In order to discover psychoanalysis, it was deemed necessary to commence one’s own private analysis, begin reading Freud -as well as favoured commentators- and attend seminars conducted by senior adepts. Particular emphasis was placed upon learning Freud’s case histories so as to familiarise oneself with the principal characteristics -or in the more technical language of Lacan “structures”- of neurotic patients.
The main two styles of neurosis were hysteria and obsession. A third style was phobia. This was an oscillating affair involving an unstable balance: reminiscent of oscillations reported by some bisexuals. In Freud's phobic structure, the oscillations had two poles: one pole was perversion, the other could best be termed as an "anxiety neurosis"
These psychological fashions, styles, quirks, eccentricities, or “neuroses” were ways of fantasising about oneself and coping with one’s real. Furthermore they were enacted or repeated for the benefit of others., as well as repeating ones past.
Assessing and addressing “clinical structures” became the bread and butter of jobbing analysts. The entire field of neuroses had a common factor in what was called repression: a mechanism, (often unsuccessful) of trying to get rid of unwanted thoughts, habits actions, desires, and various other unpleasantries whether personal, natural, or social.
A completely different style of being, living, and presenting oneself to oneself in the world of objects and people was supposed to be light years away from the neuroses being absolutely different in quality, quantity, and presentation.
Freud was never a really good doctor with a relaxing bedside manner. He wisely disallowed “psychotics” from becoming his patients; though some of his trainees admitted such sufferers into treatment. Himself well acquainted with contemporary psychiatry, Freud optimistically believed it would soon advance radically and begin discovering cures -whether surgical, physical, or pharmacological- to treat psychoses successfully. He exchanged letters with the celebrity psychiatrist Ludwig Binswager (1881-1966) as well as the eminent Eugen Bleuler (1857-1939), still known for his pioneer work on a group of symptoms clustering around the title the “the schizophrenias”. He was one of the signatories recommending Freud for a Nobel prize. But whatever his personal or professional relations with psychiatrists, Freud never even dreamed of psychoanalysis becoming a cure for the psychoses.
The one detailed work Freud wrote about a sectioned insane person was based upon a contemporary autobiography written by a senior high court judge containing a candid account of his struggles. This judge was wrestling with his beliefs about god, the world, and his own role in a divine tragedy -because it was definitely no comedia like Dante’s . To put it simply, judge Schreber believed god was turning him into a woman so that he would eventually become God’s “slut” and repopulate the world with their children. The medical diagnosis was paranoid dementia -a condition thought to be terminal for body, personality, as well as brain functions.
Though Freud postulated Judge Schreber’s persecutory beliefs centred around conflicts of homosexual desire; he resolutely rejected any attempt to try to “cure” such people with psychoanalysis. Why? Because such sufferers were organically destined to succumb to a dementia which was as inevitable, lethal, and as cruel as any Alzheimer’s.
Freud continued to hold this opinion for the rest of his life. Two decades later, during the winter of 1930, Princess Alice of Battenberg was admitted to Kurhaus Schloß in Tegel with a diagnosis of schizophrenic paranoia. Later she was moved to Binswanger’s famous asylum for international celebrities at Kreuzlingen in Switzerland.
When consulted by Tegel’s Director and the head of the Kreuzlingen Respite, Freud recommended that the best way forward treatmentwise was for the patient’s ovaries to be exposed to high-intensity X-rays. It is not all clear whether that procedure was supposed to enhance her femininity or -contrariwise- initiate a menopause. Danny Nobus has helped to untangle some practices related to this odd procedure. Be that as it may by recommending that psychotic patients like Princes Alice should be treated with drastic physical interventions like this, Freud was sticking to his conviction that the clinical applications of psychoanalysis were confined to what he called the neuroses. A complete consideration of endocrinological, organic, or neurological factors for the causation and treatment of psychoses would, he continued to believe, prove ultimately to be the most successful avenues for addressing this diagnostic category.
Eventually Princess Alice went on to perform quiet acts of heroism during the 1940’s whilst living in near squalor. She later become a nun and eventually mother in law to a reigning queen. She died in December 1969 well into her eighties at Buckingham Palace, the home of her son Philip and daughter in law Elizabeth II. In her final years Princess Alice was physically frail, but completely lucid. During1988 her body was moved from Windsor for reburial at an orthodox convent in Jerusalem. Ten years later she was honoured at Yad Vashem as a “righteous among the nations” for sheltering Jewish people from persecution during the Nazi era. Her surviving children attended.
Freud, then, bequeathed his followers several certainties:
- Most human beings were either neurotic or psychotic.
- Though there were sub-categories to both psychoses and neuroses, these two principal categories were supposed to be absolute in that ones principal clinical status lasted one’s entire life. Once one was psychotic s/he remained psychotic for life. Likewise people labouring with neuroses.
- Neurotics, believed Freud, might find some relief in the “ordinary unhappiness” offered through psychoanalysis. Psychotics by contrast had to await empirical cures through medical science : drugs, surgery, combinations, or some other therapy (like radiation)
I first began to study Freud, Bleuler, and Jaspers on psychosis in my twenties just before volunteering in an old fashioned psychiatric hospital. I found this dementia approach to psychosis frightening, cruel, and hopeless. The long term outcomes of "dementia" psychoses seemed as inevitable, lethal, and as cruel as the most famous dementia -Alzheimers- in modern societies. Staff referred regularly off-hand to “burnt out schizophrenics”. These were inmates who had become demented. The only therapies considered were continued pharmacology and some form of occupational: like community singing at Christmas,
Approximations to Psychosis
Despite his scepticism about psychoanalytic treatment for psychosis, and his belief of the absolute differences between psychoses and neurosis in terms of treatment, it seems Freud did believe there to be several close approximations to psychosis where available to neurotics.
- One was “falling” or “being” in love with a person of which male to female heterosexuality was the paradigm. Nevertheless Freud himself enjoyed an ongoing intellectual and clinical love-affair with another eccentric male doctor -a surgeon and theoretical speculator- which nearly cost a patient’s life. One of their agreements was this. Every human being or was basically bi-sexual. Eventually this continuous adoration, regular congresses, and swapping of opinions turned to utter hatred and contempt. So that was one close approximation. To psychosis available even to doctors.
- Another difficult experience of love approximating to psychosis is perhaps narrated by Freud’s voluminous exchange of letters with his fiancé Martha. Personally I do not know how to approach this literature in two volumes called Brauterbriefe and dislike reading it. However in both” hetero” and “bi” situations what Freud hated about love was being in a “passive” position -overwhelmed with passion, drives, phantasies and feeling nearly out of control. Eventually Frau Dr Freud was confined to the role of a Hausfrau with little intellectual or cultural rapport with her husband and his colleagues.
- Another approximation to the delusions of madness were the ideas of philosophy and religions. Freud saw only minute differences between the florid ravings of Schreber and views propounded by the Vienna Circle or the philosophical theology of his contemporary Martin Buber. Even his own speculations about metapsychology he likened to a witches brew.
- Apparently human beings could behave dangerously mad in certain social situations, especially when they surrendered themselves to a charismatic leader -whether religious or political. Freud also referred to analysts being a mad hoard
- A final -and for me decisively important psychotic way of being- was identified by both Freud himself and psychoanalytic world president, Ernest Jones. They called it therapeutic insanity. I was available only to psychoanalytic practitioners -particularly eminent ones who were a little off-centre in practice or theoretically divergent. Sandor Ferenczi exemplified this new psychoanalytic structure of psychosis. By contrast mere amateur or armchair analysts where firmly in the ranks of neurotics as “wild” practitioners.
As I explained elsewhere, Ferenczi became the psychoanalyst of last resort, accepting patients others rejected as being too challenging . He was keen to be off-loaded by other analysts. In this he resembles the great “Doctor of the IT” - a clinician called Groedeck- who became the physician of last resort for many desperate patients (analysts included).
The alleged psychotic signs exhibited by the wayward Ferenzci were:
- He could never bring an analysis to an end. He always wanted and needed more.
- A therapeutic madness (mania) was displayed by his need to take on and cure all sorts of desperate and inappropriate cases.
- His therapeutic techniques and theories were unstable, idiosyncratic, as well as deviant.
- He had pushed himself out of the social network of psychoanalysis. This was supposed to be a sort of self-willed ostracisation.
These observations of both Freud and Jones were obviously a calculated slur against of former colleague and ally. Ferenzci was not suffering from any psychosis whether organic or interpretational. His true diagnosis was pernicious anaemia.
Much has been written about Ferenzci’s calculated ostracisation by Freud, Jones, and their international movement. They arose to a surprising new life decades later when psychoanalytical practitioners began to talk about “ordinary” psychosis.
Carlo Bonomi Jones's allegation of Ferenczi's mental deterioration: a reassessment International Forum of Psychoanalysis 1998
S Freud and L Binswanger The Freud-Binswanger Letters Open Gate Press 2002.
S Freud and E Bleuler Ich Bin Zuversichtlich, Wir Erobern Bald Die Psychiatrie Briefwechsel 1904 - 1937 Schwabe 2012
Danny Nobus The Madness of Princess Alice:
Sigmund Freud, Ernst Simmel and Alice of Battenberg at Kurhaus Schloß Tegel History of Psychiatry, 31(2), pp. 147–162.
Schultz-Venrath, Ulrich. (1995). Ernst Simmels psychoanalytische Klinik Sanatorium Schloss Tegel GmbH (1927-1931). Frankfurt am Main-Washington
Relativity: Klein
I believe the first step towards regarding psychosis, rather than neurosis, as the foundational psychological pattern in human life came from Melanie Klein. Her infants survived early life by becoming extremely schizoid and depressed. Mourning, thankfulness and empathic kindness -if one is lucky- eventually normalise the earlier mad stages of an infant.
These infantile struggles portrayed by Klein impressed Lacan so much, that they become the primary inhabitants of his “Imaginary” register along with other types of insanity Lacan had witnessed as a doctor -particularly paranoid illnesses.
Ordinary Psychosis.
There is a vast literature on the modern history of this concept. To be completed
Reading Suggestions
M.-H. Brousse, “Ordinary Psychosis in the Light of Lacan’s Theory of Discourse,” unpublished.
Santiago Castellanos : Paranoias and Madnesses of Everyday Life https://congresoamp2018.com/en/textos-del-tema/paranoias-y-locuras-de-la-vida-cotidiana/
J.-A. Miller, “Semblants et sinthomes,” la Cause freudienne, 69.
J.-A. Miller, “The Ironic Clinic,” Psychoanalytic Notebooks, 7.
J.-A. Miller, “Paradigms of Jouissance,” Lacanian Ink, 17.
E. Laurent, “Ordinary Psychosis,” unpublished.
Pierre Sidon Bye Bye Ordinary Clinic, Hello Singularity 2018
https://congresoamp2018.com/en/textos-del-tema/bye-bye-ordinary-clinic-hello-singularity/
Thomas Slovos : Ordinary Psychosis. lacan.com Spring 2009
World Association of Psychoanalysis Congress XI 2018 THE ORDINARY PSYCHOSES AND THE OTHERS Under Transference. Guidance Texts https://congresoamp2018.com/en/textos/
