Sigmund Freud (1856-1939), the founder of psychoanalysis, was born in Freiberg, Moravia, today in the Czech Republic. His father Jakob, 40, and his mother Amalia, 21, were from families of tradesmen in the Jewish villages (shtetls) of the Austro-Hungarian Empire. Jakob was twice a widower with two grown sons. The family moved to a poor, predominantly Jewish neighborhood in Vienna when Freud was a child. He completed his medical studies at the University of Vienna at the age of twenty-five, specializing in zoology, neurology, and physiology. Initially intent on a career in research, he turned to a training in medicine and soon took an interest in what were called “nervous illnesses.” In the course of research on the physical and psychological effects of cocaine he became a regular user in the late 1880s and early 1890s. At the encouragement of his mentor and collaborator Josef Breuer, Freud went to Paris in 1895 to study with Jean-Martin Charcot, the French psychiatrist who used hypnosis to demonstrate, often in theatrical public displays, that young women suffering from such debilitating symptoms as convulsions, tics, and partial paralysis were not afflicted with damaged uteruses as accepted opinion held, let alone by demonic possession as had been believed for centuries. Charcot identified the symptoms’ source in mental trauma and attributed hysteria to men as well as women.

If such physical suffering had a psychological origin, then these disorders of the soul were neither signs of moral defect as religion proclaimed nor mere effects of physiological or hereditary causes as contemporary psychiatry supposed. Freud sought some new path to explore this “psychosomatic” hinge, some new method to ply between body and mind, neurology and psychology. As he began his medical practice treating patients who suffered from a diffuse array of fatigue, unease, loss of appetite, or irritability (“neurathesia”) or more acute outbreaks of hysteria, he drew on two guiding assumptions from Breuer and Charcot: a trauma must lie at the source and the recollection of the traumatic event through hypnosis would lead to a cathartic elimination of the symptom (“Heredity and the Neuroses,” S.E. 3:141-56). If these two postulates were borne out, then the curative moment would occur by bringing the trauma to consciousness. Breuer’s treatment of Anna O., eventually identified as Bertha Pappenheim, confirmed the power of recollection but also discovered an alternative to hypnosis, since the breakthrough occurred when she recalled the trauma in the course of her conversations with Breuer without being hypnotized. Anna O. dubbed the experience the “talking cure,” and Freud called the new method “psycho-analysis” (S.E. 3:152). So began the first form of talk therapy.

During the highly experimental first decade of his practice, Freud mixed hypnosis and talk therapy and often treated friends and relatives. He and Breuer drew their patients from their own mainly Jewish and bourgeois milieu, the lifeworld which emerged into secular urban life from the traditional patriarchal world of Orthodox Judaism (Roudinesco, 64-95; Schorske, 181-207). Trauma, recollection, and catharsis were the undisputed elements to be unified in theory and practice. The role of recollection posed a new question as well: how to understand the mind’s ability to retain psychologically formative events without remembering them?

Freud’s experience in treating thirteen or so female patients in the 1890s prompted his first major linkage of therapeutic practice and psychological theory. Vignettes of some of those cases were part of his contribution to Studies on Hysteria (1893-1895), co-authored with Breuer. Freud determined that the source of each of his patient’s hysterical symptoms was an early sexual excitation, typically the result of interactions initiated by a playmate or sibling; the forgotten childhood episode became symptom-forming when an experience of sexual abuse as an adolescent or young woman gave belated meaning to the early experience. First “an element of consciousness was created which was excluded from the thought-activity of the ego and remained, as it were, in storage,” while in the later experience “a new impression forcibly brought about an associative connection between this group and the ego” (S.E. 2:133). The “associative connection” did not manifest itself in remembering but rather in the formation of the psychosomatic symptoms. It was the task of therapy—be it by hypnosis, talk, or suggestion—to induce the patient’s recollection. In two papers published in 1896, “Heredity and the Aetiology of the Neuroses” (S.E. 3:141-56) and “Further Remarks on the Neuro-Psychoses of Defence” (S.E. 3:157-85), Freud claimed that the sexual violation in adolescence in each of the cases he treated was perpetrated by the patient’s father, and that when the therapy brought that to light along with the earlier experience the patients’ symptoms were relieved.

The two essays were largely rejected by other specialists, and within several months Freud himself privately rebutted his own claims. None of the therapies had truly reached a conclusive resolution; patients improved but no one was cured as the catharsis theory required. Moreover, it had become ever less credible that every hysterical patient had been sexually abused by her father, despite clear evidence in some cases. The ill-named “seduction theory” did not hold up. Freud did not believe his patients had lied, nor could he accept that his often persistent suggestions led them to a false conviction about abuse. His new hypothesis was that the memories of seduction were in fact fantasies. The “psychical reality” of fantasy, as he explained later, was as important in forming symptoms as the “material reality” of actual events (“An Autobiographical Study,” S.E. 20:34). He did not admit his original error for several years, in part because sexual abuse did play a part in some of his patients’ lives. He also, however, now lacked an efficacious therapeutic technique and an adequate theory to go with it. He nonetheless held to his belief, contrary to Breuer, that sexuality was at the base of neurosis, but the connection of fantasy, sexuality, and neurosis was by no means clear.

The mistaken theory about the etiology of hysteria in women would eventually be replaced by a theory of the psychosexual development of male heterosexuality. The path from seduction theory to Oedipus complex was circuitous, rich in implications, and faulty. Freud’s later retrospective accounts of the history of psychoanalysis present the new theory seamlessly following from its forerunner and correcting its errors. In fact, though, the discontinuities and leaps in his thinking between 1896 and 1910 are more intriguing, and revealing, than any narrative of implacable progress.

In keeping with the mix of clinical experiment and self-experimentation that underlay all his thinking, Freud intensified his “self-analysis” in the wake of his doubts about the seduction theory. The first fruit of this undertaking became his most enduring and influential work, The Interpretation of Dreams (1900). There soon followed The Psychopathology of Everyday Life (1901) and Jokes and Their Relation to the Unconscious (1905). The trilogy investigates what Freud had previously described as those “element[s] of consciousness” that are “excluded from the thought-activity of the ego and remain, as it were, in storage” (S.E. 2:133). He now gave a stronger and more precise meaning to “unconscious”; namely, it is a thought, wish, or memory that has been repressed. Via dreams, slips of the tongue, mistaken acts and missteps, or jokes, the repressed element emerges into consciousness in a disguised form. It becomes conscious on the condition that it is not recognized as what it is. More revealing than hypnosis or narcotics, dreams were the “royal road to the unconscious.” Freud’s innovation was to see that the difference between the dream’s “manifest content” and “latent content,” between its enigmatic appearance and unconscious thoughts, is the mark of repression. An act of interpretation is required to penetrate the misrecognition and disclose the repressed content.…

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