Some Aspects of Charcot's Influence on Freud
Identifieur interne : 000074 ( Istex/Corpus ); précédent : 000073; suivant : 000075Some Aspects of Charcot's Influence on Freud
Auteurs : Julian A. Miller ; Melvin Sabshin ; John E. Gedo ; George H. Pollock ; Leo Sadow ; Nathan SchlessingerSource :
- Journal of the American Psychoanalytic Association [ 0003-0651 ] ; 1969-04.
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- Teeft :
- Basic books, Charcot, Clinical demonstrations, Daring ventures, Freud, Hogarth, Hogarth press, Hypnoid hypothesis, Hypnotic technique, Hysteria, Hysterical neurosis, Hysterical phenomena, Hysterical symptoms, Martha bernays, Mental treatment, Neurological patients, Psychological phenomena, Sigmund freud, Standard edition, Theoretical formulations.
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DOI: 10.1177/000306516901700215
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ISTEX:E5AAF0641CB601565FB6A91DB22F816DFE424822Le document en format XML
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Gedo</name><affiliation><mods:affiliation>912 South Wood Street Chicago, Ill. 60612 (Dr. Sabshin)</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Pollock, George H" sort="Pollock, George H" uniqKey="Pollock G" first="George H." last="Pollock">George H. Pollock</name><affiliation><mods:affiliation>912 South Wood Street Chicago, Ill. 60612 (Dr. Sabshin)</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Sadow, Leo" sort="Sadow, Leo" uniqKey="Sadow L" first="Leo" last="Sadow">Leo Sadow</name><affiliation><mods:affiliation>912 South Wood Street Chicago, Ill. 60612 (Dr. Sabshin)</mods:affiliation></affiliation></author><author wicri:is="90%"><name sortKey="Schlessinger, Nathan" sort="Schlessinger, Nathan" uniqKey="Schlessinger N" first="Nathan" last="Schlessinger">Nathan Schlessinger</name><affiliation><mods:affiliation>912 South Wood Street Chicago, Ill. 60612 (Dr. Sabshin)</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:E5AAF0641CB601565FB6A91DB22F816DFE424822</idno><date when="1969" year="1969">1969</date><idno type="doi">10.1177/000306516901700215</idno><idno type="url">https://api.istex.fr/document/E5AAF0641CB601565FB6A91DB22F816DFE424822/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000074</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000074</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Some Aspects of Charcot's Influence on Freud</title><author wicri:is="90%"><name sortKey="Miller, Julian A" sort="Miller, Julian A" uniqKey="Miller J" first="Julian A." last="Miller">Julian A. 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<contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Miller</surname><given-names>Julian A.</given-names></name><degrees>M.D.</degrees><aff>912 South Wood Street Chicago, Ill. 60612 (Dr. Sabshin)</aff></contrib></contrib-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Sabshin</surname><given-names>Melvin</given-names></name><degrees>M.D.</degrees><aff>912 South Wood Street Chicago, Ill. 60612 (Dr. Sabshin)</aff></contrib></contrib-group>
<contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Gedo</surname><given-names>John E.</given-names></name><degrees>M.D.</degrees><aff>912 South Wood Street Chicago, Ill. 60612 (Dr. Sabshin)</aff></contrib></contrib-group>
<contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Pollock</surname><given-names>George H.</given-names></name><degrees>M.D.</degrees><aff>912 South Wood Street Chicago, Ill. 60612 (Dr. Sabshin)</aff></contrib></contrib-group>
<contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Sadow</surname><given-names>Leo</given-names></name><degrees>M.D.</degrees><aff>912 South Wood Street Chicago, Ill. 60612 (Dr. Sabshin)</aff></contrib></contrib-group>
<contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Schlessinger</surname><given-names>Nathan</given-names></name><degrees>M.D.</degrees><aff>912 South Wood Street Chicago, Ill. 60612 (Dr. Sabshin)</aff></contrib></contrib-group>
<pub-date pub-type="ppub"><month>04</month><year>1969</year></pub-date><volume>17</volume><issue>2</issue><fpage>608</fpage><lpage>623</lpage><custom-meta-wrap><custom-meta xlink:type="simple"><meta-name>sagemeta-type</meta-name><meta-value>Journal Article</meta-value></custom-meta><custom-meta xlink:type="simple"><meta-name>search-text</meta-name><meta-value>JULIAN SOME ASPECTS OF CHARCOT'S INFLUENCE ON FREUD : GEORGE POLLOCK, H. M.D. LEO SAWW, M.D. NATHAN SCHLESSINGER, h1.D. i A. MILLER,h1.D.t hlELVIN SABSHIN, n1.D. GEDoJ 'ImD* JOHN (15, 22, 23) members of the Workshop on Scientific Methodology have considered the origins and modifications of some early concepts in psychoanalysis. We had been interested in the influences impinging on Freud during the early days of discovery and concept formation. In this context, Freud's trip to Paris to study with C.harcot seemed pivotal in his shift from neurological and physiological to psychopathological work. Although Jones (19) traces the principles upon which Freud constructed his theories back to the influence of Briicke, he also states: "It was assuredly the experience with Charcot in Paris that aroused Freud's interest in hysteria, then in psychopathology in general, and so paved the way for resuscitating Breuer's observation and developing psychoanalysis" (Vol. 1, p. 75). IVe have examined Charcot's writings (3) as well as some of those who have commented upon his work (5, 16, 17, 18, 24) to understand Charcot's theoretical perspective, his clinical technique, his research methods, aspects of his personality, and to assess the relative impact of each of these factors upon Freud. N PREVIOUS PAPERS I Charcot the Theorist Charcot recognized hysteria as a mental phenomenon and formulated a specific etiological theory for it (cf. 24). Although he was From the Workshop on Scientific I'~1cthodologyof the Chicago Institute for Psychoanalysis, Chicago, and the University of Illinois Department of Psychiatry. 608 LCIIARCOT'S INFLUENCE ON FREUD 609 quite aware of certain emotional factors relevant to the development of the disease, he simultaneously leaned heavily on a concept of an inherited neuropathic tendency. This oscillation between a psychosocial and a biological theory characterized his ultimate formulation of hysteria (cf. 17). Charcot accumulated a large mass of clinical data until he was able to discern an organized pattern and he had less concern for theoretical explanations than for subdividing clinical entities and for reorganizing groups of disparate symptoms into a whole syndrome. O n this score, Freud wrote, "the whole trend of his mind leads me to suppose that he can find no rest till he has correctly described and classified some phenomenon . . . but that he can sleep quite soundly without having arrived at the physiological explanation of that phenomenon" (7, p. 13). Indeed, Charcot was one of the most brilliant observers and classifiers in all of psychiatric and neurological history. Freud (10) quotes his response to an objection to a clinical demonstration which was contrary to the theory of Young-Helmholtz. He replied: "La thborie, c'est bon; mais Fa n'empCche pas d'exister [Theory is good; but it doesn't prevent things from existing]." Such an attitude is of course in keeping with the demand that theory explain observed fact or be altered-an attitude which maximizes empirical induction and potentially minimizes deduction. In keeping with his extraordinary capacity to build syndromes out of disparate symptoms Charcot pieced together the various components of hysteria into a single syndrome that was all-inclusive. Freud (7) states that Charcot "began by reducing the connection of the neurosis with the genital system to its correct proportions by demonstrating the unsuspected frequency of cases of male hysteria and especially of traumatic hysteria" (p. 11). A linkage between sexual function and the hysterical neurosis was clearly made, but the next step to sexual feeling or drive was not made. Other material suggests that a preconscious perception of psychosexuality related to hysteria was present but underemphasized or disguised by Charcot as in the following statement: "For my o.wn part I am far from believing that lubricity always is at work in hysteria; I am even convinced of L610 JULIAN A. MILLER ET AL. the contrary. Nor am I either a strict partisan of the old doctrine which taught that the source of all hysteria resides in the genital organs; but . . I believe it to be absolutely demonstrated that, in a special form of hysteria-the ovary does play an important part" (3, Vol. 1, p. 247; italics added). Charcot's statement implies that in some cases he does believe that "lubricity" is involved-a concept he makes use of in his clinical descriptions, but not in his theoretical formulations of hysteria. I n 1888 Freud, as a disciple of Charcot, was still writing, "As regards what is often asserted to be the preponderant influence of abnormalities in the sexual sphere upon the development of hysteria, it must be said that its importance is as a rule over-estimated" (8). Freud acknowledged the importance of sexual problems but was ambivalent and doubtful like Charcot. Charcot's ideas about the origins of hysteria derive in large part from the experimental induction of hysterical phenomena through hypnotism. TVith this technique he was able to produce symptoms which exactly replicated the naturally occurring phenomena. This, of course, is a quite legitimate experimental technique (cf. "Koch's postulates"). T o be able to produce symptomatology by such a process was a significant advance and it opened many new possibilities in the study of hysteria. It is an abuse of the technique, however, to assume that the naturally occurring symptoms must invariably be produced in an identical manner. Although Charcot made a significant contribution to the understanding of the origins of hysteria, he tended to, overgeneralize from the "experimental" replication. Our conclusion can be illustrated by the following: Charcot described two male patients who sustained brachial monoplegias following accidents. He was able to create the identical condition in two women who were patients in the Salpttrihre. After demonstrating that by suggesting he could create paralysis in his subjects, he went on to show that he could induce the same state without verbal suggestion but with a blow to the selected area-thus replicating even the manner in which the symptom was produced in nature (3, Vol. 3, p. 307). . LCIIARCOT'S INFLUENCE ON FREUD 61 1 'With regard to this impressive clinical demonstration it is well to keep in mind that serious questions have been raised about Charcot's research methodology. He repeatedly tended to discount learning, training, and compliance with the experimenter. After having demonstrated that he could produce a paralysis by the hypnotic technique, Charcot argued for the existence of a naturally occurring state in which hysterical symptoms are likely to occur in the same manner: "A peculiar mental condition often develops . . . which is very intimately connected . . . with the hypnotic state. In both of these conditions, in fact, the mental spontaneity, the will, or the judgement, is more or less suppressed or obscured, and suggestions become easy . . . the slightest traumatic action . . . may become the occasion of a paralysis, or a contracture, or an arthralgia." In another discussion of those with a predilection for hysteria, Charcot anticipated Breuer's hypnoid hypothesis by commenting as follows: "It appears that the hypnotic condition which in the case of the normal person-is an artificial state may be for those singular beings an ordinary one, their normal condition. These individuals sleep, if you will. allow the term, while they appear perfectly awake. They comport themselves in ordinary life as in a dream, treating as parallel the objective reality in the dream imposed on them, at least they make hardly any difference between the two." I n addition to his own observations Charcot was also aware of the ideas (cf. 21) about different kinds of consciousness or "splitoff'memories (later to be understood as dissociation). Thus, Charcot developed a formulation which is strikingly similar to Breuer's "hypnoid hypothesis" elaborated in the Studies on Hysferia (1). In considering the lasting influence of Charcot on Freud it is interesting to note that by 1895 Freud had some reservations about the "hypnoid" theory which postulated an altered state of consciousness at the time of the induction of the symptom (15, 22). It seems clear that Charcot, like Breuer, confined the study of psychological phenomena to certain selected patients, while it was Freud's task to overcome this barrier and develop a universal concept of conflict and defense (22, 23). Nonetheless, in 1893 Freud was able to say: "M. Charcot was the first L612 JULIAN A. MILLER ET AL. to teach us that to explain the hysterical neurosis we must apply to psychology" (11, p. 171). Charcot the Clinician Although Charcot's explanations of hysterical phenomena probably had limited impact upon Freud's theoretical formulations of hysteria, there is another area which we feel to be impressive and relevant from the point of view of his influence on psychoanalysis: this is Charcot's behavior as a clinician and as a psychotherapist. H e used hypnosis, suggestion, exhortation, and environmental and transference manipulations in ways which were apparently effective and which are quite similar to their current use. We have already alluded to Charcot's awareness-at least preconsciously-of quite important psychological correlations to hysterical symptoms. Although he did not integrate these psychological processes into his theoretical constructs, he described them in his clinical reports, which Freud heard, and which he could later recollect as his own ideas developed. In presenting his case histories, Charcot frequently included events of psychological importance. T h e inclusion of these data . suggests his preconscious awareness of their relevance to the disorders of the patients. Despite his preconception about the etiological significance of a hereditary "neuropathic" tendency in the family history, such traumatic phenomena as the death of an important person, exposure to a frightening experience, and illtreatment by a parent in childhood are all cited as Occurrences which Charcot assumed in some way to be relevant and in some cases quite important to the illness. As an example of this, we cite a case of a hysterical woman who became ill at age fifteen. Charcot writes: "the ill-treatment she had suffered from her father, who was addicted to alcoholic excesses, and her subsequent career as a prostitute, have doubtless exerted a certain etiological influence" (3, Vol. 1, p. 277). His comments assign not a simple correlation but an etiological role to the experiential events and also show a linkage to sexuality as a relevant phenomenon without assuming the prevalent moralistic posture about sexuality. LCIIARCOT'S INFLUENCE ON FREUD 613 About another case of hysteroepilepsy he states: "the probable causes of these nervous accidents . . . deserve mention. She had, as she said, a series of frights; one at the age of 11, she was terrified by a mad dog; two, at the age of 16 she was struck with horror at the sight of the corpse of a murdered woman; three, at the same age, she was a p i n terrified by robbers" (3, Vol. 1, p. 278). Although Charcot had no systematic way of conceptualizing or explaining the effects of emotional trauma, it appears that he had a striking perception of its importance in hysteria, whatever his statements about the predisposing factors may have been. As early as 1877, he described recoveries from hysteria which could occur as a result of severe emotional disturbance, such as shocking events in the hospital setting and other dramatic occurrences like the pilgrimage to Lourdes. . By 1885 he seemkd convinced that hysteria requires a mental treatment: "We have here a psychical affection, it is therefore by a mental treatment that we must hope to mod'ify it." As illustrated by the case cited in which Charcot described ill-treatment in childhood as a relevant consideration, he was aware of the deleterious effects that parents may have on children. In another case, Charcot describes a boy with headaches and hysterical seizures who could not be cured until his father would consent to leave him in a sanitarium and effect a complete separation (3, Vol. 3, p. 83). A similar description of a girl with anorexia nervosa in whom he achieved a remarkable recovery illustrates this as well as his general intuitive understanding of parental roles in the child's psychopathology. H e describes a consultation request from the parents of this girl to whom he wrote advising them: "Bring the child to Paris, place her in one of our hydrotherapeutic establishments, leave her there . . . and I will do the rest" (3, Vol. 3, p. 212). Some weeks later the patient was brought to Paris. Charcot's poignant account follows: I went to the establishment indicated, and there I saw a lamentable sight. She was a tall girl, 14 years of age, who had reached the last stage of emaciation, in a dorsal decubitus, with weak voice, extremities cold and blue and the head drooping. . . . There was, inde.ed, every reason to be uneasy, very uneasy. L614 JULIAN A. AIILLER ET AL. I took the patient's parents aside, and after having addressed to them a blunt remonstrance, I told them that there ' remained, in my judgement, but one chance of success. It was that they should go away . . . as quickly as possible. . . . They could lay their departure to my door, a matter which was of little importance provided that the girl was persuaded that they were gone and that they went immediately. Their acquiescence was difficult to obtain in spite of all my remonstrances. Perhaps I was eloquent for the mother yielded first and the father followed, uttering maledictions. . . . Isolation was established; its results were rapid and marvelous. T h e child, left alone with the nun who acted as nurse, and the doctor of the house, wept a little at first, though an hour later she became very much less desolate than one would have expected. T h e very same evening, in spite of her repugnance she consented to take half a little biscuit, and wine. On the following day she took a little milk, some wine, soup and then a little meat. Her nutrition became improved, progressively but slowly. At the end of 15 days she was relatively well. Energy returned and a general improvement in nutrition, so far t h a t at the end of the month I saw the child seated on the sofa and capable of lifting her head from the pillow. Then she was able to walk a little. Then hydrotherapy was brought into play and two months from the date of the commencement of the treatment she could be considered as almost completely cured. Power, nourishment, appetite, left very little more to be desired. It was then that the girl, when questioned, made the following confession to me: "As long as poppa and mamma had not gone-in other words, as long as you had not triumphed (for I saw that you wished to shut me up), I was afraid that my illness was not serious, and as I had a horror of eating, I did not eat. But when I saw that yoii were determined to be master, I was afraid. And in spite of my repugnance, I tried to eat, and I was able to, little by little." I thanked the child for her confidence, which, as you will understand, is a lesson in itself" [3, Vol. 3, pp. 212-2141. Thus, in his clinical vignettes Charcot demonstrates an intuitive grasp of many psychological connections. In his reports we find him using these connections although unable to formulate them further into a coherent, system of psychopathology or psychotherapy. Although not necessarily consciously aware of their LCIIARCOT'S I N F L U E N C E ON FREUD 615 significance, he makes refcrericcs to the importance of childhood events for later psychopathological syndromes, to a relationship bctween sexual life and hysteria, to "c1ircs" of hysteria occurring only through psychological (emotional) means, to the traumatic effect of fearful and frightening experiences, to the problem of secondary giin reinforcing a pattern of illness, and of the harmful effects ivhich parents may have upon childrcn which therefore may necessitate isolation of the child if treatment is to be successful. Charcot the Man IVe should now like to consider Charcot's personal characteristics especially those which he displayed as a c1inic:ll teacher. Most of the clinical demonstrations took place at Charcot's weekly lectures which were quite spectacular, attracting not only a scientific audience but also "society people, actors, writers, magistrates, and journalists" (16, p. 175), because of their theatricality and show manship. I n his work with hysteria, Charcot's interest in dramatic impact seems to have superseded his passion for scientific accuracy. T h e suggestibility of the hysterics, together with the great pressure of them to perform for "the Master" influenced the field which he observed in a way which may not have been equally significant for his neurological patients who were presented in the same amphitheatre. T h e failure to recognize this made Charcot vulnerable and overly sensitive to criticism. Guillain, his b i o p i pher, describes a man of "violent feelings" nicknamed "Caesar" who staged "shows" rather than scientific experiments (16). I t may be this same quality which served as a more personal motive for his interest in hysteria. Hysterical patients offered a dramatic opportunity (impossible with most neurological patients) not only for vivid demonstrations but for the exercise of an almost omnipotent, magical power as a healer. Freud, however. did not seem to note these tendencies at first, but reported a different impression of his new teacher upon arriving in Paris: "I saw n o sign, however, that Charcot showed any preference for rare o r strange material or that he tried to exploit it for mystical purposes" (7, p. 13). L616 JVLIAN A. MILLER ET AL. Freud's statements about the impact Charcot had upon him are found in his letters of the time (6). On November 24, 1885, he wrote to Martha Bernays: I am really very comfortably installed now and I think I am changing a great deal. I will tell you in detail what is affecting me. Charcot, who is one of the greatest of physicians and a man whose common sense borders on genius, is simply wrecking all my aims and opinions. I sometimes come out of his lectures as from out of NBtre Dame, with an entirely new idea about perfection. But he exhausts me; when I come away from him I no longer have any desire to work at my own silly things; it is three whole days since I have done any work, and I have no feelings of guilt. My brain is sated as after an evening at the theater..IVhether the seed will ever bear any fruit, I don't know; but what I do know is that no other human being has ever affected me in the same way. In another letter (January 20, ISSS), he indicates the regard he has for Charcot by way of a humorous reference to Charcot's daughter. In describing her to his fiancee, he states: Mlle Charcot is . . . small, rather buxom, and of an almost ridiculous resemblance to her great father, as a result so interesting that one doesn't ask oneself whether she is pretty or not. . . . Now just suppose I were not in love already.and were something of an adventurer; it would be a strong temptation to court her, for nothing is more dangerous than a young girl bearing the features of a man whom one admires. Freud was drawn to study in France with Charcot largely because of the latter's interest in psychological phenomena, particularly hysteria. T h e French school of neuropathology . . . seemed to me to promise something unfamiliar and characteristic in its mode of working, and moreover to have embarked on new fields. . . . p h e ] findings of the French school-some of them (upon hypnotism) highly surprising and some of them (upon hysteria) of practical importance-had been met in our countries with more doubt than recognition and belief. . . . I gladly seized the opportunity . . of forming a judgement upon these facts based on my own experience [7, p. 5f.l. . LCHARCOT'S INFLUENCE O N FREUD 617 Charcot had accepted hysteria as a legitimate concern for study, although we know little of his personal motivations for pursuing this interest. Guillain quoting Pierre Marie offers only a perfunctory explanation: IVhat happened at the SalpCtrikre was that . . . the administration took advantage of the evacuation of (a dilapidated) building finally to separate the nonpsychotic epileptics and the hysterics from the insane, and inasmuch as both groups of these patients manifested episodic behavior, it was considered logical to group them together and establish a special quarter called "Quartier des epileptiques simples." Since Charcot was the senior of the two physicians at the Salpetrihe, this new service automatically was assigned to him. Thus, quite involuntarily and by force of circumstances, Charcot found himself engulfed in the problem of hysteria [lG, p. 1351. Since Charcot's position was without peer he could obviously have changed clinical services in a reasonable time had he so wished. In fact, this kind of rotation was customary in Paris at that time. IVe would infer that more personal motives led him toward his psychological investigations. However, the grouping together of hysterics and epileptics, which seemed so fortuitous in stimulating Charcot, also served as a source of error, since it produced, by virtue of the suggestibility of the hysterics, many of the major seizures Charcot described. Although he differentiated between the two types of seizures, his uncritical acceptance of the manifest symptoms and problems in his experimental methods opened the way ultimately to serious criticisms of his results and methodology, especially by Liebault and Bernheim. T h a t Charcot had a great impact upon Freud is attested to not only by Jones (19) and Freud's own letters of the time, but also by the fact that he named his eldest son Jean hlartin, after Charcot, and that his own study shows striking similarities to that of Charcot. In a letter to Martha Bernays on January 20, 1886, he describes Charcot's study (6); I just want to add what his study looks like. It is as big as the whole of our future apartment, a room worthy of the magic castle in which he lives. . . . Along the side walls of the L618 JULIAN A. MILLER ET AL. larger section stands his ciiornious library on two levels, each with steps to reach the one above. . . . T h e other section has a fireplace, a table, and cases containing Indian and Chinese antiques. T h e walls are covered with Gobelins and pictures; the walls themselves are painted terra cotta. T h e little I saw of the other rooms on Sunday contained the same wealth of pictures, Gobelins, carpets and curios-in short, a ni1iseutn. T h e photograph of Freud's studies in Vienna (19, Vol. 2, p. 400) and London show similar collections. Eissler (4) cited further data suggesting that Freud had identified with Charcot. Other letters Freud wrote to hlartha Bernays during his period in Paris illustrate Charcot's influence on him in more detail (6). T h e letters also illustrate the capacity Freud had for vivid description at age twenty-nine. At ten o'clock M. Charcot arrived, a tall man of fifty-eight, wearing a top hat, with dark, strangely soft eyes (or rather, one is; the other is expressionless and has an inward cast), long wisps of hair stuck behind his ears, clean shaven, very expressive features with full protruding lips-in short, like a worldly priest from whom one expects a ready wit and a n appreciation of good living. H e sat down and began examining the patients. I was very much impressed by his brilliant diagnosis and the lively interest he took in everything, so unlike what we are accustomed to from our great men with their veneer of distinguished superficiality [Oct. 21, 18851. I would love to give you a description of his home; b u t this must wait for another day. IVVhat's more, he invited me . . . to come to his house tomorrow evening after dinner; "I y aura d u monde." You can probably imagine my apprehension mixed with curiosity and satisfaction. IVhite tie and white gloves, even a fresh shirt, a careful brushing of my last remaining hair, and so on. A little cocaine to untie my tongue. I t is quite all right of course for this news to be widely distributed in Hamburg and Vienna, even with exaggerations such as that he kissed me on the forehead (A la Liszt). As you see, I am not doing a t all badly and I am far from laughing at you and your plans [Jan. 18, 18861. T h e allusion to Liszt's acknowledgment of Chopin when the latter took Paris by storm suggests the fantasy of surpassing the Master, in view of Freud's identification with Chopin. LCHARCOT'S INFLUENCE ON FREUD 619 Later Freud wrote to Martha of Charcot singling him out to work with his assistant: I am now the only foreigner at Charcot's. Today . . . I had the chance of making a certain impression on him. H e was talking about a patient, and while the others were laughing, I just said: "Vous parlez de ce cas dans vos leqons," and quoted a few words of his. This seems to have pleased him, for an hour later he said to his assistant, "Vous allez prendre cette observation avec M. Freud," then turned to me and asked if I would like to "prendre une observation" with M. Rabinski [the assistant]. Needless to say, I had no objection. It is a case that Charcot seems to find interesting: personally I don't think much of it, but I shall probably have to write a paper about it with the assistant. Anyway, the point of the incident is that Charcot singled me out at all, and since then the assistant's behavior toward me has changed. . . . And all this in response to one nod from the Master Wan. 27, 18861. ' There is evidence that the trip to Paris had additional personal meaning to Freud, beyond'his contact with Charcot. A letter to Minna Bernays suggests that at that period of his life Paris had a meaning similar to that which Rome held at a later time. H e writes (6): I am under the full impact of Paris and, waxing very poetical, could compare it to a vast overdressed Sphinx who gobbles up every foreigner unable to solve her riddles. . . . Suffice it to say that the city and its inhabitants strike me as uncanny; the people seem to me of a different species from ourselves; I feel they are all possessed of a thousand demons. . . . As you realize, my heart is German provincial and it hasn't accompanied me here; which raises .the question whether I should not return to fetch it [Dec. 3, 18851. T h e explicit identification with Oedipus who solved the riddle of the Sphinx and thus became ruler of Thebes has the same possible significance as the previous reference to Chopin and Liszt. These clues about the importance for Freud of his visit to Paris led us to wonder what specifically he had found there in this time of transition from neurologist to psychiatrist. Certainly, it seems true that Charcot's attitude about the legitimacy of study- L620 JULIAN A. MlL.LER ET AL. ing hysteria was important. Jones states (19, Vol. I, p. 219): "Charcot's attitude to hysteria afforded very much encouragementwhat psychologists call "sanction"-to Freud, and he remained grateful to him for it." Beyond this "sanction," however, there seem to be two basic areas to consider: first, the actual knowledge and method which Charcot could communicate and teach; second, Charcot personally as a real and/or transference figure for Freud at this crucial stage (cf. 10). TVe have inferred that the personal experience with Charcot and in Paris seems to have had a profound impact on Freud, but the conceptual framework that Charcot could teach was of limited usefulness. T h e clinical demonstrations were important, but the theories about hysteria contained little that odd survive. Freud may have used the clinical examples to provide data for synthesis into a form quite different from that of Charcot. Indeed, the seeds of his intellectual disengagement from Charcot were visible even before Freud left Paris. In this context it is particularly interesting to note that in 1889 Freud went to Nancy to visit the severest critics of Charcot in order to perfect his hypnotic technique (12). H e did not discuss other reasons for the trip to Nancy, but he was at that time already aware of possible deficiencies in Charcot's ideas and techniques. In his Preface to Bernheim's Suggestion, which he had just translated, Freud wrote (9): "If the supporters of the suggestion theory are right, all the observations made at the SalpOtrikre are worthless: indeed, they become errors in observation." Thus Freud was finally able to consider the possibility that Charcot had induced symptoms in his patients by suggestion "in a manner of which he himself was unconscious" (9) (cf. 16, pp. 169f., 174ff.). Jones (19, Vol. I, p. 229) points out an error in Freud's recollection of this period in his Atitobiographical Study (14). Freud states that as a consequence of this Nancy visit he was stimulated to translate two works of Bernheim. Jones points out that Freud had already published one of the works with an extensive preface in 1888. T h e slip on Freud's part suggests ambivalent feelings about his need to seek validation about what he had seen in Paris as it conflicted in part with his own scientific reality testing; i.e., a critical review of what he had taken from Charcot was taking LCHARCOT'S INFLUENCE ON FREUD 621 place in him, albeit in the face of some resistmce. By 1892 this emancipation had gone so far that Freud presumed to annotate his translation of the master's lectures-and without asking Charcot's permission to do so. Although he went out of his way to deny that he was thereby setting himself above his "honored teacher," Freud stated his differences with Charcot very openly (10). I n 1925, Freud reviewed these events in his Ailtobiographical Study: IVhat impressed me most of all while I was with Charcot were his latest investigations upon hysteria, some of which were carried out under my own eyes. He had proved, for instance, the genuineness of hysterical phenomena and their conformity to laws . . . , the frequent occurrence of hysteria in men, the production of hysterical paralyses and contractiires by hypnotic suggestion and the fact that such artificial products showed, down to their smallest details, the same features as spontaneous attacks, which were often brought on traumatically [14; p. 131. As we have already suggested, Charcot's attitude in his psychotherapeutic work was that of a n omnipotent character, powerfully manipulating the transference situation. Freud tried to imitate this stance but could never feel at ease in it, nor be satisfied with the limited effectiveness and understanding that were part of it. In this connection, an anecdote described by Freud expresses his attitude quite clearly: IVhen a patient [of Bernheim in 18891 who showed himself unamenable [to hypnosis] was met with the shout: -IVhat are you doing? Vous voiis contre-siiggestionnez ', I said to myself that this was an evident injustice and an act of violence. For the man certainly had a right to counter-suggestions if people were trying to subdue him with suggestions [13, p. 891. Freud developed new techniques, more rationally based, as he was able to separate himself and his technique from that of his teachers. Concl iisio n In this paper we have attempted to assess the impact of Charcot upon Freud. Our study suggests that a powerful capacity for iden- L622 JULIAN A. MILLER ET AL. tification existed in Freud, accompanied by a capacity to modify that identification, selecting special areas in which it was retained, while changing others that did not prove fruitful. It seems plausible to assume that the capacity for this kind of identification and differentiation is an important factor in unusually creative individuals such as Freud. Lowenfeld (20) wrote: Identification with great men of the past seems to be an aspect of the growth of greatness in men, one of the conditions which make it possible. Greatness is deeply related to conflict -the struggle between powerful forces within, out of which the strength arises to stand alone and fight outside forces. Great father images appear to be necessary in the waging of this battle. Daring ventures into the unknown require protection in the history of revolutionary ideas or actions. Quite possibly, sublimations of the highest order are not achievable without such identifications [p. 6851. Our view corroborates Lowenfeld's thesis that Charcot served as one of a series of living models for these identifications, sublimations, and ultimate resolution within Freud. Earlier Brucke and Breuer probably served the same needs for him, as Fliess did later. Charcot has been characterized as a great pictorial artist who "lectured to enormous effect, evoked clinical pictures with unsurpassed clarity" (17). Freud identified with this powerful figure and utilized Charcot's strength and sanction to investigate unexplored psychological phenomena, but he soon needed to differentiate his own ideas from those of Charcot. Freud's "daring ventures into the unknown" went far beyond the concepts of Charcot, but the experience in Paris served as a decisive propulsive force into this new venture. BIBLIOGRAPHY 1. Breuer. J. & Freud, S. Studies on hysteria (1895). Standard Edition, 2. London: Hogarth Press, 1955. 2. Briquet, hI. Trait4 Clinique et Therapeutique de I-HystCrie. Paris: Alcan, 1859. 3. Charcot, J. M. Clinical Lectures on Diseases of the Nemous System, 3 Vols. London: New Sydenham Society, 1877-1889. 4 . Eider, K. R. Medical Orthodoxy and the Future of Psychoanalysis. New York: International Universities Press, 1966, p. 392f. 5. Ellenberger, H. F. Charcot and the Salpetrikre school. Amer. 1. Psychother., 19~243-267. 1965. LCIIARCOT'S INFLUENCE ON FREUD 623 6. Freud, S. Letters of Sigmund Freud, ed. E. Freud. New York: Basic Books, 1960. 7. Freud, S. Report of my studies in Paris and Berlin (1956 [1886]). Standard Edition, 1:5-15. London: Hogarth Press, 19GG. 8. Freud, S. Hysteria (1888). Standard Edition, 1:41-57. London: Hogarth Press, 1966. 9. Freud, S. Preface to the translation of Bernheim's Suggestion (1888). Standard Edition, 1:75-85. London: Hogarth Press, 1966. 10. Freud, S. Preface and footnotes to Charcot's Tuesday Lectures (1892-1894). Sfandard Edifion, 1:133-143. London: Hogarth Press, 1966. 11. Freud, S. Some points for a comparative study of organic and hysterical motor paralyses (1893). Standard Edition, 1: 157-172. London: Hogarth Press, 1966. 12. Freud, S. Charcot (1893). Standard Edition, 3:11-23. London: Hogarth Press, 1962. 13. Freud, S. Group psychology and the analysis of the ego (1921). Standard Edition, 18:67-144. London: Hogarth Press, 1955. 14. Freud, S. An autobiographical study (1925 [1924]). Standard Edition, 20:3-74. London: Hogarth Press, 1959. 15. Gedo. J. E.. Sabshin, M., Sadow, L., gt Schlessinger, N. "Studies on Hysteria": a methodological evaluation. This Journal, 129'35-751, 1964. . 16. Guillain, G. J. M . Charcot, 1825-IS95,His Life-His Work, ed. & tr. P Bailey. 17. Havens, L. L. Charcot and hysteria. J. N e w . Ment. Dis., 141:505-516, 1966. 18. Janet, P. Charcot, J. h. ., son Oeuvre psychologique. Rev. Philosophique, 39569605, 1895. 19. Jones, E. T h e Life and IVork of Sigmund Freud, 3 Vols. New York: Basic Books, 1993-1957. 20. Lownfeld, H. Sigmund Freud. This Journal, 4:682-691, 1956. 21. Ribot, T. A. Maladies de In Afdmoire. Paris: Alcan, 1881, pp. 111-112. 22. Sadow, L., Gedo, J. E.. Miller, J.. Pollock. G. H.. Sabshin, M.,SC Schlessinger, N. T h e process of hypothesis change in three early psychoanalytic concepts. T h i s 23. Schlessinger, N.. Gedo, J. E., hiiller, J., Pollock. G. H., Sabshin, M.. & Sadow. New York: Hoeber, 1959. Journal (in press). This Journal, 15:404-422, 1967. 24. Veith, I. Hysteria: T h e History of a Disease. Chicago: University of Chicago Press, 1965. Submitted September 8, 1967 912 South W o o d Street Chicago, Ill. 40612 (Dr. Sabshin) L. 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