Freud and the Seduction Theory: A Brief Love Affair (review)

What an unfortunate title! Would it not suggest to anyone not already in the know that Kurt Eissler was discussing Freud's thoughts about romantic liaisons, rather than child abuse? It is hard to guess why it was chosen by the late author, for he does not present any evidence that Freud had a special fondness for this particular notion about the genesis of hysteria.

The title should call our attention to the fact that Eissler here is at some pains to correct those who have understood Freud's three early papers (1896a; 1896b; 1896c) as advocating a primarily traumatic etiology for neurosis. Eissler does refer to the alleged episodes from patients' early childhood as traumatic, but he makes it clear that Freud's point is that dreadful episodes during the first few years did not produce hysteria unless the genital organs of the children in question were directly stimulated. Moreover, Freud was willing to include events that were recalled as indifferent or even pleasant at the time. Indeed, there were cases involving liaisons lasting several years that, in "The Aetiology of Hysteria," he calls "love-relations" (1896c, 21) between an adult and a child; and a history of multiple assaults is characterized by Eissler as an "extensive love life" (113).

Near the beginning, Eissler quotes Freud as having said, in prepsychoanalytic days:

As regards what is often asserted to be the preponderant influence of abnormalities in the sexual sphere upon the development of hysteria, it must be said that its importance is as a rule over-estimated. . . . . [H]ysteria is found in sexually immature girls and boys. . . . Furthermore, hysteria has been observed in women with a complete lack of genitalia [sic!]. (Freud 1888, 50-51; quoted on 70)

Notice that Eissler lets pass wholly unremarked Freud's words about how sexual abnormalities are "often asserted to be the predominant influence." Indeed, he quotes the passage to show "Freud's naiveté and innocence when he entered the field of psychopathology." And notice that the "[sic!]" is Eissler's own astonished interpolation, not further followed up. Why, one wonders, was he so incurious about the relation between this etiological theory and other, contemporary ideas about the causes of hysteria?

Anyone who has read the papers of Carlo Bonomi (1994; 1997; 1999) is likely to think that the partly quoted passage from page seventy shows, instead, Eissler's own "naiveté and innocence" about the period in the history of psychiatry to which he was trying to make a contribution. As Bonomi (1997) points out, in the contemporary psychiatric literature,

the sexual etiology of the neuroses was conceived as a morbid state of the sexual organs that affected the nervous system by reflex. The localization of the noxa in the genitalia permitted an etiological therapy of the neurosis, which comprehended treatments like . . . drug applications on the external organs, cauterizations, and minor and major surgical operations. . . . The "castration" of hysterical women was first introduced by Hegar in 1872. (38)

Bonomi continues:

In Friedrich Merkel's 1887 dissertation in medicine [A Contribution to the Study of Castration in Neurosis] . . . the castration of hysterical women is defined as the most discussed problem of those times. . . . Significantly, the practice had reached its apex in the very same year when Freud (1896a; 1896c) coined the term psychoanalysis within the framework of a new theoretical understanding of the sexual etiology of hysteria. (39)

The fact was, Bonomi argues, that Freud's mention of having seen a still-hysterical patient all of whose external genitalia had been removed is one evidence that he was very much aware of, and distressed by, the fact that the sexual etiology of hysteria was taken for granted and had led to a rational (if grotesquely disfiguring) therapy. Fliess's nasal reflex theory, Bonomi continues, "played a crucial role in the transition from the old to a...