Freud's Schreber Between Psychiatry and Psychoanalysis: On Subjective Disposition to Psychosis

Views: 104
Ratings: (0)

This book investigates what was distinctive about the predisposition to psychosis Freud posited in Daniel Paul Schreber, a presiding judge in Saxony's highest court. It argues that Freud's 1911 Schreber text reversed the order of priority in late nineteenth-century conceptions of the disposing causes of psychosis - the objective-biological and subjective-biographical - to privilege subjective disposition to psychosis, but without returning to the paradigms of early nineteenth-century Romantic psychiatry and without obviating the legitimate claims of biological psychiatry in relation to hereditary disposition. While Schreber is the book's reference point, this is not a general treatment of Schreber, or of Freud's reading of the Schreber case. It focuses rather on what was new in Freud's thinking on the disposition to psychosis, what he learned from his psychiatrist contemporaries and what he did not, and whether or not psychoanalysts have fully received his aetiology.

List price: $28.99

Your Price: $23.19

You Save: 20%

 

9 Slices

Format Buy Remix

CHAPTER ONE: Freud's exemplary case of psychosis: Daniel Paul Schreber

ePub

Introduction

In 1934, twenty-three years after Freud's Schreber text appeared, Arnold Zweig was able to ask Freud what to read in order to understand his teaching on psychosis—apart from his “Dr Schreber”, which he already knew (Freud, E. L., 1968, p. 99). Freud had written a number of papers on psychosis, but his 1911 text, based on what the famous German judge, Daniel Paul Schreber (1842–1911), had said about his illness (Schreber, 1903a, hereafter DW), was and remains the principle source for anyone wanting to understand Freud's aetiology of paranoia and schizophrenia. Before we can examine Freud's interpretation of the case, we need to investigate what Schreber said in his memoirs, and take account of the supplementary information provided by his patient and personnel files, as well as the expert witness reports by his doctor in Sonnenstein Castle asylum, Dr Guido Weber. After a brief biographical sketch, we will consider Schreber's clinical picture in 1884, when he was first admitted to Professor Paul Flechsig's psychiatric clinic in Leipzig; in 1893, when he was readmitted to the university clinic after being appointed a presiding judge at the Oberlandesgericht in Dresden, and transferred to Sonnenstein Castle asylum; and in 1907, when he relapsed after his mother died and his wife had a stroke. Weber reported to the court considering Schreber's discharge that the content of his final delusion was a religious mission from God to renew humanity, and that, for that purpose, he had to become a woman. We will trace the course of Schreber's hallucinations and delusions and see that although his autobiography does indicate an evolution (from persecution by Flechsig and God to his befriending the idea of becoming a woman, and, finally, claiming a redemptive mission), what remained a constant from the start of his second illness was the femininity of his subjective position.

 

CHAPTER TWO: Disposition to psychosis in Freud's Schreber text

ePub

Introduction

Freud's interpretation of Schreber is perhaps the most discussed case in psychoanalytic history (Richardson, 1988, p. 24). We will now investigate what he makes of Schreber's autobiography, and, in particular, his thinking on what predisposed the famous judge to paranoia. After analysing the structure of Freud's 1911 text, we will examine what he thinks precipitated Schreber's second illness—an outburst of homosexual libido in relation to Flechsig. We will consider his deduction that this was based on a prior homosexual position in relation to Moritz Schreber, or what we will call the “accessory disposition”, and, since there has been much debate on this component of Freud's aetiology, we will research the background to his positing a relationship between homosexuality and paranoia. We will also return to Schreber's patient file for evidence of Freud's claim, and discuss what homosexuality has to do with Schreber's delusion of being a woman. And while Freud had already related paranoia to homosexuality, and spoken about a return of the libido to autoeroticism in paranoia, this chapter will show that what is new in his Schreber text is his understanding the specific disposition to paranoia as a fixation at infantile narcissism. We will study the roots of his thinking on narcissism, and ask how this disposition differs from those he had proposed in his earlier work. We will also ask what makes this disposition subjective, and review the early reactions to it. In Chapters Eight and Nine, we will see what has been made of it more recently.

 

CHAPTER THREE: Psychosis in Freud's papers before and after his Schreber text

ePub

Introduction

This chapter will situate Freud's Schreber text in the evolution of his thought by studying his papers on psychosis before and after 1911. While Macalpine and Hunter have argued that Freud originally made no distinction between neurosis and psychosis, it will be seen that although Freud initially regarded repression (Verdrängung) as a defence mechanism common to both, he already understood the rejection (Verwerfung) responsible for the more serious and psychotic illness, amentia, as a more energetic and successful defence. We will also find that, in his earliest thinking on paranoia, Freud was already trying to work out the difference between paranoia, as a psychotic illness, on the one hand, and obsessional neurosis on the other. And where his 1911 text understands Schreber's repression not simply in terms of a defence against something intolerable, but as a libidinal withdrawal and regression to infantile narcism, we will see how his libido theory developed afterwards. Why Freud could later refer to the homosexual element of his aetiology in a number of papers without mentioning the libidinal fixation will also be addressed, and we will ask if this was because of developments in his drive-theory or because of the nature of the illness being discussed. Finally, we will consider the significance of Freud's second topology, and its leading him to speak of a disavowal (Verleugnung) in psychosis rather than repression, and ask whether he gave up his earlier understanding of disposition in terms of libidinal fixations. The relevance of this will become clear in Chapters Eight and Nine when we find that Melanie Klein and Ronald Fairbairn have understood Schreber in terms of Freud's later theories, whereas Lacan represents a return to Freud's 1911 text.

 

CHAPTER FOUR: Freud and Emil Kraepelin

ePub

Introduction

Freud's Schreber text agrees with Kraepelin's separating dementia praecox from paranoia, and, although it follows Weber's diagnosis of classical paranoia, it also recognizes traits of Kraepelin's dementia paranoides in Schreber. We will see in this chapter that Freud accepted Kraepelin's new nosological distinctions, but not his aetiology, and that Kraepelin, for his part, rejected Freud's Schreber text aetiology. We will examine the reasons for Kraepelin's criticisms of Freud, and ask what light their missed encounter sheds on the relationship between psychoanalysis and psychiatry today. Both Freud and Kraepelin were born in 1856. Both were trained in neurology and brain anatomy, and both had reservations about Meynert's brain mythology. Both had inherited the tension, not so much between the psychics and the somat-ics in the first half of the nineteenth century, but between the stream of empirical psychiatry, introduced by Griesinger in the middle of the nineteenth century, and the stream of brain anatomy. Kraepelin called himself a psychiatrist with psychological inclinations, and Freud developed what Bleuler called “depth psychology”. Both spent time in Paris with Charcot. Both wrote on dreams (Freud, 1900a; Kraepelin, 1906), and both drew on Wundt. Nevertheless, none of this led to a fruitful exchange between them. It is probable that an exchange of letters took place between them, although to date it has not been possible to find any trace of their correspon-dence.1 This chapter will consider the biographical and philosophical reasons for the apparent gulf between them. We will see in Chapter Six that, to a large extent, it could be bridged in Bleuler.

 

CHAPTER FIVE: Freud and the Viennese psychiatrists

ePub

Introduction

We will now investigate the extent to which Freud was influenced by his psychiatrist contemporaries in Vienna— Meynert, Krafft-Ebing, and Wagner-Jauregg. First, we will see that Freud's medical training was according the scientific paradigms of the second Viennese medical school, something which confirms our view that his aetiology of psychosis did not represent a return to Romantic psychiatry. We will discover what Freud learned from Meynert, not just in terms of brain anatomy and psychiatric concepts, but also caution about hereditary disposition to psychosis. And since Freud travelled to Charcot shortly after he left Meynert's clinic, and what he brought back was rejected by Meynert, we will also take account of what he did and did not receive from Charcot. Why there was not a fruitful exchange between Freud and Krafft-Ebing—the leading light in Viennese psychiatry after Meynert died—will be addressed, and we will consider Freud's views on Krafft-Ebing's psychoneuroses in healthy brains and psychical degenerations in brains burdened by heredity. Finally, we will see that although Wagner-Jauregg's thinking on heredity came close to Freud's own, Freud did not accept his positing a pathological physiology basis to psychosis. Of all the Viennese psychiatrists, Freud was most influenced by Meynert, so we will begin by tracing Freud's way to Meynert's psychiatric clinic, and evaluating his time there.

 

CHAPTER SIX: Freud and Eugen Bleuler

ePub

Introduction

Eugen Bleuler was the first university professor of psychiatry to engage with Freud's theories and to apply them to psychosis even before Freud's Schreber text appeared. But we will see, in this chapter, that he was unhappy with Freud's sexual libido, and that his critique of Freud's Schreber text was rather negative. Nevertheless, we will also see that, contrary to common belief, although Bleuler distanced himself from the psychoanalytic movement, he continued to hold and teach the essential theories of Freud, which he accepted from the start, and that he maintained to the end that their theoretical differences were side-issues. This chapter will study the reasons for Bleuler's openness to Freud, and trace the reception of Freud's ideas. On the other hand, we will ask why Freud kept a theoretical distance from “the Swiss”, Bleuler included. It will be seen that although Freud was delighted to have Bleuler as a collaborator, and saw him as a bridge to institutional psychiatry, he wanted to preserve psychoanalysis in its original form, and was not satisfied to interpret psychotic symptoms in the light of psychoanalytic theory, as Bleuler did, but was more interested in understanding what caused them in the first place.

 

CHAPTER SEVEN: Hereditary disposition in Freud's aetiological chain

ePub

Introduction

Schreber's patient file highlights a hereditary burden in him and it lists his father's compulsive ideas and murderous impulses; his mother's nervousness; his mother's cousin's chronic paranoia; his sister's hysteria; and his brother's paralysis and suicide. The reason Freud does not refer to heredity in his Schreber text is that he did not have access to this information. Hence, his speaking about Moritz Schreber as an excellent father. This book is about subjective dispositions to psychosis, but we will see in this chapter that heredity is actually an important dis-positional factor for Freud, one that he thinks psychoanalysis can do nothing about. We will also see that Freud does not do away with constitutional factors when he prioritizes subjective ones. We will begin with a brief sketch of the place of heredity and hereditary degeneration in the history of psychiatry. It will then be seen that while Freud is critical of an indiscriminate diagnosis of degeneration, he does not dismiss it, but even holds it responsible for abnormalities in sexual constitution. As for heredity as such, we will trace the development from Freud's initial criticism of heredity being over-emphasized, especially by French psychiatry, to his recognizing its significance, and then stressing it at times himself. Nevertheless, we will find that Freud never regards heredity alone as a sufficient cause of mental illness. As we will discover, it was his Schreber text that led him to subordinate the combined dis-positional factors of inherited constitution and childhood sexual experience to libidinal fixations.

 

CHAPTER EIGHT: The reception of Freud's 1911 aetiology by psychoanalysts

ePub

Introduction

This chapter will investigate the extent to which psychoanalysts have received Freud's Schreber text aetiology of paranoia. It will show that influential psychoanalysts have tended to concentrate—positively and negatively—on the accessory component to the neglect of the specific one, the fixation at narcism. It will also be seen that those who have taken account of it, have tended to move beyond it to interpretations based on Freud's later drive theory and second topology. We will begin by examining the positions of those who claim to stand with Freud, Maurits Katan and William Niederland, and then turn to those who have questioned Freud's Schreber text aetiology, Ida Macalpine and Richard Hunter, Zvi Lothane, Melanie Klein, and Ronald Fairbairn. In our next chapter we will see that Lacan has received Freud's Schreber text aetiology more fully than these.

Maurits Katan

More than three decades after the appearance of Freud's Schreber text, Maurits Katan—a Dutch Jew forced to emigrate to America by the Nazi invasion of Holland—took a renewed interest in Schreber. From 1949 onwards, he published numerous articles on Schreber which he believed confirmed Freud's view that Schreber's delusions were a defence against homosexuality and an attempt at recovery (Katan, 1949, 1950a,b, 1952, 1953, 1954, 1959, 1960, 1969, 1975, 1979). In Katan's work, Schreber's delusion of the end of the world was an attempt to ward off dangers associated with homosexuality, and he agrees with Freud that it was fear of castration that made Schreber repress this homosexuality. But he neglects the importance attributed to the libidinal fixation at narcism in Freud's Schreber text. Hence, his being able to regard Schreber as having suffered from schizophrenia while, for Freud, he had a different disposition point. It might also be argued that Katan makes too much of what the Denkwürdigkeiten says about masturbation. In his view, Schreber only needed the delusion of the end of the world—in which men no longer existed—as long as he was unable to manage the temptation to masturbate in response to homosexual phantasies (Katan, 1949, p. 66). This is the sense Katan makes of the attendant von W's having accused Schreber of masturbation and Schreber's denying it. For Katan, von W's presence was moving Schreber to masturbate with phantasies about him, and the denial meant that he had managed to ward off the temptation. On the other hand, Katan thinks that Flechsig and his assistants had excited Schreber to such an extent that he found it difficult to resist masturbation. Like Freud, he takes Schreber's six emissions in one night to be masturbatory equivalents, and he believes they were due to homosexual arousal in the pre-psychotic phase. Thereafter, Schreber had tried to ward off masturbation with his psychosis, according to Katan, but he had remained terrified of yielding to temptation, which would have meant his keeping the world, but losing his soul or contact with God. In exchange for his soul—”soul murder”—Katan proposes, Schreber would gain permission to masturbate with homosexual phantasies (ibid., pp. 63–65). Hence, his understanding the end of the world delusion—in which Flechsig and his assistants did not exist in reality—as a defence against an attraction to them and masturbation. But having obtained the desired contact with God, Katan contends, Schreber could freely masturbate, but only in a way which excluded erections and emissions (Katan, 1950a, p. 198, 1950b, pp. 32–33).

 

CHAPTER NINE: Jacques Lacan on Freud's Schreber

ePub

Introduction

The French psychiatrist–psychoanalyst, Jacques Lacan, drew on Freud's Schreber text in his 1932 doctoral thesis. His yearlong Seminar III on the psychoses, Les structures freudiennes des psychoses, from 1955–1956, and its 1958 “summary” entitled “On a question prior to any possible treatment of psychosis”, took their lead from Freud's 1911 text (Lacan, 1932, pp. 261–263, 1993, 2002e). His 1967 “Proposition” on the psychoanalyst of the school (Lacan, 1968, pp. 27–28) stood by what he said in Seminar III, and he continued to refer to Schreber well into the 1970s. We will see in this chapter that Lacan thought that Freud was right to link the themes of the father and castration in relation to Schreber, although he did not think that repression of homosexuality would have been sufficient to bring about the collapse of Schreber's world. For him, it was a foreclosure of the Name-of-the-Father signifier, later the father as “exception”, that disposed Schreber to psychosis. Furthermore, it will be seen that Lacan received Freud's 1911 aetiology more fully than other psychoanalysts, in that he also integrated the fixation at narcissism into his reading of the case. In his view, Schreber's world never progressed beyond imaginary relations, because he had not undergone the “paternal metaphor”—Lacan's own way of linking the father and castration—and his psychotic subjectivity was marked by a regression to the narcissism of the infant captivated by its own mirror image.

 

Details

Print Book
E-Books
Slices

Format name
ePub (DRM)
Encrypted
true
Sku
9781780498065
Isbn
9781780498065
File size
0 Bytes
Printing
Disabled
Copying
Disabled
Read aloud
No
Format name
ePub
Encrypted
No
Printing
Allowed
Copying
Allowed
Read aloud
Allowed
Sku
In metadata
Isbn
In metadata
File size
In metadata