Freud's Schreber Between Psychiatry and Psychoanalysis

On Subjective Disposition to Psychosis

Thomas Dalzell

• Publisher: Routledge
• Year: 2018
• Print ISBN: 9780367107185
• eBook ISBN: 9780429914072
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

This book investigates what was distinctive about the predisposition to psychosis Freud posited in Daniel Paul Schreber, a presiding judge in Saxony's highest court. It argues that Freud's 1911 Schreber text reversed the order of priority in late nineteenth-century conceptions of the disposing causes of psychosis - the objective-biological and subjective-biographical - to privilege subjective disposition to psychosis, but without returning to the paradigms of early nineteenth-century Romantic psychiatry and without obviating the legitimate claims of biological psychiatry in relation to hereditary disposition. While Schreber is the book's reference point, this is not a general treatment of Schreber, or of Freud's reading of the Schreber case. It focuses rather on what was new in Freud's thinking on the disposition to psychosis, what he learned from his psychiatrist contemporaries and what he did not, and whether or not psychoanalysts have fully received his aetiology.

Chapter One
Freud's exemplary case of psychosis: Daniel Paul Schreber

Introduction

In 1934, twenty-three years after Freud’s Schreber text appeared, Arnold Zweig was able to ask Freud what to read in order to understand his teaching on psychosis—apart from his “Dr Schreber”, which he already knew (Freud, E. L., 1968, p. 99). Freud had written a number of papers on psychosis, but his 1911 text, based on what the famous German judge, Daniel Paul Schreber (1842–1911), had said about his illness (Schreber, 1903a, hereafter DW), was and remains the principle source for anyone wanting to understand Freud’s aetiology of paranoia and schizophrenia. Before we can examine Freud’s interpretation of the case, we need to investigate what Schreber said in his memoirs, and take account of the supplementary information provided by his patient and personnel files, as well as the expert witness reports by his doctor in Sonnenstein Castle asylum, Dr Guido Weber. After a brief biographical sketch, we will consider Schreber’s clinical picture in 1884, when he was first admitted to Professor Paul Flechsig’s psychiatric clinic in Leipzig; in 1893, when he was readmitted to the university clinic after being appointed a presiding judge at the Oberlandesgericht in Dresden, and transferred to Sonnenstein Castle asylum; and in 1907, when he relapsed after his mother died and his wife had a stroke. Weber reported to the court considering Schreber’s discharge that the content of his final delusion was a religious mission from God to renew humanity, and that, for that purpose, he had to become a woman. We will trace the course of Schreber’s hallucinations and delusions and see that although his autobiography does indicate an evolution (from persecution by Flechsig and God to his befriending the idea of becoming a woman, and, finally, claiming a redemptive mission), what remained a constant from the start of his second illness was the femininity of his subjective position.

Who was Daniel Paul Schreber?

In his Denkwürdigkeiten eines Nervenkranken, the autobiography he used to support his case for release from the Sonnenstein asylum (DW, p. 1; Macalpine & Hunter, 1955, hereafter M, p. 41), Dr jur. Daniel Paul Schreber, a presiding judge (Senatspräsident) in Saxony’s highest court, wrote:

I have been mentally ill twice, both times as a result of mental overstrain; the first time (as Landgerichtsdirektor in Chemnitz) on the occasion of my standing for election to the Reichstag, the second because of the unusually heavy burden of work I found on taking up my new appointment as a Senatspräsident in the Ober-landesgericht in Dresden. [DW, p. 34; M, pp. 61–62]

The first illness referred to here had broken out in the autumn of 1884, but was healed by the end of 1885. Schreber was able to return to work in January 1886, and take up the new post of director of the district court in Leipzig, to which he had been transferred while still in the psychiatric clinic. His second bout of illness began in October 1893, and, although he would spend more than eight years in the Sonnenstein under Weber, the Denkwürdigkeiten claimed that, during both periods of illness, he spent a great part of his time in the psychiatric clinic attached to Leipzig University and run by the famous brain anatomist, Paul Emil Flechsig. In fact, he was only in Flechsig’s clinic for six months during his first illness, and seven at the start of his second. This is already an indication of the significance of Flechsig for Schreber. When he was first admitted to the university clinic, Flechsig diagnosed severe hypochondria (KG, pp. 1; 14 [26]). Extracts from Schreber’s patient file there—lost in the bombing of Leipzig in December 1943—and his Sonnenstein records are included in the Leipzig-Dösen file, which remains extant and was published by Franz Baumeyer in the 1950s (Baumeyer, 1955, 1956). Having recovered from his first illness, Schreber remained well until he heard about his nomination to Dresden in 1893. He then had dreams that his old illness was returning, and, having arrived in Dresden, he could not sleep and began to have auditory hallucinations. He was readmitted to Flechsig’s clinic and he soon started to lose himself in a world of mysticism, and he no longer recognized his wife. He came to believe that Flechsig was persecuting him, and he thought that nowhere could be worse than Flechsig’s clinic (DW, pp. 98–99; M, p. 101). When he was transferred to Sonnenstein, however, according to Weber’s first expert witness report for the court dated 9th December 1899, what had developed into hallucinatory insanity crystallized into the clinical picture of paranoia, with a fixed delusional system and preservation of mental clarity (Weber, 1899, DW, p. 271; M, p. 202). This description, as we will see, could easily have been taken from Kraepelin’s psychiatry text-book (Kraepelin, 1883, pp. 284–285, 303–305).

Back in November 1894, not long after the Sonnenstein admission, Weber’s report for the president of the Oberlandesgericht, Karl Edmund Werner, in relation to Schreber’s ability to resume work (discovered in his personnel file by Devreese), spoke of hallucinatory insanity with delusions of persecution, but it was still undecided on the prognosis and allowed for a positive outcome, since the delusional ideas had not become fixed into a closed system. On the basis of this report, Werner—formerly a Senatspräsident him-self—recommended a temporary guardianship for Schreber with the agreement of his wife, and the Ministry of Justice placed him in temporary retirement (Devreese, 1986, pp. 214–218, 220–222). The Ministry requested a further report to be submitted after one year had lapsed and, when Weber supplied it in November 1895, it was decided to make the retirement permanent (Weber, 1895, pp. 240–242). The report stated that the situation was less favourable than a year before, that the traits of the clinical picture had become fixed, that the delusional ideas had become more or less systematically set, and that, although some improvement could still be hoped for, it could not be assumed that Schreber would ever reach full psychical intactness again, or be able to resume his duties.

Before he was transferred from the university clinic to Sonnenstein, Schreber’s attitude to Flechsig had changed considerably. While Flechsig may actually have been awkward to deal with (Kraepelin found him particularly difficult in Leipzig, and there is anecdotal evidence that he disliked jurists (Kraepelin, 1983, p. 22; Schreiber, 1987, p. 74)), he began to take on a delusional significance for Schreber. As we will see, Schreber would accuse him of what he called “soul-murder” (Seelenmord). In Sonnenstein, Weber could report that he endlessly repeated the name “Flechsig”, preceded by the word “kleiner” (little), which he used to stress sharply (Weber, 1899, DW, p. 383; M, p. 269). And even when the Denkwürdigkeiten had been completed, the voices that he heard were still calling out Flechsig’s name hundreds of times a day, and accusing him of being primarily responsible for his troubles (Schreber, 1903b, DW, p. viii; M, pp. 33–34).

We will, later, consider Freud’s view that Flechsig represented Schreber’s brother, Daniel Gustav, who was born in 1839, and shot himself in 1877, only weeks after being appointed a judge in Bautzen. According to the Leipzig clinic file, Gustav suffered from paralysis (KG, p. 1 [1]), and it is also known that an asylum admission had been considered for him (Baumeyer, 1955, p. 523, 1956, p. 68). Schreber himself was born in July 1842. Apart from Gustav, he had another older sibling, Anna, born in 1840. After Schreber came Sidonie in 1846, and Klara, who would later suffer from hysteria, in 1848. Their father, Daniel Gottlob Moritz Schreber (1808– 1861), was the famous orthopaedist and educationalist. Han Israëls has argued that his fame has been exaggerated by psychoanalysts (Israëls, 1989, p. 231), but, in fact, he has a street called after him in Leipzig and he is still known in Germany today for the gardens and associations bearing his name. Recorded in the patient file, however, is the fact that he suffered from compulsive ideas and murderous impulses. He died at the age of fifty-three, the age at which his son’s second illness would break out. As we will see later, the American psychoanalyst, William Niederland, has investigated the orthopaedic apparatuses invented by Moritz Schreber, such as his iron Geradehalter, designed to ensure straight posture in children by being fixed to the chest and table, as well as his writings on education. He has concluded that Moritz was a psychopath whose interests in educational reform were only a mask for his sadism (Niederland, 1959a, p. 161). We will also see that Morton Schatzman, an American anti-psychiatrist, has argued that Schreber’s persecutory delusion was due to real persecution from his father (Schatzman, 1973). Whether or not this medical-doctor father was the basis of Schreber’s persecutory idea of God, who was unable to deal with living people, but only corpses (DW, pp. 55, 141; M, pp. 75, 127), is yet to be seen. Little is known about Schreber’s mother, Pauline. Lothane has uncovered some factual information about her (Lothane, 1992, pp. 15–16), but we cannot be certain about Baumeyer’s claim that she was depressive and passive vis-à-vis her domineering husband (Baumeyer, 1970, p. 245). What we do know is that Schreber lived with his mother until he got married in 1878 at the age of thirty-six.

Schreber complained in the Denkwürdigkeiten that the staff in Sonnenstein appeared to have completely forgotten his state and high official position (DW, pp. 146–147; M, pp. 130–131). In fact, before his second admission to the university clinic, he held one of the second highest posts in Saxony’s judiciary. Werner was Präsident of the Oberlandesgericht, and immediately under him were Schreber and five other judges. Academically, Schreber was a high achiever, and he received various honours during his career. In 1888, he was made a first class Ritter in the royal Saxon order of service. He had begun to study law in Leipzig in 1860, and had attained top marks in his pro praxi et candidatura and Legal Practice examinations (Busse, 2003, pp. 523–527). He would later become a doctor of law—the only one among the Senatspräsidenten in Dresden—and then pass the State examination in 1870. At twenty-three, he took the judge’s oath and began a legal career which would see him appointed a Gerichtsrath in Leipzig’s Appeal Court in 1874 and its District Court in 1877. It was perhaps his working for a year at the Ministry of Justice in Berlin—the year he got married, 1878— that caused his rapid promotion through the legal system. The following year he was appointed presiding judge at the Landgericht in Chemnitz. In October 1884, he stood as a Conservative–National Liberal candidate in the Reichstag elections, but the electoral area in which he stood had traditionally been Social Democratic and he attained only twenty-five per cent of the vote (ibid., p. 525). According to the Denkwürdigkeiten, it was the strain of these elections that caused his first illness. In 1886, he took up the position of presiding judge in Leipzig, having been discharged from Flechsig’s clinic. And, finally, after spending four years as president of the Land-gericht in Freiburg, he was nominated a Senatspräsident in Dresden in 1893 at the age of fifty-one.

First admission to Flechsig's university clinic

Schreber claimed that his first hospital admission was due to the strain of standing in the elections in October 1884 (DW, p. 34; M, p. 61). Baumeyer has suggested that he suffered from hypochondria before his marriage in 1878, but this is not clear from the medical records (Baumeyer, 1955, pp. 515, 527; 1956, pp. 62, 70). According to Schreber himself, his first illness broke out towards the end of 1884 as a result of exhaustion caused by the Reichstag elections. After spending some weeks at Sonneberg for convalescence, he was transferred to Flechsig’s clinic in Leipzig on 8th December. The first thing to be entered in his patient file there was that he was hereditarily burdened (hereditär belastet) (KG, p. 14 [26]). He was thought to be suffering from hypochondria, and he regarded himself as incurable. His symptoms included speech disturbances, a very unstable mood, and suicidal ideas. He believed he would die at any moment, and he imagined that he could not walk. But, as the Denkwürdigkeiten stated, his first illness ran its course without any reference to the supernatural (DW, p. 35; M, p. 62). After his recovery in 1885, for which he was grateful to Flechsig (he made allowances for Flechsig’s not allowing him to weigh himself, which, he believed, would have cured him sooner, and he later paid Flechsig a personal visit and offered him an appropriate honorarium), he spent several mainly happy years with his wife, Sabine Baur, a time rich in external honours, as he put it, which was clouded only by not being blessed with children.

Readmission to Flechsig's clinic and transfer to Sonnenstein Castle

Eight years later—in June 1893—Schreber was informed by the Minister that he was about to be nominated a Senatspräsident at the Oberlandesgericht, and, shortly afterwards, he had some dreams to which he paid little attention at the time. He dreamt that his old illness was returning and he was relieved to discover that he had only been dreaming. More importantly, he had an experience one morning while still in bed—whether asleep or already awake he was not sure—which would deeply affect him. The idea came into his mind “that it must really be beautiful to be a woman submitting to intercourse” (DW, p. 36; M, p. 63). This thought was so alien to his way of thinking, he claimed, that he would have rejected it if fully conscious. He moved to Dresden in October to take up his new position, and there he found the burden of work uncommonly great. Also demanding was the fact that he had to chair the five-judge college, Karl Moritz Lamm, Herman Wettler, Augustin Julius Lossnitzer, Oskar Konstans Leonhardi, and Max Alfred Thierbach (Königliches Gesammtministerium, 1893, p. 213), some of its members being up to twenty years older than him and more familiar with the running of the court. There were few opportunities for socializing, since he and his wife were new to Dresden, and, after a few weeks, the situation became too much for him. His sleep began to be disturbed and he started to take bromide. His first bout of sleeplessness began at the end of October or the beginning of November 1893. Every time he tried to sleep, a strange noise in the bedroom wall would wake him up again. At first, he took this to be a mouse, but later, after hearing such noises for years, he became convinced that they were “divine miracles” (DW, p. 38; M, p. 64).

Because of his worsening condition, he and his wife took a holiday with the intention of visiting Flechsig again in Leipzig. According to the Denkwürdigkeiten, he received an injection of morphine en route, as well as chloral, after which he experienced heart trouble, as in his first illness. And, after a bad night in Chemitz, he made his way directly to Flechsig’s clinic. There, a very talkative Flechsig spoke of the great advances psychiatry had made since his first illness—including a new sleeping cure—and he gave Schreber the hope that his whole illness could be healed in a single sleep (DW, p. 39; M, p. 65). As we shall see, much has been made of this sleeping cure by interpreters of the case. Schreber took the medication and went to bed in his mother’s apartment in Leipzig, but he still could not sleep. In an anxious state, he left the bed and tried to kill himself, only to be stopped by his wife. The next day, Flechsig ordered his readmission. Having been taken into the clinic on 21st November 1893, his thoughts were only of death, and, even when he was put in a special cell overnight, he tried to kill himself again. His wife used to visit him daily and take lunch with him, but, around 15th February 1894, she took a four-day break to visit her father in Berlin. During this time, Schreber’s condition greatly deteriorated, to the extent that, when he saw his wife again, he no longer recognized her as a living being, but only a miracled-up human form after the style of what he called “fleetingly improvised men” (flüchtig hingemachten Männer) (DW, p. 44; M, p. 68), the meaning of which will become clearer later. Decisive for this further breakdown, according to Denkwürdigkeiten, was a night during which he experienced an unusual number—half a dozen—of nocturnal emissions. His father, Moritz, had written that if such emissions happened more often than usual, it indicated an excitability of the sexual organs caused by a weakness, and that they would result in a general weakening of nerve strength, and possibly the complete loss of procreative power (Schreber, D. G. M., 1861, pp. 181–182). According to a report by Flechsig, Schreber then began to lose himself in a world of mysticism and religion. He heard God speaking to him. Devils played games with him, and he heard holy music (KG, p. 2). There was not as yet, however, any mention of a redeeming mission from God. It was also from this time on that he began to believe that Flechsig was not out for his good, and that Flechsig was speaking to his nerves without being present, the evidence being the impression that Flechsig could no longer look him in the eye (DW, p. 45; M, p. 68).

Flechsig suspected that he was suffering from hypochondria again—what Schreber himself called “softening of the brain”— although auditory and visual hallucinations were also indicated. He expected to die shortly, and he had ideas of persecution. He even thought he had the plague. More importantly, Flechsig reported that Schreber believed that his penis had been twisted off by a nerve probe, and that he took himself to be a woman, although he also felt the need to energetically reject the Urningsliebe of certain persons (KG, pp. [2]-2). Urningsliebe was a term coined by Carl Heinrich Ulrichs for homosexual love, and used in a series of essays he published in Leipzig in the 1860s and 1870s (Ulrichs, 1864, 1868, 1879; 1898a,b,). Since Ulrichs was a jurist and a number of his essays were addressed to the judiciary, Schreber was probably familiar with them. As Hubert Kennedy has pointed out, “unnatural voluptuousness” (Wollust) was not a crime in Hannover, so Ulrichs was accused of being a nuisance, and had to give up his position as an Amtsassessor in the judiciary (Kennedy, 1997, p. 384). Interestingly, given Schreber’s later delusion of being God’s woman, for Ulrichs, an Urning or male homosexual, was a female soul contained in a male body (Ulrichs, 1864, pp. 20, 24–25). Like Schreber, he spoke of a power streaming through his body, and his own writing was in self-defence, too. On the other hand, Schreber could have found Ulrichs’ term in Krafft-Ebing’s Psychopathia sexualis (as a clinical– forensic study, it, too, would have been of interest to the judiciary), which regularly used Ulrichs’s terminology, and explained the claim that gender was not bound to physiology in terms of an Urning being an anima muliebris in corpore virili inclusa (Krafft-Ebing, 1886, p. 58).

After his deterioration in February 1894, Schreber not only regarded his wife as a phantom, but he thought his whole environment was a world of appearances. He believed that nowhere in the world could be worse, and, in June, he was transferred to the private Lindenhof clinic near Dresden, run by Dr Reginald Pierson, after attendants suspected he was trying to leave. When these approached him, Schreber did not bother to ask where he was being brought, because he regarded them, too, as only fleetingly improvised men. Leaving the clinic, he even wondered if the streets of Leipzig were not just theatre props, although the people he saw at the railway station in Dresden did seem to him to be real passengers (DW, pp. 99–100; M, pp. 101–102). His short time at Pierson’s clinic, too, was dominated by fleetingly i...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• ACKNOWLEDGEMENTS
• ABOUT THE AUTHOR
• PREFACE
• INTRODUCTION
• CHAPTER ONE Freud's exemplary case of psychosis: Daniel Paul Schreber
• CHAPTER TWO Disposition to psychosis in Freud's Schreber text
• CHAPTER THREE Psychosis in Freud's papers before and after his Schreber text
• CHAPTER FOUR Freud and Emil Kraepelin
• CHAPTER FIVE Freud and the Viennese psychiatrists
• CHAPTER SIX Freud and Eugen Bleuler
• CHAPTER SEVEN Hereditary disposition in Freud's aetiological chain
• CHAPTER EIGHT The reception of Freud's 1911 aetiology by psychoanalysts
• CHAPTER NINE Jacques Lacan on Freud's Schreber
• Conclusion
• REFERENCES
• INDEX