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“The only thing modern about it is the architecture. The treatment is completely antiquated, just different types of confinement.”
“Are your colleagues involved?”
“No . . . Some American named Briggs is running it,” he said disparagingly. “Bottomless funds for mortar, and next to nothing for neurological research. The man cares only for the view.”
He went on to explain that at this facility, as well as at others, once a patient was labeled a “chronic dement,” anything could happen. Doctors would routinely remove whatever body part they assumed to be the cause of the illness—thyroid gland, teeth, tonsils, portions of the brain. They douched patients to treat depression, induced malarial fevers to help impaired mental function, or put the poor souls in a continuous bath that could last from one day to one week. In addition, they filled them with laudanum, barbiturates, bromides, and purgatives.
To Minna, his assessment sounded grim, but still an improvement over mid-century hospitals where patients were chained to walls and confined to cavelike rooms with small openings where the food was passed through. And she had even heard stories about “Sunday viewings,” where the public would pay the guards a fee to view the “dements” in their natural habitat.
She told him that she did have some knowledge of current treatments. “My last employer, Baroness Wolff, was once treated with Erb’s electrotherapy for depression. I watched as electrical currents were applied to different parts of her body. It was most unpleasant.”
“Ah, the Battery Room.”
“Why, yes, exactly,” Minna said. She remembered the noxious odor of chlorodyne and alcohol as she peered through the open door into a room where bright brass disks of huge electric batteries glittered under a glass dome. Suspended from the walls were all kinds of queer apparatus, which were used to shock patients who were suffering from a morass of strange physical maladies. Minna thought it appalling, but settled herself in one of the chairs in the waiting area, sitting next to a woman whose son had just been readmitted after setting fire to his couch, claiming his father was hidden in it.
“I’ve complained many times about that protocol,” he said. “I’m convinced that Erb’s therapy doesn’t help patients with nervous disorders, and that a partial recovery is the most that could be expected. How did your employer fare?”
“Not well, I’m afraid. She shot herself.”
“Is that true?”
“No. Just wishful thinking,” Minna said with a wry smile, as if they were sharing some private joke.
Freud looked at her, appraising her face, his eyes crinkling at the corners with unmistakable appreciation. Then he resumed in a serious tone.
“The fact is, electrotherapy and those other barbaric methods just don’t work. When I studied in Paris with Dr. Charcot, hypnotism was the recommended cure, but I eventually found that it, too, was ineffective.”
Minna remembered that Sigmund had gone to Paris around ten years earlier to study with the famous French neurologist.
“I always thought hypnotism was a bit far-fetched,” she ventured. “But at least you got to live in Paris.”
“Well, there was that,” he said with a smile. “And in the beginning, hypnotism did seem to work. We put patients in a trance and got some encouraging results. But as time went on, the treatment left much to be desired. Not every patient could be hypnotized; some of them just weren’t suggestible. I imagine you wouldn’t be, either.”
“Why would you say that?”
“Just a hunch. Maybe we’ll try it sometime,” he said lightly, as he placed his hand gently on the small of her back and guided her around a puddle. “In any event, even when the treatment was effective, the symptoms would usually reappear. It was disheartening, actually. The patients made so little progress. They still had nightmares, deafness, speech impediments, paralysis—a myriad of symptoms. But when I returned to Vienna, I discovered my most effective therapeutic tool was sitting right in front of me. All I needed to do was to get the patients to talk about themselves.”
“Honestly, Sigmund, it sounds like such a simple way to get such astounding results.”
“Yes. In theory, it’s marvelously simple. In reality, a bit more complicated. But the crux of the matter is, my colleagues were dealing with hysterics from a neurological perspective and getting nowhere. I watched patients struggle with depression, delirium tremors, shifts of mood, phobias, and compulsions, and nothing we did seemed to help. But when I asked them to lie down on a couch and talk about their past—abusive fathers, distant mothers, childhood traumas, whatever drifted into their mind without censorship—all of their disturbing, even horrifying memories spewed forth. And then, by peeling off the layers, observing, interpreting, and guessing, one could discover what caused the symptoms. And by doing that, eradicate them.”
“My God, Sigmund. It’s cathartic, isn’t it? It frees patients by encouraging them to talk about their past.”
“Exactly. The couch is my laboratory.”
“But if I may play the devil’s advocate, for a moment?” she asked, holding up her index finger as he smiled indulgently. After all, this was why he liked her and she knew it.
“Why would anyone lie down with a complete stranger and tell him her most intimate thoughts, her inner secrets, even her perversions?”
“I’ll tell you why. People who have been through years of horrendous pain will do anything if they think it will help. And once they start talking, they can’t stop. Their memories overtake them, and they begin to realize what they’ve been suppressing all these years. There is meaning in the dark corners of human life and in that meaning lies hope.”
She wanted him to go on. She wanted to ask him about his patients. Specific examples. Specific results. But mostly she wanted to tell him that his discoveries were profound as well as humane. That if he was right, all treatment, as they now knew it, would be antiquated. That he could change history.
“It’s so nice to have someone to talk to . . .” he said, looking at her intently, “someone who understands. My colleagues think I’m off on a quixotic mission. And so does Martha.”
A flurry of women in crinoline hurried by, pushing them to the side, and the rattling of an omnibus, followed by a two-horse dray, drowned out the voices of the pedestrians around them. Minna looked up as he pulled another cigar from his pocket. He lit it, thoughtfully puffing, while he watched an aimless group of students loitering in the park across the street.
Her mind was reeling, but she was hesitant to say more. She leaned over self-consciously to fix her boot once again. It was now rubbing her ankle raw. She sat down on the nearby bench, trying to loosen the offending laces. He studied her as the afternoon light glowed softly on her hair.
“What are you looking at?” she asked, glancing up.
He held her gaze and smiled slightly.
“I’m looking at you.”
7
A few days later, when the children were busy with the governess, Minna decided to attend Sigmund’s lecture at the university. After all, he had invited her on the day she arrived, and although he hadn’t mentioned it since, she felt certain the offer had been sincere.
The University of Vienna was just a fifteen-minute walk from the apartment, and she could make it if she hurried. Minna crossed the tree-lined Ringstrasse, rounding the corner at the Parliament building, and continuing through the elite Rathaus quarter, with its massive neo-Gothic public buildings. It was still unseasonably warm, and by the time she reached the university, her dress was damp with sweat and her hat slightly askew.
She wandered around the campus for a few minutes, searching for the medical school. The imposing university buildings were monumental in scale and purposely intimidating, she felt. Particularly the giant, overblown Greek mythological sculptures planted here and there, glorifying this noble center of liberal learning. She approached a few studen
ts to ask directions before finally finding her way to the correct building. She struggled with the heavy door, gathered her courage, and climbed the staircase to the lecture hall on the second floor. By the time she got there, Freud had already begun.
The room was filled to capacity, young men standing in the back, in the aisles, many of whom were wearing dark suits and yarmulkes. It was a well-known fact that the majority of medical students at this university were Jewish, as well as most of the doctors in Vienna. In fact, the emperor’s personal physician was in Freud’s B’nai B’rith group, as was the surgeon general of Austria.
Freud stood at the podium, his voice echoing through the chamber. He looked relaxed, even a bit amused. He did not have a powerful voice, nor did he project a particularly commanding image. And yet as he talked, he had this strange, monumental pull over her. She noted that he was wittier, more confident now, and he delivered his words with compelling force, like an evangelical at his Sunday sermon. Even at this early point in the lecture, the students had put down their pens, mesmerized as he entertained them with anecdotes and jokes that would most likely be circulated in the cafés afterward. In her eyes, he was magnificent.
“I’m reminded of a couple—I may have spoken of them before. Their marriage was tormented with a variety of conflicted feelings and misinterpreted signals . . . and, after weeks of talking to them, I thought we had something of a breakthrough.” He paused melodramatically. “But then the wife said to her husband, ‘When one of us dies, I’m going to Paris.’”
The students erupted in appreciative laughter as Minna scoured the hall, searching for a place to sit.
“But I digress. As we were discussing last week, neurosis is a frequent consequence of an abnormal sexual life, and in fact, I’m finding sexual repression to be the key to understanding neurotic illness and human behavior in general.”
Some titters from the audience. Now he began to discuss the crux of his report titled Studies in Hysteria, concerning sexual repression and its effect on people.
“Gentlemen, I’m going to provoke you to astonishment. That is my goal.”
He was so sure of himself, she thought, but his face was highly changeable and could shift abruptly, depending on his mood. One moment he was glaring at the students. The next, he was charming and animated, embracing his audience as if they were all sharing some intimate knowledge.
“We are all helplessly in thrall to traumatic memories from our past, and these memories are invariably of a sexual nature. Even our most impressive achievements are stained by the animality of our nature. That is our fate. And if you think this revelation that I alone have come up with is grim, you are correct. In effect, gentlemen, with the basics of this theory, I am bringing you the plague.”
The students shifted in their chairs and a few of them smiled. At this point, they were used to Freud’s hyperbole.
“We humans,” he went on, “are infected with our past. The challenge for you, my good men, is to understand this revolutionary theory and to use it in the future to cure the many patients who are incorrectly diagnosed.”
Minna smiled to herself at his grandiose certainty, a tone that had infused his letters to her over the years.
The late-afternoon sun filtered through the length of the tall, narrow windows, and Minna removed her heavy coat and gray leather gloves. She hadn’t anticipated a full house. Not one empty seat. Trying to be unobtrusive, which wasn’t easy, considering that medical schools were only for men, she balanced her coat in one arm and her purse in the other. She stood there, craning her neck to see if there were any available seats. A young man on her left noticed her and, after his initial surprise, stood politely, offering his chair. She thanked him and sat down, removing her large plumed hat (perhaps not the best millinery choice for that day). She didn’t want to cause a stir by walking down the aisle. Even so, she could hear a few students whispering about “the woman in the class.”
Freud went on to discuss the origin of his theory. “It all began,” he told them, “with a patient named Anna O., the twenty-one-year-old daughter of a wealthy Viennese family, who had first seen my colleague Dr. Josef Breuer with unexplained paralysis of the right arm. Over the next few weeks, he found her symptoms multiplied. Persistent cough, numbness in the extremities, delirium, and even the inability to speak German, her native language. Dr. Breuer diagnosed her as ‘hysterical’ and treated her with hypnosis, but it was not effective.”
It occurred to Minna that Sigmund spoke as he wrote in his letters: clearly, persuasively, and in great detail, and to her surprise, he never once looked down at a piece of paper.
“Anna had deeply tragic but beautiful fantasies and morbid daydreams,” Freud recounted. “In one of them, a snake tried to attack her father, who in real life was ill and for whom she was caring. She tried to kill the snake but her right arm was useless. Her fingers turned into little snakes, and then the entire arm was paralyzed.
“And now I will tell you the breakthrough,” he proclaimed, stepping down from the podium. He was clearly relishing the effect he was having on his audience. The room was dead silent, his low baritone reverberating off the wooden walls.
“Anna started talking about her dreams and her accompanying fears, in English, but you can’t have everything,” he said, waving a hand in the air as the students laughed. “But then her symptoms improved, almost disappeared. What accounted for the cure, you ask?
“I’ll tell you,” he said, growing more serious.
“Hysterical patients suffer from their memories. Memories of traumatic events that may even occur in infancy and, I repeat, are sexual in nature. But talking about them, or as Anna so charmingly called it, ‘chimney sweeping,’ helped chase away the demons.”
Minna could imagine how this theory at first might seem preposterous—all neurosis originating from sexual causes. But now, listening to his reasoning, she was intrigued. He went on to analyze other cases and theories.
It was clear to Minna that Freud had honed his skills of communication, drawing heavily on literature, philosophy, science, sexuality, and the mystery of human relationships. He was far from the stereotypical handsome man, but when he spoke, his words and actions had a captivating quality, inducing excitement and racing pulses among the young men. Minna could see it in their eyes. The air was charged with creativity as he offered his audience fresh possibilities, new ways of thinking. He made them laugh and laugh again. They were drawn to his oddities, his contradictions, and . . . why didn’t she just say it? To his greatness.
The air was beginning to feel close in this male sanctum. Minna pulled off her scarf. She glanced back at the podium as Freud smiled and nodded in her direction. She met his gaze and then nodded back. She wanted to freeze this unexpected, secret pleasure in her mind. The instant of eye contact was over in a flash, but it seemed to silence him momentarily. She wasn’t sure how, in this large lecture hall filled with a sea of students, but the room suddenly became as intimate as dinner for two.
• • •
Freud’s lecture went on for over two hours. He described disturbed patients who had come to him with traumatic stories of sexual fantasies, dreams, and guilt regarding illicit behavior. He talked about a young man who had had intercourse with a prostitute and was exhibiting bizarre paranoid symptoms. A young woman who had been molested by her father suffered hysteria and breakdowns. Others who were afflicted with paralysis of the limbs, nervous cough, headaches, inability to speak, terrifying hallucinations. A bewildering number of symptoms and psychological states resulting from sexual traumas. People who were so disturbed they had been given chloral hydrate, morphine, and chloroform to sleep or been hung by their limbs in metal cuffs and subjected to electrotherapy.
Afterward, Minna watched the students, many of whom looked young enough to be members of the Vienna Boys Choir, push forward and crowd around him, bombarding him with questions. Occasional bursts o
f male laughter reverberated through the hall and she moved slowly against the tide, making her way to the back door. She was almost there, her back to the podium, when somehow she felt he was looking at her.
“Fräulein Bernays,” he called out, the sound of his voice suddenly silencing the din in the room. “Would you mind waiting a moment?”
She turned toward him and nodded. She had already put on her coat, hat, and gloves and was shifting, uncomfortably warm, from one boot to another as she stood near the door. He stepped down from the podium and lit a cigar, and the pungent odor of smoke drifted up to where she was standing. A few minutes later, he excused himself from the students still surrounding him and climbed the stairs to where she stood.
“I hope I didn’t bore you . . .” he said, knowing full well that he hadn’t.
She thought for a moment, wondering whether or not to offer an observation, but then, as usual, decided to forge ahead.
“You had your students’ complete attention, and adoration, I might add, but when you stated that all hysteria was caused by sexual dysfunction, they seemed, well, rather, incredulous,” she said.
His gaze became appraising. “No, my dear. That’s not what I said at all. I said that the original root of hysteria would be sexual.”
“I might have missed that.”
“I find that hard to believe . . .” he said, a half smile playing on his lips.
“In any event, couldn’t you argue that some cases of hysteria could be caused by, say, fear, death, or abandonment?”
“My reasoning is perfectly clear. . . .”
“Well, it might be confusing. . . .” she said, her words coming out with less force than she had planned. “For example, your patient, the twelve-year-old boy who wouldn’t eat . . . that’s very clear, he’d been molested. Certainly that cause and effect is easy. But others are more difficult. . . .”