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How Freud Worked: First-Hand Accounts of Patients
Reviewed by ALAN A. STONE, M.D.
Am J Psychiatry 1998;155:851-851.
View Author and Article Information
Cambridge, Mass.

by Paul Roazen. Northvale, N.J., Jason Aronson, 1995, 328 pp., $30.00.

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R.H. Etchegoyen, Past President of the International Psychoanalytic Association, recommends Paul Roazen's latest book as "satisfying an intellectual appetite" and "the best source of inspiration for clinicians." I can only wonder whether we read the same book. His unqualified endorsement does demonstrate, however, that Anna Freud's legacy has run out and it is now safe for the leaders of organized psychoanalysis to walk on her grave. This is a book that Anna Freud would despise: it hangs out the dirty linen of Freud, his family, and his inner circle without any serious intellectual or historical perspective.

Consider the chapter on Dr. Edith Jackson, who is one of the 10 patients Roazen discusses. Dr. Jackson was known at Yale Medical School in my time there during the 1950s as the person who brought rooming-in to our maternity service. Ev~ery~one also knew that Dr. Jackson, a spinster, had a lengthy analysis with Freud in the 1930s, that she was independently wealthy, and that her father's first wife, Helen Hunt Jackson, had written the great American classic Ramona. Despite this near-legendary background, Dr. Jackson was totally unpretentious; an impressively kind and amiable soul, she was widely admired as a professional role model for her simple "salt of the earth" goodness and humility. Roazen interviewed her in 1966. The chapter about her is entitled "Forbidden Sex." Like Roazen's other "first-hand accounts," it has been reconstructed from "diary-like notes" and his memory 30 years after they were made. The thesis of "Forbidden Sex" is that Dr. Jackson had a sexual affair with Freud's oldest son Martin while she was in analysis with his father. "With Dr. Jackson I had a special interviewing agenda," he tells the reader—he actually wanted to find out from her about the alleged affair. Kurt Eissler, whom Roazen has the gall to accuse of "duplicity," had interviewed Jackson about her correspondence with Freud for the Freud Archives in 1954. Roazen faults Eissler for "missing the forest for the trees," Roazen's forest being the alleged liaison with Martin. "I knew that Martin collected women the way his father collected antiquities," Roazen writes. He goes on: "Martin's romance with Edith was obviously a hard subject for me to bring up, since I did not want to wreck the interview as a whole. I suspected that she gained some idea of what I was after, for she stopped at one point and asked me bluntly what I was hinting at." Roazen's approach in my opinion is neither clinically inspiring nor intellectually serious; it is ethically repulsive. Roazen did not succeed in his shameless agenda, but 3 years after this interview he wrote about one of Freud's sons getting revenge on his unappreciative father by having an affair with an unnamed analysand. Roazen reveals in this book that the allegation came through Helene Deutsch from one of Edith Jackson's close friends.

Roazen seems to have gotten a great deal of his information from an aging Helene Deutsch, one of the towering figures of Viennese and American psychoanalysis. One can wonder whether her judgment was still intact, but this source certainly justifies his claim that he "had been told on good authority." Still, even if it is true, is this allegation about Edith Jackson an important fact of social or intellectual history or is it a piece of scabrous gossip? Roazen seems unaware that he has any professional or personal responsibility to attempt to make that distinction. His chief concern as historian in this chapter is whether the romance included sex.

There is no doubt that the private lives of psychoanalysts are relevant to the social history of their profession and its theories. Still, this chapter is offensive and sordid. Some of the other chapters add details to what was already known, but the prevailing theme is Viennese gossip.

Anna Freud took a dim view of Roazen's earlier work. She warned her friends and colleagues against him and restricted his access to the Freud Archives. This book has another "special agenda"; it is written against her and her school of ego psychology. Roazen shows no interest in ego psychology as theory. His target is the neutral analyst and the clinical orthodoxy of Miss Freud's American followers. Roazen sees Anna Freud as the leader of "a conspiracy of silence" that denied the radical difference between what Sigmund Freud actually did and the Freudian ideal. The nine other patients Roazen interviewed (Albert Hirst, David Brunswick, Mark Brunswick, Robert Jokl, Kata Levy, Irmarita Putnam, Eva Rosenfeld, James Strachey, and Alix Strachey) said enough to demonstrate that Freud violated all of his own technical rules and the tenets of Anna Freudian orthodoxy. He analyzed some patients for free, he socialized with patients he liked, he simultaneously analyzed husbands and wives as well as brothers and sisters, he made indiscreet remarks, he brought himself and his interests into the analysis, he manipulated people, and he obviously tried to recruit his bright and interesting patients to become psychoanalysts. There is no denying that Anna Freud's orthodox Freudians would have thrown the great man out of their institutes. However, most of what Roazen reveals in this book is stale cheese, a catalog of Freud's aberrations measured by today's standards, not an account of how he worked.

Roazen was not the first to reveal that Sigmund Freud analyzed his own daughter, Anna, but that revelation is a recurrent focus of this book: what might it say about her orthodoxy? Roazen seems to have asked everyone he interviewed about it, and yet he never puts their answers in historical or meaningful perspective. Obviously, by contemporary standards it is an unthinkable boundary violation with incestuous overtones. Interestingly, as Roazen himself acknowledges, almost everyone in Vienna knew about it at the time, yet few of them were shocked. Why not?

Perhaps they were not shocked because they saw it in their social and historical context. Consider the famous case of Little Hans. Freud wrote it up in 1909 and considered it a quite successful treatment of a childhood phobia. The analysis was conducted by the boy's own father under Freud's supervision. Freud never repudiated that "analytic" treatment and stated that the father, because of his knowledge of the child, was in a better position to understand than an ordinary analyst would be. No doubt more than one analyst tried to follow this example. Certainly Freud did. Not only did he analyze Anna, but as late as 1935, 4 years before he died, he wrote in a letter to Edoardo Weiss that he considered it had been a "success." If this analysis later came to be a shameful secret to Anna Freud, it was certainly not to her father.

The social and intellectual history of psychoanalysis involves opening our eyes to sordid facts and gaining new understanding. Roazen's book neglects the second half of that serious undertaking.

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