Sites of the Unconscious: Hypnosis and the Emergence of the Psychoanalytic Setting by Andreas Mayer (review)

Another addition to the voluminous literature on Freud and the history of psychoanalysis? While the subject matter is mostly familiar, Andreas Mayer introduces a striking originality in terms of assumptions, conclusions, and, especially, methodology. Rather than situating hypnotism as a crude precursor to be superseded by psychoanalysis (as did Freud and most subsequent historians), Sites of the Unconscious argues for the centrality of hypnotism to the emergence in the late nineteenth century of various practices of investigating the mind, among which Freud’s “experimentalism without a laboratory” (p. 198) was ultimately the most successful. Mayer presents his method as focusing on “the concrete sites of knowledge production … the material set-up of clinics, museums, laboratories, or consulting rooms” (p. 4). This he contrasts with the traditional “person-centered and often polemical” historiography.

The first half of Sites of the Unconscious, “French Cultures of Hypnosis,” begins around 1880 with Jean-Martin Charcot’s investigations at the Paris Salpêtrière hospital, soon afterward challenged by physicians at the Nancy medical faculty led by Hippolyte Bernheim. Dominated by Charcot, already a famous neurologist, the Paris group, richly equipped with patient “material” as well as material resources, used hypnotism experimentally in order to construct an objective understanding of hysteria, an effort aided by the new technology of graphic recordings of physiological changes.

The more loosely organized Nancy group disputed that hypnosis revealed an objective neurological basis of hysteria (the prototype of psychological ailments). Bernheim attributed all the results obtained by the Salpêtrière school to the subjective impact of suggestion. Based on this insight, the Nancy physicians employed hypnotism successfully to treat patients. The Nancy position was generally considered to have prevailed over its Paris rival in the hypnotism controversy. But Mayer, invoking a “symmetrical perspective” (p. 71), cautions against facile judgments about historical winners and losers; he shows in detail how the Paris experimental approach proved fruitful not only among Charcot’s Paris followers but also in German and Swiss clinics. On balance, however, the Nancy precedent of using hypnotic suggestion as therapy tended to dominate among Viennese practitioners, including Freud.¹

The second part of Sites of the Unconscious traces the adoption of hypnosis in laboratories and clinics in German-speaking centers. Oskar Vogt’s laboratory at a Bavarian spa employed hypnosis to investigate the mind. Vogt’s “fractionation” method (p. 186) involved waking patients from hypnotic sleep at frequent intervals to question them about their unconscious experiences. On the purely therapeutic side, the Viennese laryngologist Johann Schnitzler, assisted by his son, Arthur, physician, journalist, and author, gave enthusiastic publicity to the technique. In these instances and others such as the Burgholzli clinic in Zurich, Mayer explores new or poorly known developments.

However, the title of part 2, “The Emergence of the Psychoanalytic Setting” (p. 109) (also the book’s subtitle), indicates the central focus on Freud’s endeavor. Mayer claims that psychoanalysis emerged gradually in the context of and in continuity with established programs of hypnotic suggestion. He thus rejects the interpretation of a psychoanalytic revolution, long favored by champions of Freud (as well as by more recent critics) Freud himself had studied with both Charcot and Bernheim, published on hypnosis, and used the technique during his initial decade in private practice. Moreover, supposedly Freudian innovations—one-on-one therapy with emphasis on verbal interaction in a comfortable, secluded setting, self-experimentation by therapists, using reports of dreams to probe the unconscious—were in one form or another current among contemporaneous exponents of hypnotism.

Mayer’s evidence suggests that the transition from hypnosis to psychoanalysis was a small step mediated more by experimentalist concerns and material arrangements than by theories. But his methodology has limitations. On the crucial question of why Freud abandoned hypnosis in favor of analysis, Mayer acknowledges but pointedly leaves aside discussion of theoretical reasons, referring the reader instead to a secondary source...