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Freud, His Illness, and Ourselves

Article  in  The American Journal of Psychoanalysis · July 2008

DOI: 10.1057/ajp.2008.2 · Source: PubMed

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 The American Journal of Psychoanalysis, 2008, 68, (103–116)
© 2008 Association for the Advancement of Psychoanalysis 0002-9548/08 $30.00
www.palgrave-journals.com/ajp

FREUD, HIS ILLNESS, AND OURSELVES

André Haynal

The history of Freud’s illness shows that he tried to avoid confrontation with it, and to treat
it as unimportant. In his personal letters, the ill body remains outside—as another person,
“Konrad,” not he himself—and it is not taken into account. Particularly in Freud’s correspond-
ence with Ferenczi, we realize to what extent certain phenomena, especially depressive ones,
he considered somatic, with a tendency to dismiss them, and this despite important occasional
insights, such as about the role played by hate in psychosomatic illnesses. In the post-Freudian
development, these topics have been more and more integrated in the dialogue, in the
discourse between the analyst and the analysand.

KEY WORDS: Freud’s physical illness; history of psychoanalysis; psychosomatic

medicine; psychoanalytic dialogue.

DOI:10.1057/ajp.2008.2

I.
Since mid-February 1923, Freud could no longer fail to realize that he
had a tumor in his mouth. As a matter-of-fact, six years earlier, in 1917,
he had already noticed a similar, painful swelling on his palate. Ironically,
that tumor disappeared after a patient had offered him a beautiful box of
Cuban cigars, an enchanting oasis of blue smoke in the midst of the
upheaval of WWI that shook the whole world. At that time, Freud did not
attach much importance to the pain (cf. Schur, 1972, p. 310). Without
doubt, he feared that he might be forbidden to smoke. In 1923, however,
the tumor had grown too large for him to ignore. At that time, as in the
case of his previous cardiac condition, Freud still had no physician whom
he would have consulted regularly, although he was surrounded by
physicians.

André Haynal, M.D., is past president of the Swiss Psychoanalytical Society and former Vice
President of the European Psycho-Analytical Federation, Professor of Psychiatry (Emeritus),
University of Geneva, Switzerland, Training and Supervising Analyst, Swiss Psychoanalytic
Society.
Address correspondence to André Haynal, M.D., 5 bd Philosophes, CH-1205 Geneva,
Switzerland; e-mail: [email protected]
Paper presented at the Clinical Sándor Ferenczi Conference, August 2–6, 2006, Baden-
Baden, Germany.
104 HAYNAL

He had suspected the illness before that fateful year of 1923. It appeared
like a premonition that in May 1921 he wrote that strange letter to Ferenczi,
in which, on the occasion of his 65th birthday, he wrote that “seven organs
are vying with one another for the honor of being allowed to make an end
to my life” (Freud and Ferenczi, 2000, p. 56).
Anyhow, at the end of the second week of April 1923, when The
Ego and the Id (Freud, 1923b) was published, Freud consulted the derma-
tologist Max Steiner. Steiner examined him and concluded that it was a
malignant tumor, an epithelioma. He advised an excision, but deceived
Freud in telling him that it was a leukoplakia (Schur, 1972, p. 350). Schur
comments in his book that leukoplakia, a benign tumor, a pre-cancerous
lesion of the oral mucosa, is associated with chronic tobacco abuse, and
adds: “Steiner … told Freud to give up smoking, a medically sound but
untimely piece of advice. Judging from my later experience, this advice
was much more threatening and unacceptable to Freud than surgery”
(ibid.).
In the same week, Felix Deutsch payed a visit to Freud for private reasons.
The Professor “took him aside as he was about to leave and asked Deutsch
to look at his mouth, remarking: ‘Be prepared to see something you won’t
like’” (ibid.). He was right. Deutsch examined him in the twilight of the
window, and “at the very first glance” realized that he “was dealing with
an advanced cancer. To play for time [to think], I made a second examina-
tion and decided to call it ‘a bad case of leukoplakia,’ due to tobacco
abuse, which would make a biopsy and excision of the tumor necessary.
Freud promised to follow the recommendation and told me that he had
had this lesion for a long time already, and that it recently became exac-
erbated” (Deutsch, 1956, p. 297).
Felix Deutsch, the husband of Helene Deutsch, was a general practi-
tioner, who was analyzed by Siegfried Bernfeld. He had organized the first
clinic for “organic neuroses” in 1919, where a course on what later became
known as psychosomatics was given. He was light years removed from
oncology. How could he diagnose with certainty a malignant tumor in
looking into the mouth in the dim light coming from the window? From
the beginning, things did not match up.
According to Jones, Deutsch was “discomposed to hear Freud ask him
for help to ‘disappear from the world with decency’ if he was doomed to
die in suffering. Then Freud spoke of his old mother, who would find the
news of his death very hard to bear. … So Deutsch contented himself by
saying there was a simple leukoplakia which it was advisable to remove”
(Jones, 1957, p. 90).
Soon afterwards, a doctor, a zhinologist was chosen. We can ask
ourselves: Why did he choose Markus Hajek? Why not have recourse to a
 FREUD AND HIS ILLNESS 105

renowned specialist—Marais Pichler, for example? The answer is not easy.

According to Anna Freud, it was Freud himself who made the decision
(Gay, 1987, p. 419).
Freud presented himself at the clinic, at the time agreed upon, without
telling anybody at home. He was operated on while sitting on a chair
(Schavelzon, 1983, p. 57). In his book, Schavelzon shows a photograph
of this operating theater: a dark and plain room, which is rather reminiscent
of a waiting room in some city healthcare center. To mention just one fact:
Deutsch accompanied the patient, but did not remain with him during the
operation.
The operation was performed with local anesthetics, and consisted in the
ectomy of the anterior right palate, an incision that went as far as the right
dental border. After two hours, the operation was interrupted due to a strong
hemorrhage, and the wound was not closed with organic tissue (ibid.).
The operation was terminated with the stopping of the strong hemor-
rhage, and a message sent to the family: “Bring clean clothes.” Martha and
Anna hurried to the hospital, where they found Freud sitting on a kitchen
chair, with blood all over his clothes. There was no free room or even a
bed in the clinic, and so a camp bed was rigged up in a room already
occupied by a patient, whom Anna Freud later described as “a retarded
dwarf” (Gay, 1987, p. 419). As the story goes, this retarded dwarf saved
the life of the Professor. Martha and Anna had to leave the hospital, as no
visitors were allowed during mealtimes. Upon their departure, they were
reassured that the patient would be all right. When they returned, however,
they learned that he had had a new attack of profuse bleeding. The bell
had been out of order, and Freud found himself helpless. Fortunately, the
dwarf rushed for help, and after some difficulty the bleeding was stopped
(Schavelzon, 1983, p. 58).
After this terrible episode, Anna refused to leave her father alone. “The
nurses,” she wrote, “did not have a good conscience about the failure of
the bell, [and] were very kind. They gave me black coffee and a chair and
my father, the dwarf and I spent the night together” (Gay, 1987, p. 420).
In the morning, there was a new hemorrhage. There was no house surgeon
present at the hospital (Jones, 1957, p. 91), and Anna dressed the wound.
Freud was weakened by the loss of blood, half-drugged from the medicines,
and was in great pain. The next morning, Hajek, with the morbid thick skin
of physicians, demonstrated the case to a crowd of students. The patient’s
state did not permit a transferral to a more appropriate clinic, although
the highly renowned Löw Sanatorium was only a block away; it was in this
institute that future operations were performed. The next day, Freud left
this sombre clinic to rejoin his family. Thus ended the first of the 33
operations Freud underwent before the fatal end in 1939.
106 HAYNAL

In sum, the intervention was a disaster. First inconsistency: Was an oper-

ation of more than two hours, including the ablation of half the palate,
really superficial? According to Jones, the biopsy revealed that the tumor
was cancerous. Although the tissue was analyzed, we do not know by
whom the biopsy was made, and a report never surfaced. On the other
hand, Hajek did not take the usual precautions to avoid the retracting of
the tissue scarring over. The result was a considerable contraction, which
caused great pain after the operation. This was an unforgivable error. From
then on, the most painful problem, and the one most difficult to address,
was this tissue “contraction,” the main reason why none of the future pros-
theses was satisfactory. The heavy apparatus, which covered the concavity
of the palate, became a veritable instrument of torture, a symbol of his
suffering.
Hajek did not write down a medical report, and prescribed X-ray treat-
ment, followed by treatments with radium capsules. Freud did not react
well to the treatment: generalized pains, headaches, vomiting, and fatigue
were the consequences of the radiotherapy. Max Schur gave his medical
opinion, corresponding to that of Schavelzon: “first, radiotherapy for this
type of malignancy is usually unsuccessful. This was later stated by the
experts Professors Rigaud and Lacassagne, directors of the Institut Curie in
Paris. Second, radium treatment, outside of Paris and especially in Vienna,
was carried out somewhat haphazardly. The radiation Freud received only
caused tissue damage and violent pain” (Schur, 1972, p. 357). Schavelzon
writes: “We have no technical references for the treatment with radio-
therapy, and, as far as the radium is concerned, the dosage was dispropor-
tionate” (1983, p. 61). Schur goes even as far as saying that “until 1936
there were no pathological signs of a malignant cancer” (1949, p. 74).
As far as the history of Freud’s “illness” is concerned, recent studies have
revealed that the story is not as simple and straightforward as it is recounted
in the traditional literature, and that Freud probably did not yet suffer from
cancer when the first surgical intervention took place. For instance, there
is no trace of any trustworthy cytological examination in the early stages.
It has even been suggested that it was precisely those various interventions
and re-operations that played a part in rendering the leukoplakia malignant.
Let us remind ourselves that it was only as late as in 1936 that the diagnosis
of Freud’s cancer could be established on scientific grounds (Schavelzon,
in Rodrigué II, 1996, pp. 287ff.).
After the last of the 33 operations, when Freud was informed about his
situation, he wrote to Eitingon on March 5, 1939: “Now we know, more
or less, where we are standing. A biopsy showed that it really is an attempt
of the carcinoma to again take my place” (Freud and Eitingon, 2004,
p. 920; italics added).
 FREUD AND HIS ILLNESS 107

II.

How did Freud live with his illness, what did he think about it, and what
can all this teach us psychoanalysts today?
What made Freud write in 1922, shortly before that fateful year when
his tumor was discovered, “that the analytic treatment of gross organic
diseases is not unpromising, since a mental factor not infrequently contrib-
utes to the origin and continuance of such illnesses” (1923a, p. 250)? It
is true that he also wrote to Viktor von Weizsäcker: “For pedagogical
reasons, I had to keep analysts from making such examinations. … [T]hey
had to learn to confine themselves to psychological ways of thinking.
We may be grateful to the internist to have widened the scope of our
insights. … [Our] attention has been called to the psychogenetic factors in
organic illnesses … [and also to the fact that] a neurosis can often be
followed and substituted by an illness”—all of which would give “the
impression of a provisional state” (October 16, 1932; in Weizsäcker, 1954,
pp. 182–185).
Although many terms in psychoanalytic theory point to the importance
of somatic roots of psychic life—such as the concepts of drives or instincts,
the dimension of sexuality, which is also based on the biology of the human
being before becoming phantasy, or the ego, which is initially also conceived
as a body ego—this approach to and treatment of the bodily dimension
seems to have been fragmentary and fraught with difficulties. Is this so
because of a methodological question, as the just-quoted passage seems
to indicate? Or because of the necessity to concentrate on what is impor-
tant, namely, the psychical? All this despite the fact that the scientific group
around Freud, the “Wednesday Society,” or later the Viennese Psychoana-
lytical Society, was to a large part composed of general practitioners and
of so-called Badeärzte—balneologists and physical therapists. Freud himself,
however, was not particularly well versed in physical medicine (with the
exception of neurology, especially pediatric neurology).
In addition, Freud’s personal texts are full of his preoccupation with the
state of his health. In his early letters to Abraham, for example, that is to
say toward someone whom he hardly knows yet, and with whom he is not
yet on intimate terms, he is ready to make frequent allusions to various
health problems. On February 16, 1908, for instance, he writes of “the
recovery, more or less, of the domestic patients”(Freud and Abraham, 2002,
p. 27; italics added); on March 1, he remarks that his “daughter left … to
convalesce” (ibid., p. 30); on July 11, he feels “in great need of the holiday”
(ibid., p. 49); on April 27, 1908, he suffers from a “conjunctivitis”
(ibid., p. 88); on May 23, he is “too tired to work” (ibid., p. 92), etc.
The same can be said of his letters to other correspondents (e.g., to Lou
108 HAYNAL

Andreas-Salomé). Even before their famous meeting in Munich in 1910, he

writes to Jung on December 22, 1910: “Don’t be dismayed if you do not
find me in the best of health” (Freud and Jung, 1974, p. 382), and again,
shortly afterwards: “strange headaches … lapses of memory” (ibid., p. 393)—
later attributed to gas escaping from the gas lamp in his study—which Freud
initially “diagnosed … as arteriosclerosis, to which I resigned myself” (ibid.,
p. 394), another factor that moved Freud to nominate Jung to be elected
the life-long president of the International Psychoanalytic Association (IPA).
In any case, all this seems to indicate a strange avoidant behavior. Let
me explain by making a small detour via Switzerland, and by introducing
the author of a book that plays a central role in this. Carl Spitteler (pseu-
donym of Carl Felix Tandem), born in 1845 in Liesthal, the capital of the
Swiss demicanton “Basel-Land,” deceased in 1925 in Lucerne, was awarded
the Nobel Prize in 1919, inter alia for his neutral, “Swiss” stance during
the First World War. This political attitude alone may have been responsible
for the sympathies he gained in Freudian circles, but it was above all his
book Imago, which appeared in 1906, that was greeted with enthusiasm.
It was Jung (1911–1912) who introduced this term (“imago”) into the
psychoanalytic nomenclature. This term was, however, also adopted, and
used in the title of the journal founded in 1911 by Hanns Sachs and Otto
Rank (to this day, an American Imago is still published). The novel’s main
character, Victor, “was accustomed … to calling his body Konrad” (p. 21).
This metaphor was borrowed by Freud (who often connected it to armer—
poor—Konrad), and became standard jargon in the letters exchanged by
the psychoanalytic pioneers. They did not address their body as such, but
talked as if about the “other”—Konrad, that is (cf. Freud’s letters to Ferenczi
(Freud and Ferenczi, 1993, p. 408) and Abraham (Freud and Abraham,
2002, p. 552)). In German culture, by the way, this name also alludes to
the secret associations of poor peasants, who called themselves “Armer
Konrad” during the Peasant’s Wars in Germany (1514), after the pejorative
name given to them by nobility. Konrad is thus sort of a poor guy, a strange
double, a doppelgänger, who is able to make himself felt from time to time,
in a perturbing way, unexpectedly and mysteriously, without his appear-
ances being foreseen or understood.

*
One may be inclined to think that the evocation of methodological
problems and the habit of talking about “Konrad” served to avoid a direct
confrontation with somatic problems. As we have seen, however, and as
we will still see more fully, the preoccupation with the ill body did not
stop.
 FREUD AND HIS ILLNESS 109

Freud and Ferenczi often took the waters, in Karlsbad, among other
places, one of those spas with their strange, nostalgic atmosphere, which
stimulated reminiscences, and concentrated their visitors’ attention on their
body, their needs, and their wishes (this atmosphere was later captured in
a famous film about Marienbad, another one of those spas). During one of
these stays, Freud made the following comment on August 5, 1913: “I am
unmistakably in a toxic condition similar to the one you saw me in last
year, and even more similar to the one I had at the beginning of the first
Karlsbad cure. Moody, irritable, tired [sic], but this time no weakness of
the heart. Always ruminating over the same dark thoughts [sic], taking little
things hard, aversion to food, but after filling my stomach, I regularly
brighten up” (Freud and Ferenczi, 1993, pp. 504–505). Here the irritability,
the dark thoughts, and the fatigue are not considered as belonging to the
psychic domain, but are viewed as somatic troubles, to be cured in the
spa, and not by psychic exploration.
Not so Ferenczi, however, who comments on October 3 of the same
year with regard to Freud’s recurring gastric troubles: “[L]et us hope the
stomach ailment will turn out to be a transitory symptom. We should actu-
ally—according to the experiences of the last few years—already be better
acquainted with the conditions that at times have an unfavourable influence
on your health … For my part, I maintain that Karlsbad and the Karlsbad
cure are disadvantageous to you. The toxic effect has always set in promptly;
we have never seen any favourable effects” (ibid., p. 510). Freud answers
on October 12: “I am certainly ready to give up the drinking cures, to
which I owe something, completely normal intestinal functioning, which
has been undisturbed for three months now. I just took a first step toward
looking after myself; I gave up the hour between 8 and 9 in the morning,
i.e., I dismissed the designated patient without replacing him” (ibid.,
p. 513).

III.
Having become witnesses of the degree of intimacy that existed between
Freud and Ferenczi, we may now be able to better understand that Ferenczi
could suggest to the Master, on February 26, 1926, to take Freud into
analysis because of his cardiac and gastric troubles: “What do you say
about the strange coincidence that, just now, when you are concerned
about heart ailments, from the many cases that were being presented by
us, I happened to cite the theme of coronary disturbances. What was said
there is plainly already an answer to what you have heard. I am firmly
convinced that—even if nicotine plays a part in the matter—something
psychic can be decisive in the so-called myocardites and stenocardias”
110 HAYNAL

(Freud and Ferenczi, 2000, p. 250). Let us note that Ferenczi, with his
remarkable intuition, writes of “so-called” myocardites and stenocardias,
something that was proven by the following years, as Freud’s heart never
gave out during the whole 83 years of his life. Ferenczi goes on writing:
“As vehemently as I pleaded in favour of intervention in the solution of
your jaw malady, I believe just as decidedly that the heart can and should
be not only medicinally but also psychically supported. Perhaps this is the
occasion on which I can say to you that I find it actually tragic that you,
who endowed the world with psychoanalysis, find it so difficult to be—
indeed, are not at all—in a position to entrust yourself to anyone.1—If your
heart ailments continue, and if the medications and diet don’t help, then
I will come to you for a few months and place myself at your disposal as
an analyst—naturally: if you don’t throw me out” (ibid.; italics added).
Although quite a few of his disciples (including Rank) tried, during the
course of their relationship with Freud, to contribute to a psychoanalytic
understanding of his illness, only Ferenczi and Groddeck (cf. Freud and
Groddeck, 1970) offered in all seriousness and resoluteness to take Freud
himself into analysis. Did Freud think—given the developmental state of
his theory at the time—that psychoanalysis was not yet ready to treat
somatic manifestations and physical illnesses, whether or not they were of
“organic” origin? Even if it was perhaps out of the question for Freud to
turn to whomever it was for analysis, would it have been possible that
Ferenczi or Groddeck had been able to really help him? Could Freud have
risked to show himself vulnerable (notabene, in a state of dependency) at
the age of 70 or even older? Perhaps Ferenczi was right in thinking that
the Master was in no position to entrust himself to anybody. We can easily
imagine the difficulty of entering into a state of submission and dependency
with someone Freud might have seen as “inferior,” in analytic understanding,
to him, the discoverer of psychoanalysis. Perhaps it was not the heart that
was the problem, but what he could not, and did not want to see.
In any case, he eventually chose the so-called Steinach operation, an
allegedly endocrinal-organic intervention, to reinforce his (hormonal) resist-
ance against the forces of the illness—instead of a psychoanalysis that could
have also been considered in this perspective.
Tired of therapy, “saturated” and “fed up” by analysis as a therapy, he
writes to Ferenczi on January 11, 1930: “Very possible that you are doing
analysis better with both, or with all, your patients than I am (Sie bei beiden
oder allen Patienten die Analyse besser machen als ich), but I also don’t
have anything against that. I am saturated with analysis as therapy, ‘fed up,’
und who, then, should[…] do it better than you? (wer sollte es besser
machen, wenn nicht sie)” (Freud and Ferenczi, 2000, p. 380; italics
added).
 FREUD AND HIS ILLNESS 111

If we admit that Freud was discouraged with regard to the curative power
of psychoanalysis the way he practiced it, is it thinkable that it was health
troubles that led him, at least partly, in his later works of the years around
1936–1939—a few years after the death of Ferenczi, and after having
worked through his mourning—to again take up some of the latter’s ideas,
in particular the topics of splitting, of introjection, of the role of the
mother, thus indirectly touching also on the “dark continent” (Freud, 1926,
p. 212)?
In any case, returning to Ferenczi’s offer to analyze him, Freud thanks
him warmly for this “touching suggestion,” adding that “[t]here may indeed
by a psychic root” (February 27, 1926; Freud and Ferenczi, 2000, p. 252).
Which “psychic root”? Is this about that state of anxiety he describes to
Eitingon on March 22, 1924: “I am constantly tortured by one thing or
another” (Freud and Eitingon, 2004, p. 344)? Or did he anticipate further
developments, telling Thornton Wilder, the American writer, in 1938, “that
it might some day be shown that cancer is allied to ‘the presence of
hate in the subconscious’” (in Freud, 1992, pp. 297–298)? And if hate
it is, what is it about? Could this have to do with the “dark continent”
and the difficulties he had with his mother, difficulties his biographers
begin to grasp? The mother had lost a son a year before the birth
of Sigmund, and, a year later, gave birth to him, and was thus in a state of
mourning at the beginning of his life—and this in spite of all his idealiza-
tion of her; after all, we know what lies behind such idealizations.
Let us remind ourselves of the fact that he did not care to go to the
funeral of his mother in 1930, but instead preferred to send his daughter
Anna—always the poor Anna—to represent him. Ferenczi thought that
Freud had “sacrificed” the interests of women, and that “he wants to ignore
the traumatic moment of his own castration in childhood” (Ferenczi, 1985,
p. 188). Without any doubt, there existed a tension between Freud and his
mother.
Taking this as a point of departure, it is perhaps possible that he did not
know how to take good care of himself, just as his mother could not take
good care of him, and that he lacked an image of a sufficient, comfortable,
and efficient enough mother, to whom he could turn and confide in. A link
is conceivable between Freud’s denial of the body and his work on nega-
tion, published in 1925. What does he want to verneinen, to negate? Could
this not be the “dark continent,” of which he writes in the following year?
(Freud, 1926, p. 212).
Is there a connection between the attempts to eliminate, or trivialize,
the somatic dimension, and Freud’s core drama, of which we find traces
in his personal writings, and particularly in his correspondence with
Ferenczi? His problem with his mother seems to have given rise to a not
112 HAYNAL

very kind attitude towards himself, a sort of masochism—a problem he also

tried to grasp in his speculations about the death instinct.
He neglects his own health, while complaining constantly and without
reserve in a depressed mood, and indulging in his passion for tobacco, a
particularly destructive passion in his state. On June 1, 1931, he writes
to Eitingon that “in view of my age and the degree of uncomfortableness
I have to suffer each day, abstinence [from tobacco] … does not seem
justified to me” (Freud and Eitingon, 2004, p. 739). Did Freud, during
his whole life, follow a masochistic tendency in his series of breaks with
the better part of his disciples and friends? Even Abraham could perhaps
have had the same fate if he had lived long enough, as we might
suspect when reading their correspondence. Already early on Freud
complained about his “splendid isolation” (Freud, 1914, p. 22). He
also confessed not to have profited from the sexual revolution he
helped to set in motion (Hale, 1971, p. 376). Was it also because of his
masochism that Freud refused, for a long time, to emigrate, at the risk of
his life?
In intense identification with the masochism of his daughter, he used
Anna’s case to write his own article entitled “A child is being beaten”
(Freud, 1919). Young-Bruehl (1988, pp. 103–104) writes that Freud’s article
is partly based on Anna and her analysis with him (i.e.: of the six patients
discussed, one is probably Anna). Anna Freud in her turn took Freud’s article
as the starting point for her later work on beating phantasies and daydreams
(1922a, b). Here, too, the patient on whom this text is based seems to be
Anna herself.
Let us note that in his remarks to Ferenczi on Anna’s Oedipus, he appar-
ently does not realize that he might himself be partly at the source of his
daughter’s masochism. To Lou Andreas-Salomé, he writes (July 3, 1922):
“In her relations to men, she is inhibited because of me. Up until now, she
has had much misfortune in her friendships with women. … Sometimes I
desperately wish her to have a good man, sometimes I am shying away
from the loss.” And when he takes her into analysis for a second time: “I
have undertaken a seventh analysis with quite special feelings: my Anna,
who is so unreasonable as to cling to an old father” (May 13, 1924)
(Falzeder, 2003, p. 89).

IV.
Some may feel discomfited that I am not giving an image of Freud the
God, but of Freud the human being, which, however, in my opinion does
not at all diminish his genius or the value and impact of his ideas, even if
his insights also had their limits. It seems, by the way, that Einstein was
 FREUD AND HIS ILLNESS 113

wrong with his last great theory—but he and Freud remain no less beacons
of humanity.
Personally I am more interested in Freud’s personality, his position, the
biographical and historical places he takes as a starting point for his
discourse, and the development of his theory, than by an exegesis of his
texts that is robbed of all its historical context. There is no doubt that
personal experiences feed and enrich psychoanalytic thinking. It can be
enlightening to understand the links between the lives of great psychoana-
lytic thinkers and the elaborations, even if sometimes hypothetical, of their
theories. Writing the history of psychoanalysis is not a foolish enterprise.
The history of ideas can become crucial: historia docet, history teaches us,
and we can draw conclusions from it for ourselves.
We could go on with a more detached Freud, a more philosophical one,
as it were, discovering other biases to deepen our understanding of the
problem of the “ill.” I cannot enter here into a detailed chronological study
of this problem, but it is for instance tempting to listen to what he writes
in the middle of the First World War, in his little gem of a piece entitled
Vergänglichkeit, “On transience” (Freud, 1916). During one of his famous
walks “through a smiling countryside” (p. 305), in the company of a young
poet, probably Rilke, and “a taciturn friend,” he talked about mourning
and the liberation it can bring about: “our capacity for love (our libido) is
once more liberated” (p. 306). We sense an effort to bring about positive
transformations, a better solution, as he says on the occasion of another
walk in September 1917, accompanied by Anna. She expressed her wish
that she could stay here forever, that everything could stay the same as it
was at that moment. Freud answered that one experiences pleasure in the
moment because it is transitory. The idea struck Anna as strange and without
meaning (Unwerth, 2005, pp. 192–193). Later, on May 12, 1923, she wrote
to Lou Andreas-Salomé, with reference to that scene, that something very
secretive and true could be hidden behind those words. In reading Beyond
the Pleasure Principle (Freud, 1920) with its Nietzschean undercurrents,
she thought that this eternity and peace, which arose nostalgia in her, were
nothing but death itself. It is the same in the ninth of Rilke’s Duino Elegies,
in which transience leads to liberation.
And what about ourselves? To return to the context of “Freud, his illness,
and ourselves” in view of what has been said, we can understand that
Freud eventually did not make a lasting contribution to psychosomatic
medicine; this work was left to his successors. Freud’s creativity was in
constant progression, fuelled by new ideas, and so his theory is composed
of multiple strata. His intuitions—as of the role played by hate in cancer—
were not further elaborated by himself, but have resurfaced later in other
important contributions.
114 HAYNAL

What I find even more important is that we remind ourselves of the fact
that Freud conceptualized psychoanalysis in one self-analysis, in the writing
of his principal work, The Interpretation of Dreams (1900). This was not a
“talking cure,” to borrow Anna O.’s expression, but a “writing cure.” This
also contributes to the fact that the defense mechanisms studied by Freud,
such as repression or censorship, are linked to the act of writing, in contrast
to projection, introjection, and splitting, which appear in the later develop-
ment of psychoanalytic thinking, conceived during the maternal listening
and the participation in the “inside” of the other.
What Freud lacks is dialogue on this deeply intimate subject. Numerous
times he writes to his followers (Rank, among others) that it is not so
important to be analyzed by someone else; a study of one’s own dreams
would suffice. Perhaps Freud’s illness was eventually his isolation, having
no partner to think and reflect with. We have since learned that it is in the
relational experience, in the exchange of a deep dialogue, open to accepting
the other’s thinking that we find the cornerstone of a return to the speech,
the “talking cure”—a form of human solidarity that perhaps sometime even
opens up for us the secrets of the soma, too.
It is through this speech that “Konrad” can be heard, become audible,
and become part of ourselves, by putting these ills into words.
As a matter-of-fact, from its beginning, psychoanalysis is a theory of the
“ill”ness. According to Freud’s dictum, hysterics suffer from reminiscences,
from the memory of traumatic scenes, and we can help them in overcoming
that illness by talking in a kind of debriefing, as it would be called today.
It is in this discourse that hopes of transformations and changes can arise.
As has been shown by some authors, Freud’s thoughts about the problem
of the “ill”2 can impress us by their pertinence. They do not, however, seem
to have helped him much.

NOTES

1. And above all not to someone considered a pupil or a disciple.

2. For other perspectives on the topic of Freud and illness, see Romm (1983) and Kollbrunner
(2001).

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