On the occasion of the opening of the Hebrew University 1 страница

(1925)

Historians have told us that our small nation withstood the destruction of its independence as a State only because it began to transfer in its estimation of values the highest rank to its spiritual possessions, to its religion and its literature.

We are now living in a time when this people has a prospect of again winning the land of its fathers with the help of a Power that dominates the world, and it celebrates the occasion by the foundation of a University in its ancient capital city.

A University is a place in which knowledge is taught above all differences of religions and of nations, where investigation is carried on, which is to show mankind how far they understand the world around them and how far they can control it.

Such an undertaking is a noble witness to the development to which our people has forced its way in two thousand years of unhappy fortune.

I find it painful that my ill-health prevents me from being present at the opening festivities of the Jewish University in Jerusalem.

EDITORIAL CHANGES IN THE ZEITSCHRIFT

(1924)

Dr. Otto Rank has acted as editor of this journal ever since its foundation in 1913, even though it is only since 1920 that he has been named on its title-page as sole editor. During his period of military service in the War, his place was taken by Dr. Hanns Sachs, who was at that time in Vienna. Since the beginning of the current volume Dr. S. Ferenczi has also had a share in the editing.

At Easter, 1924, Dr. Rank accepted an invitation which took him to New York. On his return home he announced that he had decided to transfer his activity as a teaching and practising analyst to America - at least for a part of the year. Thus it became necessary to place the editorship of the Zeitschrift in other hands. It is not within the rights of the Director to give public expression to his opinion of the level and achievements of this journal. No one who is inclined to appreciate them should overlook or forget how much of its success is due to the tireless devotion and exemplary work of the retiring editor.

Dr. Rank’s place will now be taken by Dr. S. Radó of Berlin. He will be supported as advisers and collaborators by Dr. M. Eitingon (Berlin) and Dr. S. Ferenczi (Budapest). All communications and contributions for the editor should be addressed to Dr. Sándor Radó, Berlin-Schöneberg, Am Park, 20. The business side of the Zeitschrift will be conducted as before at the offices of the Internationaler Psychoanalytischer Verlag in Vienna (Manager: A. J. Storfer).

AN AUTOBIOGRAPHICAL STUDY (1925)

Several of the contributors to this series of ‘Autobiographical Studies’ have begun by expressing their misgivings at the unusual difficulties of the task they have undertaken. The difficulties in my case are, I think, even greater; for I have already more than once published papers upon the same line as the present one, papers which, from the nature of the subject have dealt more with personal considerations than is usual or than would otherwise have been necessary.

I gave my first account of the development and subject matter of psycho-analysis in five lectures which I delivered in 1909 before Clark University at Worcester, Mass., where I had been invited to attend the celebration of the twentieth anniversary of the foundation of that body.¹ Only recently I gave way to the temptation of making a contribution of a similar kind to an American collective publication dealing with the opening years of the twentieth century, since its editors had shown their recognition of the importance of psycho-analysis by allotting a special chapter to it.² Between these two dates appeared a paper, ‘On the History of the Psycho-Analytic Movement’, which, in fact, contains the essence of all that I can say on the present occasion. Since I must not contradict myself and since I have no wish to repeat myself exactly, I must endeavour to construct a narrative in which subjective and objective attitudes, biographical and historical interests, are combined in a new proportion.

¹ The lectures were first published (in English) in the American Journal of Psychology (1910); the original German was issued under the title of Über Psychoanalyse.

² These Eventful Years (New York, 1924). My essay, translated by Dr. A. A. Brill, forms chapter lxxiii. of the second volume.6 I was born on May 6th, 1856, at Freiberg in Moravia, a small town in what is now Czechoslovakia. My parents were Jews, and I have remained a Jew myself. I have reason to believe that my father’s family were settled for a long time on the Rhine (at Cologne), that, as a result of a persecution of the Jews during the fourteenth or fifteenth century, they fled eastwards, and that, in the course of the nineteenth century, they migrated back from Lithuania through Galicia into German Austria. When I was a child of four I came to Vienna, and I went through the whole of my education there. At the ‘Gymnasium’ I was at the top of my class for seven years; I enjoyed special privileges there, and had scarcely ever to be examined in class. Although we lived in very limited circumstances, my father insisted that, in my choice of a profession, I should follow my own inclinations alone. Neither at that time, nor indeed in my later life, did I feel any particular predilection for the career of a doctor. I was moved, rather, by a sort of curiosity, which was, however, directed more towards human concerns than towards natural objects; nor had I grasped the importance of observation as one of the best means of gratifying it. My deep engrossment in the Bible story (almost as soon as I had learnt the art of reading) had, as I recognized much later, an enduring effect upon the direction of my interest. Under the powerful influence of a school friendship with a boy rather my senior who grew up to be a well-known politician, I developed a wish to study law like him and to engage in social activities. At the same time, the theories of Darwin, which were then of topical interest, strongly attracted me, for they held out hopes of an extraordinary advance in our understanding of the world; and it was hearing Goethe’s beautiful essay on Nature read aloud at a popular lecture by Professor Carl Brühl just before I left school that decided me to become a medical student.

When, in 1873, I first joined the University, I experienced some appreciable disappointments. Above all, I found that I was expected to feel myself inferior and an alien because I was a Jew. I refused absolutely to do the first of these things. I have never been able to see why I should feel ashamed of my descent or, as people were beginning to say, of my ‘race’. I put up, without much regret, with my non-acceptance into the community; for it seemed to me that in spite of this exclusion an active fellow-worker could not fail to find some nook or cranny in the framework of humanity. These first impressions at the University, however, had one consequence which was afterwards to prove important; for at an early age I was made familiar with the fate of being in the Opposition and of being put under the ban of the ‘compact majority’. The foundations were thus laid for a certain degree of independence of judgement.

I was compelled, moreover, during my first years at the University, to make the discovery that the peculiarities and limitations of my gifts denied me all success in many of the departments of science into which my youthful eagerness had plunged me. Thus I learned the truth of Mephistopheles’ warning:

Vergebens, dass ihr ringsum wissenschaftlich schweift,

Ein jeder lernt nur, was er lernen kann.

At length, in Ernst Brücke’s physiological laboratory, I found rest and full satisfaction - and men, too, whom I could respect and take as my models: the great Brücke himself, and his assistants, Sigmund Exner and Ernst Fleischl von Marxow. With the last of these, a brilliant man, I was privileged to be upon terms of friendship. Brücke gave me a problem to work out in the histology of the nervous system; I succeeded in solving it to his satisfaction and in carrying the work further on my own account. I worked at this Institute, with short interruptions, from 1876 to 1882, and it was generally thought that I was marked out to fill the next post of Assistant that might fall vacant there. The various branches of medicine proper, apart from psychiatry, had no attraction for me. I was decidedly negligent in pursuing my medical studies, and it was not until 1881 that I took my somewhat belated degree as a Doctor of Medicine.

The turning-point came in 1882, when my teacher, for whom I felt the highest possible esteem, corrected my father’s generous improvidence by strongly advising me, in view of my bad financial position, to abandon my theoretical career. I followed his advice, left the physiological laboratory and entered the General Hospital as an Aspirant. I was soon afterwards promoted to being a Sekundararzt, and worked in various departments of the hospital, among others for more than six months under Meynert, by whose work and personality I had been greatly struck while I was still a student.

In a certain sense I nevertheless remained faithful to the line of work upon which I had originally started. The subject which Brücke had proposed for my investigations had been the spinal cord of one of the lowest of the fishes (Ammocoetes Petromyzon); and I now passed on to the human central nervous system. Just at this time Flechsig’s discoveries of the non-simultaneity of the formation of the medullary sheaths were throwing a revealing light upon the intricate course of its tracts. The fact that I began by choosing the medulla oblongata as the one and only subject of my work was another sign of the continuity of my development. In complete contrast to the diffuse character of my studies during my earlier years at the University, I was now developing an inclination to concentrate my work exclusively upon a single subject or problem. This inclination has persisted and has since led to my being accused of one-sidedness.

I now became as active a worker in the Institute of Cerebral Anatomy as I had previously been in the physiological one. Some short papers upon the course of the tracts and the nuclear origins in the medulla oblongata date from these hospital years, and some notice was taken of my findings by Edinger. One day Meynert, who had given me access to the laboratory even during the times when I was not actually working under him, proposed that I should definitely devote myself to the anatomy of the brain, and promised to hand over his lecturing work to me, as he felt he was too old to manage the newer methods. This I declined, in alarm at the magnitude of the task; it is possible, too, that I had guessed already that this great man was by no means kindly disposed towards me.

From the material point of view, brain anatomy was certainly no better than physiology, and, with an eye to pecuniary considerations, I began to study nervous diseases. There were, at that time, few specialists in that branch of medicine in Vienna, the material for its study was distributed over a number of different departments of the hospital, there was no satisfactory opportunity of learning the subject, and one was forced to be one’s own teacher. Even Nothnagel, who had been appointed a short time before, on account of his book upon cerebral localization, did not single out neuropathology from among the other subdivisions of medicine. In the distance shone the great name of Charcot; so I formed a plan of first obtaining an appointment as University Lecturer on Nervous Diseases in Vienna and of then going to Paris to continue my studies.0

In the course of the following years, while I continued to work as a junior physician, I published a number of clinical observations on organic diseases of the nervous system. I gradually became familiar with the ground; I was able to localize the site of a lesion in the medulla oblongata so accurately that the pathological anatomist had no further information to add; I was the first person in Vienna to send a case for autopsy with a diagnosis of polyneuritis acuta.

The fame of my diagnoses and of their post-mortem confirmation brought me an influx of American physicians, to whom I lectured upon the patients in my department in a sort of pidgin English. About the neuroses I understood nothing. On one occasion I introduced to my audience a neurotic suffering from a persistent headache as a case of chronic localized meningitis; they all quite rightly rose in revolt and deserted me, and my premature activities as a teacher came to an end. By way of excuse I may add that this happened at a time when greater authorities than myself in Vienna were in the habit of diagnosing neurasthenia as cerebral tumour.

In the spring of 1885 I was appointed Lecturer in Neuropathology on the ground of my histological and clinical publications. Soon afterwards, as the result of a warm testimonial from Brücke, I was awarded a Travelling Bursary of considerable value. In the autumn of the same year I made the journey to Paris.

I became a student at the Salpêtrière, but, as one of the crowd of foreign visitors, I had little attention paid me to begin with. One day in my hearing Charcot expressed his regret that since the war he had heard nothing from the German translator of his lectures; he went on to say that he would be glad if someone would undertake to translate the new volume of his lectures into German. I wrote to him and offered to do so; I can still remember a phrase in the letter, to the effect that I suffered only from ‘l’aphasie motrice’ and not from ‘l’aphasie sensorielle du français’. Charcot accepted the offer, I was admitted to the circle of his personal acquaintances, and from that time forward I took a full part in all that went on at the Clinic.

As I write these lines, a number of papers and newspaper articles have reached me from France, which give evidence of a violent objection to the acceptance of psycho-analysis, and which often make the most inaccurate assertions in regard to my relations with the French school. I read, for instance, that I made use of my visit to Paris to familiarize myself with the theories of Pierre Janet and then made off with my booty. I should therefore like to say explicitly that during the whole of my visit to the Salpêtrière Janet’s name was never so much as mentioned.

What impressed me most of all while I was with Charcot were his latest investigations upon hysteria, some of which were carried out under my own eyes. He had proved, for instance, the genuineness of hysterical phenomena and their conformity to laws (‘introite et hic dii sunt’), the frequent occurrence of hysteria in men, the production of hysterical paralyses and contractures by hypnotic suggestion and the fact that such artificial products showed, down to their smallest details, the same features as spontaneous attacks, which were often brought on traumatically. Many of Charcot’s demonstrations began by provoking in me and in other visitors a sense of astonishment and an inclination to scepticism, which we tried to justify by an appeal to one of the theories of the day. He was always friendly and patient in dealing with such doubts, but he was also most decided; it was in one of these discussions that (speaking of theory) he remarked, ‘Ca n’empêche pas d’exister’, a mot which left an indelible mark upon my mind.

No doubt not the whole of what Charcot taught us at that time holds good to-day: some of it has become doubtful, some has definitely failed to withstand the test of time. But enough is left over that has found a permanent place in the storehouse of science. Before leaving Paris I discussed with the great man a plan for a comparative study of hysterical and organic paralyses. I wished to establish the thesis that in hysteria paralyses and anaesthesias of the various parts of the body are demarcated according to the popular idea of their limits and not according to anatomical facts. He agreed with this view, but it was easy to see that in reality he took no special interest in penetrating more deeply into the psychology of the neuroses. When all is said and done, it was from pathological anatomy that his work had started.

Before I returned to Vienna I stopped for a few weeks in Berlin, in order to gain a little knowledge of the general disorders of childhood. Kassowitz, who was at the head of a public institute in Vienna for the treatment of children’s diseases, had promised to put me in charge of a department for the nervous diseases of children. In Berlin I was given assistance and a friendly reception by Baginsky. In the course of the next few years I published, from the Kassowitz Institute, several monographs of considerable size on unilateral and bilateral cerebral palsies in children. And for that reason, at a later date (in 1897), Nothnagel made me responsible for dealing with the same subject in his great Handbuch der allgemeinen und speziellen Therapie.

In the autumn of 1886 I settled down in Vienna as a physician, and married the girl who had been waiting for me in a distant city for more than four years. I may here go back a little and explain how it was the fault of my fiancée that I was not already famous at that youthful age. A side interest, though it was a deep one, had led me in 1884 to obtain from Merck some of what was then the little-known alkaloid cocaine and to study its physiological action. While I was in the middle of this work, an opportunity arose for making a journey to visit my fiancée, from whom I had been parted for two years. I hastily wound up my investigation of cocaine and contented myself in my monograph on the subject with prophesying that further uses for it would soon be found. I suggested, however, to my friend Königstein, the ophthalmologist, that he should investigate the question of how far the anaesthetizing properties of cocaine were applicable in diseases of the eye. When I returned from my holiday I found that not he, but another of my friends, Carl Koller (now in New York), whom I had also spoken to about cocaine, had made the decisive experiments upon animals’ eyes and had demonstrated them at the Ophthalmological Congress at Heidelberg. Koller is therefore rightly regarded as the discoverer of local anaesthesia by cocaine, which has become so important in minor surgery; but I bore my fiancée no grudge for the interruption.

I will now return to the year 1886, the time of my settling down in Vienna as a specialist in nervous diseases. The duty devolved upon me of giving a report before the ‘Gesellschaft der Aerzte’ upon what I had seen and learnt with Charcot. But I met with a bad reception. Persons of authority, such as the chairman (Bamberger, the physician), declared that what I said was incredible. Meynert challenged me to find some cases in Vienna similar to those which I had described and to present them before the Society. I tried to do so; but the senior physicians in whose departments I found any such cases refused to allow me to observe them or to work at them. One of them, an old surgeon, actually broke out with the exclamation: ‘But, my dear sir, how can you talk such nonsense? Hysteron (sic) means the uterus. So how can a man be hysterical?’ I objected in vain that what I wanted was not to have my diagnosis approved, but to have the case put at my disposal. At length, outside the hospital, I came upon a case of classical hysterical hemi-anaesthesia in a man, and demonstrated it before the ‘Gesellschaft der Aerzte’. This time I was applauded, but no further interest was taken in me. The impression that the high authorities had rejected my innovations remained unshaken; and, with my hysteria in men and my production of hysterical paralyses by suggestion, I found myself forced into the Opposition. As I was soon afterwards excluded from the laboratory of cerebral anatomy and for terms on end had nowhere to deliver my lectures, I withdrew from academic life and ceased to attend the learned societies. It is a whole generation since I have visited the ‘Gesellschaft der Aerzte’.4 Anyone who wants to make a living from the treatment of nervous patients must clearly be able to do something to help them. My therapeutic arsenal contained only two weapons, electrotherapy and hypnotism, for prescribing a visit to a hydropathic establishment after a single consultation was an inadequate source of income. My knowledge of electrotherapy was derived from W. Erb’s text-book, which provided detailed instructions for the treatment of all the symptoms of nervous diseases. Unluckily I was soon driven to see that following these instructions was of no help whatever and that what I had taken for an epitome of exact observations was merely the construction of phantasy. The realization that the work of the greatest name in German neuropathology had no more relation to reality than some ‘Egyptian’ dream-book, such as is sold in cheap book-shops, was painful, but it helped to rid me of another shred of the innocent faith in authority from which I was not yet free. So I put my electrical apparatus aside, even before Moebius had saved the situation by explaining that the successes of electric treatment in nervous disorders (in so far as there were any) were the effect of suggestion on the part of the physician.

With hypnotism the case was better. While I was still a student I had attended a public exhibition given by Hansen the ‘magnetist’, and had noticed that one of the subjects experimented upon had become deathly pale at the onset of cataleptic rigidity and had remained so as long as that condition lasted. This firmly convinced me of the genuineness of the phenomena of hypnosis. Scientific support was soon afterwards given to this view by Heidenhain; but that did not restrain the professors of psychiatry from declaring for a long time to come that hypnotism was not only fraudulent but dangerous and from regarding hypnotists with contempt. In Paris I had seen hypnotism used freely as a method for producing symptoms in patients and then removing them again. And now the news reached us that a school had arisen at Nancy which made an extensive and remarkably successful use of suggestion, with or without hypnosis, for therapeutic purposes. It thus came about, as a matter of course, that in the first years of my activity as a physician my principal instrument of work, apart from haphazard and unsystematic psychotherapeutic methods, was hypnotic suggestion.5

This implied, of course, that I abandoned the treatment of organic nervous diseases; but that was of little importance. For on the one hand the prospects in the treatment of such disorders were in any case never promising, while, on the other hand, in the private practice of a physician working in a large town, the quantity of such patients was nothing compared to the crowds of neurotics, whose number seemed further multiplied by the way in which they hurried, with their troubles unsolved, from one physician to another. And, apart from this, there was something positively seductive in working with hypnotism. For the first time there was a sense of having overcome one’s helplessness; and it was highly flattering to enjoy the reputation of being a miracle-worker. It was not until later that I was to discover the drawbacks of the procedure. At the moment there were only two points to complain of: first, that I could not succeed in hypnotizing every patient, and secondly, that I was unable to put individual patients into as deep a state of hypnosis as I should have wished. With the idea of perfecting my hypnotic technique, I made a journey to Nancy in the summer of 1889 and spent several weeks there. I witnessed the moving spectacle of old Liébeault working among the poor women and children of the labouring classes. I was a spectator of Bernheim’s astonishing experiments upon his hospital patients, and I received the profoundest impression of the possibility that there could be powerful mental processes which nevertheless remained hidden from the consciousness of men. Thinking it would be instructive, I had persuaded one of my patients to follow me to Nancy. This patient was a very highly gifted hysteric, a woman of good birth, who had been handed over to me because no one knew what to do with her. By hypnotic influence I had made it possible for her to lead a tolerable existence and I was always able to take her out of the misery of her condition. But she always relapsed again after a short time, and in my ignorance I attributed this to the fact that her hypnosis had never reached the stage of somnambulism with amnesia. Bernheim now attempted several times to bring this about, but he too failed. He frankly admitted to me that his great therapeutic successes by means of suggestion were only achieved in his hospital practice and not with his private patients. I had many stimulating conversations with him, and undertook to translate into German his two works upon suggestion and its therapeutic effects.

During the period from 1886 to 1891 I did little scientific work, and published scarcely anything. I was occupied with establishing myself in my new profession and with assuring my own material existence as well as that of a rapidly increasing family. In 1891 there appeared the first of my studies on the cerebral palsies of children, which was written in collaboration with my friend and assistant, Dr. Oskar Rie. An invitation which I received in the same year to contribute to an encyclopaedia of medicine led me to investigate the theory of aphasia. This was at the time dominated by the views of Wernicke and Lichtheim, which laid stress exclusively upon localization. The fruit of this enquiry was a small critical and speculative book, Zur Auffassung der Aphasien

But I must now show how it happened that scientific research once more became the chief interest of my life.7

II

I must supplement what I have just said by explaining that from the very first I made use of hypnosis in another manner, apart from hypnotic suggestion. I used it for questioning the patient upon the origin of his symptom, which in his waking state he could often describe only very imperfectly or not at all. Not only did this method seem more effective than mere suggestive commands or prohibitions, but it also satisfied the curiosity of the physician, who, after all, had a right to learn something of the origin of the phenomenon which he was striving to remove by the monotonous procedure of suggestion.

The manner in which I arrived at this other procedure was as follows. While I was still working in Brücke’s laboratory I had made the acquaintance of Dr. Josef Breuer, who was one of the most respected family physicians in Vienna, but who also had a scientific past, since he had produced several works of permanent value upon the physiology of respiration and upon the organ of equilibrium. He was a man of striking intelligence and fourteen years older than myself. Our relations soon became more intimate and he became my friend and helper in my difficult circumstances. We grew accustomed to share all our scientific interests with each other. In this relationship the gain was naturally mine. The development of psycho-analysis afterwards cost me his friendship. It was not easy for me to pay such a price, but I could not escape it.

Even before I went to Paris, Breuer had told me about a case of hysteria which, between 1880 and 1882, he had treated in a peculiar manner which had allowed him to penetrate deeply into the causation and significance of hysterical symptoms. This was at a time, therefore, when Janet’s works still belonged to the future. He repeatedly read me pieces of the case history, and I had an impression that it accomplished more towards an understanding of neuroses than any previous observation. I determined to inform Charcot of these discoveries when I reached Paris, and I actually did so. But the great man showed no interest in my first outline of the subject, so that I never returned to it and allowed it to pass from my mind.

When I was back in Vienna I turned once more to Breuer’s observation and made him tell me more about it. The patient had been a young girl of unusual education and gifts, who had fallen ill while she was nursing her father, of whom she was devotedly fond. When Breuer took over her case it presented a variegated picture of paralyses with contractures, inhibitions and states of mental confusion. A chance observation showed her physician that she could be relieved of these clouded states of consciousness if she was induced to express in words the affective phantasy by which she was at the moment dominated. From this discovery, Breuer arrived at a new method of treatment. He put her into deep hypnosis and made her tell him each time what it was that was oppressing her mind. After the attacks of depressive confusion had been overcome in this way, he employed the same procedure for removing her inhibitions and physical disorders. In her waking state the girl could no more describe than other patients how her symptoms had arisen, and she could discover no link between them and any experiences of her life. In hypnosis she immediately discovered the missing connection. It turned out that all her symptoms went back to moving events which she had experienced while nursing her father; that is to say, her symptoms had a meaning and were residues or reminiscences of those emotional situations. It was found in most instances that there had been some thought or impulse which she had had to suppress while she was by her father’s sick-bed, and that, in place of it, as a substitute for it, the symptom had afterwards appeared. But as a rule the symptom was not the precipitate of a single such ‘traumatic’ scene, but the result of a summation of a number of similar situations. When the patient recalled a situation of this kind in a hallucinatory way under hypnosis and carried through to its conclusion, with a free expression of emotion, the mental act which she had originally suppressed, the symptom was abolished and did not return. By this procedure Breuer succeeded, after long and painful efforts, in relieving his patient of all her symptoms.

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