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Poiesis Prax (2009) 6:191–202

DOI 10.1007/s10202-008-0064-0

FOCUS

Psychological trauma from the perspective of medical
history: from Paracelsus to Freud

Heinz Schott

Published online: 2 December 2008 
Springer-Verlag 2008

Abstract Psychological traumatisation, as we understand it today, was—in terms
of the history of ideas—anticipated by various approaches which have had a lasting
impact on modern psychiatry, psychotherapy, and psychosomatic medicine. On the
one hand, there is the traditional concept of possession and exorcism with its
impressive psychodynamics. On the other hand, there is the theory of the imagi-
nation, of an illusion in the sense of a pathogenic infection. Especially the
pathological teachings of Paracelsus (sixteenth century) and Johann Baptist van
Helmont (seventeenth century)—the latter having advanced the former’s alchemist
approach—demonstrate the extent to which demonological, parasitological, and
psychological ideas were amalgamated in their ‘‘ontological’’ notion of a disease.
Only the introduction of hypnotism in the middle of the nineteenth century made
possible a psychological or psychodynamic understanding of psychological trauma
in the modern sense. Hypnotism was striving to strictly dissociate from the magical
and natural philosophical speculations of mesmerism and its theory was quite
compatible with the model representations of scientific medicine. Sigmund Freud
was able to tie in his ideas of hysteria and neurosis with this concept and especially
to define repression of (infantile) sexuality as the cause of a culturally ineluctable
psychological trauma. Finally, a brief survey of medical history is given to explore
artificial trauma as a healing factor.

Zusammenfassung Die psychische Traumatisierung im heutigen Verständnis
wurde ideengeschichtlich von verschiedenen Ansätzen antizipiert, welche die
moderne Psychiatrie, Psychotherapie und Psychosomatik nachhaltig beeinflusst
haben. Zum einen ist hier das traditionelle Konzept von Besessenheit und Exor-
zismus mit seiner eindrucksvollen Psychodanymik zu nennen, zum anderen die
Lehre von der Imagination, der Ein-Bildung im Sinne eine pathogenen Infektion.

H. Schott (&)
Medizinhistorisches Institut der Universität Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany
e-mail: heinz.schott@ukb.uni-bonn.de

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D’un autre côté. anticipée par diverses approches qui ont eu un impact durable sur la psychiatrie moderne.). au sens moderne du terme. D’un côté.g. the adjective ‘‘traumatic’’ came into use. However.) und Johann Baptist van Helmont (17. il y a la théorie de l’imagination. psychodynamisches Verständnis des psychischen Traumas im modernen Sinne möglich. the term traumatisation had only referred to a physical injury due to a forceful external impact. Abschließend wird in einem medizinhistorischen Abriss das künstliche Trauma als Heilfaktor kurz beleuchtet. la psychothérapie et la médecine psychosomatique.Universallexikon‘‘ makes clear that there 123 . C’est surtout l’enseignement de la pathologie de Paracelse (16ième siècle) mais aussi Johann Baptiste Van Helmont (17ième siècle). telle que nous la comprenons au- jourd’hui. Around the middle of the nineteenth century. Résumé La traumatisation psychologique. e. conformément à l’histoire des idées. Sigmund Freud a été capable d’associer ce concept dans ses notions d’hystérie et de névrose et surtout de définir la répression de la sexualité (infantile) comme étant un trauma psychologique culturel inéluctable. in the concept of ‘‘traumatic neurosis’’ (cf.192 Poiesis Prax (2009) 6:191–202 Gerade bei Paracelsus (16. only towards the end of the century—even before the dawn of psychoanalysis—it was also used to describe the effects of emotional shocks. L’hypnose s’est évertuée à se dissocier complètement des spéculations philosophiques magiques et naturelles de mesmérisme et sa théorie était assez compatible avec les représenta- tions en règle de la médecine scientifique. de l’illusion impliquée dans une infection pathogène. Jh. 1 Historical concepts of (psychological) traumatisation The term ‘‘trauma’’ is derived from ancient Greek and means wound or injury. ce dernier ayant fait évoluer l’ancienne pratique de l’alchimie. der sich strikt von den magisch-naturphilosophischen Spekulationen des Mesmerismus ab- grenzen wollte und dessen Theorie durchaus kompatibel mit den Modellvorstellungen der naturwissenschaftlichen Medizin war. nous avons le concept traditionnel de pos- session et d’exorcisme avec ses manifestations psychodynamiques impressionnantes. la parasitologie et les notions psychologiques étaient amalgamés dans leur conception ‘‘ontologique’’ de la maladie. fut. qui démontrent à quel point la démonologie. wurde ein psycho- logisches bzw. Jahrhunderts. Finalement. ist zu beobachten. Jh. a rendu possible une compréhension psychologique ou psychody- namique du trauma psychologique. Neurose anknüpfen und insbesondere die Verdrängung der (infanti- len) Sexualität als Ursache des kulturell unhintergehbaren psychischen Traumas begreifen. The relevant article in Zedler’s . parasitologische und psychologische Vorstellungen in ihrer Krank- heitslehre (ihrem ‘‘ontologischen’’ Krankheitsbegriff) miteinander verquickt waren. Prior to this.. Oppenheim 1889). un bref tout d’horizon de l’histoire médical nous permet d’aborder le trauma artificiel comme un facteur de guérison. wie sehr dämonologische. Erst mit der Einführung des Hypnotismus in der Mitte des 19. L’introduction de l’hypnose. au milieu du 19ième siècle. Hieran konnte Sigmund Freud mit seinem Begriff der Hysterie bzw. der dessen alchemischen Ansatz weiterentwickelte.

as in the case of reaching into the epee to stop it as it is being thrust towards you. The greater the power with which the injury-causing instrument is applied and the stronger the resistance of the body part in question. imagination. we are dealing with an infection model which seems to have played an important role in all cultural circles at all times. limited to a single organism. From the beginning of medical history. Only modern scientific medicine saw the psyche as a concomitant of processes happening in the brain and the nervous system. such that the injury-causing instrument is moved towards our body as well as the body moving towards the instrument. cast aside as obsolete ‘‘occultisms’’ (cf. however. ‘‘psychodynamic’’ factors (to use today’s parlance) had also been taken into account. This results in a power play between a harmful influence or influx (from the outside) and a protective defence (from the inside) within the organism of the recipient. that ‘‘psychological’’ in our present parlance refers to something different from those magically visualised processes as they were imagined in early modern times—from Paracelsianism to Mesmerism—as the reality of a hidden nature. Accordingly. through its power and impression. cosmological and astrological ideas of magic (such as mantics or telepathy) were a thing of the past. imagines. we will look at the concept of imaginatio. there are a number of pivotal concepts representing a ‘‘psychological’’ traumatisation. cf. This amounts to the same difference as that of being stabbed to death or of walking into the dagger. Innate malforma- tions or physical anomalies seemed to be striking instances of the power of the imagination: For example. etc. sticks to and stays with the shaping fruit of the womb for the forming of the birth. Schott 2000). column 1533) This idea of a physical injury also appears in various forms as a pictured model for a ‘‘hurt’’ or the pathogenesis. ‘‘sugges- tions’’. to which we will limit ourselves in the following. In the late nineteenth century. or blindly running into the stab coming towards you.Poiesis Prax (2009) 6:191–202 193 are two ways for this to occur: Either the injury-causing instrument is moved towards the body or the body moves towards the instrument. the stronger and more effective the injury tends to turn out. This kind of ‘‘over- sight’’ (‘‘Versehen’’) of the woman was typical of a generally accepted doctrine. In the history of plague defence—during the plague epidemics in the late middle ages and early modern times as well as the cholera epidemic in the nineteenth century—a common topos said that ‘‘despair’’ made people receptive for the epidemic in the same way that ‘‘trust in God’’ protected them against it.’’ (cf.’’ 123 . one distinguishes between active and passive violence (violentia vel activa. It is important to note. ‘‘when pregnant women see one thing or another causing such a strong idea and imagination that afterwards such a fantasy. which only lost its validity with the progress of embryology towards the end of the 18th century. First. column 1785). It is called an ‘‘oversight’’. In modern medicine. a pregnant woman being startled by the sight of a hare was believed to cause a harelip in the child (‘‘mother’s mark’’). The idea is that a harmful influence emanates from a sender who hurts or makes a recipient ill using certain means (materia peccans. Zedler 1749. however. demons. says Zedler (1749. both movements happen simultaneously.). vel passiva): ‘‘Often. Here.

using the theory of the ‘‘psychological trauma’’ as the core of an emotional complex. The Flemish physician and alchemist Johann Baptist van Helmont ascribed the state of ‘‘Melancholia hypochondriaca’’ to Saturn’s influence on the milt. is not only reminiscent of demonological ideas. as early as 1775. was only clearly defined in the second half of the nineteenth century with the rise of hypnotism and ‘‘suggestion’’. ‘‘Psychological trauma’’ in the modern sense. Breuer and Freud 1893. Schott 1993:25). It was also pervaded by the basic notion of an infection. Incidentally. 1895) is not wholly unlike the exorcism of an evil spirit. despair invoked the image of the plague. Traumatisa- tion was the basic process causing infection. however. The most ancient concept of the (psychological) trauma is ‘‘being possessed’’ by evil spirits. who was making a great stir with his spectacular mass exorcisms. culminating in witch hunts and the persecution of heretics during the transition from the Middle Ages to modern times. Thus. At the same time. he or she was considered impure and contagious. Their ‘‘guardian spirit’’ had left them and exorcising the evil spirit was the only possible cure (cf. but was simply and unwittingly using the animal magnetism method (Schott 2003). but also of their practice. van Helmont was also anticipating both bacteriological and psychological ideas of the late nineteenth century.194 Poiesis Prax (2009) 6:191–202 The concept of impressio also refers to a traumatising ‘‘impression’’. stemming from Babylonian clay tablets. was not exorcising the devil. It especially describes the evil. This example shows that during early modern times. Any pathological alteration without a visible cause was ascribed to the intrusion of demons and spirits. the psychocarthartic method of ‘‘abreacting’’ a ‘‘strangulated affect’’ (cf. shortly after establishing his ‘‘animal magnetism’’ cure. demonological. Once a person was befallen by a demon. shows the immense power of persuasion of this concept. Van Helmont used the concepts of idea morbosa (morbid idea) and animal phantasticum (bestial imagination) to demonstrate disease as being an infection coming from an ‘‘image’’. The most ancient written evidence. harmful impact of the luminaries and plays an important role in the tradition of Paracelsianism. psychological and psychosomatic ideas were inextricably interlinked. For example. Kerner 1843). parasitological. Suffering from trauma due to being possessed (including the pursuant exorcism) is experienced as reality in certain religious (especially Roman Catholic) circles to this day—by sufferers and priests alike (Capra 1997). of the evil entering the weak. most of all by illness demons. which—in the case of a weakened spirit (archeus)—caused the plague. In this context. causing ‘‘milt-addicted’’ (melancholy) images and corre- sponding diseases to develop. This medically motivated demonology was mostly perpetuated in the Christian Occident and grew more acute through its religious implications (‘‘obsessed by the devil’’. ‘‘pact with the devil’’). 123 . Franz Anton Mesmer declared in a survey that the ‘‘exorcist’’ clergyman Johann Joseph Gaßner. a parasitic ‘‘seed’’. Modern psychotherapy. It should be kept in mind that even around 1830 ‘‘being possessed’’ was still seriously discussed by romantic naturalists and doctors. reference should be made to the publications by senior medical officer Justinus Kerner from Weinsberg (cf.

Paracelsus seeks to illuminate this process in a dramatic scene. put his hand into water.). Paracelsus 1922–1933. ‘‘by way of its own nature’’ become more evil and ‘‘sorestruck’’ and spoil the whole body (cf. Paracelsus was a representative of astrological. Paracelsus also explains this process employing another image.) Interestingly. In his work ‘‘Philosophia magna’’ (leaving aside the question of the authenticity of the text) he describes a kind of astrological infection. of course. Also.Poiesis Prax (2009) 6:191–202 195 2 Imagination as a traumatic illusion: magic in Paracelsus Theophrast von Hohenheim. Paracelsus 1922–1933. it is stronger than ‘‘a real shot’’ from a rifle or crossbow since it leaves no opening from which the foreign substance can be extracted. This injection being. This idea brings to mind witchcraft. such as amulets or prayers. 123 .). and nobody can see the intrusion […]. He also recommends an intensive training in ethical behaviour as protection against the dangerous influence of the luminaries (a quasi self-purging education in line with alchemist ideals). This is followed by disease and pain. even if Paracelsus is trying to explain how a ‘‘fiendish’’ ascendant can make men impotent.’’ We are literally dealing with a morbid intrusion here. It is as if a well-armed man who encounters a limping dwarfish man levelling his rifle at him is actually scared by the encounter: ‘‘If we are falling into weakness. Thus mankind will be able to emancipate itself from astrological impressions! (This idea is reminiscent of Freud’s therapeutic goal of psychoanalysis—to ‘‘strengthen the Ego’’. Paracelsus is familiar with the process of self-traumatisation. people are attacked. They can inject all sorts of foreign substances under the skin and into the human body. It reaches into the body ‘‘and grips for the kidneys in the same way that a fisherman reaches into the water crushing a fish with his grip so that it may die and perish’’ (ibid. The metaphors of ‘‘in-jection’’ and ‘‘inter-vention’’ represent a rich image of the morbid trauma. which was frequently discussed at the time. the strength of our faith directs itself against us like a rifle and we must bear and suffer what we are casting at each other’’ (cf. The ‘‘in-trusion’’ of ‘‘spirits’’ can also occur in the following way: ‘‘The same way as a man can pick up a stone with his hand. lived during the time of the Reformation and was known for his vivid. magical and alchemist approaches integrated with a Christian world view. (Mass) ‘‘despair’’ as the false set of beliefs might poison heaven such that certain people would be seized with the plague. 20 et sqq. He considers the ‘‘fiendish ascendents’’ to be a dangerous (astrological) cause of disease. vol 9:279 et sqq. which is intruded such that the things make them heavy from the inside and can be found. Thus the ‘‘injected’’ matter can. done in such a masterly manner ‘‘that it can shoot such a thing into a human without opening of the skin or an injury appearing like an opening […]’’. metaphorical style of writing (in old Modern High German. let the stone go and retract his hand […] with the hole made by the hand closing up again.). alias Paracelsus. vol 14:19 et sqq. ‘‘as is their belief’’. Paracelsus names magic and religious means of resistance. ‘‘Luther’s German’’).

‘‘mental infection’’ through hypnosis and suggestion The late eighteenth and early nineteenth century ‘‘animal magnetism’’ (Mesmerism) became. way into modern times. prayers.). with 123 . was represented by arrows being fired off a crossbow and entering the human body. It refers to the Roman god Cupid (resp. he was depicted as a boy with a crossbow firing off poisonous arrows causing ‘‘lovesick- ness’’. 662/4). drew on Paracelsus’s idea that ‘‘despair’’ or ‘‘fright’’ might cause the plague. Amor or Eros) falling in love with Psyche. the infection. ibid. most notably seizures: ‘‘If a violent dread or a similar affright occurs/it leads to images/which cause a seizure/which one cannot get rid of all life long’’ (cf. not ‘‘sensually’’ imagined in human inner life. The most notable seventeenth century Paracelsian. Cupid’s arrows form a complementary variety of traumatisation. the patron saint of plague sufferers (and shooting clubs) is very prevalent throughout the Christian Occident. in part. Helmont 1683:593/10) Van Helmont thus goes beyond the original teachings of the imagination as a delusion: The plague’s seed is not meant in a ‘‘psychological’’ way. This imagery of an infectious disease was still drawn on even in Renaissance times by the philosopher Ficino. Naturally. which were not only plague epidemics in a bacteriological sense. This can trigger all sorts of illnesses. He used the term fascinatio to explain the transmission of lovesickness via emanations from the eyes (in a combination of humoralpathology and theories of sympathy) (cf.196 Poiesis Prax (2009) 6:191–202 In the context of the Black Death in the fourteenth century and the many extensive plague waves of the following centuries. the disease transmission of the ‘‘plague poison’’. Attempts were made to ground it on the then current scientific bases. heir to the teachings of magical alchemical medicine. It is easy to picture the extent to which— especially in the area of folk medicine—amulets. Sebastian. and faith in God were felt to be magic shields against those kinds of arrows. thence the real plague itself will break out shortly afterwards/ even though the sensual soul of the person has otherwise no insight into the nature of the plague. is directly visualised as a somatic traumatisation in the pictures of arrow-riddled St. ibid. Johann Baptist van Helmont. but its image (idea) lies within the body like the seed of a disease. 944/12). The ‘‘images of fright’’ seem especially pathogenic. In Hellenistic times. What today sounds like a metaphorical phrase about psychological traumatisation when Paracelsus explains it. Schott 2002:99 et sqq. By proceeding from the assumption of a disease-causing idea. 3 ‘‘Transfert’’. Sebastian. There is plenty of evidence in the visual arts of the time showing this process. Images of St.’’ (cf. he was able to envision a parasitological infection even more lucidly: ‘‘And therefore it is no wonder that also an affright in the face of the plague/ can form and beare a complete image (idea) of the plague including the true plague-poison. it was adapted to fit the contemporary framework of the Enlightenment and its teachings. They blemish ‘‘the vital spirits in an extremely poisonous and strong way / and the vital spirits have a close connection with these images’’ (cf.

in which he first coined the term ‘‘hypnotism’’. ultimately conceived to be the result of a nervous reflex mechanism. not only beneficial suggestions can have an effect. For instance. 1891:16) defined suggestion as ‘‘the process. and eventually lead to the concept of the ‘‘psychological trauma’’. I transfer the deafness to the other side by suggestion. He had his eyes closed when he was told that he was bleeding from an open vein. If I suggest complete deafness to him [the test subject]. the man was found dead after a few minutes. 1888:77) objected to Charcot’s (late-mesmerist) attempts to transfer sensory disorders from one body part (even from one person!) to another using a magnet: ‘‘I can […] make a transfer through suggestion […]. Although it was only warm water that was flowing down him. we would now like to look at the turn to modern medicine. Bechterew 1905:35) Impressed by the victories of bacteriology—Robert Koch discovered the tuberculosis bacillus in 1882. However. Bernheim held the expressions ‘‘je transfère’’ (I transfer [the suggestion]) and ‘‘je suggère le transfert’’ (I suggest the transfer) to be synonymous (cf. Rather than pursuing this point any further. Any heterosuggestion can only have an effect if it turns itself into autosuggestion. but also the complementary idea of resistance. Traumatic suggestions under hypnosis attracted much attention.’’ (cf. to establish a sustainable and scientifically acceptable theory for ‘‘psychotherapy’’—and it was he who essentially coined the term (cf. ibid.’’ Thus. such as the suggestion of heat causing blebs. which Freud called ‘‘involuntary desire to resist’’ (cf. in 1843. the ‘‘force de résistance’’ or ‘‘résistance inconsciente’’ (against thera- peutic suggestions). James Braid. Freud not only took over the idea of the transfer (which he subsequently modified considerably). a surgeon from Manchester. which can be used therapeutically with the aim of ‘‘letting the soul interfere in order to heal the body’’ (cf. if the patient is in ‘‘rapport’’ with the physician. A very striking example of such traumas under hypnosis was an execution experiment described by Russian psychiatrist Wladimir Bechterew to demonstrate the power of suggestion. only in the 1880 s did internist Hippolyte Bernheim from Nancy manage. Schott 1984). Unfortunately. ‘‘dynamics of imagination’’). There was a considerable eagerness to experiment in the field of hypnosis and suggestion in the decades around the turn of the century. causing a trauma or disease. 123 . suggestion means transfer. the event is not (yet) fully identifiable. i. ‘‘Neurypnology or the Rationale of Nervous Sleep’’. However. through which an idea is introduced into and accepted by the brain’’. he claims not to be able to hear the clock held to his ear. published his magnum opus. but one can assume that physicians and scientists participated in it: ‘‘A haptic suggestion experiment was used on a criminal sentenced to death. He was trying to create a basis for medical hypnosis. Schott 1997:293). frightful or terrifying ideas can be induced. Thus.e. on the basis of his ‘‘suggestive therapeutics’’. which also touches upon trauma therapeutics of medical psychology. Bernheim (cf.Poiesis Prax (2009) 6:191–202 197 electricity playing a very prominent role. Bernheim 1888:5). but also pathogenic ones. the same year that Bernheim turned to suggestion theory—medical psychologists also began drawing on their concept. Bernheim (cf. 32). The suggested idea is then reflexively (automatically) turned into action (‘‘Vorstellungsdynamik’’.

Interest- ingly. Bechterew saw a clear analogy between physical and psychological infections. after all. especially hysterical lameness. Later on. was only published over half a century later (Freud 1950). Freud 1916/17:284). He suggests that a ‘‘mental epidemic’’ can be triggered by the ‘‘psychological transfer’’ (transfert) of powerful pictures. the 123 . and neurosis: The Freudian approach Against the backdrop of the above-mentioned prehistory of psychoanalysis. What he is saying is that trauma shows an inability of the mental apparatus to deal with stimuli according to the ‘‘constancy principle. In it he claims that a trauma (more precisely. hysteria. He assumed that the symptoms would only be brought out after an ‘‘incubation’’.g.’’ Breuer also stressed the significance of the ‘‘hypnoidal state’’ for the effectiveness of the trauma. 4 Dream. Charcot managed to experimentally produce similar kinds of lameness under hypnosis and thus demonstrate that there was no somatic explanation. a psychological ‘‘processing’’ of the trauma. In this way. which he wrote in manuscript form in 1895. ‘‘an indirect over-injection of certain mental states from person to person circumventing their will’’ (Bechterew 1905:12). but the affright. Freud characterised trauma mainly from an ‘‘economic’’ point of view: An experience involving an increase in stimuli that have not been properly processed would lead to a continual dysfunction of ‘‘energy management’’: ‘‘The neurosis would be analogous to a traumatic disease and would be caused by the inability to deal with an overly strong affective experience’’ (cf. However.’’ ‘‘Anti-cathexes’’ are needed in order to contain the flood of excessive sensual stimuli. the result of a minor physical injury. 1893:84) tied on to these insights and explained that there was a ‘‘pathogenic analogy between regular hysteria and traumatic neurosis’’: The cause of a traumatic neurosis is not. calling for an ‘‘abreaction’’ or psychological treatment. in Le Bon’s well-known treatise ‘‘The Crowd: A Study of the Popular Mind’’ (cf. i. the term ‘‘mental bacillus’’ (contagion mental) established itself especially with regard to mass-suggestion. as a pre-condition for hysterical schizophrenia (‘‘hypnoidhysteria’’). one of the few graphics by Sigmund Freud refers to such a ‘‘psychological transfer’’ or infection of the mass: In his treatise ‘‘Group Psychology and the Analysis of the Ego’’ (1921) he uses arrows to give a ‘‘graphic demonstration’’ of the process. 1895:15). We will focus on Freud’s early theories. e.g. Thus.198 Poiesis Prax (2009) 6:191–202 suggestion was defined as e. the trauma can set off a neurosis. Regarding ‘‘traumatic hysteria’’. Breuer and Freud (cf. we would now like to give a short outline of Sigmund Freud’s approach. But first we will turn to Charcot once more. There is an interesting intermediate step on the path to the creation of psychoanalysis: Freud’s ‘‘Project for a Scientific Psychology’’ (‘‘Entwurf einer Psychologie’’). Freud 1921:128). the psychological trauma. in which some individuals have ‘‘substituted their Ego ideal with one and the same object’’ (cf.e. in which the psychological trauma plays a central role. Charcot assumed a primarily physical trauma triggering a terrifying sense of being in a life-threatening situation by the persons concerned. Charcot was unable to give a neurological explanation for lameness as a result of a trauma.

he valorised the notion of the ‘‘psychological reality’’ and simultaneously devalorised that of the trauma that had occurred in reality. Breuer and Freud 1893:86). The pathogenic memory of the actual seduction scene eventually turned into the cause of the ‘‘psychoneurosis’’. this memory is ‘‘rooted in reality’’. criticised for shutting his eyes to actual sexual abuse.) It is typical of Freud to employ the construct of a ‘‘primal scene’’ trying to give some sort of actual basis to his ‘‘psychological reality’’. a first scene of a (mostly) harmless ‘‘seduction’’ in (early) childhood by an adult person has no importance as such. This way. He claimed that the premature sexual experience was subsequently suppressed. Freud stressed a very strict seduction theory. He claims that there are ‘‘primal fantasies’’. i.Poiesis Prax (2009) 6:191–202 199 memory of a ‘‘sexual trauma’’) has its pathogenic effects only later. Because of this angst she is afraid the clerk might repeat the [sexual] assault and therefore runs away. Freud thus changes his perspective of the notion of ‘‘reality’’: From a psychodynamic point of view—regarding the aetiology of neuroses—it seemed to be irrelevant whether or not an experience had occurred in reality or just in someone’s imagination. Those ‘‘infantile sexual scenes’’ especially the infantile coitus were supposed to be very serious traumatic sources of the neurosis. he claims. this laughter (unconsciously) awakens memories of the general shop proprietor. He was thus trying to vividly demonstrate how memories can retrospectively turn into a trauma. like the Oedipus complex. In his ‘‘Project’’. Freud has been.) uses the case history of Emma. 123 . Only after adolescence a (often harmless) second scene will awaken the childhood memory and generate a sexual sensation. 1950:432 et sqq. a repression in the form of a ‘‘pathological defence’’. as in the above case. and is still. From 1897 on. […] This memory awakens what it certainly could not back then.’’) For a short period about 1896. Freud (cf. (Because of this view. that ‘‘hysterics mostly suffer from reminiscences’’ (cf. which are phylogenetically rooted in human prehistory and relate to an actual trauma.e. He stated that sexual abuse. because of the fact that the ‘‘seduction’ would not provoke sexual feelings of the child. who suffers from the compulsion of not being able to enter a shop alone. Freud 1950:435). Between 1895 and 1897. a physical reality. aggression of the small child by an adult person would produce hysteria. an ‘‘assault’’. as is well-known. which turns into angst. With this line of reasoning. What happens is that the patient dreams back to an earlier phase of life. violation. This will lead to hysteria. The sexual seduction of a passive child he also called. when Freud was increasingly turning to the ‘‘interpretation of dreams’’ and. Thus. (‘‘The two clerks in the shop are laughing. submitted himself to self- analysis (cf. which he abandoned later on. to show a schema of repression and symbolic displacement of ideas through the Ego. a sexual release. he saw the (sexual) ‘‘seduction’’ of a child by adults (especially its parents) as a real trauma and the cause of a later illness. Freud’s view changed: He now believed that the sexual seduction corresponded with an ‘‘unconscious fantasy’’. however. This corresponds with his slightly earlier insight. ‘‘Repressed memories which retrospectively turn into a trauma are found everywhere’’ (cf. about which we are informed by mythology’s subject matter. Schott 1985).

however. Another method is ‘‘flagellation’’. The encapsulation of trauma is represented as three layers to the dissociated pathogenic core: (1) as linear and chronological (‘‘memory fascicle’’). i. as he explains in his chapter on ‘‘The Psychotherapy of Hysteria’’ (cf. e. Even in homeopathy 123 . Schott 1980). Freud explains in great detail how this core effectively unfolds its power and gains momentum as a foreign body in the human psyche. e. especially the psychological work of the therapist of ‘‘getting the resistance to melt away’’ (amongst others through the ‘‘pressure technique’’. dissociated area of association relating to the trauma. we would like to conclude by looking at a basic medical concept which resembles the expression ‘‘for a terrible ill. and (3) as dynamic relative to the logical linking of thought content. a medical textbook (cf. Paullini 1698).g. flogging someone as a healing method. a delivery from a (delusional) ide´e fixe. such as casting patients into cold water unawares (and pulling them out only when they are on the verge of drowning) in order to enforce. We are talking about artificial trauma as a therapeutic factor. which was accounted for medically (‘‘physically’’) as well as pedagogically (‘‘morally’’) and discussed in. Breuer and Freud 1895:252 et sqq.g. exorcism). the smallpox vaccination is based on a purposeful injury and transmission of the miasma. Surgery is the most plausible example of this kind of trauma. manually applying pressure to the patient’s forehead). there is a great number of diverse treatment methods implying a traumatisation which is not a surgical intervention in the strict sense. method of dissipation and expulsion (incl. (2) as concentric relative to the varying levels of resistance (the resistance gets stronger in the vicinity of the core). (2) The extraction of the malady (or evil). In medical history. Surgery can be defined as a therapeutic (and thus permissible) physical injury. Examples of ‘‘traumatic’’ inducements for the therapeutic purposes are all varieties of shock treatments employed in early psychiatry around 1800. methods of ‘tuning the temper’. 5 The artificial trauma as a healing factor: a medical historical outline Moving to a more abstract notion of the ‘‘psychological’’ trauma in the strict sense of the term. amongst others. and on the creative dream work rather than the pathogenic. according to Edward Jenner. He is talking about ‘‘abreaction’’ and the ‘‘associative correction’’ of a traumatic fixation.200 Poiesis Prax (2009) 6:191–202 Freud’s psychological trauma appeared in the context of his ‘‘Studies on Hysteria’’ as the ‘‘pathogenic core’’ of neurosis. Although Freud mostly retains the basic principles of this treatment technique in his self-analytically oriented ‘‘Interpretation of Dreams’’. amongst others. His goal was to reconnect the excluded. creating a ‘‘crisis’’ meant to be indirectly therapeutic. There are two reverse basic processes: (1) The inducement of partially painful impulses. he does perform a fundamental change of perspective in his main work: He now focuses on the unconscious rather than the psychological trauma as the primary emotional instance of infantile desires. This psychodynamic model representation of hysteria forms the basis of Freud’s early psychoanalytical treatment technique.e. dissociated ‘‘core’’. For instance.). back to the general circulation sphere of associations (cf. The idea of inducing therapeutic traumas appears in several medical concepts around 1800. a worse remedy’’.

From the perspective of the history of ideas. an instrument with very sharp short needles and a spring balancer mechanism he superficially pierced certain sites of the epidermis (1–2 mm deep) and then applied the ‘‘Original Baunscheidt Oil’’ to generate mild pustules. This is the problem of the ‘‘iatrogenic disease’’. We would be talking about malpractice if therapeutically inflicted traumas turned out to become real traumas causing damage rather than helping the patient. but as an indication of healing because the hurtful matter was apparently draining off (pus laudabile. The teacher and mechanic Baunscheidt (1851) invented a so-called naturopathic treatment in Bonn. of haemostasis). Thus Baunscheidtism belongs to the group of dissipating methods. in the case of the assumed ‘‘phrenitis’’). being induced by the ‘‘ascetic priests’’ (in a quasi-hypnotic way). sweating. The more effective the medication. This humoralpathological tradition provides us with a particularly illustrious example of artificial traumatisation as a healing method. cupping. in terms of therapy. the painful memory of a traumatic experience during psychoanalysis and the artificially generated ‘‘transference neurosis’’ may in a sense be categorised as belonging to the historical series of ‘‘therapeutic traumas’’. laudable pus). psychoanalysis—like any other medical treatment method—is faced with a fundamental problem. vomiting. Artificial suppuration was therefore applied as treatment. of which many editions and translations were published: By stimulating certain skin areas. ‘‘miasmas’’ were supposed to be secreted from the ‘‘life fluids’’ and thus the functionality of the organ in question stimulated (Baunscheidt 1851). Sanies did not count as a disturbing factor (e.g. e. explicitly focus on the moment of driving out the fixed psychological trauma (the terms ‘‘abreaction’’ and ‘‘discharge’’ point to the underlying idea of dissipation). which he himself called ‘‘Baunschscheidtism’’—which is also the title of his main work. It would be an interesting research endeavour to find out those moments in the history of modern psychotherapy in which ‘‘traumas’’ were intentionally (or unintentionally!) inflicted on patients for therapeutic purposes.g. exceptional and fierce the disease will turn out to be’’ (cf. In this way. Particularly in the tradition of ancient humoralpathology. bloodsuckers. Using a ‘‘Lebenswecker’’ (‘‘life awakener’’). The idea of a ‘‘beneficial crisis’’ plays a central role in Franz Anton Mesmer’s healing concept of animal magnetism. aperients (‘‘purging’’). Dissipation methods of extracting the malady play an equally important part in therapeutic history. the purification or regulation of bodily fluids was linked with procedures of dissipation: blood-letting. which Friedrich Nietzsche identified in his ‘‘Genealogy of Morals’’ as the ‘‘modern disease’’ par excellence. which Karl 123 .Poiesis Prax (2009) 6:191–202 201 with its ‘‘principle of simile’’. Baunscheidt’s ‘‘life awakener’’ was praised as a cure-all—even curing cholera—and became an international sales success. Schott 1998:248). Even in psychiatry around 1800 the hair rope was pulled under the nape skin of ‘‘lunatics’’ to provoke a dissipation of harmful matters from the brain (esp. In his very first presentation of the homeopathic principle in 1796. Hahnemann wrote: ‘‘Every effective medication activates some sort of disease in the human body. etc. which. in the form of a hair rope being pulled under the skin and left there for a long time so the sanies could flow off the exposed ends of the rope. the more peculiar. the traumatisation is significant in so far as therapeutic change can be induced through ‘‘initial aggravation’’ in the sense of an ‘‘artificial disease’’.

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