Book review by Dr Jonathan Sklar, Psychoanalysis and History, 2016/18(2): 278-282.
This is an impressive and complex book that investigates the origins of psychoanalysis from the interiority of Freud’s self analysis of his dreams, centred on Irma’s injection dream, and his then analysis of Emma Eckstein. Bonomi suggests that this dream discovery acts as a hinge between the pre-analytic world of Freud the medical doctor and paediatrician, and the founding of psychoanalysis around the hidden trauma of circumcision behind the analytic cornerstone of castration. During 1860–90 it was normal practice for hysteria to be treated by gynaecologists by means of various surgical procedures such as amputation or scarification of the clitoris, on sexually mature women as well as little girls, as well as removal of the ovaries, cauterization of the labia, infibulations and circumcision (Hegar, Broca, Bohmi, Forel, Schroder, Tissier, Brown, Brown-Sequard, Kromer, amongst many surgeons of the time). In 1887 Friedrich Merkel noted in his book Beitrag zur Casuitistik der Castration bei Neurosen (Contributions to the Study of Castration in the Neuroses) that in just a few months the number of operations reported in the medical literature rose from 180 to 215 and listed 35 papers on the subject of castration as the treatment for hysterical women (Merkel, 1887). Between 1850 and 1879 masturbation was treated surgically more frequently than any other measure (Spitz, 1952, p. 499). Such castration practices involved punishment for neurosis and hysteria and were undoubtedly traumatic, attacking the body, the mind and the functioning of sexual life.
Around the same time, physicians were gathering observations on masturbation in babies and children into a theory that children needed to be protected from neurotic morbidity and general insanity due to such bad habits. For instance Behrend (1860) wrote
. . . we undertake a small operation in order to provoke such a pain with its wound that it would leave a child a lasting impression and would make any attempt at masturbation painful. In boys the operation should be done on the prepuce, making a cut, etc. In girls it should, similarly, consist of a strong cauterization on the labia majoram or inside the vagina entrance or, as doctor Gross suggests, of small excisions all around the clitoris’. (Behrend, 1860, pp. 328–329)
In 1877, Baginsky writing in his Handbook of School Hygiene indicated that childhood masturbation often arose from ‘loathsome nursemaids’. Later he remarked that the frequency of hysteria in children was mainly caused by ‘the bad example given by hysteric fathers or mothers’ (Baginsky, 1889, p.490). Masturbation was for Baginsky a plague; something evil and impure.
Bonomi uncovers the fact that Freud spent three or four weeks in Berlin in March 1885 training with Adolf Baginsky in his Poliklinic für kranke Kinder. On returning to Vienna, Freud worked in Kassowitz’s Public Institute for Children’s Diseases three days a week for ten years, from 1886 to 1896. Bonomi questions why Freud writes so briefly about castration as an actual medical treatment, as background to his thinking on hysteria, especially as some of his female patients had such operations (Bonomi, p. 39). Furthermore, he questions why Freud does not refer to his own paediatric observations on infantile sexuality rather than distancing himself, as in the following passage: he ‘learnt from colleagues that there are several publications by paediatricians which stigmatize the frequency of sexual practices by nurses and nursery maids, carried out even on infants in arms’(Freud, 1896, p. 207). Again in 1914, he wrote that his discovery of infantile sexuality had been founded almost exclusively on the findings of analysis in adults, which led back into the past, since he ‘had no opportunity of direct observations on children’ (Freud, 1914, p.18). The elusive key is in the hidden connection between castration and circumcision. Freud is only open about circumcision in 1933, ‘as a cure or punishment for masturbation’, and as Bonomi trenchantly states, even then only in reference to his American patients (Freud, 1933, p.87). Yet, despite this apparent oversight, it is Freud who makes the great leap from treatments for hysteria in women, as well as for masturbation in children, which were punitive, cruel and traumatic – on the mind as well as the body – to the talking cure. He thereby created a new psychic treatment based on the concept of the unconscious mind.
We now turn to Fliess and Emma Eckstein and the commencement of psychoanalysis with Freud’s famous dream of 24 July 1895 about Irma’s injection. Bonomi’s contention is that there is a hidden motif as Eckstein had undergone an operation as a child that cut one of her labia short. The traumatic scene of Freud witnessing Fliess re-operating on her nose and removing a piece of gauze causing suppuration led Freud to feel faint and temporarily leave the operation (this is reminiscent of a similar later collapse in the presence of Jung). In Bonomi’s new reading, it is her childhood trauma that precipitated a psychic reaction in Freud, which, despite his efforts to defend against it, determined a number of central aspects of his self-analysis and theorizing. This led to several consequences that consumed Freud with guilt; in particular, the putting of his analytic patient at risk by referring her to a nasal surgeon who ‘castrated’ her by removal of a turbinate bone in her nose, which connected Freud with the gynaecological castrating practices of the day. It led to his distancing himself from Fliess and to his own sexual model, which allowed Freud the freedom to develop within his own self-analysis.
Yet for Bonomi the motif of castration found in the dream served as a trigger for a sexual phantasy of fellatio. At that time it was common practice for the mohel to suck the penis after circumcision to reduce the bleeding from the cut (a practice associated with orthodox East European Jews which included Freud’s father Jacob), called metzizah b’peh. Freud’s younger brother by two years, Julius died six months after his birth. The argument is that when Alexander was born (when Freud was ten years old), he attended the ceremony, saw the cut, the fellatio and the pain that became, by après coup, a traumatic primal scene for Freud and was part of his self-analysis, including the idea that his father was perverted. On 15 October 1895, Freud arrived at the conclusion that his sexual phantasy had all along been informed by what he would later identify as the Oedipus complex. For Bonomi castration has the act of circumcision in its shadow as a subject deeply uncomfortable to discuss openly in the Interpretation of Dreams, as it gave psychoanalysis too Jewish a base in the openly anti-Semitic Vienna of the day. Freud sheds his Jewish identity, preferring the Greeks and victorious Hannibal over his father who had to pick up his fur hat from the gutter following an anti-Semitic attack witnessed by young Freud. It seems he even suggested Alexander’s name during family discussions about the name of the baby, as a break with orthodox family tradition of naming a child after dead grandparents.
Freud’s determination to break free from social and religious binds are examined in great detail through the analysis of Emma Eckstein and the extraordinary links that Bonomi makes for her being Freud’s Other, as it were, in his self analysis. She is the Eck-Stein (Eck means corner), the corner stone of psychoanalysis. Bonomi regards Freud as having identified with his patient in such a way as to allow him the possibility of tracing out the themes of punishment for masturbation and castration anxiety. Emma’s phantasy of having a penis developing as a consequence of genital mutilation reiterates Fliess’s theory of bisexuality, but now deeply discovered within the dream as the centre of the unconscious. Reading this complex book inevitably takes one back to rethinking the unconscious origins of psychoanalysis itself, as discovered in Freud’s self-analysis. The difficulty in believing some of the new and re-found chains of association that Bonomi uncovers from Freud’s own dreams recalls the psychic leap one has to make in reckoning with Freud’s original revelations about the content of the unconscious. This is even more the case given the moments when Freud decides to go no further, partly for reasons of maintaining some privacy and self confidentiality, but also partly due to the resistance of the unconscious to interpretation (the hidden navel of the dream).
Controversy has dogged Bonomi’s path for many years as he has honed and gathered more evidence for his thesis. He records here how an earlier chapter of the book, sent as a paper, had been rejected by the IJPA in 2011 as he had failed to present solid, convincing evidence that Eckstein had undergone a castration procedure as a child. Moreover, there was no evidence to support that Freud had not circumcised his male children, with one reviewer stating ‘This seems highly unlikely since Freud’s parents were alive and along with Martha, would have been deeply disturbed’ (Bonomi, p. 9). From this Bonomi realized that the decision not to circumcise was the ‘concrete and factual way in which Freud had symbolically killed his father’. The practice of metzizah b’peh was even described by a New York lawyer, writing to Bonomi, as impossible and wrongly described. Yet in 2004, out of concern for the potential spread of herpes infection, the New York City of Health and Mental Hygiene advised parents and mohelim that metzizah b’peh with direct oral suctioning of the circumcision wound should never be performed. To return to the theme of actual castration, it was as late as the 1920s that Marie Bonaparte, whilst in analysis with Freud, underwent clitoridectomy: a subject rather veiled and somewhat dissociated from her history with Freud.
So, in the twenty-first century, we appear to have returned to the earliest controversies about such psychoanalytic connections and chains of associations, in a way that harks back to the publication of The Interpretation of Dreams in 1900, where the uncovering of meaning from the hidden depths of the unconscious was experienced as an attack on that which was thought to be known in consciousness. To this extent, Bonomi is restoring the radical potential of psychoanalysis. Perhaps, this book suggests, Freud today can still surprise us with the possibility of mining and weaving further and complex ideas behind the surface of what we think we know.
This volume is the first of a pair of books. The second will have the subtitle ‘Sigmund Freud and Sándor Ferenczi’. It is likely that Bonomi will continue on his pathway and will flesh out their profound theoretical disagreements about the role of early trauma in the development of the mind. In particular, the first volume, by placing an actual trauma of ‘the cut’ at the bedrock of the soma-psyche, may already allow for a more balanced and refined reading of their great debate on the role of trauma in the development of the unconscious, which has continued within psychoanalysis ever since Ferenczi read his original paper, ‘Confusion of tongues between the adults and child’, to a diffident Freud in 1932.
Behrend, F. J. (1860) Über die Reizung der Geschlechtstheile, besonders u¨ ber Onanie bei ganz kleinen Kindern, und die dagegen anzuwendenden Mittel. J. Kinderkrankheiten 35, pp. 321–329.
Freud, S. (1896) The Aetiology of Hysteria. In S. Freud, The Standard Edition of the Complete Psychological Works of Sigmund Freud. Trans. from the German by J. Strachey. London: Hogarth Press, vol 3, pp. 187–221.
Freud, S. (1914) On the History of the Psycho-Analytic Movement. SE 14, pp. 1–66.
Freud, S. (1933) New Introductory Lectures on Psychoanalysis. SE 22, pp. 1–182.
Merkel, F. (1887) Beitrag zur Casuistik der Castration bei Neurosen. Nuremberg: J. L.Stich.
Spitz, R. A. (1952) Authority and masturbation: some remarks on a bibliographic investigation. Psychoanalytic Quarterly 21: 490–527.
DR JONATHAN SKLAR, MBBS FRCPsych, is a training analyst and fellow of the British Psychoanalytic Society. He teaches regularly in London, Chicago, Cape Town and Eastern Europe. From 2007–2011 he was Vice President of the European Psychoanalytic Federation. His psychoanalytic papers have been published in Italian, Spanish, French and Portuguese. He is presently on the board of the International Psychoanalytic Association. Address for correspondence: Flat 4, 33 Priory Terrace, London NW6 4DG. [firstname.lastname@example.org]