God Dreck

Download as pdf or txt
Download as pdf or txt
You are on page 1of 67
At a glance
Powered by AI
The passage discusses the author's background and approach to patient treatment without focusing on specialization. It also touches on his view of psychoanalysis and its relationship to medicine.

The author believes that psychoanalysis should not be restricted only to cases of neurosis, and that its effects can extend to treatment of organic illnesses as well.

In psychoanalysis, 'repressions' refer to complexes from a patient's past that cannot be consciously brought back into awareness, possibly extending to prenatal events.

Published in the United States of America by

International Universities Press, Inc.


315 Fifth Avenue
NewYork,N.Y.10016

Contents
All rights reserved. No part of this publication may
be reproduced, stored in a retrieval system, or
transmitted in any form, or by any means, elec-
page
tronic, mechanical, photocopying, recording or Introduction by Lore Schacht 1
otherwise, without the prior permission of
The Publisher. 1 Correspondence with Sigmund Freud
(1917-1934) 31
2 Psychic Conditioning and the Psychoanalytic
Treatment of Organic Disorders (1917) 109
3 On the It (1920) 132
4 The Compulsion to Use Symbols (1922) 158
5 Vision, the World of the Eye, and Seeing without
the Eye (1932) 172
6 The Meaning of Illness (1925) 197
7 Clinical Communications (1928) 203
8 Some Fundamental Thoughts on Psychotherapy
(1928) 211
9 Treatment (1926) 222
10 Massage and Psychotherapy ( 1931) 235
11 The Human Being, not the Patient, Requires
ISBN 0-8236-3205-9 Help (1927) 241
12 Language(1912) 248
Library of Congress Catalog Card number: 76-46813
Select Bibliography 265
cLimes Verlag, Wiesbaden, 1964, 1966 and Index 267
1970
Translation, Selection and Editorial Matter
c The Hogarth Press Ltd. 1977
Freud Letters c Sigmund Freud Copyrights
Ltd. 1970

Manufactured in Great Britain

Will
Introduction

Looking back over his life at 64, Groddeck wrote:


I run a sanatorium which is visited by people who do not find
help in other places. Sometimes I am lucky with these diffi-
cult cases, sometimes not. I am a pupil of Schweninger, who
was, perhaps, the greatest doctor of the last century. Follow-
ing in his footsteps I suddenly found myself, without knowing
it, faced with the necessity of evaluating unconscious pro-
cesses in the treatment of organic diseases. When a few years
later I came upon Freud's works I had to give up the idea that
I was a discoverer myself, not without a struggle. For it be-
came apparent that I had first read asout these in a notice in
the daily paper Rundschau. The only achievement I can claim
for myself with some justification is the introduction of a
knowledge of the unconscious into the treatment of all
patients, and particularly those patients who suffer from
organic illnesses, and that I am as aware as Freud that psy-
choanalysis is a world-wide affair and only partly a medical
affair and that its tie-up with medicine is a disaster. I do not
have a title, but there are people who love me and I have
insights which make my life harmonious in so far as that is
possible at all. I cannot send a prospectus of my small clinic-
15 rooms - where I am assisted by my wife, not only in the
household. There is no prospectus. My charges are adjusted
to the means of my patients, in the treatment I rely on my
head and on my hands and on the view that every patient has
his or her own illness and that the person who wants to help
them has to practice the saying: nil humanum a me alienum
esse puto (I believe that nothing human is strange to me) and
also on the exhortation: Children, love one another! I have
patients of all kinds; I am not a specialist, but a general prac-
titioner with the knowledge and experience gathered in an
active professional life. And I may perhaps be allowed to say
that I have not forgotten during my life as a doctor that man's
true profession is to become a human being. 1
1
l'f

THE MEANING OF ILLNESS INTRODUCTION


This is an extract from a letter written by Groddeck to Hans an entertaining experience for me, my father loved talking to
Vaihinger, Professor of Philosophy, on May 8, 1930, in which these people and asking them questions about their lives and
he also discussed his father's doctoral thesis 'De morbo demo- their opinions, and I acquired some insight into work-
cratico nova insaniae forma', and argued that Nietzsche had ing-class life and into the struggle between the employers
probably known it. and the people who were only considered hands working for
Walter Georg Groddeck, born on October 13, 1866, the the firm; important as this was for my personal development,
youngest son of a physician, in Bad Kosen, grew up in a house- there was something else that influenced me even more
hold where the memory of his maternal grandfather, the liter- though I did not know how to appreciate it at the time: I got
ary historian Koberstein, was held in high esteem and where up to know the medical profession not by meeting sick patients,
to the Seventies of the last century many well-known scholars of but by meeting healthy people. This proved to be of invalu-
German literature used to meet. From childhood on he knew able importance to me ... At that time moreover, the event
that he was going to be a doctor, too, by his father's wish. occurred that jolted me out of my dreamlike existence and
When his father lost his money in 1881 through a series of gave my career its decisive direction: my father had a stroke
miscalculations, the family moved to Berlin. while treating patients. 2
I barely scraped through the final exams of my grammar Apart from the influence exerted by his father Groddeck's
school in March 1885 because I was an unruly schoolboy and medical career was shaped decisively by his meeting with Ernst
my teachers were less satisfied with my conduct than they Schweninger as a student and by later becoming his assistant.
were with my knowledge. I was to study medicine, and as my Schweninger (1850-1924) had achieved fame as Bismarck's
father did not have the means to finance my studies at a uni- '• personal physician and held a teaching post at the Kaiser
versity and was favourably impressed by the medical train- Wilhelm UniversiHit in Berlin from 1894. His method of treat-
ing course offered by the army since he knew one of our best ment was based on the idea that the doctor was merely the
military doctors, Oberstabsarzt Villaret, the intention was to
t
l
catalyst who starts off the therapeutic process. He was opposed
send me to one of the military medical schools. When I to the use of drugs and specially favoured diet, hydrotherapy,
arrived in Berlin where my father was working as a slum and massage. After finishing his tour of duty as a military
doctor I was told that I had applied too late and would not be doctor, Groddeck went to Baden Baden to become the assistant
able to start until the autumn .... In order not to waste all of Schweninger whom he had known since his student days. In
that time I put myself down for a lecture course in Chemis- 1900 he set up a clinic of his own there. Because his reputation
try; if I remember rightly I went three times and one of the quickly spread beyond Baden Baden he soon established a flou-
lectures I remember clearly, it was about arsenic; but my rishing practice. His domestic life was less happy at first - his
father believed that the most useful thing I could do was to sit marriage in which there was a child ended in separation, and
in on his consultations with his patients. Under the pretext of because of the difficulties he had in obtaining a divorce he had
making notes and writing out prescriptions on his dictation I to wait until 1923 before he could get married a second time, to
was assigned a chair next to his desk from where I was able to his Swedish assistant, who had worked with him since 1915.
watch all that was happening. These were the early days of Groddeck began to write. Apart from articles on medical
the general health insurance scheme, my father had applied questions, he contributed to the arts page of the Frankfurter ,Zei-
to be a general practitioner in the scheme and day in day out tung and even wrote novels later on (Ein Frauenproblem, 1903; Ein
there was now a constant stream of bakers, bricklayers, and Kind der Erde, 1905; Die Hochzeit des Dionysos, 1906 ). He was also
other workers pouring into his consulting rooms and seeking interested in social problems and gave regular talks at the
to confirm their admission into the scheme. This was quite workers' community centre in Baden Baden. He also initiated
2 3
INTRODUCTION
THE MEANING OF ILLNESS
Everyday Life and The Interpretation of Dreams. On May 27, 1917,
the founding of a consumers' cooperative.
he decided to write Freud a letter. This turned into a long letter,
In his essay 'Georg Groddeck als Sozialreformer und
the longest he ever wrote to Freud; in it he outlined his main
Mensch' (Georg Groddeck as social reformer and human
ideas in a systematic and lucid way such as he hardly ever
being), Michael Pichler writes:
achieved again, and he asked Freud whether he should consider
In Spring 1912 the consumers' cooperative that could be con- himself a psychoanalyst or whether he was going beyond psy-
sidered Dr. Groddeck's work was able to open its first shop. choanalysis. Freud's answer came quickly, onjune 5, 1917:
But the enterprise had yet to be put on a firm basis, since the
business community was trying its hardest to prevent it from . . . I understand that you are requesting me urgently to
supply you with an official confirmation that you are not a
succeeding. The doctor always thought up new ways and fol-
psychoanalyst, that you do not belong to the members of the
lowed them in his own thorough fashion. For example, he hit
group, and will be able to call yourself something special,
on a very effective publicity method. He announced a series
and independent. Obviously, I am doing you a service if I
of talks on the theme: 'Health and Sickness', held in the
push you away from me to the place where Adler, Jung,
Bletzer Brewery, at first in a small room nicknamed 'cigar
and others stand. Yet I cannot do this; I have to claim you,
box' on account of its shape. There was only a small group of
I have to assert that you are a splendid analyst who has
friends of the doctor's and members of the consumers' coop-
understood for ever the essential aspects of the matter. The
erative in the beginning. But the first talk proved so inter-
discovery that transference and resistance are the most im-
esting and fascinating that the second talk drew such crowds
portant aspects of treatment turns a person irretrievably into
that the cigar box was full to capacity. For the third talk the
a member of the wild army. No matter if he calls the uncon-
garden room had to be used, and all the following talks were
scious 'It'. Let me show you that there is no need to extend
so well attended that all the available chairs in the building
the concept of the unconscious in order to make it cover your
had to be brought in to seat the audience. The series proved a
great and lasting success, not only for the doctor, who was experience of organic illnesses ....
pleased by it, but also for the consumers' cooperative. The This is the beginning of the remarkable relationship between
discussions which followed every lecture made these Freud and Groddeck in which Groddeck insisted on calling
evenings particularly interesting. When the series came to an himself Freud's pupil without really playing the part. The fact
end after twelve talks there was general disappointment. The that he never gave up his own opinions, particularly the concept
talks were published in 1913 as a book by Hirzel in Leipzig, of the It which he had found a long time before he met Freud
under the title Nasamecu (Natura sanat, medicus curat - and which he put forward with self-confidence, did not prevent
nature heals, the doctor cures) and subtitled 'Der gesunde Groddeck from revering Freud as the great master; he even
und kranke Mensch' (The healthy and sick person)} seemed to long for permission to revere him. The ideas of
Freud's which he used and applied in his work remain essen-
The book Nasamecu marks the transition between two phases
tially limited to those mentioned in his first letter to Freud,
in Groddeck 's life, the phase during which he was
namely the ideas of the unconscious, of transference and of re-
Schweninger's pupil, and the phase in which he tried to be
.sistance. Yet his admiration of Freud went far beyond this:
Freud's pupil. The book is written, on the one hand, in homage
to his teacher Schweninger whose therapeutic principles are Allow me in conclusion to say something about Freud. His
commemorated in the title (Natura sanat, medicus curat). It work, his discoveries of the unconscious, of resistance and
contains, on the other hand, a criticism of psychoanalysis transference have been compared to the discoveries made by
which Groddeck at the time knew by hearsay only. In 1913 Copernicus. This may be a useful comparison for scholars.
Groddeck at last began to read Freud, The Psychopathology of 5
4
THE MEANING OF ILLNESS INTRODUCTION
But he did more for us as human beings. He discovered that will in the world, I cannot adopt your view, as indeed you do
apart from the human languages of sound and gesture there not expect me to. But there is a big difference between Rabe-
are hundreds of other languages a thousand times more im- lais and Groddeck. The former remains within his role as a
portant and true than the former, means of communication satirist and avoids the error of putting himself forward as a
which bring people closer to each other. In the context of savant. Groddeck, however, wavers between science and
world history Freud did something that can only be com- belles lettres . . . .
pared to the work of the founders of religion if we have to
To which Freud replied, on 23 March:
make a comparison at all. He taught people new ways of
understanding one another, he brought them closer together, ... I was delighted with your remarks about Groddeck. We
he built a thousand bridges across the gap that separates really must be able to tell each other home-truths, i.e. incivi-
human beings from each other, he gave to those who followed lities, and remain firm friends, as in this case. I am not giving
him a newer, deeper, happier, more childlike way of living, a up my view of Groddeck either, I am usually not so taken in
new kind ofloving and a new kind of believing. To know is to by anybody. But it does not matter. 6
doubt, to believe is not to doubt. In science Freud forced us to l ' Of the psychoanalysts such as Ernst Simmel, Karen Horney
doubt and re-examine everything we thought we knew up
and Frieda Fromm-Reichmann who came to admire Grad-
to then. In our personal lives he brought us a belief, the belief
deck, Sandor Ferenczi enjoyed the most lasting friendship with
in loving one another. He increased in us the ability to get to
him. Suffering from severe nephrosclerosis, he had become a
know each other which results spontaneously and inevitably
patient of Groddeck 's on the advice of F. Deutsch in 1921. 7 He
in a greater human love and respect for others, it reduces the
was soon able to go home with all his symptoms cured, and
compulsion to lie, offers the possibility of a greater freedom of
used to take regular 'therapeutic holidays' with Groddeck in
living and reduces anxiety. I am glad I know him. 4
Baden Baden.
Unique in the relationship between Freud and Groddeck is Many analysts were critical of Groddeck and yet on the oc-
the fact that Freud continued to show interest in and concern casion of Groddeck 's sixtieth birthday there was an article in
for Groddeck's writings until Groddeck's death in 1934, that he the lnternationale ,Zeitschrift fur Psychoanalyse by Ernst Simmel,
defended him against other analysts and gave his permission to who writes, among other things:
publish his works in spite of the reservations he had against
When we think of Groddeck as members of the International
them or mentioned about them to other people. An example is
Psychoanalytic Society we remember the day when he first
the following passage from a letter to Oskar Pfister, dated
February 4, 1921: appeared in our midst in person during the conference at The
Hague. He went up to the platform and announced: 'I am a
I energetically defend Groddeck against your respectability. :~ wild analyst.' He was right. Yet one should understand the
What would you have said if you had been a contemporary of word 'wild' in a way that is different from the usual meaning
Rabelais? Poor Rank will have to be my scapegoat more of a psychoanalyst who launches into therapy with mentally
oftennow. 5 ill patients without any training let alone a trace of under-
Pfister wrote back on 14 March: standing for the spirit of psychoanalysis. Groddeck may call
himself wild -- as a member of our movement who owes his
I understand very well that it is impossible for you to think training to nobody except himself. He may be called wild be-
otherwise. The state of mind that leads you to encourage cause of his passionate nature which wants to help where
Groddeck is exactly the same as that which made you the dis- others have resigned or are hiding their impotence behind
coverer and pioneer of psychoanalysis. But, with the best the mock techniques of exact diagnostics. His nature is the
6 7
THE MEANING OF ILLNESS INTRODUCTION
source of that 'wildness' which has en~ bled him, a fanatic of
the art of healing, thanks to his unique gifts, to apply success- ~;
Jf,
may appear in a fragmentary form in several essays without
·ever being dealt with extensively elsewhere. Groddeck 's
fully Freud's discoveries about the unconscious psyche in the 'I
thoughts seem to have been in permanent flux although most of
fight against organic illnesses. Groddeck's wildness is also ~•'t
the time they were concentrated on one and the same basic
the courage to pursue singlemindedly one goal, it is the ab- idea, his concept of the It. Yet there is not the consistent argu-
solute truthfulness which he sees embodied in Freud.
Groddeck's wildness is also the hatred with which he fights
the old fashioned medical practices by which, before Freud,
'
l,

~
ing out of an idea nor the construction of a coherent theoretical
system.
Groddeck's style is of such brilliance and beauty that one is
the doctor was placed in the centre of the healing situation inclined to present him in an introduction like this through his
instead of the patient, out of a kind of medical narcissism. We
believe that a wildness of this kind should not be criticised,
t
,,'l
I
own words mainly, in order not to mispresent or dilute and
fragment the specific quality of his thought. Yet occasionally
particularly when it is accompanied by such blessed innate there is a marked discrepancy between his brilliant exposition
artistic gifts as in the case of Groddeck. of ideas and passages in which he seems to get lost in a labyrinth
While we psychoanalysts are busy and have to be busy of etymological derivations by which he hopes to justify and
learning everything Freud discovered and keeps on dis- confirm his speculations. The present selection consists mainly
covering in psychoanalysis and discussing and teaching of his theoretical and psychoanalytical writings, leaving out,
these things in our 'school', i.e. in our societies, while we have among other things, his psychoanalytical novel Der Seelensucher
guidelines and have to set guidelines for our therapeutic ac- (The Seeker of Souls), 1921, and his biographical essays.
tivity, Groddeck can do without these because his extensive In the following pages I shall outline Groddeck 's most im-
work with organically sick patients is without parallel so far. portant themes in the sequence adopted for this book.
He uniquely fits the distinction made by the philosopher
ORGANIC ILLNESS
Georg Simmel between artist and scientist: 'The scientist
Groddeck claimed to have come to the psychiatric and psy-
sees because he knows, the artist knows because he sees.' We
choanalytic treatment of patients with chronic organic ill-
know or seek to know what we can get by learning. Groddeck
nesses by way of being a practising physiotherapist, and he
sees and knows without making this detour. 8
has often been called the founder of psychosomatic medi-
In 1934, Groddeck left Germany on the advice of his friends cine. This is an honour he would probably have shrugged off
in order to escape arrest by the Gestapo. He had an invitation since he was keen on showing that there was no basic differ-
from the Swiss Psychoanalytical Society to give a talk. He gave ence between organic and mental illness. In his first letter to
the talk 'Vom Sehen, von der W dt des Auges und vom Sehen Freud he outlined his main ideas about the nature of organic
ohne Augen' (Vision, the World of the Eye and Seeing without illnesses and put forward the suggestion that
the Eyes). 9 A few days later he died in a clinic in Knonau, Swit- the distinction between body and mind is only verbal and
zerland, having suffered his first heart attack in 1930 and not essential, that body and mind are one unit, that they
another one shortly before his trip to Switzerland. contain an It, a force which lives us while we believe we
are living.
GRODDECK 's WRITINGS Encouraged by the interest Freud showed in him, he
Groddeck 's writings contain an extraordinary wealth of ideas wrote and published the essay 'Psychic Conditioning and
which are sometimes formulated very briefly, almost aphoristi- the Psychoanalytic Treatment of Organic Illness' (pp 109-31
cally, or illustrated by one clinical example alone, until they get below) in the very same year; it was reviewed by Ferenczi in
taken up again in a later work. Because of this peculiarity, ideas the /nternationale ,Zeitschrijt; and contains the following
8 9
THE MEANING OF ILLNESS INTRODUCTION
remarks. The It can choose the soul or the body, it manifests lJ~.1 used in medicine without any further thought, since it is im-
and makes itself understood not only in dreams but also in the 1\
possible to get human thought habits away from their beaten
physiognomy, the behaviour or in a serious organic illness. tracks, I thought up the term It. I liked the indefiniteness
It may set up conditions in which the pathogenic agent about it - X would have been too mathematical, and X,
becomes effective, if it considers that an illness will serve a moreover, demands a solution, my It, however, suggests that
purpose (p. 112 below). only a fool would try to understand it. There is nothing there
The It ties a person down, if necessary, it saves him by ill- to understand. Yet since the It is the most important thing
ness from dangers of a more serious nature than danger of life about people, everybody who uses it says: we do not under-
can ever be, it forces him to certain activities by certain dis- stand anything about life, we can only live it. All definitions
abilities, to rest through heart disease or tuberculosis (pp. are thus made null and void, they have nothing but a mo-
115-16 below). mentary meaning, are only justified in so far as they are
useful. One cannot build on definitions as if they were foun-
Groddeck maintains, for instance, that headaches are one of
dation stones, and it is not the task of science to construct
the most widespread and well-known methods used by the It to
since the structure of life is there and is indestructible unless
immobilise thoughts and drives, that short-sightedness can
it changes by itself. Everything is changeable, therefore de-
serve as a means to spare a person the sight of objects unbear-
finitions are changeable, too, and the more so the wider their
able to him and, conversely, that the long sight of the elderly
frame of reference. The time has come either to do away
helps them symbolically to make death appear far off.
completely with the words soul and body or to redefine
The idea of illness being of use to the person suffering from it, them.
even enabling him to express himself or to understand himself,
So far I cannot find any meaning in the word psychogen-
is put most lucidly in the essay 'The Meaning of Illness' (pp esis.11
197-202 below). Yet it is not restricted to organic illness alone:
We have become very careless in our use of the label neurosis GRODDECK'S CONCEPT OF THE IT
and have completely lost sight of the fact that illness is not In his early book, Hin zur Gottnatur (Towards God Nature),
an evil in itself but always a meaningful process and not Groddeck wrote in 1912 already:
infrequently brings out forces which are only effective
within the context of being ill. 10 There is no such thing as an I, it is a lie, a misrepresentation
to say: I think, I live. It ought to be: it thinks, it lives. It, i.e.
Groddeck differentiates neither between organic and the great mystery of the world. There is no I. 12
mental illnesses nor between health and illness. For him
health is only one form of It manifestation. The It decides on 'The great mystery of the world' is also called 'Gottnatur'
whether a person is ill, healthy, or recovering from an illness. (God Nature) by Groddeck, an expression he got from Goethe:
Thus Groddeck 's conception of illness has to be understood What more can man gain from life
in the context of his efforts at understanding the great un- Than have God nature revealed to him:
known, the It:
How it turns matter into spirit
For me, the question of psychogenesis does not exist. Ill- How it makes the creations of the spirit live on. 13
ness is a sign of life, and even the most celebrated scholar
knows nothing about the causes of its origin and as little In his Christmas letter of 1922 Freud writes:
about the causes of its disappearance. One can only fanta- I think you got the It (in a literary, not an associative way)
size about that. Since the terms 'psyche' and 'physis' are from Nietzsche.
10
11
THE MEANING OF ILLNESS
Groddeck himself writes retrospectively, in a letter to a
doctor patient dated June 11, 1929, 14 that he used the term the
It 'in connection with Nietzsche and for reasons of con-
',, INTRODUCTION
godfather, present at the christening'. In the comparison he
uses there he calls himself the plough, Freud the farmer who is

I
ploughing:
venience'.
From the first, Freud refused to understand the It in the way The plough, which has finally through hard experience come
in which Groddeck wanted him to see it. Already in his first to the conclusion that it is not an Ego, tends to consider the
letter to Freud Groddeck went so far as to say that the It, as a ,\ '
concept of the It as an illusion produced by the It. At least it
force by which man is being lived even if he believes to be living Il cannot decide to do without the assumption that every cell
himself, manifests itself as much in his thoughts and emotions, f'' has its own consciousness and thus possesses independent
his organic and mental illnesses, as in the external appearance discharge. The Ego, in its opinion, is apparently not even
of man, and he drew attention to the fact that Freud's concept able to control the motility of voluntary muscles, much less
of the unconscious had to be widened in order to allow the psy- that of the intestines, kidneys, heart, or brain. In doing this it
choanalytic examination of physical illness. Freud's answer does not deny the Ego or the Super-Ego. Yet they are merely
was: 'There is no need to extend the concept of the unconscious tools for it, not existing entities. I have the impression that
.in order to make it cover your experience of organic illnesses.' the farmer remains in the region of the so-called psyche, at
Groddeck cannot give an answer to the question, what is the least for the time being, and can perhaps ruin a number of
It? He contents himself with distinguishing the various mani- ploughs without producing a big harvest. In other words, the
festations of the It. Thus the Ego, consciousness, any human plough considers the farmer a little obstinate. But then it
expression of life, be it physical or mental, healthy or only has the brains of a plough.
unhealthy, are all manifestations of the It. Before writing this letter to Freud, Groddeck apparently
After reading the first chapters ofGroddeck's work, Das Buch allowed some time to pass, as he had written to his wife on May
vom Es (The Book ofthe It), Freud wrote on April17, 1921:
15,1923:
I understand very well why the unconscious is not enough to The Ego and the ld is pretty, but quite uninteresting for me. In
make you consider the It dispensable. reality it was written to appropriate secretly loans made by
And, at Christmas 1922: Stekel and me. And yet his ld is of only limited use for the
understanding of neuroses. He ventures into the realm of
Do you remember, by the way, how early I accepted the It organic illness only in a very sneaky way, with the help of a
from you? It was a long time before I made your personal ac- death instinct or destruction drive taken from Stekel and
quaintance, in one of my first letters to you. I made a drawing Spielrein. He disregards the constructive aspect of my It, pre-
there, which will soon be published in almost the same form. sumably to smuggle it in next time. Some of it is quite amus-
On March 25, 1923, after the publication of The Book of the It ing.
Freud congratulates Groddeck and continues: Ina later work, 'The It and Psychoanalysis', 1925, Groddeck
The work, moreover, argues the theoretically important writes, among general ideas about the conference mania of his
point of view which I have dealt with in my own forthcoming (and our) time:
work The Ego and the /d. The beginning of man who is the object of my scientific in-
Groddeck, after receiving Freud's The Ego and the ld, which quiries, is fertilisation. Whatever originates there I call the It
was published in the same year as his own Book of the It, set of man. This term aims to describe the uncertain, uncertifi-
about answering in a highly critical way on May 27, 1923, 'as able nature of this entity, the miracle .... To study and
12 13

_.L
THE MEANING OF ILLNESS INTRODUCTION
understand this It that builds up our personality according expression 'the It' and said that he had taken it over from
to a completely planned blueprint, that gives it con- me. This is true, except that the term 'It' as used for my pur-
sciousness, the illusion of thought and reason, and an ego- poses was unusable to him and he turned it into something
awareness, imprints the notion of guilt and punishment into different from what I meant. As far as I can see he chose the
it, builds cathedrals as well as houses on sand and castles in expression in order to illustrate his ideas about his concep-
the air, teaches us to love and to invent murder weapons, is tion of what he calls topic. Yet he has not changed the nature
one of the oldest pre-occupations of man. One could say he of psychoanalysis with it, neither adding nor subtracting
never did anything else. All our efforts and all our strivings anything. It remained what it was, the analysis of the con-
are directed towards this It. And in order to study it scien- scious and of the repressed parts of the psyche. But the It
tifically, methodically, we have to observe its manifestations cannot be analysed whether it is Freud's Id or mine which
and learn the language it speaks .... When one reads Freud share a common name, any more than can Ferenczi's Bios. 16
attentively, without preconceived notions and without In order to point up the difference between Freud's and
bothering about repressions, one soon discovers that his con- Groddeck 's conceptions, English translations of Groddeck 's
cept of the psyche is the same as mine, namely of a mani- 'Es' use the word It in contrast told for Freud's' Es '.
festation of life, and emphatically not the system 'conscious' A later discussion of the It in which Groddeck- pointing out
which so far it has been held to be, but the system 'uncon- other important themes - stresses the bisexuality of man, his
scious' and, absolutely dominating both, the It. Freud knows use of symbol and of language as particular manifestations of
that this psyche is not the opposite of physics, not at all, but the It, is found in his last book, Der Mensch als Symbol (Man as
only another form of life. In order to know this it does not Symbol).
need his verbal assurance, it can be read between all the lines
of all his works published so far. For him there is just as little In the ten years since I last put forward some hypothetical
division between body and soul as there is for me and every thoughts on the human It nothing has happened that would
human being. But for the purposes of his profession as a induce me to give up this often tested approach or to make
specialist of mental illness he named these things in different decisive changes in my ideas about it. I maintain the position
ways, more appropriate to his purposes, and confined him- that everything human is dependent on this infinitely mys-
self apparently to the fields of neurosis and psychosis. But he terious entity and I also persist in maintaining that nobody
really believes in the It as does and did and will do every- can fathom the depths of the It. And yet I can say a few
body, in the past, the present, and the future. 15 things about those manifestations of the It which have not
received much attention so far. I also consider it necessary to
Freud, for his part, writes onJ une 18, 1925: emphasise that the Ego is one of these manifestations. In the
Everything from you is interesting to me, even if I may not Book of the It I explained to the best of my ability what I mean
follow you in detail. I do not, of course, recognise my civi- by this.
lised, bourgeois, demystified Id in your It. Yet you know Another form of the It which is more accessible to me I
that mine derived from yours. want to call the dual nature of the It. All human life can be
seen as simultaneously male and female, child and grown-
In 'Traumarbeit und Arbeit des organischen Symptoms' up.
(The effects of dreams and of the organic symptom), 1926, The It, moreover, manifests itself as independent and as
Groddeck writes:
mutually dependent in the life as a whole as in the parts of a
Freud honoured me by drawing attention to me in his book living human being's existence, or, in other words, there is
The Ego and the ld as the person who was the first to use the apparently a similar relation between the whole human
14 15
THE MEANING OF ILLNESS INTRODUCTION
being and the cell or even smaller entities, the tissue, the in- man is without female attributes and woman without male,
dividual organ or part of the body as was expressed by the that it is possible to be all man or all woman, creeps into this
terms macrocosmos and microcosmos in former times to de- line of thought and the impression is that the whole thing is
scribe the universe and its parts. And finally the symbol as rather indecent and could or should be overcome. The possi-
manifestation of the It permeates all human life. bility that man is female-male and male-female is
My attempt at examining all these manifold forms of the It repressed. 18
was prompted by a rather singleminded and idiosyncratic
pre-occupation with works of art and language, apart from
THE SYMBOL
the pressures of everyday life and work.
The term 'unconscious' is not synonymous with 'It'. Un- Groddeck's conception of the symbol can only be understood in
conscious material was originally conscious at some time, the the context of his interpretation of the It as he himself kept
unconscious presupposes the existence of the brain. Yet the emphasising:
It exists before the formation of the brain, the brain is an And finally the symbol as manifestation of the It permeates
instrument of the It by which it opens up certain rather all human life. 19
limited areas of existence to our thought for unknown rea-
sons while taking care that the brain deludes us into believing Groddeck considers man's compulsion to symbolise to be an
all sorts of strange notions which are peculiar to man, such as expression of the It and not of conscious thought. Conversely,
the belief in an I. I repeat: It and unconscious are two totally all conscious thought and action is an inevitable consequence of
different concepts - the unconscious is a part of the psyche, unconscious symbolising. Groddeck's dictum that man is lived
the psyche a part of the It. Thus psychoanalysis is not identi- by the It is parallelled by the other dictum that man is lived by
cal with an examination of the It. The It is man himself in all the symbol, from his very beginnings. While the grown-up has
his vital minifestations and as such it is neither freely acces- difficulties in gaining insight into the interaction between the
sible to psychoanalysis nor to any other method of examina- symbol and the It, the child has this insight spontaneously.
tion, yet there are ways which lead us very close to the It and We are compelled by the repressive forces of human life
the best of these, the closest approach to the target, is psy- and of our man-dominated environment (education etc.) to
choanalysis. 17 fantasize about the real. Originally we are not dealing with
the world of objects, but with symbols. So far little interest
Groddeck discusses human bisexuality in many of his writings. has been shown in the methods by which the new-born child
He discovered that, although bisexuality plays an important learns about his environment and in his reaction to it. If I try
part in analytical theory, to imagine what I might have experienced in the womb, I
come to the conclusion that I must have considered every-
yet it is not seen as one of the fundamental phenomena, as the thing that belonged to my world as a part of my own self; the
focal point of all human existence and thought. Bisexuality self and the environment of the self were one and the same
has been talked about for quite some time, to be sure, and the thing. This symbolic way of thinking may be changed some-
woman's desire to have male sexual organs and to behave like what by the event of birth, but judging by the behaviour of
a male sexually and in other ways, and the man's desire to be babies in their first months of life I have to assume that the
a woman, to conceive, be pregnant, give birth are important infant still thinks largely in symbols during the main learning
issues in the theory and practice of interpretation of the un- period of his life, the first hours, days and weeks: a spoon is
conscious. Yet the assumption remains that a man is a man not a spoon to the child but a hand, a door not a door but a
and a woman a woman. The curious thought that in reality mouth, a bed not a bed but a womb, etc. Our conscious and
16 17
THE MEANING OF ILLNESS INTRODUCTION
unconscious thinking never rids itself completely of these essay 'Psychic Conditioning and the Psychoanalytic Treat-
early notions- which are retained almost unchanged by pri- ment of Organic Disorders' (pp. 109-31 below) already con-
mitive cultures. Until the end of our lives our understanding tained a discussion of the psychodynamics of seeing and
is tied to the symbol. No matter how rational we are we explored the causes of near-sightedness and long-sightedness.
cannot help it: a window will remain an eye, a cave a mother, He chose the same theme for his first talk to the Psychoanalytic
a pole a father. Society during the congress at The Hague (see his letter to
We also see man and his parts in symbolic ways as we did Freud, September 11, 1920). The last lectures he gave before
when we were children. Once we knew from experience that his death in Germany, England, and Switzerland were on the
the head is a whole and a part at the same time, an indepen- subject of seeing that interested Groddeck all his life. The
dent and a dependent entity, that man is a symbol for the manuscript of these, written down in 1932, had the title 'Vision,
head arid that the head is a symbol for man. The symbol does the World of the Eye, and Seeing without the Eye'. As early as
not describe the similarities between two objects; in the 1917 he wrote:
symbol two objects are thrown together, they become one. The ancients thought of the poet as blind; and it makes sense
Because we think and feel symbolically, are, in short, tied that his eyes have to look inwards. 23
to the symbol as to something belonging to human life, it is
possible to look at everything in human existence symbolic- Groddeck 's ideas about seeing centre in man's ability to
ally. 20 combine the rational exploration and understanding of the
world with an almost mystical experience of inner vision. He
With this conception of the symbol as part of the whole and himself combined in his personality an inclination for accurate
as a key to 'the mysteries of human life'21 Groddeck takes up clinical observations of surprising vividness with a constant
thoughts he had already in 1912 about an idea of Goethe's:
search for inner truths - he is scientist and philosopher in one,
He (Goethe) showed science a new way, the way to see the as Lawren<;:e Durrell, in a brilliant essay written in 1948, 24 pre-
part in the whole, to conceive of the apparent whole as a sented him. Groddeck talks about two essential ways of seeing:
symbol of the universe, to see symbolically the whole world in
The outside-inwards way of seeing is the one which is nor-
a flower, an animal, a pebble, the human eye, the sun, to ,.1' mally called vision. The inside-outwards way of seeing is the
recreate from this flower, to renew, to explore the world of 1,,
dreamer's, the visionary's way. This phenomenon is also
objects not analytically, but by taking it in as a whole. 22 present in normal vision, and seeing is thus a mixture of
It was not without good reasons that Groddeck entitled his external and internal images. 25
last, unfinished book, Man as Symbol. He had announced it in a
letter to Freud on February 7, 1932: GRODDECK, THE DOCTOR
Groddeck thought of himself first and foremost as a doctor who
It is a book in which the idiosyncrasies of language and fine strives to cure his patients. In 1917 he announced firmly that he
art are used to prove how close the connections between was not interested in constructing a theory but in doing thera-
symbol and life have always been. Medicine, particularly in peutic work:
the first part, will only be loosely linked to it, yet at the same
time I want to discuss the influence of the symbol on the Our task is less that of thinking up valid theories than of find-
whole of the organism and its individual parts - either in a ing working hypotheses that are of use in treatment. 26
volume on its own or in individual pamphlets.
In a letter to Freud, dated April 1923, he rejects any claim to
One of Groddeck's favourite themes was seeing. The 1917 having disciples and maintains that his talent is essentially 'one
18 19
THE MEANING OF ILLNESS INTRODUCTION
for treating patients'. Later, in his memoirs, he calls it his 'need an essential aid to easing the symptoms of illness for Groddeck.
to be a doctor'. 27 Hermann Graf Keyserling 30 describes in the chapter on Ger-
But who does the curing? Groddeck is deeply convinced that many of'Spectrum of Europe' his impressions ofGroddeck as a
it is not the doctor but the It. For Groddeck the doctor is less of a physician and as a human being:
therapist and more of a servant. The word treatment may lead
The greatest magician among the psychoanalysts and with-
the doctor to assume that he can determine and guide the pro-
out doubt the most important human personality of them all
cess of healing. But in reality it is the It that decides on that:
was Georg Groddeck. I met him in Sweden in 1924 and was
As the It uses something from the environment as a cause for immediately fascinated by his veritably diabolical face that
an illness, so it takes something from the environment to looked at me as if from a fiery furnace of hell and yet was so
cause recovery when it wants to manifest itself in a state of full of deep goodness. My heart went out to him in an almost
health. It treats itself. ... There is thus no right or wrong maternal way, for I felt the enormous vulnerability of this
treatment. This and this alone explains the reason why most soul which protected itself by spikiness and play-acting. As
illnesses cure themselves without a doctor, why many people long as he lived he came to Darmstadt regularly and never in
recover more readily when treated by an old shepherd or my life have I had better praise than from Groddeck in a
clairvoyant or magnetopath than by a university professor. 2 8 letter shortly before his death: 'You are the only person who
never hurt me. I am grateful to you for this.' We got to know
I shall quote from another essay in which Groddeck discusses
each other because of Groddeck 's promise to cure me within
his ideas of therapy:
a week of a recurrent phlebitis with boils which other doctors
(1) I consider the psychoanalytic method not as the method had believed not curable. I travelled to Baden Baden to
but would like to say that every method is right and that I Groddeck 's clinic and lo and behold the wounds healed, the
myself use any method that works no matter what name or swellings on the leg disappeared, and at the time of writing I
technique it may follow. have not had a relapse. Groddeck's treatment resembled his
(2) I almost never depend solely on the psychotherapeutic appearance, it was a kind of carefully directed hellish pain.
method in its widest sense in my treatment though I always My leg literally boiled, and his special kind of massage
use it. I know that this reduces the value of my experiences for during which he conducted an analysis based on my ex-
others and that I would feel in the dark, too, if I dido 't find a pressions of pain was a technically controlled form of torture.
balance in the wealth of my experience. In the long run I be- Yet in the case of patients who found him congenial Grad-
lieve that the It is the point to tackle in treating both mental deck achieved miracles. As an analyst Groddeck was the
and physical illness, and that this It can use a laparotomy or most incredible catalyst such as I have never considered pos-
a dose of digitalis in a psychological way and suggestive or sible. He said hardly anything. Yet all that needed to be libe-
analytic approaches in a physical way. rated in me came spontaneously to my mind in his presence.
(3) ... my 20 years of psychoanalytic activity have taught I owe to this meeting with Groddeck the first insights into the
me to believe that eiforts at making repressed material con- deeper significance of my mother experience. It is difficult to
scious may often have a therapeutic effect, yet as often such describe in detail what it was that made Groddeck's Wei Wu
results do not occur and conversely there are many cures so magical. On the whole it probably was his own completely
without any attempt at treating unconscious or repressed relaxed naturalness. With all this he was, of course, like all
material. It is a question of convenience whether a specific analysts I know, an unresolved analytical case, yet otherwise
case is tackled by analytical or by other methods. 29 he possessed a genuinely Lao Tse-like elusiveness. Because of
this he couldn't help being a liberating agent for other
Massage, the exploratory touching of the body, was always
20 21
THE MEANING OF ILLNESS INTRODUCTION
people; in his presence I found one image after the other selection some very important articles had to be left out, for
pouring into my consciousness - and yet Groddeck had instance the essays in his house journal, Die Arche, written for
hardly asked a question. the patients of his clinic, in which he tries to elucidate organic
symptoms, organic processes by applying psychoanalytic tech-
Groddeck sums up his attitude when he says:
niques. These clinical papers are concerned with the following
My task is not to teach, it is not to help, to give or take respon- organic illnesses in particular: headaches, arteriosclerosis, the
sibility, the doctor's profession is only concerned with the formation of kidney stones, and constipation.
moment, the doctor has to be, not to act. The more his being Furthermore, Groddeck's highly original writings on litera-
is stressed the more the doctor is instead of does, the easier it ture and the fine arts unfortunately had to be left out of this
will be for the patient to use him. For us it is not a matter of selection. They consist of a first series of literary lectures on
'we ought to' but of'we are'. 31 Ibsen's plays which Groddeck gave around 1910 in Baden
Baden and in which he concerns himself particularly with the
One is reminded of the essay 'Language' (pp. 248-63 below) interpretation of female characters (see Freud's letter of
when Groddeck mentions to Freud, on October 17, 1920, the October 28, 1917 and Groddeck's answer in November). In his
ancient wisdom 'that words put chains on thought', and later works on artistic themes Groddeck tries to prove that the
already in 1912 he discussed the possibilities and the limi-
It manifests itself not only in sickness and health, but in lan-
tations of language critically. He had called language the 'vehi-
cle of culture', and yet he had also pointed out how impossible guage and gesture too:
people find it to give words to their essential experiences, and Every year the belief- or rather superstition- that psychoan-
had further argued that in language the falsification of truth alysis is an affair for doCtors, that it is a kind of psychiatric
begins. This essay from Groddeck's pre-analytical period is of treatment which should be used for the patients' best, is
special interest because it contains or hints at themes which growing in strength. I consider it a necessary duty to fight
Groddeck took up again in his later writings. Here we find the against this erroneous belief by lecturing and writing, for if
beginnings of his idea of the It and his closeness to Goethe's this opinion becomes prevalent- and unfortunately there are
thoughts. Groddeck here talks about his great reverence for the many people who defend this position- the world would be
poet which is important for his later literary work. The inclu- deprived of the most precious thing Freud gave it. The study
sion of this essay at the end of this selection may help us trace of the unconscious - which is a possible translation of the
Groddeck's thought back to its origins. term psychoanalysis -is an affair of all mankind and its use
in medicine is only a small fraction of all that this study con-
WRITINGS WHICH COULD NOT BE INCLUDED sists of. In order to make this clear I chose the four pieces of
... People are so stupid that they expect one still to literature mentioned in the announcement- the Ring of the
remember at the end of a lecture what one said in the begin- Nibelungs, Peer Gynt, Faust, and Struwwelpeter- as ma-
ning. They do not want to know that the human mind is terial for my talks, and in order not to make people think that
mobile and yet this mobility is the only thing of interest. I I was dabbling in aesthetics I called these pieces textbooks.
enjoy jumping from subject to subject since I have become Yet this does not mean that I intend to give a course in psy-
too stiff to jump over physical obstacles .... 32 choanalysis, with the help of these textbooks. Psychoanalysis
cannot be taught, for the simple reason that it is innate in all
As I said in the beginning, Groddeck had the ability to intro- of us, that it is a human ability like seeing or hearing. I rather
duce and deal associatively with several subjects in the frame- feel like a bookseller who is asked for his advice about what
work of one essay. Only a full reading of his work will thus do books to read in order to be informed on this or that subject, a
justice to the wealth of ideas scattered through its pages. In this
23
22
THE MEANING OF ILLNESS INTRODUCTION
question which is indeed often put to me, because of the in- hearing and clamours for attention in a thousand ways, in
terest in psychoanalysis. And I must say that none of the cur- actions, dreams, and the symptoms of illness, and I would
rent textbooks will inform you as easily, simply and think that these phenomena which the doctor can see so
thoroughly about the nature of psychoanalysis as will these clearly, deserve to be examined by the moralists, too, for a
four works of literature. ss change. 34
The Ring of the Nibelungs turns into a textbook on the Oedipus A year later Groddeck argues that the child is much nearer to
complex. On Faust he writes, in a summary, that it is a con-
self-knowledge and points to the developing ego-consciousness
fession and understanding of the fact that human beings are
as an obstacle to self-knowledge:
lonely and each a world to himself. The famous German child-
ren's book Struwwelpeter he considers a complete collection of all Know thyself! Formally speaking this is an advice, an
symbols, and a sensitive presentation of the childish mind as a admonition to strive for self-knowledge, but in reality it is
description of the dual world in which the child is living, as an merely a confirmation of the fact that a person who knows
evocation of the irrational world which grown-ups find almost something about himself is a special tool in the hand of the
inaccessible. universe, of God Nature,· that he has special gifts and
In his essay on Peer Gynt he discusses the concept of the self. potential for action similar to those which all human beings
This essay is perhaps the most personal work ofGroddeck's. He possess at a certain age, i.e. during childhood. Children are
identified so deeply with the Peer Gynt character who turns the best teachers and if you do not become like children you
into a 'troll' that, as the author of The Book of the It, he signed the will not enter the kingdom of heaven. Self-knowledge is not
letters to his lady-friend Patrick Troll. knowledge of the Ego, but knowledge of our Self, our It. For
The essay attempts a confrontation of I and Self. In the me, there is no doubt that as long as the human Ego-
course of this it arrives at a definition of the Self which is based consciousness is still weak man knows more about his Self,
on the conception of the It. Groddeck had insisted in many pre- his It, than from the moment onwards when he uses the
vious articles on man's duty to confront his self. In 1926 he ominous word '1'. This word is like a pair of spectacles, an
wrote: indispensable unavoidable pair of spectacles which forces
Our time uses the words selfish and egocentric as if it were us to see everything, particularly our Self, in distortion or
the biggest character weakness to possess one of these quali- embellished and which was given to us by God Nature in
ties or to cultivate them. I have no right and no inclination to order not to be like God. 35
go into the moral and ethical implications of selfishness, but Since Groddeck developed his ideas on Man's attitude
as a physician I have to say that I find it horrifying how little towards his self in the Peer Gynt essay at particular length,
people care for themselves, even the so-called selfish and ego- I would like to quote from it some more:
centric persons, and they least of all since their lives are
usually a permanent escape from themselves; it may be right Peer Gynt can regard his 'self' as an object, he can 'vaere
to assume that they serve their ego or what they consider dig selv'; he can also 'vaere sig selvnok'. If we try to trans-
their ego, yet this ego-serving is in reality the result of a great late the 'vaerl dig selv' we must not say: 'Man, be thyself!'
fear of their selves, a turning away from the self, from their but 'Man, be a thou, a thou to thyself, or, by all means, be a
deepest emotions. For the doctor's work it would be desirable self to yourself. Stop being an ''I''. ' Try to confront yourself
if people showed more interest in themselves, in the mani- the way a child does. Make yourself a part of the great whole,
festations of the It, for the mute and yet so insistent entreaties the universe. Deal with yourself on the basis of the knowledge
of their innermost soul which strives desperately to get a that you are not an 'I', but a 'thou'. If the oft-repeated words
24 25

LAt
THE MEANING OF ILLNESS INTRODUCTION
'dig self' are taken in this sense, all the difficulties of in- man's need to play. In a letter to the woman who later became
terpretation fall away, since Ibsen allows Peer Gynt to speak his wife he wrote:
of his self or thou (though this is not the same thing) instead It is quite unimportant what we play with as long as we play,
of his '1'. It is, of course, not possible to make this clear in a and people who cannot play, who long for unobtainable
stage representation, it would become too clumsy, yet one playthings instead of making a living doll from a handker-
can learn to understand it at home and then the performance chief, are rather stupid. Those who like their own stupidity
will not lead one astray. Yet as it is at the moment the play may keep it, in God's name. Everybody should have his own
does not make sense. pleasure. (6.4.1916) 37
It should be obvious to everyone that the self is not identi-
cal with the ego, for the ego is something entirely personal The possible role of psychoanalysis in obstetrics Groddeck
and in essence illusory, something existing only in our own mentioned to Freud in his letter on November 8, 1923:
imagination. It comprehends only a very small part of a man. There is still a lot to be learnt about the mother's and the
The self on the other hand is the whole man. We all know it, baby's psyche as well as about the practice of obstetrics.
yet none of us lives in accordance with our knowledge, for we
are all under the spell of the ego idea .... It entirely depends on the reader how Groddeck's ideas will
We all fancy we must have a core at the centre, something strike and possibly affect him. Some may be irritated if not
that is not merely shell; we would like to hold within us some repelled by many of his more abstruse thoughts and by the way
specially aromatic kernel, to be a nut which holds the eternal, he jumps from idea to idea. This reaction would be nothing
the sacred. And we do not realise, cannot realise, that we new; it recalls the indignation and criticism which Groddeck
have in fact no kernel, but are ourselves, from the outermost aroused on his first appearance at the International Psychoan-
peel to the innermost minutest leaf, that the peel self is our alytical Congress in The Hague, in 1920.
own self, that we are onions. But in the onion every leaf is its Groddeck's importance to psychoanalysis is manifold.
essential nature. The onion is genuine right through, and it Through his encounter with Freud he has become a part of the
would be bad, rotten, if it tried to grow a kernel different from history of psychoanalysis. What is particularly remarkable is
the rest, and to destroy the peel as though it were something that Freud continued to encourage and support this very in-
false, something apart from its onion nature. Peer under- genious and original thinker and therapist in spite of the per-
stands this at first only intellectually. His heart wants to sonal difficulties the correspondence testifies to. Clearly
despair, his heart is keen on being a whole man, a man with a Freud's genius was able to understand and tolerate the very dif-
kernel. 36 ferent genius of Groddeck.
It is important to keep in mind what Groddeck's real inten-
GRODDECK AND PRESENT-DAY PSYCHOANALYTIC tion was:
RESEARCH It is more advisable to initiate than to exhaust a theme. This,
Groddeck was seminal in many ways. There are, first, his ideas at least, is the way my talent works. 38
about the nature of organic illness and about health, about
therapy and the importance of resistance in this, and his ideas The writings collected in this anthology are chosen from the
about psychoanalysis as an important instrument in research. four volumes of Groddeck's writings published by Limes
Yet there are many other themes which Groddeck discussed Verlag: Psychoanalytische Schriften zur Literatur und Kunst (1964),
that are topical again, for instance the importance Groddeck Psychoanalytische Schriften zur Psychosomatik ( 1966), Der Mensch und
assigned to the good relationship between mother and child. In seinEs (1970), and Der Mensch als Symbol (1973 ).
this context it may be interesting that Groddeck insisted on Der Mensch und sein Es contains, apart from the corre-
26 27
THE MEANING OF ILLNESS INTRODUCTION
spondence between Groddeck and Freud, further letters by 3. Der Mensch und seinEs, pp. 421-2.
Groddeck, twenty articles from the 1920's, mostly published in 4. 'Das Es und die Psychoanalyse nebst allgemeinen Ausfiihrungen zum
damaligen wie heutigen Kongresswesen' (The It and Psychoanalysis with
Die Arche, a magazine for the patients in his clinic, and finally general remarks about congress mania then and now), Psychoanalytische
some biographical writings and essays. The volume Psychoanaly- Schriften zur Psychosomatik, pp. 161-2.
tische Schrzften zur Psychosomatik contains essays which had been 5. Psycho-Analysis and Faith: The Letters of Sigmund Freud and Oskar lfister.
published before, in psychoanalytical or psychotherapeutic Translated by Eric Mosbacher (London, The Hogarth Press). p. 80.
journals or in Die Arche. There are also a number of unpub- 6. Ibid, pp. 81-2.
lished works, whose titles were chosen by the editor of the 7. See Groddeck 's letter to Freud, December 4, 1921.
8. lntemationale Z,eitschriftjUr Psychoanalyse, 1926.
German edition. The volume Psychoanalytische Schriften zur Litera-
9. See pp. 172-196 below.
tur und Kunst contains writings from Groddeck 's pre-analytic 10. 'Lebenserinnerungen' (Memoirs), Der Mensch und seinEs, p. 271.
period, from his analytic period, and finally extracts from 11. 'Vom Unsinn der Psychogenese' (The Nonsense of Psychogenesis), Psy-
Groddeck 's last book, Der Mensch als Symbol, which was pub- choanalytische Schriften zur Psychosomatik, p. 164.
lished in full in 1973. 12. Psychoanalytische Schriften zur Literatur und Kunst, p. 28.
The editor thanks Vision Press for permission to reprint 13. Was Kann der Mensch im Leben mehr gewinnen,
Als dass sich Gottnatur ihm offenbare:
V.M.E. Collins' translation of'Clinical Communications' and Wie sie das Feste Uisst zu Geiste verrinnen,
'Massage and Psychotherapy' from The Unknown Self and Wie sie das Geistgezeugte fest bewahre.
Exploring the Unconscious respectively. Special thanks to the edi- Johann Wolfgang von Goethe.
tors of the German editions, in particular for being able to use 14. Der Mensch und seinEs, p. 120.
the footnotes and comments to the correspondence between 15. Psychoanalytische Schrijten zur Psychosomatik, pp. 154-9.
Groddeck and Freud. 16. Psychoanalytische Schriften zur Psychosomatik, p. 209.
17. Der Mensch als Symbol, pp. 5-6.
With the exception of the letters from Freud to Groddeck 18. 'Das Zwiegeschlecht des Menschen' (Human bisexuality), Psychoanaly-
dated 5.6.1917, 8.2.1920, 25.3.1923 and 21.12.1924 which were tische Schriften zur Psychosomatik, pp. 256-7.
published in English in Letters of Sigmund Freud, 1873-1939, 19. Der Mensch als Symbol, p. 6.
edited by Ernst L. Freud (London, The Hogarth Press, 1961; 20. Der MenschalsSymbol, p. 7.
New York, Basic Books) the correspondence between Grad- 21. 'Vision, the World of the Eye, and Seeing without the Eye', p. 175.
deck and Freud is published in English for the first time in this 22. 'Language', p. 252 below.
volume. 23. 'Psychic Conditioning and the Psychoanalytic Treatment of Organic
Disorders', p. 115 below.
A number of biographical details were taken from Carl M. 24. Horizon magazine (London), vol. XVII, No. 102, edited by Cyril Con-
Grossman The Wild Analyst (New York, George Braziller, 1965; nolly,June 1948.
London, Barrie and Rackliff). 25. 'Vision, the World of the Eye, and Seeing without the Eye', p. 174 below.
26. 'Psychic Conditioning and the Psychoanalytic Treatment of Organic
LORE SCHACHT Disorders', p. 128 below.
27. Der Mensch und seinEs, p. 267.
28. 'Das Es und die Psychoanalyse ... ', Psychoanalytische Schriften zur Psychoso-
matik, p. 218.
NOTES 29. 'Uber die psychische Behandlung der Nierensteinbildung' (Psychiatric
Treatment of Kidney Stone Formation), Psychoanalytische Schriften zur Psy-
chosomatik, p. 218.
1. Letter to Professor Hans Vaihinger, May 8, 1930, in Der Mensch und seinEs, 30. See Groddeck's letter 18.12.1924, Freud's letter 21.12.24, Groddeck's
pp. 125-6. letter 13.6.1925 and Freud's letter 18.6.1925.
2. 'Erinnerung an den Vater' (Memories of my father), Der Mensch und sein 31. 'Erziehung' (Education) Der lvfenschundseinEs, p. 154.
Es, pp. 400-02.
29
28

I
THE MEANING OF ILLNESS
32. Letter to Frau von Voigt, his later wife, 10.4.1916.
33. 'Der Ring' (The Ring), Psychoanalytische Schrijten ;:ur Literatur und Kunst
p. 135.
34. 'Verstopfung als Typus des Widerstands' (Constipation as a type of re- I
sistance), Psychoanalytische Schriften ;:ur Psychosomatik, p. 185.
35. Erziehung (Education), Der Mensch und seinEs, p. 252.
1
36. 'Peer Gynt', Psychoanalytische Schrijten;:ur Literaturund Kunst, pp. 182-8. Correspondence with Sigmund Freud
37. DerMenschundseinEs,p.101.
38. Psychoanalytische Schriften ;:ur Psychosomatik, p. 388.
Baden Baden) May 27) 1917
Dear Professor,
Please allow me to begin by expressing my warmest thanks
for all that I have learnt from studying your works. The need to
express this gratitude turns into a duty because I published a
book in 1912 2 in which I expressed a rash judgment on psy-
choanalysis; on closer inspection it can be seen that my know-
ledge of psychoanalysis was then based only on hearsay. It
would not be necessary to assert that this unforgivable mistake
was due to my own ignorance- that would not make it any the
less - were it not for one interesting event in the history of my
conversion.
In 1909, three years before the publication of that book, I
started treating a lady patient, and the observations I made
with her forced me to pursue the same ideas which I later learnt
to be those on which psychoanalysis is based. I can assure you
with all truthfulness that this patient had never even heard the
word psychoanalysis, and I believe I could claim almost the
same for myself. Through her I first learnt of the peculiarities of
infantile sexuality and of symbolic action and soon, in a few
weeks in fact, I was confronted with the concepts of trans-
'I ference and resistance - I have only recently learned the terms
transference and resistance - both of which became almost
automatically the main aspects of my treatment. The pleasure
of discovery kept me in a trance that lasted for several years.
Testing my findings against other case material and the events
of daily life proved an exciting experience.
The more I shed my initial reticence to communicate my
views to other people, the more often I was confronted with the
name Freud as that of the pioneer of similar ideas. As I had en-
tertained all my life, against much evidence to the contrary, the
wishful thought that I was a creative thinker, I resisted the
30 31

r
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
knowledge of having, in a mysterious way, acquired and tinction between body and mind is only verbal and not essen-
digested somebody else's ideas. My attack in 1912 was thus tial, that body and mind are one unit, that they contain an It, a
launched from a position of prophetic envy, so to speak. In 1913 force which lives us while we believe we are living. Naturally I
I saw your Psychopathology of Everyday Life3 in the window of a cannot claim this idea for myself, either, yet it was and is the
bookshop. I bought it together with The Interpretation of Dreams4 • basis of my activity. In other words, from the first I rejected a
The effect of these books was so disturbing that I did not finish separation of bodily and mental illnesses, tried to treat the indi-
them, though I was aware of the fact that I deprived myself of an vidual patient, the It in him, and attempted to find a way into
extraordinary enrichment of knowledge and life. the unexplored and inaccessible regions. I am aware of the fact
In the course of the following years, because of time- that I am at least close to the mystical approach, if not actually
consuming psychiatric treatments, my practical work piled up engaged in it. And yet simple facts force me to continue on this
to such an extent that I had to find a new way out of the dilem- way.
ma. I had the idea of giving talks to my patients in the sana- So far psychoanalysis, if I understand it rightly, uses the con-
torium in order not to waste time on telling every individual cept of neurosis. But I suspect that for you, too, this word repre-
patient about the general basis of my ideas. This really worked sents the whole of human life. It certainly does so for me. The It,
out well. Moreover, people were so impressed that I decided to which is mysteriously connected with sexuality, with eros or
write down and to publish the freely delivered lectures. This whatever you chose to call it, shapes man's nose and hand as
plan was made in October 1916. Suspecting dimly that some- well as his thoughts and emotions; it expresses itself as much in
thing was wrong with my apparent invention, I took up your pneumonia as in cancer or in a compulsion neurosis or in hyste-
books again and was led from them to a thorough study of all ria; and heart failure or cancer caused by It activity are as much
the psychoanalytic literature that had not been silenced by the the object of psychoanalytic treatment as are hysteria or neu-
war. One of the consequences of my belated honesty is this rosis. There are no basic differences that force us to attempt
letter, which is probably primarily an attempt at self- psychoanalysis here and not there. It is rather a practical ques-
justification. tion, a question of personal judgment that decides where psy-
Yet the wish to publish the results of many years of work in choanalysis treatment should stop. I use the expression
some form or other is still there. There is, however, one treatment because I do not believe that the doctor's function
difficulty which I have not yet solved. After reading your should extend beyond treatment; it is not he who brings about
papers on the history of psychoanalysis I began to doubt the cure, it is the It.
whether, according to your definition, I could count myself a And this is the point where I doubt whether I have the right
psychoanalyst. I do not want to call myself the member of a to call myself a psychoanalyst publicly. It is not possible, while
movement if I am in danger of being rejected by the leaders of advancing such ideas, to use a terminology that differs from the
the movement as an intruder who does not belong to it, and one you have developed. It cannot be replaced, and it suits my
this is why I want to ask you to give me a few more moments of purpose, too, if the concept of the unconscious is enlarged. In
your time and read this letter. the lnternationale Zeitschrift, however, you expressly restrict the
I arrived at my, or should I say your, views not by studying meaning of the unconscious. If one extends this meaning, as one
neuroses but by observing complaints which are commonly must when considering the psychoanalytic treatment of so-
called organic. I owe my reputation as a doctor originally to my called organic illnesses, one goes beyond the frontiers laid down
activities as a physiotherapist, more specifically as a masseur. by you for psychoanalysis. In this event I shall have to add a sec-
For this reason my circle of patients is probably different from ~
tion to my projected book dealing with the confusions in my re-
that of a psychoanalyst. Long before I met the above- lation to psychoanalysis, and this will most probably not be
mentioned patient in 1909 I had become convinced that the dis- understood. It would not be a question of expanding Adler's
32 33
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
theories but rather of proving that organic complaints have the account of a blasphemy. The patient had completely forgotten
same origin as functional disorders. that at the age of nine he had thrown stones at a wooden statue
I am afraid that I have not made myself completely clear of Christ placed at the exit of the village. How strong the effect
when I talk about my It as shaping the individual, causing it to of this forgotten event must have been can be gathered from the
think, act, and fall ill. The matter may become clearer if I men- fact that the patient fainted after communicating this bit of in-
tion a few examples. formation. There were, moreover, oedipal and castration com-
A woman patient wakes up in the morning with a badly swol- plexes which hardly need to be enlarged upon. Since then there
len upper lip; the swelling is due to Herpes rash. In answer to has been no bleeding for five years, except once very slightly on
my question when it started she gives the previous day as the the day before he was drafted into the army, at a crossroads,
date, and my visiting hour as the time. During that visit I jok- opposite a crucifix. It became apparent, moreover, that the
ingly told the patient, whom I have been treating for years for man had again completely forgotten his childhood experience
polyarthritis, that her lips were too thick and this meant that and that even my reminding him of it could not revive his
she had repressed a passionate desire to kiss. An hour after es- memory of it; it only came back a few days later.
tablishing this the swelling of the lip disappeared. This prompt In this connection I will. make some observations on a ble-
reaction can certainly be called hysterical, too. But then one pharitis which was linked with masturbation complexes. The
has to call all sorts of things hysterical, among others her poly- analytical treatment of a fairly sizable goiter was successful in
arthritis that led to a double-sided patella luxation. Her case so far as the left side of the goiter disappeared completely, the
history would be too detailed to tell in this context in full, but it right side by about three quarters.
shows that her It created her polyarthritis in order to prevent Finally I want to mention a patient whose It produced
her from running away. In the last few years I have followed syphilis symptoms, very characteristic rashes, ulcers on the
carefully the various deteriorations and improvements of her penis and neck, sore throat and a positive Wassermann test.
joint complaint and have been able to effect some changes in the Everything, including the Wassermann (the name was a
condition of her joints by stirring up and removing resistance contributory factor, by the way) disappeared in the course of
against myself. the psychiatric treatment. The case is doubly interesting be-
In the case of another lady, whose condition I have observed cause during the treatment the It produced temporarily, for
for years, I was able to bring out and remove a latent phlebitis hours or days, temperatures of 40 degrees C. when certain
by a similar kind of psychological experimentation. I have also names were mentioned or certain ideas revived. The patient
gathered experience in the field of obesity and slimming and of suffered from sclerodermia, too, for which I had treated him 20
child growth. Of interest, too, are changes in the size of the nose years ago. The revival of this process at a time when I was
which can be influenced psychologically. The reaction of the already aware of the It's activities made me think of treating
mucous membranes to the influence of psychological repres- the matter by analysis. The result was a cessation of the pro-
sion in the form of colds, bronchial catarrh, diarrhoea etc. is cess and a complete healing of the newly affected areas. The
well known; its psychoanalytic treatment produces astonishing analysis, moreover, uncovered the history of the origins and
results. development of his sclerodermia in a way that I found convinc-
I would like to quote a few more examples. One of my ing; it had started on the left leg and was connected with the
patients suffers from retinal bleeding. Strangely enough, this attempt to squash a younger sibling in his mother's womb.
always happens in autumn. It emerged that this highly intelli- The love for his own and other people's legs played a decisive
gent yet totally uneducated patient -he taught himself to read part in this. Later, under the influence of repressing sadistic
and write at 18- had every day in his childhood seen a blind and pregnancy fantasies, the arms and the skin of the belly
man of whom the villagers said that he had lost his sight on were affected too.
34 35

I.
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
I hope I may assume that you, dear Professor, will under- me show you that there is no need to extend the concept of the
stand from these hints that I intend in my book to put forward unconscious in order to make it cover your experience of
the idea that all human illness, like all human life, comes under organic illnesses. In my article on the unconscious which you
the influence of an unconscious and that in this influence sexu- mention there is an inconspicuous footnote: 'We are reserving
ality can always be traced, at the very least. I can well imagine for a different context the mention of another notable privilege
that you might disavow anyone who held such a theory as of the Ucs. ' 1 I shall tell you what was not mentioned here: the as-
somebody who does not fit into the psychoanalytic circle in sumption that the unconscious act exerts an intensive, decisive
your sense of the term were he to call himself a psychoanalyst. I influence on somatic processes such as conscious acts never do.
do not want to expose myself to this. I would be very grateful to My friend Ferenczi 8 who knows about this has a paper on
you, therefore, if you could let me know what you think of this. I pathoneurosis waiting to be printed in the lnternationale ,Zeit-
shall adjust my position accordingly and, in the book, give a schrift which is very close in its ideas to yours. The same point of
clear description of what excludes me from the official school of view even caused him to undertake a biological experiment for
psychoanalysis. me which is to demonstrate that a consistent application of
I would have to do this publicly, if you told me that I am Lamarck's 9 theories of evolution turns into a conclusion of psy-
going beyond the limits of psychoanalytic practice. Yet person- choanalytic thought. Your new observations are so much in
ally, even though I came to psychoanalysis by a way other than keeping with the arguments contained in this paper that we can
through your writings, I shall always have to consider myself only wish that at the time of our publication we will be able to
your disciple whose respect and gratitude I beg you not to refer to your ideas as already published.
reject. Thus, while I would like to hold out both my hands to you to
Yours truly DR. GEoRG GRODDECK receive you as a colleague, there is only one disturbing circum-
stance, the fact that you have not managed to overcome the tri-
vial ambition of claiming originality and priority. If you are so
sure of the autonomy of your acquisitions why do you still need
Vienna, 5.6.1917 originality? Anyway, can you be sure in this respect? You must
Dear Colleague, be 10 or 15 or perhaps 20 years younger than I am (1856).
I have not had a letter for a long time which so pleased, inter- Could you have absorbed the main ideas of psychoanalysis in a
ested, and stimulated me as to make me drop the politeness due cryptomnestic way? In a way similar to my discoveries relating
to a stranger and adopt analytical frankness in my answer to it. to my own originality? What's the use of struggling for
I shall therefore make the experiment: I understand that you priorities against an older generation?
are requesting me urgently to supply you with an official confir- I regret this point of your information particularly since ex-
mation that you are not a psychoanalyst, that you do not belong perience has shown that an untamed ambitious individual
to the members of the group, and will be able to call yourself sooner or later jumps up and turns into an eccentric to the detri-
something special, and independent. Obviously I am doing you ment of science and of his own career.
a service if I push you away from me to the place where Adler\ I liked the examples you gave me from your observations very
Jung 6 and others stand. Yet I cannot do this; I have to claim much and hope that much of it will survive the test of strict in-
you, I have to assert that you are a splendid analyst who has vestigation. The whole field is not at all strange to us, yet
understood for ever the essential aspects of the matter. The dis- examples like that of your blind man have never before been
covery that transference and resistance are the most important given. And now the second objection! Why do you jump from
aspects of treatment turns a person irretrievably into a member your beautiful basis into mysticism, cancel the distinction be-
of the wild army. No matter if he calls the unconscious 'It'. Let tween mental and somatic, commit yourself to philosophical
36 37
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
theories which are not called for? Your experience does not take and plant life is as irrelevant to my purposes as inorganic life),
you any further than the realisation that the psychological fac- that ultimately everything is created by the unconscious. Con-
tor is of an unimaginably great importance also in the origin of sciousness is merely a tool of the unconscious, serving essen-
organic diseases? Yet does it cause these illnesses by itself, does tially similar purposes of communication as language or
this invalidate the distinction between mental and somatic in gesture. It often seems to me also as if the unconscious wants us
any way? It seems to me as wilful completely to spiritualise to preserve our feeling of omnipotence by way of consciousness,
nature as radically to despiritualise it. Let's leave it its extra- and is playing a very gay yet also very cruel game with us, i.e.
ordinary variety which reaches from the inanimate to the with itself. It will never be possible to uncover the connection,
organic and living, from the physical life to the spiritual. Cer- but occasionally the observer succeeds in seeing something that
tainly, the unconscious is the proper mediator between the looks like the face or the hand of the unconscious. The connec-
somatic and the mental, perhaps the long-sought 'missing link'. tions between choice of profession and the unconscious have
Yet because we have seenthis at last, should we no longer see been pointed out. Yet somebody's way of walking, posture,
anything else? movements, and the shape of a hand often enough betray our
I am afraid you are also a philospher and of the monistic conditioning by unconscious forces. Pavlov's experiments 10
inclination which discards all the beautiful differences in produced some dark hints as far as digestion is concerned; we
nature in favour of the temptation offered by unity. Can we get have known about it for quite some time with regard to breath-
rid of differences like that? ing, heart beat, pulse, and the digestive juices, and the Abder-
I would, of course, be very pleased if you answered me. In any halden experiments 11 show us the direction in which medical
case I am very interested to know how you will take my letter chemistry somehow gets involved with the unconscious. I am
which may sound much more unkind than was the intention on surprised that the question of the conditioning of consciousness
which it is based. is avoided again and again, and that this avoidance is called
Yours truly FREUD exact science while it is really exact stupidity. Surely there is
nothing to be lost by asking whether thinking takes place out-
side the context of everything else, whether we think, act and
are formed out of our own, somehow extra-wordly omnipo-
tence, or whether we belong to the circle of natural phenomena
June(?) 1917 and are lived by the will of forces which we can see quite well in
reflection. Psychoanalysis is not afraid of going back to prenatal
I would like to add a few words about the unconscious (the times and it is right to do so. Yet why does it always and persist-
It). If I understand the matter correctly, researches in the psy- ently cling on to the organ of the brain, and why does it not
choanalytic field have so far led people to derive from the un- want to see that ceteris paribus semen and ovum always produce
conscious important aspects of human life in religion, hands, eyes, brains? Surely there is no question of con-
language, art, technology, daily life, in physiology, and patho- sciousness and conscious intention here. And if the unconscious
logy. Yet there is still, at least apparently, a contrast between manages this, then perhaps it will also be able to bring on a corn
the unconscious and consciousness, as if there were two forces or guide a gesture of the hand or change the human chemistry
at work. Even in psychoanalytic circles many phenomena of life in such a way that it becomes vulnerable to germs. Just now, an
are apparently still claimed as pure products of consciousness, airship is passing over my house; does it merely look as if it w.ere
as if the unconscious had nothing to do with them. I am of the a giant membrum, is this only a symbolic association of thought,
opinion that consciousness is merely a form of expression used or was the unconscious perhaps at work and created something
by the It; that everything which happens in human life (animal in its own image which consciousness claims for its own, in self-
38 39
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
mockery? 'Like a beautiful silver bird', a woman's voice calls the waves of what we do not see from affecting the retina and
out. Isn't this a joke? thus affecting us 'reflectorially'. Reflectorially, is anyone not
I do not consider myself a monist; when I am honest with laughing? You must have found as often as I have that the
myself I notice that I take pleasure in the colourful interaction object we see, but do not perceive, is an obstacle to the well-
of all forces without always realising. Yet when I perceive that being of our subconscious.
the word science too is nothing but a game, I do not let myself My letter has grown immensely long. Yet I must first thank
be persuaded that it is all seriousness. And when I have grasped you once more for yours. It told me what I hoped it would. And
the fact that ovum and sperm make up the whole of human life thank you even more for everything else, for what you are and
including its sciences then I am no longer prepared to be what you are doing.
pushed back into the well-defined boundaries of a stupidity Yours most sincerely GRODDECK
which cannot see that life exists before the brain. Occasionally I
am tempted to take somebody by the ear and show him an
embryo. I also imagine that it is as important and as intoxicat-
ing to go in search of the unconscious as it is to count and Esorbato, 29.7.1917
recount the fibres of a muscle or to copy out of old books that Dear Colleague,
there are tubercle bacilli. That the frontiers of science and Your letter reached me and interested me very much. I sent it
mysticism get blurred for me in the process, as do the frontiers on to Ferenczi and had to wait rather a long time for its return,
of body and mind (which, for the Greeks, in their heyday, did which is the reason for my answering it late.
not exist, by the way), I do not consider a disaster, certainly not I believe that you· should consider yourself somebody who is
for me, because it interests me, and not for my patients, for I close to us inspite of the fact that your position on the question
help them as far as I am able to, like other doctors, and as for of the distribution between the somatic and the mental is not
what happens in the world at large I do not consider myself im- quite ours, and you should help us in our work. Our journals
portant enough. I shall probably not go off on a wild goose are open to you. We would be pleased to have contributions
chase, because I am too much bound up with practical things; from you, perhaps some preludes to your more substantial
everything with me ultimately gets channelled into the treat- works.
ment of patients. And with regard to this I work on the hypo- In expectation of these and with best wishes for the contin-
thesis that the It makes people ill, because it is pursuing some uation of your work
purpose which it finds useful. When a person has bad breath, Yours sincerely F R Eu n
his unconscious does not want to be kissed, and when he
coughs, it wants something not to happen, and when he
vomits, it wants to get rid of something harmful, and when
there is a corn, I invariably find a painful spot underneath the Baden Baden, 3.10.1917
corn which the unconscious wants to protect by horny skin. Sanatorium Groddeck
And when somebody gets gout in the legs it can be proved that Dear Professor,
he has a reason for walking carefully in order not to stumble My answer to your kind letter was delayed because I wanted
over something; and when somebody loses his sight then he to send you at the same time a pamphlet 12 which only reached
has merely taken a little too far a habit of the It, which is not to me today. Essentially this is a repetition of what I have already
notice most things. For it is not true that we always see merely told you in my letters. Yet it may interest you a little to see these
a fraction of what we could see; the It does not allow us to see, fruits of your suggestions.
to see consciously what is in front of us. Yet it does not prevent I thank you for the invitation to contribute to your journals
40 41
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD

occasionally. I shall certainly make use of this. Today merely 'isn't it?', 'I believe' (German: ich meine, ich (I) and mein (my)) is
some remarks to while away the time. First on the subject of also popular.
male pregnancy. Recently I treated a gentleman who suffered If you could make use of a collection of small human traits
from gout. One morning he complained of a new attack. It had like these I would have a try.
started right at the beginning of a walk. He could not remember Yours truly GRODDECK
whether he went straight to the street or through the park first. P.S. In case you think that Ferenczi or any of the other gentle-
Associations: Park- Parkin, the name of a hair growth product men would be interested in the pamphlet I would gladly send
which his brother used; as a student he himself used a brown one to them. I do not know their addresses, however.
hair growth oil, his landlady was angry because the bedding
had brown stains. Question, whether he ever dirtied his bed.
He laughs and tells me: after his wife had given birth a second Vienna, Octover 7, 1917
time, which lasted a whole night, he had dreamed the following Dear Colleague,
night that he had to push something out of his body, he had Many thanks for sending me your paper 15 which I found in-
pushed and pushed and when he woke up the child was lying teresting and important in spite of the reservations you know. I
between his legs, in the form of a stool. The gout attack passed shall find room for your paper in the Internationale ,Zeitschrift.
quickly when the association bald head-empty purse (kahler Yours most sincerely FREuD
Kopf-kahler Beutel) had been found and analysed.
In the latest issue of lmago 13 there is a paper by Levy 14 on the
story of paradise. The interpretation of apple as breast is prob-
ably right; as important, perhaps more important, is the apple Vienna, October 7, 1917
Dear Colleague,
as symbol of the behind (Italian mele). In German apple is quite
commonly used with this meaning. Even more striking is the I gratefully accept your offer to send me more copies of your
peach (peach cheeks) particularly for the eye. The snake is paper. My copy went to Ferenczi (Budapest Hotel Royal) who
closely related to the tree (Baumstamm = tree trunk, Stammbaum is going to report on it. I would like to have a second copy for
myself, and a third one should circulate in the group in order to
=pedigree). The iconographical representations of the Fall of
get people interested in your work.
Man offer a rich field. Herr Levy misses the most interesting bit
The contributions which you promised will be accepted
of the curse, the interpretation of 'it shall bruise thy head, and
readily and printed as soon as the present difficulties are over. It
thou shalt bruise his heel' (limpness post coitum and stork's tale).
would seem to me particularly to the point to have a short mani-
Ferenczi talks about hoarseness in the Psychoanalytische ,Zeit-
festo (in line with your latest work) which presented to the rea-
schrift. I have a lot of material on this subject and want to draw
dership of the journal what is new and surprising about your
attention to the fact that people get hoarse- for ever, too- when
they have got something that can only be told in whispers, a experience, and which would introduce you yourself most effec-
mysterious complex which, on one unconscious level, they want tively. You know that my interest in your lists of observations is
to communicate, while on another they struggle against it. great, and I am only uncertain about the appropriate length.
Stopping in the middle of a sentence belongs to the same syn- With sincere regards Yours FREuD
drome- or stopping in the middle of a word while writing. Very
interesting are the voice changes from soft to loud during con-
versation. In childhood complexes the voice usually goes up for Vienna, October 28, 1917
individual words only. Dear Colleague,
To qualify information by means of interjections such as I acknowledge receipt of the offprints of your paper which I
42 43
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
shall circulate in the group. Ferenczi has already sent in his mankind in the most astonishing way. Nora 20 in particular is a
report on it. good example of that. This apparent suffragette lies to a degree
Your interesting remark 16 on the analysis of Rosmersholm 17 which normally one only comes across in lecture rooms, and
has prompted me to reread the play and discuss it with my only she sermonises her husband, whom she knows to be drunk, in
assistant at the moment, Dr. Sachs 18 • We agree that we cannot private in a way which would only be justified if the circum-
give in to you. Everything seems to speak against the notion stances were quite different. It is a malicious mocking of the
that Rebecca West's confession is fictitious. Sachs believes that public which, as we know, thoroughly fell for it too.
this would cut off the play's vital nerve. I believe that the honest Similarly in The Masterbu,:tderJ 2I The Wild Duck) 22 and, above
excitement of the pas's age where she explains how one is pushed all, Rosmersholm. The play's vital nerve is in my view not altered
further and further against one's will in such a way speaks by my interpretation, the entire play merely appears in a new
against your assumption. To get Rosmer over the bridge is a light and the pathos is changed into dramatic irony. As soon as
symbol of an aim and not in itself an aim for which one might he notices the disproportion in Ibsen between means and re-
give one's life. It is merely meant to imply that he brushes aside sults one realises, I believe, that he does not write bourgeois
his wife's suicide. His impotence can certainly be established, plays but comedies. He probably knew this and was thoroughly
yet Ibsen did not bring it up again, did not make it the centre of familiar with the silent laughter of the ironist. It is an ironical
his play. tragedy that a splendid woman like Rebecca should perish be-
Today I saw a lady of 44 who wanted psychiatric treatment, cause of the milieu ofRosmersholm and a 'noble human being'.
yet I had to diagnose multiple sclerosis (neuritis in the past, With warmest wishes,
bladder trouble ... ). I have sent her away, yet I am now asking Your ever loyal disciple G RonnE c K
you whether you could take on a case like this in which there is
strong evidence of a psychological influence.
With kind regards F R E u n
Baden Baden) 19.10.1919
Dear Professor,
By the same post I am sending you a manuscript 23 which I
Baden Baden) November 1917 called a psychoanalytical novel in a fit of whimsy. The book
Dear Professor, made its obligatory round of the publishers and was in turn sent
Many thanks for your kindness. I am willing to have a try back to me with polite rejections and thanks. I have now given
with the lady patient you mention. The costs are, all inclusive up hope of finding somebody who might publish it, yet I would
except for heating 25-35 Marks a day according to the size of like you to have a look at it before it disappears for good. Maybe
the room. This includes treatment. Ferenczi, too, might be interested, and have a glance at it. I
So you haven't changed your views about Rebecca West.l 9 would be happy to reward him for his kind criticism of my pam-
Now I am merely curious to know how you explain why phlet24 with a few hours' happy reading.
Rebecca listens to the conversation between Rosmer and Kroll, In my provincial isolation I do not hear anything about the
and why she tells Kroll that he knows who wrote the anony- happenings in the outside world. My rumour-mongering book-
mous letters. Ibsen was too careful in his works to let us assume seller maintains that Imago and the Psychoanalytische ,Zeitschrift
that he had introduced both just for fun. I have found that with have died. Is that true? I had got so used to this pleasure, yet for
Ibsen's writings one always comes up against new problems, months now I have been unable to get a copy.
both aesthetic and psychoanalytic, with every new reading. In With all best wishes I remain
recent years I have gained the impression that he makes fun of Yours gratefully G RonnE c K
44 45

~
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
Baden Baden, 31.1.1920 planned. I admired your talent for graphic description, which is
Dear Professor, unusual, particularly in the railway scenes.
May I ask you to return the manuscript of my novel? I have Now I do believe with you that the book will not be to
entered into negotiations with a publisher again, probably everybody's taste. So many clever, frank, and playful ideas are
without result, yet I want to have another try. The book seems not easy to digest. And yet you should try and have it published.
to produce displeasure everywhere, at least I interpret your Worse products have been published in the name of analysis.
silence as a sign of dislike. Contributions of yours to Imago will always be welcome. At
While preparing my talks 25 for publication I came across the moment, we have not got any paper but we are trying to get
some which deal with the subject of Moses, Book J2 6 , others on some.
Struwwelpeter21 and on a few Klinger pictures 28 • If you could use Yours sincerely FREuD
these for Imago I could send them to you. But perhaps you have
material enough on hand.
With all best wishes I remain
Yours most sincerely G RoD DEcK Baden Baden, 2.3.1920
Dear Professor,
Your letter made me very happy. The novel is now on its way
to the publishers, I hope it will be printed. I am making use
straightaway of your invitation to contribute to your journals.
Vienna, 7.2.1920 Neither the Bible nor Struwwelpeter materialised, however, but
My dear Colleague, the sulphurous smoke!w may find its admirers, too. Will you
Your paper arrived, it is as inventive and original as every- please decide for yourself whether it is to be Imago or the jour-
thing you write. If you would like me to I could confirm every- nal. I have the impression that the article, earthy as it is, hovers
thing essential in it from my own experience. We shall put it between the sublimity of Imago and the earthiness of the jour-
into the journal. I hope it is merely the precursor of other nal.
contributions. With sincere gratitude and loyalty
As for your novel, may I make the suggestion that the choice Yours ever G RoD DEcK
of a less whimsical 29 title might help its publication?
Yours sincerely FREuD

Baden Baden, 7.4.1920


Dear Professor,
Under the influence of the news that the hell article 31 is to
Vienna, 8.2.1920 appear in the journal, I have written something new. If it is of no
Dear Colleague, jJ-'j,

use I beg you to excuse my eagerness.


I shall have your novel returned in the next few days by our As for the novel, I have to report that it has been rejected once
publishing house. But you are wrong: I liked it. In parts I was again. Rejections are not accompanied by detailed reasons,
most amused. The characters of old English humourists are they start with high praise of the first part and end with the ver-
well-drawn. In one respect it seems to us to resemble that model dict that the analytical part breaks up the artistic form and
of all humorous novels, Don Quixote. The hero turns in the therefore destroys the whole. The latest publisher even main-
author's hands into something more serious than was originally tained that I am losing myself in crass materialism. I shall con-
46 47
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
tinue to shop around. The fact that you mentioned the work in please you, but they certainly clear up to some extent what was
your last letter gave me back my courage. The question of a title incomprehensible before. And a few more words will show you
is always difficult. I will cast around for something else. But I what strange things happen sometimes. The analysis really
am not very hopeful. Everybody who reads it is somehow happened as I wrote it down, yet it could only turn out the way
brought up against his own repressions and then resistance it did because the patient is my stepson who has been living in
starts. my house ever since he was in his eighth year. He is gifted with a
I am writing an article on symbolism32 which is meant for highly imitative, lyrical talent which might perhaps turn crea-
Imago; but it is becoming long and will only appeal to a few tive one day. During the war he broke down with a grave neu-
people. rosis and has been in treatment with me for the last two years
With warmest wishes with many interruptions. That he expresses himself like the
Yours everGRODDECK hero of my novel is because he is jealous and embodies Thomas
Weltldn34 in nature for me. The imitation of my person which
has obviously contributed a lot to Thomas Weltlein plays a
large part in the symptoms of his neurosis and probably in their
Vienna~ 22.4.20 causes too. Treating him has its attractions and its difficulties
Dear Doctor, because of the close ties. Perhaps one day I shall have time to
Every contribution of yours is welcome. You have to get used write down his case history: it is characterised by neurotic com-
to the fact that the editors of the Psychoanalytische ,Zeitschrift here plexes, which produced a series of boils on the face and back,
value your importance. If we had money and paper our pub- and is a typical example of the condition which originally made
lishing house would put an end to your novel's perambulations. me learn to analyse patients suffering from so-called somatic ill-
I have one reservation about the most recent analysis you nesses.
sent us 33 which I would like you to help me destroy. I believe I I tried to work out why I did not immediately claim my copy-
can recognise the half-ironical patient of your analysis; there right in the essential points, but invested my stepson with traits
cannot easily be two such people. He is also too well-versed in for which I am responsible and not he, even though he formally
your way of printing and expression as well as with your article produced them under analysis. The revision shows you that
on hell. Now so far we have tried not to allow people to doubt this is due to the Christ myth. Something inside me warned me,
the documentary character of an analysis. It would open the but just as you sensed the distortion from the form of the article,
door to many abuses. Moreover, the semi-fantastic character of so did some friends to whom I showed it. And I myself had an
your analysis (the justification of which I personally recognise) uncomfortable feeling about it. This has now gone since I have
might embarrass us vis-a-vis the public. Tell me what you think honoured the truth. I am very grateful to you for having taken
of this and whether you could preserve the core of this 'analytic this burden from me.
delirium' in a thoroughly serious critical form for publication? I would like to say something special about the article. The
With warmest regards essential thing about it- for me at least- is its interpretation of
Yours FREUD the crucifixion. It struck me quite early on - probably in con-
nection with an etching by Felicien Rops 35 - and for years I
have been carrying it around with me, as well as lots of other
ideas about the New Testament. I have decided to work it into
Baden Baden~ 27.4.1920 the second part of Thomas Weltlein, which will probably
Dear Professor, remain unwritten, and to take it over into the revision of my
I do not know whether the changes in the article on the cross talks. Meanwhile I was made impatient by the fact that, one
48 49
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
after the other, my imagined discoveries were published by you your agreement after the event to my actions.
and your colleagues, and this prompted me to write the matter I have already handed on your valuable contribution to the
down in this form. I am firmly convinced that in the next two editors of the journal.
years somebody will treat the Christ theme, and often I still find By the way, isn't there an expression 'the son clings to the
myself a prey to the priority madness. mother' or, as we would say, 'he is fixated on her'?
Now it is merely a practical question for you and me whether The offer you made me for the publishing house is tempting,
the interpretation should be published in one of your journals of course. If we get paper we could consider the matter. But do
or whether it is better to wait. You can tell how this matter you know how high the costs are these days? One sheet one
preoccupies me from the fact that I first put it into the mouth of Mark, i.e. about 20 sheets for 1,000 copies 20,000 Mark. Give
my stepson and that I am also hiding behind your back and me the good news that figures like these do not matter to you!
burdening your journal with it. I believe this is obvious enough. Then I would make the suggestion that for the title you should
Please, do not publish the article. simply use the name of the hero and underneath put: a psy-
So now I have said it. It was not easy. Yet I am always satis- choanalytic novel.
fied once I decide to admit an unworthy action and to make up You ask if we would profit from having you for instance in our
for it. I am glad that you are understanding. Berlin group. I would think so; one could then meet during our
Now I would like to say a lot of nice things to you, for instance conferences (the next one is going to be held in The Hague, on
that I am once again reading your books and enjoying them. September 8).
And then that I am pleased to know somebody in Vienna who is My warmest regards. You are right, there is very little good
interested in me, without knowing me, who tells me things will in the world.
while otherwise everything in the far distance is silent and I can Yours FREUD
only hear voices which are very near.
Would you be pleased if I joined one of the psychoanalytic
societies? I won't quite fit, I know that already; yet I can say
that I am easy to get on with.
Finally a word on my novel. I receive one rejection after the Baden Baden, 21 May, 1920
other. Would it be possible to publish it in the psychoanalytic Dear Professor,
publishing house if I myself bear the costs? But what about I gladly offer you my forgiveness after the event, am very
paper- if I am immodest, please forgive me. You have to take grateful for the publication of my piece and only regret that
part of the blame for that because you are friendly to me and your idea about 'the son clings on to the mother', and 'fixated'
that is something new for me- at least on the part of doctors. and crucifixus did not get into the article. If it is not immodest I
With warmest regards would like to ask you to add it in a footnote.
Yours GRoDDECK I have applied to be admitted to the Berlin group. It would be
good to meet you sometime, and The Hague is not totally out of
my reach. For years I have considered asking you to be my very
welcome guest here for a few weeks. Yet one has to wrestle with
a wish like this before one can express it. Surely, one is allowed
Vienna, 9.5.1920 to harbour wishes.
Dear Colleague, Thomas Weltlein, a psychoanalytic novel- that's simple and
What a strange mixture of guesses and mistakes! But now good. Many thanks. That you might accept the novel for publi-
that you have made the matter all clear and tidy I want to ask cation is such a welcome piece of news that I cannot rejoice
50 51
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
enough. The question of money can be solved, though not from
my own means; yet I have friends- particularly in Holland-
who will help me and therefore as soon as there is a prospect of Baden Baden, October 17, 1920
paper, I can deposit the 20,000 Mark where and how you wish. Dear Professor,
From my own circle of acquaintances I can reckon on a few Instead of the article on symbols which I promised you a long
hundred copies sold, so that even under the worst conditions time ago I am sending you something which arose out of the
the loss will not be too great for the backer. Would you like to congress 37 • For me this attempt at sorting out the terminology is
have a try? necessary because otherwise I shall be constantly misunder-
I have changed a few small details, but I believe that you will stood. After this test I hope to be considered worthy of the
be pleased with the changes. diploma of psychoanalysis and shall return, my conscience
My work on symbols is resting at the moment. If it succeeds it cleared, to my own gibberish which I find easier to handle and
will interest you, but the question is, will it succeed? which leaves me the freedom to think what I must think. The
Warmest regards congress had a rather unpleasant consequence for me. The old
gratefully yours ever G RonDE c K experience that words put chains on thought was confirmed to
such an extent that my fear of technical terms and strict defini-
tions has become even greater than before.
The article can perhaps be used in the Zeitschrift. Did Rank 38
The Hague, 11.9.1920 tell you the title he has found for the novel? Der Seelensucher [the
Dear Professor, seeker of souls] . I like it, but I do not want to change anything
Your question of whether I was serious in the contributions 36 without your approval. By way of explanation I must add that I
I made to the congress has preoccupied me. I shall try and make introduced a story about a silhouette into the first chapter
myself clear to you. where Thomas Weltlein is called a seeker of souls which domin-
When so-called healthy people are asked to look at the ates the novel; the whole of the silhouette is printed on the title
objects in their sitting-room and then to close their eyes and page. To make the acquaintance of Rank was especially plea-
name the objects they generally leave some things out. sant for me. The few words he said during the congress
When one analyses why these specific things are not con- expressed clearly and resolutely what he was thinking, and that
sciously perceived, it turns out that they are parts of repressed is a gift I find interesting.
complexes. So there is a censor while we are awake. Otherwise I followed you round during the congress in a
If in the case of highly visual people the repressed complexes semi-trance; like somebody who is in love. And thinking back
become too intense, censorship is strengthened and the eye is on this now I am glad that I am still young enough to have
rendered short-sighted. If this is still not enough, the uncon- strong feelings, when it is worth while. My wish now is to be to-
scious destroys the retina with bleeding. gether with you once in peace. But the prospects are not favour-
The process is the same in a different field, like the formation able. I am stuck here and have to earn money and you are
of anti-toxins to overcome toxins, or like fever and pus forma- J, probably in a similar position.
tion to overcome infection. Give my regards to Fraulein Anna 39 and whoever else is in-
When the repressions are resolved, censorship can be terested in having them, and warmest regards to you
reduced and retinal bleeding is stopped. Ceteris paribus: when from your loyal disciple G RonnE c K
are you corning to Baden Baden?
Yours ever G RonnE c K

52 53
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
Vienna, November 75, 7920 sentences of my article 41 are not usable, if read senza emozione. I
Dear Doctor, beg you to cut the whole paragraph and finish the article with
I am glad that we have managed to tear such a beautiful and the words: 'emerges, that the psychoanalysis of the organic has
honest article 40 from you. It has already disappeared into the the same theoretical laws and practical results as the psychoan-
editorial file and will leave it (hopefully) to be put into the alysis of neurosis'.
second number of the new volume. Of course I know everything The matter is thus deferred, yet it is not over and done with
about your novel and approve of Rank's title. This moment a since without ado and quite cheerfully I can forego the accuracy
pretty cover illustration is being devised. here where it would be quite misplaced, whereas I shall have to
I cannot quite understand why you should feel a martyr be- find an outlet for my mysticism, without which I cannot exist,
cause you had to accept our terminology. A residue of your first somewhere else. This brings me to a matter I have mentioned
letter to me, a little bit of chalky dust from the gate through several times before. For some years now I have been hatching
•\\
which you came into our little town! I said jokingly that you 1;,
out a book which will set out calmly and lucidly what I am

turned dogmatic and fantastic at the end of your fine, original, \I thinking. I plan to shut myself away for some months in winter
and freely sceptical article and invested our unconscious, which and get down to this work, but I am afraid you won't be very
until then had been mutually understood though, thank God, pleased with it because there will be a lot of mysticism and fan-
provisional and indeterminate, with the most positive qualities tasy in it. It will be good for my relationship with you, if nothing
from secret sources of knowledge. Now every clever person
comes to a point where he starts to turn mystical, where his
,f else, to have brought this sea monster to light. I feel like a child
whom people believe to have been good while it is really plan-
most personal thinking begins. But couldn't you perhaps
change a few things in these last sentences, make a sacrificio
lf ning to do all sorts of things it knows will not be approved of by
its parents, and this is why I want you to get to know the work.
d 'emozione? It will be acknowledged with thanks. It will decide whether you can continue to allow me among
Your words about the attractive prospect of a fuller exchange your ranks.
of ideas between the two of us have found a strong echo in me. I am well aware that behind this fear of losing your approval
Yet your resigned postscript is correct too. I am in the position there is the wish to be free again. Yet this wish will not have any
of the Sybil of Cumae who wants more money for the last third influence on my work, particularly now that your letter has
of her wisdom than for the whole. I, too, am so impoverished
that I have to sell the remainder of my working time and
/ drawn my attention to the danger of emozione. The wish to be
great is still there in me and sticks its head out where it
strength dearly; fortunately it is no longer a (full) third. The shouldn't. Then I find it difficult to be silent, merely because
analogy also does not hold in that I do not meet any of the now one doesn't quite know whether what one says is right. Too
so rare kings. Thus I gather money from colleagues and trades- often I have had the experience that things which only one
men. person can say have remained unsaid because of excessive
With warm regards caution. And at 50 one can still utter a cheeky opinion that
Yours FREUD would appear impossible at 60, and as an unknown person one
P.S. My daughter is still in Berlin and will be pleased about does not carry the fetters of a past and of having been an
your kind mention of her. authority.

Perhaps I am mistaken and the book is not as dangerous as


Baden Baden, 20.7 7. 7920 all that. In any case I beg you not to come to a final verdict
Dear Professor, about me yet as far as my medical activities are concerned. And
Again I see from your letter how kind you are to me. The last as far as the human being Groddeck is concerned you won't get
54 55
'

'

'I
THE MEANING OF ILLNESS
'

--_,_
CORRESPONDENCE WITH SIGMUND FREUD
rid of him so quickly, because he won't let go. I have got a very l:,i'f holes. The whole thing deserves the name 'product oflaziness '.
tight hold of you and it would cost me a piece of my fur if I were Meanwhile the proof copy of The Seeker of Souls has arrived.
shaken off. t;,
Cover and title page are marvellous and the whole lay-out is

.\
I hope my protestations oflove are not too monotonous. But I dignified. I am very glad to see the fool run around in such good
am really assured since I saw your understanding smile that clothes. Now we have to wait and see what the world has got to
~
personifies so accurately the saying: 'do not judge!' t'".

say about it. I have not yet received your new work and shall
With warmest regards and wishes thus be able to look forward to it a little longer. I wish I could
Yours ever G RonnE c K somehow give you back part of the joie de vivre I have received
from you. Yet I can only do what good boys do for their fathers,
namely resolve to work well and prove worthy of them.
Vienna, November 28, 1920 On Monday I shall go on holiday, for the first time in 6 years,
Dear Dottor, to the Black Forest, a little house away from people, ac-
Thank you very much for the sacrifice at the end of your ar- companied by my assistant only, without servant and without
ticle for the -?_eitschrift. running the risk of seeing anybody. She will cook and I shall
I understand well that you want to make up for it (the econ- chop wood and sweep rooms; we shall roam about the forests,
omic approach!) and am looking forward very much to the feed birds and deer and sleep a lot. And if the heavens are mer-
book you announced. Yet I do not at all share your threatened ciful I shall start the book on the unconscious. Something popu-
fears, rather I believe that we shall ask you to give us this hereti- lar. A few years ago I had the urge to write it, now I have to force
cal work too, if things continue to be all right for our publishing myself.
house. I am myself a heretic who has not yet become a fanatic. I shall not be able to collaborate on the children's book I was
I cannot stand fanatics, people who are capable of taking asked to by the publisher.
their narrowmindedness seriously. By holding on to one's Outside the boys are setting off bangs and rockets and yet the
ll '
superiority and by knowing what one is doing one can do a lot of night is as warm as if it were April. Every now and then the
things which are against the tide. The courage you intend to wind shakes the trees in front of my window and life is really
show I like very much, too. Perhaps the latest little work of mine very nice.
that has just appeared, Beyond the Pleasure Principle42 , will change With warmest greetings as ever
my image in your eyes a little. in gratitude and devotion G RonnE c K
I, too, do not intend to give you up easily.
Warm regards
Yours FREUD
Vienna, 9.1.1921
Dear Doctor,
Manuscript arrived 4 \ no scolding, clever and cheeky as ever.
Baden Baden, December 31, 1920 The 'fool' 45 looks good in his clothes. He will give pleasure to
Dear Professor, many people and anger many others. Ferenczi has asked to
With my compliments for the New Year I am sending you a greet him 46 • Very envious of your forest journey, yet is there no
somewhat mis-shapen article 43 for Imago. If nothing else, it is other time of the year?
characteristic of my condition. In the first half everything is Warmest regards F REu n
dense and well-structured, then it becomes threadbare and
finally there are only a few connected strips enclosing enormous
56 57

l.
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
We shall talk about it further when the little book (yours) is
Vienna) 17.4.1921 ready. I, too, would much rather talk than write. Yet how could
Dear Doctor,
we manage that? Could you get away for a few days in summer,
It is Sunday and I am treating the day as a holiday by an- to Gastein or wherever else I may be later?
swering your letter.
You also said that I was getting away from eroticism. My
The five letters 47 are charming, I have firmly decided not to next little paper will perhaps show you that in doing so I still
let you go to another publisher. You are irresistible. Particu- take Eros along with me on my journey (Group Psychology and the
larly when you talk about yourself. I must tell you that my Analysis of the Ego 48 ).
daughter, who is so far the only reader apart from myself and With warm regards and in expectation
who came back from The Hague somehow adversely influ- Yours ever FREUD
enced, has had the same impression.
Now I am very interested to see the sequel. Will you be able
to melt the difficult material into a liquid flow again, and will
you succeed, with all your capriccios, in making the piece of Baden Baden) May 22) 1921
ground that you jump off from appear as distinctly? Your style Dear Professor,
is enchanting, your speech like music. May I start with a request? Do come here for a few weeks.
To talk about something more serious: I understand very Whenever it suits you. I know it is often tiresome to be some-
well why the unconscious is not enough to make you consider body's guest. But one can really be at ease in Marienhohe.
the It dispensable. I feel the same. Yet I have a special talent for Nobody is disturbed or allows himself to be disturbed. Like
being satisfied with the fragmentary. For the unconscious is everybody else you will get your meals sent to your room and
merely something phenomenal, a sign in place of a better ac- when you need company at meals or otherwise you can tell me
quaintanceship, as if I said: the gentleman in the havelock and I shall eat with you. For years now I have spent the whole
whose face I cannot see distinctly. What do I do if he appears day there; my own house is nothing but a place to sleep in for
without this piece of clothing? For ages now I have been recom- me. The patients- there are never more than fourteen- you will
mending in the inner circle that the unconscious and the pre- not notice, nor is there a smell of iodine or medicine. And you
conscious should not be opposed, but rather the coherent Ego will be in Baden Baden. I have seen much of the world, but
and the repressed material split off from this. But that does not there is no more beautiful spot than Baden Baden. I myself,
solve the difficulty either. The Ego is deeply unconscious, too, a Prussian, emigrated here, and I have as little love for the
in its depths, and yet fused with the core of the repressed ma- South Germans as they have for me. But the scenery here is
terial. The more correct notion thus seems to be that the cate- beautiful.
gories and hierarchies observed by us only apply to relatively The only difficulty is that you will be with a lover. But I am
superficial layers, and not to the depth for which your 'It' is the still young in this, and I shall behave as I did in The Hague,
right name. Like this, perhaps: when I was satisfied with seeing you and talking to you oc-
casionally.

~
If my information is correct, you are accustomed to having
your daughter with you. I hope she will be kind and accept my
invitation and persuade you too. Please, give her my regards.
The words and the drawing of the repressed Ego and It have
, fA I
·- ---·-··/
had their effect on me and will bear fruit. Thank you very
much!
58 59
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
My writing stagnates a little. I have a woman patient who am even confident that you won't tell anyone else prematurely:
has been labelled heart disease and chronic kidney infection. in reality one has only a single need in old age, a need for rest. It
High-grade dropsy and a strict Catholic. Initially the treatment is a quite transparent calculation. Since I shall not be able to
went fairly well. Suddenly with the help of Sunday the water pick the fruit of this tree I shall not bother to plant it. Mean but
level rose, the pulse-beat became frighteningly weak, and urine honest. One does not want to learn anything new any more, but
secretion stopped for 36 hours. On Monday morning I dis- one also does not get any real pleasure out of old things either.
covered the reason for her resistance. At half past one the bed In about 20 years you will understand me better and not think
pan was full and by next morning she had passed three litres. any worse of me then, when you remember that I subjected
Isn't that a nice story? myself to fate without any illusions.
And another one. The woman patient in question had been It is certain that I cannot be with you just to enjoy the charm
infected years ago with gonorrhoea. The condition cured itself, of your company. I should have to go into the curious influences
yet supposedly some traces of salpingitis remained. Four which you are studying. Yet there is also the transference of
months ago there was thick, yellow discharge again, without thought which demands to be let in and many other things gen-
gonococcae, heavy pain in the left side near the fallopian tubes. erally called occult. The possibility of changing pathogenic fac-
Long-drawn out gynaecological treatment. The label chosen tors by exchanging and adding sex glands etc. What one has
by a wise Englishman: septic endometritis and salpingitis, pre-
I. achieved oneself is unfinished, fragmentary, provisional; one
sumably therefore streptococci evidence. At one o'clock first ought to have a second life in order to improve on it.
analysis. Two hours later the pain had disappeared. Next And yet it is not impossible that there may still be a gap in the
morning some white discharge. Search for and find resistance. schedule and that I may one day turn up unannounced as a visi-
Since when discharge disappeared. Isn't that nice, too? If only tor at your door. I hope travelling in Germany is a pleasure
other people decided to investigate whether the distinction be- again. It isn't in this country.
tween the organic and the neurotic is justified. It· is not nice of your lady-friend 50 that she no longer urges
Dear Professor, do come here to Baden. You will certainly you to continue the correspondence.
like it. With warmest regards and thanks
All the best and warmest wishes Yours FRELTD
Your loyal disciple G RonnE c K

Baden Baden, July 2, 1921


Vienna, May 29, 1921 Dear Professor,
Dear Doctor, Your letter left me with a slight hope of your perhaps turning
What a tempting prospect you open up to me! And how up unannounced in my house. I am holding on to this and am
clever to ask my little girl, too, to prevent me from getting home- delighted about it.
sick! Of course, I have to say no. The rational reason is that this If this hope is not fulfilled I will have to be content with the
year's holidays are already planned and there is no room left for prospect of the congress, but I do not know whether there will
anything else. The real reason is different. Because I have lost be one. The journals take a long time to get here.
my youth. If I were 15 years younger no devil could have The lady-friend 50 has taken your admonition to heart and
stopped me from sitting on your neck for a few weeks and persisted in pressing my belly until I had given birth to a couple
watching the kind of skills you are practicing, as I did - earlier more spiritual children. They will be sent on to you in the next
on- with Bernheim 49 • But now I have to tell you frankly, and I few days. As I do not know how many letters you have got I
60 61

.i
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
shall start with No. 6 for good measure and send everything Bad Gastein~ 29.7.1921
after it that is ready. In any case I have to ask you to consider Dear Doctor,
the letters as temporary drafts. The material is so vast that I Received further letters to your lady-friend and read them
shall probably have to cut out a lot later. here in my holiday retreat. I particularly like your beginnings
In my practice I occasionally experience things that are and the bits of self-analysis; you are really charming in this.
worth communicating. Recently there was a case of endome- You should sacrifice a few bad habits and change a few details
tritis with stinking pus discharge that had been treated for four which the analyst would disapprove of. For instance, it is inad-
years by English and Dutch gynaecologists. The patient had visable to look for deep meanings in the Mosaic story on the
been infected with gonorrhoea- before the marriage- by her creation of man 5 1 • It is probably·a deliberate priestly distortion
subsequent husband. The gonococcae have long since disap- of the old myths and thus the only known example of the origin
peared, the endometritis remained. The marriage came about of woman from man instead of the opposite (incestuous) re-
against the will of her husband's family, ostensibly because he lationship. As to the discussion of menstruation 5 2 the same self-
married far beneath his class. In the very first interview it be- righteous person demands that the complication and layering
came apparent that the patient produced the smelly discharge is taken into account. If a woman answers the man's visit by
in order to answer every humiliation on the part of the husband starting her period early then it is not merely the old sexual
or his family by the idea: 'I am not good enough for you, but desire, but also a strong defence drive which uses the old and
your high-born son has infected me.' The symptom, which had now obsolete approach. The exploration of strawberry urtika-
lasted for four years, disappeared very quickly. By the way, it ria will merely cause offence- without clarifying anything etc.
did so only by way of psychoanalysis (or the discontinuation of As a warning example in the distance there is a certain W.
any kind of local treatment and physical treatment). The most Stekel 53 , too unreasonable and with all very inconstant.
interesting thing was that she had (apparently?) wished the in- I would like to know what the composition, extent, and aim
fection onto herself through a horror of having children. Then of the work will be like since I certainly intend to take it on. The
behind all the other things there emerged an obvious and, I fragmentary case histories of patients are crying out for more.
hope, now resolved Oedipus complex. Moreover I found here The undersigned will stay here until the 13th of August, and
another demonstration of my old theory that an increase in will then go to Seefeld in Tyrol.
weight implies symbolic pregnancy. The patient lost 11 kg in With warm regards
three weeks. Yours FREUD
One of your patients is with me at the moment, a Dr. Vene-
ziani from Trieste. I am keen to know what will become of him.
Occasionally I hear something about The Seeker of Souls. But Baden Baden~ August 6, 1921
nicest of all are the reactions of my most intimate friends to the Dear Professor,
book. They hide it carefully .. Gastein and Seefeld, there will probably be no time left for
Finally I must express once more my hope that you will come poor Baden. And I would so much like to have you here, if only
here after all. The trip is expensive but no more uncomfortable to dissuade you from the gloomy prognostications with which
than any other trip. Please, do come. you accompany my psychoanalytical career. For I probably
With all best wishes have to assume that the allusion to Stekel implies some kind of
Your loyal disciple G RoD DEcK worrying, though I cannot fathom its significance. Apart from
his book on dreams 54 I do not know anything by him; a book on
war phenomena I found so boring that I put it aside after the
first two pages. I do not know, however, what happened be-
62 63

l.
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
tween him and you. Yet you described him to me, and one of that after the death of the last Groddeck 55 I attached myself
his characteristics I accept with pleasure for myself, un- with all my power of feeling to a human being 56 , and took her
reasonableness; I am not inconstant, however. May I add a over since she reminded me daily and hourly of some member of
word of explanation concerning my unreasonableness. During my family, especially my sister 57 and my mother 58 .
my apprenticeship the words exact and objective played an im- Forgive this long explanation, be nice to me, and have confi-
portant part. I myself never managed to be exact and objective dence in me. I shall revise the letters and try and cut out every-
in the way demanded of me, and because I wasn't I watched thing that might give offence. There will still be enough left to
everybody in the field that interested me mainly, namely medi- give me the satisfaction that someone or other will pronounce
cine, who boasted of possessing these characteristics. As I anathema on me.
wanted to see the mistakes I saw them, and thus came to this In a few days I shall send you a further pile of letters to the
curious overestimation of the subjective and the contradictory. lady-friend. The question of composition, extent, and aim I can
From this developed a kind of exact paradoxicalness that te- only answer tentatively. There is no composition; my aim was
sembles unreasonableness closely and in a certain sense is un- originally to write a popular book on psychoanalysis which was
reasonableness too. My definition of terms suffered most under to help in treatment. Meanwhile I have come to understand
this. In the beginning I tried to upset every one of them and this that books are of no use in treatment. Therefore I am writing
was not too difficult. Yet gradually I lost the ability of definition without any aim, merely for my own pleasure and to help those
so that I have to try hard and understand the meaning of terms, people who like my way of writing to while away the time and
and often enough I do not succeed. A barrier has grown up that draw them a little closer to myself by teasing them. The length
blocks off quite a bit ofthe world for me. Yet the most important can be more or less as I decide. Maybe you will tell me when it is
aspect of my inability to be reasonable is not that I carry on ad enough.
infinitum, but an inability to keep order within a limited area. I do not want to reread what I have written to you. It is very
As a schoolboy my cupboard was permanently in a mess with sultry and even though I am almost completely naked I am
combs and sandwiches and schoolbooks living side by side. dripping with wisdom and sweat. I would prefer you to be here.
And this remained so. In other words I cannot see the demarca- I cannot resign myself to the thought that I shall not be given
tions between objects, only their fusion. This is a fault, but it is the pleasure of seeing your face opposite mine and of hearing
also a big advantage. Systematic minds need people like me in your vmce.
order to feel important, as the pinch of pepper that perfects the I recommend myselfto your forgiveness and remain, as ever,
dish. In the last resort, my unreasonableness is probably due to yours gratefully GRODDECK
my relations with my parents and siblings. We were brought up
with an arrogant motto: 'There are good people, there are bad
people, and there are Groddecks.' Between us and other people Seefeld in Tyrol, 27.8.1921
there is a barrier which cannot be overcome. But as an equiva- Dear Doctor,
lent I have come to harbour the wish to ignore the incest taboos I acknowledge receipt and perusal of the third instalment of
and to have no barriers between me and the Groddecks. You your letters to a lady-friend. As fascinating as the earlier ones,
can imagine what a crazy knot of complexes this produced, perhaps less whimsical. Because of its forcefulness alone this
since the incest taboos did not care for my wishes. In fact they work should become known among the public, as it emphasises
have not been broken, as far as I know, yet it must have meant a the real novelty of psychoanalysis, and it should break down
lot to me that I alone remain alive from among all the members prejudices and narrowmindedness and provoke violent out-
of my family. My poverty and recovery from illness can be bursts of insult.
dated by the deaths in my family, and it is particularly striking Cordially yours FREUD
64 65
CORRESPONDENCE WITH SIGMUND FREUD
THE MEANING OF ILLNESS
In my practical activity I still find many surprises, and I hope
I shall continue to make progress the more boldly I push on.
Hildesheim, 23.9.1921
The dangers of philosophising and of occultism are still with
Hope you were pleased with substitute. FREUD
me. I have a tendency for the first, but occultism is taboo for me.
Were you? Ferenczi
I am treating a lady suffering from arthritis deformans of
Best regards, Dr. Rank
both knee Joints and from habitual patella luxation. I hope I
Ditto Abraham 59 Ernest Jones 60
will be successful. The main result so far is that I fell off my bike
Hanns Sachs Eitingon 61
on my way to visit the patient and smashed my right knee. That
brought me back to self-analysis and with striking success.
Ferenczi wrote that Baden Baden might be chosen for the
congress in 1923. I would be madly happy if this came true and
Baden Baden, December 4, 1921
I do not believe that a more beautiful or comfortable spot could
Dear Professor,
The letters to a lady-friend are now completed. I could con- be found.
Dear Professor, accept for once my gestures of love and keep
tinue a little while longer yet it seems to me enough for the first
go. I am about to do some revision on them, shall try and cut out alive your kind interest in me.
Ever your loyal disciple GRODDECK
everything that is hostile and make them as readable as pos-
sible. A few of them I still like, yet overall I think there is too
much irony. The talks from which they originated were full of
enthusiasm and that seems to be hidden now behind the laugh- Vienna, December 29, 1921
ing mask.
Meanwhile Ferenczi has been here. I had a lot of pleasure Dear Doctor,
The delay in answering your latest letter is due to sordid
from his visit and hope that he, too, liked me and my people. He
everyday avayK17 and has now had one result, namely that
promised to come again and I think he will keep this promise.
I can wish you all the best and most beautiful things for the
Apart from the enjoyment we will get from his visit he can do
coming year 1922, and for myself, at the same time, the restora-
with it, too. We profited a lot from each other.
tion of omnipotence of thought so that my wishes will bear fruit.
So far I am content with the substitution. Yet it remains a
I am most grateful for your repeated invitations to come to
substitution and does not exonerate me from the promise that I
Baden Baden. It is good to know of an asylum where one could
shall torture you incessantly until you come here in person.
always go if one's strength should fail. Yet so far I am still pull-
Baden Baden is worth a visit and neither Troll 62 nor I myself
ing hard and am thinking of the English saying: 'There is still
missed the opportunity of asking both the Ferenczis about
Freud's wishes and needs. You cannot know what part this life in the old dog.'
Quite imperceptibly I have recently moved into old age, no
often dreamed-of fantasy plays in my life.
longer write anything myself and instead read other people's
I shall send you the manuscript of the letters 63 ready for
manuscripts. Hardly treat any patients, but train analysts by
printing towards the end of the month. Printing can then be
started at any time. For January and February I shall return to self-analysis (one patient to nine students).
When the remainder of your manuscript arrives I shall put
the wilderness again and shall start the second part of The Seeker
aside all others in order not to delay printing. I was very pleased
of Souls. This will keep me busy for next year. Ferenczi's Cri-
by the news that our foolish friend did not have an accident but
tique made me very happy. He brought it along to Baden. Mrs.
will continue to tell us about himself. Don Quixote also had a
Ferenczi 64 came, too. The two women made friends and we still
talk a lot about their visit. second part.
66 67
CORRESPONDENCE WITH SIGMUND FREUD
THE MEANING OF ILLNESS
has lost its shape is hoping to shed some fat. Habakuk, the tom-
I hope this letter will reach you before you disappear into cat, and Fick, the canary, are coming along, too. Troll-Voigt
your lone- or twosomeness. has packed the cookery book and makes my mouth water with
Sincerely yours FRE uo
descriptions of Swedish dishes.
Why do I write all this to you? To tempt you to come here
and, if you are not going to just yet, to make me imagine that
you are at least thinking of me.
Baden Baden, Werderstr. 74, 30. 72. 7927 And now finally, best wishes for the New Year. All the best to
Dear Professor,
you and your family
By the same post I am sending you the manuscript of the let- most sincerely your loyal disciple GRODDECK
ters to a lady-friend which is now ready for printing. Only the
My address is: Murberg near Sasbachwalden cj o H. Zink
14th of the letters which you have not yet seen is interesting; it
contains quite a detailed description of a curious case history.
Would you be so kind as to hand over the manuscript to
Rank. I am writing to him at the same time. I am proposing AJurberg, near Sasbachwalden, 7.2. 7922
three alternatives for the title; I like the middle one best. Per-
Dear Professor,
haps you will think of something better or Rank may have
Like last year I am using the holidays again to read Freud.
another ingenious idea as he did with Seelensucher (Seeker of
Or rather, in the first weeks I read Westerns and Marlitt's ro-
Souls).
mantic novels 66 , was bad-tempered, and slept a lot. Now, after
I am delighted that the novel is going into a second edition. It
a few long walks in the snow of the mountains, I am fit again
makes me more determined to start the second part soon, and have convinced myself that I make books from individual
especially since Polgar's review in the Berlin Tageblatt 6 !i will sentences of your work like other people, too. I do not know if
probably have an effect. this is the right way to get myself to continue the fool book, but
I shall disappear into the mountains until the first of March, it is useful, in any case, as a corrective to my arrogance in other
but I am giving you my address in the bold hope that you might
respects.
write a word to your distant admirer. I take your silence regarding the letters to a lady-friend as a
I hear little of what is happening among psychoanalysts. I
sign that you have quite a few objections to make or even that
am too far removed from Berlin. Occasionally Ferenczi tells me you disapprove in some important respects. Although I would
something, otherwise I am living out of the journals and my be very sorry I would not consider it irreparable. The letter
own experiences. form allows all kinds of changes. This is the main reason why I
Troll tells me that she hopes to get your works for translation chose this odd form of writing. I am expecting your criticism
into Swedish. I know enough Swedish to help if necessary. We and shall make use of it in a later edition, which I consider
are both happy to be able to share some literary work after six possible, as I did with one of your objections. Personally I do
years of analytical work together. not mind if my writings contain mistakes. I would only mind if
My practice this year has had some good results, for my own
you were angry about it. I shall then try and make amends.
development as well. If this continues for a few years, you will
I am struck by the fact that I have taken up the Dora frag-
be pleased with your most fantastic but most loyal disciple. ment67 again, and when on one of my recent walks I fell head
It is warm and good to live here, almost as if it were Spring first over some bits of rock I found a kind of explanation for
already. We are in the middle of our going-away preparations, this in the night. In the fragments from the analysis I talk
packing tins, blankets, crockery, and tobacco without which I about in the letters to a lady-friend the name Raabe 68 occurs. A
cannot do. The books have been mailed and the paunch that
69
68
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
schoolfriend of mine with that name broke his leg in a rocky the book would not find complete approval with the publishers.
landscape, similar to the place where I fell, and I thought of He confirms this and suggests that I make extensive cuts and
that the moment I fell. It was such a remote and desolate spot advises me where to cut. I accepted this advice gratefully and
that I would probably have been eaten up by raven and fox am hoping that this way something workable will be arrived at.
(Rabe und Fuchs, the latter is the name of my holiday dog's So far all is well, but I have used the opportunity to ask Rank
owner). Habe (raven) was near to my thought because a few what the publishers think of my writings and I would also like
days earlier I was visited by somebody in whose analysis the to ask you this question. What made me bold, strange though I
raven had played an important part ('What kind of a beggar is felt as a determined subjectivist in the midst of objectivist belie-
it? It is wearing coal black clothes'). In the letters, too, I arrived vers, plagued, moreover with a chronic knowledge of my ignor-
at Dora by way of Rabe. Yet here there is a new association. ance, what made me bold enough to express myself in public
The schoolmate Raabe was friendly with my mathematics was your personal interest in my works. Now I am not con-
teacher Buchbinder, and his daughter was called Dora. He was vinced that this interest applies to the letters to a lady-friend,
nicknamed Dragoner (dragoon) which brought me to Drago, a too, and therefore I want to ask you to tell me whether I have
name which occurs in the Genoveva legend. This legend has become a nuisance to you. I do not think it is probable that I
been on my mind recently, apparently in connection with an shall stop on the way I have chosen, or even deviate from it.
analysis, too. It was brought to my memory moreover by a However bizarre they may be, the letters at least clearly show
Christmas present, Schwab's Popular Legends 69 . Schwab is the direction in which I am moving. If this direction leads more
also an important name for me, as the letters show, too. and more into darkness and corresponds with the work of your
You can see, my thoughts are preoccupied with self-analysis disciples I would be pleased. I know nobody else but you to
and with the letters. Thomas 70 is still very far away for me. whom I could put a question which is important for me, namely
I have information for you with regard to the sexual theories whether the leaders of the psychoanalytical movement approve
of adolescence. I was consulted by a young man about impo- of or at least acquiesce in what I have written or what I shall
tence. It emerged that he had the idea at ten that for the concep- write in the same vein. Be so kind as to give me an answer to it.
tion of a child the testicle, the ovum, was pushed through the With best wishes I remain, as ever, your grateful disciple
urinal tract, and he imagined that it must be very painful. And GRODDECK
this idea, which persisted semi-consciously and remained
uncorrected in the dark recesses of the soul in spite of better
knowledge, seems to have been the main reason for his impo-
tence. At least the man was with a girl the day after his secret ViennaJ 72.2. 7922
had come out and he has been all right since then. - I send my Dear Doctor,
best regards and wishes. That you have taken the absence of an answer to your last but
Yours ever gratefully GRoDDECK I one letter (which had crossed mine) to mean criticism and dis-
satisfaction is understandable and yet far from the truth. I did
not write to you because I am being eaten up by my scholarly
and business correspondence, because I had house guests like
Murberg(Sasbachwalden)J 72.2. 7922 Ferenczi and Abraham, because for weeks I have been suffering
Dear Professor, from a creeping, feverless kind of influenza and in circum-
Dr. Rank wrote to me today that the letters to a lady-friend stances like these one tends to put off the most intimate letters
)
are being set up. I had told him for certain reasons of my own in particular. What you have heard or will hear of criticism and
and because of certain words in your letters that I assumed that suggestions for changes from Vienna is not by me but by Rank
70 71

_A.:.
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
who anyway possesses good judgment and is well disposed This is doubly easy for me because for a few days I have been in
towards you. This does not mean that I have no criticisms to possession of a lovely edition of your lectures 72 . The publishers
make, yet I would have been agreeable to let the respectable have thus surpassed themselves and I was very happy that you
idiotic public have you with all your warts and originality and let me have a copy. Many thanks for this and I hope you will get
to ask them to take you as you are. It might, however, be better well soon.
for you to let Rank influence you. My critical objections to your In a few days my holidays are coming to an end. I haven't
views emerged right in the beginning of our correspondence. done any work, but I have collected all sorts of impressions of
That I do not share your pan-psychism which borders on the forest and animals in winter and snow.
mysticism but confess my agnosia much earlier than you; that I With best wishes
believe you despise reason and science too rashly and give too Your loyal disciple GRODDECK
much honour to the university officials who you think are repre-
sentative of both of them. That you seem to have preserved flrm
traces of former fixations etc. Yet all this I recognised as your
personal right; it neither interfered with my pleasure of reading Baden Baden, May 9, 7922
your writings nor made me go wrong in my estimate of your Dear Professor,
original discoveries and opinions. During the past few days I have experienced a little episode
Keep well in your present lone- or twosomeness. which I want you to know about. I have a young patient who is
Sincerely yours FREUD trying to work out an analysis of Aristotle in a way that corre-
sponds with his own complexes. Every day this attempt brings
nice surprises although coping with the dead language is quite
difficult. When Aristotle mentions things that touch on his
Vienna, 76.2. 7922 impotence and castration complex he starts talking and always
Dear Doctor, uses the same expression -roOerz. The. translators maintain
Our letters crossed again! I am sorry if you have been doubt- that this is the same as Kant's Ding an szch and translate it ac-
ing us for a moment. Yet 'fishing for compliments' is not like cordingly. We agree that Kant invented the Ding an sich (which
you. Please do not be unhappy! It is the others who desert me; according to him is unknowable) on the basis of a castration
when I am somebody's friend I remain so for a long time. I have complex which contains masturbation anxiety and hermaphro-
enjoyed the letters to a lady-friend very much and would like to dite complexes. The Ding an sich would thus be the Ding an
make up a variation on Goethe's words; Kant, just as Luther's 'Man's heart is an obstinate and
Of all the spirits which say yes cowardly thing' and 'It is a good thing that the heart becomes
The clown is least burdensome to me 71 firm' stand for the slackness and erection of the penis and estab-
Sincerely yours FREUD lish most intimate connections .with the heart. In the course of
such a discussion my patient told me the following: he had just
read something on degrees of accuracy in a book by Moskovsky,
and Moskovsky was using the sea in his argument. (The patient
ivfurberg Sasbachwalden, 79.2.22 has an unresolved Oedipal complex and curiously enough did
Dear Professor, not understand that he was talking of himself by way of associ-
Your letter would have made me even happier if it hadn't ation- ivfeer =La mere- while he was interpreting Moskovsky
contained the news of your sneaking influenza. From this dis- /
with my help.) According to Moskovsky there are four degrees
tance there is nothing I can do except think friendly thoughts. of accuracy in the observation of the sea: first the shape of a
72 73

~·.
~
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
sphere, then that of a rotating ellipse, then the shape inHuenced not been treated generally, it is very obvious indeed with our
by moon and stars, fourthly a shape made of swinging atoms. In 'educated' people. Symbols are about the most unpopular
the analysis it now emerges that the first (chronologically the aspect of learning and science.
last) is the pregnant body, the second, lower-lying (chronologi- Sincerely yours FREUD
cally earlier) is the rotating child, the third mating, the fourth
the state before mating (moon= erection and slackening, atoms
=semen and ovum). Thus in three there is erection, beginning
of pregnancy (moon) and bustle of sperm after mating. The Baden Baden, 2. 77. 7922
four steps are the four-legged animal in the riddle of the sphinx. Dear Professor,
Sphinx derived from a¢>zyyezv = embrace. Sphinx leads on The bearer of this letter, Herr Karl Kotthaus, Tegernsee, has
to sphincter and the afterbirth. made a collection of comparative physiognomy which seems to
I do not know whether the association sphinx-sphincter has me worthy of the interest of the psychoanalyst. My judgment is
ever been used in a literary way. Yet the four degrees of accu- however not impartial because the main idea that the appear-
racy seem to me worth communicating to you. And above all I ance of the face as well as character and profession is determi-
think it is good that for once an expert- which the patient is in ned by embryonic plasm is all too close to my own fantasies and
the field of scholarly philosophy- should attempt an analysis of because I have not had enough time to think about the question
philosophical systems. As far as I am conversant with modern more thoroughly. Yet I am convinced that you will enjoy exam-
philosophers I find that, unlike pre-Aristotelian philosophers, ining the pictures and am asking you to receive Herr Kotthaus
they all suffer from Oedipal or impotence complexes connected if your time allows it at all.
with a striking avoidance of all symbols. My patient is himself a With all best wishes
typical example: he recognises the symbol, yet he can only hold Your devoted disciple GRODDECK
on to the knowledge for a second and at once changes it, after he
has culled it briefly and with difficulty from the abstract con-
cept, back into an abstraction. It is a parallel to J ung 's alleged
synthesis! Has this avoidance of the symbol, which I have come Christmas 7922
across several times as an obstacle to analysis and one that is Dear Doctor,
difficult to overcome, ever been investigated in a specific case? Are you astonished that I did not answer your interesting
Baden has put on its best blossoms in order to join me in letter with all its information earlier, or can you understand
greeting you. that the date explains everything, the delay as well as making
As always your grateful disciple GRODDECK amends?
Enough, finally about to answer it I find that this is not a
letter one can answer but one that should be talked about for
several evenings, yet since such evenings cannot be had ...
Vienna,June 7, 7922 I was very sorry that you find it necessary also to avoid a psy-
Dear Doctor, choanalytic career. This explanation of your indeed unsuccess-
Apologies for answering on a postcard instead of with a trea- ful paper 74 and your categorising my person as a mother figure,
tise. I cannot keep you waiting any longer. I am snowed under a role which I quite obviously do not fit, show clearly that you
with work. Your letter makes me think. In anaemic abstraction are trying to evade the father transference. In analysis the vic-
it is difficult to recognise anything, easier in the hallucinations tims are forced in their vital interest to get involved and to
of Kielholz, Jakob Bohme 7g. The avoidance of the symbol has accept what is useful in it.
74 75


THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
Do you remember, by the way, how early I accepted the It botany and zoology I have done nothing since Christmas, but
from you? It was a long time before I made your personal ac- this has not been without consequences for my analytic activi-
quaintance, in one of my first letters to you 75 • I made a drawing ties.
there, which will soon be published in almost the same form. With best wishes
I think you got the It (in a literary, not an associative way) Your grateful disciple GRODDECK
from Nietzsche. May I say that in my paper?
Hattingberg 76 does not deserve so much affect. He merely
practices the behaviour of the uninformed when he is showing a
Vienna, March 25, 1923
tendency to create theories like J ung who built a theory on the
Dear Doctor,
first analysis he understood. A pity that it is so difficult to teach
To begin with congratulations on the publication of the It7 9 • I
analysis, the more pity that there are so many people who do
like the little book very much. I consider it a matter of merit to
not want to be taught. They discover anew all the mistakes the
put people's noses up against the fundamentals of analysis from
older men have managed to bypass. I am sorry about Hatting-
which they constantly try to withdraw. The work, moreover,
berg, yet I am afraid there is nothing one can do for him.
argues the theoretically important point of view which I have
I wittingly undertake to plead the cause of your It book vis-a-
dealt with in my own forthcoming work The Ego and the ld80 •
vis Rank. But you do not know how difficult it is to work at the
The public will of course react to it with even more aversion
moment. The publishing house is in a critical position because
and indignation than it did to The Seeker of Souls which could be
of the depressed conditions of the market.
taken as an artistic treatment of the undesirable. Your self-
Best wishes for the coming year to you and my charming
esteem will hardly be affected by this.
translator 77 •
The discourse on Aristotle you sent me I find rather
Sincerely yours FREUD unpalatable. A sentence like: 'the an sich lives in the what, in
so far as this lives in it' is sufficient for my miserable philo-
sophical sense to paralyse understanding and judgment for
good. I have to rely on your opinion that the paper of your disci-
Baden Baden, Werderstr. 14, 11.3.1923 ple has produced certain results. I find his own presentation ob-
Dear Professor,
scure enough.
One of my patients has been at work for a number of years on I will wait for you to let me know what to do with the essay in
an analysis of Aristotle in the original language. The pro- question.
visional result of this difficult digging is the enclosed paper 78 Warmest regards to you and my translator
which he begs me to send to you for inspection. Perhaps you Yours FREUD
will find an hour for it. The writing got more and more obscure,
however, the more he worked on it. I have the impression that
the core is still intelligible; in other words this is proof for the
Aristotelian philosophy that it is rooted in the impotence com- Baden Baden, April1923
plex. I personally believe that it is the root of every conceptual Dear Professor,
philosophy, in decided contrast to the mythologically based Many thanks for your kind words regarding The Book of the It.
Weltanschauung philosophy. A narcissism based on a sense of I am prepared for it to be received with indignation. I will be
guilt with a castration complex behind the desire to masturbate helped in this not by my self-esteem, but by the inertia which
which is defending itself with words. does not allow me to linger over pleasant or unpleasant im-
I shall start work again in a few days' time. Apart from a little pressions too long. But I am sensitive to praise or criticism.
76 77

.at
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
I beg you to return Herr von Roeder's manuscript on Aris- separate the two Nachzugler (stragglers)? Some louse must have
totle to me because I no longer hope that you will accept it for crawled over your liver. Where is it now?
publication in Imago. You honour me too much when you use Yours most sincerely FREUD
the expression 'my disciple'. I have never had disciples, am
rather convinced that my talent is essentially one for treating
patients. I also consider my writing apart from The Seeker of Souls
as not very important. Baden Baden, May 27, 1923
With best wishes for Easter Dear Professor,
Ever your loyal disciple GRODDECK Many thanks for sending me The l!.go and the /d. As the god-
father of this term I am now expected to say something about it.
Yet the only thing I can think of is a comparison which throws
light on our relationship and our attitude to the world, but does
Baden Baden, May 10, 1923 not say anything about the book. In this comparison I appear to
Dear Professor, myself as a plough, and you as the peasant who uses the plough
I have written the enclosed article 81 for my own instruction. If -or perhaps another one- for his purposes. The one thing we
you were to consider publishing it I beg you to let it appear in have in common is that we dig up the ground. Yet you intend to
the ,(eitschrijt, or otherwise return it to me. Personally I am of sow and perhaps, if God and the weather allow it, to harvest a
the opinion that some kind. of admonition to use thought is crop. The plough only wants to dig up and, by the way, reduce
necessary. The sentence that people respect what they are told the stones which might blunt it. And since the plough has no
by people who do not really believe what they say expresses my eyes, but is afraid of stones, it occasionally sticks in order to
conviction. Your life's work will never be doubted, yet its devel- make the farmer watch out and prevent the plough from getting
opment is hampered, no longer by external, but by internal blunt. For the plough this is a vital question, for the farmer ulti-
forces. Yet it may be presumptuous of me to believe that these mately a question of money since he can replace the unusable
forces could be removed by me. The emphasis of the essay lies plough with a new one. Nevertheless it is not pleasant for the
rlbt on its real content but on the way it is written. farmer if his tool becomes unusable.
u·nfortunately I have not yet received the Id and the Ego. I My work 'Vorbewusst und Vorlust' (Pre-conscious and
am looking forward to it. The Book of the It is beginning to have fore-pleasure) was such a case of 'sticking'. This is no stone
its effect in the circles of my patients. yet, but it marks the plough's anxiety since it does not know
Affectionately what the farmer's intentions are, is at the mercy of the soil
Your disciple GRODDECK and cautious as to the soil's condition. You can survey the
whole field, I merely have the dim impression of stony
ground. Take, for instance, your derivation of sadism from
the destructive drives. There I stick and do not want to go
Vienna, May 27, 1923 on, for I am afraid that the soil will destroy the seeds and
Dear Doctor, cause weeds to grow. I may be wrong, but I believe that I
I hope you have now received The l!.go and the ld which was ;) know the effect you have on the soil, e.g. on your pupils,
sent off before your reminder. better than the farmer. For him a crop failure in this or that
Your little work put me into some embarrassment. I willingly spot is not so important. The present-day generation of your
accept Nachlust (after-pleasure) but what shall I do with Nachbe- disciples is of importance only to us, not to you.
wusst (after-conscious)? Quite incomprehensible. Couldn't you Then there is a real stone, or at least something that I
78 79
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
consider a stone: the psychological factor; the farmer knows: points are contained in the comparison, I am by nature simply
here the soil is stony, and this is sensed by the plough from the an unreasonable creature, a tool- finally a secret laugh about
cautious movements of the hand that guides it. It also notices displaceable energy, about libido which is taken into service by
that the farmer keeps an eye on the fertile ground of the It which the pleasure principle in order to prevent blockages and to
is next to it. Yet it does not understand why the farmer insists relieve the flow, and which is to a certain extent indifferent to
on ploughing the stony ground first, the plough does not like how the discharge comes about. And we can put aside the for-
going into the ground of the Ego where the distinction between ever unanswered question of whom it belongs to, since we pos-
psychological and physical is too pronounced for it. And the sess the tool of this displaceable energy and at most lend it to
sentence 'It is to this ego that consciousness is attached; the ego other creatures who make the tool displaceable.
controls the approaches to motility- that is, to the discharge of Most ·sincerely
excitations into the external world '82 makes a real dent. The Your anxious GRODDECK
plough, which has finally through hard experience come to the
conclusion that it is not an Ego, tends to consider the concept of
It as an illusion produced by the It. At least it cannot decide to
do without the assumption that every cell has its own con- Baden Baden, May 31, 1923
sciousness and thus possesses independent discharge. The Ego, Dear Professor,
in its opinion, is apparently not even able to control the motility I am not astonished that you do not know what to think of
of voluntary muscles, much less that of the intestines, kid- Nachbewusst. Only now do I understand what you mean by Vor-
neys, heart, or brain. In doing this it does not deny the Ego or bewusst. Up to now I imagined that the pre-conscious was close
the Super-Ego. Yet they are merely tools for it, not existing enti- in front of the conscious (spatially) and this is why I fantasised
ties. I have the impression that for some reason the farmer about something that is close behind the conscious (spatially)
remains in the region of the so-called psyche, at least for the and moreover lies after the conscious (chronologically). Leave
time being, and can perhaps ruin a number of ploughs without it at that, it is only of value as a sign of evil intent and the same
producing a big harvest. In other words, the plough considers may apply to Nachlust and disappear forgotten and forgiven.
the farmer a little obstinate. But then it only has the brains of a This brings me to the little louse which is really a huge louse.
plough. On my part the anger started when you compared me to Stekel.
Now I have started to ramble, after all, and must ask you to That is now a year and a half ago. Apart from the fact that I had
forgive me. A gleaming light was for me the explanation of un- heard what you think about Stekel, I felt guilty that I had
conscious guilt by way of the Oedipus complex and identi- appropriated a number of ideas from Stekel 's book in my
fication. On the father question I am aware of my own dreams without really digesting them. I do not feel guilty about
complexes, but I cannot so far prevent myself from getting on thefts when they conform to my nature. Yet I sometimes steal
better with the mother rather than the father. This may things which are not me and then there are evil consequences.
improve when my homosexuality is more liberated. Yet the in- The anger was increased by Rank's correspondence 83 about
vestigation of castration can hardly bypass the act of birth, or of The Book of the It and by a few words you wrote on it. And finally
sucking and weaning, and I believe for the time being that this there was the Berlin congress that finished me off. I fell violently
anxiety is centred as much in the mother as in the father, and ill afterwards and the whole time is an unpleasant memory for
that a third root can be found in discharge. Separation of semen me. Particularly the farewell party and the meal at Eitingon's.
and ovum, and- related to your destructive drive- the elimin- Hattingberg's performance caused a fit of rage which is rare
ation of material which the cell's It does not want to use. with me these days. I know roughly what led up to all these
Finally - I could go on for much longer but the essential things. In September 1921 Ferenczi had his first treatment with
80 81
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
me and I know that I felt proud and thought to myself: 'What
stupid people analysts are.' I also told him a number of times;
'You do things like this or like that, but I ... 'And I made no
exception of Freud. This was also connected with the treatment Baden Baden, November 8, 7923
of Veneziani which I was proud of in those days, though it be- Dear Professor,
came apparent later on that it was a mistake. In short, there It is a long time since I last wrote to you. I have thought of you
was a lot of bad blood, and it started in September, at the time rather more often. Indeed, the thought of Freud never leaves
of the anniversary of my father's death. Next year, Ferenczi me.
came to me again, I treated him again and was analysed by him In spite of all the strange happenings in Germany we are still
about six or seven times. He talked to me very seriously about living our old lives. Work goes on, sometimes successfully,
my father complex. I listened to all this and the result was that a sometimes unsuccessfully. Twice in the course of this summer I
few weeks later I said to his sister-in-law and stepdaughter: had the opportunity of watching pregnancy, birth and a baby's
'The other paralytics' (instead of analysts), and the uncon- first week of life. The hunch that in the field of obstetrics psy-
scious self-mockery of this still makes me laugh. This too hap- choanalysis will prove to be particularly useful has been con-
pened around the anniversary of my father's death 84 . Now this firmed by this. The complications of pregnancy- both women
afternoon something strange occurred. I had had a cold for a were having their first babies, one of them was 33 years old-
few days, had gone to bed, taking advantage of the holiday, and disappeared very quickly, in both cases birth was easy and
in my waking sleep I saw my father's face, very angry, with quick, the older woman even cried, when the head broke
raging eyes. Gradually it changed into the face he had on his through the vaginal exit: 'Oh, how beautiful, how beautiful.' I
death bed. I am not sure whether today is really my parents' was strangely touched by the course of confinement. The com-
wedding anniversary 85 , but the fact that I have had the thought mon aversion among women to feeding their baby themselves
is sufficient. Now you do not in the least resemble my father but was traced to its roots and eliminated, and with one of them,
both you and your daughter Anna whom I did not want to rec- when lactation stopped for 24 hours, the secretion of milk
ognise have my mother's eyes. And your name has lost the end started up again after it emerged that she harboured an old
bit, it should have an -e [Freude =joy]. The death and castra- carefully 'Concealed hostility towards her own mother. Yet
tion wish is obvious. I cannot say any more at present, only beg above all I learnt to understand that quite a number of baby
you, but it is unnecessary, to allow mitigating circumstances for complaints are produced by the mother, consciously or uncon-
my poor soul while you are reading these ramblings(!). sciously, and disappear after an analysis of the mother. It was
Yours most sincerely GRODDECK all so very instructive that I began to wish for more technical
ability in obstetrics. Then I would add a materni.ty hospital to
my sanatorium without fail. There is still a lot to be learnt
about the mother's and the baby's psyche as well as about the
Vienna, June 27, 7923 practice of obstetrics.
Dear Doctor, I have had a number of other experiences in my field of inter-
Thank you for your letters which have smoothed everything est. The longer one is active, unfortunately, the less confidently
out. Do not be astonished about my belated and short answer. I one deceives oneself about one's own discoveries and the more
have been ill myself and had an operation inside the mouths 6 difficult it becomes not to lose one's way in the labyrinth of the
and now I have lost a dear grandchild after three weeks of suf- unconscious because of the multiplicity of routes. There is
fering from miliar tuberculosis. That hurts and silences one. hardly anything that is communicable. More and more I am
Sincerely yours FREUD content to observe attentively, without giving in to the ambition
82 83
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
of understanding what's happening. In mid-December we shall that this first attempt has been very successful. We shall travel
close the sanatorium. Then we will go away- Emmy and I, by to Sweden at the end of January and shall talk to the publisher
the way, have at last got married at the registry office 87 - to in person. The lectures will be translated next. Then, if you are
Holland, Denmark, and Sweden, where I am to give some agreeable, The Interpretation of Dreams.
talks. But this is not yet confirmed. I have been asked to give talks in Harlem and Stockholm,
Every now and then I have news of you, I have also been told also perhaps in Copenhagen. Typing the Swedish text helps me
about your operation. My thoughts and best wishes are with polish up my knowledge ofthe language.
you whom I love so much. The sanatorium is closed until the middle of March, thus I
Yours most sincerely GRODDECK have time for work. But so far I have not been in the mood. The
second part of The Seeker of Souls has not yet surfaced enough for
me to write it down. I want it to be good. The Book of the It I had
already distanced myselffrom before I wrote it.
Now I must come back to your illness once more. I have
Vienna, November 25, 7923 become so enamoured with my views that I cannot believe in
Dear Doctor, incurable diseases. Failure is due to the doctor, it is not inherent
First of all my congratulations, at bottom I'm all for doing in the illness. Yet the doctor has to be willing and the patient,
things the proper way. Now I am of course also interested to too. Since you are both in one person, only one of them will have
know whether you will allow your wife the freedom of pressing to be persuaded to be willing. It is not fitting that the egg wants
on with my translations. to be cleverer than the hen. But I love you and cannot do with-
Your professional writings are, as always, interesting, new out you.
and promising. Yet I shall willingly refrain from any attempt at This is the first letter I have written on the typewriter. Maybe
inlluencing you, something you do not always receive well. the mistakes show you what has got repressed. I am, as ever,
About myself I can say that I am ill. You seem to know the your grateful disciple GRODDECK
details. I know of course that it is the beginning of the end.
However, one cannot know whether it will develop steadily or
at intervals. But there has to be an end, and that does not mean
that there will not be further developments. One of them will be Vienna, December 78, 7923
found with you. Dear Frau Doktor,
With warm regards to you both The story of your working block and how it was overcome
Yours FREUD amused me very much. Of course I am much milder in my opin-
ion of the people you met in Berlin in 1922 and allow them their
human weaknesses.
Your repeated kind invitation to come to Baden Baden with
Baden Baden, Werderstr. 74, 5. 72.7923 my daughter cannot be rejected out of hand. For the time being,
Dear Professor, however, you are goingback to Sweden, I am not fit for travel-
Your letter confirmed what I had heard by way of rumour. I ling; when I have recovered in the Spring I shall have to work,
am sad, I cannot say more about it. and what will happen in summer nobody can predict. Yet one
You ask about the Swedish translation 88 . The fact that this should not be too sure of anything. By the way, isn't there a
letter is typed 89 shows you how far it has progressed. I am about meeting before that, at Easter in Salzburg?
to type out a clean copy. As far as I manage to be impartial I feel If you should ask in Stockholm about my chances of getting
84 85

a&.
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
the Nobel prize you will hear that I have been a candidate for a communicated this numerical example my wife concludes that
number of years and always failed thoroughly. Perhaps the ap- everything connected with it has a special importance for your
plication, which was not of course initiated by me, is thus null unconscious. As far as she knows you are 67 this year, exactly
and void already. the age at which the master of ordnance was retired. My wife
With warmest regards for both of you and best wishes for believes, and I share her view, that there might be an access to
your coming journey. the deeper layers of your unconscious which might perhaps
Yours FREUD lead to the curative layers of your being. We send our best
wishes, with hopes for a meeting in Salzburg and ultimately in
Baden, too.
I remain your loyal disciple GRODDECK

Baden Baden, Werderstr. 74, 4. 7. 7924


Dear Professor,
My reply to your kind letter to my wife is the news that the
translation of Everyday Lzfe into Swedish is ready for printing. I have looked again briefly at the passage with 246 7 in it and
We are taking the manuscript with us on our trip to Sweden, consider it necessary to go into it also because I myself changed
where my wife will ask a Swedish expert to look at it, and will !-\ the 246 7 to 426 7. The explanation for my error is interesting,
then hand it over to the publisher. Then he will start immedi- but I leave it out in order to discuss your numerical example.
ately on the translation of the lectures and wants to ask the pub- Shortly before it there is the story of the reversal of names and
lisher to send her a copy of the latest edition for the purpose. As the nursery maid. Her sister, Rosa, Dora (which probably has a /
far as I can judge the translation is good, i.e. it follows strictly special meaning), the poor people who cannot even remember their
the words of the original. names (marriage? name forced on one by the state), Erna,
We are going to Sweden to visit our relations there, at the Lucerna (Luzern?). There must be some sense in your publish-
same time I am to give some talks in Stockholm and Gothen- ing the hysteria fragment of all things.
burg. I have also put myself down today for a paper for the con- Immediately after the story there is Adler. Perhaps the word
gress: 'On the future development of psychoanalysis', which I Adler has more meaning than the man for you. I believe that in
shall prepare myself for this time since it is to deal with funda- the case of an illness as persistent as this one should be sus-
mental questions. If I were to rely on the inspiration of the picious of the early suggestions because they are used by the It
moment for it, it wouldn't be what it should be. in a cunning way, though correct in themselves. In the sen-
Herr von Roeder, whose essay on Aristotle is in the latest tences in between you talk of some cases with very intimate con-
number of Imago, would like to take part in the congress. I have tent which defy communication, and continue by saying
written to Berlin for a ticket, but I wanted to let you know about 'therefore I want to'. This 'therefore' has no rational basis and
it at the same time. is bound to strike one since you are otherwise so very precise in
My wife will accompany me to Salzburg. Perhaps she will get your sentence constructions. Afterwards, by the way, the ex-
a different impression there from the one she got in Berlin. In pression 'discretion' is used in connection with 'unfortunately'.
fact for some years now I can hardly bear to be in Berlin. ~E; The word and concept 'discretion' play too great a part in your
Jl~
While translating, my wife made a discovery which may be of '~ i~ works to explain this away as the discretion of the doctor or of
'(,t,
value to you, if you haven't thought of it already. The obser- ·;( the decent human being. Here, somehow, the ideal Ego is
vations of a completely impartial person are always of value. speaking, and the It stands behind it and laughs. It struck me,
The matter in question is the number 2467 90 . Since you have moreover, that in the Adler example there is the number 17,
86 87
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
that is exactly the same as the number in your example where a a confirmation. Now fortunately it seems to have been avoided,
displacement from 19 to 17 takes place. That I was struck by I have started a new working year.
UB [Unterbewusstsein =unconscious] must be due to my own cir- Best wishes for your trip!
cumstances, but I must tell you that before my wife came along Yours FREUD
with her 67 I had thought of the abbreviation UBW, ac-
companied by the often felt and often examined sensation of
aversion for the sign UBW.- The next story has the numbers 17 Baden Baden) December 78) 7924
and 19, and when you take the word yourself again, we get Dear Professor,
426718, that is almost 2467. 'The youngest child in a long row You are right, I have not written to you for a long time 91 .
of children and a father lost early on.' Ferenczi told me a few things about you and I hope he did the
Now to the story itself. The friend, the letter, corrections, same to you about me. There is not much to report. When I
dream interpretation, 'no longer meaning to change', mistakes. heard that you were not coming to Salzburg I lost interest in the
The sentence: 'It would be best to quote (why best?) .... congress and rewrote the talk I wanted to give and put it in my
caught redhanded.' The letter is certain to be very meaningful. flies, a clear sign that I had written it with you in mind as audi-
You put next to the general, a rare exception in the book, the ence. I also understand better and better that I love you but not
initials E. M. Does that mean something? The explanation why the curious atmosphere of many congressional lions striving
you followed the career of this man is so strange that you can against one another. I am only friendly with Ferenczi, and he is
direct your attention to it. And now your wife appears with a nice enough to come and see rne here. Otherwise I continue in
question, and in this passage you are again uncustomarily my quiet course of practising medicine and admiring Freud
ambiguous or you leave something out. For why does your wife from a distance. An interruption was a trip to Berlin with my
ask in a way as if she were identical with the general? The wife where I much enjoyed giving a few quite successful lec-
reader cannot follow. Something is missing. I protest. A firm tures92.
point in my memory. You decide to retire at 6 7. Finally there is My opinion of Count Keyserling 93 is very subjective. Person-
a sentence which starts with the word 'evidently' and draws the ally I like him very much. I do not know anything about his
conclusion. The word 'evidently' is suspect, like the words philosophy, but I was pleased that he did not at all mind my ig-
'probably, certainly, etc.'. norance, not even after he had given me a few of his works and
I did not deceive myself that my words...,.. now I am about to realised that I did not read them. His article on psychoan-
write something quite different from what I wanted to write. alysis94 I can also only judge subjectively. He talks so much
Instead of distortion the truth. I want you to be prompted by about me 95 that I have to assume that somehow he has played
this digression to investigate your illness again closely and - Judas in his conscience towards himself and towards me. But
come to Baden. that would only prove the fact that he has a sensitive con-
With best wishes to you and your family science, something I already know from the short time I treated
the two GRODDECKS him, and that I have made a mistake in the course of his treat-
ment. I liked him because he is a happy enjoyable mixture of
man and child in which the harmless and the kind, a small,
boastful, intuitively reacting child predominates. This is the
ViennaJJanuary 75) 7924 reason, I believe, for the astonishing influence he exerts on indi-
Dear Doctor, viduals and crowds. He knows how to create a contented equ-
So you andjor your wife noticed it, too! I have been cross all able mood at least for the time that one is with him, and if he
the time that it might possibly have given the forces of the occult ascribes this effect to his wisdom he indulges in his tendency to
88 89

~
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
boast, I believe. The nice thing is that he knows of this tendency the others. The cause would be helped by this.
and laughs about it. He has an overwhelming laugh, when he Your mention ofFerenczi makes me sense the reproach that I
talks about himself honestly. He is very vain, but not at all con- have not yet visited you in your beautiful home town. I would
ceited. The interpretation of a dream, in which a buttertly like to, but you must realise my present situation and how difti-
called Kohlweissling figured, seems to me to be characteristic of cult it is for me now, perhaps for ever, to travel.
his nature. 'Weissling, Weiseling (= wise one), that's me', he With warm regards to both of you
said, and' I am talking Kohl, Kohl (rubbish)'. This is about all I Yours FREUD
have to say about Count Keyserling. I only want to add that you
haven't seen him alone. I know from my personal experience
that one is only honest with you when nobody is listening. This
is something that can be explained from your nature, some- Baden Baden, March 76, 7925
thing that may become the fate of other analysts after 30 years Dear Professor,
of confessional work and can be felt with you particularly, be- I feel like writing and would like to tell you that I am thinking
cause you are the king. of you. It may gradually emerge why the urge is so vivid at the
A polemical attack on Keyserling I believe would be point- moment to actually make me write. The last few years have not
less. Your work lives, grows, and flourishes of its own accord been quiet for me, now it seems to be better again. Above all
and will outlast many Keyserlings. there is a growing urge to sum up my experiences since 1920. In
My wife sends her w~rmest regards and many thanks for what form this should be done I don't yet know. I am drawn
your kind words. neither to the irony of The Seeker of Souls nor to the curiously
I remain, as ever, your loyal disciple GRODDECK mixed mood of The Book of the It. Something autobiographical is
stirring in me; at least I am busy reading all sorts of memoirs
and dreaming vaguely about how something like this could be
Vienna, December 27, 792~1 done analytically. Presumably one should stick to the actual
Dear Doctor, course of one's life. Yet I can imagine an associative form as
I am really rather pleased that you have a sympathetic view well.
of Keyserling. I could not make him out when I met him. Of And this is the reason why I am longing for you so much. In
course I never contemplated a polemical battle with him. rv1y an analytical biography of that kind you would play an import-
remarks in this direction arose from the fear that you might sus- ant part. The pater peccavi comes into my mind. And every-
)
pect such intentions behind my questions. But then his remarks ¥1 thing that should go into the book will, before I accept it, have
'l
on psychoanalysis 96 in his most recent essay were particularly
naive. r to wait until I have told you of my plan. This does not mean
officially that it will be carried out.
I am, of course, disturbed by a trait of yours which I would Greetings to everybody who is interested in me and warmest
like to influence, even though I know that I shall not make much regards
headway. I am sorry that you want to erect a wall between Your grateful disciple GRODDECK
yourself and the other lions in the congress menagerie. It is difli-
cult to practice analysis in isolation. It is an exquisitely sociable
undertaking. It would be much better if we roared and cried to-
gether in unison and in the same boat, instead of grumbling in Baden Baden, April 75, 7925
our different corners. You know how much I value your per- Dear Professor,
sonal affection, but it is time for you to transfer some of it on to I have read your autobiography 97 and enjoyed it very much.
90 91

I
.~.,\,
~I
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
In the final sentence there is so much simple force that I am con-
vinced of your recovery. Everything is certainly leading uphill Baden Baden, June 73, 7925
and the observer and investigator knows that this wanderer will Dear Professor,
continue to climb for a long time and with firm steps, full of Do not get frightened about the content of this letter, it does
vitality and the ability to take in and digest impressions. not demand to be read. But you have a right to know what I am
Landauer 98 told me that he will visit you in Vienna. I am doing. The meetings 100 which are mentioned in the enclosed
looking forward to hearing more from him. He is a pleasant seem to go well. There are almost only laymen here, only oc-
person whose nature and words I trust and whom I like listen- casionally a doctor turns up. The discussion is about God and
ing to. the world, and people are learning gradually to express them-
We experience all sorts of things here, some things I believed selves freely.
I had known for a long time assume new and stimulating forms. I saw Keyserling recently and he told me about you. He was
I am curious to know where it will all lead to. So far I can only deeply impressed by you. And what he said about you made me
tell by my fattening belly that I am pregnant again. I am keen to happy. I have reason to think that he doesn't wish me any
write an analytical biography. My wife is trying to persuade me harm.
to write a methodical work on the It. Maybe it will all evaporate Will you come to Homburg? I have put myself down for a
into a few small articles. talk 101 and hope that I shall be more successful this time in put-
Best regards from us two. ting over my ideas. Yet for me everything depends on the
Your loyal disciple GRODDECK moment and very much on the audience.
Personally I am flattered that you have again expressed your I wish you all the best, more than you believe possible. l\1y
view on the qualification of non-medical practitioners to prac- wife sends her best regards.
tice psychoanalysis 99 . Ever your loyal disciple GRODDECK

Vienna, Apri/2(), 7925 Vienna,June 78, 7925


Dear Doctor, Dear Doctor,
Thank you for your two latest letters. I am glad that you like Thank you for your reports and enclosures. Everything from
the autobiography. I wrote it without inner urgency merely on you is interesting to me, even if I may not follow you in detail. I
the insistence of the editor. do not, of course, recognise my civilised, bourgeois, demystifled
That you are gestating and that there may be an eruption ld in your It. Yet you know that mine derived from yours.
soon I am glad to hear. You know I like originality even if it is Keyserling made a better impression on me this time. We
linked with a little obstinacy. The latter on its own, as it mani- spent a very interesting evening together. He talked very well of
fests itself in Hattingberg, I cannot stomach, it seems to me a you while declaring H.- probably in a complimentary fashion
poor substitute for the former. I am not very well locally. l\1y -the biggest ass he had ever known.
masochism as object of treatment is almost used up, it is time I shall not come to Homburg. I have to get used to all kinds of
for me to be independent of the doctor. renunciation. But of course if what you wish for me comes true,
With warmest regards to you and your wife I c- better things than I think possible, then I shall come.
Yours FREUD Warm est regards to you and your wife
Yours FREUD

92 93

~~.
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
own It continue to live for a long time for your own sake and
Budapest, Hotel Szent Gellert, 73. 77. 7925 that of your friends and patients.
Dear Professor, On behalf of the Wiener Psychoanalytische Vereinigung,
On the 24th and 25th my wife and I shall be in Vienna on our Chairman
way back to Baden Baden. If you have time and inclination to signed FREUD
receive your most loyal admirer you would please him very Secretary DR. R. H. J OKL
much.
With all best wishes
Your disciple GRODDECK October 73, 7926
My Ego and my ld congratulate your It on its fait accompli,
hoping that it may please its inscrutable decree to allow itself a
long happy lease oflife.
Vienna, 77. 77.7925 FREUD
My dear friends,
If I do not happen to be ill again around the 24th of this
month I shall be very pleased to see you both in my house. Baden Baden, Hutte, October 77, 7926
Yours most sincerely FREUD Dear Professor,
Many thanks for the charming wire. As far as I can tell con-
sidering the enigmatic nature of my It it seems to be willing to
allow itself a long happy lease of life. In any case it is pleased
with the sympathies of your Ego and Id and proud.
Vienna IX, Berggasse 79, 23. 77. 7925 We have gone on holiday again after an eventful year, at first
My dear friends, as expected I was ill again, this time with a
into our beloved hut, but soon we want to go to Berlin where I
non-specific tooth trouble, have not quite recovered from an op-
am to give some talks 102 again and after that probably to
eration, and now dare invite you to a conversation tomorrow London.
Tuesday 24th of the month, at 12 o'clock.
Ferenczi and Frau Andreas-Salome 103 were here and told me
Yours most sincerely FREUD about you and your state of health. I receive all the news which
is related to the object of my last passion greedily and
remember it.
My wife sends her warmest regards and wishes.
Wiener Psychoanalytische Vereinigung Ever your grateful and devoted disciple GRoDDECK
Vienna, 77 October 7926
On your 60th birthday our association sends you its warmest
congratulations. Even your enemies in the scientific field are Baden Baden, October 77, 7926
admirers and friends of your person. We are all grateful to you To the Wiener Psychoanalytische Vereinigung
for the idosyncratic views with which you opened up barely Many thanks for its honour-conferring congratulations on
explored areas. Then we all want to thank you for the happy my 60th birthday.
laugh into which you transformed our normally so serious in- The interest which the association and the entire inter-
vestigation of the psyche, in your Seeker of Souls. May your very national psychoanalytical movement have shown in my views is
94 95
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
an effective stimulus to me to push on into areas ahead of us and had a welcome effect. At all events it ended with a rejection of
barely explored and to make them accessible in such a way that the narrow-minded claim by the Americans and a recom-
they become susceptible to the investigations of methodical mendation at least for lay analysis. The new president, Dr. Eit-
science. ingon, is above all cautious and conciliatory, probably the right
The Seeker of Souls, which I consider the expression of my best helmsman in a stormy sea. I am very pleased to have our friend
efforts, I hope to revive in the not too distant future so that Ferenczi close by. So far I have had no opportunity to talk to
laughter will not be forgotten in the midst of so much serious- him alone, so much do the visitors after the congress claim
ness. priority.
With heartfelt thanks DR. G Eo R c GRODDECK Greetings to you and your wife FREUD

Vienna, September 7, 1927 Baden Baden, September 9, 1927


Dear Doctor, Dear Professor,
To follow up your news that the publishers have not yet an- A letter from you produces high spirits which I shall use to
swered your question 104 concerning the continuation of The answer you straight away. This is not meant to be taken as
Seeker of Souls I shall protest energetically to Storfer 105 , when I begging for a further letter though I cannot deny that it would
send him the drawings. I can only influence the matter by sym- please me.
pathetic words, the objective situation is known only to him. I share your view about the unfitness of illustrations for books
The drawings caused me a certain embarrassment. I would like like these but the public occasionally has curious wishes. It is
to judge them as you do. (The page with the urinating lion possible that it might like an illustrated edition. The publishers
seems to be anatomically wrong.) Yet I have repeatedly had the will know best whether the attempt would be rewarding.
experience that cartoons like these neither give pleasure in I know that you do not like The Book of the It. But I have never
themselves nor increase the pleasure in the text. I had it with understood why you put it in the same class as Stekel 's books.
the illustrations by Benikshank- I believe he is written like this The expression It mythology does not help me, it might be
- to Dickens, with the illustrations to the big Balzac edition taken as a compliment as well as a reproach.
which I possess, and most recently with the woodcuts for the The value of a book is decided by the reader, and there is no
posthumous edition of Anatole France which I receive from the point in an author's defending his book; one knows anyway
French group since I turned 70. I would therefore prefer to de- that he likes it, otherwise he would not publish it. But you are
clare myself quite incompetent. not really a teacher who is responsible for his pupils' achieve-
In the story of the second Seeker of Souls I miss the contin- ments, you are not even a reader in the normal sense of the
uation of a thread which sticks out of the first part: the relations word, but you are Freud and as such you better judge the follies
ofT. W. 106 to his niece. Otherwise I am glad to see your creative of your admirers with leniency. In the same way in which your
vein Rowing again, after having got yourself into a position of praise invigorates your criticism kills.
cancelling all distinctions and into an unsatisfactory monotony When I look at the achievements of psychoanalytic literature
with regard to the It mythology. I cannot hide the fact that P. in the last years I find the same monotony which you found in
T. 107 , even though I borrowed something from him, seemed the It mythology, only in a different key. Why do you not allow
much less sympathetic to me than T. W. me the mitigating circumstances you allow others? In spite of
I think you were missed at the congress 108 . Your warning your rejection I believe that this book possesses some merits
about overestimating professional medical interests would have that should not be underrated. First, all the facts in it are true;
96 97

a
THE MEANING OF ILLNESS
CORRESPONDENCE WITH SIGMUND FREUD
they are true not only to my own gullible person, I receive more
and more confirmation of the reality and spiritual truth of my Baden Baden, September 1, 1930
arguments from licensed and unlicensed doctors. Secondly the
book is not boring. Thirdly it discusses frankly a number of My most respected teacher and dearly beloved human being,
issues which urgently needed discussing; and fourthly, it deals Since I have reason to distrust the legibility of my hand-
with a subject I know better than other people. writing you must excuse my writing to you by typewriter
The fact that not one of the members of the society dared instead of by hand, though I have not yet learnt to dictate, I
follow my suggestions -Deutsch 109 and the American 1111 , whose manage quite a reasonable speed this way.
name I now forget, do not count seriously- is not due to the Your picture gives me great pleasure and was a surprise such
wrongness of my case; there are enough people outside the so- as I rarely have. I did not realise that you knew what you meant
ciety who are trying with difficulty to learn from the corpus vile of
to me personally.
the patient what Freud has been saying and what cannot any Unfortunately I heard too late that you were awarded the
longer be ascribed to the field of neurosis. I cannot help think- Goethe Prize. As far as I have heard, all kinds of people consider
ing that this striking behaviour of unity is due to fear of your dis- it necessary to comment on this. If I may be allowed to judge by
approval. One knows your opinion of The Book of the It, yet one my experience then there is no one in the whole wide world who
does not know or at least one pretends as if one did not know would deserve it more than you do. I was brought up in Goethe
what your view is on the use of psychoanalysis in cases of worship, but I did not understand him very well until I learnt
organic disease. I am conceited enough to draw a conclusion about psychoanalysis. On the assumption that psychoanalysis,
from your years of silence on my activities which goes as fol- which for me is not a medical affair but something totally differ-
lows: Groddeck has a useful idea, but I - Freud - cannot ent, has enabled me better to ask the right questions I am turn-
approve of the way in which he puts it; he must and will have to ing to you, the new careful disguiser, in the hope that you will
help himself alone. This is an honour for me, but it was very be allowed to tell the boy something at least of the best things
painful for very long.
you know.
Please recommend us both to your family and accept the When Faust is carried to heaven by the angels after his death
most respectful regards from myself and my wife a few words accompany this event which your disciple has pon-
Your loyal disciple GRODDECK dered until his head was spinning round like a mill-stone.
What bothers me, are the inverted commas round the ex-
pression 'Whoever strives and toils can be saved by us ' 111 -
they are in the Weimar edition even, in which the colon after
Vienna, September 7, 1929 'evil' is left out. According to Eckermann Goethe told him that
Dear Doctor,
the enigma of Faust is solved in this riddle. Though I do not
When I meet Dr. Runge I shall be pleased to help him as far trust Eckermann very much - a family tradition- I cannot as-
as is in my power. Now I shall go to Berlin with my father for a sume that he has misunderstood, particularly since he tells us
while, but in October I shall be back with the Vienna Society at length in what follows the other remarks that Goethe made
and Dr. Federn is sure to introduce him there. about it; this sound like genuine Eckermann, it only conf1rms
My father is very well here as you are certain to be told by Dr. that a mention may have been made of the importance of this
Ferenczi, too.
passage. The inverted commas prove that the famous words
Kind regards about striving and toiling are a quotation, and do not neces-
Yours ANNA FREUD sarily tell us the angel's opinion. If it is true, as I assume, that
this sentence is the evil itself, that to believe one could be saved
98 99
CORRESPONDENCE WITH SIGMUND FREUD
THE MEANING OF ILLNESS
by striving and toiling is evil, I would be helped a lot. which I recall often. I beg her to sacrifice a leisure hour and to
I do not intend to coax an answer out of you with this ques- report to you briefly.
tion, I would much rather you refuted me. Much as I would like I am in roughly the same situation as I was at the time of The
Goethe to be a star witness of my perverse ideas, my godlikeness Seeker of Souls, yet I do not know whether you can help me this
makes me afraid. time. It is possible that you are of the same opinion as I am that
The best thing is perhaps not to answer, but the best is not the material I deal with would be better published as the opin-
always the pleasantest for your disciple, now grown old, ion ofthe slightly morbid Thomas Weltlein. But at the moment
GRODDECK and probably for the rest of my life I lack the strength to tell sto-
Would you please tell Miss Anna how sorry I am not to have ries and invent structures. This is why I have chosen the serious
greeted her in Frankfurt. I trust her to have a forgiving heart. approach. ·
It is a book in which the idiosyncrasies of language and fine
art 112 are used to prove how close the connections between
symbol and life have always been. Medicine, particularly in the
first part, will only be loosely linked to it, yet at the same time I
Grundlsee, September 5, 1930 want to discuss the influence of the symbol on the whole of the
Dear Doctor, organism and its individual parts 113 - either in a volume on its
As you know one is not obliged to express one's thanks for own or in individual pamphlets. I enclose a sample of both pro-
congratulations, particularly if they are related to a public jects, which might be sufficient to decide whether the psy-
recognition. choanalytic publishing house can consider the matter or not.
Fortunately your letter contains other things, too, about The first chapter was accepted by Storfer 114 for the psychoan-
which I can be pleased. alytic movement and will probably appear in the next number;
When I am back in Vienna and near my bookshelves I shall I enclose the two following chapters. The fragments on vision
try and puzzle out the passage you singled out, shall consult give an impression of the second part. It is all very unfinished
Eckermann, whom I find as unsympathetic as you do, and shall still and needs revision. I hope by autumn to finish the first part
write to you about it. and a considerable chunk of the second.
Meanwhile I do not understand Goethe any better than The fact that I submit the work in the form of a monster and
Groddeck. Will I be lucky as a Goethe critic? It seems to me do not wait until the baby is presentable is due to the uncer-
hard-earned bread. tainty of whether the publishers will decide in principle to pub-
The celebration in Frankfurt is said to have been very nice. lish the work. This should not turn into an obligation, it is
My daughter would certainly have liked to see you in the Goe- merely a request. Since I know from experience how long it
thehaus. takes when one has to go from publisher to publisher selling a
Yours most sincerely FREUD f1nished work, I shall try to start the whole business off at least.
Storfer told me that he is leaving the publishers on the 1st of
April. If I understood him rightly your son is taking his place. I
told him at the same time of the step I have taken vis-a-vis you.
Baden Baden, February 7, 1932 Will he be kind enough to send me the manuscripts some time,
Dear Professor, no matter whether I get a yes or a no for an answer.
To go straight to the point: I do not expect you yourself to I remain with best regards and wishes your now unfor-
read the enclosed manuscripts but maybe Miss Anna has still tunately a little senile and fragile, but always grateful disciple.
got a soft spot for me in memory of our meeting in The Hague GRODDECK

100 101
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
You are important to us if only as somebody who takes a con-
tinuing interest.
Most sincerely yours FREUD
Vienna, March 25, 7932
Dear Doctor,
In spite of your kind letter to me my father insisted on read-
ing your manuscript himself. He wants me to tell you that even Baden Baden, March 6, 7934
before it he had not believed in your 'spiritual senility', but all Dear Professor,
the less so after the reading. But I am to tell you that the plea- Many thanks for your kind letter. The two essays were delib-
sure he found in it unfortunately does not have any practical erately kept indistinct. Otherwise I would have started with
consequences. This is not the manuscript's fault, it is the situa- Amor in the Melancholia print. I consider the print an illus-
tion the publishing house is in at the moment. My brother 115 tration of the consequences which ensue when the erotic prin-
has taken it over in order to steer it slowly and cautiously out of ciple oflife is denied. To write more explicitly about the cancer
the dangerous financial situation. This caution unfortunately question than I have done does not seem advisable to me yet. I
implies a big reduction of production which for a while has to be sent you the things because you have so often proved your inter-
confined to the journals and -to books for which the authors est to me in my activities and because I wanted to send you a
themselves will pay the printing costs. I hope this won't last sign of life. I did not count on publication, but if Imago wants to
long, but apparently it is the only way to keep the publishing print them, it can have them.
firm alive. Ever your grateful disciple GRODDECK
You will understand this. For there are so many similar sto-
ries about these days. I am sorry that your letter does not sound
as if you were in high spirits and that I am not doing anything
now to improve these.
I am to give you my father's regards. He is well, again and NOTES
again he overcomes the physical difficulties he encounters with
wonderful energy and vitality. 1. First published in Georg Groddeck, Der Mensch und sein l!..'s, Wiesbaden,
Most sincerely yours ANN A FREUD 1970.
2. Nasamecu. Der gesunde und der kranke Aiensch, Leipzig, 1913.
3. :(ur Psychopathologie des Alltagsleben, Berlin, 1904. Trans.: The 1\ychojwtho-
logy of Everyday Life, Standard Edition, Vol. VI.
4. Die Traumdeutung, Leipzig and Vienna, 1900. Trans.: The lnterjmtation of
Vienna, March 4, 7934 Dreams, Standard Edition, Vols. IV and V.
Dear Doctor, 5. Alfred Adler (1870-1937), Austrian psychoanalyst, later founded indi-
To read one or two articles by you remains a pleasure even if vidual psychology. See his fundamental Study of Organ-Inferiority, Vienna
and Berlin, 1907.
one cannot bring oneself to take your side, as happened to me 6. Carl Gustav Jung (1875-1961 ), Swiss psychologist and psychiatrist.
this time. As for the Melancholia print 116 I cannot think myself 7. 'Das Unbewusste', Vienna, 1915. Trans.: 'The Unconscious', Standard
into the intensity of that particular age's thought. Cancer is un- Edition, Vol. XIV, p. 187.
fortunately much nearer to my mind, but what you say about 8. Sandor F. Ferenczi (1873-1933), Hungarian psychoanalyst. The paper
it 117 seems too indistinct to me and probably to you, too. How- referred to was published under the title 'Von Krankheits-oder Patho-
neurosen' (1916), and is translated as 'Disease- or Patho-Neuroses' in
ever, I shall certainly present the two essays to the editors of Further Contributions to the Theory and Technique of Psycho-Analysis (London:
Imago. The Hogarth Press).
102 103
THE MEANING OF ILLNESS CORRESPONDENCE WITH SIGMUND FREUD
9. J. B. Antoine de Lamarck (1744-1829), French scientist. choanalyse, VI, 1920. Reprinted in Psychoanalytische Schriften zur Psychosoma-
10. Ivan Petr. Pavlov (1849-1936 ), Russian physiologist. tik.
11. Emil Abderhalden (1877-1950), Swiss physiologist. 34. The hero ofGroddeck's novel, Der Seelensucher (see note 23 above).
12. Groddeck, 'Psychic Conditioning and the Psychoanalytic Treatment of 35. FelicienRops (1833-1898), Belgianpainterandetcher.
Organic Disorders'. See Chapter 2 below, pp. 109-31. 36. 'Ober die Psychoanalyse des Organischen im Menschen' (On psychoan-
13. Imago. Zeitschrift fiir Anwendung der Psychoanalyse.auf die Natur und alysing the organic in human beings). Paper read to the Sixth Inter-
Geisteswissenschaften. (A journal for the application of psychoanalysis national Psycho-Analytic Congress in The Hague, Sept. 1920. Intern.
in Science and the Humanities.) Vienna, 1912-193 7. :(eitschrijt fur Psychoanalyse, VII, 1921. Reprinted in Psychoanalytische Schrzf-
14. Ludwig Levy, 'Sexualsymbolik in der biblischen Paradiesgeschichte', ten zur Psychosomatik.
Imago, V, 1917. See Groddeck's discussion of this paper in Chapter 4 37. Op. cit. See note 36 above.
below, 'The Compulsion to Use Symbols', p. 158. 38. Otto Rank (1886-1939), Austrian psychoanalyst. At the time Managing
15. See note 12 above. Director of the Internationaler Psychoanalytischer Verlag.
16. The letter containing this remark could not be found among Groddeck's 39. Anna Freud (1895 ), daughter of Sigmund Freud.
papers. 40. Op. cit. See note 36 above.
17. Hosmersholm, play by Henrik Ibsen. 41. Op. cit. See note 36 above.
18. Dr. Hanns Sachs (1881-1947), psychoanalyst. 42. Beyond the Pleasure Principle (1920), Standard Edition, Vol. XVIII.
19. Rebecca West. Groddeck, 'Tragodie oder Komodie. Eine Frage an die 43. 'Der Symbolisierungszwang' (The Compulsion to Use Symbols), Imago,
Ibsenleser' (Tragedy or Comedy. A question put to readers of Ibsen), VIII, 1922. See Chapter4 below, pp. 158-71.
Leipzig, 1910. Reprinted in Psychoanalytische Schriften zur Literatur und 44. Op. cit. See note 43 above.
Kunst, Wiesbaden, 1964.
45. DerSeelensucher.
20. A Doll's House, play by Henrik Ibsen. See Groddeck, 'Tragodie oder
46. Review of Der Seelensucher by Sandor Ferenczi. Imago, VII, 1921.
Komodie', op. cit.
21. The Master Builder, play by Henrik Ibsen. See Groddeck, 'Tragodie oder 4 7. The first five letters of Das Buch vom Es, Vienna, 1923. Trans.: The Book of
the It, Vision Press, London, 1950; Vintage Books, New York, 1961.
Komodie', op. cit.
22. The Wild Duck, play by Henrik Ibsen. See Groddeck, 'Tragodie und 48. Group Psychology and the Analysis of the l:.go (1921 ), Standard Edition, Vol.
Komodie', op. cit. XVIII.
23. 'Der Wanzent5ter oder die entschleierte Seele Thomas Weltleins' (The 49. Hippolyte Bernheim (1837-1919). Physician and psychiatrist. Freud
bug killer or the unveiled soul of Thomas Weltlein). A psychoanalytic studied the effects of hypnotic suggestion with Bernheim in 1889.
novel, published later under the title Der Seelensucher (The Seeker of 50. Das Buch vom Es. Psychoanalytische Briefe an eine Freundin (The Book of the It.
Souls), Vienna, 1921. Psychoanalytic letters to a lady friend). See note 47 above.
24. Op. cit. See note 12 above. 51. The Book of the It, 1961, p. 102.
25. Hunderfiinfzehn psychoanalytische Vortdige, gehalten im Sanatorium 52. Ibid., p. 109.
Groddeck Baden Baden 1916-1919 (115 psychoanalytic lectures held at 53. Wilhelm Stekel (1868-1940), Viennese neurologist, psychoanalyst.
the Groddeck Clinic, Baden Baden). Manuscript. 54. Wilhelm Stekel, Die Sprache des Traumes (The language of dreams), Wies-
26. PaperreadNovember8, 1916. baden, 1911.
27. Paper read August 24, 1918. Printed in Psychoanalytische Schrzften ,-;ur 55. The brother, Hans Groddeck (1860-1914 ),journalist.
Literatur und Kunst. 56. 1915 first encounter with Emmy von Voigt, nee Larssen (1874-1961),
28. PaperreadMay22, 1918. Max Klinger (1857-1920). who became his wife and assistant.
29. 'Der Wanzent5ter', see note 23 above. 57. SisterCaroline, 1865-1903.
30. 'Wunscherfiillungen der indischen und gottlichen Strafen' Wish fulfil- 58. Mother: Caroline Groddeck, nee Koberstein, 1825-1892.
ments by secular and heavenly punishments), Intern. :(eitschnft fiir Ply- 59. Dr. Karl Abraham (1877-1925 ), psychoanalyst.
choanalyse, VI, 1920. Reprinted in Psychoanalytische Schrzften ,-;ur
60. Ernestjones (1879-1958), psychoanalyst.
Psychosomatik.
61. Eitingon, Max E. (1881-1943 ), psychoanalyst.
31. Reference to article on wish fulfilments.
62. Emmy Groddeck.
32. 'Uber das Es' (manuscript dated 1920). Trans.: 'On the It', Chapter 3
below, pp. 132-57. 63. TheBookoftheit,op.cit.
33. 'Eine Symptomanalyse' (A symptom analysis). Intern. :(eitschrzftfiir 1\y- 64. Gisella Ferenczi.
65. Alfred Polgar, Berliner Tageblatt, 20.12.1921.
104 105
CORRESPONDENCE WITH SIGMUND FREUD
THE MEANING OF ILLNESS
90. The Psychopathology of Everyday Lzfe. Standard Edition, Vol. VI, pp. 242-3.
66. Eugenie Marlitt (1825-1887), romantic novelist.
91. The Freud letter mentioned by Groddeck was not among his posthum-
67. Sigmund Freud, 'Fragment of an Analysis of a Case of Hysteria' (1905 ),
ous papers.
Standard Edition, Vol. VII.
92. Lectures at the Lessing Hochschule, Berlin, October-November 1924,
68. The Bookofthe It, 1961, p. 222. title: 'Das Es. Einfahrung in die Psychoanalyse' (The It. Introduction to
69. Gustav Schwab (1792-1850), editor and writer of German legends and Psychoanalysis).
folk tales. 93. Hermann Graf Keyserling (1880-1946 ), philosopher and social psycho-
70. The second volume of the novel Der Seelensucher. logist. See the Introduction, p. 21.
71. Von allen Geistern, die bejahen 94. 'Heilkunst und Tiefenschau. Der Weg zur Vollendung' (Therapy and
Ist mir der Schalk am wenigsten zur Last. Understanding. The Way to Perfection). Gesellschaft far freie Philo-
(Modified quote from Goethe, Faust I, Prolog im Himmel: sophie (Society of Free Philosophy) Nos. 8/9, Darmstadt, 1924.
Von allen Geistern, die verneinen, 95. In the above-mentioned paper Keyserling writes: 'Groddeck is the least
Ist mir der Schalk am wenigsten zur Last.) prejudiced among the psychoanalysts and moreover the doctor most
72. Introductory Lectures on Psycho-Analysis (1916-17), Standard Edition, Vols. aware of the implications of his trade I have met.'
XV and XVI. 96. 'Heilkunst und Tiefenschau'. See note 94 above.
73. Arthur Kielholz, Jakob Bohme (1575-1624), Ein pathographischer
97. An Autobiographical Study (1925), Standard Edition, Vol. XX.
Beitrag zur Psychologie der M ystik. Schriften zur Angewandten Seelen-
kunde, 1919. (A pathographic contribution to the psychology of mysti- 98. Karl Landauer, psychiatrist and psychoanalyst.
cism. Essays on applied psychology.) 99. Sigmund Freud, The Question of Lay Analysis (1926), Standard Edition,
74. Groddeck's lecture on the It at the International Psycho-Analytic Con- Vol. XX.
gress in Berlin (25 to 27 September 1922). The manuscript does not 100. Saturday evening meetings at the Groddeck clinic with discussions on
exist. psychoanalysis and other subjects.
75. 17.4.1921. 101. Groddeck read a paper to the Hamburg congress (September 1925) on
76. Dr. Hans von Hattingberg, German psychoanalyst. His lecture to the 'The It and Psychoanalysis' ('Das Es und die Psychoanalyse'). Die Arche,
Congress was entitled:' An analysis of the psychoanalytic situation.' I 10 (20. 9.1925) Reprinted in Psychoanalytische &hrzften ;::,ur Psychosomatik.
77. Emmy Groddeck translated Freud's The Psychopathology of Everyday Life 102. Lecture series 'Das Es' (The It) Lessing Hochschule, Berlin, Autumn
into Swedish. 1926.DieArche,II, 1926,15,16, 17, 18.SeeChapter9below,p.222.
78. 'Das Ding an sich. Analytische Versuche an Aristoteles' Analytik (The 103. Lou Andreas-Salome (1861-1937), writer, friend ofNietzsche and Rilke,
thing in itself. Analytical essays on Aristotle's analytics), by Egenolf came into contact with the Vienna Psychoanalytic Society and with
Roeder von Diersburg (1890-1968), Doctor of Philosophy. Imago, IX, Freud in 1911.
1923, no. 3. 104. Groddeck 's letter to the publisher is not in the posthumous papers.
79. Das Buch vom Es (The Book of the It). Dr. Oskar Pfister mentions the follow- 105. Albert Josef Storfer (1888-1944), director of the Internationaler Psy-
ing remarks made by Freud, in Schweizerische ,Zeitschriftfur Psycho!ogie, Vol. choanalytischerVerlagin Vienna, 1921-1932.
IX, No.2, p. 153: 'Freud told me soon after the publication of Da.1 Buch 106. Thomas Weltlein, hero of the novel, The Seeker of Souls.
vom l!..'s ( 1923) in conversation: "Groddeck is quite certainly four fifths 107. Patrick Troll. The letters in The Book of the It were signed Patrick Troll.
right in his belief that organic illnesses can be traced to the It and per-
haps in the remaining fifth he is also right."' 108. International psychoanalytic congress, September 1927, in Innsbruck.
80. The l!..go and the ld (1923 ), Standard Edition, Vol. XIX. 109. Dr. Felix Deutsch (1884-1964 ), psychoanalyst.
81. 'N achlust und N achbewusst' (After-pleasure and after-conscious). 110. Smith Ely Jelliffe (1866-1945 ), psychoanalyst.
82. The l!..go and the ld, Standard Edition, Vol. XIX, p. 17. 111. 'Wer immer strebend sich bemuht, den konnen wir erlosen' (Faust II, V).
See Groddeck, 'Ein Faustzitat '. Reprinted in Psychoanalytische Schnften ~-:ur
83. Rank had suggested modifications and cuts in The Book of the It. Literatur und Kunst.
84. 22.9. (1885). 112. Der Mensch als Symbol. Vienna, Internationaler Psychoanalytischer
85. 14.9. (1852). Verlag, 1933.
86. Jaw operation for cancer. 113. See, for example, Groddeck's article 'Vision, the World of the Eye, and
87. The diflicult financial situation during the war and int1ation had delayed Seeing without the Eye', Chapter 5 below, pp. 172-96. Two other such
the divorce from his first wife. articles are 'Yom Menschenbauch und dessen Seele' (The body's
88. See note 77 above. middleman) and 'Yom Mund und dessen Seele' (The mouth and its
89. This letter was not among the letters sent by Anna Freud to Emmy soul), both included in Psychoanalytische Schrzften ;::,ur Psychosomatik.
Groddeck in 1934. A copy was found among Groddeck's papers. 114. See Psychoanalytische Bewegung, IV, 2 (March/ April1932).

106 107
THE MEANING OF ILLNESS
1·15. Martin Freud (1889-1967).
116. Durer's 'Melancholia'. See Psychoanalytische Schriften zur Literatur und
Kunst.
117. 'Von der psychischen Bedingtheit der Krebserkrankung' (The psychical 2
conditioning of cancer), fragment 1934. Included in Psychoanalytische
Schriften zur Psychosomatik.
Psychic Conditioning and the Psychoanalytic
Treatment of Organic Disorders*

On June 5, between noon and 1 o'clock, I suddenly felt very


tired during work. Yet after a while the tiredness disappeared
again. In the afternoon between 4 and 5 o'clock, I felt ill and
had difficulty in swallowing. The back of the palate, the velum,
and the uvula were very red. That night I had a vivid dream, a
rare experience for me. OnJune 6, a very busy day, the pain in-
creased, the red areas expanded, and both tonsils were con-
siderably swollen.
June 7 was a holiday. In the morning I began to analyse my
dream and the symptom of swallowing difficulties and came to
the conclusion that my unconscious, my It, refused to swallow a
piece of knowledge it found unpleasant. It was the knowledge
that certain ideas concerning the interaction between an indi-
vidual's unconscious and his life were not my own, as I had
been telling myself for years, but Sigmund Freud's. My rational
mind had drawn these conclusions already, as can be seen from
my correspondence with Freud. Yet in the course of analysis it
became apparent that deeper layers of my being resisted my
conscious thoughts.
On June 5, between noon and 1 o'clock, during the hour
when I felt temporarily tired, I had a short meeting with a lady
called Dora. The word Dora, a name that appears in Freud's
fragment of an analysis of a case of hysteria, was the instrument
by which my conscious recognition of Freud's priority tried to
penetrate into my inner unconscious mind. The r~sistance my
unconscious put up took the form of tiredness which effectively
counteracted the name Dora and all its associations. In the
afternoon between 4 and 5 o'clock there was another attempt at
* 'Psychische Bedingtheit und psychoanalytische Behandlung organischer
Leiden', Leipzig, 1917. Reprinted in Psychoanalytische Schriften zur Pfychosoma-
tik, Wiesbaden, 1970.

108 109
THE MEANING OF ILLNESS PSYCHIC CONDITIONING
getting the unconscious to recognise the priorities. This hap- June 5. At the time when I had scarlet fever I suffered from a
pened in connection with a conversation on mortgages and strong sense of guilt which was due mainly to the sexual experi-
debts. In the analysis mortages led to hysteria, debts to guilt ences of my adolescence, clearly revealed by the analysis. Ap-
and thieves. The unconscious resisted this second and more vio- parently I still retain some remnants of this, although rationally
lent attack by closing off my inner self by means of a painful in- I have long since come to understand that my experiences were
flammation. It took hold of the word Gauner (thieves) and chose harmless. In a way that is very familiar to me and may be com-
the defensive line of the Gaumen (palate), continued to fortify its pared to chemical processes in statu nascendi, these remnants
position by implicating the uvula and the tonsils, and finally which were surfacing got mixed up with the psychic poisons
expressed its anger in dreams. from the Dora-Freud complex and thus caused the outbreak
The result of my analysis of dreams and symptoms on the and the curious remission of the illness after the first attempt at
morning of the 7th which I have given in its conclusions only analytical treatment.
was the disappearance, in the course of 30 minutes spent in To the simple description of this illness I would like to add
analysis, of the entire tonsil swelling and of most of the redness some remarks which might be of general relevance. At first
on the palate. To my astonishment, however, some time later sight the description does not establish with certainty that the
the inflammation started up again in a virulent form until in the illness was psychologically conditioned or that it was cured by
afternoon the illness had reached the same intensity. This time means of psychoanalysis. It goes without saying that the in-
I conducted the analysis while my assistant watched the symp- flammation must have involved other features too. In no case is
toms of the inflammation. Before starting, the tonsils, the it possible to establish the complete chain of causes. We can
palate etc. were carefully examined and felt. I then followed this only name the most obvious links. In talking of the cause of an
up with an experiment in association. Now the ihtlammation illness or of casual treatment we have to bear in mind that we
receded quickly and after a quarter of an hour of analysis had consciously switch off this better, purely human knowledge in
disappeared, apart from a sharp and thin red line across the favour of clinical treatment. I should also stress the objection
palate. This went away, too, in the course ofthe evening. that my interpretation is based on a play with words or ideas,
What had I learned from this analysis? I discovered that the while in reality other conditions which are generally recognised
struggle of the conscious against the unconscious mind was not in science obtained. To be specific, I have not so far mentioned
centred on the word Dora-Freud, but on the word Char- the fact that I had a patient at the time who complained of a
lotte-Scharlach (scarlet fever). Just before I talked to Dora I had sore throat, among other things. It is possible that I caught the
been shown a child with an exanthema which on first sight I infection from her. But it is not probable. I have known the
took to be a scarlatina exanthema. There was evidence that the woman a long time; every few weeks she suffers from swallow-
sudden tiredness had not started when I was with Dora, as I ing difficulties which for her have become a weapon against the
originally assumed, but in the interval between Lotte and her. difficulties of life. These attacks are rarely accompanied by the
Scarlet fever has played a fateful role both in my own life and symptoms of inflammation; and on this occasion anyway I
in that of a number of my nearest relatives, and I am haunted by could detect no redness or swelling.
the fear that I might perish one day from the after-effects which If it is nevertheless assumed that my illness was caused by
I never quite overcame. The resistance of my unconscious was transference, then the problem has merely been shifted and
mainly directed against the death association Char- enlarged. The question then is whether the individual can
lotte-,)charlach which was closely connected with the vanity and become infectionable through the interaction of his conscious
inability complex Dora-Freud. The focal point was the word and unconscious mind, a question which I would answer in the
,)chulrl (debt and guilt) which occurred frequently in the conver- affirmative.
sation on mortgages and bills of exchange on the afternoon of In as much as a personal It which lives man continuously
110 111
THE MEANING OF ILLNESS PSYCHIC CONDITIONING

transforms the secretion of digestive juices, the blood dis- and tired, and partly as an excuse for his failure, partly in order
tribution, the activity of the heart, in short, the entire organic to gather new strength, it makes him ill. To bring out this point
life of the personality under the influence of certain sensations, I need only mention the well-known transference mechanisms
impressions, or unconscious associations, in as much as this It of inferiority complexes from the mind to the body which occur
protects itself against the menace of chemical and mechanical in daily life, physiologically and pathologically, such as the fail-
and bacterial attacks by its incalculable abundance, it may set ure of muscle power or the digestive troubles accompanying de-
up conditions in which the pathogenic agent becomes effective, pressions or the changes in breathing or circulation, or a
if it considers that an illness will serve a purpose. reduction of sexual potency. In my own case the idea of being
The assumption that only the hysterical personality is cap- inferior to Freud was repressed for at least eight years with
able of producing an illness for certain purposes I consider to be great effort, but the decision was looming up just at the time of
a fundamental and dangerous error. Every person has this abi- my throat infection. The ghost of scarlet fever with its impli-
lity and everybody makes extensive use of it. The hysterical cations of the impotence of death or infirmity has been with me
and, to a lesser extent, the neurotic personality forces the for more than three decades; it was and still is pushed back into
observer more often than other patients to assume that the ill- deeper layers of consciousness but it caused all the more
ness in question is deliberate. And he himself harbours this re- damage when it was aroused by the sight of a scarlatina-like
markable idea, which is not at all easily explained. But in exanthema.
penetrating deeper into the complex forms of mental life one These suggestions have certainly not explained the inner
will soon discover that apparently conscious intentions are connection between the unconscious activity of my Ego and the
merely offshoots of unconscious forces, and that the symptoms temporal disposition, yet they may have described them suf-
of illness which the hysterical personality produces do not at all f1ciently.
correspond to his original intentions but, as in every other As an effective temporal factor I picked out from the matter
person, to deeply hidden decisions of his unknown It. It could, constituting the It the idea of impotence, mainly in order to
in fact, be said that it is often easier to uncover fragments of emphasise its universality and its significance in all processes of
such unconscious processes in persons who are not neurotic life. In dealing with the individual disposition I want to draw
than in hysterical individuals whose mask is very difficult to lift attention to a peculiarity of the human unconscious, of the It,
because they are ashamed and full of suspicions against them- which might be called the caution of the unconscious; I am
selves. almost tempted to use the expression the understanding of the
Turning now to the question of one's capacity to fall ill, i.e. It since its manifestations are so similar to those of conscious
the individual, local and temporal disposition in the given case reasoning, except that they are far superior to the latter. For the
of the throat infection, we learn something first about the tem- unconscious selects from among the wealth of phenomena,
poral disposition. opens itself up to what it wants to let in, and shuts itself off from
Special circumstances triggered off two complexes on one those sensations and their consequences which it considers
particular day- Dora-Freud and Charlotte-.Scharlach, both con- damaging. It may suffice to draw attention to the reflective ac-
taining fears of impotence. Throughout life every human being tivity of the lids, the conjunctiva, and the iris. Less often
is accompanied by this fear of impotence. As long as the idea of noticed, yet certainly not less remarkable, is the fact that count-
inferiority is linked with hope, it supports life and releases less times in the course of a day the It- in order to avoid visual
mental and physical forces in the form of ambition and a desire impressions- turns the head, the eyes, the body away from the
to learn and to compensate for talents that are lacking. If it is object, or that it diminishes the intensity of perception tempor-
accompanied by doubt or even despair, then all vitality is arily or permanently, or even that it immediately represses per-
sapped. The individual's It tenses up, makes him feel exhausted ceived impressions into deep or superficial layers of the un-
112 113
THE MEANING OF ILLNESS PSYCHIC CONDITIONING
conscious. Only a very small fraction of our visual input reaches wards at an angle so that he can move easily in two directions,
our consciousness. Nor should it be otherwise, else there or forwards for attack, or inwards in order not to get caught in
would be great confusion. the traps set by life. This sensitive It sends out constant warn-
Experiments which have so far had to be rather cursory but ings within the confines of daily life, and when somebody's
which make up in quantity what they lack in quality have con- temper, passions, fears get dangerously out of hand it weakens
vinced me that the unconscious rejects those impressions, his foot at the ankles, makes him trip, puts brakes on to curb
among others, which recall uncomfortable memories and his haste in the form of corns, bunions, blisters; glues him - in
would thus stir up conflicts that are not completely solved. The the case of the high-flying dreamer- to the ground as a spastic
It's sensitivity varies from person to person, a fact which has not and throws him atactically into the air, renders painful the
proved explicable so far even though it is reasonable to assume protuberant, groping toes, deposits mineral salts in his joints
that some kind of shock, usually at an early age, often prenatal and finally strikes him down with gout, which temporarily or
and perhaps even before conception, must be responsible for permanently immobilises him.
this. To put the matter in another way, it is as if at some time or All this is not necessarily so -life is too varied, its vital forces
other a foreign body had got into the unconscious and caused and their interactions are locked away in mysterious depths
infections all around it. As a consequence it is painful not only which no human mind can fathom; it is not necessarily so but
when the splinter is touched but in the surrounding area too. it can be and is not infrequently like this. Every now and then
Likewise an initially minot complex may expand gradually and we manage to catch a glimpse of man's nature and are puzzled
over-sensitise one or more of the sensory organs. It is certainly by that thing which we call disposition, constitution. Oc-
easy to see that a human being does not perceive or miscon- casionally the unconscious obliges and answers with an im-
ceives objects which are unbearable for its It, even when they provement or a cure when its inner burdens and poisons are
are pushed in front of his nose. If the early-acquired sensitivity brought to consciousness by investigation and guesswork and
of an eye is too great, the It protects itself most simply by short- are rendered harmless.
sightedness, in certain circumstances even by blindness. If, This unconscious, into whose territory we are only now be-
usually by means of psychoanalysis, there is a successful at- ginning to penetrate, again and again creates human beings
tempt at diminishing this unbearable sensitivity, mild short- with eyes, ears, legs, hands, and necks from semen and ovum;
sightedness can be observed to recede. It is significant in terms why should it be difficult or even impossible for it to shape the
of this disposition to being cured that short-sighted people oc- character of its creation in all its mental and its physical
casionally perceive certain objects clearly which they should aspects? If it shapes the body, shouldn't it be able to endow it
not be able to see considering their degree of short-sightedness. with certain dispositions for certain reasons or make these
The It's dealings with the problem of age, of imminent death, disappear again as it makes breasts grow and wither, or hair or
are particularly curious. It makes the eyes long-sighted, puts skin? In fact, it does create these dispositions, and will make a
everything, even death, symbolically into the distance, pro- change to the heart perhaps or the lungs. And if we listen to its
longs life as it shortens the step of the old and makes their way voice instead of switching ourselves off through the prejudice
longer with the same object of creating an illusion, reduces, that we are fond of calling knowledge, then we may find out
moreover, the ability to sleep in order to extend the duration of quite a few secrets.
life. This unconscious, this It, does not always and not often
Just as the sensory organs are guided by the It - and this enough consider health the greatest good. The ancients
applies to hearing, to the sense of smell and above all to touch as thought of the poet as blind; and it makes sense that his eyes
well as to sight - so is every expression of life. It makes a have to look inwards. Hephaistos had a limp, Wayland the
person's walk steady or unsteady, makes him place his feet out- smith was unable to move. The It ties a person down, if neces-
114 115
THE MEANING OF ILLNESS PSYCHIC CONDITIONING

sary, it saves him by illness from dangers of a more serious always lean and weak act like a baby without knowing? He is
nature than danger oflife can ever be, it forces him to certain ac- longing for the mother's breast and loses weight because this is
tivities by certain disabilities, to rest through heart disease or not given to him even though he sees breasts everywhere which
tuberculosis. are withheld from him. He demands sympathy or he punishes
The question, to what end?, has been neglected for too long his parents from a very early age for having hurt him or he, his
in our medical thinking. In spite of the bad reputation which unconscious, considers soft fleshiness as too feminine, etc.
teleology enjoys now one should try and investigate for once to The observation of the It in its individual dispositions can be
what end a person contracts a lung or heart disease, why the It made from various points of view. I stressed one characteristic
makes him disappear or prohibits him the use of stairs, for what of the unconscious, caution, because this procedure of our
reason it blocks his anus and makes him unable to excrete or deepest mental forces can easily be traced in my own life. In the
causes food and drink to race through his intestines so that ability to fall ill the sensitive It somehow creates secure posi-
thousands of substances which seem harmless to reason yet tions for itself into which it can escape. The illness, be it acute
dangerous to the unconscious are eliminated quickly. In certain or chronic, infectious or not, makes the individual rest, protects
circumstances the It wants a man to stay lean, weak, or fat. him from being hurt by the outside world or from well-known
Hunger and thirst, lack of appetite and inner secretions are phenomena which are unbearable. My own psyche constantly
used by the It for certain purposes which can often be dis- uses such long-prepared places of refuge, and it has done so ever
covered. The It influences fat formation, growth and character since a certain day in my childhood when it was deeply
as if it were a rational being. It is the duty of the doctor to find shocked.
out what meaning this uncomfortable obesity may have, with An apparently harmless wound on the knee which, looking
its attendant dangers of a stroke, heart trouble, or dropsy, what back, proves to be the cause of a permanent weakness and
this leanness and tuberculosis may signify. The unconscious vulnerability of my left leg, the leg on the bad side, caused a
does not merely reveal itself in dreams, it reveals itself in every change in my physical make-up which was accompanied by a
gesture, in the twitching of the forehead, the beating of the change of character, from being forthcoming to being curiously
heart, yet also in the quiet warning of a uric-acid diathesis, a reticent. I was thus given an obstacle to guard against hasti-
sensitive sympathicus, the phthisic behaviour, and finally in the ness, a compulsion to be cautious. In the course of my later life I
insistent voice of illness too. developed sciatica and gout troubles with deformities of the
Occasionally this language can be understood. There is a fat joints which for decades, temporarily and apparently never
man; they say he eats too much or drinks excessively. Maybe he without reason and purpose, made it impossible for me to go for
does, maybe he doesn't. When one searches his soul one may long walks and sometimes even prevented me from walking at
find that his belly is fat because as a child he was worried about all. In recent years this condition has improved decisively - I
the facts of life, because he longs to be pregnant and have a may be allowed to say only by applying self-analysis- and not
child, because symbolically he is constantly being impregna- only has the pain gone, but my toes, which once pointed side-
ted, because almost any kind of food, an egg, a carrot, a bean, a ways, have now reverted to the normal straight position. And
cherry, milk, beer must once have given his unconscious the yet I can still discover a curious interaction between the physi-
idea that a child would grow in him. Or the idea came from a cal pain of gout and the cautious hesitation which makes me
picture or a book or religion or a kiss or from having his palate avoid or reduce physical danger, and I always derive a special
medicated, and now it is constantly half awake and one imagin- kind of enjoyment from this, such as one only gets from the
ary pregnancy follows another. But maybe there is also an inner ironic observation of one's self. Among other things I remember
emptiness which needs to be filled, perhaps an easily hurt sensi- that a year ago I treated a patient whom I did not find sympath-
tive It which needs a thick skin. Doesn't the person who is etic. When I was on my way to her I regularly felt pain in my left
116 117
THE MEANING OF ILLNESS PSYCHIC CONDITIONING
leg which disappeared at once when I reminded myself of the everybody can see daily how pregnant women are expected to
reasons for it, namely as a warning not to show my antipathy. I be ashamed of their condition, that they hide it from view, that
was moreover able in a few cases of polyarthritis and arthritis people, particularly children, giggle behind their backs, and
deformans to bring about a deterioration or an improvement of that the neighbours' comments in the beer cellars are about
the condition experimentally by stirring up and solving 'breeding like rabbits'. To relieve the senseless torture inflicted
repressed complexes. by this hypocritical environment woman is helped by her un-
At a later time, at the beginning of my twelfth year of age, I conscious." It gives her dizziness, fainting, heartburn, deforma-
suffered from an acute illness with high temperatures which tion of the body, unpleasant smell, white discharge, infection of
was called, in old parlance, a nervous fever; this was again con- the ovaries and the womb, unpredictable bleeding, and finally
nected in time and probably in origin with particularly import- cancer; all this keeps temptation away and repels everything
ant emotional events. I had to stay in bed for a long time and that might excite her desires. The menopause with its tempor-
was reduced to a state of stupor, which totally prevented me ary increase in sexual desire in both male and female is particu-
from thinking, by headaches such as I had never experienced larly instructive in this connection, puberty perhaps even more
before. After that I developed a tendency to headaches which so.
became unbearable particularly in the first years of my medical The emergence, during the teens, of unpleasant character
practice. They, too, have now disappeared and, more import- traits, the reduction of intellectual achievement and concen-
antly, the bony hard swellings on my temples and on the ends of tration are not the only signs of resistance put up by the It to
the muscles at the back of my head which had changed the relieve the pressures that exist during this age of one's life when
shape of my head for decades have receded too. custom forbids desire while nature provides it at its most in-
Using headaches to stop thinking and instinct is one of the tense. The deformation of the body is apparent even without
most common and well-known of the techniques employed by the usual paleness and spinal distortion, without consumption,
the unconscious. The migraine suffered by women during their and it is truly astonishing that nobody seems to understand the
periods is a means by which their unconscious silences the reason for this, particularly when comparison is made with the
sexual drive that is highly active at that time but according to boyish and girlish personality of a more innocent age. The cold
custom cannot be gratified. How curiously and thoroughly the sweaty hands of the developing adolescent are not without
It functions is evidenced by the back pains during the period reason, they are to ward off the tender touch of other hands;
which prohibit the forward movement of the pelvis required for the chapped lips are clearly a kiss-repellent, and acne, so
sexual intercourse. There would be more systematic knowledge characteristic of puberty, keeps the courting admirer at arm's
in the confused and obscure field of female complaints if length. All these teenage phenomena combined with the
the decision were made to find out in individual cases why senseless admonitions of parents, teachers, books are also a
these complaints come about. We would then discover that warning against the inescapable and harmless auto-eroticism
over and above individually conditioned cases it is the ominous and self-gratification.
influence of the morality of our time which forces women with- Can all these processes be explained mechanically and
out exception to be hypocritical and to dissimulate. The female chemically, in purely material terms? In material terms, of
personality is taught not to feel sexual pleasure, and this has course, but not in purely material terms. Is it a shortcoming
been so strictly enforced that the modern age assumes frigidity of our discipline that it has persisted in the materialist pos-
in women to be a natural endowment, while people in the past ition which elsewhere has receded into the background again.
never had any doubt that women are more in need of sex than Doctor and patient rival each other in their resistance to the
men. The problem of the falling birthrate does not need com- idea that the body is dependent on the soul. The patient still
plicated investigations for its causes to be seen clearly since considers it shameful if the doctor seeks out psychological
118 119
THE MEANING OF ILLNESS PSYCHIC CONDITIONING
reasons for his physical complaints. The body is so much logical influences and that fever could have psychological
more powerful and apparently almost nobler than the soul as causes? Of course it could be so, because the unconscious does
well. If only somebody could do away with this narrow single- not make a distinction between body and soul; according to its
mindedness of research and thinking! own purposes it uses the body in some cases, the soul in others. I
The success of psychoanalytic treatment speaks for the de- have ample proof of this from my practice, proof which I find
pendence of health and ill-health, of body and soul, on uncon- convincing. Occasionally, the It does not even bother about cre-
scious forces, and the legitimacy of its use in cases of physical ating a definite local disturbance when it produces a fever. Sud-
illness forced itself on me against my own will. I did not come to denly there is a high temperature, as sudden as the dizziness
psychoanalysis through treating nervous diseases like most of caused by the repression of an idea. I remember a patient who
Freud's pupils but was forced to practise psychotherapy and suffered from such inexplicable bouts of fever. He was treated
psychoanalysis because of my physico-therapeutic activity with by many doctors, including myself, unsuccessfully; one could
chronic physical complaints. The success of post hoc ergo propter not find any trace of a diagnostically useful symptom. Only
hoc taught me that it is as justifiable to consider the body depen- years later, after I had become more familiar with the technique
dent on the soul and to act on this assumption as vice versa. of analysis, did I discover by chance the characteristics of this
Post hoc ergo propter hoc; I have no hesitation in assuming that fever. One thing was constant in its apparent irregularity,
this notorious conclusion is verifiable- under certain circum- namely the fact that occasionally a bout started when the
stances, because I would not know how one could ever have patient went to visit his mother or returned from a visit to her. It
arrived, or how it could ever be humanly possible to arrive, at a took a long time to progress from this discovery to the complete
different conclusion than by equating post and propter. Indig- solution of the complex illness behind which the unconscious
nation is not justified when it is directed against the equation had hidden a passion, but eventually a successful cure was
per se, only when the equation is performed rashly. I have achieved.
waited long enough before applying it to the interaction of soul Hysterical fever. - As far as I know nobody has ever di-
and body, to the influence of the unconscious It. And even when agnosed it as hysteria. But words are always available and I
I came out with it for the first time, in a book on the healthy and cannot prevent people from using the term hysteria. To counter
the sick personality* in 1912, I still considered it necessary to the objection, however, I want to mention another case history
take a stand against psychoanalysis. I regret that I wrote and which is remarkable for the fact that fever could be produced
published sentences there which are wrong, and I am sorry that experimentally, so to speak, by uttering certain names or
I only learnt very late, from his works, about Freud's doctrine words. This illness, too, had been treated by many doctors. For
when I had already been practising it unconsciously for a long two years we tried to find something and thought of tubercu-
time, a doctrine whose validity is only disputed by people who losis as well as syphilis as explanations. The tuberculin reaction
do not know it or do not understand how to apply it. was negative, however, but at least the Wassermann was posi-
The fact that man blushes when he is ashamed, goes pale tive, and a blistering rash, ulcers on the penis, sore throats left
when he is alarmed, sheds tears when he is sad, breathes hard little doubt as to what the diagnosis should be. And yet one
or with difficulty, that his heart beats faster or stops in passion, doctor after the other dropped the original assumption of a
that the intestinal tracts move faster when he is anxious and syphilitic disease. The ever-changing patter~ of the case did
that there is a sweat of fear is well enough known, apparently not seem to fit any category, and the symptoms did not respond
too well known for notice to be taken of it. Should it be so im- to any therapy. They came and went as they pleased. Finally I
possible that an organism's temperature balance, like its tried psychoanalysis and the attempt was successful beyond my
system of circulation and its growth, be governed by psycho- expectations, as far as the therapeutic results and the enrich-
* Nasamecu. Der gesunde und kranke A4ensch, Leipzig, 1913. ment of my own experience were concerned. It was interesting
120 121
THE MEANING OF ILLNESS PSYCHIC CONDITIONING
in this context that the syphilitic symptoms could be produced It seems to me significant that this same summer I received my
at will by deliberately stirring up still un-analysed parts of the first conscious explanation about the relations of the sexes. I
syphilitophobic unconscious. was never troubled by adolescent acne. Yet I have constantly
The above-mentioned illness which occurred when I was observed a phenomenon in myself, the occasional appearance
twelve supplied my unconscious with another weapon- sleep. of small eczema on the hairline of my head, on the eyebrows or
From that time until I was in my mid-thirties I slept 12 to 14 lips, which goes away sooner or later. By and by I have had to
hours a day. I could sleep at any time and in any situation, ap- convince myself that this constitutes an attempt at resistance on
parently Without dreaming or at least without remembering on the part of my unconscious. These hardly noticeable skin com-
waking what I had dreamt. During my time at boarding school plaints only occur when I begin to get irritated by somebody
I was often punished for this addiction to sleep; finally, since present. Every time I tried to make conscious the specific nature
punishment proved of no avail, I was sent to a doctor. He in- and object of my libido and the unconscious complex hidden in
terpreted my excessive sleeping correctly and gave the advice to it I managed to get rid of the rash in 24 hours. Yet certain
let me be. In this way I avoided many things which might have phenomena make me wary of using this kind of treatment on
destroyed my soul. Later, like every doctor, I met patients with myself unless absolutely necessary since the usefulness of the
a similar need for sleep. The sudden tiredness and the ability to unconscious measures adopted by the It is all too clear. In the
go to sleep at once probably lead to fainting and spasmodic fits, course of my practice, however, I have gained experience of
hysterical or otherwise. eczema on the hands, psoriasis, boils etc. which considerably
Two other strange characteristics appeared then which enlarged my knowledge of the ways in which the It expresses
might be seen as protective measures taken by the sensitive It: itself and functions. The unconscious is particularly effective in
periods of half-awake states of vegetating, and an ability to the way it uses deformations of the nose, an organ whose con-
forget details or whole periods of my life. Generally this uncon- nections with sexuality are more numerous than is generally
scious procedure of rendering uncomfortable impressions assumed. Having observed a few times the influence of psy-
harmless should be considered a fortunate gift; it makes life choanalysis on red noses or rhinoma- which, however, does not
easier, concentrates energy on special achievements and keeps make itself felt from one day to the next- one can hardly fail to
us alert for a few hours. Yet it is possible that too much material endorse the interpretation I have just given, that it is an attempt
is added to the original kernel of the complex; the It becomes at repulsion.
more and more sensitive; the need to stop thinking and to forget Perhaps the most astonishing event of my medical practice
is applied to more and more areas of life, and this prepares the was the treatment of a grave case of scleroderma which led to a
ground for increasing imbecility of a senile or different kind. surprising result. For a long time I intended to use this case his-
In its desire to avoid disturbing impressions, the unconscious tory as an illustration of unconscious activities in the body
quite often tries to obstruct the proper functioning of certain organism, yet finally I decided to use my own case since it
systems in the organism, by a slowing down or an acceleration would not entail considerations of discretion.
of the circulation, of breathing or of food intake in the widest There were events in my 17th year which were of decisive im-
sense of the word. This has the most varied consequences start- portance for the whole of my later development and were
ing with mild degrees of constitutional weakness and going on closely connected with the story of my throat infection. I con-
to grave cachexias on a local or a general basis. tracted a disguised form of scarlet fever. In retrospect I assume
During my feverish illness I also developed a phenomenon, that in this event, too, the protective forces of my unconscious
the significance of which I mentioned earlier on. My face was became active in order to deal with newly aroused sexual com-
covered with a rather extensive impetigenous rash which was plexes which were in need of repression. In the course of the ill-
followed, after cure, by loss of head hair in the celsi-form area. ness I suffered a grave diphtherial throat infection with abscess
122 123
THE MEANING OF ILLNESS PSYCHIC CONDITIONING
formation and a kidney infection that became chronic. Perhaps the It finds it so useful as a control point that more or less
one could investigate the reason why the unconscious used a chronic catarrhs develop. During my 20th year my unconscious
kidney infection to function as the policeman in my life. Yet fell back on this weapon which we find so frequently used by
here I have to fall back on speculation again and am unable to children, and it has continued to do so ever since.
find cogent reasons. I can merely add that some of my earliest At the time I was doing active service as a one-year volunteer.
memories are of rainwater tubs, gutters and wells, and that I By nature, for reasons unknown to me, I do not respond well to
had a tendency to enuresis nocturna until puberty. Whatever compulsion and silent obedience, and that is why I still con-
that may signify, the lingering traces of scarlet fever and neph- sider this period as a soldier a particularly hard time of my life.
ritis came into the open again combined with pneumonia - It was only bearable because I coughed away insufferable im-
again in connection with sexual complexes ~ and led to a long pressions, a kind of defence mechanism which my It never gave
drawn-out oedema. Oedema in the retina made my eyes up and which is very common among human beings. Almost
weaker, and for a long time I was troubled by a tendency to everybody coughs occasionally, and there is a wide range from
nausea and vomiting. Temporary blindness and the wide- the barely noticeable clearing of one's throat to the heavy
ranging restrictions on movement and work forced me to attacks resembling fits of suffocating. It is well known that
retreat completely into myself. I was barred from the quick many people start the day by coughing. This way they cast out
route to public success which, as I understand now, would have the impressions of their dreams and blow away the minor and
been my undoing, considering my nature. major anxiety fantasies and embarrassments of the day which
Rarely in my life have I met conditions which so strikingly are associated with these. Whatever manages to penetrate in
proved the practicality of unconscious forces as this illness. It spite of this and appears poisonous to the It is dissolved and
took about ten years before I had overcome the consequences of wrapped up in mucus, brought out and finally even spat on.
this caesura in my life, as far as I could rid myself of them at all. The curious thing about this process is that the unconscious
I shall not enter into any further discussion of what the It equates physical and psychological intruders and treats them
intends and achieves when it strikes a person down in the midst the same. If one is at all attentive it is easy to discover in daily
of an intensely productive period, leaves him dangling over the life that a single word which stirs up a poisonous psychological
abyss for a long time, and gives him the spectral company of complex releases the same cough as the breathing-in of chlor-
death and infirmity. The question of education by illness would ine. There is no reason to be surprised about a reaction like this.
lead us too far afield in the present context. Every child knows that a repulsive sight may cause vomiting as
In mentioning the oedema I have jumped ahead in this if it were a genuine case of poisoning. And since the sight or
account of my illnesses, and I shall now return to events which smell of delicious food or even the rattle of plates causes the
relate to an earlier phase of my life. They tell us something saliva and stomach glands to secrete their juices, it is under-
about the reasons why the unconscious chooses certain parts of standable that the mucous membrane of the respiratory tract
the body as strategic points of its illness-producing activity, in can behave in a similar way.
other words, how a local disposition arises. Already during the The usefulness of the larynx entrance as a control station for
scarlet fever the tendency of the unconscious to close off the en- psychological impressions was considerably increased later by
trance to my inner life becomes evident. In general, the uncon- my unconscious in that the nasal tracts acquired the ability to
scious rarely uses throat infection at a mature age as a weapon swell up when certain associations were activated. Even this
of resistance, while in childhood and puberty the tonsils serve seems not to have been enough for the unconscious, and in the
as the constantly active guards of the sensitive soul. In contrast past few years it has put the secretion of mucus into the service
to this the mucous membrane of the respiratory tract remains of these easily-recognisable purposes, and the comparison with
sensitive throughout the whole of life with man·y people; often former times is striking. Every now and then I have met people
124 125
THE MEANING OF ILLNESS PSYCHIC CONDITIONING
in my practice who have reacted even more intensely than I do from the conscious mind later, yet it seems to remain in the un-
to the evil smell of a word or a thought. Almost at once they conscious. During puberty the problem of making and having
start a cold in the nose which often disappears within half an . children returns with more urgency, not only into con-
hour. These remarks reveal plainly that I assume a psycho- sciousness but also into the unconscious, the repressed com-
logical cause for hay fever and act on this assumption - not plexes of which are associated with the conscious thought
unsuccessfully. I also feel compelled to draw the conclusion processes and with all kinds of fantasies of spiritual and godlike
that the disposition to any kind of bronchial illness and lung impregnation and illegitimacy. The enlargement of the thyroid
complaint can be created by the unconscious. coincides in time and, as it appears to me, in origin with these
We cannot presume to understand the purposes and reasons curious processes which have so far been unexplored. On the
of unconscious life. It is necessary to bear in mind that every ob- one hand there is the wishful thinking of having a child in one's
servation is one-sided, and it is advisable occasionally to look throat, on the other purposive preventive measures are taken by
deliberately at one side of a question only, as I did when I con- the It against oral fertilisation. This ambivalence will only as-
sidered the purposiveness of action. Yet I want to stress the tonish those people who have never studied psychoanalysis in
point that I am aware how this rigid stance distorts the perspec- depth. Those who know how to use it know that the It fulfils not
tive of all objects. Nevertheless I beg acceptance of the idea that only two, but various and inexplicable functions simul-
the It considers the throat to be the entrance into the inner taneously. There are analogous processes at work when a
human being. This idea is fertile and practical even if it may be , grown-up develops an enlarged thyroid, and that these must
wrong or crude. have been very active in my case is proved by the result of my
The complexity of the unconscious operations when a par- self-analysis, in the course of which the goiter disappeared
ticular spot is chosen to be a local disposition and a guardian of almost completely, including the fibroid core.
human survival can be shown by another event in the chain of The objection that a man cannot have the wish or fantasy of
my illnesses. About 1904 the It built itself another barrier on pregnancy is invalid. Apart from the fact that every human
my neck in the shape of a goiterous growth which originally being is and has to be man and woman at the same time, which
kept to the left-hand side, the sin side of the thyroid, and later should not be forgotten when the question of unconscious and
extended to the right-hand side, the relation side, as well. In conscious fantasies regarding self-gratification and self-
both these cases there was a fibroid growth with a hard core fertilisation comes up, apart from this fact theories of oral fer-
surrounded by areas of loose tissue. Gradually the core and the tilisation are held at an age when a child has not yet grasped the
loose new tissue got bigger and so did the neck triangles as the impossibility of a male pregnancy. By means of these childhood
face became swollen. Within a few years the circumference of ideas about conception the understanding of throat infections,
my neck increased from 39 to 45 centimetres. The conse- particularly those of an early age, can be grasped in one detail
quences were breathing difficulties and restriction of movement of the poisoning complex. The interrelation of poisoning and
and activity, which proves the meaning of the illness if one con- pregnancy complexes recurs again and again.
siders its aim. Other connexions are less obvious, yet they make The investigation of the local disposition is a source of enjoy-
more sense if the close interaction of thyroid and sexual func- ment for the psychoanalyst as long as his chief pleasure lies in
tion is remembered. In particular the almost normal thyroid surprising discoveries and sudden results. Often the subjective,
enlargement that occurs during the adolescence of girls should localised experience of an illness can be eliminated or greatly
be taken into account here. Freud proved in his work on the improved when the question of the symptom's purpose arises.
sexuality of children that we all believe ip the intestinal preg- The unconscious gives astonishingly precise answers, for
nancy for a time and from this it follows naturally that impreg- example, that hoarseness makes us whisper when we communi-
nation occurs when the seed is swallowed. This idea disappears cate a secret, or that a pain in the arm warns us of a tendency to
126 127
THE MEANING OF ILLNESS PSYCHIC CONDITIONING
brutality or stealing, that bad breath helps us hide an intense voices with which the It talks.
emotion, blushing to disguise the face behind a veil etc. Many of Thus the question is not whether we can say with certainty:
the sudden cures which we attribute to the suggestive power this or that unconscious idea has produced the illness, but
and the personal influence of the doctor can in fact be traced whether we have a right to maintain that the illness disappears
back to the It's sudden decision that an individual is no longer when this or that context has been revealed; in other words, if
in need of this or that protective measure. By looking at those there is any prospect of affecting organic illnesses positively by
forces of the organism which dispose us to contract illnesses I using psychoanalysis.
was led deeply into the problem of the unconscious. Has the Nobody has ever doubted that we can influence the It in its
problem been solved? No. It has not even been grasped, only psychological and physical functions by material intervention
hinted at. A conclusive statement about what the unconscious of a chemical, physical, or surgical nature. The idea that by
really is cannot be gleaned from my argument. The statement psychological intervention the matter of the It, or, if one may
that an It, a God, dominates our body and our soul means as use the expression, the human body can be changed, that it can
little as the idea that bodily and mental life are nothing but be brought from illness back to health or vice versa merely
external changing forms and embodiments of an It. The saying sounds strange, yet it has been known for a long time and as
that life consists in the interaction between body and soul is no long as the world exists it will be put into action all the time and
more than another way of stating the problem, not an expla- at every moment. Both procedures have ultimately the same re-
nation. In the last resort one is again made to understand that sult, they both have the same point of departure, namely the
all knowledge is fragmentary, that the 'X' oflife cannot be fath- unconscious of the human being. The amputation of a member
omed, that no more can be said about the words body and soul is not a healing process, the reaction of the unconscious to the
than that they are words which cannot express the idea. amputation is rather to revitalise the wounded stump and the
I have thus come to the point of admission that there is no organism that is impaired by the specific illness and the oper-
psychological cause for physical illness. The unconscious is ation. Whoever has had the idea that it is not the operation
neither psyche nor physis. Personally I doubt whether the ques- which helps the leg and consequently the patient to recover- an
tion can ever be put properly or that there will ever be an an- insight that seems to be easy and yet it is very difficult-, that
swer to it. This would mean that we could survey and judge the our medical practices can never effect a direct cure but merely
unconscious without conscious thought, the unconscious to set some healing factors in motion that are completely un-
which consciousness is either a partial or a complete adjunct. known to us, that the aim of treatment is not to cure by means of
The fact that the question is not answered and that it cannot our art as if by magic but to set free unconscious forces, will also
even be posed is oflittle relevance to us doctors. Our profession understand that it might make sense under certain conditions
is one of practical achievement. It does not matter that we to stimulate these healing factors of the It by using psychoan-
should say how the patient is helped but that we should give alysis.
him help. Our task is less that of thinking up valid theories than One might picture the process of recovery as if it were are-
of finding working hypotheses that are of use in treatment. structuring of the organism. In the unconscious the personal
With the help of working hypotheses that have been proved organism possesses all its labour force, and usually all its ma-
false, astonishing discoveries have been made in all fields, in terials too, with which to set about this restructuring. If it does
chemistry, physics, and particularly in medicine. So far prac- not go about the restructuring work out of its own free will as it
tical medicine does not have any exact theories, but its history does more or less successfully in most cases, then there must be
demonstrates that those doctors are most successful who have some obstacle that paralyses the unconscious forces. Maybe
the courage to be singleminded without troubling themselves there is a wall which has to be demolished from outside, or
about the anathema of logic and who listen to one of the many debris which has to be removed; every now and then some
128 129
THE MEANING OF ILLNESS PSYCHIC CONDITIONING
building materials are lacking, then the surgical operation, the would be in trouble if the beneficial influence of analysis was
physical or chemical treatment is necessary. Perhaps the It's dependent on completeness. It has never been possible nor will
labour force is lazy, has got too used to the familiar conditions it ever be possible to be exhaustive in any single analysis. Yet in
and has become too comfortable, or it underestimates its own reality the matter takes quite a different course. Treatment
abilities and does not dare to do the work. Then suggestion, does not have to go as far as that, it cannot go as far as that and
persuasion, orders are needed. Yet it is also possible that a confront the Ego consciously with all the complexes of the past.
strange prohibition, a prohibition issued by former masters or What is necessary is to prod the It into activity.
present tenants who are under contract inhibits the It which This too can only be discussed metaphorically. The It pos-
feels in honour bound, or that its characteristic gifts have been sesses fermenting forces which might be latent in certain con-
developed into wrong techniques by education. If this is the ditions. When they are awakened by intervention - be it
case then the best approach is to lift this apparent prohibition physical or psychological - they start working independently
and the wrong techniques from the depths of a former or more and penetrate one or the other part of the unconscious accord-
recent past, and force the It to make a new decision. This is the ing to the kind and force of the ferment activated and they put it
psychoanalytic technique, an approach which has the advant- into action. Yet the unconscious is timeless, it lives and lets live
age that it recognises the aspect in charge of the restructuring, from the moment of conception. The same forces which are at
namely the It, and negotiates with it as if it were the expert. work in the 20-year old are already at work from the beginning.
At times all these approaches are possible, at others only one Fermenting forces might have been switched off in the earliest
of them is, occasionally they have to be changed. Yet it would stage of life and come into action later. That they come into
be negligent, since Freud has shown us the way, to leave out one action is only due in a small degree to our treatment; the real
of them, namely the psychoanalytic one, because it was forgot- decision for health or illness is not made by us doctors, it is up to
ten for a long time and has not yet become fashionable, or the It, the unconscious. I have no doubt that the It is able to in-
merely to use it in cases of neurosis because it is assumed that fluence deep layers which are not accessible to human con-
the body can only be treated physically - a statement the sciousness by the fermentation activities of higher strata.
untruth of which is testified daily by every doctor, even against I am prepared for my views to be received with surprise-
his will, by his actions. even among some psychoanalysts, though not all of them, not to
In the comparison with restructuring I spoke of a prohibition mention physicians who are misinformed about Freud's doc-
which can inhibit the unconscious forces. This is a different way trines as I myself used to be. I have tried to be one-sided and am
of expressing the concept of repression which plays an import- therefore aware of the mistakes which have crept into the argu-
ant part in psychoanalysis. In the practice of psychoanalysis ment. My only intention was to state as clearly as possible that
and the treatment of repressions of this kind, one sooner or later the restriction of psychoanalytic treatment to the area of neu-
has the surprising experience that during analysis certain rosis does not correspond to our knowledge of the effect of
phenomena appear and disappear with a regularity that cannot analysis. This restriction is too narrow.
be accidental and is apparently connected with the analysed Psychoanalysis must not and shall not stop at organic illness.
complexes. One can observe psychological and physical The whole extent of its range will reveal itself.
changes of objects which existed long before the individual's
memory threshold sets in, i.e. before the fourth year of age. It is
necessary therefore to assume repressions of a kind which
cannot be brought back into the patient's consciousness.
Finally, the significance of prenatal events has to be resorted to,
and with success. Yet here we are very much in the dark and we
130 131

You might also like