Although some of his theories are still hotly debated, Sigmund Freud, (1856–1939) is widely regarded as a trailblazer in the realm of psychiatry and psychology. The Austrian psychiatrist and neurologist, who was allegedly the first to offer a comprehensive explanation of how human behavior is determined by the conscious and unconscious forces, is regarded as the founder of psychoanalysis.
Along with the “talk therapy” that remains the staple of psychiatric treatment to this day, Freud popularized, among other notions, such concepts as the psychosexual stages of development; Oedipus complex; transference; dream symbolism; Ego, Id and Super-Ego; and the one that has become part of colloquial English more than any other psychiatric term—the Freudian slip.
An award-winning essayist, literary critic, book reviewer, commentator, and author, Frederick Crews is Professor Emeritus of English at the University of California, Berkeley. His most recent book is Follies of the Wise: Dissenting Essays (2006).
Simply Charly: In 1993, you wrote an extremely critical review, entitled “The Unknown Freud,” in the pages of the New York Review of Books that ignited tremendous debate over the merits of Sigmund Freud’s scientific standing. How did a literary critic like yourself get mixed up in this business of Freud-bashing?
Frederick Crews: I must begin with a mild rebuke. “Freud-bashing” is the label automatically applied by Freudians to any criticism of Freud that seems to jeopardize the standing of their idol. Use of this cliché in most hands (not yours) partakes of the bad habit, cultivated by Freud himself, of changing the topic from the merits or demerits of his doctrine to the alleged psychological instability of his vicious critics. To cure yourself of ever using the term again, you might read my chapter, “Confessions of a Freud Basher,” in The Memory Wars: Freud’s Legacy in Dispute, 1995.
And now to address your question: I was a Freudian critic of literature in the later 1960s. By 1970, however, I had developed too many reservations about the cogency of psychoanalytic theory to continue in that vein. A decade later I was prompted, by a wave of ingenuous Freudian enthusiasm in university humanities departments, to go public with a fundamental critique. Several further articles about the self-validating character of psychoanalytic discourse preceded the 1993 essay, which began as a simple book review but became a general argument about Freud’s empty pretensions, both theoretical and therapeutic.
SC: More recently, just when everyone thought the controversy over Freud had dissipated, you reignited the debate in the very same pages that ignited the first debate in a two-part review on Freud’s controversial use (or abuse) of cocaine. What brought you back into the ring?
FC: First, I must stipulate that there has been a lively tradition of revisionist work on Freud dating back to 1970. The key names from that period are Henri F. Ellenberger, Frank Cioffi, and Paul Roazen, the last of whom never meant to demean psychoanalysis. But Roazen’s biographical researches had the effect of undermining what Ellenberger called “the psychoanalytic legend”—the fable of Freud’s single-handed discovery of the unconscious. Subsequent writings by Frank J. Sulloway, Adolf Grünbaum, Peter J. Swales, and Malcolm Macmillan, among others, advanced that process of disenchantment in different ways.
I mention these milestones because it isn’t true I’ve started or even “reignited” anything in Freud studies, as they are apprehended by learned scholars. My work has been largely a running commentary, with explicit acknowledgment, on primary research done by others. It’s true, however, that the New York Review reaches a broad base of educated readers, many of whom were well disposed toward psychoanalysis without knowing much about it. Yes, I do seem to have affected that audience. Nevertheless, I don’t count myself among the historians and philosophers who have taught us why we should be wary of Freud’s claims.
The New York Review recently asked me to review a book about Freud, the surgeon William Halsted, and cocaine, a drug that both had used in abundance for many years. I could hardly refuse, because I’ve been at work on a book-length examination of the pre-psychoanalytic Freud, and I could see that the work chosen for review was characterized by erroneous claims, ingratitude to key studies dating back to the early 1980s, and reiterated idealization of Freud as a great psychological pioneer.
The book I reviewed does correctly allege that Freud’s use of cocaine was far more extensive than most people have realized. Because the author has swallowed “the psychoanalytic legend” whole, however, he feels obliged to maintain that Freud’s drug consumption exercised no effect on his scientific efforts. My review pointed out the resultant confusions and contradictions in the book, and I defended the thesis (proposed by Elizabeth Thornton in a much-derided but important work of 1983) that cocaine was of decisive importance in Freud’s intellectual development.
SC: In the spring of 1884, Freud began experimenting with cocaine by consuming copious amounts of it and recording the drug’s physiological and psychological effects. Several months later, in June of that same year, he published a monograph on its various effects and uses. What was the upshot of this paper? And what was it about cocaine that so attracted Freud?
FC: Freud’s official biographer Ernest Jones, whose privately expressed opinion was that the founder of psychoanalysis had taken more cocaine than was good for him, did openly state that the primary appeal of cocaine for Freud was erotic. In brief, it made him feel like a man. That was one reason he remained undissuaded by his several misadventures with the drug and by the storm of criticism that came his way when its addictive properties, which he had blithely dismissed, were widely recognized. As late as 1887, Freud was still publicly proclaiming that cocaine was harmless unless injected; and now he was denying flatly that he had recommended that procedure. But he had indeed done so; the published record is clear. Was he lying outright in 1887, or was his cocaine consumption warping his memory as well as his judgment? Questions like this are worth pursuing in depth, but it hasn’t been done. Freud’s 1884 essay “On Coca,” dashed off shortly after cocaine had first been brought to his notice, was a presumptuous document—not just a potted historical review from the Incas onward, but also a confident recommendation of various medical uses of the supposedly innocuous drug. The subjective, confessional, and overconfident manner of the article, at variance with all of Freud’s prior scientific papers, suggested that he was writing in a somewhat intoxicated state. This essay contained the first of several boasts that Freud had carried out (or, in some versions, merely witnessed) Europe’s first instance of successful morphine withdrawal via cocaine. But the treatment in question had already failed by the time Freud published his essay, and he had personally witnessed the patient’s collapse.
SC: Freud’s evangelism and grandiose claims for cocaine led to tragic consequences for his friend and colleague Ernst Fleischl von Marxow. Can you describe the circumstances of Fleischl’s untimely death?
FC: The brilliant physiologist and polymath Fleischl was Freud’s teacher in medical school and then his most admired friend. A mishap during an autopsy had left him with an infection that necessitated the amputation of a thumb and the subsequent onset of neuromas that produced incessant, unbearable pain. In those circumstances, Fleischl became a morphine addict, continuing to produce outstanding scientific work but contemplating suicide because he had no means of curing his addiction. When Freud read about the use of cocaine to help in morphine withdrawal, he immediately decided to apply this cure to Fleischl. He didn’t consider that the journal in which he had learned of such wondrous treatments was a house organ of the Parke, Davis pharmaceutical firm, drumming up sales for cocaine. Nor did he ask himself how Fleischl was supposed to manage his chronic pain without morphine. (Cocaine produces temporary euphoria, not lasting analgesia.) Freud’s letters to his fiancée show that his rush to cure Fleischl was largely motivated by his own desperate ambition to become sufficiently famous and prosperous to get married. Within days, Fleischl had been placed on a regimen of gradually replacing morphine with cocaine. In fact, however, he couldn’t do without the morphine; he very nearly died; and the net outcome was that he became a double addict. From May 1884 to June 1885, Freud watched his friend fall to pieces until at last, the insomniac Fleischl experienced delirium tremens, including hallucinations of insects crawling through his skin. Yet Freud, who was taking cocaine himself all this time and even lending some of it to Fleischl, never tried to arrest this second addiction. His mentor Josef Breuer did so with some success in June 1885; but later evidence suggests that Fleischl went back on cocaine as well as morphine, and eventually added the addictive drug chloral hydrate as well. He died in agony in 1891, having ceased to do meaningful scientific work when his double addiction took hold.
Freud’s remorse over Fleischl’s suffering and death haunted his dreams, but even when he alluded to his guilt in The Interpretation of Dreams (1900), he continued to misstate the extent of his responsibility. The whole episode constituted medical malpractice of the most egregious kind; but it was far from unique in a career that featured a great number of misdiagnoses and false claims of cure. Freud was an incompetent physician who had never wanted to be a practicing doctor in the first place. In addition, he was an unscrupulous habitual liar who would say anything that might advance his fortunes or get him out of a jam.
SC: Did Fleischl’s death do anything to dampen Freud’s enthusiastic use of the drug?
FC: As you see, Fleischl lived until 1891. We do know, from Freud’s 1885-86 letters to his fiancée, that he remained proud of his public association with cocaine after Fleischl’s June 1885 collapse; and the same letters show us that Freud repeatedly took cocaine to calm his social anxiety during a fellowship stay in Paris. Not coincidentally, that was when he first started having hallucinations involving “thought transference,” a paranormal phenomenon that he later declared to be a reality.
Interestingly, Freud in Paris occasionally tells Martha Bernays that he is writing under the influence of cocaine; and when he says so, the voluble letters sometimes indulge in flights of megalomaniacal ambition, with fantasies of glorious victory or martyrdom. That is the mood that would eventually, in the mid-1890s, issue in psychoanalysis—a theory that was meant to revolutionize the world, establish Freud as having bested his (imaginary) enemies, and crown him as the peer of Copernicus and Darwin. The linkage of those fantasies with cocaine verges on the obvious.
In the 1890s, Freud was taking cocaine by a more intoxicating means than before: painting his nostrils with the drug instead of consuming oral solutions of it. Thus the cocaine that got inhaled now bypassed the mitigating effect of his digestive system and went straight to his brain. “I need a lot of cocaine,” he wrote to his cocaine-using friend Wilhelm Fliess in 1895. That was the year of Studies on Hysteria, the book (jointly written with Breuer) that announced the psychoanalytic revelation—which, however, was still being continuously altered as Freud struggled with, and sought to disguise, his consistent therapeutic failure.
SC: The case of Emma Eckstein became another embarrassing episode in Freud’s career. Did Freud’s cocaine use play any part in it?
FC: The Eckstein case was all about cocaine. Fliess’s favorite diagnosis, the “nasal reflex neurosis,” rested on the idea that the nose and the genitals are intimately associated and that problems with the latter, such as irregular menstrual periods, can be fixed by applying cocaine to the patient’s nose. Freud, who was literally in love with Fliess, and who was following Fliess’s medical advice by taking cocaine for his own headaches, stomachaches, heart palpitations, and nasal infections (!), subscribed to Fliess’s theory and applied it to his patients, one of whom was Emma Eckstein.
Fliess believed that if applications of cocaine to the nose failed to halt a patient’s symptoms, he or she would have to submit to cauterization of the nose or, if that too failed, to outright surgical removal of a nasal bone. Freud accordingly called Fliess in from Berlin to Vienna to perform this last-resort operation on poor Eckstein. The procedure was horribly botched, leaving the now disfigured Eckstein hovering near death for months.
The most interesting aspect of the case, however, is to be found in Freud’s letters to Fliess during the same period. This seems to have been the time of maximum cocaine use on Freud’s part. The letters waver between acknowledging Fliess’s responsibility and denying it, but they finally come down on the “psychoanalytic” side. Eckstein, Freud wrote, isn’t bleeding because you, Fliess, left a half meter of rotting iodoform gauze in the remains of her nasal cavity; no, she is bleeding as a means of attracting my own sympathy and love.
Here was the very birth of psychoanalysis as a theory of mind over matter. As Thornton showed in 1983, this form of diagnosis, far from being a great innovation, was a reversion to the psychosomatic medical superstition of antiquity and the Middle Ages.
SC: When and why did Freud stop using cocaine?
FC: There are two likely dates, 1896 and 1899. The only evidence for the former is that in 1896 Freud wrote to Fliess that he was putting aside the “cocaine brush” for good. That letter, however, has to be read in the context of the death and funeral of Jacob Freud—an event that profoundly affected his son and that briefly turned him away from Fliess and toward the family memories (or “memories”) that would inform psychoanalytic theory. Subsequent letters clearly show that Freud soon returned to his infatuation with Fliess and continued to do his bidding–and Fliess’s main bidding was the medicinal application of cocaine.
In 1899, Freud was continually tippling wine at a rate that alarmed his wife, who was now counting the empty bottles. That uncharacteristic behavior on Freud’s part can be interpreted as an attempted replacement of cocaine by alcohol. If he had truly rid himself of cocaine in 1896, it is unlikely that he would still have depended on a substitute drug in 1899. I therefore tentatively favor the latter date. But if this guess is correct, it means that Freud’s “masterpiece,” The Interpretation of Dreams, was written under the influence of cocaine. That hypothesis makes sense in a number of ways, such as the text’s outsized ambition, its self-contradictions, and its failure to deal earnestly with objections and rival possibilities for the meaning and function of dreams.
SC: You’ve written that Freud’s cocaine use can be plausibly associated with his “tendency to draw premature conclusions, to engage in salesmanship for untested panaceas, to disregard the welfare of patients, and to cover his tracks when forced to retreat.” If you’re correct in your assertions, then these are pretty damning allegations of scientific malfeasance. What evidence do you adduce to support such statements?
FC: The evidence is diffused through the entire vast record. If your question is meant personally and seriously, I recommend that you begin reading the revisionist literature, including recent contributions by Allen Esterson, Han Israëls, Robert Wilcocks, Jacques Bénesteau, and Michel Onfray. The picture that emerges from their studies is now largely conceded by scholars who, for their own reasons, remain sympathetic to the Freudian worldview.
Thus the burden of proof has now shifted: How can a man with Freud’s intellectual peculiarities and ethical limitations, and with a complete incapacity to devise cogent experiments or address objectively based criticisms, ever have made basic discoveries about the mind?
The short answer is that he never did so. Psychoanalytic theory in his hands was self-promotion and bluffing. And it is very likely that his cocaine use played a major role in driving him to put aside the scientific standards he had learned from world-class mentors and to create a system of thought that was insulated from empirical review. Ultimately, the most important effect of cocaine on Freud was to encourage him to trust his errant intuitions instead of subjecting them to rigorous skepticism.
SC: Why do you suppose that Freud’s entangled episode with cocaine hasn’t been more widely known or even addressed?
FC: Psychoanalysis has been not just a theory and a practice but an activist movement, focused primarily on its own propagation and on the defeat of its detractors and apostates. The history of that movement has been one long cover-up of Freud’s actual deeds. Its two major instruments have been censorship and lies.
Don’t take my word for it. Instead, read an extremely important new book, The Freud Files: An Inquiry into the History of Psychoanalysis, by Mikkel Borch-Jacobsen and Sonu Shamdasani. There you will find chapter and verse for the sordid record, including Freud’s retreat from accountability and the strenuous efforts of his followers, after World War II, to sequester key evidence from the public.
SC: The late biologist Sir Peter B. Medawar famously stated that “psychoanalytic theory is the most stupendous intellectual confidence trick of the twentieth century. . . .” Do you agree? Why?
FC: Medawar was exactly right. Read Borch-Jacobsen and Shamdasani, and you yourself will be obliged to agree.