“Fools say they learn by experience. I prefer to profit by other people's experience.” Otto von Bismarck

Why Even Bother with Freud?

My reason for discussing Freud’s influence in the medical sphere is that he demonstrated how easy it is to do bad science and also to pull the wool over the eyes of those not well-versed in the scientific method (which still includes more doctors than one might wish). Freud’s way of investigating and thinking embodied much of what is antithetical to scientific methodology and also to scientific probity. He failed spectacularly to learn by other people's experience, if only he had listened to Bismarck! The scientific method is about attempting to be objective, logical and honest and especially about how to avoid the “delusion of experience” (1): note also my comments on Karl Popper in Pt 1 & my commentary “How your mind works”.

As Karr said: “Plus ça change, plus c'est la même chose” (the more things change, the more they are the same). Before the scientific method clawed its way into prominence in the 19th century superstitious and poor thinking, encouraged and facilitated by the church’s powerful repressive influences over teaching, writing and book production, had been dominant for a millennium and more (remember Galileo). Even now we are struggling to shake off the vestiges of superstitious and illogical thinking: indeed, much of the population is still susceptible to such influences and the Catholic Church, which moves even more slowly than lawyers, has only just acknowledged Galileo was correct.

History reminds us of other similar and popular pseudo-scientific ideas that are worth recalling. Phrenology, a prototypical pseudo-science, has close parallels to Freud’s practices and ideas in its history and influence because the data, supposedly confirming its validity, was gathered in the same unsystematic, careless, biased, selective and illogical manner (1). Most people, including “scientists”, were unable to recognise those simple errors or undertake a critical analysis of the subject of phrenology.

Also remember the popular and very influential book expounding the ideas of the Jesuit priest Pierre Teilhard in “The Phenomenon of Man”. The Nobel prize-winning scientist and essayist Sir Peter Medawar dissected and exposed Teilhard in an essay (2) in which he asks a key question: “how was it that people came to be taken in by Teilhard's book, The Phenomenon of Man?”

http://vserver1.cscs.lsa.umich.edu/~crshalizi/Medawar/phenomenon-of-man.html

Besides recommending Medawar’s complete essay I shall quote his answer to his own question of how people were taken in:

“We must not underestimate the size of the market for works of this kind, for philosophy-fiction. Just as compulsory primary education created a market catered for by cheap dailies and weeklies, so the spread of secondary and latterly tertiary education has created a large population of people, often with well-developed literary and scholarly tastes, who have been educated far beyond their capacity to undertake analytical thought. …”

Medawar’s view of Teilhard’s work (he could equally have been referring to Freud) was that: “the greater part of it, I shall show, is nonsense, tricked out with a variety of metaphysical conceits, and its author can be excused of dishonesty only on the grounds that before deceiving others he has taken great pains to deceive himself”.

The Jesuitical pseudo-profundity of Teilhard's opaque and tortuous text bamboozled many “intellectuals”, which is no surprise, after all he was a Jesuit priest and the word “Jesuitical” has not acquired its implications of dissembling and deceit without reason. Teilhard was elected to the French Academy of Sciences, sacré bleu!

More recently the “Da Vinci Code” book has similarities, particularly in the way it disingenuously presents supposedly historical facts in a fictional narrative in a way that confuses and blurs fact and pseudo-fact with fiction and thus beguiles many into searching for non-existent things in the real world: in fact very like what Freud did.

There are few who can see through such writers, even if they are only half-competent in what I call “the art of intellectual obfuscation”: that is what Teilhard, Velikovsky, Freud and their likes were disabled by, although they were convinced that they were naturally gifted. That is because education does not teach people the vital basic thinking skill, how to apply the scientific method critically and analytically. That includes medical education, which explains why although doctors are supposed to be scientifically educated, they not infrequently embrace pseudo-scientific explanations and systems of thought (like homeopathy, chiropractic, acupuncture etc).

Although Freud is still widely known and prominent in the public psyche and the “Arts” it is important to note that for decades he has been universally ignored in the academic literature of psychology (3) and even more so in medicine (4).

Freud’s Cult

As with so many of these guru-worshipping semi-secret cult-like groups the analysts developed all sorts of odd rituals and ideas and cultivated paranoia concerning other people’s supposed attempts to suppress their wonderfully insightful breakthroughs (that is to say Freud’s breakthroughs, after all he asserted autocracy). Exaggerating the hostility the rest of the world appears to exhibit towards your group is a sure way of increasing the groups’ cohesion and loyalty, especially if you are Jewish (almost all of them were) and sensitised to persecution. Freud created a secret committee of his selected acolytes who were presented with a Greek intaglio mounted in a gold ring. That is at best puerile, at worst, the ground-work for a cult, but to my mind more reminiscent of children's books like “The Secret Seven”***; did they cut their fingers and seal it with blood? It is notable that some people closely associated with Freud themselves used the word “religion” to describe what Freud was doing with his ideas and followers (5, 6). As with all religions, schisms rapidly followed.

*** Interestingly, I note Shorvon (7) also used the “The Secret Seven” analogy in his review.

Freud maneuvered himself into the position where he operated outside of the academic and scientific establishments of his day: he actively discouraged his adherents from having university appointments and little, if any, of his own or others work was overseen, peer reviewed or part of the wider scientific discourse. Freud turned his show into a independent movement and from then on it became the story of the prophet, his followers and his persecutors.

To endure such groups need a place of pilgrimage where the revered objects and texts are safeguarded and venerated (the couch is in a museum, but apparently needs re-upholstering!). Freud's disciples, there is no more apt word to describe them, made sure that such a place was maintained. First of all, when he left Vienna around the beginning of the war, he recreated his office, in detail, in his new residence in the UK. That is a noteworthy, some will think strange, thing to do. After his death (1939) his daughter Anna became keeper of the archives; she ordained various of his papers were not to be made available till sundry future dates, evidently extending into the 22nd century. These papers of course are kept secret, except to the anointed few. Freud burnt many of his patient case notes and other papers at various times.

When many of the above mentioned elements are present one can be sure that one is dealing with pseudo-science or nonsense, not real science. Freud’s enterprise was not even remotely related to science.

A journey into the literature on this subject will soon make you think that you are reading tracts and polemics on the origin and meaning of the sacred texts of one of the world's many religions. You will become lost in endless debates and schisms about meaning, interpretation and truth. But nowhere will you find reproducible observations, replicable methods, nor experiments, nor trials.

Forget about it: get a life!

Freud’s Fringes

It should not be forgotten that there was a more dubious and darker side to his acolytes analytic eccentricities with many of the early proponents, to use Wilhelm Reich as but one of many possible examples, becoming variously obsessed with the occult, parapsychology, telepathy and other beliefs near and beyond the fringes of reality (and morality). Reich finished up in jail in America for selling his machine that supposedly gathered sexual orgasm energy (it is, of course, illegal to sell orgasms across USA state boundaries). Freud himself dabbled in such areas, but there at least his acolytes outshone him, providing a vivid Catherine-wheel display of crazy ideas and bizarre thinking. Immanuel Velikovsky (1895-1979) was another such psychoanalyst who produced irrational ideas in his best-selling book “Worlds in Collision”. A doctor/analyst writing about astronomy and astrophysics! Could anything be more ultracrepidarian? Velikovsky, like Teilhard, took-in huge numbers of educated people.

Such a profusion of strangeness suggests there is something inherent in the mindset of those inclined to psychoanalytic ideas which predisposes to woolly and faulty thinking. That tendency goes hand-in-hand with a disability to either properly understand or implement the scientific method.

After more than 100 years playing with their ideas analysts have never come up with a proper recognised scientific trial of any substantive heuristic or scientific merit, but they have come up with a myriad of excuses as to why they cannot do science (cf. Popper). Indeed, why would they do a proper trial? If you can charge high fees for (not) talking to people, and sometimes not even listening (Freud used to sleep during some of his consultations) why would you do anything to rock the boat? (Remember, analysis is almost exclusively a private practice activity).

My experience of analysts during my psychiatric training in London in the 1970s was that I had never met such a bunch of dysfunctional, neurotic and disordered people, quite a few of whom were worse than the poor patients they were treating.

It is abundantly clear that Freud himself was a mixed up and odd fellow, his most remarkable faculty was perhaps for self-delusion; indeed Professor Crews suggested he was comparable to Walter Mitty (see link below). He was certainly a heavy cocaine user for a long time: that alone would preclude him from being allowed to practice medicine in any civilised country.

He could not stop himself smoking cigars even after he suffered more than 20 operations for mouth cancer. There must have been multiple jokes circulating about the symbolism of his cigar, but thankfully they do not seem to have survived (except “sometimes a cigar is just a cigar”, which he probably never said, it sounds more like a Groucho Marx riposte). He seemingly also pressured, or bullied, his acolytes into smoking cigars.

On occasion, when getting emotional in arguments (especially with Jung), he fainted/pissed himself (lost control of his bladder): an odd thing for a mature adult to do. His household included his wife’s sister whose bedroom could only be accessed via Freud’s bedroom (there is evidence they had a sexual relationship, see (8)). That is sufficient information to suggest a picture of a probably odd and rather unpleasant man.

He was in many ways a failure for much of his professional life until he was about 50 (5), this failure reached its apogee after his visit to Paris to see Charcot’s theatre of hysterical performing prostitutes (his lecture on this, on his return to Vienna, was widely ridiculed). The public were allowed into the Salpêtrière hospital to watch Charcot’s clinical demonstrations which were so popular that there was often a traffic jam of carriages in the streets around the hospital. The women were paid for their performances and I suspect for other things besides. The shows were a great source of vicarious erotic titillation: some fascinating information on that is in Shorvon’s review (7, 9).

It would be a deprivation not to mention also the fascinating story of Blanche Marie Wittman. She was Charcot’s “Queen of hysterics” for years and appeared in various stages of undress in many demonstrations (was she Charcot’s lover? Shorvon certainly thought so). Her symptoms rapidly disappeared after Charcot’s death, and after many years in hospital she suddenly functioned well enough to become assistant to Madam Curie (of Nobel prize fame)! There is a famous painting of Charcot and Blanche by Brouillet, a lithograph of which Freud had hanging above the couch in his consulting room. I suspect that, then and now, many people would raise an eyebrow, or worse, if their wife/daughter was attending a therapist with such a suggestive/seductive painting so displayed immediately above the patient’s prone form on the couch. A further air of eastern decadence was added by the “Smyrna” rug, as Freud referred to it, which covered the couch (10). As a collector of antiques and curios it seems he did not know much about Persian carpets (Smyrna is on the west coast of Turkey and the carpet is Persian).

For Freud to have been attracted to and taken in by Charcot’s erotic theatrical charade tells us about Freud’s personality and his serious lack of critical acumen. The lecture he gave on his return to Vienna has been described as a disaster. He was reprimanded by Professor Meynert, the department head.

That marked the end of his university affiliation, modest as that had been: he entered solo private practice but was sufficiently close to failure professionally, being shunned even by the predominantly Jewish doctors in Vienna, that he may never have got anywhere if Breuer had not taken pity on him and helped by referring to him young middle-class Jewish hysterics (5). At that time Freud’s practice was so slack that he was contemplating taking a job as a quack at a health spa (11).

He seems to have felt always that he was pre-ordained to make his mark in the intellectual world (such messianic streaks are frequently problematic and rarely associated with objective scientific enquiry), so it is predictable and understandable that he would be eager to find some means of achieving fame, whatever the cost. He was on a mission. That helps us to understand why he needed to be disingenuous and fraudulent in his distorted reporting of cases.

In short, his revelations and beliefs (they constituted neither scientific observations nor theories) were built on distortions, deceits and inventions: to what extent did he deceive himself before he deceived others? and to what extent were grandiosity and paranoia factors? fuelled by his cocaine use? Remember, he had hoped that his (naïve) ideas about cocaine were to be his route to a degree of fame to rival Darwin.

Let us just stop and think about that for one moment. At that stage in his career he was essentially an academic nobody, and yet he was entertaining visions of becoming as famous as Darwin! That is as close to insanity as I would want to get.

As Professor Crews said in the NYRB (8/12/2011) “Freud imagined himself a second Darwin, but he had more in common with Walter Mitty.”

http://www.nybooks.com/articles/archives/2011/dec/08/freud-question-exchange/?pagination=false

The magnificent intellect that was endowed into Richard Feynman (one of the great Nobel prize-winner physicists of our age) led him to label Freud as a "cargo cult scientist … who was closer to L. Ron Hubbard [of scientology notoriety] than to Einstein” (12).

It is noteworthy that the American intellectual and medical establishment paid far more attention to Freud that the British ever did; he never gained much traction in the UK and in medical (and psychological) circles there has been little or no mention of him for a long time (4). Indeed, to attempt to introduce scientific discussion about Freud would mark someone as a non-scientist in the eyes of most scientists.

Such observations and comments are not ad hominem material, they are relevant in so far as a critical informed judgement about the truth, objectivity, methodology and value of his work must necessarily include an assessment of the background and probity of the man who wrote it: that is, the degree to which it may be considered trustworthy and reliable. Without such an assessment one cannot judge if it is worthwhile investing the effort of the many hundreds of hours that would be needed to read and study his material. On such measures Freud fails to score or impress, except egregiously. If he had lived in the modern era he would have been recognised as a self-agrandising plagiarist, fraud and liar: to be fair, that is probably how many of his contemporaries regarded him, their opinions are just less prominently recorded by history (13).

Finally, note that medical science did not divorce Freud, he purposefully and calculatingly divorced himself from the educational institutions of science and medicine and set up his own institutions and journals that he could control. Disagree even slightly with Freud and you were finished, as Oberndorf discovered (Sulloway, p 270).

I will close by quoting Freud himself (letter to Wilhelm Fliess, Feb. 1, 1900), in what may have been a fleeting moment of insight, which says it all.

“I am actually not at all a man of science, not an observer, not an experimenter, not a thinker. I am by temperament nothing but a conquistador–an adventurer, if you want it translated–with all the curiosity, daring, and tenacity characteristic of a man of this sort”.

References 

 

1.Dean, G, Phrenology and the Grand Delusion of Experience. Skeptical Inquirer, 2012. 36(6): p. http://www.csicop.org/si/show/phrenology_and_the_grand_delusion_of_experience/.

 

2.Medawar, P, The Phenomenon of Man in "The strange Case of the spotted mice". 1st published in New York Review of Books Jan 23  17, 1969.

 

3.Robins, RW, Gosling, SD, and Craik, KH, An empirical analysis of trends in psychology. Am. Psychol., 1999. 54(2): p. 117.

 

4.Tallis, RC, Burying Freud. Lancet, 1996. 347(9th March): p. 669-671.

 

5.Shorter, E, A history of psychiatry: from the era of the asylum to the age of Prozac. 1997: Wiley.

 

6.Sulloway, FJ, Reassessing Freud's case histories. Isis, 1991. 82: p. 245-275

 

http://sulloway.org/Freud'sCaseHistories(Isis-1991).pdf.

 

7.Shorvon, S, Fashion and cult in neuroscience—the case of hysteria. Brain, 2007. 130: p. 3342-3348.

 

8.Silverstein, B, What Happens in Maloja Stays in Maloja: Inference and Evidence in the “Minna Wars”. Am. Imago, 2007. 64: p. 283.

 

9.Goetz, CG, Bonduelle, M, and Gelfand, T, Charcot: constructing neurology. 1995: Oxford University Press.

 

10.Warner, M, Freud’s Couch: A Case History. Raritan: A Quarterly Review, 2011. 31(2): p. http://www.freud.org.uk/file-uploads/files/file/Marina%20Warner%20in%20RARITAN.pdf.

 

11.Masson, JM, The complete letters of Sigmund Freud to Wilhelm Fliess. Cambridge: Harvard U. P., 1985: p. 378.

 

12.Feynman, R, Cargo cult science. In: Surely you're joking Mr. Feynman! London: Unwin Paperbacks, 1985. 1985.

13. Goleman, D, As a Therapist, Freud Fell Short, Scholars Find. New York times, 1990(6 March). http://www.nytimes.com/1990/03/06/science/as-a-therapist-freud-fell-short-scholars-find.html?pagewanted=all&src=pm