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After Freud Left
A Century of Psychoanalysis in America
The University of Chicago Press
Copyright © 2012 The University of Chicago
All right reserved.
ISBN: 978-0-226-08137-3
Chapter One
Psychotherapy, 1909: Notes on a Vintage SONU SHAMDASANI
The year is 1909. Henry Ford commences manufacturing the Model T. Marinetti publishes the Futurist Manifesto, and Sergei Diaghilev's Ballets Russes took the stage by storm in Paris. In Rome, Joan of Arc was beatified, and the city of Tel Aviv was founded. Henry James's Italian Hours appeared, alongside Gertrude Stein's Three Lives. The Nobel Prize for literature was awarded to the now long-forgotten Selma Lagerlöf (the first woman to have won it). Notable births include Isaiah Berlin, Benny Goodman, and Lester Young, and in psychotherapy, Rollo May and Jerome Frank.
In the psychotherapeutic world, iconic significance is attached to Freud's 1909 visit to America. But did this have anywhere near the importance subsequently attributed to it? The subsequent rise of psychoanalysis and the psychoanalytic rewriting of history had the effect of obliterating much of the landscape of the world of psychotherapy and dynamic psychiatry that Freud encountered. Before one can assess the effects of Freud's trip, then, one needs to salvage and repopulate this landscape. In the following pages, I plan to give a panning shot of the state of psychotherapy and dynamic psychiatry in 1909, restricting myself to publications and events in 1909 itself, as a synchronic view may highlight features that tend to be obscured by the more usual diachronic perspectives. As the topic of this book is "After Freud Left," my contribution will depict the scene "Before Freud Came."
In the psychological world, the major conference in 1909 was undoubtedly the Sixth International Congress of Experimental Psychology in Geneva, held under the presidency of Théodore Flournoy. The list of participants reads like a virtual who's who of psychologists in 1909: James Mark Baldwin, Edouard Claparède, Paul Dubois, Joseph Grasset, Harald Hoffding, Ernest Jones, C. G. Jung, Oswald Külpe, James Leuba, William McDougall, Alphonse Maeder, Morton Prince, Théodule Ribot, Charles Richet, Sante de Sanctis, Albert von Schrenk-Notzing, Charles Spearman, Robert Yerkes, Theodore Ziehen, and so on.
Congress-goers under the presidency of Théodore Flournoy were invited to promenade around Lake Geneva and had an official dinner offered by the state and town of Geneva. For someone deciding their 1909 schedule of which congresses to attend, this would likely to be top of the list. It was also covered in the New York Times—the only congress of psychology covered in the paper that year. On 6 August, the New York Times ran a piece on the next conference: "The Psychological Congress today accepted by acclamation the American invitation to hold its next congress, which will occur in 1913, at Boston." William James was designated as honorary president. This congress never took place. The New York Times also covered the debates at Geneva: "August 14. Scientists returning from the Congress of Psychology at Geneva report a remarkable debate over the question whether animals, including man, move and act of their own volition or from purely mechanico-chemical impulses."
At the congress, themes were chosen for discussion with two reporters designated for each one. These papers were pre-circulated several months before. I focus on one session that has the most direct bearing on psychotherapy, namely, that on the subconscious. This featured papers by Max Dessoir, Pierre Janet, and Morton Prince. Max Dessoir, a neo-Kantian professor of psychology in Berlin, began his paper on the "underconscious," which was basically a restatement of his work in the 1880s and 1890s on the double "I," by indicating how subsequent research had confirmed his earlier investigations.
Pierre Janet has to be considered the most significant figure in psychotherapy in 1909. In 1909, Janet held a prestigious chair of experimental and comparative psychology at the Collège de France. He did not actually attend the conference, as he had to pull out at the last moment, but his paper was pre-circulated and read for him. He began by describing how the old and sterile discussions of the unconscious in the history of philosophy and psychology had been displaced by his own work on the subconscious in the 1880s at Le Havre and then at the Salpêtrière. According to Janet, this meant that the problem of the subconscious was now based on clinical investigations of certain mental troubles, signaling a complete break with the older philosophical notions. He noted that he himself had always used the term "subconscious" in a restricted sense. Others, by contrast, had used the term infinitely more widely, which had simply resulted in a pseudoscience. The main clinical issue that he discussed here was the relation of the subconscious of the hysteric and the depersonalization of the psychasthenic. He concluded by noting that the question of the subconscious was born in the psychiatric clinic, and it was simply not mature enough to leave it.
The other main speaker was Boston psychologist and neurologist Morton Prince. In 1909, he was lecturing in Tufts University and had recently, in 1906, founded the Journal of Abnormal Psychology. Like Janet, Prince also had at this point severe qualms about the use of the subconscious. He began by noting:
It will be agreed that the term subconscious is commonly used in the loosest and most reprehensible way to define facts of a different order, interpretation of facts, and philosophical theories. It is often extended in its scope to cover facts of such diverse character that there is no obvious or substantiated ground for including them in the same class and referring them to the same basic principles. The same is true of the term "The Unconscious" (das Unbewusste) for which "subconscious" is often used as a synonym.
He could not have put it more clearly than that. Prince then differentiated six different prevalent meanings concerning the subconscious: the portion of our consciousness that is outside the focus of consciousness; the psychological interpretation of certain physiological facts; the same phenomena interpreted physiologically; all past conscious experiences; the subconscious self; and the metaphysical doctrine of the subconscious. He tried to instigate some linguistic reformation in terms of what was actually meant under these terms and their compatibilities and incompatibilities. He concluded: "I would suggest that it would be worthwhile for this Congress to recommend a terminology to be adopted by future writers to avoid the confusion which now arises from the various meanings attached to the terms conscious, subconscious, unconscious, etc." His recommendation, of course, never prevailed.
In the Journal of Abnormal Psychology, Prince published several chapters of a work in progress on the unconscious, and I shall just refer to those chapters published that year. These concerned experimental and other evidence of conservation of experiences that could not be recalled and the influence of the unconscious on the psychophysical organism. Here, Prince returned to what one could regard as the staple of experimental psychology of the subconscious of the 1880s and 1890s, namely, automatic writing and crystal gazing. He also noted some more recent investigations: "Jung and the Zurich School have, as a result of extensive studies, adduced evidence to show that the delusions, hallucinations, and other symptomatic phenomena of dementia praecox can be traced to past experiences, to complexes formed in the unconscious of which they are the expression."
While signaling his approval of the term "complex" in the general sense, he raised severe misgivings concerning the direction of the new Freudian studies:
The fundamental basis of Freud's theories is the functioning of unconscious complexes without their being awakened in consciousness.... The evidence for the relation between the psychical effects and their supposed unconscious causes, as worked out in individual cases by the author of "Psychopathologie des Alltagslebens," is often fantastical and curious rather than scientific, and therefore far from convincing. The use of these theories by the Zurich investigators too often partakes of these characteristics, which mar their otherwise brilliant work.
So while stating a sort of cautious acceptance of general psychological principles of the complex, Prince indicated his misgivings concerning fantastical interpretations done by Freud and Jung. He concluded by noting that, properly speaking, there is no subconscious, supplemental, or secondary self. These were merely metaphors.
We return to Janet, whose work extended beyond the Geneva congress. In 1909, he published what, by his standards, was a short book, clocking in at 400 pages. This was a résumé of his earlier work on the neuroses, focusing in particular on hysteria and psychasthenia, bringing them into line with his new conceptions of mental functioning. He considered neuropathic symptoms, fixed ideas and obsessions, amnesias, doubts, troubles of language, choreas, tics, paralyses, phobias, troubles of perception, instincts, visceral functions, hysterical attacks, fugues, crises of agitation, depression, and double personality. In fact, all of us would probably find ourselves in there in some place. This work was nothing less than a general textbook of the neuroses. And he ended with offering, seemingly the first time for Janet, a general definition of the neuroses:
The neuroses are maladies bearing on diverse functions of the organism, characterized by an alteration of the superior parts of these functions, stopped in their evolution, in their adaptation to the present moment, to the present state of the external world and of the individual and by the absence of the deterioration of the already ancient part of these same functions which could very well exert themselves in an abstract manner, independently of present circumstances. In résumé, the neuroses are troubles of diverse functions of the organism, characterized by the stoppage of development without deterioration of the function itself.
It is evident from this that Janet's nuanced style is something that simply was not going to make much headway in the following decades, which were characterized by the rise of behaviorism. He added that psychological analysis was the point of departure for methods of psychotherapy, which were the only means applicable for the treatment of the neuroses, on which he hoped to concentrate his next volume. The volume in question was nothing less than his master work, Psychological Medications, which took a decade to appear. Thus Janet was providing his definition of what the neuroses were and indicating that, in his following work, he intended to show how they should be treated.
The major book on psychotherapy that appeared in 1909 was published by Hugo Münsterberg, then professor of psychology at Harvard. This was another 400-page work—possibly the longest book with the title Psychotherapy in the English language up to this point. It met with a rave review in the New York Times, entitled "Psychotherapy under analysis: Hugo Munsterberg writes a highly important and illuminating book, dealing with the new psychology." Münsterberg, who was also an M.D., practiced hypnotism for therapeutic purposes for no charge and limited his therapeutic work according to his scientific interests. He began by noting that psychotherapy needed to be sharply distinguished from psychiatry, the treatment of mental diseases, because psychotherapy could also be applied to physical conditions. What was common to all forms of psychotherapy was the method, which he succinctly put as follows: "The psychotherapist must always somehow set levers of the mind in motion." Münsterberg noted that at the current time, there were two predominant schools of psychotherapy: "The one school nowadays lives from the contrast between consciousness and subconsciousness and makes all psychotherapy work with and through and in the subconscious. The other school creates a complete antithesis between mind and body and makes psychotherapy a kind of triumph of the mind over the body." An example of the first would be Pierre Janet, and of the second, Paul Dubois, of whom more anon.
Münsterberg claimed that that both schools were fundamentally wrong. As to the former, he noted: "The fantastic position allowed to a subconscious mind easily gives to the doctrine a religious or even a mystical turn, and the artificial separation between the energies of the mind and those of the body leads easily to a moral sermon." In a lengthy chapter on the subconscious, he began simply by noting: "The story of the subconscious mind can be told in three words: There is none." Slightly less succinctly he continued: "The subconscious mental facts are either not mental but physiological, or mental but not subconscious." He indicated he had already spent several chapters discussing suggestion and hypnotism without any reference to the unconscious. Suggestion and hypnotism played a large role in psychotherapy, as did persuasion, but he argued that there was no strict division between organic and functional diseases. There was much to be said for recovering reservoirs of unused energy, a conception stemming from William James in The Energies of Men, something we shall take up shortly. He also made passing reference to Freud: "Interest in suggestion does not represent today a last step of psychotherapy. The latest movement, which is entirely in its beginning, the development of which no one can foresee, but which promises wide perspectives, is connected with the name of Freud in Vienna." What was novel about this, he noted, was that for the first time there was in sight a psychotherapy that not only aims to remove symptoms but the disease itself. Given his caustic criticisms of almost any other form of psychotherapy, these endorsements stand out in this book. Münsterberg's general conclusion was that the time had come when every physician should study psychology. Scientific psychology had to furnish the basis for full understanding of psychotherapy. Psychology should be on the medical curriculum, and there should be institutes of psychotherapy.
This project of developing a general science of psychotherapy was the central endeavor in 1909 for August Forel. The main institutional development in psychotherapy that year was Forel's founding, in Salzburg, Austria, of the International Society for Medical Psychology and Psychotherapy. In his memoirs, he recalled:
That such a society was necessary was shown by the fact that Professors Dubois and Monakow had founded a Neurological Society which was quite a superfluous rival of our Swiss Alienists' Society. Dubois, who knew nothing about hypnotism, spoke of it with disdain, although he himself unconsciously suggested his patients by a so-called "persuasion"! By the confused conceptions of this gentleman a fatal and artificial divorce would have been effected between the actually identical departments of psychiatry and neurology.
In Forel's view, it would be a complete disaster to separate psychiatry and neurology. In August, he sent circulars off to the principal representatives of European psychotherapy, including Freud and Jung, asking them to join. Forel felt that the lack of coordination between different orientations in psychotherapy was a critical problem. He wanted to create order in this "Tower of Babel" by facilitating scientific exchanges and establishing "a clear international terminology, capable of being accepted in a general manner by different people"—in other words, to form one general science of psychotherapy. In his official announcement of its foundation, he stated the following:
[Psychotherapy] thus comprises, above all, therapeutic suggestion, psychoanalysis and analogous methods, based directly on a well understood psychology. ... But scorned and neglected in general by the faculties of medicine, psychology and psychiatry have been studied above all by autodidacts who have formed special or local schools, such as at Paris, Nancy, Vienna, etc., schools which have each developed according to their special ideas, without contact with the others, without in-depth scientific discussions, without agreement on terms.
(Continues...)
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