By Professor R.C. Tallis
© The Lancet
A century has passed since Freud started publishing the works that established his reputation as a scientist, healer, and sage, as one of the major thinkers of the 20th century, and as, in the words of the Freudian literary critic Harold Bloom (cited by Webster, p3, ref 1), “the central imagination of our age”. Although his standing as a clinical scientist and biologist of the mind has always been precarious among those capable of judging scientific competence, his admirers have by no means been confined to the laity. In 1938, the secretaries of the Royal Society brought him their official charter to sign, “thereby joining his signature with Newton’s and Darwin’s” (ref 1, p 430). Despite much early hostile criticism-sometimes motivated by overt or covert anti-Semitism-Freud’s reputation simply grew. He was, and remains, more famous than his critics, who have often seemed mere detractors. And yet his reputation is deeply mysterious. Esterson (ref 2) has reflected that “the rise of psychoanalysis to a position of prominence in the twentieth century will come to be regarded as one of the most extraordinary aberrations in the history of Western thought”. Medawar (ref 3) expressed similar sentiments:
“Opinion is gaining ground that doctrinaire psychoanalytic theory is the most stupendous intellectual confidence trick of the twentieth century: and a terminal product as well – something akin to a dinosaur or a zeppelin in the history of ideas, a vast structure of radically unsound design and with no posterity.”
The tide now seems to be turning against Freud as the long overdue detailed and systematic appraisal of his contribution to our understanding of the psychobiology and organisation of the human mind, of the place of reason and passion in human affairs, and of the aetiology and treatment of mental illnesses has finally been undertaken. The verdict has been uniformly negative: Freud as a scientist, metapsychologist, and diagnostician of society emerges as a quack. This view has not greatly perturbed true believers. Freud’s theories, notoriously, have an inbuilt survival kit: disagreement with them is regarded as a symptom of the very resistance they themselves predict, and therefore counts as confirmatory evidence. Psychoanalysis thus enjoys an extraordinary ability to shake off decisive criticism. The American historian Paul Robinson (cited by Webster ref 1), writing as recently as 1993, asserted that Freud’s critics “would do him no lasting damage”:
“At most they have delayed the inevitable process by which he will settle into his rightful place in intellectual history as a thinker of the first magnitude. Indeed the very latest scholarly studies of Freud suggest that the anti-Freudian moment may already have begun to pass.”
Evidently, anyone who would dispose of Freud once and for all faces a rather special challenge. A recent book has risen to that challenge: Richard Webster’s ‘Why Freud was wrong’ is not only a mighty work of synthesis, bringing together the immense recent research that has unpicked the interwoven legends of Freudian so-called science and Freud the man, but also places psychoanalysis in a wider context that enables us to understand the aetiology (I use the word advisedly) of the thought and of its influence. The result is a definitive critique from which it seems unlikely that Freud’s reputation and that of the pseudoscience he invented will ever recover. Freud wanted, above all, to be recognised as a scientist, and famously resented friendly critics such as Havelock Ellis who suggested that psychoanalysis was more of an art than science. Grünbaum (ref 4) has examined Freud’s procedures and shown how they bear no resemblance to the methods that have proved elsewhere so effective in arriving at reliable, generalisable, and practically useful conclusions. Consider the discovery of the repressed Oedipus complex. For Freud, this was the key to every neurosis; and it is the cornerstone of psychoanalytic thought. It was postulated on the basis of data acquired during his period of self-analysis. The crucial datum (note use of the singular) was Freud’s recollection of a long train journey with his mother, when he was 2 years old, during which, according to the differing accounts he gives, he either must have seen her naked or actually did so, as a result of which he conceived a sexual desire for her. A few weeks after retrieving this quasi-memory, he concluded that the male sexual love of the mother was a universal event of early childhood. This huge jump was subsequently supported, Freud claimed, by direct observations in children, especially in analysis. Details, however, are strikingly lacking. Out of a single evaporating drop of pseudo-fact, he had created a roomful of steam. Those few of Freud’s case histories that are possible to assess are invalidated, as evidence, by a confirmatory bias. Esterson (ref 2) shows how, again and again, Freud muddled his own conjectures of what was going on in his patient’s unconscious with their accounts of what they later remembered and, over time, he came to represent the former as the latter. It was hardly surprising, then, that, like a first-year medical student or a hypochondriac making diagnoses, Freud found that everything he recalled from his consultations could fit his theories. This circularity, whereby the theory created the facts that supported the theory, should have been evident to anyone reading the published works, but few had noticed it. Only his disciples were sufficiently committed to read Freud’s primary clinical papers, and the books in which Freud presented his work to a wider public dishonestly suggested much independent corroborative evidence. “The applications of analysis”, he had blithely informed his disciples, “are always confirmations of it as well” (quoted in ref 2, p 246). In psychoanalysis Freud says:
“the physician always gives his patient . . . the conscious anticipatory ideas by the help of which he is put in a position to recognise and to grasp the unconscious material” (Standard Edn 10:104, quoted in ref. 2)
But it is in the nature of psychoanalysis that analytical experience is strongly influenced by the subjective notions of the physician who supplies the anticipatory ideas. Woe betide the analysand if he (or more often, she) does not cooperate. Freud described his brutally inquisitorial methods with extraordinary candour:
“The work [of therapy] keeps coming to a stop and they keep maintaining that this time nothing has occurred to them. We must not believe what they say, we must always assume, and tell them too, that they have kept something back . . We must insist on this, we must repeat the pressure and represent ourselves as infallible, till at last we are really told something . . . There are cases, too, in which the patient tries to disown [the memory] even after its return. ‘Something has occurred to me now, but you obviously put it into my head’ . . . In all such cases, I remain unshakeably firm. I . . . explain to the patient that [these distinctions] are only forms of his resistance and pretexts raise by it against reproducing this particular memory, which we must recognise in spite of all this”. (ref 5)
Not surprisingly, this approach, more like rape of the mind than history taking, led to catastrophic diagnostic errors. When a little girl whose abdominal pains he had been treating as an “unmistakable” hysteria died of an abdominal lymphoma 2 months after he had seemingly cured her, he defended himself robustly, claiming to have dealt satisfactorily with the hysteria (which he said “had used the tumour as the provoking cause”). Such were the means by which Freud built up the minute corpus of empirical data on which he erected – like an inverted pyramid-his huge theoretical edifice. In her pioneering study Thornton (6) showed how, by the time of his fundamental discoveries, Freud had moved far away from the science of his day and in which he had been trained. His speculations were crucially influenced by an old-fashioned quasi-scientific Naturphilosophie (particularly evident in his foundational Project for a scientific psychology ref 7), by the lunatic numerological notions and mystical fantasies of Wilhelm Fleiss-whom Freud described variously as the Kepler of biology and as his Messiah, and from whom he derived the idea of infantile sexuality-and by his own cocaine addiction. There are many reasons why it has taken so long to recognise Freud as a “cargo cult scientist” (to use Feynman’s ref 8 term), who was closer to L. Ron Hubbard than to Einstein. Freud’s mastery of the rhetoric of science to sustain his scientific fairy tale has been brilliantly investigated by the literary critic Robert Wilcocks.(ref 9). The Fliessian roots of Freudian thought were long suppressed by the keepers of the flame policing the archives. (refs 10, 11). Endless recycling of a handful of so-called classic cases created the impression of a huge clinical database.
And then there has been the reputation of Freud the man. Freud, George Steiner observed, was “a master narrator and builder of myths” (quoted in ref 1, p 7). The most important of these myths was hat of himself as a selfless searcher after truth, a man of granite-like integrity, utterly incapable of fraud or even self-deception. This myth has not withstood close inspection. Thornton’s (ref 6)exposure of the early cocaine episode was a fatal blow. Freud, desperate for academic glory, claimed to have found the cure for morphine addiction: substitution by cocaine which, he asserted, was non addictive. He allowed his paper to be published, even when he knew that his single case, a close friend, had become a hopeless cocaine addict. The pattern of basing claims for universally applicable cures on a tendentiously reported. series of n=1 cases was established.
Webster (ref 1) builds on Thornton’s (ref 6) portrait of a ruthlessly ambitious man, a brutally insensitive and unscrupulous clinician, quite unrepentant about those of his terrible diagnostic blunders of which he was aware, and a supreme manipulator of friends and colleagues in his endless quest for self-promotion. This portrait, convincing, chilling, and unforgettable, firmly rooted in documentary evidence, is somewhat at odds with the shilling lives and hagiographies (notably that of the obsequious Ernest Jones ref 2).
The sheer crankiness of Freud’s ideas was concealed by his marvellous prose, which gave the ideas a veneer of clarity and a feeling of inevitability. Most cranks write badly. Moreover, his lunacy came from an unexpected angle: just like real science, analytical theory was difficult, technical, tough minded, and counterintuitive. His work also seemed at first to offer liberation-from prudishness, hypocrisy, and oppressive institutionalised religion, to ‘which he gave a secular interpretation that put it in its place as a distorted expression of human desires. And, although his vision of humanity was not merely diminishing but also impoverishing, it was richly elaborated and wonderfully expressed. Freud had an untrammelled imagination (fuelled in the crucial years by cocaine) and a wonderful ability to connect the remotest corners of his intellectual world-to relate, as Webster puts it, “the sexual anatomy of prehistoric birds to the obstinacy of 2-year-old children and the organic evolution of crocodiles to the meanness of Viennese aristocrats”. So the idea of the work and the image of the man converged in that of a tough-minded clinical scientist who saw things that were concealed from others and had the courage to speak the unspeakable truths about humanity. Then there was the attraction of the movement he founded. As Gellner (ref 13) has argued, Freud’s theories were alluring because they seemed to arise out of scientific clinical medicine while simultaneously answering to the residual religious longings of a secular age: “Freud did not discover the unconscious but endowed it with a ritual and a church”- thus combining the white coat with the cassock. The church was “manned by a well-groomed clergy who promised a new kind of salvation” (ref 13) and who were incorporated into closely regulated guild. The early psychoanalytical movement was very much a gnostic brotherhood. As Strachey (cited by Malcolm ref 14) reported, new recruits required no qualification other than a training analysis with Freud or one of his approved disciples-a process that combined the ritual of confession with the laying on of hands. People are starting to count the cost of the talking cure that Freud invented and marketed. The criticism hat psychoanalysis is expensive and inefficacious has given way to the graver charge that it is often dangerous and destructive. Psychoanalysts have frequently imitated their master in attributing to psychological causes serious illnesses that have organic origins, with often fatal consequences. Even where they are not medically incompetent, their peculiar ideas often confuse and further undermine desperately vulnerable individuals. Few psychoanalysts are as nakedly psychopathic as Lacan, (refs 15, 16) Freud’s most prominent French disciple, but many do not shrink from manipulating the affections and misplaced faith of their clients to ensure continuing lucrative commitment to their quack remedies. Freud’s once unique ability to suggest to his patients the very facts that he required to support and fulfil his theory-fantasies, reinforced by his aura of wisdom; is now disseminated among hundreds of thousands of disciples who may not be psychoanalysts but who have derived from his theories a belief in the central importance of certain kinds of repressed memories and in the therapist’s privileged access to them. The scale of the damage has recently become manifest in the USA, where, according to Crews, (ref 5) since 1988 1,000,000 families have been estimated to be affected by therapist-inspired charges of sexual molestation, supposedly uncovered by the awakening of repressed memories. There are especially bitter ironies here. During this century, as Webster (ref 1) points out, many women have suffered immensely as a result of orthodox psychoanalysts construing real episodes of sexual abuse as oedipal fantasies. Now the all- knowing therapist is able to persuade individuals that they have suffered sexual abuse of which they have no recollection. The irresponsible guesswork of the recovered memory therapists damages; not only those who have not been sexually abused, but also threatens to discredit the testimony of those who have. Common to both the Freudian therapists’ denial of real sexual abuse and recovered memory therapists’ imputation of sexual abuse the victim does not recall is an arrogant over-riding of the testimony of ordinary people. The zealots are unlikely to be impressed by arguments that the theory of repression is both unnecessary and incoherent. When Freudians talk about the unconscious, they are often simply talking about things of which we are conscious but are not yet conscious of reflectively.’ In accordance with their own theories, they should not, of course, fuse these things: the unconscious is supposed to be composed of psychic elements that have been actively repressed rather than simply not yet brought into full consciousness. But this crucial notion of active repression is incoherent. As Sartre( ref 18) pointed out, the unconscious has to know what it is that has to be repressed in order (actively) to repress it; it has also to know that it is shameful material appropriate for repression. If, however, it knows both these things, it is difficult to understand how it can avoid being conscious of it. The only way round this difficulty would be to reduce repression to forgetfulness, and this would undermine the fundamental Freudian principle that repression is, unlike mere forgetfulness, active and targeted. The greatness of Webster’s book lies not only in his review of the primary and secondary literature, nor only in his wonderfully lucid and witty prose, but in the penetration of his understanding of the man and his influence. Webster is also a brilliant story-teller. His account of the early days of the movement – the schisms pursued with the irrationality and vindictiveness of confessional wars, the loves that collapse into hatreds, the paranoia, the misuse of clinical judgment to discredit enemies, the use of personal insult and demonological abuse to deal with reasoned dissent – is utterly enthralling. And he never loses sight of the fundamental themes: Freud’s messianic fantasies, his lifelong dream, as Freud himself states, of “opening all secrets with a single key”, his deep insecurity, his raging hunger for recognition, and the theological and biogenetic underpinning of his thought.
Webster’s critique offers a context within which Freud can be placed and a viewpoint from which he can be seen. Webster shows how, despite his biological rhetoric, Freud belongs firmly within a gnostic and Manichean framework, and is imbued with a Judaeo-Christian asceticism that would puritanically dispose of the body. Freud does “not so much sexualise the realm of the intellect as intellectualise the realm of the sexual” – by reducing it to abstract categories, and so separating clean mind from dirty body, lifting Man out of Nature by favouring abstraction over incarnation. Webster takes issue with this “doomed and tragic attempt. to reconstitute at the intellectual level a sensual identity which has been crucified at the level of the vital and spontaneous body” and. offers the beginnings of an alternative, Darwinian, framework for understanding humanity. This latter is a marvellous challenge to people, including myself, for whom neo-Darwinian thought spectacularly fails to account for the distinctive features of humankind. (ref 19) Even when psychoanalysis has been shown to be utterly misconceived-as the basis of a treatment, as a theory of human nature, as a means of thinking about society and the world-it is difficult to shake off a sneaking suspicion that it must have some kind of special validity, if only because it has always been there, with its all-purpose explanations, since one first came to reflective consciousness. After Webster’s book, we can not only see that psychoanalysis is utterly without merit but also wake up out of it: Why Freud was wrong – at once a major intellectual biography and a signal contribution to the intellectual history of our times-is liberating. Towards the end of 20th century, Webster has lifted the incubus Freud placed, at the beginning of the century, on the minds of all those who think about their own, and human, nature.
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5. Standard Edition 2: 279-80, quoted in Crews F. The revenge of the repressed The New York Review of Books, part I, Nov 17, 1994: 54-60; part II, Dec 1, 1994: 49-58.
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16. Roudinesco E. Jacques Lacan, Esquisse d’une vie, histoire d’un systeme de pensee. Paris: Fayard, 1993.
17. Chapman A H, Chapman-Santana M. Is it possible to have an unconscious thought? Lancet 1994; 344: 1752- 53.
18. Sartre J-P. Doing and having: existential psychoanalysis In: Being and nothingness, translated by Barnes H. London: Methuen, 1957: 557-75
19. Tallis R. The explicit animal London: Macmillan, 1991.
Department of Geriatric Medicine, Hope Hospital, Salford M6 8HD, UK
(R C Tallis FRCP)
Correspondence to: Prof R C Tallis