The psycho-analytic VIew of psychogenic disturbance of VIsion 5 страница

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.7

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.)

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.9

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.0

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.

In textbooks of psychiatry we frequently come across statements to the effect that megalomania can develop out of delusions of persecution. The process is supposed to be as follows. The patient is primarily the victim of a delusion that he is being persecuted by powers of the greatest might. He then feels a need to account to himself for this, and in that way hits on the idea that he himself is a very exalted personage and worthy of such persecution. The development of megalomania is thus attributed by the textbooks to a process which (borrowing a useful word from Ernest Jones) we may describe as ‘rationalization’. But to ascribe such important affective consequences to a rationalization is, as it seems to us, an entirely unpsychological proceeding; and we would consequently draw a sharp distinction between our opinion and the one which we have quoted from the textbooks. We are making no claim, for the moment, to knowing the origin of the megalomania.

¹ ‘It is only, he writes towards the end of the book, ‘as possibilities which must be taken into account, that I mention that my emasculation may even yet be accomplished and may result in a new generation issuing from my womb by divine impregnation.’ (293.)1

Turning once more to the case of Schreber, we are bound to admit that any attempt at throwing light upon the transformation in his delusion brings us up against extraordinary difficulties. In what manner and by what means was the ascent from Flechsig to God brought about? From what source did he derive the megalomania which so fortunately enabled him to become reconciled to his persecution, or, in analytical phraseology, to accept the wishful phantasy which had had to be repressed? The Denkwürdigkeiten give us a first clue; for they show us that in the patient’s mind ‘Flechsig’ and ‘God’ belonged to the same class. In one of his phantasies he overheard a conversation between Flechsig and his wife, in which the former asserted that he was ‘God Flechsig’, so that his wife thought he had gone mad (82). But there is another feature in the development of Schreber’s delusions which claims our attention. If we take a survey of the delusions as a whole we see that the persecutor is divided into Flechsig and God; in just the same way Flechsig himself subsequently splits up into two personalities, the ‘upper’ and the ‘middle’ Flechsig, and God into the ‘lower’ and the ‘upper’ God. In the later stages of the illness the decomposition of Flechsig goes further still (193). A process of decomposition of this kind is very characteristic of paranoia. Paranoia decomposes just as hysteria condenses. Or rather, paranoia resolves once more into their elements the products of the condensations and identifications which are effected in the unconscious. The frequent repetition of the decomposing process in Schreber’s case would, according to Jung, be an expression of the importance which the person in question possessed for him.¹ All of this dividing up of Flechsig and God into a number of persons thus had the same meaning as the splitting of the persecutor into Flechsig and God. They were all duplications of one and the same important relationship.² But, in order to interpret all these details, we must further draw attention to our view of this decomposition of the persecutor into Flechsig and God as a paranoid reaction to a previously established identification of the two figures or their belonging to the same class. If the persecutor Flechsig was originally a person whom Schreber loved, then God must also simply be the reappearance of some one else whom he loved, and probably some one of greater importance.

¹ Jung (1910a). Jung is probably right when he goes on to say that the decomposition follows the general lines taken by schizophrenia in that it uses a process of analysis in order to produce a watering-down effect, and is thus designed to prevent the occurrence of unduly powerful impressions. When, however, one of his patients said to him: ‘Oh, are you Dr. J. too? There was some one here this morning who said he was Dr. J.’, we must interpret it as being an admission to this effect: ‘You remind me now of a different member of the class of my transferences from the one you reminded me of when you visited me last.’

² Otto Rank (1909) has found the same process at work in the formation of myths.2

If we pursue this train of thought, which seems to be a legitimate one, we shall be driven to the conclusion that the other person must have been his father; this makes it all the clearer that Flechsig must have stood for his brother - who, let us hope, may have been older than himself.¹ The feminine phantasy, which aroused such violent opposition in the patient, thus had its root in a longing, intensified to an erotic pitch, for his father and brother. This feeling, so far as it referred to his brother, passed, by a process of transference, on to his doctor, Flechsig; and when it was carried back on to his father a settlement of the conflict was reached.

We shall not feel that we have been justified in thus introducing Schreber’s father into his delusions, unless the new hypothesis shows itself of some use to us in understanding the case and in elucidating details of the delusions which are as yet unintelligible. It will be recalled that Schreber’s God and his relations to Him exhibited the most curious features: how they showed the strangest mixture of blasphemous criticism and mutinous insubordination on the one hand and of reverent devotion on the other. God, according to him, had succumbed to the misleading influence of Flechsig: He was incapable of learning anything by experience, and did not understand living men because He only knew how to deal with corpses; and He manifested His power in a succession of miracles which, striking though they might be, were none the less futile and silly.

¹ No information on this point is to be found in the Denkwürdigkeiten.3

Now the father of Senatspräsident Dr. Schreber was no insignificant person. He was the Dr. Daniel Gottlob Moritz Schreber whose memory is kept green to this day by the numerous Schreber Associations which flourish especially in Saxony; and, moreover, he was a physician. His activities in favour of promoting the harmonious upbringing of the young, of securing co-ordination between education in the home and in the school, of introducing physical culture and manual work with a view to raising the standards of health - all this exerted a lasting influence upon his contemporaries.¹ His great reputation as the founder of therapeutic gymnastics in Germany is still shown by the wide circulation of his Ärtzliche Zimmergymnastik in medical circles and the numerous editions through which it has passed.

Such a father as this was by no means unsuitable for transfiguration into a God in the affectionate memory of the son from whom he had been so early separated by death. It is true that we cannot help feeling that there is an impassable gulf between the personality of God and that of any human being, however eminent he may be. But we must remember that this has not always been so. The gods of the peoples of antiquity stood in a closer human relationship to them. The Romans used to deify their dead emperors as a matter of routine; and the Emperor Vespasian, a sensible and competent man, exclaimed when he was first taken ill: ‘Alas! Methinks I am becoming a God!’²

¹ I have to thank my colleague Dr. Stegmann of Dresden for his kindness in letting me see a copy of a journal entitled Der Freund der Schreber-Vereine [The Friend of the Schreber Associations]. This number (Vol. II. No. 10) celebrates the centenary of Dr. Schreber’s birth, and some biographical data are contained in it. Dr. Schreber senior was born in 1808 and died in 1861, at the age of only fifty-three. From the source which I have already mentioned I know that our patient was at that time nineteen years old.

² Suetonius, Lives of the Caesars, Book VIII, Chapter 23. This practice of deification began with Julius Caesar. Augustus styled himself ‘Divi filius’ [‘the son of the God’] in his inscriptions.4

We are perfectly familiar with the infantile attitude of boys towards their father; it is composed of the same mixture of reverent submission and mutinous insubordination that we have found in Schreber’s relation to his God, and is the unmistakable prototype of that relation, which is faithfully copied from it. But the circumstance that Schreber’s father was a physician, and a most eminent physician, and one who was no doubt highly respected by his patients, is what explains the most striking characteristics of his God and those upon which he dwells in such a critical fashion. Could more bitter scorn be shown for such a physician than by declaring that he understands nothing about living men and only knows how to deal with corpses? No doubt it is an essential attribute of God to perform miracles; but a physician performs miracles too; he effects miraculous cures, as his enthusiastic clients proclaim. So that when we see that these very miracles (the material for which was provided by the patient’s hypochondria) turn out to be incredible, absurd, and to some extent positively silly, we are reminded of the assertion in my Interpretation of Dreams that absurdity in dreams expresses ridicule and derision.¹ Evidently, therefore, it is used for the same purposes in paranoia. As regards some of the other reproaches which he levelled against God, such, for instance, as that He learned nothing by experience, it is natural to suppose that they are examples of the tu quoque mechanism used by children,² which, when they receive a reproof, flings it back unchanged upon the person who originated it. Similarly, the voices give us grounds for suspecting that the accusation of soul-murder brought against Flechsig was in the first instance a self-accusation.³

¹ p. 891.

² It looks remarkably like a revanche of this sort when we find the patient writing out the following memorandum one day: ‘Any attempt at exercising an educative influence must be abandoned as hopeless.’ (188.) The uneducable one was God.

³ ‘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...’ etc. (23).

Emboldened by the discovery that his father’s profession helps to explain the peculiarities of Schreber’s God, we shall now venture upon an interpretation which may throw some light upon the remarkable structure of that Being. The heavenly world consisted, as we know, of the ‘anterior realms of God’ which were also called the ‘fore-courts of Heaven’ and which contained the souls of the dead, and of the ‘lower’ and the ‘upper’ God, who together constituted the ‘posterior realms of God’ (19). Although we must be prepared to find that there is a condensation here which we shall not be able to resolve, it is nevertheless worth while referring to a clue that is already in our hands. If the ‘miracled’ birds, which have been shown to be girls, were originally fore-courts of Heaven, may it not be that the anterior realms of God and the fore-courts¹ of Heaven are to be regarded as a symbol of what is female, and the posterior realms of God as a symbol of what is male? If we knew for certain that Schreber’s dead brother was older than himself, we might suppose that the decomposition of God into the lower and the upper God gave expression to the patient’s recollection that after his father’s early death his elder brother had stepped into his place.

In this connection, finally, I should like to draw attention to the subject of the sun, which, through its ‘rays’, came to have so much importance in the expression of his delusions. Schreber has a quite peculiar relation to the sun. It speaks to him in human language, and thus reveals itself to him as a living being, or as the organ of a yet higher being lying behind it (9). We learn from a medical report that at one time he ‘used to shout threats and abuse at it and positively bellow at it’ (382)² and used to call out to it that it must crawl away from him and hide. He himself tells us that the sun turns pale before him.³ The manner in which it is bound up with his fate is shown by the important alterations it undergoes as soon as changes begin to occur in him, as, for instance, during his first weeks at Sonnenstein (135). Schreber makes it easy for us to interpret this solar myth of his. He identifies the sun directly with God, sometimes with the lower God (Ahriman),4 and sometimes with the upper. ‘On the following day... I saw the upper God (Ormuzd), and this time not with my spiritual eyes but with my bodily ones. It was the sun, but not the sun in its ordinary aspect, as it is known to all men; it was...’ etc. (137-8.) It is therefore no more than consistent of him to treat it in the same way as he treats God Himself.

¹ [The German word ‘Vorhof’ besides having the literal meaning of ‘fore-court’, is used in anatomy as a synonym for the ‘vestibulum’, a region of the female genitals.]

² ‘The sun is a whore’, he used to exclaim (384).

³ ‘To some extent, moreover, even to this day the sun presents a different picture to my eyes from what it did before my illness. When I stand facing it and speak aloud, its rays turn pale before me. I can gaze at it without any difficulty and without being more than slightly dazzled by it; whereas in my healthy days it would have been as impossible for me as for anyone else to gaze at it for a minute at a time.’ (139, footnote.)

4 ‘Since July, 1894, the voices that talk to me have identified him directly with the sun.’ (88.)6

The sun, therefore, is nothing but another sublimated symbol for the father; and in pointing this out I must disclaim all responsibility for the monotony of the solutions provided by psycho-analysis. In this instance symbolism overrides grammatical gender - at least so far as German goes,¹ for in most other languages the sun is masculine. Its counterpart in this picture of the two parents is ‘Mother Earth’ as she is generally called. We frequently come upon confirmations of this assertion in resolving the pathogenic phantasies of neurotics by psycho-analysis. I can make no more than the barest allusion to the relation of all this to cosmic myths. One of my patients, who had lost his father at a very early age, was always seeking to rediscover him in what was grand and sublime in Nature. Since I have known this, it has seemed to me probable that Nietzsche’s hymn ‘Vor Sonnenaufgang’ [‘Before Sunrise’] is an expression of the same longing.² Another patient, who became neurotic after his father’s death, was seized with his first attack of anxiety and giddiness while the sun shone upon him as he was working in the garden with a spade. He spontaneously put forward as an interpretation that he had become frightened because his father had looked at him while he was at work upon his mother with a sharp instrument. When I ventured upon a mild remonstrance, he gave an air of greater plausibility to his view by telling me that even in his father’s lifetime he had compared him with the sun, though then it had been in a satirical sense. Whenever he had been asked where his father was going to spend the summer he had replied in these sonorous words from the ‘Prologue in Heaven’:

Und seine vorgeschrieb’ne Reise

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