Freud’s Clay Feet

The New York Review of Books - - News - Lisa Ap­pig­nanesi


The Mak­ing of an Il­lu­sion by Fred­er­ick Crews. Met­ro­pol­i­tan, 746 pp., $40.00

Fred­er­ick Crews has a loy­alty of pre­oc­cu­pa­tion rare in a lit­er­ary aca­demic. His at­tacks on Sig­mund Freud be­gan way back in the mid-1970s with his pub­licly pro­claimed con­ver­sion away from the Freudian lit­er­ary crit­i­cism he prac­ticed at the time. Since then his as­sault has drawn sus­te­nance from a va­ri­ety of re­vi­sion­ist Freud sleuths and schol­ars. High among the sleuths is the tire­less Peter Swales, a one­time as­sis­tant to the Rolling Stones and a fol­lower of the cultish G.I. Gur­d­ji­eff, who grew in­ter­ested in Freud be­cause of his co­caine use and sniffed out all man­ner of facts about the orig­i­nals of his cases and his sup­posed af­fair with his sis­ter-in-law. The schol­ars in­clude more aca­demic thinkers whose con­clu­sions about Freud don’t al­ways agree with Crews’s, what­ever their ar­gu­ments with Freud’s prac­tice or writ­ings. Like Karl Pop­per or Adolf Grün­baum, they may also ques­tion Freud’s sta­tus as a sci­en­tist—whether he was one at all, or whether his claims are suf­fi­ciently sup­ported by em­pir­i­cal ev­i­dence.

Crews’s 746-page biography, Freud: The Mak­ing of an Il­lu­sion, damn­ing and mes­mer­iz­ing by turns, is about the young Freud and reaches The In­ter­pre­ta­tion of Dreams only on page 543, al­low­ing just a few brief glimpses into the sec­ond part of his life. It marks the zenith of what has be­come Crews’s cru­sade “to put an end to the myth of psy­cho­anal­y­sis and its cre­ator” by strip­ping Freud of both his em­piri­cist cre­den­tials and the im­age of a “lone ex­plorer pos­sess­ing coura­geous per­se­ver­ance, de­duc­tive bril­liance, tragic in­sight, and heal­ing power,” a se­ries of at­tributes Crews finds in Freud’s own self-por­trayal and in Ernest Jones’s land­mark biography (1953–1957).

The ide­al­iza­tion of Freud the man that Crews is so keen to prove a blind­ing il­lu­sion is hardly preva­lent. Most schol­ars, com­men­ta­tors, and even an­a­lysts don’t need it to make use of Freud’s in­sights into the opac­ity and un­pre­dictabil­ity of the hu­man mind, or the ways in which love and hate co­ex­ist, or how our child­hoods echo through us, some­times trap­ping us, or how our iden­ti­fi­ca­tions with early fig­ures in our lives shape the com­pli­cated hu­mans we be­come. Or per­haps most im­por­tant, how much we share with those whom we ca­su­ally la­bel with the many di­ag­noses in the Di­ag­nos­tic and Sta­tis­ti­cal Man­ual of Men­tal Dis­or­ders (DSM). Jones him­self, by the time he wrote his biography of Freud, had shifted his the­o­ret­i­cal al­le­giances to Me­lanie Klein, the Hun­gar­ian an­a­lyst who so in­flu­enced the Bri­tish Py­cho­an­a­lytic So­ci­ety. In­deed, the Freud il­lu­sion was only preva­lent in the United States from the 1950s un­til about 1968. At that time, Freud was taken up first by lib­eral then by rad­i­cal in­tel­lec­tu­als like Her­bert Mar­cuse; and Freudian ther­apy, in an Amer­i­can trans­la­tion, formed part of psy­chi­atric train­ing. Freud, who had died in 1939, be­came an of­ten comic know-it-all fig­ure in pop­u­lar cul­ture. Iron­i­cally, de­spite this “fame,” in 1956, the year of his cen­te­nary, there were only 942 card-car­ry­ing psy­cho­an­a­lysts in the coun­try.

It is the at­ten­tion Freud re­ceives that most ir­ri­tates Crews. His open­ing line head­ily claims: “Among his­tor­i­cal fig­ures, Sig­mund Freud ranks with Shake­speare and Je­sus of Nazareth for the amount of at­ten­tion be­stowed upon him by schol­ars and com­men­ta­tors.” Surely not. And surely not even in Amer­ica, where Je­sus—with his clergy and priests, many of whom count as schol­ars and com­men­ta­tors, not to men­tion his count­less churches, fol­low­ers, web­sites—still gets more at­ten­tion than the author of The In­ter­pre­ta­tion of Dreams and Civ­i­liza­tion and its Dis­con­tents. But Crews is on the march against the man who pur­port­edly had a “crav­ing to pull down the tem­ple of Pauline law.” Per­haps Pope Pius XII hadn’t no­ticed this when in 1953 he for­mally ap­proved “the use of psy­cho­anal­y­sis as a heal­ing de­vice,” in­di­cat­ing that “sci­ence af­firms that re­cent ob­ser­va­tions have brought to light the hid­den lay­ers of the psy­chic struc­ture of man.”1 Pope Fran­cis him­self re­cently re­vealed that he had had psy­cho­anal­y­sis at the age of forty-two. He called his an­a­lyst a coura­geous woman.

Crews’s sub­ti­tle echoes Freud’s The Fu­ture of an Il­lu­sion (1927), in which Freud ar­gues that our re­li­gious be­liefs are “ful­fil­ments of the old­est, strong­est, and most ur­gent wishes of mankind.” Crews doesn’t ex­plore—as Ernest Gell­ner did in The Psy­cho­an­a­lytic Move­ment (1985)—how the growth of psy­cho­anal­y­sis may be un­der­stood as akin to the de­vel­op­ment of a re­li­gious move­ment, or how its claims, while pre­tend­ing to be sci­en­tific, are ac­tu­ally those of a be­lief sys­tem in dis­guise. His main thrust is al­ways ad hominem. Crews is con­vinced that if Freud is shown to be a case-fak­ing scoundrel more in­ter­ested in money than pa­tients, then ev­ery­thing he has writ­ten about re­pressed mem­o­ries, sex­u­al­ity and de­sire, fan­tasy and the Oedi­pal ro­mance of the fam­ily, dreams, slips, and the ev­ery­day work­ings of the hu­man mind will be seen to be only the seedy fic­tions of a de­mented, hyp­no­tiz­ing Cali­gari, af­ter whose cab­i­net Crews sug­ges­tively names one of his chap­ters. In Crews’s view Freud was a man who set out to “achieve fame at any cost” and who sac­ri­ficed “his in­tegrity as both a sci­en­tist and a physi­cian” to that end. Hav­ing in­vented a sci­ence with no em­pir­i­cal base, only fab­ri­ca­tion, Freud, with his in­abil­ity to “forgo his lux­u­ries,” his “com­mer­cial men­tal­ity,” and his aim “to pro­tect and pro­mote his brand,” was able to per­pe­trate a gi­gan­tic hoax on the twen­ti­eth cen­tury.

The rhetor­i­cal strat­egy at work here is that of a tal­ented pros­e­cu­tor. It traps the reader. Ei­ther you buy into the facts Crews fore­grounds and rel­ish the mount­ing glee of his at­tack or you’re pro­pelled into an iden­ti­fi­ca­tion with the ac­cused and ever strug­gling for breath, wish­ing that a de­fense at­tor­ney were in sight. It also makes you won­der why on June 23, 1938, a bare two weeks af­ter Freud, flee­ing Nazi per­se­cu­tion, landed in Eng­land with his im­me­di­ate fam­ily, he re­ceived a visit from rep­re­sen­ta­tives of the Royal So­ci­ety, the world’s old­est sci­en­tific es­tab­lish­ment. Founded in 1660, in­spired by Fran­cis Ba­con, and in­clud­ing among its em­i­nent fel­lows Isaac New­ton and Charles Dar­win, it had elected Freud to be one of its own. Why had this elite sci­en­tific body de­cided to name Freud to its ranks? The ci­ta­tion cer­tifi­cate reads “for pi­o­neer­ing work in psy­cho­anal­y­sis.” The everdis­pu­ta­tious fel­lows, with their long view of his­tory, knew that sci­ence is not a nar­row do­main whose res­i­dents, like ad­her­ents of a strict re­li­gion, fol­low one rigid set of eter­nal rules, but rather a ca­pa­cious and di­verse man­sion where ob­ser­va­tion of not only the an­i­mal but also the hu­man world could count as sci­ence, where doubters could live side by side and en­gage in heated ar­gu­ment. They also, in their wis­dom, rec­og­nized that sci­en­tists are not uni­formly con­sis­tent ei­ther in their ideas or in their lives. Nor is it al­ways clear how one shapes the other. New­ton, who had for­mu­lated the laws of mo­tion and univer­sal grav­i­ta­tion, was also a mys­tic with be­liefs strange even for his time, and be­haved fraud­u­lently in a dis­pute with Leib­niz. Crews, by con­trast, seems to ide­al­ize sci­ence and even to de­his­tori­cize it, for­get­ting that at the time Freud be­gan his prac­tice, dan­ger­ous patent medicines were touted by many doc­tors in the US; clin­i­cal tri­als of drugs were not in­sti­tuted un­til 1947.

Crews is only in­ter­ested in Freud’s spec­u­la­tions and ob­ser­va­tions when they re­late to hys­te­ria and his ear­li­est cases, or to his ri­val­ries, claims to pri­or­ity, and “lazy re­luc­tance to col­lect suf­fi­cient ev­i­dence.” He por­trays Freud as “aroused” by “envy” of the well­con­nected young French psy­chol­o­gist Pierre Janet, and claims that Freud sim­ply bor­rowed Janet’s con­cep­tions of the un­con­scious and symp­tom for­ma­tion. But the Stan­dard Edi­tion of Freud’s writ­ings has sixty ref­er­ences to Janet and his ideas, trac­ing a sus­tained ar­gu­ment with him be­tween 1888 and 1925. Freud may want to win the de­bate, but there is noth­ing to in­di­cate that he thought his own ideas came to him ex ni­hilo—as his own notes and count­less ref­er­ences to lit­er­a­ture an­cient and mod­ern sug­gest.

Crews brings a great many, if highly se­lec­tive, facts to his case. His early Freud is not only a sloppy neu­rol­o­gist but a de­luded co­caine ad­dict, a be­trayer of friends, ho­mo­erotic in his de­sires (though he may have com­mit­ted adul­tery with his sis­ter-in-law), and a doc­tor who had very few pa­tients on whom to base his ever-chang­ing the­o­ries. Those he did have he let down or harmed or falsely sug­gested ail­ments to. His only pa­tient was him­self. When he didn’t steal his ideas from oth­ers, he pro­vided no ver­i­fi­able ev­i­dence for any of his own. He was also neu­rotic, de­pres­sive, and sex-ob­sessed. The rest is all a gi­ant con. The whole ed­i­fice of psy­cho­anal­y­sis, Freud’s in­sights over

many vol­umes, is a sham—as must, by de­duc­tion, be the world­wide in­sti­tu­tion of psy­cho­anal­y­sis from Brazil to China and its off­shoot ther­a­pies.

Many of the ba­sic facts of Crews’s ac­count, as he ad­mits, al­ready ap­peared in Ernest Jones’s chatty but far fuller life of Freud. Jones, de­spite the myth he is pur­ported to have launched, was no ha­giog­ra­pher. He wrote of Freud’s use of the then new drug co­caine, his Vic­to­rian views on women and their psy­chic sat­is­fac­tion in hav­ing chil­dren (even if Freud wel­comed women into the new pro­fes­sion), his changes of mind as his prac­tice pro­gressed, the au­to­bi­o­graph­i­cal con­tent in The In­ter­pre­ta­tion of Dreams, and more.

All this was in the 1950s, when bi­ogra­phies of public fig­ures rarely went into pri­vate mat­ters. When Jones’s biography ap­peared in the US in 1956, Time stated that it came from the “wart­sand-all” school. Crews for­gets the “all” and wants only to pick at the warts, ag­gra­vate them, and find new ones. In the process what emerges is a lurid Freud who is some­thing of a Faus­tian car­toon vil­lain. “By 1895,” Crews writes,

Freud had al­ready awarded him­self a li­cense to invent, sup­press, al­ter, and rear­range facts in the in­ter­est of en­hanced self-por­trai­ture and the­o­ret­i­cal vin­di­ca­tion . . . . The Katha­rina chap­ter [in Stud­ies on Hys­te­ria] puts us on no­tice that its author...would stop at noth­ing in man­u­fac­tur­ing “ev­i­dence” of his imag­i­nary prow­ess.

Though Crews has writ­ten much about the va­garies of mem­ory, for his cur­rent pur­poses it is re­li­able only as long as it con­cerns neg­a­tive mem­o­ries of Freud. Freud’s own mem­o­ries, in Crews’s view, in­evitably lie. In the cli­max to a chap­ter in­tent on un­der­lin­ing Freud’s lack of suc­cess with his early hys­ter­ics, his un­trust­wor­thy and re­pug­nant na­ture, and his be­ing “widely re­garded with sus­pi­cion” by elite Vi­en­nese Jews, Crews quotes Arthur Koestler’s mother speak­ing in 1953 about her ex­pe­ri­ence with Freud sixty-three years ear­lier. Hav­ing been sent to the young neu­rol­o­gist in 1890 at age nine­teen and gone only re­luc­tantly, she re­calls that “he was a dis­gust­ing fel­low,” his in­ter­est in sex was “scan­dalous and out­landish,” and no one in her cir­cle took him se­ri­ously. She sounds just like a teenager to me, though it’s slightly odd, if what she says about the pre­vail­ing view is true, that she was sent to Freud at all.

Such ev­i­dence could of course be used to demon­strate Freud’s sense of him­self as a lone out­sider, but Crews doesn’t want that ei­ther. Freud’s own sev­enty-page Au­to­bi­o­graph­i­cal Study (1925) is used to ques­tion his ve­rac­ity about the dis­ap­point­ment he ex­pe­ri­enced when he first went to the Univer­sity of Vi­enna in 1873 at the age of seven­teen. “Above all,” the sixty-eightyear-old Freud wrote, “I found that I was ex­pected to feel my­self in­fe­rior and an alien be­cause I was a Jew.” Crews is skep­ti­cal:

If Freud had been met with os­tracism on en­ter­ing the univer­sity, he surely would have wanted to end the or­deal as speed­ily as pos­si­ble, but he lin­gered over an eclec­tic pot­pourri of cour­ses. Nor does it ap­pear that he was de­prived of an ac­tive so­cial life.

Since 21 per­cent of the stu­dent body were “al­ready” Jews, though they com­posed 10.1 per­cent of the Vi­en­nese pop­u­la­tion, Crews dis­trusts Freud’s mem­ory, and sees it only as feed­ing his own myth of an “out­cast who had nobly em­braced his fate.”

Of course, there is some­thing of the noble lonely pioneer in Freud’s Au­to­bi­o­graph­i­cal Study. It was part of a se­ries com­mis­sioned by Leipzig pub­lish­ers of brief lives of em­i­nent doc­tors, sev­eral of whom write in the same vein. These are the tropes of the pro­fes­sion. They re­mem­ber the heroic age of medicine: they are Ib­se­nesque en­e­mies of the peo­ple who have had steep paths to climb, strug­gles to es­tab­lish new fields—epi­demi­ol­ogy, public health medicine, new dipthe­ria an­ti­tox­ins, and, yes, psy­cho­anal­y­sis. The ro­man­tic leg­end that Crews at­tacks—and ar­guably it is no more ro­man­tic than the sci­en­tific ro­mance of the care­ful, per­sis­tent siever of years of ac­cu­mu­lated ev­i­dence—is not pe­cu­liar to Freud, even if his may be the one we know best.

But it is Crews’s query­ing of Freud’s feel­ings about anti-Semitism that is it­self ques­tion­able here. Con­trary to what he states, anti-Semitism was in fact preva­lent when Freud en­tered the univer­sity. But no young per­son hun­gry for knowl­edge, as Freud was, and strained in fi­nances would be eas­ily routed by prej­u­dice and leave his stud­ies. Crews is sadly deaf to am­biva­lence, the si­mul­ta­ne­ous wishes to be­long and make a tri­umph of feel­ing your­self apart, in par­tic­u­lar when it comes to Freud.

The vo­lu­mi­nous cor­re­spon­dence be­tween Freud and his fi­ancée, Martha Ber­nays—known as Die Braut­briefe since it cov­ers the pe­riod of their en­gage­ment—has re­cently been made avail­able on the Li­brary of Congress web­site, and also pub­lished in metic­u­lously edited form in Ger­man. Of the five pro­jected vol­umes, three have ap­peared in Ger­man2 and one in English. Though a se­lec­tion of the let­ters had been pub­lished be­fore and Jones had had ac­cess to all of them, the Braut­briefe is one of the new sources Crews brings to his biography.

The let­ters be­gin in June 1882, when Freud is an im­pov­er­ished young re­searcher and end in Septem­ber 1886, af­ter he had re­turned home from his four months of re­search in Paris at the Salpêtrière hos­pi­tal with Jean-Martin Char­cot, the Napoleon of the Neu­roses. They cover the pe­riod when Freud set up in pri­vate prac­tice, along­side his hos­pi­tal work, so that he could earn enough of a liv­ing on which to sup­port a wife and chil­dren, as well as the many other mem­bers of his fam­ily who were de­pen­dent on him. The Braut­briefe, elo­quent on both sides, are used by Crews largely to throw vit­riol at

2Sig­mund Freud and Martha Ber­nays, Die Braut­briefe, edited by Ger­hard Ficht­ner, Ilse Grubrich-Simi­tis, and Al­brecht Hirschmüller in col­lab­o­ra­tion with Wolf­gang Kloft (Frankfurt am Main: Fis­cher, 2011–2015).

Freud. Freud’s con­stant ref­er­ences to money and des­per­ate need for it—ei­ther from new dis­cov­er­ies that would se­cure fu­ture posts or, to­ward the end of the pe­riod when he has de­cided to aban­don re­search, from new pay­ing pa­tients—are never seen as some­thing Martha might ex­pect from a fi­ancé forced to de­lay their mar­riage. In Crews’s view they’re a sig­nal that Freud val­ues wealth above sci­en­tific in­tegrity or his pa­tients.

Crews is taken aback by the daily toll of Freud’s let­ters with their de­tails of “mi­graine headaches, crip­pling de­pres­sion, and out­bursts of fierce anger,” oc­ca­sion­ally against Martha, but mostly against peo­ple who have slighted him. It’s Martha, too, who gets all the ups and downs that ac­com­pany Freud’s co­caine habit dur­ing these years, his lust­ful fan­tasies, and, far more sadly, his con­fessed fail­ure to cure his friend Ernst Fleis­chl von Marxow of mor­phine ad­dic­tion. It’s hard for Crews to imag­ine why Martha Ber­nays—in­tel­li­gent, well read, from a more priv­i­leged back­ground—waited for and de­cided to marry the dis­hon­est, bungling bully Crews por­trays and stay with him through six chil­dren and fifty years. Her de­ci­sion is even more as­ton­ish­ing given Crews’s be­lief in the cir­cum­stan­tial ev­i­dence that pur­port­edly places her sis­ter Minna, who moved in with the Freuds soon af­ter their sixth child ar­rived, squarely in her hus­band’s bed, not only on trav­els, one of which might have ended with an abor­tion, but in a house filled with chil­dren who never no­ticed. No one else ever ac­tu­ally saw the two in bed to­gether ei­ther, nor have any records of an abor­tion been found by as­sid­u­ous in­ves­ti­ga­tors into Freud’s life. The ru­mor of the re­la­tion­ship comes from a ca­sual re­mark that Carl Jung—him­self a serial adul­terer— made in 1957 that Minna had con­fessed the af­fair to him as he was leav­ing the Freud apart­ment in 1907.

Crews’s ful­some con­cen­tra­tion on the de­tails of what he blithely calls “Sig­mund and Minna’s love­fest on the banks of Lake Garda” and the sup­posed sub­se­quent abor­tion is meant to un­der­mine the moral cre­den­tials that have been at­trib­uted to the “leg­endary” Freud by his bi­og­ra­phers Ernest Jones and Peter Gay. But equally im­por­tant for Crews is the op­por­tu­nity the episode gives him to do some tex­tual anal­y­sis—to give us “an ob­ject les­son in how to ap­pre­hend Freud’s texts with due aware­ness of their guile.”

His aim is to re­veal that much of Freud’s writ­ing on dreams, screen mem­o­ries (or mem­o­ries that hide deeper or older mem­o­ries), love, sex, and mar­riage is more au­to­bi­o­graph­i­cal than we al­ready know. His Freud is ut­terly solip­sis­tic, never ac­tu­ally draw­ing on pa­tients or any hu­man and so­cial ob­ser­va­tion. So Freud’s es­says on sex, love, and mar­riage (1908, 1910–1911) are built on his own case, not on more gen­eral be­hav­ior. Yet his Vi­en­nese con­tem­po­raries, like Arthur Sch­nit­zler and Ste­fan Zweig—as well as early fem­i­nists who de­cry the lack of ed­u­ca­tion, in­clud­ing sex­ual ed­u­ca­tion, for women at the time—paint a pic­ture of life that cor­re­sponds to Freud’s de­scrip­tions.

Crews has a good grasp of the gen­eral cul­ture of neu­ro­log­i­cal and psy­chi­atric medicine at the turn of the last cen­tury, but in his zeal­ous at­tempt to in­dict Freud, he fails to give it proper his­tor­i­cal weight. There were no cures for psy­chi­atric ill­nesses, in­clud­ing hys­te­ria, with its wide range of of­ten se­vere symp­toms. Treat­ments were harsh, pen­i­ten­tial, and some­times ter­mi­nal. Be­cause Freud learned from Char­cot, Crews tries to dis­par­age him. Char­cot was in­deed the­atri­cal in his public lec­tures and used hyp­no­tism. But hyp­no­tism was one of the time’s sci­en­tific ex­per­i­men­tal meth­ods, and in Char­cot’s case a di­ag­nos­tic tool. Crews chooses not to men­tion that what Freud learned from Char­cot was “la chose gen­i­tale”— the sex­u­al­ity that was ev­ery­where in the hos­pi­tal and in the sto­ries the hys­ter­ics told about them­selves and to which Freud, un­like Char­cot, lis­tened. In con­trast, Crews rightly ad­mires the Ger­man psy­chi­a­trist Emil Krae­pelin, a con­tem­po­rary of Freud’s, for his or­derly dis­ease clas­si­fi­ca­tions and de­scrip­tions, the kind that form the ba­sis for the DSM. Krae­pelin may have kept the kinds of ta­bles Crews val­ues, but he was also a be­liever in the born crim­i­nal and a firm eu­geni­cist, facts Crews doesn’t bother with. Both Krae­pelin and Char­cot had large asy­lum pop­u­la­tions to draw on for their de­tailed clin­i­cal de­scrip­tions. But nei­ther was pri­mar­ily in­ter­ested in cur­ing the men­tally ill. Freud at least at­tempted to do so. At the time, men­tal hospi­tals and pri­vate clin­ics used what­ever drugs they could find, from chlo­ral to potas­sium bro­mide, to calm their pa­tients. The an­guished be­hav­ior of the ill—of­ten ver­bally, sex­u­ally, and phys­i­cally ag­i­tated—is well known. It’s hardly sur­pris­ing that Josef Breuer used seda­tives on Bertha Pap­pen­heim, known as Anna O., the first pa­tient in the Stud­ies on Hys­te­ria, or that Freud at first tried that and what­ever other tech­niques were avail­able to him. Man­ag­ing such pa­tients was the best that could be done. Fail­ure was the norm.


Freud left drugs and hyp­no­tism be­hind for his new, far gen­tler talk­ing and lis­ten­ing ther­apy. Most hospi­tals and asy­lums, even clin­ics, did not. In the course of the more “sci­en­tific” twen­ti­eth cen­tury came mir­a­cle cures, of­ten deadly on ap­pli­ca­tion, such as in­sulin, tooth-pulling, lo­bot­omy, and elec­tro­con­vul­sive ther­apy (ECT). Mod­ern ECT en­tails a more pow­er­ful ap­pli­ca­tion of elec­tric­ity than the nine­teenth-cen­tury elec­trother­a­pies the young Freud used, and for which Crews mocks him. Crews’s de­ci­sion to turn Freud’s work with his early hys­ter­i­cal pa­tients into an ex­posé of his cal­low in­com­pe­tence makes for un­sa­vory read­ing. Many men­tal and emo­tional ill­nesses are in­tractable or re­cur­rent. If Freud at first turned to a sex­ual and even­tu­ally a fa­mil­ial eti­ol­ogy for the in­ter­nal con­flicts that in his view led to ill­ness, he of­ten enough, as in the case of Dora, alerted us to his own mis­takes in treat­ment. What­ever Freud’s high­handed and pa­tri­ar­chal mis­read­ings of this trou­bled ado­les­cent girl, Dora didn’t com­mit sui­cide, as her par­ents were wor­ried she might; nor did Freud’s other pa­tients. That may not be a mirac­u­lous re­sult, but nei­ther is it a total fail­ure, as any­one work­ing in to­day’s chal­leng­ing men­tal health en­vi­ron­ment would surely agree. Freud, un­like many in his time, at least ac­knowl­edged that women’s voices were worth lis­ten­ing to—that women were sex­ual be­ings with de­sires. Crews chooses not to give any pos­i­tive ac­counts of anal­y­sis with Freud, but there have been no­table ones, not least from the Amer­i­can poet H.D. (Hilda Doolit­tle) and the Rus­sian-born writer and psy­cho­an­a­lyst Lou An­dreas-Salomé.

Nor is it ac­cu­rate for Crews to claim that Freud had al­most no pa­tients in his early years on whom to base his in­sights, or that he rou­tinely mis­di­ag­nosed. His pa­tient record book from 1896 to 1899 is held by the Li­brary of Congress. Freud saw about sixty pa­tients a year for over five hun­dred vis­its. It was through these ses­sions and his own self-anal­y­sis that he moved from a short-lived use of hyp­no­sis to a talk­ing treat­ment based on free as­so­ci­a­tion and dream and trans­fer­ence anal­y­sis. Af­ter 1900, aside from the war years, he was work­ing with pa­tients some eleven hours a day.

Putting psy­cho­log­i­cal con­flicts into words in a ther­a­peu­tic set­ting seems to help. The re­cent ex­po­sure of the ex­tent to which neg­a­tive ev­i­dence in clin­i­cal tri­als of much-hyped psy­choac­tive drugs was mas­saged away with the help of doc­tors on phar­ma­ceu­ti­cal com­pany pay­rolls, the way clin­i­cal re­sults high­lighted only what would prove prof­itable, the mask­ing of side ef­fects, sui­cide among them—all this has made the pur­ported mis­deeds of psy­cho­an­a­lysts look be­nign.3 The talk­ing ther­a­pies may pro­duce no in­stant mir­a­cles; nei­ther do they do com­pa­ra­ble harm. In­sur­ers may want to think again about costs over a pa­tient’s life­time. Then, too, hand in hand with the de­vel­op­ment of these new, highly touted “sci­en­tific” psy­choac­tive drugs, the num­ber of suf­fer­ers from men­tal dis­or­ders has grown enor­mously.

Un­like Adam Phillips in his brilliant Be­com­ing Freud (2014) or Joel White­book in his re­cent in­tel­lec­tual biography (2017), Crews is never in­ter­ested in touch­ing on what Freud’s writ­ing might still con­vey about the mys­ter­ies of our ev­ery­day lives. I think when it comes to Freud and psy­cho­anal­y­sis, I’ll take my cue from Stan­ley Cavell:

Most philoso­phers in my tra­di­tion, I be­lieve, re­late to psy­cho­anal­y­sis, if at all, with sus­pi­cion, ha­bit­u­ally ask­ing whether psy­cho­anal­y­sis de­serves the ti­tle of a sci­ence .... I am for my­self con­vinced that the cor­pus of Freud’s writ­ing, and a con­sid­er­able amount of writ­ing that de­pends upon it, has achieved an un­sur­passed hori­zon of knowl­edge about the hu­man mind. Ac­cord­ingly I would not be sat­is­fied with an an­swer that de­clares psy­cho­anal­y­sis not to be a sci­ence, if that an­swer de­nies that hori­zon of knowl­edge.

3See Mar­cia An­gell’s ar­ti­cles in these pages, among them “Drug Com­pa­nies & Doc­tors: A Story of Cor­rup­tion,” Jan­uary 15, 2009; “The Epi­demic of Men­tal Ill­ness: Why?,” June 23, 2011; and “The Il­lu­sions of Psy­chi­a­try,” July 14, 2011. See also David Healy, The An­tide­pres­sant Era (Har­vard Univer­sity Press, 1999) and Let Them Eat Prozac: The Un­healthy Re­la­tion­ship Be­tween the Phar­ma­ceu­ti­cal In­dus­try and De­pres­sion (NYU Press, 2004).

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