new race of men, born from the spirit of
Schreber’ would, so he thought, revere as their ancestor this
man who believed himself the victim of persecution. By this means
an outlet was provided which would satisfy both of the contending
forces. His ego found compensation in his megalomania, while his
feminine wishful phantasy made its way through and became
acceptable. The struggle and the illness could cease. The
patient’s sense of reality, however, which had in the
meantime become stronger, compelled him to postpone the solution
from the present to the remote future, and to content himself with
what might be described as an asymptotic wish-fulfilment.¹
Some time or other, he anticipated, his transformation into a woman
would come about; until then the personality of Dr. Schreber would
remain indestructible.