BernheimV1, Istex, Corpus, bibRecord, 000349

The Scientific Style of Breuer and Freud in the Origins of Psychoanalysis

Identifieur interne : 000349 ( Istex/Corpus ); précédent : 000348; suivant : 000350

The Scientific Style of Breuer and Freud in the Origins of Psychoanalysis

Auteurs : Nathan Schlessinger ; John E. Gedo ; Julian Miller ; George H. Pollock ; Melvin Sabshin ; Leo Sadow

Source :

Journal of the American Psychoanalytic Association [ 0003-0651 ] ; 1967-04.

RBID : ISTEX:9E1D63E13FC6854B338EF995D1FCC71EFC0F1124

English descriptors

Teeft :
- Active investigator, Alternative hypotheses, Breuer, Cathartic method, Clinical evidence, Clinical theories, Disclaim responsibility, Everyday life, External world, Final product, First step, French school, Freud, Hogarth press, Inductive, Inductive method, Inductive reasoning, Internal conflict, International universities press, Josef breuer, Methodological evaluation, Nathan schlessincer, Nathan schlessinger, Natural phenomena, Nervous system, Observational data, Other hand, Other parts, Physiological concepts, Physiological explanations, Physiological papers, Physiological research, Physiology, Psychoanalysis, Psychological observations, Psychological research, Reality testing, Respiratory physiology, Scientific method, Scientific process, Scientific style, Scientific styles, Scientific work, Semicircular canals, Sense organ, Standard edition, Strong inference, Successful treatment, Technical ingenuity, Theoretical propositions, Transference.

Url:

https://api.istex.fr/document/9E1D63E13FC6854B338EF995D1FCC71EFC0F1124/fulltext/pdf

DOI: 10.1177/000306516701500210

Links to Exploration step

ISTEX:9E1D63E13FC6854B338EF995D1FCC71EFC0F1124

Le document en format XML

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         <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>30 N. Michigan Avenue Chicago, Ill. 60602</aff>
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         <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>30 N. Michigan Avenue Chicago, Ill. 60602</aff>
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         <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>30 N. Michigan Avenue Chicago, Ill. 60602</aff>
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         <pub-date pub-type="ppub"><month>04</month>
<year>1967</year>
</pub-date>
<volume>15</volume>
<issue>2</issue>
<fpage>404</fpage>
<lpage>422</lpage>
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<meta-value>Journal Article</meta-value>
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<meta-value> T H E SCIENTIFIC STYLE OF BREUER AND FREUD I N T H E ORIGINS OF PSYCHOANALYSIS : SCHLESSIKGER, M.D. .. NATHAN JOHN E. GEDO, M.D. JULIAN RIILLER,I . D . t h i GEORGE POLLOCK, H. 3II.D. i MELVIN SABSHIN, N . D . : LEO SADOW, ALD. I (15) investigating the methodology of the Studies 011 Hysteria members of this workshop noted as an unexpected finding a striking difference between the scientific styles of Breuer and Freud as manifested in this particular monograph (7). Freud presented clinical evidence and theoretical propositions at various levels of abstraction which could be derived from observational data by inductive reasoning. His hypothesis formation through deductive logic was clearly labeled and sparingly employed. He used deduction to validate his theories by making clinical predictions which could then be tested in the consulting room. Breuer, on the other hand, presented some data of observation but mostly theory (indeed, the "Theoretical" chapter was his sole responsibility). We could not demonstrate a clear and consistent connection between his theoretical constructs and the clinical evidence presented. Nor could we find a coherent and progressively developing theoretical framework into which further observations could be fitted. This appeared in sharp contrast to Freud's contributions in the work which demonstrated systematic methods of scientific thinking. Breuer seemed to give free rein to speculative thinking. He reasoned frequently by analogy and deduced ideas from theories which were highly abstracted, often borrowing from other sciences, N A PREVIOUS PAPER From the Workshop on Scientific hiethodology of Psychoanalysis of the Institute for Psychoanalysis, Chicago, Illinois. tDied March 9, 1966. I 404 THE SCIENTIFIC S N L E OF FREUD AND BREUER 405 notably physiology. T h e value and usefulness of his work are amply demonstrated by the fact that many of Breuer's conceptions of 1895 have subsequently proved to be sound and fruitful. What is striking is the absence of specific data upon which the abstract concepts are based. This difference in "scientific style" between the two authors of the Studies on Hysteriu piqued our curiosity, stimulating our interest in a comparison of scientific styles and in their significance. TVe became particularly interested in bringing into clearer focus the relatively mysterious figure of Josef Breuer, so important in the prehistory of psychoanalysis. T h e fact that we were impressed with the astuteness, capacity and depth of involvement demonstrated in his contributions made his subsequent withdrawal all the more puzzling to us. TVe wondered about what led him to initiate and then to abandon his explorations, leaving to Freud the completion of the voyage of discovery. T h e rationale of evaluating a man's scientific style on the basis of his published results requires some comment. TVe have assumed that scientific work consists of a series of stages or part processes which culminate in the process of communicating the results to the scientific community. From inspiration to finished product a process of reality testing unfolds formally designated as scientific method, whereby fantasies and hunches are given shape and form and precise verbal expression, so that word representations correspond to thing representations as closely as possible. Breuer gave an apologetic poetic expression to this process in the "Theoretical" chapter when in reference to physiological expositions of complex psychical processes, he described the best efforts as but shadows, noting, however, that even the weakest tries "honestly and modestly . . . to hold on to the outlines of the shadows which the unknown real objects throw upon the wall. . in spite of everything, the hope is always justified that there may be some degree of correspondence and similarity between the real processes and our idea of them" (p. 251). I n an analogous context, Kris (19) has stressed the complexity of interrelated factors in the psychological understanding of a work of art. Thematic content and organization, relationship to the life history of the artist, his established style, the function of creativity, the environmental influences, such as historical circum- .. 406 NATHAN SCHLESSINCER ET AL. stances i n the development of the art, may determine in one way or another the mode of expression and the stuff with which the artist struggles in creation. T h e evaluation of a creative scientific contribution is no less complex. Our method has been to review the available biographical materials about Breuer, including his intellectual milieu, and to study many of his published scientific papers for clues about his scientific style. T h e insights provided by a study of biographical data in conjunction with Breuer's psychological research will be communicated in a separate paper by PoIlock (22). TVe shall here attend to the question of scientific style, divorced for the moment from biography. T h e published report need not reflect the history of the process of discovery-indeed, it usually focuses away from this and concentrates on the content. TVhat then can we learn of scientific style from a published report? In the broadest sense, scientific style designates the characteristic modes utilized by the scientist in various phases of the scientific process: creative thinker, observer, investigator, theoretician, and author. TVhile the evaluation of the scientific style of a man from his published work alone has its limitations, the scientific report does offer evidence about the stage of elaboration of the ideas in question which the author wishes his audience to assess. Such an appraisal is made on the basis of logical structure, methodology, and correspondence to reality. This is true whether the work in question presents new hypotheses or models, validation with clinical evidence, or both. Inferences of a lower order of validity may be made from the published report about stages in the scientific process prior to the communication of results. Particularly where a sharp difference in writing appears in a series of scientific publications and a style of reporting that has been relatively constant gives way to quite a different form, one would expect this difference to be meaningful and would search for determinants in the particular situation under study in any available data bearing on the situation. Changes in the style of communication may well be correlated with or suggestive of changes in internal psychic processes either structural or economic. Kris has discussed the function of style i n the creative artist involving the transition from immediate discharge in a masturbatory fantasy through the solitary daydream THE SCIENTIFIC STYLE OF FREUD AND BREUER 407 to attempts at interposing organizing factors into the production. H e emphasizes regressive stylistic phenomena occurring in the inspirational phase as a variety of experience in the service of the ego. T h e final product must, however, achieve a solution satisfactory to the internal audience-measuring u p to the standards of the ego ideal so that self-approval is maintained and superego criticism withstood. T h e mastery of the ego over the content of the work and its accompanying tensions are the significant intrapsychic accompaniments of the production. With submission of the work for appraisal by an external audience, the response may have important consequences, particularly for the artist who is insecure. A positive reaction heightens self-approval for the artist. An unfavorable reception threatens the artist's solution and the balance of forces within the artist. That the process of communication is a critical step is illustrated by the fact that some artists have destroyed their work or have refused to permit its publication. T h e parallels for creative scientific discoveries need not be belabored. T h e product in preparation and communication must similarly pass muster before an internal audience, a passage that may be marked by permanent suppression, repression or denial (constituting a complete failure of the scientific process), or by changes in style, influenced by internal conflict, demonstrable in the final product, and signifying far more than a matter of semantics or literary skill. Freud commented on this fact in The Psychopathology of Everyday Life (13). He states: "Even in forming an appreciation of an author's style we are permitted and accustomed to apply the same elucidatory principle which we cannot dispense with in tracing the origins of individual mistakes in speech. A clear and unambiguous manner of writing shows us that here the author is at one with himself; where we find a forced and involved expression which (to use an apt phrase) is aimed at more than one target, we may recognize the intervention of an insufficiently worked-out, complicating thought, or we may hear the stifled voice of the author's self-criticism." I n the 1910 edition, Freud added the following quotation from Boileau (Art Poe`tiqzre): "tVhat is well thought out presents itself with clarity, and the words to express it come easily" (p. 101). 408 NATHAN SCHLESSINGER ET AL. I1 In pursuing our investigation of Breuer's scientific style, we first examined his published reports before, during, and after his psychological research.l At age twenty-six, he published his famous "Study of Respiratory Physiology" in collaboration with E. Hering (16). His investigations on the sense organ of equilibrium (3) were published at the age of thirty-two. T h e discovery of the cathartic method of psychotherapy was made when he was forty. Studies on Hysteria was published when he was fifty-two, more than twelve years after the conclusion of the treatment of Anna 0. T h e work on respiration started from the clinical observations by the laryngologist, Turck. Breuer conceived the idea of a selfregulatory process-a hypothesis of feedback control mechanisms which proved to have wide, general applicability. This was tested experimentally under the guidance of Hering. Breuer devised novel techniques which permitted observation of the natural excitatory processes occurring in pulmonary tissue during expansion and contraction of the lungs. Previous investigators had either stimulated or severed the vagus nerve which had precluded observation of th.e normal physiological state. Breuer obtained meaningful data about the natural phenomena by inventing intubation techniques which permitted the measurement of air pressure within the lungs in the intact animal. Extensive work with a number of species attests to his thoroughness and indefatigability. T h e experiments demonstrated the accuracy of predictions he had made from his hypothesis. T h e results were reported at some length, as was customary at the time, without statistical evidence, but with close and precise reasoning. Speculation is at a minimum in this report, all the more important because the absence of speculation was a somewhat unusual feature of the papers of his day. T h e Hering-Breuer reflex has stood as a fundamental contribution to physiology and its details need not be reviewed here. I n his research on equilibrium and position sense, Breuer took the hypothesis of the physiologist, Goltz, that the semicircular canals served as the sense organ for equilibrium. His extensive 1 T e are indebted to Dr. Ernest nfond for reviewing the paper on respiratory V physiology, and to Dr. Ernest Wolf for his translation and comments on a number of physiological papers cited in the bibliography (3, 4, 5, 6, 7). THE SCIENTIFIC STYLE OF FREUD AND BREWER 409 experiments were performed on pigeons in his own home and he worked completely alone. According to the otologist, de Kleijn, who wrote one of the Breuer obituaries (lo), these experiments and observations refined the theory so satisfactorily and tested it so well that fifty years of subsequent work had resulted in only minor modifications. Similar conclusions were reached almost simultaneously by E. hlach and Crum-Brown, each of whom pursued a different methodological tack. However, it was Breuer's work alone which was buttressed with ingenious experimental research that permitted a step-by-step demonstration of the physiological mechanisms with little left to speculation. T h e crucial departure from previous work in the field was Breuer's meticulous avoidance of damage to the delicate structures he wished to observe in the course of experimental surgery. Other investigators had injured the brain in dissecting the semicircular canals, thereby hopelessly contaminating the results. Breuer demonstrated superior deductive and predictive abilities and technical ingenuity in his studies. H e showed extraordinary perseverance in pursuing intensive anatomical research on fish, reptiles, birds, and mammals to test the generalizability of his findings. hloreover, he was able to meet rejection of his thesis by influential scientists whose prejudices were mobilized by it with judicious and patient rebuttals, including further experimental proofs based on new techniques. Subsequent to his work in psychoanalysis, as late as 1907 (at age sixty-five) he was able to reinterpret data presented to attack his theory, successfully demonstrating that the phenomena could be explained on the basis of his ideas. This attitude stands in marked contrast to his diffidence and hesitancy with regard to his psychological findings. It is clear, then, that in his physiological papers, Breuer utilized with consistent and consummate skill the rigorous scientific methodology acquired from his distinguished teachers of the Helmholtz school. Having through induction arrived at a hypothesis based on his own observations or upon those of others, he was able to devise crucial experiments in which predictions derived from his hypothesis could be tested. Painstaking and ingenious technical procedures permitted validation studies yielding definitive results. 410 NATHAN SCHLESSIKGER ET AL. Natural phenomena were observed with the minimum amount of intervention required or study. T h e improvisation of tools and techniques to facilitate observation was an established characteristic of his research. Finally, and perhaps most important from our point of view, Breuer showed superior capacities in communicating his discoveries in a clear, consistent, and logically organized manner. IVe can conclude that the mental equipment which Breuer brought to his fateful encounter with Anna 0. combined a rigorous scientific attitude, profound respect for natural processes and their inherent lawfulness, an intense desire to understand, the capacity to improvise and facilitate observation while avoiding injury, and the therapeutic passion of a great clinician. All the more striking, then, are the variations in his style of reporting psychological research. His speculation, reasoning by analogy and f the sparseness o evidence offered to back his hypotheses in the "Theoretical" chapter had never occurred before and were never to occur again in his published scientific work. I t is a striking fact that the differences thus established between the "Theoretical" chapter and other parts of Studies on Hysteria demonstrate a change in style for Breuer in the book itself, since his description of the case of Anna 0. is very much in keeping with his physiological reports. A summary of findings in our methodological evaluation in the Stzcdies on Hysteria may be useful in focusing on dramatic differences that engaged our attention as we examined the hierarchy of observed data, interpretations, generalizations, clinical theory, and metapsychology. I n Breuer's "Theoretical" chapter, only eight of twenty-six interpretations were supported by observational evidence, whereas in the remainder of the book, two of a total of fifty-three interpretations were without such backing. At the level of generalization, if one deleted as supporting evidence those interpretations which were not themselves arrived at by induction, seventeen out of twenty-eight generalizations in the "Theoretical" chapter, and three out of fifty-seven elsewhere in the book were found not to have been based on inductive reasoning. IVith regard to clinical theories, analogous results were obtained. There were thirty-one theories in Breuer's chapter and THE SCIENTIFIC STYLE OF FREUD AND BREUER 411 fifteen of these were supported only by evidence not based on induction. On the other hand, only one of twenty theories in the other parts of the book was found not to be based on an inductive pyramid. Turning to a closer examination of Breuer's psychological research, we know that he discovered the cathartic method of psychotherapy when he was forty years old and for the next twelve years collaborated with Freud in the elaboration of hypotheses based upon the observations of the case of Anna 0. and other patients treated by Freud. After the publication of the Studies on Hysteria, when Breuer was fifty-three, he turned away from psychological research to return to physiology. He did not again achieve the originality of the discoveries of his youth but continued to publish reports until he was seventy. His correspondence cited illustratively in H. H. hleyer's biography-but unavailable in its entirety -revealed a broad range of cultural and intellectual interests and a remarkable erudition. His thorough familiarity with questions of epistemology is demonstrated in Meyer's biographical account (20) of his correspondence with the philosopher, Brentano, as well as in his running commentary on research problems in his contributions to Studies on Hysteria. I n Breuer's psychological work with Anna O., we were particularly impressed with his ability to observe phenomena even under circumstances which were quite alien to his ordinary experience. I n his obituary of Breuer, Freud (14) noted what a novel procedure it had been in 1880 to continue observing and treating a single patient over a two-year period. This departure from convention was particularly remarkable in Vienna, steeped in the German psychiatric tradition and far removed from the French school with its relative therapeutic hopefulness. I n his own evaluation of his work with Anna O., Breuer wrote with characteristic modesty, "my merit lay essentially in my having recognized what an uncommonly instructive and scientifically important case chance had brought me for investigation, in my having persevered i n observing it attentively and accurately, and my not having allowed any preconceived opinions to interfere with the simple observation of the important data" (9, p. 319). T h e case history prepared for publication in 1895, more than 412 NATHAN SCHLESSINCER ET AL. a dozen years after the event, attests to the carefulness of the observations and their recording. Breuer's intense clinical interest, his amazing flexibility in being willing to be guided by the expressed needs of the patient in devising the technique of therapy, the inductive hypotheses he formed about the genesis of hysterical symptoms which he proceeded to test out systematically represent the applications of his talents at their best. H e thus observed that symptoms would disappear when unconscious processes from which they had arisen could be made conscious. T h e clinical encounter was aborted by the emergence of a transference-countertransference embroilment for which Breuer had no known precedent so that he mistook its manifestations for an unmanageable reality. Not only did he withdraw from this patient; he also abandoned the direct investigation of psychological problems altogether. Breuer later wrote: "Thus at that time I learned a very great deal: much that was of scientific value, but something of practical importance as well-namely, that it was impossible for a `general practitioner' [in English] to treat a case of that kind without bringing his activities and mode of life completely to an end. I vowed at the time that I would not go through such an ordeal again" (9, p. 319). I t is significant that in 1907 Breuer repeated his assertion of 1595 that the case of Anna 0. was carried to completion without the finding of a sexual basis, in spite of the patient's avowal of her love for him and her pseudocyesis and hysterical childbirth. T h e refusal to consider these manifest sexual phenomena as etiologically relevant suggests the continued operation of defensive denial and isolation. However, his interest in psychological matters continued after he terminated the treatment of Anna 0. H e referred many patients requiring psychotherapy to Freud, so that his discussions of psychological observations were necessarily made from a detached position. This was a significant departure from his usual scientific style as an active investigator, and we speculate that this departure was apparently dictated by unresolved internal conflict. T h e "Theoretical" chapter documents further consequences of this conflict1 Strachey has noted the paradox that Breuer, who had devised a psychological treatment for hysteria, wrote a physio- THE SCIENTIFIC STYLE OF FREUD AND BREUER 413 logical treatise for the Sttidies on Hysteria. His work was full of references to intracerebral excitations and analogies between the nervous system and electrical conduction phenomena, while Freud, who was seeking physiological and chemical explanations, merely recorded psychological observations and conclusions in the book. Breuer's intent to describe psychological processes in the language of psychology was convincingly justified by his arguments for it, but he was unable to carry it through. Instead, he wrote a brilliant, speculative essay in physiological terms. H e alternated in painful ambivalence between caution and boldness. His discomfort is shown in his emphasis on the danger in being tricked by figures of speech into creating a mythology-yet he uses spatial metaphors to express functional relations, returns repeatedly (albeit apologetically) to the analogy with electrical phenomena, and acknowledges that his physiological explanations can never explain complex psychological events. H e carefully labels his entire effort as a first step in a new region of knowledge, referring to it as a clumsy hypothesis concealing rather than bridging p p i n g lacunae. Such a reliance on a level of physiological explanation may be readily understood as an early step in the creative process. However, his apparent fixation at this level in published form, when he has argued for a psychological exposition, is suggestive of an internal conflict that goes beyond the conscious elements recognized and expressed by the author. It is also striking that in his introduction, Breuer states that he will not attempt to distinguish between his own ideas and those originating elsewhere and he claims originality for very little of what he has written. H e justifies this on the ground that so much was passing into the public domain about hysteria at the time, that it was difficult to remember the origins of specific ideas. By contrast, Breuer's other scientific writings carefully refer to antecedent authors. Considering the unusual nature of the material and a potentially critical audience, one would expect greater attention to the customary style of presentation. T h e introduction seems to disclaim responsibility for the content of the book as though it were a detour from his accustomed work. One might attempt to explain Breuer's writing style in the Studies as the professorial assurance of the older, established scientist. Such an 414 NATHAN SCHLESSINCER ET AL. evaluation is contradicted by Breuer's reluctance to publish the book and the absence of a similar casualness in any of his subsequent works. T h e disclaimer of responsibility and ambiguity is consistent with the defensiveness provoked in Breuer by recathecting the Anna 0. experience. Further evidence of conflict may be noted in Breuer's ambivalence toward the question of the significance of sexual factors. He dealt with his ambivalence by making bold assertions which exaggerated the assurance he felt about the issues with which he was wrestling. H e described sexuality as "the most powerful source of persisting increases of excitation" in the genesis of hysteria and even of other neuroses (p. 200) (e.g., "the great majority of severe neuroses in women have their origin in the marriage bed" [p. 2461). Yet, Breuer was never able to accept this conclusion emotionally. In a letter in late 1895, Freud recounted that Breuer had announced his conversion to a belief in the sexual etiology of neurosis at a public meeting, only to tell Freud privately afterward that he did not believe it (2, p. 134). In a letter of 1900, Freud wrote to Fliess about a patient referred by Breuer in whose case sexual factors had proved to be crucial. tVhen she reported her improvement to Breuer, the latter (according to the patient), clapped his hands and said again and again, "So he [ix., Freud] is right after all!" (2, p. 319f.). In 1907, Breuer himself wrote that the prominent place assumed by sexuality in the Studies "arose from no inclination towards the subject but from the findings-to a large extent most unexpected-of our medical experience., . I confess that the plunging into sexuality in theory and practice is not to my taste. But what have my taste and my feeling about what is seemly and what is unseemly to do with the question of what is true?" (9, p. 320). While Breuer could thus recognize that such reactions had little to do with what was true, their influence, once aroused, affected profoundly his function as a scientist. This may be illustrated again at the level of theory formation. I n 1895, the main theoretical disagreement between Breuer and Freud concerned the alternative hypotheses they espoused about the mechanism of symptom formation: Breuer's hypnoid . THE SCIENTIFIC STYLE OF FREUD AND DREUER 415 hypothesis vs. Freud's concept of defense, primarily against sexuality. I n reference to the hypnoid hypothesis, TVaelder (25) has pointed out that it was a theory conceived and held by Breuer in utter remoteness from contact with actual patients. It was a hypothesis which adequately explained the patient's perceptual distortions on the basis of postulated alterations in the receptor apparatus. This was in the tradition of Breuer's physiological concepts (which also dealt with the reception of stimuli from the external world, leading to the activation of reflex systems) and of hleynert's psychophysiology as well, with its emphasis on the return of memories of percepts when hallucinations occur. Unencumbered by defensive emphasis on physiological explanations, Freud had no need to cling to a psychology founded on the model of (external) stimulus response. He became aware quite early (with R., the case of LUCY in 1891) that the problem of perception in neuroses was that of perceiving internal processes (later to be conceptualized as drive derivatives)-from this, the concept of "dcfense" followed as a logical inference. In a very real sense, Breuer was the victim of his previous successes operating as a defense at this point. Freud's subsequent clinical experiments confirmed the usefulness of the concept of defense and led to the recognition of a dynamic unconscious producing transference phenomena in everyone, including the investigator. Breuer's concept of "unconscious" in 1895 was of a portion of psychic content experienced and elaborated during a pathological state and therefore continuously operative without being capable of becoming conscious. Such an "unconscious" is an isolated, unusual, pathological phenomenon-a conception which permits the observer a maximum distance from the observed. This shortcircuits the recognition of an unacceptable impulse life influencing behavior by transference across a repression barrier. It places the locus of the problem in a particular altered state of perception at the time of the traumatic event rather than seeing the more dynamic process of intrapsychic life occurring in everyone. Our critique of Breuer's style indicates the possible effects of internal conflict on his scientific endeavors in psychological research. However, his application of physiological concepts to the 416 NATHAN SCHLESSINCER ET AL. realm of psychology was a significant first achievement. Bernfeld (1) has carefully demonstrated the origin of the theoretical propositions in Breuer's chapter in Brucke's teaching. T h e deterministic philosophy, the emphasis on forces within the organism were essential tenets of the physiology of Brucke. T h e mind is seen as a self-regulating process, like respiration, depending on the relative quanta of energy in brain cells, brain, body, and external world. I n spite of the emphasis on physiological language, the bridge to the dynamic and economic points of view is clearly apparent. Many of Breuer's hypotheses have continued to be important for psychoanalytic theory. Strachey, in his Editor's Introduction to the Studies on Hysteria (7, p. xxiii), singled out three major concepts which psychoanalysis specifically owed to Breuer: the distinction between bound and mobile energy; the idea that hallucination is a retrogression from imagery to perception; and the thesis that perception and memory cannot be performed by the same apparatus. Breuer notes that the latter idea is one that had been expressed by h4eynert (7, p. 189). T h e sophistication and intuitive ability evident in Breuer's essay might be illustrated by two examples of hypotheses that have only recently been shown to be fruitful and highly significant. One concerns a passing reference to the significance of imprinting and its possible role in the genesis of somatic symptoms through ideogenic modifications in the nervous system. T h e second recognizes the significance of an absence of stimuli in creating unpleasure and discusses the concept of an optimal energy level. Recent advances in ethology and in the psychology of perception have begun to exploit these profound ideas. It is readily apparent on examining the wealth of ideas recorded in the "Theoretical" chapter that Breuer served as a most stimulating collaborator to Freud in their discussions. Thus Breuer's contribution to psychoanalysis is an important one and our study of differences in style and attempts to understand its meaning are significant precisely because of the magnitude of his contributions and his ability in the field. Cranefield (9) has already focused attention on the essential agreement between Brcuer's claim of his contribution to psychoanalysis and Freud's account of Breuer's contribution. Breuer discovered that symptoms arise from the unconscious and disappear THE SCIENTIFIC STYLE OF FREUD AND DREUER 417 when the processes which sustained them are made conscious. He presented these discoveries to Freud and explored the theoretical implications with him. Freud pursued the clinical work alone, integrated Breuer's findings with the discoveries of Charcot, and discovered the phenomena of defense and repression and the significance of early childhood and of sexuality in neurosogenesis. I11 T h e conclusion we reach is that the essential difference in scientific style between Freud and Breuer that we observed in our evaluation of the Studies on Hysteria did not consist in a difference in methodology. Freud ivas able to persist where Breuer withdrew in the face of internal conflicts stirred up by his discoveries. T h e fact that inner turmoil was also raging within Freud during the crucial period of the birth of psychoanalysis is well documented in his correspondence with Fliess. For personal defensive reasons, Freud had a high investment in a theory of childhood seduction as an etiological agent in neurosis at the time of the publication of the Studies on Hysteria. His aggressive pursuit of evidence to substantiate these views may have heightened Breuer's dismay about "unseemliness" and thereby hastened the rupture in their collaboration. T h e process of modification in the seduction hypothesis and two other early hypotheses, the hypnoid and actual neuroses, has been explored by our TVorkshop and will be communicated by Sadow et al. (23). Freud's great and extraordinary achievement ivas his capacity to extend the range of psychological observation to include not only his patients but also himself. His own analysis opened the gate to his increased understanding of the problem of transference. T h e magnitude of this step and the struggle required to take it are illustrated by such anguished statements in the letters to Fliess as this one of July, 1897: "Something from the deepest depths of my own neurosis has ranged itself against my taking a further step in understanding of the neuroses" (2, p. 212). T h e contrast between the attitudes of the two men is glaring when we compare Breuer's struggle to accept the unseemliness of others with Freud's motto from Terence: "Nothing that is human is alien to me." I n historical perspective we can assess the obstacles that had 418 NATHAN SCHLFSSINCER ET AL. to be overcome in the discovery of psychoanalysis. Although Freud was evidently fascinated by Breuer's account of the Anna 0. encounter which was communicated to him in 1882, he did not begin to engage in psychotherapeutic work immediately. His famous attempt to relate the story of Breuer's work to Charcot in 1886 is sufficient evidence of his interest; it also shows that he did not then dare to launch into these deep waters without sanction from recognized authorities. Indeed, even when he had become the Viennese missionary for the radicalism of the French who were taking hysteria seriously as a subject for scientific inquiry, his actual clinical efforts did not consist in an application of the cathartic procedure. His 1888 paper on "Hypnotism and Suggestion" (11) shows him to be a thoroughgoing disciple of the French school. A case report from this period of his therapeutic activity, "A Case of Successful Treatment by Hypnotism*' (12) shows no trace of Breuer's cathartic method. It was not until disillusionment had set in with the therapeutic efficacy of suggestion that Freud, perhaps in desperation, turned to Breuer's seemingly dangerous and explosive technique. T h e story of this disillusionment is recorded by Jones (18). IVhen Freud went to Nancy in 1889 to learn hypnotic technique from Bernheim and LiCbault, he took a difficult patient with him. Bernheim couId not hypnotize her deeply enough either and "frankly admitted. . . that his great therapeutic successes by means of suggestion were only achieved in his hospital practice and not with his private patients" (p. 238). It is true that Freud claimed that he always used hypnotism to try to trace back the history of symptoms, but the first evidence of this occurs only in the case of Emmy von N., begun in May, 1889. Even then, he took the precaution of hospitalizing the patient, and the suggestive method was tried concurrently. I n other words, Breuer was by no means alone in recoiling from the implications of the Anna 0. experience. From the perspective of 1889, Breuer's misadventure might be viewed by someone else with sufficient detachment as warranting a new triaI for the technique. No disaster developed from the Emmy von N. experiment. It was perhaps uniquely fortunate that Freud's first cathartic patient produced a negative, hostile transference rather than an erotic one. This may have helped Freud to grasp the essential concept of THE SCIENTIFIC STYLE OF FREUD AND BREUER 419 transference which then provided him with the means to maintain therapeutic distance, whatever emotional reactions were produced in the clinical situation. In this sense, then, Breuer had served as the essential pioneer. H e was the first to experience the full impact in a therapeutic situation of what we now know as a transference neurosis. He had n o precedent to help him put this in perspective. Freud encountering the phenomena of transference had the experience of Breuer to fall back on in addition to his own analysis. H e couId recognize that the intensity of the patient's feeling toward him had occurred also with a previous psychoanalyst. It in no way diminishes Freud's achievement to recognize that knowing of Breuer's encounter with the phenomenon contributed to his being able to see it as a repetition and as something appropriate to an analytic situation. To recapitulate, it was Freud's ability to include himself and to see processes of transference occurring in himself that enabled him to continue his discoveries in psychoanalysis. Breuer had not been able to breach the wall that separated the doctor from the patient and to recognize in himself the disturbances of internal economy, in order to see them in their ultimate perspective. In comparing the contributions of Breuer and Freud, we have shown that Freud's theories evolved from the data of his clinical (and self-) observations, traversing the entire hierarchy of abstraction, from interpretations to generalizations to clinical theories to metapsychology. Breuer, removed by internal conflict from contact with patients, was unable to utilize the inductive method to arrive at his clinical interpretations, generalizations, and theories. I t is no coincidence that nonclinicians who attempt to classify psychoanalytic propositions (Sullivan [24]) similarly leave a conceptual gap between data of observation and high level theories. IVolman (26) has stated similar views as follows: "There is no reason to minimize the importance of clinical evidence proper. Psychoanalytic case studies are neither quantitative nor controlled, yet they bring a wealth of empirical findings and can be conclusive. As a rule, the case study method should be the first step in inquiry. Case studies play a crucial role in finding out relevant variables. T h e necessity for this first-hand acquaintance with empirical data must never be overlooked in psychological research." 420 NATIIAN SCHLESSIXGER ET AL. T h e gap in the inductive pathway to theory building noted above forces the nonclinician to rely exclusively on deductive reasoning. Breuer's deductive work was precise, but, of necessity, unverified. As we have shown earlier, where intrapsychic conflict did not interfere with his creativity Breuer was also capable of brilliant inductive leaps. T h e psychoanalyst-as-scientistneeds both skills. At this stage in the history of science, it becomes more and more a pretense to say that laws and theories are based simply on observation of facts. I n fact, they are arrived at by creative leaps which may occur in either direction, i.e., inductively from observational data or deductively from pre-existing hypotheses. Einstein has gone so far as to state that basic concepts are freely invented and not discovered by any logical method. Yet, their elaboration and development must include the freedom to use induction and deduction appropriately in the framework of the scientific method; Hutten (17) has called methodology "the intellectual counterpart of the mental attitude of reality testing." I n a sense what we have demonstrated is the importance of a consistent application of scientific method in the origins of psychoanalysis. T h e broad significance of this issue in scientific pursuits today has recently been emphasized by Platt (21) in the description of a method he calls "strong inference." Essentially, he ascribes the tremendous strides taken in biochemistry and nuclear physics to the elaboration of basic discoveries through a concentrated and systematic conscious reliance on scientific method as set forth by Bacon. Platt emphasizes the use of alternative hypotheses so that the major research effort is expended on discarding or modifying hypotheses that are fallacious rather than proving and defining hypotheses that are favored. T h e implementation of such a concerted approach in the evolution of analytic theory may have fruitful consequences. Summary TVe have suggested a definition of scientific style, discussed the rationale for its study in published works, and explained differences in style demonstrable in the Studies on Hysteria. THE SCIENTIFIC STYLE OF FREUD AND BREUER 42 1 An examination of Breuer's physiological research before and after his work in psychology demonstrates his deductive skills, technical ingenuity, perseverance, and precision in reporting results. I n the Sttidies on Hysterin, the description of the case of Anna 0. is in keeping with his physiological research. However, Breuer's withdrawal from the role of active investigator in the face of a transference-countertransference embroilment with denial and isolation of the sexual implications had fateful consequences. I n the "Theoretical" chapter, there are inspired ideas, but the speculation, reasoning by analogy, and sparseness of evidence in his hypotheses represent a distinct and unique departure in Breuer's style. H e appears to disclaim responsibility for his ideas, varies from caution to boldness in his assertions, and clings to his physiological theory. Breuer, presumably removed by emotional conflict from contact with neurotic patients, was unable to utilize the inductive method adequately in arriving at interpretations, generalizations, and theories. Freud, on the other hand, persisted in observing patients and himself. T h e sequence of his efforts is briefly summarized. T h e significance of the interplay between inspiration and careful work with patients to confirm or refute ideas is stressed, emphasizing the role of scientific method as a form of reality testing and a stimulus to fruitful research. BIBLIOGRAPHY 1. Bernfeld, S Freud's earliest theories and the school of Helmholtz (1944). The . Yearbook of Psychoanalysis. 1:31-47. New York: International Universities Press, 1945. 2. Bonaparte, hi., Freud. A., Kris, E., Eds. The Origins of Psychoanalysis: Letters to Il'ilhebn Fliess, 1887-1902. New York: Basic Boob, 1954. 3. Breuer, J. Ncue Versuche an den Ohrbogengiingen. Arch. ges. Pliysiol.. 44:133152, 1888-1889. 4. Breuer. J. Uber Galvanotropismus bei Fischen. Zbl. Physiol., 16:481-483, 1902. 5. Breuer, J. Bemerkungen zu Dr. Hans Abels Abhandlung "Uber Nachempfindungcn im Gebiete des Kincsthetischen und Sinnes." Z. Psychol. 6 Physiol. Sinnesorg., 45:58-84, 1907. 6. Breuer, J. Uber Ewalds Versuch rnit dern "Pneumatischen Hammer" (Bogengangapparat). Z. Psychol. & Physiol. Sinnesorg., 47:373-378, 1908. 5. Breuer, J. PS Freud, S Studies on Hysteria (1883-1899). Standard Edition, 2. Lon. don: Hogarth Press, 1955. 8. Breuer, J. & Kreiol, A. Uber die scheinbare Drehung des Gesichtsfeldes TvPhrend der Einivirkung einer Centrifugalkraft. Arch. ges. Physiol., 70:494-507. 1898. 422 NATHAN SCHLESSINGER E T AL. Hogarth Press, 1950. 12. Freud, S. A case of successful treatment by hypnotism (1893). 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Pollock, G. H. T h e possible significance of childhood loss in the Josef BreuerBertha Pappenheim (Anna 0.)-Sigmund Freud relationship. Read at the Association for Psychoanalytic Medicine, New York, November 30. 1965. : 23. Sadow, L., Gedo. J. E., Aliller, J., Pollock, G. H., Sabshin, AI., S Schlessinger, N. T h e process of hypothesis change in three early psychoanalytic concepts. Read before the American Psychoanalytic Association, May 6. 1966. 24. Sullivan, J. From Breuer to Freud. Psychoanal. & Psychoanal. Rev., 465990, 1939. 25. Itlaelder, R. Freud and the history of science. This Journol, 4:602-613, 1956. 26. JVolman. B. Psychoanalysis and applied science. Amer. Imago, 21:153-164. 1964. 9. Cranefield, P. F. Josef Breuer's evaluation of his contribution to psycho-analysis. Znt. J . Psycho-Anal.. 39:319-322, 1958. 10. de Kleijn, A. Josef Breuer. Acta Otolaryng., 10:167-171, 1926. 11. Freud, S. Hypnotism and suggestion (1888). Collected Papers, 5:ll-24. 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The Scientific Style of Breuer and Freud in the Origins of Psychoanalysis

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