Towards the end of 1892, ‘Miss Lucy R’, a pale and delicate English governess living in Vienna, made her way to the surgery of a young neurologist on Berggasse 19 for the treatment of a ‘suppurative rhinitis’. Miss Lucy was tired, in low spirits and complained of ‘a muzzy head’. And though she had lost her sense of smell, she was endlessly tormented by the smell of burnt pudding.
Sigmund Freud was 36 years old when he began attending to Miss Lucy. Trained at the Salpêtrière Hospital in Paris by the great neurologist Jean-Martin Charcot, Freud had already published monographs on hypnosis, epilepsy, and cocaine, which he continued to self-administer for ‘vitality and capacity for work’. Now he was applying his able and imaginative mind to the mystery of hysteria – whose bewildering array of symptoms were still considered hereditary ‘stigmata’. Upon examining the 30-year-old governess, he found her physically healthy, save for her nose’s insensitivity to touch. What struck him most about this case was the recurrent smell of burnt pudding.
Freud rejected the possibility of an organic explanation, even though acrid or burning smells are commonly associated with migraines, epilepsy and sinus infections. Instead, he deduced that Miss Lucy’s hallucination was a ‘memory-symbol’, a psychic trace standing in for a forgotten or repressed trauma, possibly related to sexual seduction or abuse. ‘What I suspect,’ he told her bluntly, ‘is that you are in love with your master, the director, perhaps without being aware of it yourself, and that secretly you are nursing the hope that you really will take the place of the mother.’
Studies on Hysteria (1895), co-authored with his physician friend and mentor Josef Breuer, would prove to be Freud’s breakthrough work. The book, based on Miss Lucy and four other cases, led him to two important insights. First, the physical symptoms of hysteria were caused when intolerable ‘ideas’ were evicted from the conscious mind. Second, the most effective antidote to hysteria’s psychic befuddlement, the best way of returning the patient to ‘ordinary unhappiness’, was what Breuer’s patient Anna O dubbed ‘the talking cure’. Forget the hypnotic overtures that Freud had been dabbling with since his time with Charcot at La Salpêtrière – from now on, free association coupled with attentive listening would be the proprietary salve of psychoanalysis.
Freud’s early writings on hysteria garnered little fanfare from his clinical peers. On reading Studies, Richard von Krafft-Ebing, the chair of psychiatry at the University of Vienna, dismissed the so-called theory of hysteria, including Freud’s contention that symptoms often came from childhood molestation or abuse, as ‘a scientific fairy tale’. Similar misgivings were voiced by laboratory psychologists working to place their discipline on empirical foundations. To use a sobriquet coined by the combative psychologist Edward Scripture, founder of the Yale Experimental Psychology Laboratory, Freud was an ‘armchair psychologist’, and his serial ruminations on ‘the unconscious’ – on dreams, on infantile sexuality, on jokes and parapraxes – reflected an equally unscientific ambition: that psychoanalysis would evolve as ‘a profession of lay curers of souls who need not be doctors and should not be priests’.
Four decades after treating Miss Lucy, Freud had permeated Western thought. He’d built a therapeutic empire by identifying the id, ego and superego as the forces of a ‘power struggle’ between instinct and morality ‘going on deep within us’. Yet as Freud’s cultural stock rose, his writings remained testament to an elective blindness, showing imperial disregard for most of his philosophical precursors and peers. In all his major publications on the unconscious, from Studies through to Civilization and its Discontents (1930), Freud barely acknowledged the pioneering Pierre Janet, the French psychiatrist well-known for his theory that traumas caused personality to dissociate into conscious and unconscious parts.
There was no mention of Friedrich Nietzsche, who held that the unconscious mind yielded the deepest truths, or of Arthur Schopenhauer, who identified will itself as unconscious. Freud all but ignored the experimental work on unconscious inference that Hermann von Helmholtz had undertaken since the 1840s. And he showed curmudgeonly disdain for the rival theories of his one-time acolytes and ultimate critics Alfred Adler (who put stock in feelings of inferiority) and Carl Jung (a proponent of archetypes inhabiting the unconscious).
In fact, despite Freud’s renown, several approaches to the unconscious had already been established before the advent of psychoanalysis. According to the Canadian psychiatrist and historian Henri Ellenberger, Freud & Co were merely the latest representatives of the ‘mythopoetic’, who sought reality in dreams and fantasies. Earlier theorists had regarded the unconscious as a secret recorder of impressions and sensations that lay beyond the narrow beam of consciousness, an incubator for creative, innovative and inspirational insights, and a gateway to the secondary or submerged personalities linked to somnambulism, hypnotism, hysteria and fugue states.
Other investigators grounded their work in mechanistic physiology, using the language of neurons and cortical excitation. By the mid-19th century, these researchers had much to say about the ‘latent’ and ‘automatic’ nature of acquired habits and actions, sparking a long-running debate on the whys and wherefores of ‘unconscious cerebration’. In The Physiology of Common Life (1860), the English philosopher George H Lewes observed:
In learning to speak a new language, to play on a musical instrument, or to perform unaccustomed movements, great difficulty is felt, because the channels through which each sensation has to pass have not become established; but no sooner has frequent repetition cut a pathway, than this difficulty vanishes; the actions become so automatic that they can be performed while the mind is otherwise engaged.