Sunset Star 7 by Brian Sapere

 

The Freudian Slip

 

 

Sam Sapere

Spring 1991

 

The Freudian Slip

A Vested Interest in Error

 

Gene, a 15-year-old runaway, is picked up on a police sweep for male prostitutes.  Terrified at the prospect of being returned to his father's home, Gene decides finally to tell two workers at the juvenile hall what he has never confided to anyone – that his father had coerced him into having "all kinds of sex" with him since he was eight years old.  The man and woman workers remained uncomfortably silent during Gene's story and then told him to wait in the room.  Then, in Gene's words:

 

A few minutes later another man came in and asked me if what I had said was the truth.  I told him yes, and he said he had traced my father and had found out he was the owner of a store and a deacon in our church and an umpire for the Little League.  He told me what I had said was a terrible thing to say about "a man like your father."

 

He told me my parents had been notified and were on their way to pick me up. . . . Then he assured me he wouldn't repeat the "dreadful lies" I had said about my dad and that what I had said would stay a secret as long as I understood how terrible it was that I would even think, much less say, "things like that" about my father (qtd. in Butler 26).

 

Gene attempted suicide that evening at juvenile hall.  He was lucky enough to be taken to a hospital where the staff took his account of his family life seriously and was later admitted to a psychiatric ward for adolescents (Butler 26-27).

A young woman who was sexually abused by her father for six years reports that as a girl, at the age of 14, she was accompanied by her mother to a meeting with a psychiatrist.  The psychiatrist told her she had an overactive imagination and the girl's mother told her to forget the whole thing (Bass and Thornton 18).

According to Sandra Butler the above incidents are all too common.  The very people who are mandated to help abused children are often found to be inflicting further trauma on a child by insisting or insinuating that the child is lying, or that the actions of the aggressor were somehow invited by the child, secretly enjoyed by the child, a fantasy arising from unresolved Oedipal conflicts, a "hidden need" to be victimized, etc.  In other words, the blame is often subtly or blatantly shifted onto the child-victim by what Butler refers to as the "professional family", i.e., police, counselors, crisis-line workers, lawyers, judges, doctors, clergy, psychiatrists, and other authority figures in the general populace (144-149).

Every book I have come across on the subject of childhood sexual abuse provides several examples of professional counselors denying or minimizing the impact of their clients' accounts of the abuse.  These books place varying degrees of responsibility for this dilemma on the shoulders of Sigmund Freud.  His later theories of infantile sexuality and the Oedipus complex support(ed) the cultural bias and erroneous belief that most reported childhood scenes of sexual assault are false, i.e., fantasies not to be believed.

 All the authors also point out that Freud, in his early years, did originally believe 18 hysterical patients and their accounts of childhood sexual assault, but that he later changed his mind.  In each case, the child was forced, convinced, or seduced into participating, but the term "seduction theory" is the name that has stuck for the ideas Freud originally developed from these 18 cases.

No author has held Freud solely responsible for societal and professional blindness to the significance of childhood sexual abuse, but since he is regarded as the father of psychoanalysis and has had enormous influence in and out of the field of psychology around the world, it seems important to take a look at why he no longer believed his patients' truthful statements.  Since there is so much current evidence that childhood sexual abuse is a widespread problem that results in harm to the abused individual and society, many researchers maintain that if Freud had not abandoned his original beliefs, much human suffering could have been avoided and many more professionals would now be in a better position to support clients who report instances of abuse.

There are many professionals who contend that Freud's later theories are still valid, that Freud did not discount the harm resulting from childhood sexual traumas that occurred in reality, and that Freud's later theories had room to emerge partly because he eventually came to the conclusion that early sexual trauma was too rare an event to play a major role in the development of all  hysteria and neurosis.

After reading some of the arguments on both sides of this controversy, I began to take a deeper look into certain questions that had not been fully answered in any of the discussions.  This inquiry led me to to a postulation concerning why Freud renounced his seduction theory – and may supply a new piece to the puzzle.

I believe Freud's repression of his awareness of the validity of his patients' accounts of sexual trauma was partially due to a traumatic event early in his career – one which occurred around the time he was developing his early theory of seduction.  The trauma Freud experienced concerns his closest friend, Wilhelm Fliess, during their collaboration in an experimental surgical procedure that nearly resulted in the death of Emma Eckstein, one of Freud's first patients and a friend of the family.  If she had died from this experiment, it is possible that Sigmund Freud would not be a household name today.

In order to give adequate background to this event and its consequences, I will have to go into some detail.

In 1896 Freud published a paper (The Aetiology of Hysteria) based on the results of his case work with 18 hysterical patients.  In all 18 cases the cause for the symptoms of hysteria were traced back to "infantile sexual scenes", i.e., sexual contact imposed on the unwilling child by an adult or older sibling. Freud originally believed that the symptoms of his patients were signs that repressed memories of real traumatic events were beginning to surface (Masson 3-5). In some cases, the symptoms disappeared when the original trauma and powerful feelings of anger and disgust, helplessness and betrayal associated with it, were experienced by the now adult patient (Masson 10).

Freud's first delivery on the "Aetiology of Hysteria" was given in a lecture at the Psychiatric Society in Vienna. In a subsequent letter to his friend, Wilhelm Fliess, Freud says his paper "met with an icy reception from the asses".  Freud also confided to Fliess his indignation at his colleagues' response: "And this after one has demonstrated to them a solution to a more than thousand-year-old problem, a 'source of the Nile!'  They can all go to Hell!" ( qtd. in Masson 9).

The impact of the "icy reception" was not limited to indignation and defiance, however, as Freud writes to Fliess ten days later: "I am as isolated as you could wish me to be: the word has been given out to abandon me and a void is forming around me"  (qtd. in Masson 10).  But he did – "in defiance of [his] colleagues" – publish the paper shortly thereafter (Masson 10-11).

Freud's closest friendship in his formative years as a scientist was with Wilhelm Fliess – an ear, nose, and throat specialist in Berlin.  The two men held similar views about the role of sexuality in the development of what were then known as the "actual neuroses".  Fliess believed that an important connection was to be found between the nose and the sexual organs [!], and that surgery on the nose would help in a cure of sexual problems [!] (Masson 55-59).

Emma Eckstein, perhaps Freud's first analytic patient, was concerned with the "dangers of masturbation", and suffered from dysmenorrhea (painful menstruation).  In Fliess's book on this subject, he says, "Women who masturbate are generally dysmenorrheal.  They can only be finally cured through an operation on the nose if they truly give up this bad practice" (qtd. in Masson 57).  Freud apparently consented to Fliess's recommendation to operate on Emma Eckstein's nose, and Masson tells us that Freud would probably have taken charge of Emma's "giving up [the] bad practice" (masturbation) in psychological treatment (57).

The operation almost killed the patient.  In a series of complications of over two months duration, Emma Eckstein suffered severe pain, infection, and hemorrhaging in her nose.  The first hemorrhage was caused by the removal of half a meter of gauze mistakenly left in by Fliess, who had left town shortly after the operation.  In Freud's letter to Fliess relating this mishap, Freud's initial reaction of horror, "we had done her an injustice; she was not at all abnormal . . ." is followed by a few paragraphs full of reassurances that Fliess was not at fault, and that "it was a mistake that anyone could have made" (Masson 60-70).

Freud's initial acceptance of Fliess's "nasal theory" is not the only one of Fliess's beliefs that Freud accepted, that seems naive from the present point of view.  Fliess also developed a theory that many "critical dates" concerning sexual development, onset of menstruation, conception, birth, death, etc., could be analysed and even predicted by observing the relationship of the "female period" (28 days) and "male period" (23 days) to the date of some other – apparently disconnected – critical event (Masson 94-96).  This mysterious theory of periodicity becomes perfectly "clear" in Fliess's following example:

 

For if one continues 280 days from March 24, [birth date of Fliess's sister-in-law's son] that is, 10 times 28, one comes to December 29, the very same date on which, 4 years earlier, my eldest son came into the world (December 29, 1895).  And 20 years earlier, on December 29, 1879, my only sister became suddenly deathly ill with chills and died thirty hours later (qtd. in Masson 98).

 

Masson continues, "since Fliess considered himself to be the only person to have understood these great laws of nature, it is not surprising that Freud would have been under considerable pressure either to recognize the same laws or to begin to distance himself from Fliess" (98).

In the course of the crisis with Emma Eckstein, Freud (no surgeon himself) had to bring in, at different times, three local surgeons to help save Emma's life.  Fliess's apparent response to this bad news was a request for a letter from these other surgeons exonerating him – which he did not get, since they did not have a very high opinion of Fliess's "art" (Masson 66-72).

Freud's acceptance of Fliess's ideas made it easier for Freud to accept his friend's suggestion that Emma's bleeding was not a result of mishandled surgery, but a case of hysterical bleeding occurring at "critical dates."  The following passage is from a letter of April 26, 1896, from Freud to Fliess (Masson 100):

 

First of all, Eckstein.  I shall be able to prove to you that you were right, that her episodes of bleeding were hysterical, were occasioned by longing, and probably occurred at the sexually relevant times (the woman, out of resistance, has not yet supplied me with the dates) (qtd. in Masson 100).

 

The "longing", Freud explains in a May 4 letter, "is an old wish to be loved in her illness," and subsequent bleedings are interpreted by Freud "as an unfailing means of re-arousing my affection" (qtd. in Masson 101).

Freud's proof for this assertion is Emmas's history of nose bleeds, and her own description of a scene "from the age of 15, when she suddenly began to bleed from the nose when she had the wish to be treated by a certain young doctor who was present…"  The critical dates, however, never became available (Masson 101).

Regarding this passage Masson points out that Freud's use of the German word for "scene" here has begun to shift towards a connotation of fantasy and "wish fulfillment"; whereas in a previous correspondence, Freud makes reference to Emma's memories with a different word for "scene" – which clearly indicated Freud's belief that her memories represented real events (101).

Masson concludes that Freud's shift and renunciation of the seduction theory was due to a lack of "personal courage" in facing the opposition and isolation from his colleagues; and that Freud's need to absolve Wilhelm Fliess of responsibility for Emma Eckstein's suffering played a key role in Freud's later belief that his other hysterical patients' symptoms were caused by longing, i.e., Emma's "longing" later being associated with an unresolved Oedipal conflict (107).

 Freud's obvious admiration of Wilhelm Fliess is a subject  given much attention by Freud's biographers.  Ernest Jones writes that the Freud/Fliess relationship  was "the only really extraordinary experience in Freud's life" and thought it unusual for Freud "to develop a passionate friendship for someone  intellectually his inferior" (qtd. in Masson 73).  Erich Fromm expresses their friendship "as a satisfaction of a purely emotional dependency" – that "Freud needed somebody who would confirm him, comfort him, encourage him, listen to him and even feed him" (42).  And while Peter Gay admits to "stretching the term," he believes that Freud unwittingly employed Fliess as a psychoanalyst, and goes on to say that Freud's "virtual refusal to appraise his intimate friend realistically hints that he was caught in a severe transference" in which "Freud idealized Fliess beyond measure. . ." (58).

 Although no one comes right out and says so, it appears that the nature of Freud's dependency on Fliess was that of a child to a father; whereas Freud often had the usual amount of doubts about his own capabilities, he regarded Fliess as superior and above reproach.

Picture Freud's position during the crisis with Emma   Eckstein:  His private practice is struggling financially, his wife is pregnant with their first child, and his father is on his deathbed.  Although he has some doubts, Freud sees the experimental procedure as an opportunity that might develop into a financially/emotionally rewarding and successful collaboration with his closest friend.  In a letter to Fliess one week before the operation Freud writes that "my lack of medical knowledge once again weighs heavily on me . . . I would not have dared to invent this plan of treatment on my own, but I confidently join you in it." (qtd. in Masson 60).

 The operation is performed by Fliess early in February, 1895, and he leaves Vienna soon afterwards.  In early March, Freud writes to Fliess of Emma's grave condition which includes severe pain, massive hemorrhaging, and draining two bowlfuls of pus from the wound.  But Freud only asks Fliess to send "authoritative advice" (Masson 61).  Over the next two months Emma almost dies at least three times.  There is no indication in Freud's correspondence that Fliess ever returned to Vienna to assist in Emma's crisis.  The correspondence is fraught with the desperation and gloom of a young physician struggling with a crisis beyond his expertise – one which could easily end his career.  But Freud almost always makes sure to absolve Fliess of any personal qualms and responsibility  (Masson 57-72).

 Where was Wilhelm Fliess during all of this?  Perhaps he could not have returned immediately to Vienna from Berlin due to pressing concerns of his own practice.  He apparently did not show up during the entire two month period in which his patient's life was hanging by a thread.  What does this indicate?

 

Max Schur, Freud's personal physician, comments on Fliess's operation:

 

The previously unpublished correspondence of these months revealed Freud's desperate attempts to deny any realization of the fact that Fliess would have been convicted of malpractice in any court for this nearly fatal error (qtd. in Masson 68).

 

What are other implications of Fliess's unprofessional behavior that would have been difficult for anyone in Freud's position to accept?  That…

 

l. Fliess was not that concerned with the welfare of his patient.

2. Fliess was primarily concerned with his own reputation as being a "good doctor".

3. Fliess did not mind testing his unproven theories on a human guinea pig.

4. Fliess failed to send "authoritative advice" because he did not know what he was doing.

5. Freud had put his patient in the hands of an incompetent.

6. Fliess's uncaring posture towards his patient reflected his general attitude towards his friend – Freud.

 

The above points would indicate that Fliess was a self interested fraud with no conscience, professional integrity, or basic human decency, i.e., that he was an unreliable person and no friend at all.  Freud had some inkling of these implications in his initial reactions to Fliess's incompetence (the gauze left in her nose): "So we had done her an injustice; she was not at all abnormal . . ."   A year later, however, when he has supposedly discovered the "real cause" of her bleeding (hysterical longing), Freud ends the paragraph with this statement: "She still owes me details and specific dates." – the dates that would have presumably fit Fliess's own theory of periodicity.

This significant shift in Freud's attitude toward Emma Eckstein – as "not at all abnormal" to being indeed otherwise – is most interesting.  Freud's shift from sympathizing with the agony of her suffering to feeling certain that his patient is responsible for her bleeding and "owes" the dates to support Fliess's theory, demonstrates some of the defense mechanisms Freud employed to keep the reality of a traumatic situation repressed:  denial, rationalization, self-justification, and projection.  It appears that Freud was the one with a "hysterical longing" for affection and furthermore displaced his anger at being abandoned by his friend and mentor onto the victim, Emma; finally culminating in his identification with the aggressor: Wilhelm Fliess.

In short, because Freud was so dependent on Fliess as a confidant and friend, while also having so much vested interest in error associated with his mentor's capabilities as a doctor, he could not bear to face the possibility that his "only Other" was, in reality, a fraud with no scruples.  Also, Freud was implicated as a partner in the crime, while faced with his own ignorance and blindness concerning who could be trusted and believed and who could not.  Thus, he apparently had to suppress the truth and repress the reality of the situation and implications, along with all the associated conflicting and disturbing emotions involved.  Otherwise, as in any traumatic situation of this kind, anger and grief would have surfaced around what amounted to betrayal by Freud's closest friend – when Freud was abandoned – left alone to deal with an agonizing life and death crisis for which Fliess was primarily responsible.

 Freud's inability to adequately deal with this trauma – face reality and process his feelings of helplessness, etc. – appears to have accounted for his subsequent "illness", the symptoms of which were somewhat expressed through his later bewildering fantasy theories.  The Oedipal theory, for instance, shifts the blame (seductive behavior) back onto the victim. 

 

According to Alice Miller:

 

It is not the trauma itself that is the source of illness but the unconscious, repressed, hopeless despair over not being allowed to give expression to what one has suffered and the fact that one is not allowed to show and is unable to experience feelings of rage, anger, humiliation, despair, helplessness, and sadness.  Pain over the frustration one has suffered is nothing to be ashamed of, nor is it harmful. It is a natural human reaction. However, if it is verbally or nonverbally forbidden natural expression, then natural development is impeded and the conditions for pathological development are created (Miller, "For" 72).

 

In a letter to Fliess of early January, 1897 – regarding Emma's hemorrhaging – Freud states, "As far as the blood is concerned, you are completely without blame!" (qtd. in Masson 105), suggesting that the patient is to blame for the problem.

I agree with Jeffrey Masson that there is a connection between Freud's "discovery" that Emma's bleeding was hysterical, and Freud's later belief that most of his patients who had revealed scenes of early sexual assault were describing fantasies, not realities.  Although her case is not mentioned specifically by Freud as one of the 18 patients in the "Aetiology of Hysteria," it is clear that he considered her a hysteric; there is also evidence that Freud previously believed Emma had been sexually assaulted as a child (Masson 87-89).  After the operation, however, he seems to regard her memories as mere fantasies.

Freud was compelled to change his mind about the validity of his hysteric patients' recollections of early sexual abuse, because if all or most of their memories were real, then it would follow that Emma's accounts were true as well – that her hemorrhaging was not due to longing at all, but due to Fliess's AND Freud's incompetence.

The train of thought leading back to Freud's early realization that an injustice had been done to Emma was apparently too painful a route to follow; so it became a forbidden path in the labyrinth of his intellectual conceptualizations and emotional conflicts.  And the relevance of his original insights into the damage done by childhood sexual abuse (a concept Freud did not totally abandon) was significantly and unfortunately diminished, along with the credibility of his truthful patients.  He wanted to believe this type of abuse too rare an event to account for so many of his patients' symptoms, like so many other members of the "professional family" wanted to believe.

Jeffrey Masson's view "that Freud was wrong to abandon the seduction hypotheses" met with the following response from the psychoanalyst Anna Freud, Sigmund's daughter:

 

Keeping up the seduction theory would mean to abandon the Oedipus complex, and with it the whole importance of phantasy life, conscious or unconscious phantasy.  In fact, I think there would have been no psychoanalysis afterwards (qtd. in Masson 113).

 

Peter Gay notes that while Freud did believe that some of his patients had been sexually assaulted at an early age, "What Freud repudiated was the seduction theory as a general explanation of how all neuroses originate."  Gay states that although the struggle that ended with Freud's repudiation of his theory was "strenuous and unsettling . . . the rewards were dazzling.  The way to his sustained self-analysis, to the recognition of the Oedipus complex and of unconscious fantasies now lay open" (95-96).

This is the standard argument used by many supporters of Freud's later theories – that the development of these theories would not have been possible if Freud had not renounced his earlier theory of seduction, i.e., psychoanalysis as a therapeutic practice would not exist.  (This is of course thought of as a tragedy.)  But Gay makes a good point in reminding us that all neuroses cannot be explained by the seduction theory.  Certainly not all people exhibiting neurotic symptoms have been sexually abused.

In her book, Freud and his Father, Marianne Krull makes an interesting suggestion regarding how things could have developed differently if Freud had been willing or able to see how the seduction theory might have been employed as a general explanation for all neuroses. "In my view, Freud had developed a true psychoanalytic theory with his seduction theory – all he needed to do was get rid of its extreme fixation on sexual seduction (69).  According to Krull:

 

Seduction in childhood, [Freud] might have continued the argument, need not necessarily have been sexual to produce a traumatic effect. A different form of seduction, of misleading the child, for instance by a mother who preaches morality while being "unfaithful," or by a parent whose strict sense of justice is a mere cloak for extreme brutality, or love that is nothing short of possessiveness and persecution, and many similar forms of hypocrisy could easily have been fitted into the frame of the seduction theory if Freud had really wanted to extend it in that direction (49).

 

Krull concludes that "Freud could easily have expanded his seduction theory into a 'misguidance theory': the child is misguided by his or her parents or primary caretakers and hence develops neurotic aberrations"; and that Freud "took a step backward  . . . with his Oedipus theory (70).

In any case, the unwillingness of some members of the "professional family" to believe or support victims of childhood sexual abuse is still evident today.  Alice Miller illustrates this dilemma as follows: "Possibly it is the therapist's unconscious fear of his repressed anger against his own parents…" ("Thou" 14).  The consequence of a combination of repression of anger and idealization of parents and other authority figures – mixed with the dictate of the Fourth Commandment (Honor Thy Father And Thy Mother) – is the birth of another more powerful, unspoken commandment that Miller named "Thou Shalt Not Be Aware".

Miller believes that many therapists are unconsciously at the mercy of this hidden commandment.  In order to protect the image of their own parents who traumatized them in some way, such therapists will not be able to give validity or support to their clients' truthful accounts of traumatic experiences.  Miller further maintains that "successful" termination with this type of therapist (in denial of truth) often results in what she calls the "final murder" of the client's true self and corresponding true perceptions of reality.  Thus, most of the client's repressed pain and anger is left unrealized and unresolved; he or she goes on pretending that everything is fine, while desperately trying to appear "normal" – especially since going to see a therapist was often the last hope ("Thou" 54-58).

The purpose in presenting my case is not to malign the image or reputation of Sigmund Freud, nor to suggest that he was primarily responsible for the ignorance of others.  There were certainly other factors which contributed to Freud's renunciation of the seduction theory besides the ones I have mentioned.  I have contended that the traumatic event of the Fliess/Emma episode had a severe negative effect on Freud's willingness to admit the truth and validity of his patients' memories of sexual trauma.  Freud's own personal predicament and inability to face reality is given as an example of how most of us employ defense mechanisms to keep strong negative feelings toward an authority figure from surfacing.  And if the traumatized authority figure is in a position of power, the repressed feelings serve to keep the truth hidden from others as well, just as Alice Miller points out.

However, anyone who has a sincere interest in finding out the reality of the situation – as opposed to protecting an idealized image of parents or authority figures (or their sacred theories)  – has only to examine the facts.

Diana Russell's survey of 930 women in San Francisco – using sound research methodology – reported the following: "38 per cent of the women reported at least one experience of incestuous and/or extra familial sexual abuse before reaching the age of 18; 28 percent reported at least one such experience before reaching fourteen." (61).

 

 A different study of 238 Afro-American and white women of Los Angeles in 1985 obtained remarkably similar results (Russell 69).

 

Florence Rush reports more:

 

More than half of all victims of reported rape are under 18, and 25 percent of this number are under twelve.  Dr. Pascoe . . . of the University of California, estimated that "upwards of 80 percent of the kids in Juvenile Hall had been sexually molested regardless of the reason that put them there."  Dr. Frederick Green of . . . Washington, D.C., found that sexually abused children "are more common among the Children's Hospital patients than broken bones and tonsillectomies" (5).

 

It is estimated that "twenty-five million women in the United States will experience sex with a male adult before age thirteen" (Rush 5).

Alice Miller sums up the Freudian attitude – one which is  fortunately shrinking but still echoing in many professionals' minds:

 

Almost all of them say the same thing as if with one voice: "Freud never disputed that sexual abuse can sometimes occur in reality as well as in imagination, but those victims rarely consult an analyst."  Unfortunately they do.  They come in droves and they stay.  They . . . wait for the miracle that never happens and in fact mustn't be allowed to happen.  For the miracle comes with the truth, and it is the truth that is forbidden ("Banished"  61).

 

 

 

Works Cited

 

 

Bass, Ellen, and Louise Thornton, eds.  I Never Told Anyone: Writings by Women Survivors of Child Sexual Abuse.  New York: Harper and Row, 1983.

 

Butler, Sandra.  Conspiracy of Silence.  San Francisco: New Guide Publications, 1978.

 

Fromm, Erich.  Sigmund Freud's Mission: An Analysis of his Personality and Influence.  New York: Harper and Brothers, 1959.

 

Gay, Peter.  Freud: A Life for our Time.  New York: W. W. Norton and Co., 1988.

 

Krull, Marianne.  Freud and his Father.  New York: W. W. Norton and Co., 1986.

 

Masson, Jeffrey Moussaieff.  The Assault on Truth: Freud's Suppression of the Seduction Theory.  New York: Farrar, Strauss, and Giroux, 1983.

 

Miller, Alice.  Banished Knowledge: Facing Childhood Injuries.  New York: Doubleday, 1990.

 

—  For Your Own Good: Hidden Cruelty in Child-Rearing and the Roots of Violence.  New York: Farrar, Strauss, and Giroux, 1989.

—  Thou Shalt not be Aware: Society's Betrayal of the Child.  New York: Meridian,1986.

 

Rush, Florence.  The Best Kept Secret: Sexual Abuse of Children.  Englewood Cliffs , New Jersey: Prentice Hall, Inc., 1980.

 

Russell, Diana E.H.  The Secret Trauma: Incest in the Lives of Girls and Women.  New York, Basic Books, Inc., 1986.