Zvi Lothane, MD

 of Freud’s works, Sabina Spielrein first emerged from oblivion as an historical person with the publication by W. McGuire of the epochal correspondence between Freud and Jung in 1974. This made no stir until 1980, when Spielrein’s German diaries and correspondence with Freud and Jung were published by Aldo Carotenuto, a devoted Italian Jungian. Carotenuto, intent on exonerating Jung, portrayed Spielrein as both seductive and schizophrenic, blaming her as the cause of their alleged sexual affair. 

The legend died hard and paved the way for a cottage industry of scandal: professionals and lay protesters decrying an alleged boundary violation in therapy in journal articles, books, plays (

 by Christopher Hampton, 2002), and feature films (

 2002, by Roberto Faenza). New heights of sexploitation are scaled in David Croneberg’s big-budget kitschy film, 

 with foreplay scenes of Jung spanking Spielrein and blood stained sheets of defloration, copied from Hampton’s play, the main source of the plot.

The media blitz in the press was taken up in articles published in 

 Contrary to the claim in Wikipedia, Cronenberg’s is not a historical film but loosely fictionalized history, projecting our own morality regarding premarital sex and adultery on Spielrein and Jung at the beginning of the 20th century, pandering to popular tastes. It does not rise to the level of the German filmmaker Elisabeth Marton’s 2002 documentary, 

 a thoughtful and credible recreation of this fascinating trios’ relationships, or of the equally sensitive 1996 off-Broadway 

 by Willy Holtzman, a similarly delicate rendering of that drama, that leaves matters to the imagination, not for prudery’s sake but out of respect for the persons involved.

Having researched the life and work of Sabina Spielrein, I feel duty-bound to point out the many falsehoods in that film and in John Kerr’s book, 

 published in 1993, the other source of the screenplay. Kerr’s main source was Carotenuto and he did not yet know of the Swiss psychiatrist Bernard Minder who published Spielrein’s clinical chart or the existence of a Russian archive. My publications about Spielrein’s life and work started in 1996.

1. The Spielrein drama did not initiate the historic correspondence of Freud and Jung, nor was she ever the cause of their breakup. The first to write was Freud, in 1906, thanking Jung for sending him his new book, 

. They went on to developed a strong professional friendship with Jung appointed president of the fledgling International Psychoanalytic Association and editor in chief of the first psychoanalytic journal and chosen by Freud’s to be his crown prince. From the beginning, Jung expressed doubts about the universal validity of Freud’s sexual etiology of the neuroses and even more so of psychoses, later disagreeing with Freud’s interpretation of the Schreber case in 1911. Jung went on to substitute Freud’s libido theory with his own de-sexualized version libido in 1912 and attacked Freud’s personally whereupon Freud terminated their relationship in 1913.

2. Later in 1906 Jung anonymously reported to Freud about “treating an hysteric with your method. Difficult case, a 20-year old Russian girl 

, ill for six years.” However, by 1906 Spielrein was no longer a patient, for she was Jung’s inpatient at the famed Burghlzli hospital for nine months, from 1904 to 1905, and was now his student his student at the Zurich University School of Medicine. Spielrein wrote to Freud in 1909: “Four and a half years ago Dr. Jung was my doctor, then he became my friend and finally my “poet,” i.e., my beloved.” In 1999 I published hitherto unknown Spielrein letters showing what Spielrein meant by poetry: tender love, no sexual intercourse, and hopes to marry Jung.

3. John Kerr wrote in his book: “For myself, I find it at least plausible that the two stopped short of intercourse” (p. 224). In a 1999 paper I presented unpublished Russian letters exchanged between Spielrein and her mother stating and excerpts from her still unpublished Russian diary, stating the same: she stated she never crossed that boundary with Jung. Spielrein dreamt of marrying Jung but her mother told her to abandon such fancies. Whether she and Jung did or did not is not for us to prejudge or conclude. It could not have happened while she was an inpatient, nor in any office, for there was no record of any subsequent treatment or fees paid. Conclusion: no treatment, no boundary crossing.

4. On the other hand, Jung, who married one of the richest brides in Switzerland to become rich himself, confessed to Freud the issues he had with “polygamous components” in his marriage. In her 2005 official Jung biography Deirdre Bair documented Jung’s womanizing behavior and his being threatened with divorce by his wife. Jung made up nonexistent difficulties with Spielrein as patient instead of asking Freud for an analysis of his adulterous proclivities.

5. Between 1906 and 1909, Jung continued to mention Spielrein anonymously a few times (eg, “A female patient has kicked up a vile scandal solely because I denied myself the pleasure of giving her a child”). But this was no public scandal written about in the papers; the scandal was Jung’s indignation when he suspected Spielrein of spreading malicious slander about him. It turned out it was another woman who did the slandering such that the “scandal” was just a storm in the teapot. In 1909 it was Spielrein who finally came forward in a letter to Freud about her disappointments with Jung. Jung and Spielrein resolved their dispute in short order and continued their friendship, worked on her dissertation, and corresponded for years.

6. Jung’s talking in the film about the “method” he allegedly invented is false, as is his calling it 

 in French, which does not make sense for he was a German Swiss. Jung learned the method from Freud, by reading 

 and other writings and by the many discussions about it and other patients they had in person, starting in 1907, and in their letters.

Down through the decades, psychotherapy and psychoanalysis have been portrayed in many Hollywood films and in television sitcoms but not with the suggestion that they are dangerous methods because sexual emotions are stirred up in therapy, or because boundary crossings happen regularly and frequently rather than sporadically, contrary to professional ethics, to become lawsuits that may wreck professional careers. It is thus a mystery why so many psychiatrists and psychoanalysts have lavished so much attention and praise on a mediocre film that has not only disappointed some Jungians and Freudians but many other viewers as well.


•Appelbaum P, Lothane Z. Letter to the Editor. 

In Defense of Schreber/Soul Murder and Psychiatry

. Hillsdale, NJ/London: The Analytic Press;1992a. 
•Lothane Z. The schism between Freud and Jung over Schreber: its implications for method and doctrine. 

. 1997;6:103-115. 
•Lothane Z. In defense of Sabina Spielrein. International Forum of Psychoanalysis.1996;5:203-217 (also in: Mahony, Bonomi & Stensson, eds.

: Behind the Scenes Freud in Correspondence.

 Stockholm: Scandinavian Universities Press; 1997.
•Lothane Z. The schism between Freud and Jung over Schreber: its implications for method and doctrine. 

 1997;6:103-115. 
•Lothane Z. Tender love and transference: unpublished letters of C.G. Jung and Sabina Spielrein. International Journal of Psycho-Analysis. 1999;80:1189-1204 (also published in German, Italian, Polish, and Russian).
•Lothane Z. Freud’s alleged repudiation of the seduction theory revisited: facts and fallacies. 

 2001;88:673-723.
•Lothane Z. Tender love and transference: unpublished letters of C. G. Jung and Sabina Spielrein (with an addendum/discussion on love). In: Covington C, Wharton B. 

Sabina Spielrein Fogotten Pioneer of Psychoanalysis.

 Brunner-Routledge: Hove and New York;2003:191-225.
•Lothane Z. Afterword (English) (published as Nachwort von Zvi Lothane). In: Spielrein S. Tagebuch und Briefe. Die Frau zwischen Jung und Freud. (Hg.) Traute Hensch, vernderte, um das Nachwort von Zvi Lothane und den Epilog von Christa von Petersdorf ergnzte Neuauflage. Gieen: Psychosozial-Verlag, 2003, a new German edition of A. Carotenuto’s 1980 Diario di una segreta simmetria, 2003; 249-278. 
•Lothane Z. Review of 

, by Deirdre Bair. Boston/New York/London: Little, Brown and Co; Journal of the American Psychoanalytic Association; 2005;53:311-324.
•Lothane Z. Verfhrung/Entfhrung, mit/ohne Psychoanalyse. Oder: was suchen jdische Mdchen bei germanischen Helden und vice versa? 

 2006;29(106,III):97-124.
•Lothane Z. The snares of seduction in life and in therapy, or what do young Jewish girls (Spielrein) seek in their Aryan heroes (Jung), and vice versa? 

Articles

Down through the decades, psychotherapy and psychoanalysis have been portrayed in many Hollywood films and in television sitcoms but not with the suggestion that they are dangerous methods.

Psychotherapy and Psychoanalysis: The Real Spielrein Between Jung and Freud

My patient, Gwen, a 69-year-old office worker, sometimes made me wonder if I was conducting psychotherapy or engaging in combat. I had been seeing Gwen for 10 years, after she had been through 35 years of group and individual therapy and had numerous trials of various medications. Gwen suffered from recurrent depression and anxiety and had a history of alcohol abuse and self-mutilation. Typically, she would arrive at our sessions with memorized speeches filled with dramatic depictions of current calamities and crises, accompanied by florid descriptions of aches and pains in various parts of her body. Gwen often acted seductively in our sessions, expressing sexual and romantic feelings for me and the wish to shower me with gifts.

If all this sounds a bit histrionic, you are on the right track. In fact, Gwen provides us with a window into what I have termed “dramatology”-a paradigm for understanding not only important aspects of life but also many psychiatric disorders and their treatment.

 I’ll return to Gwen shortly-but first, I need to lay the foundation for understanding my approach to treatment.

Human existence means living with others and expressing oneself in action, specifically, interaction with others. Communication-with or without words-is the most essential human interaction; indeed, it ensures both individual and social survival. Consider the bond between mother and child. It progresses from bodily contact and communion through the other 4 senses to communication with words. In the process, the infant learns language and love-the foundation for all future interpersonal relationships, including the psychotherapeutic relationship.

Communications are made simultaneously to oneself, as intrapersonal (intrapsychic), or to another person (interpersonal), silently or vocally. Dramatology holds that symptoms, including psychiatric symptoms, are also communications conveyed-through words, posture, tone of voice, and movements of the face and limbs. Indeed, symptoms may be understood as messages sent by one person and received by another.

What’s the connection between psychiatric symptoms and drama? Drama (from the Greek root 

, to act) is a composition adapted for enactment by actors on stage. Through gesture, mimicry, costume, and scenery, drama tells a story through action and dialogue. Life is the wellspring of drama and drama imitates life. Shakespeare’s “All the world’s a stage / And all the men and women merely players” does not abolish the difference between fictional and real-life dramas-it merely underscores their shared focus. In real life, we express emotions and ideas in words. And, at all times, we embody or enact these emotions and ideas; that is, we dramatize them.

Freud’s Copernican revolution was that hysteria is 

-her story or his story. Breuer and Freud

“hysterics suffer mainly from reminiscences

 [authors’ italics].” The hysteric person’s memories of distressing and traumatic-and thus, dramatic-events and encounters are enacted in a variety of inner experiences and overt actions. It is a widespread misconception that Freud was expunged from DSM-IV to make it scientific. In truth, Freud lives on in conversion, somatization, and somatoform disorders.

In DSM-IV, conversion disorder (CD) symptoms are referred to as “pseudoneurological” and CD criteria require that “psychological factors be associated with the onset and exacerbation of” CD. From the perspective of dramatology, conversion symptoms constitute psychological and social communicative conduct. In this view, hysterical paralysis is neither a genuine paralysis nor a pseudoparalysis. It is no paralysis at all; rather, it is an embodied metaphor. In essence, the hysteric person is someone impersonating a genuine paralytic person-and also frequenting medical and psychiatric emergency departments, inpatient and outpatient services, and private offices.

Dramatology approaches human encounters, events, and scenes as dramatic enactments of characters in conflict and crisis. Dramatology comprises 2 forms: dramatization in thought and dramatization in action. Dramatization in thought involves images and scenes lived in dreams, daydreams, and fantasy scenarios. These are accessible in therapy through spontaneous memories and free association. Dramatization in action involves real-life scenes and situations of love and hate, faithfulness and adultery, ambition and apathy, triumph and de-feat, despair and hope, and living and dying.

Dramatology also sees the psychiatrist-patient encounter in a unique light. Harry Stack Sullivan differentiated between the clinician’s observation of the medical patient and the participant’s observation of the psychiatric patient.

 Dramatology goes further: it sees psychiatric treatment not just as observation but as actual participation in the psatient’s real-life drama. Specifically, the patient’s dramatization in action calls for here-and-now confrontations, as we shall see in my encounters with Gwen.

Gwen was the eldest child of a prim and proper mother, who died of multiple sclerosis, and a father who was loud, vulgar, and adulterous. Gwen’s brother was born when she was 2; she was 8 when her congenitally deformed and mentally retarded sister was born. Her mother “fattened up” Gwen and gave her enemas until she was 15. Gwen remained emotionally tied to her parents until they died. Her father was pathologically curious about Gwen’s sex life, and he beat her brother with a belt, sometimes dragging him across the room. Her brother-who used to call Gwen “a whale”-tore the head off her favorite doll, tortured insects, drowned Gwen’s kitten, and eventually was given a diagnosis of schizophrenia. He apparently died of starvation. Her sister, shortly after birth, slipped from Gwen’s hands onto the floor, causing Gwen lifelong guilt. In our first session, I said to Gwen, “You had a childhood holocaust.”

Gwen grew up compliant and submissive, clinging to relatives, friends, employers, and doctors. She continually tried to wrest love from others through ingratiation and compulsive altruism (eg, by giving gifts, alms, and food to the homeless), alternating with bursts of rage and passive-aggressive manipulations. Gwen never married and had multiple affairs with sickly, old married men, whom she fantasized rescuing from their infirmities and impotence. Sometimes Gwen engaged in fleeting lesbian encounters, which led nowhere. She often felt as if she were “in a black hole, making myself act crazy so as not to show up my crazy family.”

Since age 8, Gwen had an imaginary companion, which she described as “a fetus, enclosed in half an almond-shaped shell in my stomach-a healthy child to compensate mother for my sister.” This imagined scenario produced another fantasy: being split into “good Gwen” and “bad Gwen” and “living trapped in a plastic bubble.” This splitting of self, she indicated to me, was insurance against “making mistakes or being angry. It was the bad Gwen’s fault. If you knew the real Gwen, you would love me. This way no one can hurt me or abandon me.” In the course of free association, Gwen dramatized “birthing sessions,” complete with screaming, with “the wet fetus leaving my body and soul forever.” These fantasies were Gwen’s “big secret” and inhibited her ability to focus on what people were saying to her. She had to “burst the bubble” to reconnect with the world. Often, in our sessions, Gwen complained of “dizziness,” which spontaneous association revealed as unverbalized anger.

Once, at the start of a session, Gwen showed me a 1975 US government telegram about her brother’s death. She then pointed to the flowers on my table, and the following (reconstructed) dialogue ensued:

Gwen: Where did you get those lovely daisies?

Dr Lothane: These are not daisies, these are chrysanthemums.

Dr L: You are insulting my veracity! [my voice deliberately raised]

G: You sound like my mother, she would take it personally.

Dr L: Why do you insist that these are daisies? 

G: The best defense is a good offense. Of course, I knew these were chrysanthemums.

This mundane interchange illustrates dramatic therapeutic participation, with my voice raised for emphasis. Gwen defended against the pain of anger at her mother and brother. She also defended against anger with herself, for having wasted so much of her life, unable verbally to challenge her parents, her brother,or her previous therapist. Gwen also harbored anger at me for not having cured her yet. As in many similar, previous instances, Gwen’s behavior was infuriatingly perverse-deliberately denying the truth of her perception by calling my flowers daisies. She needed to be confronted over her talking without thinking-a habit that repeatedly got her into trouble with people.

In my work with patients like Gwen, I combine confrontation with “reality coaching,” which works on both a cognitive and an emotional level. I teach patients social skills and psychological self-regulation. Eventually, Gwen was able to give up dependence on all her medications; dispense with her defensive maneuvers; accept herself as she is, be more in touch with herself “in the moment,” and be more direct and forthright in communicating with people.

In her own assessment of our work, Gwen wrote: “Dr Lothane uses humor and confrontation to let you reveal yourself. He sees through lies and self-deception. He always listens with the ‘third ear.’ He allows me to be aggressive and angry, to wish him dead out loud. He can talk in psychotic language and understands before I do what makes me tick.”

Pluralistic psychiatry views psychotherapy as an indispensable treatment method.

 Of course, we need DSM-type diagnoses to communicate with colleagues, to present at scientific meetings, and to file insurance claims. In contrast, dramatology represents a paradigm shift, a new synthesis, and a novel therapeutic technique. Dramatology transcends narrative description, diagnostic categories, and dynamics based on formulas. It approaches the 2 participants-doctor and patient-not as abstractions or generalities but as unique individuals in all their “aliveness”: in their dress, age, speech, culture, physical features, and capacity both to love and to be loved.

In dramatic interactions, patient and doctor are drawn into conscious and unconscious enactments that take both persons by surprise and offer considerable heuristic and healing value. Such enactments also transcend transference and countertransference: they pose no danger if both participants adequately process the therapeutic encounter and keep faith with principles of ethics and mutual responsibility. In the drama of the therapeutic encounter, patient and doctor work in tandem: in search of love, justice, and truth.

Lothane Z. Dramatology in life, disorder, and psychoanalytic therapy: a further contribution to interpersonal psychoanalysis. 

 Lothane Z. The power of the spoken word in life, psychiatry, and psychoanalysis: a contribution to interpersonal psychoanalysis. 

 Lothane Z. The uses of humor in life, neurosis, and in psychotherapy. 

The Myth of Mental Illness: Foundations of a Theory of Personal Conduct.

 Vol 2. Standard ed. London: Hogarth Press; 1955.


Participant Observation: The Psychotherapy Schools in Action.

 Pies R.The good psychiatry does: a brief review. 

http://www.psychiatrictimes.com/clinical-scales/display/article/10168/1518165

Life as Theater: A Dramaturgical Sourcebook.

Psychological Development in Health and Disease.

 Philadelphia: Saunders; 1962.
Freud S. The neuro-psychoses of defence. In: 

The Standard Edition of the Complete Psychological Works of Sigmund Freud (1893-1899).

 Vol 3. London: Hogarth Press/Institute of Psycho-Analysis; 1986:41-61.
Lothane Z. Confrontations: clinical applications. In: Nichols MP, Paolino TJ, eds.

 Basic Techniques of Psychoanalytic Psychotherapy.

Dramatology approaches human encounters, events, and scenes as dramatic enactments of characters in conflict and crisis. 

Dramatology: A New Paradigm for Psychiatry and Psychotherapy

Psychotherapy is as old as civilization. Literally soul therapy, the term is a misnomer, since soul is a mystical notion and what is meant is the whole person. The misnomer also survives in the name psychiatry, literally soul medicine. Yet nobody is crusading against psychiatry and psychotherapy because soul is unscientific. What is important is that psychotherapy and psychiatry are job descriptions that refer to what we actually do when as providers or recipients of the service called psychotherapy, we use words to convey meaningful messages to each other, or to evoke desirable acts from each other. 

Doings, i.e., operations, are in the realm of method. Operationally, we should properly call psychotherapy word therapy. But we think and speak with words: it is not only the proverbial pen but also the spoken word that is mightier than the sword. Words connect us as speakers and listeners, both in everyday dialogue and in that special conversation we call psychotherapy, words that speak of love or hatred, that hurt or heal.

Healing human suffering through the spoken word has its roots in such a common experience as the soothing words of the mother to a child that is hurting, whether physically or psychologically. Later in life such solicitude is sublimated as care and empathy, the sympathy for another person's suffering, an essential ingredient of every therapy. Anna O. made history when she called the conversations with her doctor, Josef Breuer (1895d), the future mentor of Freud, the "talking cure," at a time when cure still meant treatment. Here is another interesting connection between words and what they stand for. Today treatment means physical therapy of physical illness, but etymologically treatment is related to tractatus and treatise, i.e., discourse. Similarly, doctor, one who treats the body, derives from the Latin verb docere, to teach, as in doctrine, or teaching. 

Today psychotherapy is practiced formally by professionals-psychiatrists, psychologists, social workers and psychoanalysts-and informally, by others, in ways folksy or fancy, in all walks of life. It is also practiced in dealings with doctors, dentists, lawyers, clergy and in the mass media. Prominent in the history of psychotherapy and its entry into medical science were pioneers Franz Anton Mesmer and his followers and Sigmund Freud, the founder of psychoanalysis.

Freud coined the term psychoanalysis as a synonym for psychotherapy and developed a method, or technique, for understanding and interpreting the verbal productions of persons in health and disease. He enriched the method of psychotherapy he learned from Breuer by adding the technique of free association and the concept of transference. This enabled Freud to discover depth psychology, an analytical method for understanding the meaningful connection between manifest content of symptoms, thoughts, dreams and acts and their latent content, and hence the motivational dynamics of consciously deliberate versus covertly-driven behavior. 

The discovery that symptoms had this dual structure, conscious and unconscious, that they were not just brain events but mind events, enabled Freud to elucidate the role of fantasy, the emotions, psychological trauma and the role of sex and love in human relations. But experiences are told in words, meanings are shaped into memories, metaphors, and myths, i.e., stories. In time, the above-defined aspects of Freud's method became the generic foundation for all the other schools of dynamic verbal therapy, whatever their theories (Lothane 1981, 1983, 1984, 1994a). 

Following early endorsement by psychiatry's Eugen Bleuler in Zurich, psychoanalysis went on to revolutionize the static-descriptive, organic psychiatry of the turn of the century , converting it into the dynamic psychiatry of today, especially in the United States. Freud influenced the ideas of Adolf Meyer, M.D., a Swiss immigrant who knew Bleuler, William Alanson White, M.D., and the interpersonal dynamic concepts of Harry Stack Sullivan, M.D.

The foregoing is relevant to meet the currently oft-heard criticism that psychotherapy or psychoanalysis is not scientific, as if scientific is one and the same defining criterion for all the known sciences. Are botany, mathematics, paleontology, physics and psychology sciences in the same way? Rather, since science means knowledge, to qualify as a scientific discipline, psychoanalysis should be defined by its own method. When seen from the vantage of method, psychotherapy qualifies as scientific when it is empirical, i.e., based on experience, observation, rigorous thinking and critical judgment. To proceed empirically is not the same as being able to reproduce observed phenomena experimentally, in closed laboratory situations, nor does it mean that every phenomenon can be quantified: experimentation and quantification cannot be the sole scientific criteria for studying persons in life situations. 

To make another comparison: medicine is not a quantitative science per se, it is an empirical art of healing the body utilizing a number of basic sciences: anatomy, physiology, bacteriology, pathology, pharmacology and others. Psychotherapy, psychoanalysis and dynamic psychiatry are empirical healing arts of persons suffering from problems in living and/or mental disorders. 

What are their basic sciences? The social sciences of anthropology, history and philosophy, but also knowledge provided by the sciences of experimental psychology, biology, epidemiology, pharmacology. As healing arts and as discourse, both medicine and psychotherapy can be enriched by human wisdom from any source, most importantly by great literature, art and religion. Over and above, both medicine and psychotherapy are ruled by a special code of ethics that applies to the doctor/patient relationship. The Hippocratic oath in medicine and the requirement of impartiality in psychoanalysis are both based on the principle of serving, not using, the patient.

Whereas the therapeutic situation is not reproducible like a laboratory experiment, no more than a life situation is, it can be defined methodologically and tested operationally. While imperfect and liable to error, it remains a unique field of observation of human nature, and when properly controlled for error, it becomes a reliable setup for such observation. A well-managed psychotherapeutic situation, and a properly conducted case study, meet the requirements of science, e.g., as shown in studies by Luborsky. In summary, psychotherapy is an empirical method, or technique, based on procedures and processes employed in the therapeutic situation, and in keeping with ethical principles. 

The method of psychoanalysis is most often confused with the various theories or doctrines or schools of psychoanalysis, a confusion that began with Freud himself. One of the reasons for the confusion is a tendency to overgeneralize empirical data of observation, converting them into universal theories of causation. The two best-known examples of such zealous generalizing as to cause of disorder were (1) Freud's theory of the sexual etiology of the neuroses and (2) his so-called seduction theory. Regarding the first, both adult and infantile sexuality are ubiquitous phenomena, and can act as a potential cause of mental disorder; but to qualify as an actual-both sufficient and efficient-cause, it has to be clinically demonstrated in a given case. The same goes for aggression or any other dynamic motivational factor. Viruses are everywhere, but they do not cause a manifest viral illness by their mere presence in us, and when they do, it must be clinically proven, other cofactors considered. Therefore, sexuality does play a decisive role in many cases, but not uniformly in all cases.Regarding seduction theory, in 1896 Freud discussed seduction and sexual trauma, i.e., the traumatic arousal of infantile sexuality by abusive manipulations, or seductions, of parents and others, as a ubiquitous cause of neurosis. In 1897 Freud realized, to his own dismay, he had overstated the causal role of childhood seduction as an actual remembered experience, since patients confessed to having fabricated such stories. In 1905 Freud still held infantile sexual trauma as fact, but added other factors to the equation of childhood sexual experiences: spontaneous sexual activity, e.g., masturbation and the associated guilt and shame, thus the compensatory fantasies of being seduced. 

Freud never claimed that seduction does not exist. He entitled a chapter in Wolf Man (1918) "The seduction and its immediate consequences." Elsewhere (in a 1924 footnote to the 1896 paper and in his papers on female sexuality of 1931), Freud reaffirmed the reality of seduction. This sketchy account shows that Freud's error was to posit childhood seduction, i.e., childhood sexual trauma, as a universal cause of disorder, and he duly corrected this impression. It is thus amazing that analysts still maintain, erroneously, that the seduction theory is dead, that Freud's bad theory was replaced by a better theory, i.e., the sexual drive theory and the oedipus complex. 

Freud never gave up the seduction theory (Lothane 1987), for there is no causal contradiction but a requisite complementarity between spontaneous childhood sexuality and the premature sexual arousal of children when used as incestuous sexual objects. It was never an either/or proposition between a memory of an actual event or a fabrication of one, but the subtle interplay of perception and fantasy, impression and impulse, fantasy and memory, which happens to us all and in all ages. This is what Freud-bashers fail to understand.

Freud critic J.M. Masson (1976) stated that Freud never abrogated the seduction theory. However, in 1981, The New York Times reported that Masson accused Freud of cowardliness and dishonesty for abandoning the seduction theory! Clearly, it was not Freud but Masson who changed his mind, and without offering a clear explanation. What got analysts even more incensed was a comment in Masson's "revelations": He accused psychoanalysis of being sterile, and that hurt. Understandably, analysts retaliated, and the resulting furor became grist for fascinating copy by Janet Malcolm in The New Yorker, creating a media circus. 

Masson's accusations of Freud climaxed in his 1984 strident best-seller, The Assault on Truth. But it was Freud who was assaulted and truth lost out. Masson may have actually believed he was trying to heal psychoanalysis; what he succeeded in doing was to usher in an era of Freud-bashing. In an antipsychiatry book of 1988 Masson went so far as to issue a "battle cry" for the abolition of psychotherapy. He might as well have promoted the abolition of parenthood. 

None of Freud's numerous theories were found thornier than his sexual theory of neurosis and sexuality and his prescription for sexual happiness in society, expounded in 1905 and 1908, respectively. They provoked bashing, defined as hurling hard verbal abuse at a person or group with a view to discredit and destroy, by prominent colleagues such as Aschaffenburg, Hoche and Krafft-Ebing. Ad hominem attacks on Freud, as well, ensued. In a 1992 book, E. Fuller Torrey, M.D., claimed that Freud's sexual theories had the malignant effect of destroying American sexual morality. Nevertheless, he also found some good things to say.

The strategy of the current crop of Freud-bashers is to assault as evil both Freud and his psychoanalytic method, relentlessly and implacably. The front-runner in this crusade is literature professor Frederick Crews, formerly a pro-Freudian, thus a variation on the theme of "the God that failed." Crews' Freud-bashing rhetoric, filled with emotionality, seizes upon Freud's occasional cognitive or ethical lapses, or mistakes in interpreting cases.Under the cover of Esterson's thin revisionist thesis that the seduction theory, as "the myth of the birth of psychoanalysis," became the "founding of psychoanalysis per se," Crews argues that both the "feminists and the defenders of children [who hold]...that those stories [of sexual abuse] were true have been drastically misled." Is Crews denying the reality of child abuse, which Freud clearly stated in his 1896 paper? The culprit is Freud himself, alleges Crews, "[who] laid down the outlines of the seduction plots, which he then fleshed out from the 'clues' supplied by his bewildered and frightened patients, whose signs of distress he took to be proof that his constructions were correct." Although "it may seem wonderful," mocks Crews, "that [Freud] was able to let go of his seduction theory at all," in truth Freud was so beset with a "severe problem with reality testing, dishonesty and cowardice" that, in desperation, he replaced the phony seduction theory with another phony theory, to wit: "in their fantasy life, [patients] and every other child who ever breathed had been the would-be seducers of their opposite-sex parents." 

What is the moral of this story? Psychotherapy and psychoanalysis are here to stay. Moreover, the current either/or between biological and psychodynamic psychiatry, between dialogue and drugs, is another pseudoissue: there is a need for both, there will always be a dynamic psychiatry. 

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Psychotherapy is as old as civilization. Literally soul therapy, the term is a misnomer, since soul is a mystical notion and what is meant is the whole person. The misnomer also survives in the name psychiatry, literally soul medicine. Yet nobody is crusading against psychiatry and psychotherapy because soul is unscientific. What is important is that psychotherapy and psychiatry are job descriptions that refer to what we actually do when as providers or recipients of the service called psychotherapy, we use words to convey meaningful messages to each other, or to evoke desirable acts from each other.

Zvi Lothane, MD

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