Critical Theory A
10 July 2007
It is of personal interest that I am drawn to Sigmund Freud’s essay Psychoanalytic Notes Upon An Autobiographical Account Of A Case of Paranoia (Dementia Paranoides) because in reading about his investigation into the paranoiac neurosis of Dr. Schreber, I am reminded of a personal experience similar to his religiosity which had followed a state of paranoia in my own life. Not only can I can relate to and empathize with the perception of such a delusion, but also, I have come to terms with defending the condition as being only as unnatural as the consensus of society will allow and determine what natural or ‘normal’ is to be. As for Freud, he was challenged by not only the need to prove his new science to skeptics that psychoanalytic interpretation as a scientific practice is genuine, but also in his case study of Dr. Schreber, how it reveals variances of complexities in his history of paranoia that becomes apparent to Freud during his analysis; In order to fully interpret Schreber’s case, he must identify with similar experiences and behaviors within the medical community and within himself. Just as he proclaims a general development of the libido to all humanity, “There comes a time in the development of the individual at which he unifies his sexual instincts in order to obtain a love object”—as in the assorted levels of sexual development––by relating to the case in order to make a hypothesis, he brings his role and the whole analytic process into question.
In investigating Schreber’s case, Freud becomes a participant himself and is challenged simply because he is at the forefront of establishing his practice. He announces in the introduction, “Paranoia presents difficulties of a peculiar nature to physicians who, like myself, are not attached to public institutions. We cannot accept patients suffering from this complaint, or, we cannot keep them for long, unless there is some prospect of therapeutic success.” (83) Freud expresses apprehension for involvement with such cases which implies how paranoia was regarded at the time and it was not largely treated by physicians. Yet, it is essential for his practice to review such a case and the contingency looming over its outcome will create an expectation that he is fully aware of. He appears to have a lot at stake with this case because it is more than an analysis from the viewpoint of a physician concerned with the health of a patient in the field of psychiatry. Freud’s interpretation of paranoia is a condition that if substantiated, could provide the basis from which Freud’s philosophy for treatment which he calls ‘psycho-analysis’––can be established. For it is his attempt to create a precedent, a foundation for his break-through practice that will change the way in which the medical community will treat patients if he is successful, in which case, could be widely accepted. In his postscript to the essay he says, “And I am of opinion that the time will soon be ripe for us to make an extension of a principle of which the truth has long been recognized by psychoanalysts, and to complete what has hitherto had only an individual and ontogenetic application by the addition of its anthropological and phylogenentically conceived counterpart.” (159) He’s taking psychiatry further by his invested interest to not only prove to himself of his beliefs but to his peers that he has developed a specialized discipline worth exploration.
However, that isn’t to say that Freud does not possess doubts as to the success of such an ambition. And during the extent of this particular case, he becomes a participant or a character if you will in his writing that so closely examines the psychosis of Schreber that he discloses a paranoiac conscience about himself, “I will pause here for a moment to meet a storm of remonstrances and objections. Any one acquainted with the present state of psychiatry must be prepared to face the worst.” (118) Here he demonstrates his vulnerability and understands the risks involved with making an incorrect hypothesis, and even more so, the risk of pioneering a scientific practice that is fallible. This fatalistic speculation considers Schreber’s case instrumental in his practice. He details the patient’s pathological phenomena in depth. From delusional ideas where “He was in direction communication with God,” or how “He even came to believe that he was living in another world.” (89) Other details offered in Dr. Weber’s report made two points: “His belief that he has a mission to redeem the world” (92) by assuming the “Role of Redeemer” (93) and that of his “Transformation into a woman” (93) which caused Freud bewilderment because the redemption depended upon Dr. Schreber’s emasculation.
Does Freud begin to question his method at this point? We can agree that he does question it. Toward the closing of his essay in the section called On The Mechanism Of Paranoia there is another example of Freud’s exposed reconsideration that is particularly interesting. In this section he confesses, “It remains for the future to decide whether there is more delusion in my theory that I should like to admit or whether there is more truth in Schreber’s delusion that other people are as yet prepared to believe.” (154) That is to say, however detached from reality Schreber may have appeared to have been during his states of mental instability, he is a highly intelligent being and it is not unfathomable to consider his delusions to be real. But more significantly, Freud has come to the assumption through closely observing and relating to Schreber’s case based on specific paranoiac and delusional events, that his own rational interpretations are no less delusional.
In addition, Freud points out to the benefit of Schreber’s positive character traits based on the report drawn by Dr. Weber that he “Shows no signs of confusion or of physical inhibition, nor is his intelligence noticeably impaired. His mind is collected, his memory is excellent, he has at his disposal a very considerable store of knowledge, and he is able to reproduce it in a connected train of thought.” (90) Additionally, after Schreber accompanied Dr. Weber at his family board for meals, he goes on to account that he “Gave evidence of a lively interest, a well-informed mind, a good memory, and a sound judgment; his ethical outlook, moreover, was one which it was impossible not to endorse.” (91) Freud attests to addressing Dr. Schreber in his essay this way because the patient is a physician. One who is a physician himself, submits himself to being subjected to an analysis of his condition for having exhibited delusional behavior, as Dr. Schreber had, would be well aware of how his own education affords him the knowledge to recognize something out of order in his own life . Furthermore, he anticipates the inspection of his condition by other physicians to differ in procedure and result. Given that anyone with adequate intelligence could bring into question the manner in which an observing physician to his condition would have an effect on one’s reaction just by the plain act of being observed, this in itself, would have impact upon his condition. In other words, if you exhibit abnormal behavior as Schreber had, it may flare up upon inspection or his anticipation could suppress it from noticeability. Even though his faculties appeared to be in order and coherent at this point before submitting himself again years later, it is to his benefit, that because he is a doctor himself he recognizes his behavior and voluntarily submits himself to seek help. He is aware of the practice physicians engage upon during examination and is the more prepared for it. Therefore, Freud takes extreme precaution when conducting his investigation because he understands that Dr. Schreber is respected, a physician himself, and whose interpretations of the world––no matter how radical, deserve appreciation. Lastly, Freud suggests, “Psychiatrists should take a lesson from this patient, when they see him trying, in spite of his delusions, not to confuse the world of the unconscious with the world of reality.” (119)
Freud’s psychoanalytic investigation into Dr. Schreber’s case of paranoia presents an extremely interesting account of detail to outline the events of the patient’s fantastical delusions. Yet, what’s even more interesting is how through the examination, the examiner is being examined himself. Freud, the father of psychoanalysis left clues in his essay that hint to the notion that he is just as venerable to neurosis as Dr. Schreber and because of that, it appears that the process of science itself can produce paranoiac attributes in its most trusted advocates. This conclusion may seem a bit off kilter to bring light to Freud’s seemingly honest introspection, but it makes his scientific method more viable because he does recognize imperfection in himself and questions it rather than being so certain of his theories that he is blind to the natural occurrences of change and for that, the achievements of his success are deserved for he has stood the tests of time.