SHRINKING HISTORY, On Freud and the Failure of ... - Planet.ee

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the Association. For some unexplained reason each follow-up inquiry
resulted in a dramatic failure of the majority of originally
participating analysts to submit reports, and eventually a total of
595 neurotic patients was determined. Of these, 289 (or 49%) "did
not complete" the treatment. That left 306. On further inquiry only
210 of the 306 patients were reported on; of these, 35 patients were
reported to be fully cured (that is, symptom-free), while the
remaining 175 ranged from "cured," but with residual symptoms
remaining, to "improved." On the basis of these results the
Association concluded that "about 97% of the patients who undertake
analysis for neurotic reactions and 'complete' it, are 'cured' or
'improved.'" *(13)
Surely, this will not do. Perhaps, since it was Freud who first
directed that any inquiries regarding the efficacy of analysis focus
on individual cases, we will do better by looking at his own
therapeutic record. Freud's writings cover a span of more than half a
century of work, filling the pages of nearly two dozen books and well
over a hundred papers in addition to his voluminous correspondence.
These writings include pronouncements on a staggering variety of
themes ranging from slips of the tongue and the meaning of jokes to
the history of humankind and the future of religion- all drawing from
and elaborating on, in one way or another, his psychoanalytic method.
It may then come as a surprise to some that in all this writing Freud
discussed at length no more than half a dozen of his own cases, all
of which were handled within a relatively short period of time: the
cases known as Dora (1905); Little Hans (1909); Lorenz, or Rat Man
(1909); Schreber (1911); Wolf Man (1914); and the female homosexual
(1919).
On closer examination, however, as Michael Sherwood of the Harvard
Medical School has pointed out, even this small number must be
qualified. Dora was treated only briefly with no discernible
positive effect. Little Hans only met Freud once, very briefly- the
entire "analysis" having been carried out by the boy's father, a
close follower of Freud. Lorenz was a complete and apparently
successful analysis. The Schreber case was only a historical
reconstruction based on published memoirs. The Wolf Man case dragged
on for many years, with different analysts and resulted in the
eventual apparently paranoid breakdown of the patient. The female
homosexual, like Dora, quickly terminated after virtually no attempt
at treatment and with no effect. Thus, as Sherwood notes, "only the
Lorenz case is a complete analysis," and even with it there are
possible problems of therapist suggestion. *(14)
Of course, Freud did see many more patients than this. A thorough
search of all his works by one researcher has turned up 145 cases of
at least passing mention in his writings. * But, for whatever reasons,
Freud chose not to discuss most of these cases at length. It is
little wonder that in the most recent and rather friendly large-scale
survey of psychoanalytic theory and therapy, Seymour Fisher and Roger
Greenberg are forced to admit, with delicate understatement, that
Page 30 , Shrinking History, - David E. Stannard