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History and Evolution of Dynamic Psychiatry: A Timeless Classic
History and Evolution of Dynamic Psychiatry: A Timeless Classic
REVISITED
Zvi Lothane, M. D.
I am still awash with fond memories of the days I spent in Melbourne (and Sydney, and
beyond), where I was invited to speak of love, life, Freud, and Schreber at the Freud
Conference 1998, a 21 year-old tradition that came into being thanks to the indefatigable
Douglas Kirsner. It was thus with great satisfaction that I accepted the invitation to write
processes and, currently, to the storms buffeting dynamic psychiatry and psychoanalysis
in the United States (Lothane, 1996a, b, 1998d). It is also a testimonial to how this book
Upon first reading, Ellenberger instantly appealed to me for two reasons: one
general and one specific. The first had to do with his sweep of his scholarship, the
the cultural climate of the various periods and in the work of psychologically minded
psychiatrists, such as Janet, Freud, and Jung. The second was Ellenberger’s particular
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focus on the historic importance of the German physician Franz Anton Mesmer (1734—
later psychoanalysis. My own keen interest in Mesmer was kindled in the mid-1960’s,
an early association between Freud and Mesmer thanks to a widely read 1932 book by
Stefan Zweig, Mental Healers. Few people today realize that such household words as
derive from the practices and theories of what was the rage of the late 18th and early 19th
century: Mesmer’s animal magnetism, an intellectual revolution that that inspired major
Ellenberger (Crabtree, 1993). In brief: the crimson thread runs from Mesmer to his
disciple the Marquis de Puységur, to Liébault and Bernheim, the Nancy school of
hypnosis and its Austrian branch, represented by Josef Breuer and Freud, and leading to
As the title of Ellenberger’s great book spells out, Breueur’s and Freud’s great
fundamental discovery is that of “the unconscious,” using the noun form. My own
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namely: psychological processes, both ideational and emotional, show a surface and a
Early on in the 19th century, the Marquis de Puységur, the true founder of
suffering from a “mild respiratory disease,” who then showed two distinct personas: “he
fell into a strange kind of sleep in which he seemed more awake and aware than in his
normal waking state. He spoke aloud, answered questions and displayed a far brighter
mind than in his normal condition. … Intrigued, Puységur produced this type of crisis
again in Victor and tried it successfully on several other subjects. Once they were in that
state, they were able to diagnose their own diseases, foresee its course of evolution, and
prescribe the treatments” (Ellenberger, p. 71). What Ellenberger does not spell out is that
in his magnetic-hypnotic state, roughly equivalent to the state of free association, the
shepherd youth Victor was able to speak freely about how he had been personally
affected by his boss Puységur in their social relationship. Hirschmüller (1989), the author
of the definitive biography of Breuer, does not mention Mesmer or Puységur but only the
late 19th century practitioners of this method Binet, Janet and Delboef, quoted in Breuer’s
and Freud’s footnote: “We can now explain how the hypnotist promotes cure. He puts the
subject back into the state in which his trouble first appeared and uses words to combat
that trouble, as it now makes its emergence. … we shall perhaps find that by taking the
patient back by means of a mental artifice to the very moment at which the symptoms
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first appeared, we may make him more susceptible to a therapeutic suggestion” (Breuer
The technique as described was called by Breuer abreaction and applied in his
treatment of Anna O.; later Freud renamed it the cathartic method. Thus Breuer, noting
the influence of “Binet and two Janets [Perre and Jules],” feels “obliged to speak of
abnormal states of consciousness in which these pathogenic ideas arise, and to emphasize
the fact (my italics) that the recollection of the operative psychical trauma is not to be
found in the patient’s normal memory but in his memory when he is hypnotized,” that the
form of ‘double conscience’ [the French term] (italics in the original)” (Breuer & Freud,
1895 [1893], p. 12), which includes normal state of consciousness, the so-called
condition prime (first consciousness) and the condition seconde (the second, or secondary
state, i.e., the hypnotic state of consciousness). What is essential to realize is that
unconscious dynamics was not merely a theory, it was a phenomenon, endowed with the
highest degree of psychic reality, in spite of the false allegation of the current crop of
Freud detractors, e.g., Adolf Grünbaum in the USA and Australia’s own Malcolm
Macmillan.
the person behind which lies the expanded, unconscious, second layer, or the
unconscious, latent content. It takes the special condition of hypnosis, of the widening of
consciousness, to bring the latent content into the sphere of awareness. That is why I
italicized the word fact in the quote above: unconscious mental processes are not just a
hypothesis, a theory, they are a factual reality, hidden for the time being but potentially
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discoverable when certain preconditions are met. Thus, in Anna O., “throughout the
entire illness her two states of consciousness persisted side by side: the primary one in
which she was quite normal psychically, and the secondary one which may well be
acting as a stimulus ‘in the unconscious.’ … It is hard to avoid expressing the situation by
saying that the patient was split into two personalities of which one was mentally normal
But here comes the surprising discovery: those situations of the condition
same time the occasions of cause of the pathological formations as well as occasions of
cure of those formations: “the ideational complexes which were produced during her
absences or condition seconde [were in] fact … disposed of by being given verbal
expression during hypnosis,” for “every one of the spontaneous products of her
imagination and every event which had been assimilated by the pathological part of her
mind persisted as a psychical stimulus until it had been narrated in her hypnosis, after
The equation of the symptoms and the dream discovered by Breuer, Freud’s
common models, one simple the other complex. [diagram omitted] The simple model can
be expressed graphically by two lines running parallel, the upper is the level of
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consciousness and apparent manifestations, the lower is the level of unconsciousness and
the hidden manifestations that are the cause [my italics] of the conscious manifestations.
relationship of cause and effect and … there is a therapeutic relationship. The S[ymptom]
bringing it into awareness and abreacting it. The clinical interpretation, the scientific
understanding and the therapeutic removal thus almost coincide. This is a development of
what Janet and Breuer have found. Freud’s innovation was his dynamic concept of the
and held in the unconscious by means of an active force called repression [italics in the
original]. … The same model applies to the psychology of dreams, with the difference
that instead of symptom S we have the manifest content, instead of trauma T we have the
latent content, and between them the forces of repression are called censor and result in
the mechanism of displacement and condensation” (pp. 497—498). It was Dalbiez who
profoundly understood that symptoms and dreams are in that both showing a two-tiered
causal and reciprocal semiotic relationship. This reality makes the Freudian method of
interpretation unique and different from any other hermeneutic approach: Traumdeutung,
dream interpretation, is the reverse of Traumbildung, the way the dream is unconsciously
condensation, the latter equally at work in the construction of poetic tropes. But whereas
hermeneutic of tropes relies on reading the shared symbols embedded in the structure of a
shared language, dream and symptom interpretation are individual and require the causal
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psychoanalytic method of free association in order to arrive at the personal-historical
method on it as well (Balter, Lothane, & Spencer; Lothane, 1981, 1984, 1994a, 1997). I
have also applied this methodological approach to what still remains incomplete in
Freud’s opus: the dynamics of love (1982, 1987a, 1987b, 1987c, 1989, 1998b, 1998f)
and of the ethics of love (Lothane, 1987, 1998a, 1998b, 1998d, 1999).
and commonsensical. It is sad but true that both Freud believers and Freud bashers have
not pursued this path: both became ensnared in putting theory above method. The most
remarkable instance of a collision course between apostles and apostates occurred in the
fateful feud between notorious Freud detractor Jeffrey Masson (1984) and the late Freud
defender Kurt Eissler concerning Freud’s alleged abandonment of the seduction theory
(Malcolm, 1984): I argued against both and showed that Freud never did such a thing
The problem started with Freud himself: he did not often speak of method but was
not entirely silent about it either. In 1903 Freud composed a brief article, “Die Freud’sche
one better and rendered: “Freud’s psychoanalytic procedure,” not incorrect, since both
method and procedure refer to doing rather than theorizing, but imprecise. Freud did not
say Verfahren, or Prozedur: Why not stick to Freud’s own term, “method”? This
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translation reflects Strachey’s disregard of method and in keeping with his life-long
ambition to make Freud “scientific” (Lothane, 1996a, b, 1998c, 1998d). The latter
ambition is deployed with a vengeance by the current crop of Freud bashers, such as
Grünbaum (Lothane, 1998e), Macmillan (Lothane, 1994b), and Storr (Lothane, 1998g).
These critics variously attacked the man Freud and his method and theories without
realizing the difference between method and theory and between arguments ad rem and
Farrell (1996) who scaled new heights of ad hominem bashing by “diagnosing” Freud as
clinically paranoid! Had these authors studied Ellenberger diligently and taken him to
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