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Revolution in Mind: The Creation of Psychoanalysis
Am J Psychiatry 2008;165:921-922. doi:10.1176/appi.ajp.2008.08020190

by George Makari. New York, HarperCollins, 2008, 624 pp., $32.50.

This attractive book represents a prodigious effort on the part of Dr. George Makari, who is director of Cornell’s Institute for the History of Psychiatry, Associate Professor of Psychiatry at Weill Medical College, Adjunct Associate Professor at Rockefeller University, and a faculty member of Columbia University’s Psychoanalytic Center. It also contains a scattering of rather interesting photographs, some of which I have never seen before, which give relief to the dense and scholarly text. The book begins with a brief prologue and is then divided into three parts, followed by an epilogue, acknowledgements, source abbreviations, notes, permissions, illustration credits, and an index. The first part deals with what Makari calls “Making Freudian Theory,” the second with “Making the Freudians,” and the third with “Making Psychoanalysis.”

It takes great courage for a person who is perhaps not a full-time professional historian to try to write a history of psychoanalysis. How does one start out to write such a history? The author of this book has mixed together innumerable thumbnail sketches of significant and, I think, not so significant individuals, along with a running narrative of how the field developed and a review of the many quarrels, schisms, and confusions that it entailed. By including these thumbnail sketches, the author takes the risk of interrupting his narrative and losing the thread of his discussion. Because there are so many of them, the names begin to swirl before one’s eyes. I had the advantage of being already familiar with most of the names and people described, and I have no complaints about these sketches except for one, in which Makari claims that “it seems likely” (p. 149) that Freud had an affair with his sister-in-law. I think the evidence for this is not convincing yet and the word “possibly” would have been much more appropriate.

It is up to professional historians to decide the accuracy of the many reported events and descriptions of individuals presented in this book. I formed an idea of how it would be for readers who are not familiar with the history of psychoanalysis when I read the first part of the book, which contained a large number of names and descriptions of individuals that were unknown to me. As to whether all these individuals had as much influence on Freud as the author seems to imply, I cannot judge, but I can say that this is not an easy text to read. The main audience for this book would probably be professional psychoanalysts or candidates. Other readers might be psychiatrists who are interested in the history of psychiatry and, of course, the most critical readers would be professional historians. There have been many books on the history of psychoanalysis, and biographies of substantial and significant characters in that history have been repeatedly written. This book has the advantage of bringing it all together and of including many lesser known individuals whose influence on Freud may have been significant. It seems to me to be a work of enormous labor, and the author is to be congratulated on his studiousness and diligence in writing such a tome.

According to Makari, his reason for writing this book is that “a wide array of ideas, experiences, judgments, and debates have disappeared….More than that we have lost a world, a world not so distant, but one made more remote by the European slaughters of the twentieth century. It was a world that made Freud, the Freudians, and the psychoanalysts, and it was a world in part made by them” (p. 2). He contends, along with a “large number of historians” (p. 3), that much of Freud’s thinking was dependent on ideas put forth by others in various fields and endeavors, “ranging from the ancients to his contemporaries” (p. 3). This accounts for much of the material that composes the first part of the book, and I fear the reader may be put off by such sentences as those found together on page 76: “Freud’s dream book would be part Kant and Schopenhauer, part Brücke, Exner, and Meynert, part Helmholtz, Hering, and Fechner, and in its final synthesized form, Freud….In The Interpretation of Dreams, Freud revisited these mysteries, mingling his own reflections with those of philosophers like Aristotle, Artemidorus, Kant, Schelling, and Schopenhauer.”

None of this is meant to criticize the author’s historical research, as the book contains a great many interesting aspects of the development and progression of psychoanalysis which appear to me, a nonhistorian, to be fairly accurate. Perhaps the struggle to give birth to psychoanalysis can be summed up by the author’s words, “Freud had given the mind the power to wound itself” (p. 45), but also, as Joseph Breuer pointed out, “Freud is a man given to absolute and exclusive formulations” (p. 92).

The second part of the book begins a discussion of what has come to be known as the “psychoanalytic civil wars,” and again the text contains many thumbnail biographical sketches. Makari describes the attempt to produce some kind of clinical standardization of psychoanalysis, and as Makari points out in discussing Freud’s 1910 address in Nuremberg, “Psychoanalysts, it seemed, were fated to be gadflies and outcasts, carrying a message no one wanted to hear” (p. 245). How much of this was a result of Freud’s authoritarian personality, especially in the way he presented his discoveries, and how much was actually due to mores built into Victorian (and perhaps our own) culture is another matter to be debated by historians.

The author, I think, was a little too kind to Alfred Adler. There could have been more discussion of Adler’s need, based on oedipal hostility, to not be considered a son of Freud, rather than their disagreement over theories. The resulting unfortunate schism was due to an authoritarian Freud and a stubborn and rebellious Adler butting heads. Actually, many of Adler’s ideas later became incorporated into psychoanalysis, as Makari points out.

Makari is correct in maintaining that the fundamental dispute between Freud and Carl Jung, besides the disreputable unsavory personal aspects of it, was that “Freud believed fantasies were driven by unconscious sexual drives, [and] Jung concluded that the fantasies of any individual carried the memories of the entire race” (p. 270). The break with Jung is described in detail and the author concludes, “The Freudian community was now a tangled web of envy, jealousy, paranoia, and ambition. Amid the excitement of spreading a new psychology and therapy, the psychologists could not keep themselves from internecine conflict, and worse still, the squabbles seemed scientifically insoluble” (p. 281).

The third part describes Freud’s revision of his theories around the age of 58 and the subsequent development of modern psychoanalysis, which Makari calls a “stunning reversal” (p. 297). Repeatedly Freud developed new ideas, which became canonized in the minds of his colleagues, only to follow with a revision of these ideas. Makari paints Freud as a true “restless intellectual who felt most alive in the heat of creation. His ideal was to be a great discoverer, a man of science who rattled the world with new truths” (p. 297). The author believes this extraordinary reversal of Freud’s theories began with his famous metapsychological essay On Narcissism. From there Freud went on to concentrate on the theory that humans “did not seem to be primarily sexual, but cruel and violent, not psycho-sexual but a psycho-killer” (p. 310), a subject which I have recently discussed at length (1). The new focus in psychoanalysis was now based on a broader vision of love and hatred, which resulted in the final revision of instinct theory in Freud’s Beyond the Pleasure Principle.

There now occurred an increasing emphasis on the clinical appearance of transference, “a key to analytic technique and a new conceptual center for the postwar psychoanalysts to rally around” (p. 335). As he moves into describing the realm of ego psychology, which predominated psychoanalysis for quite a while, the author uses the term “I” for ego, “Over I” for superego, and “It” for id, reflecting some of the recent controversy over the proper translation of Freud’s writing. The use of ego, superego, and id was popularized by the standard edition of Freud’s work translated by James Strachey (2), now in the process of revision, and the ordinary reader may become confused at this deviation from general contemporary usage of these terms. It is only near the end of the book that the author explains his use of “I,” “Over I,” and “It” instead of the more common translation of ego, superego, and id.

Makari explains that “the great flowering of psychoanalysis occurred between 1918 and 1938” (p. 299). The status of pre-World War II psychoanalysis, with its enormous blossoming in Berlin, is nicely described, and the unfortunate break from Freud of many of his most intimate followers, such as Otto Rank and Sándor Ferenczi, is interestingly depicted. The assumption by Jung that a racial psychology differentiated Germans and Jews is reported, along with the destruction of the Berlin psychoanalytic movement by the Nazis. The emigration of continental psychoanalysts to England, including Freud himself, that culminated in the schism between Anna Freud and Melanie Klein in the British Psychoanalytical Society is also explained. This history ends essentially in 1946, and I was puzzled as to why Makari did not extend his history to the present day, describing the huge influx of lay analysts in the United States and the unfortunate marginalization of psychoanalysis in American psychiatry. Perhaps this will constitute the next volume of his study.

I would strongly recommend this book to anyone interested in the development and subsequent history of psychoanalysis. It is produced by a meticulous and obviously competent scholar who is deeply interested in his subject.

1.Chessick RD: Psychoanalytic Clinical Practice. London, Free Association Books, 2000
2.Freud S: The ego and the id (1923), in Complete Psychological Works, standard ed, vol 19. London, Hogarth Press, 1961


+Book review accepted for publication February 2008 (doi:10.1176/appi.ajp.2008.08020190).



1.Chessick RD: Psychoanalytic Clinical Practice. London, Free Association Books, 2000
2.Freud S: The ego and the id (1923), in Complete Psychological Works, standard ed, vol 19. London, Hogarth Press, 1961

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