Sunday, 1 January 2017

Freud’s First Case Study. Who was its ‘Heroine’? Fact or Fiction? Richard Skues conducts Inner Circle Seminar 237 (9 July 2017)

Sigmund Freud, 1891

Freud’s First Case Study
Who was its ‘Heroine?
Fact or Fiction?

Richard Skues
Inner Circle Seminar No. 237
introduced by
Anthony Stadlen
Sunday 9 July 2017
10 a.m. to 5 p.m.

In 1892 Freud published his very first significant case history. It concerned a woman who was unable to breastfeed her newly born children, but whom Freud treated successfully by means of hypnosis. The patient is one of the very few of Freud’s extended cases whose identity has always remained obscure. This seminar, with the guidance of Dr Richard Skues, will examine closely the details of the patient that Freud gives us and aim to solve, together, the puzzle of her identity, looking at primary candidates and sifting the evidence for and against each one. In the course of this we shall consider not only the extent to which Freud was straightforward in his presentation of cases, but in more general terms whether, in the light of the ethical requirement of strict confidentiality, it is possible to write an accurate psychoanalytic or psychotherapeutic case history without sacrificing detail that could be crucial for an adequate understanding of the patient and the therapeutic process.

Richard Skues is a renowned historian of psychoanalysis, as well as a superb teacher. He has memorably conducted a number of the Inner Circle Seminars over the years, drawing on his extensive researches into Freud and the early history of psychoanalysis and on his findings published in a number of papers. In particular, he has conducted a seminar based on his book Sigmund Freud and the History of Anna O.: Reopening a Closed Case (2006), the definitive book on another of the early case histories, Breuer’s patient ‘Anna O.’

His coming seminar is perhaps one of the most important of all since our seminars began 21 years ago.


Freud said that his theories were dispensable and (he used the English phrase) ‘open to revision’. To understand and evaluate psychoanalysis we should, he said, examine and ‘judge’ his small number of detailed individual case studies and analyses of specific dreams and slips. The case studies in particular he offered explicitly as true accounts, in which he strove for accuracy in all respects except the minimum disguise necessary for confidentiality. To change any other detail would be, he said, an ‘abuse’. And one should make clear what had been disguised.

For most of the twentieth century, nobody questioned Freud’s truthfulness at this basic level of reporting. His interpretations of what he reported were ridiculed by many as wild, crazy, far-fetched, absurd, the theories of a charlatan; but his honesty as a reporter of facts was unquestioned. And psychoanalysts such as Kanzer and Glenn, in their book Freud and his Patients (1980), argued that, like the plays of Sophocles and Shakespeare, Freud’s case studies would never be replaced as paradigms from which psychoanalysts and others would learn their craft, whether by agreement or dissent.

However, since the 1970s, philosophers, journalists, and even some historians have claimed that Freud, far from being an accurate reporter, was a liar and fraud whose case studies were fiction, even on one occasion portraying a patient who never existed.

This constitutes a grave crisis for psychoanalysis, and for psychotherapy generally. If the case studies which Freud said we should take as embodying his most fundamental discoveries are discredited as fraudulent, what then?

Leading Freudian and, significantly, Jungian analysts have pleaded that all case studies are necessarily fictional; that ‘narrative truth’, not mere ‘historical truth’, is what counts; that, in fact, we are all fictions; and that, for example, Freud’s living ‘Wolf Man’ patient was an ‘impostor’, while the ‘real’ Wolf Man existed precisely in the pages of Freud’s immortal case study and nowhere else. This hardly seems a satisfactory resolution of the crisis.

But why is this also a crisis for other forms of psychotherapy, such as Jungian and existential? Are they not independent of Freudian psychoanalysis? No. For example, the pioneer existential therapists (Binswanger, Boss, Szasz, Laing, Esterson) were all psychoanalysts. They would have been horrified at the schizoid way existential analysis and psychoanalysis are taught today as if they were in mutual contradiction. Boss and Holzhey wrote: ‘Daseinsanalysis wants only to be a purified psychoanalysis’: purified, that is, of natural-scientistic ‘metapsychology’. For what they saw as the phenomenological discoveries of Freud and later psychoanalysts, they had deep respect. They saw existential therapists who were ignorant of psychoanalysis as simply incompetent. Such therapists are likely to use vulgarised psychoanalytic ideas in any case, but without realising they are doing so, and without insight into their origin. In this sense, psychoanalysis and existential analysis stand or fall together.

Was Freud a fraudulent fictionaliser, or was he a conscientious chronicler, or perhaps a bit of both? This is what Richard Skues will help us decide on Sunday 9 July.

As explained above, this is not merely an historical footnote, but is of immediate practical urgency for us as therapists. As a true teacher, Richard Skues will not lecture us on his own views of the matter. Rather, he will show that we ourselves have the means to find the answer.

You are encouraged to bring smartphones and tablets so that we may participate in active research together. If you book, you will be sent a copy of Freud’s first case study as an email attachment.

Your contribution to the dialogue will be warmly welcomed.

Venue: Durrants Hotel, 26–32 George Street, Marylebone, London W1H 5BJ

Cost: Psychotherapy trainees £120, others £150, some bursaries; coffee, tea, biscuits, Durrants rock, mineral water included; payable in advance; no refunds or transfers unless seminar cancelled

Apply to: Anthony Stadlen, ‘Oakleigh’, 2A Alexandra AvenueLondon N22 7XE
Tel: +44 (0) 20 8888 6857  +44 (0) 7809 433 250

For further information on seminars, visit:

The Inner Circle Seminars were founded by Anthony Stadlen in 1996 as an ethical, existential, phenomenological search for truth in psychotherapy. They have been kindly described by Thomas Szasz as ‘Institute for Advanced Studies in the Moral Foundations of Human Decency and Helpfulness’. But they are independent of all institutes, schools and universities.

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