F eud's, Case S udies and he Locus
o Psychoanaly ic Knowledge
(")
CARL. E. PLETSCH"*
INTRODUCTION:
THE @TESTION OF PSYCHOANALYTIC KNOWLEDGE
Reading h ough Sigmund F eud's case s udies in ch onological
o de is a mos ins uc i e expe ience o anyone in e es ed in he
in ellec ual his o y o psychoanalysis. One quickly sees, o example,
how F eud's echnique e ol ed om he me hodical and a he in u-
si e a emp s o dispel pa icula symp oms ha we obse e in
S udies
on
Hys em'a
(1
895)
o he me hod o ee associa ion ha he desc ibes in his
epo on he case o Do a
(1905).
O one sees how F eud's concep ion
o he ans e ence de eloped, om he p imi i e no ion o ans e ence
as
some hing o be a oided o dispelled, o he ma u e concep ion o
ans e ence as he in aluable cen e o analysis, he e y phenomenon
ha has o be analyzed (again in he analysis o Do a). In his pape 1
shall e iew F eud's case s udies wi h s ill ano he ajec o y in mind:
how F eud's sense o he signi icance o his w i en case s udies
hemsel es e ol ed.
1
shall show how his ini al emba assmen o e he
necessi y o desc ibing his cases in g ea de ail was e en ually supplan-
ed by a con idence ha his case s udies we e impo an ehicles o
psychoanaly ic knowledge. As his a i ude changed, his ini ial anxie y
abou how o he medical and na u al scien i ic eade s would adjudica e
his cases was displaced by a willingness o asse delica e, enuous
hypo heses in his cases, la gely o he bene i o he psychoanaly ic
communi y i sel . And on a mo e abs ac and pe haps less conscious
le el, he posi i is ic belie in he
impo an e
o heo y and he objec i e
e i iabili y o hypo heses ha F eud had subsc ibed o om he ime he
(*)
Una e sión esumida de es e abajo se ha publicado en,
Pa isan Re iew,
49/1,
101-1 18,
(1982).
**
Depa nen o His o y, 454 Hamil on Hall 070 A, Uni e si y o No h Ca olina, Chape1
Hill, NC 27514. USA.
DYNAMIS
Ac a Hispanica ad Medicinae Scien ia umque His miam Illus andam.
Vol. 2, 1982, pp. 263-297.
ISSN: 021 1-9536.
264
CARL. E. PLETSCH
had decided o s udy medicine was a leas empo a ily challenged by
ano he iew o knowledge, a iew ha 1 shall
y
o cla i y in his pape .
My examina ion o F eud's case s udies is necessa ily an in e oga-
ion o only a pa o he F eudian
oeu e.
Bu i leads inexo ably o he
ques ion o psychoanaly ic knowledge, i s locus, cha ac e , and epis-
emological s a us. Fo we canno examine he cases wi hou conside ing
hei ela ionship o F eud's o he w i ing. We canno help wonde ing
whe he F eud w o e his case s udies o a speci ic eade ship, o
example, o whe he he cases communica e o hei eade s in a unique
ashion. These ques ions will lead us o delinea e an impo an issu e in
F eud's hinking and o specula e upon how F eud's mos peculia ly
psychoanli ic knowledge di e s om o he o ms and kinds o know-
ledge.
Two no ions aken om he discou se oEghilosophy o science will
assis us in ou examina ion o F eud's case s udies: ((exempla sa and
«pe sonal knowledge)). We mus no ei y hese no ions, howe e , o
pe mi hem o dis ac us om he ques ion o psychoanaly ic know-
ledge. Le i be clea om he ou se ha 1
am
no ying o de end
psychoanalysis o o answe he ( edious) ques ion o whe he o no
psychoanalysis is a science. No
am
1 ying o demons a e he alidi y
o hese no ions o ( exempla )) and ((pe sonal knowledge)) in he
discou se o he philosophy o science. 1
am
using hese no ions in
connec ion wi h F eud's case s udies o he much mo e modes
heu is ic pu pose o illumina ing he place o case s udies in he
discou se o psychoanalysis and specula ing upon he na u e o psy-
choanaly ic knowledge, a peculia so o knowledge ha 1 belie e
emains o be adequa ely desc ibed.
This is no he place o elabo a e upon how he e m «exempla » has
been used by desc ip i e philosophe s o science, bu 1 mus admi ha
my unde s anding o he way in which F eud's (and la e psychoana-
,
lys s') case s udies cons i u e exempla s in psychoanalysis di e ges in
one e y impo an espec om he meaning o he e m gi en by
Thomas Kuhn. In his a emp o show ha sha ed heo y and co es-
pondence ules a e no su icien o explain disciplina y cohe ence in
ce ain na u al sciences, Kuhn used he e m ((pa adigm)) in one o i s
senses o mean asha ed examples o success ul p ac ice)), which s uden s
o hese disciplines lea n, and which hen se e o main ain he
cohe ence o hei esea ch communi y
(1).
In Kuhn's la e essays, hese
(1)
In his la e essays Kuhn uses he e m ((exempla s)) o his sense o his o iginal e n
((pa adigm)).
C :
The S uc u e o dcien z i Re olu ions.
Chicago, Uni e si y o Chicago P ess,
F eud's Case S udies and he Locus o Psychoanaiy ic Knowledge
265
a e e med exempla s. My imp ession is ha psychoanaly ic case s udies
-F eud's in pa icula -- se e he pu pose o helping psychoanalys s
iden ie he p oblems posed by hei pa ien s and pe mi psychoana-
lys s al1 o e he wo ld, si ing done in hei consul a ion ooms wi h
hei pa ien s, o p oceed in pa allel ashion,
e en hough he examples a e
no always success ul.
The case o Do a comes o mind once again: he
ailu e o F eud's a emp s o eason wi h Do a and he ab up e mi-
na ion o analysis be o e he apy could be e ec ed does no seem o
de ac om he alue o he case. The p esen a ion o such an awkwa d
case as an exempla migh well gi e a desc ip i e philosophe o science
like Kuhn pause, o say no hing o a neo-posi i is . Bu his seems
unp oblema ic he e, p ecisely because 1 am no ying o de end
psychoanalysis as a science o demons a e he alidi y o he no ion o
exempla s.
Wha e e one hinks o psychoanalysis, i is a ac ha F eud's case
s udies ha e been ex emely impo an ehicles o he adi ion o
psychoanaly ic knowledge. Somehow F eud's cases s ill communica e
essen ial knowledge o psychoanalys s. I is much easie , howe e , o say
wha hey a e
no
han o speci j wha hey a e and how hey wo k in he
discou se o psychoanalysis. Al hough hey a e by no means de oid o
heo e ical conside a ions, o example, hey a e al1 highly de ailed
in es iga ions o qui e idiosync a ic cases. F eud seldom e en claimed
o hem he alue o illus a ions o heo y, and as ime wen on he
ceased o make such claims al oge he . And as 1 ha e al eady sugges ed,
hey a e no qui e like exempla s in ha hey ob iously do no depend
upon being examples o
success ul
p ac ice. Many con e sa ions wi h
psychoanalys s and a eading o he memoi li e a u e o psychoanalysil
sugges , howe e , ha wha psychoanalys s de i e om hei s udy o
F eud's cases is a sense o how F eud hough , and, mo e pa icula ly,
how he hough wi h his pa ien s.
E en o he non-psychoanaly ic eade
F eud's case s udies seem o communica e how i eels o do psychoa+
nalysis and lea n om pa ien s. In con as o his heo e ical w i ings
like he
Th ee Essays on he Theo y o SexualiS,
o exposi o y-didac ic ones
like he
In oduc o y Lec u es on Psychoanalysis,
F eud's case s udies may be
he locus o in e subjec i i y in psychoanalysis. I is e en emp ing o
hink ha he communica ion be ween F eud and he psychoanaly ic
eade s o his case s udies is modeled on he kind o communica ion
ha ob ains be ween malys and pa ien in psychoanalysis p ope . I
his is app oxima ely ile, i sugges s F eud's exemplq cases unc ion
1962, and mo e speci ically
The Essen ial Tension: selec ed S udies in Scien z ic T adi ion and
Change.
Chicago, Uni e si y o Chicago P ess, 1977, pp. 306 and 318-319.
266
CARL.
E.
PLETSCH
as
a kind o ((pe sonal knowledge)), bo owing now om Michael
Polanyi
(2).
S udying hem, psychoanalys s aci ly lea n o hink like
F eud.
The ques ion o emos in my mind while w i ing his pape is
how he
s a us F eud acco ded he knowledge deposi ed in his case s udies e ol ed in his own
hinking.
Bu o he ques ions can ne e be a om he su ace o inqui y:
how, o example, ha e F eud's case s udies been u ilized by his
ollowe s in psychoanalysis? How ha e la e psychoanalys s ein e -
p e ed hese case s udies? And how ha e he new cases epo ed by
o he psychoanalys s eshaped he Co pus o psychoanaly ic knowledge?
Al hough 1 shall no be able o answe hese ques ions in he b ie
compass o a pape on F eud's own hinking, 1 belie e my p esen
inqui y is gi en g ea e signi icance by he ac ha psychoanalys s ha e
indeed s udied F eud's cases as exempla y solu ions o p oblems. They
ha e oo, 1 belie e, lea ned mo e and mo e consis en ly om he case
s udies han om F eud's mo e adi ionally o mula ed heo e ical
p oposi ions. The whole p ocess o psychoanaly ic educa ion ensh ined
in he ins i u es o psychoanalysis sugges s his, al hough again i would
ake a sepa a e pape o demons a e i conclusi ely. I is e y la gely he
case s udies, F eud's and he cases published subsequen ly in he same
spi i by his ollowe s, ha ha e enabled psychoanalysis o main ain i s
g ea me hodological cohe ence o so long, and du ing a pe iod when
mos o F eud's o mal heo e ical s a emen s ha e been shown o be a
leas pa ially alse
(3).
Psychoanalys s a e o cou se no al1 ully awa e o he ac ha case
s udies play such an impo an ole in hei discipline. Many i no mos
psychoanalys s a e s ill consciously wedded o a posi i is ic concep ion
o science, and hey place g ea s o e in he heo y o psychoanalysis
when hey ep esen i o he public a la ge.
I
1 am igh :, howe e , hey
(2)
See POLANM,
M.
(1958),
Pe sonal Knowledge: owa ds a pos -c i ica1 Philosophy.
Chicago,
Uni e si y o Chicago P ess.
(3)
On psychoanaiy ic educa ion see: GOODMAN,
S.
(ed.) (1977),
Psychoanaly ic Educa ion
and Resea ch.
New Yo k, In e na ional Uni e si ies P ess, and LEWIN, B. D.; ROSS,
H.
(1960),
Psychoanaly ic Educa ion in he Uni ed S a es.
New Yo k, In e na ional Uni e si ies
P ess. Fo e idence o he ole o case s udies in main aining he cohe ence o he
psychoanaiy ic discipline, one should aiso conside he pe iodicai li e a u e o psychoa-
naiysis and he p ominence o case s udies in i . Two o he publica ions a e aiso
in e es ing in his con ex : one, didac ic, is Hedda Bolga 's essay on The Case S udy
Me hod, in WOLMAN, B. B. (ed.) (1965),
The
Handbook o clinical Psychology.
New Yo k,
McG aw-Hill; he o he , his o ial, is Ha old G eenwaid's edi ion o
G ea Cases in
Psychoanalysis.
New Yo k, Ballan ine Books, 1959, whe e he edi o explici ly sugges s ha
hese mos equen ly s udied and ci ed cases cons i u e a mo e signi ican his o y o
psychoanalysis han a ecoun ing o he e olu ion o heo y o echnique.
F eud's Case S udies and he
Locus
o Psychoanaly ic Knowledge
267
a e much mo e de ensi e abou he agili y o his body o heo y han
hey need o be. Fo ~ hen hey communica e wi h hei pa ien s and
wi h each o he , hey a e demons ably mo e in e es ed in he sub le ies
o insigh ound in pa icula cases gene a ed by. hei me hod han hey
a e in he alidi y o gene al heo e ical p oposi io is.
This sugges s ha psychoanaly ic knowledge, he knowledge pecu-
lia o psychoanalysis, is cons i u ed a he di e en ly han he know-
ledge o a mo e ho oughly heo y-based science. In ac , 1 use he wo d
«knowledge» in e e enice o psychoanalysis, ins ead o «science», p e-
cisely in o de o sugges ha he e y ques ion o science is misleadding
when applied o psychoanalysis
(4).
I so, hen he g ea ene gy expen-
ded in ying o e o mula e F eud's heo e ical p oposi ions o make
hem expe imen ally eis able may no -in spi e o he alue such e o s
may ha e o o he pu poses- con ibu e much o ou unde s anding
o wha psychoanaly ic knowledge eally is
(5).
A
uly desc ip i e
(4) Se e al o he disciplines o ques ionables scien i ici y ha e applied o he s a us o
special o ms o knowledge in o de o ci cum en he ques ion o science, which seems
always o en ail a compa ison wi h physics. This ac ic gi es ise o he plu al o m,
aknowledges)). This seenis no el bu i could become as common as «sciences» is now.
And since «knowledge» is so much less eigh ed wi h ideology han «science», his migh
acili a e mo e and mo e genuine desc ip i e app oaches o he in ellec ual capi als o
he anomalous disciplines o p~~choanalysis, e hnog aphy, his o y, e c. In ollowing his
sugges ion, howe e , one necessa ily aises he al e na i e ques ion o «a » o cc a b,
'
and ha wo will need o be di e en ia ed be o e i wiii be use ul.
(5) Fo he e o s o es F eud's heo ies expe imen ally, see EYSENCK, H.
J.;
WILSON, G.
D. (eds.) (1973),
The Expe imen al S udy o F eudiam Theo ies,
London, Me huen, and
SARNOFF, 1. (1 97 l),
Tes ing F eudian Concep s,
New- Yo k, Sp inge . Mo e ecendy
Seymou Fishe and Roge G eenbe g ha e ca alogued and analyzed he as li e a u e
de o ed o'expe imen al s udy o F eud's heo ies in hei book
The Scien i lc C edibili y o
F eud's Theo ies and The a y.
New Yo k, Basic Books, 1977; he same au ho s ha e edi ed a
book o exempla y es s o F eudian heo ies, en i ied
The Scien i ic E alua ion o F eud's
Theo ies and The apy.
New Yo k, Basic Books, 1978.
On F eud's heo ies mo e gene ally, hei genesis, hei «s yle», and hei s a us as
science, see ELLENBERGER, H. (1970),
The Disco ely o he Unconscious.
New Yo k, Basic
Books; a ious pape s by Robe R. Hol , e.g, Two In luences on F eud's Scien i ic
Though : a F ag nen o in ellec ual Biog aphy, in: WHITE, R. W. (ed.) (1963),
The S udy
o li es,
New Yo k, A he on P ess, pp. 364-387, F eud's Cogni i e S yle,
Ame ican Zmago
22,
163-179 (1965), and A Re iew o Some o F eud's Biological Assump ion and hei
In luence on his Theo ies, in: GREENFIELD, N. S.; LEWIS, W. C. (eds.) (1965),
Psychoanalysis and cu eni! biological Though ,
Madison, Uni e si y o Wisconsin P ess,
pp. 93-124; GEDO,
J.
15.; GOLDBERG, A. (1973),
Models o he Mind: a psychoanaly ic
Theo y,
Chicago, Uni e iii y o Chicago P ess. GEDO,
J.
E.; POLLOCK, G. H. (eds.)
(1976),
F eud: he Fusion o Science and Humanism,
New Yo k, In e na ional Uni e si ies
P ess; he wo k o Roy Schae e , especially Ac ion: i s Place in Psychoanaly ic In e p e-
a ion and Theo y,
The Annual o Psychoanalysis,
1,
159-1 96 (1 973) and
A
New
Language o
Psychoanalysis,
New Ha en, Yale Uni e si y P ess, 1976; and mos ecen ly, F ank
Sulloway's
F eud: Biologis o he Mind,
New Yo k, Basic Books (1979).

268
CARL.
E.
PLETSCH
1
accoun o psychoanalysis,
1
am sugges ing, would ha e o pay much
mo e a en ion o case s udies as eposi o ies and ehicles o his
knowledge han has been he case hus a . Such a desc ip i e accoun
would o cou se in ol e an ex ensi e s udy o he pe iodical li e a u e o
psychoanalysis, i s monog aphs, and o psychoanaly ic educa ion 'as
p ac iced in he ins i u es. The p esen pape is only a beginning in ha
di ec ion, an a emp o see how F eud came o he en a i e conclusion
ha case s udies we e he gen e o peculia ly psychoanaly ic knowledge,
and (as a co olla y) o aim his mo e heo e ical s a emen s a he
ex apsychoanaly ic eade . I is o cou se also an a emp o pose he
ques ion o psychoanali yc knowledge as a ques ion o discou se.
F eud published his i s case s udies join ly wi h Joseph B eue ,
whose pa ien
((A ma
0.))
had ac ually in en ed he (( alking cu e)) ha
cons i u ed he udimen a y psychoanaly ic me hod ha F eud p ac i-
ced in he 1890's. These i s case s udies appea ed in
S udies on Hys e ia
in 1895. F om ha yea un il 191 5 when F eud comple ed his case
his o y o he Wol Man
(F om he His o y o an In an ile Neu osis,
which was
no published un il 191 8), his me hod was con inually e ol ing. And
especially du ing he la e hal o his pe iod, F eud's ene gies we e
dedica ed e y la gely o he o ma ion o a school o disciples and
ins i u ionalizing psychoanalysis. We shall see ha F eud's p eoccupa-
ions wi h his me hod o in es iga ion and wi h o ming a communi y o
psychoanaly ic in es iga o s go e ned his inno a i e use o case s udies.
1
shall ocus he e in u n upon each o he case s udies F eud w o e in
his wen y yea pe iod.
1.
STUDIES
ON
HYSTERIA
I
S udies on Hys e ia
is one o he leas cohe en wo ks in he F eudian
Co pus. Fo one eason, i was w i en by wo au ho s who did no ag ee
en i ely on i s subs ance. Fo ano he , he p incipal au ho had no ye
comple ed his so-called sel -analysis o e en begun he syn hesis o his
ideas ha he would publish as he
In e p e a ion o D eams
in 1900. Thus
S udies on Hys e ia
emained a se ies o agmen s, bu i s agmen a y
and en a i e na u e pe mi s an unhinde ed iew o he au ho s' anxie y
abou he case s udies hey epo in i . ~ eud's' and B eue 's conce ns
we e no unlike wha any la e nine een h-cen u y na u al scien is s
would ha e el when, s ill caugh in he h oes o gi ing bi h o a new
kind o knowledge, hey could only epo hei agmen a y insigh s in
case s udies.
In his s udy o Anna O., o example, B eue el obliged o «excuse»
himsel o eci ing he de ails o he case by d awing an analogy
F eud's Case S udies and he Locus o Psychoanaly ic Knowledge
269
be ween Anna
0.
and he cla i y o he p o oplasm o he eggs o he sea-
u chin which enable he his ology s uden o see wha happens in he
eggs o o he species whose egg-p o oplasm is opague: «The in e es o
he p esen case seems o me abo e al1 o eside in he ex eme cla i y
and in elligibili y o i s pa hogenesis)). B eue 's analogy was la e used by
F eud oo, as he edi o s o he
S anda d Edi ion
o his w i ings poin ou .
And his gene al a gumeni ha pa hology may illumina e he wo kings
o he heal hy pe sonali y became an impo an jus i ica ion o he
alue o psychoanaly ic esea ch. Bu i is in e es ing o no e ha bo h o
hese ideas a ose in esponse o B eue 's (and F eud's) anxie y abou
epo ing in such de ail on a single unusual example. S angely enough,
he sea-u chin analogy is ac ually inapp op ia e in his mos impo an
espec , since Anna
0.
did no cons i u e a ypical exa nple o a di e en
species bu an indi idual o he same species whose pa hology migh
ha e made he wholly idiosync a ic. Thus he analogy se es p incipally
o mask he p oblem which na u al scien is s o he ime would ha e
ound mos unse ling
(6).
The S o y o Anna
O.
-now hough o ha e been Be ha Pap-
penheim in eal li e: he social wo ke , philan h opis and ounde o he
Jüdische F auenbund-
was he i s and mos ex ao dina y o he cases
epo ed in
S udies on Hys e ia.
Hen i Ellenbe ge desc ibes F eud's
lea ning o he s o y o B eue 's pa ien , along wi h his expe ience wi h
Cha co a he Salpe ie e in Pa is, as one o he wo pe sonal expe ien-
ces ha led him o de ise a new heo y o he neu oses
(7).
B eue had
ea ed Anna
O.
in he ea ly 1880's and o se e al easons was uncom-
(6) STRACHEY, J.,
e al.
(eds.),
The S anda d Edi ion o he Comple e Psychological Wo ks o Sigmund
F eud,
London, Hoga h, ol. 2, p. 41. The analogy may seem imp obable oday, bu in
he in ellec ual clima e o physiological psychia y ha p e ailed in he 1890's i was no
unusual-see SULLOWAY,
F'.
(1 979),
op. ci .
(7) ELLENBERGER, H. (1970),
op.
ci .,
p. 480. Ellenbe ge dis inguishes hese wo pe sonal
expe iences om he la ge ends in neu ology and psychia y ha also con ibu ed o
F eud's hinking abou he neu oses.
The w i ings o la e psychoanalys s on Anna O.
/
Be ha Pappenheim a e oo nume ous
o lis . A ew o he mo e i npo an : ELLENBERGER, H. F., The S o y o Anna O.: a
c i ical Re iew wi h new Da a,
Jou nal o he His o y o he Beha io al Sciences,
8,
267-269
(1972); JENSEN, E.
M.,
Anna O.
-
a S udy o he la e Li e,
Psychoanaly ic Qua e ly,
39,
269-293, (1970); MEISSNER,
W. W.
A S udy on Hys e ia: Anna O. Redi i ia,
The Annual
o Psychoanalysis,
7,
17-52 (1979); POLLOCK, G. H., The Possible Signi icance o
Childhood Objec Loss in he Jose B eue -Be ha Pappenheim (Anna
O.)-
Sigmund
F eud Rela ionship,
Jou nal o he Ame ican Psychoanaly ic Associa ion,
16,
7 11-739 (1968),
Be ha Pappenheim's pa hological Mou ning possible E ec s o Childhood Sibling Loss,
Ibid.,
20,
476-493 (1972), and Be ha Pappe-eim: Addenda o he Case His o y,
Ibid.,
21,
328-332 (1973); and mo e-gene ally, S. REICHARD, A Re-examina ion o "S udies
on H~s e ia",
Psyckoanaly ic Qm edy,
25,
155-177 (1956).
270
CARL.
E.
PLETSCH
o able abou e u ning o he case. As Ellenbe ge no es, he case
(( adically di e [ed] om o he cases o hys e ia [ epo ed] a ha ime,
bu [was] analogous o he g ea exempla y cases o magne ic illness in
he i s hal o he nine een h cen u y,
...
»
The case o Anna
O.
seems o
ha e appea ed o be a e e sion o an ea lie and os ensibly p e-
scien i ic psychology. As Ellenbe ge epo s,
To he olde magne ize s, Anna O.'s s o y would no ha e seemed as
ex ao dina y as i did o B eue . I was one o hose cases, so equen in
he 1 8201s, ye so sca ce in he 1880's, in which he pa ien dic a ed o he
physician he he apeu ic de ices he had o use, p ophesied he couqse o
he iiiness, and announced i s e minal da e. Bu in 1880, when au ho i-
a ian use o hypnosis had supplan ed he o me ba gaining he apy, a
s o y such as ha o Anna O. could no longe be unde s ood (8).
The anxie y o he wo au ho s, he e o e, mus ha e been based on he
kind and quali y o case s udy hey we e epo ing, and no only on he
ac o epo ing case s udies. Case s udies we e common enough in
medicine and neu ology a he ime. Jus wo yea s be o es publishing
S udies
on
Hys ie a,
F eud had published a con en ional case his o y
illus a ing how e ec i e hipno ism could be in clea ing up symp oms in
a case o hys e ia
(9).
This was qui e unp oblema ic since he case
me ely illus a ed a ela i ely common medical p ocedu e and appea ed
o alida e a heo y. In
S udies
on
Hys e ia,
howe e , F eud and B eue
we e admi ing he lack o medical and physiological au ho i y o e
hys e ia and, by implica ion, a ibu ing o he pa ien s he knowledge
and powe o cu e hemsel es. As F eud no ed, hei cases also had
mo e o a li e a y han a scien i ic cha ac e
(10).
And ha , aken in
conjunc ion wi h he ac ha F eud and B eue we e using hei cases o
illus a e ye non-exis en heo y, was wha made
S udies
on
Hys e ia
an
anomalous book on an anomalous subjec .
O
cou se
S udies
on
Hys e ia
consis ed o mo e han me ely case
s udies. The i s chap e was a pape ha F eud and B eue had
p e iously. published, a ((P elimina y Communica ion)) on hys e ia, de i-
(8) ELLENBERGER, H. (1970),
op.
ci .,
p. 484. This gi es iníe es ing ele ance o a ema k
o Robe Da n on in his book,
Mesme ism and he End
o
he Enligh enmen in F unce,
Camb idge (Mass.), Ha a d Uni e si y P ess,
p.
173: «Wo ks by nonmesme is s usudly
hono Mesme as a misunde s ood and some imes he oic p ophe o mode n psycho-
logy. I may be ha psychoanalysis de eloped om a line o occul scien is s, linking
F eud, Cha co , and B aid wi h Be and, Puysegu , and Mesme , jus as chemis y
eme ged om alchemy.))
(9)
A
Case o a success ul T eaunen by Hypnosis
in:
STRACHEY,
J.
e . al.
(eds.) (1966),
S anda d Edi ion,
ol.
1,
London, Hoga h, pp.
1
15-128.
(10) See below, p. 27
1.
F eud's Case S udies and he Locus o Psychoanaly ic Knowledge
27
1
ning hei place on he on ie o esea ch and dis inguishing hei
app oach om ha o o he in es iga o s. And he book concluded wi h
a ((Theo e ical)) chap e by B eue and a pape on ca ha sis as he
essen ial ing edien o ( l'he Psycho he apy o Hys e ia)) by F eud. Thus
he wo au ho s ca e ully b acke ed hei de ailed case s udies by
heo e icd s a emen s, gi ing hei case s udies he o mal appea ance
o me e illus a ions. Bu . his was an obliga o y o mali y dic a ed by he
no ns o scien i ic epo ing, no ms o which B eue and F eud
na u ally subsc ibed. Ne e heless, he heo e ical po ions o
S udies
on
Hys e ia
we e he p o oundly en a i e po ions and he case s udies he
eal subs ance o i . OnXy in he case s udies could he au ho s speak
com o ably in he indica i e mood -only he e we e hey eally su e o
hei g ound. And he e we e good easons o his, ha F eud a leas
ecognized.
In his discussion o he case o F au Emmy on N., also published in
S udies o Hys e ia,
F eud no ed he di icul ies a ising om he ac ha
hys e ia was a diagnos ic ca ego y wi hou igo ous o commonly
accep ed de ini ion: «UnXess we ha e i s come o a comple e ag eemen
upon he e minology in ol ed, i is no easy o decide whe he a
pa icula case is o be eckoned as a hys e ia o some o he neu osis.))
O cou se he ac ha hys e ia was a poo ly unde s ood bu no o ious
class o ne ous diso de s is p ecisely wha in e es ed F eud. One migh
say ha hys e ia was an acknowledged ca ego y o anomalous men al
diso de s in he 1890's. Anyone who could unde s and and de ine he
na u e o his diso de would clea up many mys e ies in neu opa-
hology. As F eud pu i , «we ha e s ill o awai he di ec ing hand which
shall se up bounda y na ks in he egion o he commonly occu ing
neu oses and which shall b ing ou he ea u es essen ial o cha ac e-
iza ion.)) In he mean ime, howe e , (we a e s ill accus omed o
diagnosing a hys e ia,
...
om i s simila i y o amilia ypical cases.))
Thus F eud explained he necessi y o epo ing case s udies o himsel
by emembe ing ha hys e ia was no hen a well unde s ood disease,
bu an icipa ed ha sonie g ea scien is -and in he e y ac o his
w i ing upon he subjec we can see ha he al eady an icipa ed he
possibili y ha he migh be ha ((di ec ing hand»- would clea up he
con usion by de ining he dis inc i e ea u es o hys e ia. Then hys e ia
would come in unde he umb ella o medical science and case s udies
would no longe be necessa y
(1
1).
(1
1)
S anda d Edi ion,
ol.
2,
p.
85.
We also no e ha F eud exp eses he ge m o
an
idea o
( scien i ic e olu ions)) in his passage.
27
8
CARL.
E.
PLETSCH
possibili y o an o de ly ecoun ing o a pa ien 's li e (25). Fu he mo e,
F eud ecognized ha he e we e se e al s o ies o be old ha could
ha dly be old simul aneously. In he Do a case he dis inguished only
be ween he na a ion o his in e p e i e echnique and he econs c-
ed biog aphic s o y in which he pa ien 's pa hology had de eloped.
Bu he no longe el ha he could wea e hese s o ies oge he as he had
in
S udies
on
Hys e ia.
i
ha e in his pape le en i ely ou o accoun he echnique, which does
no a al1 ollow as a ma e o cou se, bu by whose means done he pu e
me al o aluable unconscious hough s can be ex ac ed om he aw
ma e ial o he pa ien 's associa ions. This b ings wi h i he disad an age
o he eade being gi en no oppo uni y o es ing he co ec ness o my
p ocedu e in he cou se o his exposi ion o he case.
1
ound i qui e
imp ac icable, howe e , o deal simul aneously wi h he echnique o
analysis and wi h he in e nal s mc u e o a case o hys e ia:
1
could
sca cely ha e accomplished such a ask, and i
1
had, he esul would
ha e been almos un eadable
(26).
F eud had lea ned a g ea dela abou he epis emological s a us o
he knowledge he was de i ing om hys e ical pa ien s in he yea s since
1895. Pa adoxically, wha he had lea ned made him bo h mo e and less
sanguine abou he p ospec s o communica ing his knowledge. He was
much mo e awa e o ' he di icul ies o demons a ing he alidi y o his
obse a ions and hypo heses o he medical wo ld a la ge, bu he had
begun o see ha o he ini ia es and especially p ac i ione s o psychoa-
nalysis we e in a peculia ly ad an ageous posi ion o app ecia e his case
s udies. E nes Jones w i es ha we do no know why F eud hesi a ed so
long o publish he Do a case, and s ic ly speaking ha is ue, bu he
way his hinking had changed since 1895 sugges s a e y s ong eason.
He simply, ook his ese a ions abou he case's incomple eness e y
se iously. And in iew o he s ill almos comple e lack o a psychoana-
ly ic communi y in 1901, i is no wonde ha he did no publish i hen.
In 1905 hings looked di e en and he illus a i e alue he case held
o o he psychoanalys s ou weighed his ese a ions abou he possi-
bili y o i s being app ecia ed by he unini ia ed.
(25)
S anda d Edi ion,
ol.
7,
pp.
16-18.
(26)
Ibid.,
ol.
7,
pp.
12-13
and
112.
Ci ed passage appea s on p.
112.
On p.
13,
F eud w i es
ha «Apa om he d eams, he e o e, he echnique o he analy ic wo k has been
e ealed in only a e y ew places. My objec in his case his o y was o demons a e he
in ima e s uc u e o a neu o ic diso de and he de e mina ion o i s symp oms; and i
would ha e led o no hing bu hopeless con usion i
1
had ied o comple e he o he
ask a he same ime.» This is
an
e en mo e explici ecogni ion o he impossibili y o
econciling he na u alis ic na a i e wi h he wo k o anaiysis.

F eud's Case S udies and he Locus
o
Psychoanaly ic Knowledge
279
Anyone seeking o unde s and wha psychoanaly ic knowledge is
should y o unde s and F eud's dilemma a his junc u e. 1 belie e ha
i
we canno app ecia : F eud's mo i es in conside ing whe he o
publish he Do a case, we may be easonably su e ha we do no
unde s and he way in which psychoanaly ic knowledge de eloped and
how i is cons i u ed.
111.
LITTIE
HANS AND THE
RAT
MAN
When F eud inally decided o publish his accoun o Do a's case i
was a e ou yea s o empo izingj as 1 ha e al eady poin ed ou . In
ac , he pape had bee i accep ed o publica ion as ea ly as Janua y,
190 1 by Ziehen, he edi o o he
Mona sch i ü Psychia ie und Neu ologie,
he same jou nal in which i ac ually appea ed in 1905 (27). Bu his was
he las o F eud's. case s udies ha was o appea in a medical jou nal
no di ec ly associa ed wi h he psychoanaly ic mo emen . (Jones no es
ha F eud ga e his las lec u e be o e a medical audience in 1904.) O
cou se in 1900 when F eud wo ked wi h Do a and w o e he his o y o
he case, he couldn' be expec ed o ha e had disciples o a jou nal
de o ed e~ clusi ely o psychoanalysis. I was only in la e 1902 and 1903
ha he i s mee ings o wha was o become he Vienna Psychoanaly ic
Socie y we e held in F eud's wai ing oom, and only in 1908 ha he i s
((in e na iona.1)) mee ing o psychoanalys s was held in Salzbu g. I was a
he Salzbu g mee ing ha he decision was made o publish a psychoa-
naly ic pe iodical (28). As one migh suppose, he
Jah buch
was ounded
in
o de o gi e he g oup i s own o um in which o u he de elop
psychoanalysis wi hou he in e e ence o he unini ia ed -a s ep aken
by he p ac i ione s o i ually e e y eme gen discipline o subdisci-
pline (29). Thus in 1909 F eud was able o publish his nex wo case
his o ies in he i s wo numbe s o he i s psychoanaly ic pe iodical,
he
Jah buch U psychoanaly ische und psychopa hologische Fo schungen.
These
we e his epo s on he cases commonly known as Li le Hans,
Analysis
o
a Phobia in
a
Fi e-Yea -Old
Bay,
and he Ra Man,
No es upon a Case
o
Obsessional Neu osis.
In iew o he ci cums ances in which hey we e
(27) See he ((Edi o s No e)),
S anda d Edi ion,
London, Hoga h, ol.
7,
pp. 3-5 (1953).
(28) See JONES, E. (1955),
The
Li e
and Wo k o -igmund F eud,
ol 2, pp. 38-45.
(29) See also Jung's p e a o y s a emen in he i s olume, and Jone's accoun o F eud's
le e in which he exp essed sa is ac ion a being id o ou side in e e ence and able o
communica e wi h his disciples in hei own publica ion,
ibid.,
p. 45.
I
is signi ican ha
his impo an s ep in c ea ing a disciplina y ma ix should ha e been ma ked on
F eud's pa by he con ibu ion o wo case s udies (and no o he communica ions) o
he i s olume o he
Jah buch.
280
CARL. E.
PLETSCH
published, i should come as no su p ise ha F eud's accoun s o hese
wo cases should be de oid o ha de ensi e sensi i i y
is
6
is
non-
psychoanaly ic eade s which ma ked his accoun o he Do a case. The
cases published in 1909 we e clea ly aimed a a eade ship o psychoa-
nalys s, a eade ship which had only eme ged in he ime since he
w i ing o he Do a case (30).
The case o Li le Hans especially gi es he imp ession o a con i-
bu ion
en e nous,
and i became he e y i s i em in he i s issue o he
Jah buch.
The sense o amilia i y de i es in pa , o cou se, om he ac
ha he aw ma e ials o he epo we e supplied by he li le boy's
pa en s, who we e, acco ding o F eud, ((among my closes adhe-
en s)) (3
1).
Acco ding o F eud, oo, he had « o many yea s been u ging
my pupils and my iends o collec obse a ions o he sexual li e o
child en)) in o de o compa e he da a o such obse a ions o hypo-
heses abou ea ly sexual li e de i ed om he analysis o adul s, e.g.,
hose ha he had published in he
Th ee Essays on he Theo y
o
Sexuali y
(1905). The case o Li le Hans is he mos ob ious mi o his eques ,
some hing he pa en s o he child sha ed wi h F eud, and which F eud
hen sha ed wi h his o he disciples. Bu he e we e impo an and
posi i e heo e ical easons o sha ing his case wi h psychoanalys s.
F eud acknowledged ha he hypo heses in he
Th ee Essays,
seem as s ange o an ou side eade as hey seem incon o e ible o a
psycho-analys . Bu e en a psycho-analys may con ess o he wish o a
mo e di ec and less oundabou p oo o hese undamen al heo ems.
Su ely he e mus be a possibili y o obse ing in child en a i s hand
and in al1 he eshness o li e he sexual impulsed and wishes which we
dig ou so labo iously in adul s om among hei own déb is -especially
as
i is also ou belie ha hey a e he common p ope y o al1 men, a pa
o he human cons i u ion, and me ely exagge a ed o dis o ed in he
case o neu o ics
(32).
He e we see ha F eud con inued o ega d he case s udy as somewha
in e io in signi icance o heo e ical o mula ions, bu acco ded i an
i npo an ole in he con i ma ion o hypo heses, i.e., in he alida ion
(30)
The wo cases cons i u e ol.
10
o he
S anda d Edi ion.
(3 1)
The a he was
Max
G a ,
a
music c i ic and membe o F eud's ea ly ci cle who a ended
he ((Wednesday mee ings)).
I is in e es ing ha his ela i ely simple case ha F eud published o didac ic eason
done, and no because i illus a ed any new complexi ies o echnique o ma ked ou
any new e i o y o diagnosis, has been e y li le he subjec o la e psychoanaiy ic
in es iga ion o w i ing. This would seem o con i m F eud's s a emen s abou he
g ea e alue o he cases on he on ie s o knowledge, e en i hey canno be
comple ely esol ed, gi en in his accoun o he case o he Wol Man. See below, p.
290.
(32)
S anda d Edi ion,
ol.
10,
pp.
5-6.
F eud's Case S udies and he Locus o Psychoanaly ic Knowledge 28 1
p ocess
(33).
I is also in e es ing o no e ha he seems no longe
wo ied abou he ac lha his is only
one
case.
Wo king now in he con ex o wha he was la e o cal1 a he
psychoanaly ic mo emen )), F eud disco e ed ano he use o he case
his o y - he pedagogical. In his conclusion o he
Analysis o a Phobia in a
R e-Yea
Old
Boy
he w o e ha ,
S ic ly speaking,
1
lea n no hing new om his analysis, no hing ha
1
had no al eady been able o disco e ( hough o en less dis inc ly and
mo e indi ec ly) om o he pa ien s analysed a a mo e ad anced age.
Bu he neu oses o hese o he pa ien s could in e e y ins ance be aced
back o he same in an ile complexes ha we e e ealed behind Hans's
phobia.
1
a n
he e o e emp ed o claim o his neu osis o childhood
he signi icance o being a ype and a model,
...
(34).
This is a pa icula ly ini e es ing passage, in iew o he emendous
i npo ance ha case s udies, and pa icula ly F eud's case s udies, ha e
occupied in he cu iculum o he psychoanaly ic ins i u es. The accoun
o Li le Hans's phobia and i s emo al cons i u es he i s psychoana-
ly ic case s udy w i en la gely o didac ic easons
(35).
O cou se F eud
had called his accoun o Do a's analysis ((sui able as a i s in oduc o y
publica ion)), bu wi h he scien i ic eading public a la ge in mind. In
he case o Do a F eud wan ed o demons a e his unde s anding o
hys e ia; in ha o Li le Mans he wan ed o show psychoanalys s how
psychoandysis p oceeds and ha he sexual ae iology o adul neu oses
could be con i med in he analysis o a child. The di e en audience ha
F eud en isioned is c ucial o he e olu ion o his hinking abou he
alue o his case s udies.
F eud's epo on his analysis o he Ra Man,
No es upon a Case
o
Obsessional Neu osis,
con i ms his imp ession abou he in ended ea-
de ship o which F eud now di ec ed his case s udies
(36).
The case o
(33)
C
JONES, E. (1955),
The
Li e
and Wo k o Sigmund F eud,
ol. 2, pp. 258-262.
(34)
S anda d Edi ion,
ol. 10, p. 147.
(35) I was also he i s child a ialysis, a p ac ice la e de eloped along sligh ly di e en lines
by Melanie Klein. See he
Psychoanalysis o Child a
(London, Hoga h, 1932) and
especidy he
Na a i e o a Child Analys s
(London, Hoga ).
(36) The pos -F eudian psycheoanaly ic li e a u e on he case o he Ra Man is abundan . See
KANZER, M. (1952), The T ans e ence Neu osis o he Ra Man,
Psychoanaly ic Qua e ly,
21,
181-189; ZETZEL,
E.
11.
(1966), 1965: Addi ional No e upon a Case o obsessional
Neu osis: F eud 1909,
In e na ionalJou nal o Psycho-Analysis,
47,
123-129; MEYERSON, P.
G. (1966), Commen s on D . Ze z~l's Pape ,
ibid.,
pp. 139-142; LIPTON,
S.
D. (1971),
F eud's Analysis o he Ra Man conside ed
as
a echnical Pa adigm, abs ac ed in
Buile in
o he Philadeiphia Associa ion o Psychoanalysis,
21,
179- 183; CEDO, J. E.; GOLDBERG,
A.
(1973),
Models o he Mind,
pp.
11 1-1 14; and BEIGIER, J.
S.
(1975), A Commen a y on
F eud's T ea men o he Ila Man,
The Annual o Psychoanalysis,
3,
27 1-286.
282
CARL.
E.
PLETSCH
he Ra Man is less an illus a ion o a heo e ical hypo hesis han he
case o Li le Hans, and mo e an a emp o explo e new g ound, bu i
is
he e o e e en mo e di ec ly o ien ed o he psychoanaly ic eade ship
o he
Jah buch.
In no ing he incomple eness o his accoun o he case,
F eud explained ha he had «no ye succeeeded in comple ely pene-
a ing he complica ed ex u e o a
se e e
case o obsessional neu osis)).
Fu he mo e, F eud no ed ha obsessional neu oses we e a less easy
o unde s and han cases o hys e ia. This was pa adoxical, since
obsessional neu oses cons i u e no only «a dialec o he language o
hys e ia)), bu ((a dialec in which we ough o be able o ind ou way
abou mo e easily, since i is mo e nea ly ela ed o he o ms o
exp ession adop ed by ou conscious hough han is he language o
hys e ia)). He sugges ed ha he di icul y was due o he ac ha ewe
cases o obsessional neu osis had p esen ed hemsel es o analysis,
such neu o ics inding i possible o ((dissimula e hei condi ion in daily
li e)). In any case, obsessional neu oses cons i u ed a pa hology on he
on ie o psychoanalysis, 'much like hys e ia had been
an
anomaly in
neu opa hology when F eud began o s udy i . This is wha made F eud
eel jus i ied in communica ing his insigh s o he psychoanaly ic
communi y.
In
hese ci cums ances he e is no al e na i e bu o epo he ac s in he
impe ec and incomple e ashion in which hey a e known and in which
i is leei ima e o communica e hem. The c umbs o knowle~de o e ed
"
"
in hese pages, hough hey ha e been labo iously enough collec ed, may
no in hemsel es p o e e y sa is5ing; bu hey may se e as a s a ing-
poin o he wo k o o he in es iga o s, and common endea ou may
b ing he success which is pe haps beyond he each o indi idual
e o
(37).
Wi h his 1 belie e we begin o see ano he pa e n in F eud's hinking
abou his case s udies: hey a e exempla y in es iga ions, no necessa ily
solu ions, o p oblems o psychopa hology. He now hough o his case
s udies as pa s o a scien i ic esea ch li e a u e o which o he psychoa-
nalys s would ob iously con ibu e. E en his impe ec and incomple e
case s udies se ed o ma k ou he e i o y o u u e psychoanaly ic
in es iga ions.
In his conclusion o he sa ne case, he exp essed his wish ha
(([all hough my communica ion is incomple e in e e y sense, i may a
leas s imula e o he wo ke s o h ow mo e ligh upon he obsessional
neu osis by a deepe in es iga ion o he subjec )). F eud may ha e been
gi en o alse modes y on occasion, bu his is no one o hose
(37)
S anda d
Edi ion,
ol.
10,
pp.
156-157.
F eud's Case S udies and he Locus o Psychoanaly ic Knowledge
283
occasions. He was conce ned he e wi h he e y di icul p oblem o
dema ca ing obsessional neu oses om cases o hys e ia, as we see om
he same passage whe e he also s a es e y aguely ha «Wha is
cha ac e is ic o his neu osis -wha di e en ia es i om hys e ia- is
no , in my opinion, o be ound in ins inc ual li e bu in he psycholo-
gical ield))
(38).
This pos ula e emained o be u he speci ied by o he
wo ke s who would analyze cases o obsessional neu osis. Thus we see
ha F eud's diminished anxie y abou he incomple eness o his cases
and his con idence in he coope a ion o his psychoanaly ic ollowe s go
hand in hand. The case his o y had by his ime achie ed he s a us o a
gen e peculia ly sui ed o communica ion among psychoanalys s. F eud
clea ly saw bo h o his cases published in 1909 as a pa o a ongoing
p ocess o psychoanaly ic esebch. They we e no me ely places whe e
acqui ed insigh and knlowledge could be deposi ed ( o he bene i o
he wo ld a la ge), buu a gen e which omen ed u he esea ch by
in es iga o s who had al eady gained ..a con ic ion o he alue o
psychoanalysis.
F eud said li le enough abou he ans e ence in hese wo case
s udies piiblished in 1909, bu ha may be p ecisely because hese a e
cases w i en o psychoanalys s and psychoanalys s unde s ood his
ma e by hen. The e is good e idence in ema ks he made o non-
psychoanalys s on he subjec o ans e ence in he sa ne yea , ha he
belie ed ha expe ience in analysis was a p e equisi e o he app e-
cia ion o he alidi y o insigh s de i ed om psychoanalysis. In his
Fi e
Lec u es on Psychoanalysis
gi en a Cla k Uni e si y in 1909, F eud s essed
ha he expe ience o i-ans e ence
plays a decisi e pa in b inging con ic ion no only o he pa ien bu also
o he physician.
1
know
i
o be ue o al1 my ollowe s ha hey we e
only con inced o he co ec ness o my asse ions on he pa hogenesis
o he neu oses by hei expe iences wi h ans e ence; and
1
can e y well
imde s and ha such ce ain y o judgemen canno be a ained be o e
one has ca ied ou psycho-analyses and has onesel obse ed he
wo kings o ans e ence
(39).
This con ic ion ha his ollowe s had e i ied he alue o his insigh s by
hei own expe ience wi h he ans e ences o hei own pa ien s mus
be seen as an impo an pa o he basis o his new a i ude abou case
s udies.
The expe ience o ans e ence ha F eud now began o p esuppose
in
he eade s o his case s udies can be iewed wi h ex eme skep icism
(38)
Zbid.,
ol.
10,
p.
248.
C :
JQNES,
E.
(1955),
The
Li e
and Wo k o Sigmund F eud,
ol. 2,
p.
264.
(39)
Zbid.,
ol.
11,
pp.
51-52.

284
CARL.
E.
PLETSCH
o i can be casually accep ed as specialized aining. I can be iewed as
no mo e han he psychoanaly ic analogue o he p e equisi e aining
p esupposed in he scien i ic epo s o e e y o he specialized disci-
pline, om psychics o s a is ical demog aphy. O , expe ience wi h he
ans e ence in he p ospec i e psychoanalys 's own analysis and
in
he
supe ized analysis o his i s pa ien s can be aken as a i e o ini ia ion
bound o p oduce belie e s and hus a highly unscien i ic communi y o
in es iga o s. I seems o me ha he e is a leas a modicum o u h in
bo h o hese posi ions, and u he mo e, ha he e is li le p ospec o
esol ing he issue o he sa is ac ion o al1 hose who adop he opposed
a i udes. This much mus be admi ed. In ac , he wo posi ions o m
he pa ame e s ha gi e ise o he ques ion o psychoanaly ic know-
ledge. Fo i psychoanaly ic aining, analysis, e c., is
bo h
scien i ic
aining and eligious i e o ini ia ion, hen psychoanalysis is
nei he
simply science
no
eligious pseudo-science.
Wha s ikes me as mo e in e es ing, howe e , is ha his expe ience
wi h he ans e ence in he analy ic si ua ion ha F eud p esc ibed
migh be he complemen o he case s udies in de ining he peculia
na u e o psychoanaly ic knowledge. Fo 1 began by no ing ha psy-
choanali ic knowlegde seemed anomalous in being loca ed in case
s udies. Now in he p ocess o demons a ing he e olu ion o F eud's
own hinking owa d his iew, we ha e disco e ed ha expe ience wi h
he ans e ence is a p e equisi e o unde s anding he cases F eud
epo ed. The ans e ence seems o be he pa icula kind o ((pe sonal
knowledge)) equi ed o he psychoanalys . Bu unlike he many exam-
ples o pe sonal knowledge gi en by Polanyi in his book by ha name,
he ans e ence is only use ul when he psychoanalys is acu ely
conscious o i . Unlike he many skills ha we lea n wi hou being able
o desc ibe hem adequa ely o explain hem heo e ically, and by
de ini ion unlike aci knowledge, ans e ence is a kind o knowledge
ha depends upon he psychoanalys 's abili y o a icula e i . Thus i
may be ha he ans e ence is mo e ho oughly ((pe sonal
knowledge))
han he skills ha o he scien is s lea n by empa hy and imi a ion om
hei eache s. I seems o cons i u e a o m o in e subjec i i y ha can
only be de ined as a icula ed ((implici y)), o , in psychoanaly ic e ms,
he unconscious made conscious. This would seem o be wha makes i
bo h highly subjec i e and ye a sha ed medium o communica ion ha
cons i u es he basis o he psychoanaly ic communi y o in es iga ion.
IV.
THE SCHREBER CASE
F eud's analysis o Daniel Paul Sch ebe 's delusion was published in
he
Jah buch ü psychoanaly ische und psychopa hologische Fo schungen
in
19
1
1.
F eud's Case S udies and he Locus o Psychoanaly ic Knowledge
285
This essay,
Psychoanaly ic No es on un Au obiog aphical Accoun
o
a
Case
o
Pa anoia,
is no a case s udy in he same sense as he o he s
i
am
conside ing he e, inasmiich as F eud had no pe sonal con ac wi h
Sch ebe , no did Sch ebe himsel ha e any expe ience wi h psychoa-
naly ic he apy (as e en Li le Hans had). Sch ebe had, howe e , w i en
an
elabo a e accoun o his men al illness, and published i as his
Memoi s o a Men al Pa ien
(40). F eud used hese published memoi s as
he basis o his analysis. None heless, he case is again p esen ed
p ima ily o psychoanalys s a he han o he medical wo ld a la ge.
Thus we may no e ha by his ime F eud's hinking on his case s udies
had p og essed so a ha he made no he o ical use o he ac ha he
pa ien 's au obiog aphicd accoun was in he public domain. He migh
ha e a gued ha his would gi e his analysis an objec i i y ha his
ea lie case s udies did no possess, opening i o he e iew o o he
p o essionals in e es ed in pa anoia. Bu he was no longe conce ned in
his case s udies wi h es ablishing his g ea e capaci y o deal he apeu-
ically wi h a pa icula o m o men al illness. He was s ill e y much
conce ned ha o he psychoanalys s should ead he case and assimila e
his analysii; o i , howe e . In his espec , F eud's case his o y o
Sch ebe bea s some simila i y o his ea men o Wilhelm Jensen's
s o y ((G adi m, which also e ged upon becoming a case s udy o i s
au ho
(41).
F eud's mos gene al aim in w i ing his acoun o Sch ebe 's illness
was o es ablish he na u e o pa anoia and i s loca ion among o he
psychoanaly ically unde s ood men al diso de s. As he had been a
pains o dis inguish obsessional neu oses om hys e ia in his accoun o
he analysis o he Ra Man, in his essay on Sch ebe F eud wan ed o
es ablish pa anoia as a diagnos ic ca ego y by pene a ing o i s de ining
ea u es oo (42). Al1 o his ough o emind us,
1
hink, o his o iginal
an icipa ion in
S udies on Hys e ia,
o « he di ec ing hand which shall se
up bounda y ma ks)) among he a ious men al diso de s. Bu he
di icul ies in he a ea o pa anoia we e pa icula ly g ie ous and led o
he ac ha F eud was compelled o base his discussion o his diso de
upon a w i en accoun a he han an analysis. People su e ing om
pa anoid delusions we e no ap o submi o psychoanalysis, a p ocess
(40)
Denkwu digkei en eines Nenienk anken
(Leipzig, Mu ze, 1903),
an
English asla ion was
made
by
Ida Macalpine and Richa d Hun e and published wi h an in oduc ion as
Memoi s o my Nenious Zllness
(London, Dawson, 1955).
(41) ((Delusions and D eams in Jensen's G adi m (1907),
S anda d Edi ion,
ol.
9,
pp. 7-95.
(42) On which, see chap e h ee o he essay, «On he Mechanism o Pa anoia)),
S anda d
Edi ion,
ol.
12,
pp. 59-79.
286
CARL. E. PLETSCH
which would na u ally elici al1 hei ea s o pe secu ion and cause hem
o asc ibe he pe secu ions o he psychoanalys . Ha ing i ually no
pa anoid pa ien s, he e o e, and e aining hose ha he did encoun e
o only he e y b ie es pe iods, F eud ound himsel o ced o ely
upon he se endipi ously published accoun o Sch ebe . Thus his
apologies o he ac ha unde hese ci cums ances he was no able o
analyze he ans e ences .o he pa ien in he now well es ablished
analy ic con ex
(43).
In iew o al1 o hese di icul ies, i is al1 he mo e
in e es ing and e ealing ha F eud should ha e chosen o con ey his
insigh s on pa anoia in he o m o a case his o y.
The Sch ebe case seems o demons a e he signi icance o case
s udies as he p i ileged gen e o psychoanaly ic knowledge in a nega i e
way. F eud ound i na u al o make his a gumen s abou pa anoia in
he con ex o his case s udy, e en wi hou ans e ence, ee associa ion
o e en any pe sonal con ac wi h he subje c , because no o he mode
o epo ing cons i u ed a plausible al e na i e. To be su e, he inclina-
ion F eud ob iously el o ancho his hinking on pa anoia in Sch e-
be 's memoi s may s em as much om he unusually lo id na u e o
he pa hology o his pa icula case as om he impossibili y o gi ing a
con incing accoun o pa anoia in a mo e abs ac mode. Bu wha e e
he mix u e o mo i es, he incon es ible ac is ha F eud's epo on
he Sh ebe case
has
emained he co ne s one o psychoanaly ic
hinking on pa anoia o his day
(44).
In his ((A emp s a In e p e a ion)), he second chap e o he essay
on Sch ebe , F eud no ed ha his eade s would ((only ollow him as a
as
hei own amilia i y wi h analy ic echnique will allow hem))
(45).
Bu
he case is a good illus a ion o how F eud's psychoanaly ic colleagues
did in ac ollow him and by hei own a en ion o Sch ebe 's memoi s
amplie he conclusions ha could be d awn om a single case s udy.
A
yea a e his publica ion o he essay on Sch ebe , F eud no ed ha ,
By a happy chance he same issue o his pe iodical [ he
Jah buch]
as ha in
which
my
own pape appea ed showed ha he a en ion o some o he
con ibu o s had been di ec ed o Sch ebe 's au obiogaphy, and made i
(43)
S anda d Edi ion,
ol.
12,
p.
9.
(44)
O he eno mous li e a u e on he Sch ebe case, see especially he book by NIEDER-
LAND,
W.
G.
(1974),
The Sch ele Case psychoanaly ic P o ile
o
a
Pa anoid Pe sonaliQ,
New
Yo k, Quad angle, which con ains good bibliog aphies o ea lie wo k on Sch ebe .
The e was, o ins ance, a Symposium on he case, pape s om which we e published in
he
Zn e na ional Jou nal o Psycho-Analysis,
44
(1963),
edi ed by Philip
M.
Ki ay. O he
ecen wo k on Sch ebe is ep esen ed by CEDO.
J.
E.; GOLDBERG,
A.
(1973),
Models
o
he Mind,
pp.
125-134;
and MEISSNER,
W.
W.
(1979),
Sch ebe and he Pa anoid
P ocess,
The Annual o Psychoanalysis,
7,
3-40.
(45)
S anda d Edi ion,
ol.
12,
pp.
36-37.
F eud's Case S udies and he Locus o Psychoanaly ic Knowledge
287
easy o guess how much mo e ma e ial emains o be ga he ed om he
symbolic con en o he phan asies and delusions o his gi ed pa a-
noic
(46).
O cou se E nes Jones and o he w i e s since him ha e sugges ed ha
F eud's ema ks abou pa anoia in his accoun o he Sch ebe case
sowed he seeds o he soon o be accomplished disassocia ion o Ca l
Jung and his ollowe s om F eud, and he e en ual disa ec ion o
Sando Fe nczi
(47).
Bu so a om sugges ing ha F eud's essay ailed
in i s ole o exempla o help main ain he cohe ence o he psychoa-
naly ic communi y o in es iga ion, his demons a es he powe o he
case s udy o de ine he bounda ies o he nascen discipline. Reading
F eud's case s udies, i seems, no only guided and educa ed F eud's
willing ollowe s, bu could also se e o sepa a e less o hodox analys s
om he mo emen . In ac , F eud's nex case s udy would be e en
mo e impo an in sepa a ing e an analys s.
V.
THE WOLF
MAN
F eud's analysis o he case o he Wol Man, his las leng hy case
s udy, was w i en in he win e o 19 14- 15, en i led
F om he His o y o an
In an ile Neu osis
(1 91
8),
and published in his
Kleine Sch i en,
since he wa
had in e i~p ed he publica ion o he
Jah buch
o which i was in en-
ded. I qui e elabo a ely illus a es he ac ha F eud had come o use
his case s udies o educa e and in luence he hinking o his ellow
psychoanlys s a he han he medical wo ld a la ge. In ac , F eud used
he case o he Wol Man o a bi a e his di e ences wi h Adle and
especially wi h Jung. As he no ed in ega d o he con ex o his w i ing
he case,
A ha ime
1
was s ill eshly unde he imp ession o he wis ed e-
in e p e a ions which
C.
G.
Jung and Al ed Adle we e endea o ing o
gi e o he indings o psychoanlysis. This pape is he e o e connec ed
wi h my essay "On he His o y o he Psycho-Analy ic Mo emen " which
was published in he
Jah buch de Psychoanalyse
in
1914.
I supplemen s he
polemic con ained in ha essay, which is in i s essence o
a
pe sonal
cha ac e , by an objec i e es ima ion o he analy ic ma e ial
(48).
I should no escape ou no ice ha in linking his essay «On he His o y
o he Psychoanaly ic Mo emen )) o he case o he Wol Man he e,
F eud calls he la e ((objec i e)) and implies ha he o me is mo e
(46)
Ibid.,
ol.
12,
p.
80.
(47)
JONES,
E.
(1955),
Tke
Li e
and Wo k o Sigmund F eud,
ol.
2,
pp.
268-269.
(48)
S anda d Edi ion,
ol.
17,
p.
7.
294
CARL.
E.
PLETSCH
knowledge pa excellence. No ha hey cons i u ed he
only
kind o
psychoanaly ic knowledge. As a i s dis inc ion, one migh con as his
knowledge o psychoanalys s
deposi ed in he case s udies wi h he
knowledge
o psychoanalysis
ha F eud pu eyed in his mo e exposi o y and heo e-
ical wo ks
(62).
A de ailed in es iga ion would undoub edly yield many
u he dis inc ions based upon di e ences in he ways in which psy-
choanaly ic knowledge is ansmi ed and he uses o which i is pu
(63).
The e a e, in o he wo ds, many discou ses o psychoanalysis. Bu we do
no need o begin by knowing e e y hing; i.e., we do no need o make
an
exhaus i e s udy o al1 he di e ing discou ses o psychoanalysis
be o e we can begin o dis inguish psychoanaly ic knowledge om o he
o ms o knowledge. i case s udies a e indeed he gen e o
peculia ly
psychoanaly ic knowledge - he ke nel o
Knowledge o psychoanalys s-
we
should begin ou desc ip ion o psychoanalysis and psychoanaly ic
knowledge he e.
F eud's
oeu e
opened he discou se o psychoanalysis, bu i seems
ha
all
he issu es ha ha e de eloped in psychoanaly ic discou se
since F eud a e p e igu ed in he issu es o F eud's w i ing.
1
ha e
aced only one o hese issu es, showing ha behind he explici
di e ence be ween he gen es o F eud's w i ing in ended o di e en
audiences he e lay a ension be ween he posi i is ic no ions o science
ha F eud had imbibed wi h his medical educa ion, in which heo y
p edomina ed, and ano he no ion o knowledge ha a ose ou o o
was p oduced by he psychoanaly ic mode o knowing i sel . The iew o
knowledge implied in F eud's inc easing eliance upon case s udies, he
iew ha can be compa ed o
a
combina ion o Kuhn's exempla s and
;
Polanyi's pe sonal knowledge, ne e ully iumphed o e F eud's
;
commi men o heo y and i s e aci y. Bu e en hough his iew ne e
came o p edomina e in F eud's mind, we a e jus i ied in acco ding i
he s a us o a dis inguishing ea u e o psychoanaly ic knowledge. Fo i
ep esen s he mos adical depa u e om he adi ion o posi i is ic
scien i ic discou se in F eud's
oeu e,
and we may assume ha F eud
(62)
1
do no allude o Cli o d Gee z's dis inc ion be ween ((model o ~ and ((model o » he e.
Tha is qui e di e en .
(63)
As a as he knowledge o psychoanalysis ha is had among non-psychoanalys s is
conce ned, psychoanalysis is ob iously one hing o he psychoanaly ic pa ien who has
come o know psychoanalysis h ough his o he own expe ience in analysis and ano he
o he academic s uden o psychoanalysis who has ead F eud's ea ises by no
expe ienced analysis. And simila ly, he psychoanaly ic knowledge acqui ed by psy-
choanalis s has many o he componen s han me e ly he case s udies, e.g., wha hey
lea n om hei own aining analyses, wha hey app ecia e abou he conce ns o hei
ellow analys s, wha hey ead abou analysis, e c.

F aud's Case S udies and he Locus o Psychoanaly ic Knowledge
295
would no ha e pe mi ed himsel o be d awn in o such a depa u e i
his ne hod and he exigency o communica ing wi h his ollowe s had
no pulled him in ha di ec ion.
I onically, his s o y o how F eud came o iew his case s udies as
he locus o peculia ly psychoanaly ic knowledge -in spi e o himsel
and his posi i is ic aining- is a s o y ha could appea in an
un econs uc ed his o y o science. Wi hou much exagge a ion, we can
say ha he da a o ced F eud o his iew. Bu F eud's da a we e no he
ine da a. o he nine een h cen u y physical science. His da a we e
pa ien s, hei d eams, hei slips o he ongue, and ul ima ely hei
ans e ences and F eud's coun e ans e ences. F eud's ambi ion o
sol e he p oblem o hys e ia g adually led him o ans o m he
ins usi e hypno ic he apy he lea ned om he F ench in o a me hod o
in e subjec i i y. In his he allowed himsel o be ins uc ed by he
pa ien s, s a ing wi h Anna
O.
Bu his me hod o in e subjec i i y
-analyzing ans e ences- yielded knowledge ha F eud ound i
di icul i no impossible o con ey o eade s in he usual gen es o
scien i ic communica ion. He ound himsel o ganizing a communi y o
in es iga o s who expe ienced ans e ence in hei own analyses (o en
wi h F eud) and in hei analyses o pa ien s. Fo his communi y, he
case s udy p o ed he ideal gen e o communica ion. Thus F eud was
o ced o his no el iew o knowledge by wo s ic ly social con igu a-
ions: his ela ionships wi h his pa ien s and wi h he scien i ic commu-
ni ies, i s o medicine and physiology and la e o psychoanalysis.
This b ings us squa ely back o he ase ion ha he ques ion o
psychoanaly ic knowledge is a ques ion o discou se. Fo he wo
ela ionships ha pulled F eud owa d his iew o psychoanalysis as
pe sonal, exempla y knowledge in he case s udies u n ou o be he
i educible axes o psychoanaly ic discou se. The discou se o analys
and pa. ien
is
psychoanalysis in he sense o a p ac ice, and he discou se
o analys and ellow analys s
is
psychoanalysis in he sense o a
discipline. Wi hou hese wo le els o discou se any o he is un hinka-
ble. E e y o he discou se o psychoanalysis de i es ul ima ely om one
o bo h o hese.
F eud's case s udies (and he case s udies published since) a e o
cou se no iden ical wi h hese wo le els o discou se. Bu o al1 he
w i ings o F eud and his ollowe s, i is in he case s udies ha he
discou ses o analys lanalysand and analys l ellow analys a e mos ully
p ecipi a ed. The discou se o analys lanalysand canno by i s e y
na u e be eplica ed o a eade . As F eud no ed in his epo on he
case o he Wol Man, a e ba im ansc ip o he wo ds exchanged in a
296
CARL.
E.
PLETSCH
whole analysis would be comple ely inadequa e o ep esen ing ha
analysis o a hi d pa y
(64).
Bu a he han ansc ibe analyses, F eud
g adually de ised he case s udy as he ehicle and nea es app oxima-
ion o he in e subjec i i y ha ob ains in an analysis. This app oxima-
ion can be deciphe ed by o he analys s who ha e expe ienced ahs-
e ence in he analy ic si ua ion. Thus he discou se o analys l ellow
analys is much mo e clea ly e lec ed in he case s udies, bu again, he
ela ionship is no one o equi alence. The case s udies a e a sedimen o
his discou se, whe eas hey a e ansla ions o he discou se ana-
lys lanalysand. Bu in he case s udies we hea only one oice in he
discou se be ween analys s, he oice o F eud. And we can only a emp
o in e and ex apola e om ha oice he na u e o he discou se
a nong psychoanalys s. Wi h hese ese a ions we can s ill conclude ha
he case s udies cons i u e he mos cha ac e is ic and speci ically
psychoanaly ic knowledge in he F eudian
oeu e
(65).
Looking back hen, wha does he e olu ion o F eud's a i ude as he
w o e he case s udies e eal? F eud's awa eness o he signi icance o
he case s udy eme ged hand in hand wi h his ealiza ion ha psychoa-
nalysis cg>ns i u ed a new kind o knowledge. Ea ly in his ca ee as a
psychoanalys , when F eud hough his insigh s and disco e ies o be
aluable me ely as inc emen s o amilia scien i ic knowledge, he was
s ill obli ious o he impo ance o his epo s on pa icula cases, e en
emba assed by hem. Only when he began o ealize ha his new
insigh s migh cons i u e a new
kind
o knowledge did he begin o ealize
ha hey equi ed a no el so o epo age. Thus he case s udies lead
'
us no only o an app ecia ion o an impo an issu e in psychoanalysis
- he dis inc ion be ween knowledge o psychoanalys s and he know-
ledge o psychoanalysis- hey lead us o an awa eness o he issu es in
knowledge in gene al. In i s mos cha ac e is ic o m, psychoanaly ic
knowledge canno be adequa ely desc ibed as science o pseudoscience.
As a discou se, one discou se o se o discou ses among many o he s, i
mus be desc ibed as one o many kinds o knowledge. To con on he
ques ion o psychoanaly ic knowledge, we mus b acke he ques ion o
science.
(64)
S anda d Edi ion,
ol.
17,
p.
13.
(65) The ensions be ween he discou se o he anaiys wi h himsel , he anaiys wi h he
pauen and anaiys wi h ellow analys consu u e issu es wi hin he discou se o
he
case
s udies i sel . To examine hese a speci ically li e a y me hod would be necessq. The
place o s a would be wi h Ge a d Gene e, (# on ie es du eci ,
Figu es
11
(Pa is, Seuil,
1969), pp. 49-69, and ((Discou s du ecio,
Figu es
111
(Pa is, Seuil, 1972),
pp.
67-282.
F eud's Case S udies and he Locus o Psychoanaly ic Knowledge
297
Ea ly in his ca ee F eud was posi i ely in oxica ed by he au a o
na u al science and his highes ambi ion was o make his ma k as a
scien is . As he no ed in his
Au obiog aphzcal S udy,
and o he places,
F eud had ne e been mo i a ed by inclina ion o be a hede o
he apis . Cu iosi y and ambi ion led him o science
(66).
The ole o
scien i ic ambi ion is especially clea in
The In eq e a ion o D eams
whe e
he pu o wa d such pseudo- heo ies as ha e e y d eam mus be he
ul illmen . o a wish. Fo mulae o his so ha e enabled philosophe s o
science like he neo-posi i is Ka l Poppe o ca ego ize psychoanalysis
as
a ((pseudo-science)). Poppe claims ha ((no desc ip ion wha soe e o
any logically possible human beha io can be gi en which would u n
ou o be incompa ible wi h he psychoanaly ic heo ies o F eud))
(67).
Thus many o F eud's heo ies appea o be un es able and unscien i ic.
This is a c i icism ha psychoanalys s ind di icul i no impossible o
answe .
Bu
1
ha e ied o show ha i is an inapp op ia e c i icism.
Ce ainly i is an unin e es ing one
(68).
I
1
ha e been igh in showing
ha he case s udy g adually eme ged in F eud's wo k as he locus o he
mos speci ically psychoanaly ic knowledge, hen c i icism ha suppo-
ses psychoanaly-sis o-be loca ed in heo ies is su ely misplaced. Tha is
no o sugges ha psychoanalysis is immune o c i icism, o cou se. A
knowledge loca ed in exempla y case s udies and communica ed as
pe sonal knowledge may ha e g a e p oblems o i s own, bu hey a e
di e en p oblems han hose o heo e ical sciences.
--
(66) See ((Au obiog aphical S udy)),
S anda d Edi ion,
ol. 20, pp. 8 and 71-72, and «Th
Ques ion o Lay Analysis)),
S anda d Edi ion,
ol. 20, pp. 253-254.
(67) POPPER,
K.
R. (1972),
Objec i e Knowledge: an e olu iona~y App oach,
Ox o d, Cla en-
don, p. 8.
'68) Tha may be why Poppe has no pu sued he ma e u he han in
a
ew snide ema ks
abou psychoanalysis in passing.