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FREUD’S SCHREBER
BETWEEN PSYCHIATRY
AND PSYCHOANALYSIS
FREUD’S SCHREBER
BETWEEN PSYCHIATRY
AND PSYCHOANALYSIS
On Subjective Disposition
to Psychosis

Thomas G. Dalzell
First published 2011 by Karnac Books Ltd

Published 2018 by Routledge


2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
711 Third Avenue, New York, NY 10017, USA

Routledge is an imprint of the Taylor & Francis Group, an informa business

Copyright © 2011 Thomas G. Dalzell.

The right of Thomas Dalzell to be identified as the author of this work has
been asserted in accordance with §§ 77 and 78 of the Copyright Design and
Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or
utilised in any form or by any electronic, mechanical, or other means, now
known or hereafter invented, including photocopying and recording, or in any
information storage or retrieval system, without permission in writing from
the publishers.

Notice:
Product or corporate names may be trademarks or registered trademarks,
and are used only for identification and explanation without intent to infringe.

Cover image: Daniel Paul Schreber


Permissions summary:
Permission has been granted by W. W. Norton & Co., New York, to repro-
duce their English language versions of Lacan’s Schema R and Schema I.
From Ecrits: A Selection by Jacques Lacan, translated by Bruce Fink.
Copyright © 1996, 1970, 1971, 1999 by Editions du Seuil. English translation
copyright © 2002 by W. W. Norton. Used by permission of W. W. Norton &
Company, Inc.
Permission has also been granted by James Niederland to use his deceased
father’s photograph of Daniel Paul Schreber from the William G. Niederland
file at the Library of Congress in Washington.

British Library Cataloguing in Publication Data

A C.I.P. for this book is available from the British Library

ISBN: 9781855758834 (pbk)

Edited, designed and produced by The Studio Publishing Services Ltd


www.publishingservicesuk.co.uk
e-mail: studio@publishingservicesuk.co.uk
CONTENTS

ACKNOWLEDGEMENTS vii

ABOUT THE AUTHOR xi

PREFACE by Charles Melman xiii

INTRODUCTION xv

CHAPTER ONE
Freud’s exemplary case of psychosis: 1
Daniel Paul Schreber

CHAPTER TWO
Disposition to psychosis in Freud’s Schreber text 27

CHAPTER THREE
Psychosis in Freud’s papers before and after 67
his Schreber text

CHAPTER FOUR
Freud and Emil Kraepelin 115

v
vi CONTENTS

CHAPTER FIVE
Freud and the Viennese psychiatrists 149

CHAPTER SIX
Freud and Eugen Bleuler 199

CHAPTER SEVEN
Hereditary disposition in Freud’s aetiological chain 233

CHAPTER EIGHT
The reception of Freud’s 1911 aetiology by 267
psychoanalysts

CHAPTER NINE
Jacques Lacan on Freud’s Schreber 293

Conclusion 339

REFERENCES 347

INDEX 391
ACKNOWLEDGEMENTS

This book began as a PhD thesis in the School of Medicine and


Medical Science of University College Dublin at St Vincent’s
University Hospital. My special thanks go to Dr Cormac Gallagher
and Professor Kevin Malone, the supervisors, and to the members
of the supervisory panel, Dr Olga Cox-Cameron, Dr Rik Loose,
Dr Patricia McCarthy, Dr Barry O’Donnell, and, especially,
Dr Helen Sheehan.
I am grateful to the staff of the James Joyce and Health Sciences
libraries at University College Dublin, the Berkeley Library at
Trinity College Dublin, and the British Library in London; the staff
of the Bayerische Staatsbibliothek, the Emil Kraepelin Bibliothek in
Kraepelin’s clinic and the library of the Deutsches Museum, all in
Munich, for granting me access to the German-language texts cited
here; Dr Wolfgang Burgmair of the Max Planck Institut für Psychia-
trie, also in Munich, for allowing me to consult the Kraepelin Archiv,
and for finding editions of Kraepelin’s Lehrbuch for me which were
unavailable elsewhere; the staff at the Institut für die Geschichte der
Medizin in Vienna, especially Dr Manfred Skopec; Professor
Ferdinand Opll, director of the Viennese Stadt- und Landesarchiv;
the Bibliothèque nationale de France for providing access to early

vii
viii ACKNOWLEDGEMENTS

French psychiatry texts; the library staff at All Hallows, Dublin City
University; the staff in the manuscript division of the Library of
Congress in Washington, especially Jeff Flannery, for permission to
read Bleuler’s unpublished letters to Freud, and Lewis Wyman for
finding a photograph of Schreber in the William G. Niederland
papers; Dr Gerd Busse in Düsseldorf for directing me to that source;
and James Niederland in Englewood, New Jersey, for kindly grant-
ing me permission to use the photograph from his father’s files.
Many thanks also to Dr med. Bernhard Küchenhoff, Stv. Klinik-
direktor of the Burghölzli in Zürich, for his willingness to discuss
his research on the Freud–Bleuler relationship, and for granting me
access to the Bleuler archives; the Schwestern der spirituellen
Weggemeinschaft for their hospitality in the old admissions build-
ing of Bleuler’s Rheinau asylum; Professor Christian Müller, Bern,
for his correspondence on Bleuler’s ambivalence; and Professor
Christian Scharfetter for his comments on Bleuler’s reception of
Freud. The German Kraepelin expert, Professor Paul Hoff, deserves
special mention for discussing with me his views on Kraepelin and
Freud, and for drawing my attention to a possible exchange of let-
ters between them.
I am indebted to Dr Charles Melman in Paris for his remarks on
Schreber as L’Une and on the possibility of schizophrenic patients
healing themselves with a paranoia; to Guy Le Gaufey, Paris, for his
thoughts on Moreau de Tours’ sens génésique and on Lacan’s formu-
lae of sexuation; and Dr Christian Fierens, Brussels, for critiquing
my reading of Schreber in Lacan’s “L’Etourdit”. Thanks, too, to
Professor Albrecht Hirschmüller, Tübingen, for drawing my atten-
tion to texts by Meynert on progressive paralysis, and Professor
Edward Shorter, Toronto, for his correspondence on the cause of
Schreber’s death. I would also like to express my gratitude to Pro-
fessor Alain Vanier from the University of Paris VII, and Professor
Eadbhard O’Callaghan from the UCD School of Medicine and
Medical Science and the St John of God Hospital, Stillorgan, County
Dublin, both of whom examined the thesis on which this book
is based; Frau Birgit Horn-Kolditz at the Stadtarchiv, Leipzig, for
her assistance and permission to consult Schreber’s Krankheits-
geschichte; Dr Patricia McCarthy for supplying letters of reference;
Dr Holger Steinberg from the archive for the history of psychiatry
at the Leipzig university clinic for his comments on Schreber’s
ACKNOWLEDGEMENTS ix

patient files, and for helping me search for photographic material;


Frau Ute Fleckna of the Sächsisches Staatsarchiv, Dresden, for her
assistance with the Staatshandbücher from Schreber’s time at the
Oberlandesgericht; and W. W. Norton and Company, New York, for
permission to reproduce their English version of Lacan’s Schemas
R and I.
And, finally, I acknowledge the support of my family and
friends; the Society of Mary; the members of the cartel which read
Lacan’s “L’Etourdit” and Le Gaufey on the formulae of sexuation;
my colleagues and students at All Hallows, especially Dr Marjorie
Fitzpatrick for her help with research methodology, and at the
School of Psychotherapy, St Vincent’s University Hospital, Dublin;
and Oliver Rathbone, Lucy Shirley and Kate Pearce of Karnac
Books.
ABOUT THE AUTHOR

Thomas G. Dalzell is Editor of The Letter: Irish Journal for Lacanian


Psychoanalysis. An analyst member of L’Association Lacanienne
Internationale, and a member of the Irish School for Lacanian
Psychoanalysis, he practises psychoanalysis in Dublin. His first
doctorate was in theology (Queen’s University of Belfast) and his
second in psychotherapy (University College Dublin). He teaches at
All Hallows, Dublin City University, and at University College
Dublin. An expert on psychoanalytic understandings of schizo-
phrenia and delusional disorder, he has written on Jacques Lacan,
psychoanalysis in the history of psychiatry, and Eugen Bleuler. He
is currently engaged in research on the newly released letters from
Freud to Bleuler.

xi
PREFACE

One would have to be Irish to know from experience how essential


it is to obstinately safeguard the Name-of-the-Father so as to be
able to stand firm and to respond to the excessive demands of
reality and power, even and especially when they are hostile, so as
not to give way to indulgence or to having to please in a feminine
way.
President Schreber’s difficulty was that his father was more
of an implacable educator–authority for him than one whose
love would inscribe his son in a line of descent. How could he
assume a major professional function after being destined to
having to assume the obedient subjectivity of a minor? If Presi-
dent Schreber responds to his promotion with a delusion, it is
precisely because he lost every subjective reference because he had
not been introduced to the consubstantiality of the father and the
son.
Tom Dalzell studies with precision the position of the best of
classical psychiatry, as well as that of Freud and, finally, of Lacan.
At the same time, he does homage to a remarkable opus which was
the object of these labours, that of a madman who, in his delirium

xiii
xiv PREFACE

and suffering, had enough humanism to leave to the savants a


unique document made to enlighten them.

Dr Charles Melman
Paris
Introduction

This is not another general exploration of Sigmund Freud’s 1911


Schreber text, or another account of newly discovered historical
facts about Daniel Paul Schreber. It is a study of what was distinc-
tive about Freud’s 1911 conception of the predisposition to psy-
chosis in relation to the views of his psychiatrist contemporaries
and of psychoanalysts after him. Its hypothesis is that Freud
reversed the order of priority in late nineteenth-century aetiologies
of psychosis—objective–biological and subjective–biographical—
and that he privileged subjective causes without returning to the
subjective paradigms of early nineteenth-century Romantic psychi-
atry and without obviating the legitimate claims of psychiatry on
inherited biological predisposition.
The German Kraepelin expert, Paul Hoff, has distinguished
three historical models of psychiatric illness, real, nominal, and bio-
graphical–individual (Hoff, 1995, 1998, 2004). By real is meant the
view, exemplified in Kraepelin’s natural illness unities (Kraepelin,
1983, p. 49), that mental illnesses are biological entities which exist
in themselves and independently of who suffers them or who dis-
covers them. In other words, the stress lies on the objective nature of
the illness as something quantifiable that the patient has, as opposed

xv
xvi INTRODUCTION

to its being a theoretical construction by scientists, or a subjective


experience of a patient. While Hoff regards the extreme form of this
as a biological reductionism, in our own approach biological realism
includes not only Kraepelin’s illness entities, but the empirical psy-
chiatry introduced by Griesinger in the middle of the nineteenth
century, the brain anatomical psychiatry of Meynert, and the nega-
tive view of biological heredity spread in the German-speaking
world by Krafft-Ebing. We will see that although Freud was as much
a brain anatomist as Meynert in 1883, Meynert actually taught him
to be cautious about hereditary dispositions to psychosis. And,
while Freud accepted the existence of Krafft-Ebing’s neuropathic
constitution, and did recognize heredity as an important disposition
to both neurosis and psychosis, we will see why he insisted that a
hereditary burden of itself was insufficient to make someone ill.
The nominal definition of mental illness refers to diagnostic
terms constructed to describe an illness according to the scientific
criteria of the time. In other words, these terms are conventions
which apply under certain circumstances, rather than judgements
concerning what an illness is in itself. In Hoff’s view, the extreme
form can lead to a formal reductionism, neglecting either the con-
tent of the illness or the subjective elements which do not fit the
accepted criteria. We will have less to say about this approach, since
it is aetiologically neutral, but we will examine Freud’s position on
the naming of illnesses, especially the nosology developed by
Kraepelin. Not that Kraepelin was a nominalist. In fact, Chapter
Four will show that Kraepelin’s philosophy not only ruled out the
scientist’s constructing an illness, but demanded an objective
detachment on the part of the doctor, and it will ask if this was not
a significant reason for there being no fruitful exchange between
him and Freud. On the other hand, it will investigate why Freud
agreed with Kraepelin’s separating dementia praecox from para-
noia, and why he added Kraepelin’s paranoid form of dementia
praecox to the title of his Schreber text, although Kraepelin did not
return the compliment, but rejected Freud’s Schreber text aetiology
(Freud, 1911c). We will also see why Freud found Krafft-Ebing’s
descriptive psychiatry uninteresting, apart from his Psychopathia
sexualis (Krafft-Ebing, 1886), and why, unlike Bleuler, he was not
satisfied to interpret symptoms in the light of psychoanalytic the-
ory (Freud, 1916–1917, p. 67).
INTRODUCTION xvii

The biographical–individual approach is actually older than the


other two, but we are concerned with its expression in the first half
of the nineteenth century, in the Romantic psychiatry of clinicians
such as Johann Christian August Heinroth and Karl Wilhelm Ideler.
Romantic psychiatry related psychosis to immoral excesses, with
Heinroth putting it down to sin, and Ideler holding that it was the
non-gratification of passions that gave rise to illness. We will see,
however, that it was its ties to literary and philosophical Roman-
ticism (Naturphilosophie), with its mystical and pantheistic under-
standings of force, its tending to neglect empirical clinical experi-
ence in favour of a priori theories, and its thinking that mental ill-
ness was due to the individual’s psychological development, that
moved Griesinger to argue for a psychiatry based on science
(Naturwissenschaft), and to put an end to the poetic and philosoph-
ical conceptions of Romantic psychiatry. By the end of the nine-
teenth century, when Freud was developing his psychoanalytic
theory, the subjectivity of Romantic psychiatry had been replaced
by objectivity and new thinking which suggested a return to the
first half of the century was not welcome. Freud was aware, as we
will see, that anything demonstrating an independence of mental
life from verifiable organic alterations—such as his dream-theory—
alarmed his psychiatrist contemporaries as if it was necessarily
bringing back the times of Naturphilosophie (Freud, 1900a, p. 41). But
we will ask if Freud’s emphasis on the psychological development
of the individual, and his understanding symptoms in terms of
inner conflicts, actually did represent a return to Romantic psychi-
atry. We will see that when Freud criticized philosophy (Boehlich,
1989, p. 145), it was not the whole discipline that he was rejecting,
but the Naturphilosophie that had influenced Romantic psychiatry.
And, more importantly, when we investigate Freud’s medical train-
ing, we will find that, even before he started to work in Meynert’s
psychiatric clinic, he had been educated in the scientific methods
of the second Viennese medical school, as opposed to the Roman-
tic paradigms of the first. Hence, Bleuler’s being able to state that
Freud was no Romantic poet, or starry-eyed idealist (Bleuler,
1926, p. 1). And while Hoff finds a tendency in psychodynamic
approaches to excuse the individual for his behaviour, and con-
trasts this with Heinroth’s holding the individual responsible
for his development (Hoff, 2004, p. 22), we will ask if Freud did
xviii INTRODUCTION

exonerate the individual, and contrast Freud’s aetiology with


Heinroth’s attributing illness to a deviation from moral norms.
The subjectivity that concerns us in this book is the individual
subject’s involvement in the origin of his or her illness, and its cure.
Implicit in this is Freud’s interest in the patient as subject, rather
than an object of investigation. It is already well known that one of
the hallmarks of Freud’s approach was his listening to what his
patients said. In the case of Schreber, of course, it was a matter of
what the patient wrote. But we will contrast this with Kraepelin’s
being able to work with patients in Dorpat, without understanding
the Estonian, Russian, or Latvian languages (Kraepelin, 1983,
pp. 45–46). We will also discover that because Bleuler’s family had
suffered the disadvantage of having doctors in the Burghölzli who
were unable to understand Schweizerdeutsch, he, too, set out to lis-
ten to the speech of his patients, something which would open him
to Freud. But if Freud concentrated on subjectivity, we will investi-
gate the historical data to see whether or not the claim is verified
that he did not do away with the legitimate claims of biological psy-
chiatry. Since his contemporaries understood neuropathic disorders
to be mainly inherited, we will research the place of heredity in
Freud’s own aetiological chain, and attempt to make sense of his
regarding heredity as an important predisposing factor on the one
hand, and his making illness depend on subjective causes on the
other. In short, we will marshal the evidence to discover whether or
not Freud reversed the order of priority of dispositions to psychosis
at the end of the nineteenth century, whether or not he regressed to
Romantic psychiatry, and whether or not he removed inherited dis-
position from his aetiological chain.
Freud elaborated his thinking on the predispositions to paranoia
and dementia praecox in his 1911 text on the basis of what the
famous German psychotic judge, Dr Daniel Paul Schreber, said
about his illness. We will begin, therefore, by examining Schreber’s
1903 autobiography, Freud’s principal source of information about
him, although we will take account of his patient files and other
files more recently discovered. Chapter Two will study Freud’s 1911
text as such, and concentrate on the aetiology of psychosis he devel-
ops there. It will pay particular attention to what is new in this text
in relation to the causes of paranoia: its positing a dispositional
fixation at infantile narcissism to which Schreber’s libido could
INTRODUCTION xix

regress. That Freud continued, despite objections, to hold his views


on the disposition to paranoia after 1911, will be seen in Chapter
Three, although the effects of his later thinking on the drives and of
his second topology will also be addressed. To what extent his
Schreber text aetiology has been accepted by psychoanalysts since,
will be addressed in chapters Eight and Nine. Chapters Four, Five,
and Six will deal with the historical context in which his thinking
on psychosis evolved, that is, what psychiatrists were saying at the
end of the nineteenth century about psychosis and its causes. This
will highlight what is distinctive about Freud’s Schreber text aetiol-
ogy of paranoia, which is a fixation at narcissism as a decisive—and
subjective moment—in his causal chain of heredity, libidinal fixa-
tions, accidental childhood sexual experience, and later precipitat-
ing causes. Chapter Four will analyse the biographical and
philosophical reasons for the lack of positive engagement between
Kraepelin and Freud, and why Kraepelin rejected Freud’s 1911 aeti-
ology. Chapter Five will ask what Freud learned about disposition
to psychosis from the Viennese psychiatrist, Meynert, when he was
an assistant in Vienna’s second psychiatric clinic, and from the
French neurologist, Charcot, soon after he left it. It will also take
account of what distinguished Freud’s conception of psychosis and
its causes from those of his other psychiatrist contemporaries in
Vienna, Krafft-Ebing and Wagner-Jauregg, and discuss his views on
the neuropathic constitution proposed by the former and the bod-
ily foundation of psychosis by the latter. And Chapter Six will
examine the theoretical differences between Freud and Bleuler, and
not only in relation to Schreber. It will ask if the historical evidence
supports the commonly held view that a personal and theoretical
incompatibility replaced Bleuler’s initial openness to Freud, and, if
not, why Freud maintained a distance from the Swiss, Bleuler
included, despite his recognizing the service they had rendered.
Since Schreber’s patient records, to which Freud had no access,
stress a hereditary burden, Chapter Seven will examine the place of
heredity in Freud’s own aetiological chain, after surveying its place
in the history of psychiatry and in his German-speaking contem-
poraries. However, it will also ask why Freud concentrates on sub-
jective factors rather than inherited constitutional ones. And, finally,
chapters Eight and Nine will discuss the reception by psychoana-
lysts of Freud’s Schreber text aetiology. Chapter Eight will measure
xx INTRODUCTION

the degree to which psychoanalysts have received his specific dis-


position to paranoia in 1911. And Chapter Nine will study Jacques
Lacan’s return to Freud’s Schreber text and evaluate to what extent
he has integrated Freud’s aetiology into his own interpretation of
Schreber. If Freud did reverse the order of objective–biological and
subjective–biographical conceptions of the causes of psychosis in
favour of subjectivity, and his Schreber text posits a fixation at
narcissism as the definitive predisposition to paranoia, despite his
openness to a hereditary neuropathic disposition, we will have to
ask why it is that psychoanalysts—with the exception of Lacan—
have one-sidedly, for and against, stressed the accessory component
of his 1911 aetiology.

Abbreviations
DW: D. P. Schreber (1903a). Denkwürdigkeiten eines Nervenkranken.
KG: Heilanstalt Leipzig-Dösen (1907–1911). Krankheitsgeschichte
(case history).
M: Macalpine, I., & Hunter, R. A. (Eds.) (1955). Memoirs of My
Nervous Illness.
CHAPTER ONE

Freud’s exemplary case of


psychosis: Daniel Paul Schreber

Introduction

I
n 1934, twenty-three years after Freud’s Schreber text appeared,
Arnold Zweig was able to ask Freud what to read in order to
understand his teaching on psychosis—apart from his “Dr
Schreber”, which he already knew (Freud, E. L., 1968, p. 99). Freud
had written a number of papers on psychosis, but his 1911 text,
based on what the famous German judge, Daniel Paul Schreber
(1842–1911), had said about his illness (Schreber, 1903a, hereafter
DW), was and remains the principle source for anyone wanting to
understand Freud’s aetiology of paranoia and schizophrenia.
Before we can examine Freud’s interpretation of the case, we need
to investigate what Schreber said in his memoirs, and take account
of the supplementary information provided by his patient and
personnel files, as well as the expert witness reports by his doctor
in Sonnenstein Castle asylum, Dr Guido Weber. After a brief
biographical sketch, we will consider Schreber’s clinical picture in
1884, when he was first admitted to Professor Paul Flechsig’s
psychiatric clinic in Leipzig; in 1893, when he was readmitted to the
university clinic after being appointed a presiding judge at the

1
2 FREUD’S SCHREBER BETWEEN PSYCHIATRY AND PSYCHOANALYSIS

Oberlandesgericht in Dresden, and transferred to Sonnenstein Castle


asylum; and in 1907, when he relapsed after his mother died and
his wife had a stroke. Weber reported to the court considering
Schreber’s discharge that the content of his final delusion was a reli-
gious mission from God to renew humanity, and that, for that
purpose, he had to become a woman. We will trace the course of
Schreber’s hallucinations and delusions and see that although his
autobiography does indicate an evolution (from persecution by
Flechsig and God to his befriending the idea of becoming a woman,
and, finally, claiming a redemptive mission), what remained a
constant from the start of his second illness was the femininity of
his subjective position.

Who was Daniel Paul Schreber?

In his Denkwürdigkeiten eines Nervenkranken, the autobiography he


used to support his case for release from the Sonnenstein asylum
(DW, p. 1; Macalpine & Hunter, 1955, hereafter M, p. 41), Dr jur.
Daniel Paul Schreber, a presiding judge (Senatspräsident) in
Saxony’s highest court, wrote:

I have been mentally ill twice, both times as a result of mental over-
strain; the first time (as Landgerichtsdirektor in Chemnitz) on the
occasion of my standing for election to the Reichstag, the second
because of the unusually heavy burden of work I found on taking
up my new appointment as a Senatspräsident in the Ober-
landesgericht in Dresden. [DW, p. 34; M, pp. 61–62]

The first illness referred to here had broken out in the autumn of
1884, but was healed by the end of 1885. Schreber was able to return
to work in January 1886, and take up the new post of director of the
district court in Leipzig, to which he had been transferred while still
in the psychiatric clinic. His second bout of illness began in October
1893, and, although he would spend more than eight years in the
Sonnenstein under Weber, the Denkwürdigkeiten claimed that,
during both periods of illness, he spent a great part of his time in the
psychiatric clinic attached to Leipzig University and run by the
famous brain anatomist, Paul Emil Flechsig. In fact, he was only in
FREUD’S EXEMPLARY CASE OF PSYCHOSIS: DANIEL PAUL SCHREBER 3

Flechsig’s clinic for six months during his first illness, and seven at
the start of his second. This is already an indication of the signi-
ficance of Flechsig for Schreber. When he was first admitted to the
university clinic, Flechsig diagnosed severe hypochondria (KG,
pp. 1; 14 [26]). Extracts from Schreber’s patient file there—lost in the
bombing of Leipzig in December 1943—and his Sonnenstein records
are included in the Leipzig-Dösen file, which remains extant and
was published by Franz Baumeyer in the 1950s (Baumeyer, 1955,
1956). Having recovered from his first illness, Schreber remained
well until he heard about his nomination to Dresden in 1893. He
then had dreams that his old illness was returning, and, having
arrived in Dresden, he could not sleep and began to have auditory
hallucinations. He was readmitted to Flechsig’s clinic and he soon
started to lose himself in a world of mysticism, and he no longer
recognized his wife. He came to believe that Flechsig was perse-
cuting him, and he thought that nowhere could be worse than
Flechsig’s clinic (DW, pp. 98–99; M, p. 101). When he was trans-
ferred to Sonnenstein, however, according to Weber’s first expert
witness report for the court dated 9th December 1899, what had
developed into hallucinatory insanity crystallized into the clinical
picture of paranoia, with a fixed delusional system and preservation
of mental clarity (Weber, 1899, DW, p. 271; M, p. 202). This descrip-
tion, as we will see, could easily have been taken from Kraepelin’s
psychiatry text-book (Kraepelin, 1883, pp. 284–285, 303–305).
Back in November 1894, not long after the Sonnenstein admis-
sion, Weber’s report for the president of the Oberlandesgericht, Karl
Edmund Werner, in relation to Schreber’s ability to resume work
(discovered in his personnel file by Devreese), spoke of hallucina-
tory insanity with delusions of persecution, but it was still un-
decided on the prognosis and allowed for a positive outcome, since
the delusional ideas had not become fixed into a closed system. On
the basis of this report, Werner—formerly a Senatspräsident him-
self—recommended a temporary guardianship for Schreber with
the agreement of his wife, and the Ministry of Justice placed him
in temporary retirement (Devreese, 1986, pp. 214–218, 220–222).
The Ministry requested a further report to be submitted after one
year had lapsed and, when Weber supplied it in November 1895,
it was decided to make the retirement permanent (Weber, 1895,
pp. 240–242). The report stated that the situation was less favourable
4 FREUD’S SCHREBER BETWEEN PSYCHIATRY AND PSYCHOANALYSIS

than a year before, that the traits of the clinical picture had become
fixed, that the delusional ideas had become more or less systemati-
cally set, and that, although some improvement could still be hoped
for, it could not be assumed that Schreber would ever reach full
psychical intactness again, or be able to resume his duties.
Before he was transferred from the university clinic to Sonnen-
stein, Schreber’s attitude to Flechsig had changed considerably.
While Flechsig may actually have been awkward to deal with
(Kraepelin found him particularly difficult in Leipzig, and there is
anecdotal evidence that he disliked jurists (Kraepelin, 1983, p. 22;
Schreiber, 1987, p. 74)), he began to take on a delusional significance
for Schreber. As we will see, Schreber would accuse him of what he
called “soul-murder” (Seelenmord). In Sonnenstein, Weber could
report that he endlessly repeated the name “Flechsig”, preceded by
the word “kleiner” (little), which he used to stress sharply (Weber,
1899, DW, p. 383; M, p. 269). And even when the Denkwürdigkeiten
had been completed, the voices that he heard were still calling out
Flechsig’s name hundreds of times a day, and accusing him of being
primarily responsible for his troubles (Schreber, 1903b, DW, p. viii;
M, pp. 33–34).
We will, later, consider Freud’s view that Flechsig represented
Schreber’s brother, Daniel Gustav, who was born in 1839, and shot
himself in 1877, only weeks after being appointed a judge in
Bautzen. According to the Leipzig clinic file, Gustav suffered from
paralysis (KG, p. 1 [1]), and it is also known that an asylum admis-
sion had been considered for him (Baumeyer, 1955, p. 523, 1956,
p. 68). Schreber himself was born in July 1842. Apart from Gustav,
he had another older sibling, Anna, born in 1840. After Schreber
came Sidonie in 1846, and Klara, who would later suffer from
hysteria, in 1848. Their father, Daniel Gottlob Moritz Schreber (1808–
1861), was the famous orthopaedist and educationalist. Han Israëls
has argued that his fame has been exaggerated by psychoanalysts
(Israëls, 1989, p. 231), but, in fact, he has a street called after him
in Leipzig and he is still known in Germany today for the gardens
and associations bearing his name. Recorded in the patient file,
however, is the fact that he suffered from compulsive ideas and
murderous impulses. He died at the age of fifty-three, the age at
which his son’s second illness would break out. As we will see later,
FREUD’S EXEMPLARY CASE OF PSYCHOSIS: DANIEL PAUL SCHREBER 5

the American psychoanalyst, William Niederland, has investigated


the orthopaedic apparatuses invented by Moritz Schreber, such as
his iron Geradehalter, designed to ensure straight posture in children
by being fixed to the chest and table, as well as his writings on
education. He has concluded that Moritz was a psychopath whose
interests in educational reform were only a mask for his sadism
(Niederland, 1959a, p. 161). We will also see that Morton Schatzman,
an American anti-psychiatrist, has argued that Schreber’s persecu-
tory delusion was due to real persecution from his father
(Schatzman, 1973). Whether or not this medical-doctor father was
the basis of Schreber’s persecutory idea of God, who was unable to
deal with living people, but only corpses (DW, pp. 55, 141; M,
pp. 75, 127), is yet to be seen. Little is known about Schreber’s
mother, Pauline. Lothane has uncovered some factual information
about her (Lothane, 1992, pp. 15–16), but we cannot be certain about
Baumeyer’s claim that she was depressive and passive vis-à-vis her
domineering husband (Baumeyer, 1970, p. 245). What we do know
is that Schreber lived with his mother until he got married in 1878 at
the age of thirty-six.
Schreber complained in the Denkwürdigkeiten that the staff in
Sonnenstein appeared to have completely forgotten his state and
high official position (DW, pp. 146–147; M, pp. 130–131). In fact,
before his second admission to the university clinic, he held one of
the second highest posts in Saxony’s judiciary. Werner was Präsident
of the Oberlandesgericht, and immediately under him were Schreber
and five other judges. Academically, Schreber was a high achiever,
and he received various honours during his career. In 1888, he was
made a first class Ritter in the royal Saxon order of service. He had
begun to study law in Leipzig in 1860, and had attained top marks
in his pro praxi et candidatura and Legal Practice examinations
(Busse, 2003, pp. 523–527). He would later become a doctor of
law—the only one among the Senatspräsidenten in Dresden—and
then pass the State examination in 1870. At twenty-three, he took
the judge’s oath and began a legal career which would see him
appointed a Gerichtsrath in Leipzig’s Appeal Court in 1874 and its
District Court in 1877. It was perhaps his working for a year at
the Ministry of Justice in Berlin—the year he got married, 1878—
that caused his rapid promotion through the legal system. The
6 FREUD’S SCHREBER BETWEEN PSYCHIATRY AND PSYCHOANALYSIS

following year he was appointed presiding judge at the Landgericht


in Chemnitz. In October 1884, he stood as a Conservative–National
Liberal candidate in the Reichstag elections, but the electoral area in
which he stood had traditionally been Social Democratic and he
attained only twenty-five per cent of the vote (ibid., p. 525). Accord-
ing to the Denkwürdigkeiten, it was the strain of these elections that
caused his first illness. In 1886, he took up the position of presiding
judge in Leipzig, having been discharged from Flechsig’s clinic.
And, finally, after spending four years as president of the Land-
gericht in Freiburg, he was nominated a Senatspräsident in Dresden
in 1893 at the age of fifty-one.

First admission to Flechsig’s university clinic


Schreber claimed that his first hospital admission was due to the
strain of standing in the elections in October 1884 (DW, p. 34; M,
p. 61). Baumeyer has suggested that he suffered from hypochondria
before his marriage in 1878, but this is not clear from the medical
records (Baumeyer, 1955, pp. 515, 527; 1956, pp. 62, 70). According
to Schreber himself, his first illness broke out towards the end of
1884 as a result of exhaustion caused by the Reichstag elections.
After spending some weeks at Sonneberg for convalescence, he was
transferred to Flechsig’s clinic in Leipzig on 8th December. The first
thing to be entered in his patient file there was that he was heredi-
tarily burdened (hereditär belastet) (KG, p. 14 [26]). He was thought
to be suffering from hypochondria, and he regarded himself as
incurable. His symptoms included speech disturbances, a very
unstable mood, and suicidal ideas. He believed he would die at any
moment, and he imagined that he could not walk. But, as the
Denkwürdigkeiten stated, his first illness ran its course without any
reference to the supernatural (DW, p. 35; M, p. 62). After his recov-
ery in 1885, for which he was grateful to Flechsig (he made allow-
ances for Flechsig’s not allowing him to weigh himself, which, he
believed, would have cured him sooner, and he later paid Flechsig
a personal visit and offered him an appropriate honorarium), he
spent several mainly happy years with his wife, Sabine Baur, a time
rich in external honours, as he put it, which was clouded only by
not being blessed with children.
FREUD’S EXEMPLARY CASE OF PSYCHOSIS: DANIEL PAUL SCHREBER 7

Readmission to Flechsig’s clinic and


transfer to Sonnenstein Castle

Eight years later—in June 1893—Schreber was informed by the


Minister that he was about to be nominated a Senatspräsident at the
Oberlandesgericht, and, shortly afterwards, he had some dreams to
which he paid little attention at the time. He dreamt that his old
illness was returning and he was relieved to discover that he had
only been dreaming. More importantly, he had an experience one
morning while still in bed—whether asleep or already awake he
was not sure—which would deeply affect him. The idea came into
his mind “that it must really be beautiful to be a woman submitting
to intercourse” (DW, p. 36; M, p. 63). This thought was so alien to
his way of thinking, he claimed, that he would have rejected it if
fully conscious. He moved to Dresden in October to take up his
new position, and there he found the burden of work uncommonly
great. Also demanding was the fact that he had to chair the five-
judge college, Karl Moritz Lamm, Herman Wettler, Augustin Julius
Lossnitzer, Oskar Konstans Leonhardi, and Max Alfred Thierbach
(Königliches Gesammtministerium, 1893, p. 213), some of its mem-
bers being up to twenty years older than him and more familiar
with the running of the court. There were few opportunities for
socializing, since he and his wife were new to Dresden, and, after a
few weeks, the situation became too much for him. His sleep began
to be disturbed and he started to take bromide. His first bout of
sleeplessness began at the end of October or the beginning of
November 1893. Every time he tried to sleep, a strange noise in the
bedroom wall would wake him up again. At first, he took this to be
a mouse, but later, after hearing such noises for years, he became
convinced that they were “divine miracles” (DW, p. 38; M, p. 64).
Because of his worsening condition, he and his wife took a holi-
day with the intention of visiting Flechsig again in Leipzig. Accord-
ing to the Denkwürdigkeiten, he received an injection of morphine en
route, as well as chloral, after which he experienced heart trouble,
as in his first illness. And, after a bad night in Chemitz, he made his
way directly to Flechsig’s clinic. There, a very talkative Flechsig
spoke of the great advances psychiatry had made since his first
illness—including a new sleeping cure—and he gave Schreber the
hope that his whole illness could be healed in a single sleep (DW,
8 FREUD’S SCHREBER BETWEEN PSYCHIATRY AND PSYCHOANALYSIS

p. 39; M, p. 65). As we shall see, much has been made of this sleep-
ing cure by interpreters of the case. Schreber took the medication
and went to bed in his mother’s apartment in Leipzig, but he still
could not sleep. In an anxious state, he left the bed and tried to kill
himself, only to be stopped by his wife. The next day, Flechsig
ordered his readmission. Having been taken into the clinic on 21st
November 1893, his thoughts were only of death, and, even when
he was put in a special cell overnight, he tried to kill himself again.
His wife used to visit him daily and take lunch with him, but,
around 15th February 1894, she took a four-day break to visit her
father in Berlin. During this time, Schreber’s condition greatly dete-
riorated, to the extent that, when he saw his wife again, he no
longer recognized her as a living being, but only a miracled-up
human form after the style of what he called “fleetingly improvised
men” (flüchtig hingemachten Männer) (DW, p. 44; M, p. 68), the mean-
ing of which will become clearer later. Decisive for this further
breakdown, according to Denkwürdigkeiten, was a night during
which he experienced an unusual number—half a dozen—of noc-
turnal emissions. His father, Moritz, had written that if such
emissions happened more often than usual, it indicated an ex-
citability of the sexual organs caused by a weakness, and that they
would result in a general weakening of nerve strength, and possi-
bly the complete loss of procreative power (Schreber, D. G. M., 1861,
pp. 181–182). According to a report by Flechsig, Schreber then
began to lose himself in a world of mysticism and religion. He
heard God speaking to him. Devils played games with him, and he
heard holy music (KG, p. 2). There was not as yet, however, any
mention of a redeeming mission from God. It was also from this
time on that he began to believe that Flechsig was not out for his
good, and that Flechsig was speaking to his nerves without being
present, the evidence being the impression that Flechsig could no
longer look him in the eye (DW, p. 45; M, p. 68).
Flechsig suspected that he was suffering from hypochondria
again—what Schreber himself called “softening of the brain”—
although auditory and visual hallucinations were also indicated.
He expected to die shortly, and he had ideas of persecution. He
even thought he had the plague. More importantly, Flechsig
reported that Schreber believed that his penis had been twisted off
by a nerve probe, and that he took himself to be a woman, although
FREUD’S EXEMPLARY CASE OF PSYCHOSIS: DANIEL PAUL SCHREBER 9

he also felt the need to energetically reject the Urningsliebe of certain


persons (KG, pp. [2]-2). Urningsliebe was a term coined by Carl
Heinrich Ulrichs for homosexual love, and used in a series of essays
he published in Leipzig in the 1860s and 1870s (Ulrichs, 1864, 1868,
1879; 1898a,b,). Since Ulrichs was a jurist and a number of his essays
were addressed to the judiciary, Schreber was probably familiar
with them. As Hubert Kennedy has pointed out, “unnatural volup-
tuousness” (Wollust) was not a crime in Hannover, so Ulrichs was
accused of being a nuisance, and had to give up his position as an
Amtsassessor in the judiciary (Kennedy, 1997, p. 384). Interestingly,
given Schreber’s later delusion of being God’s woman, for Ulrichs,
an Urning or male homosexual, was a female soul contained in a
male body (Ulrichs, 1864, pp. 20, 24–25). Like Schreber, he spoke of
a power streaming through his body, and his own writing was in
self-defence, too. On the other hand, Schreber could have found
Ulrichs’ term in Krafft-Ebing’s Psychopathia sexualis (as a clinical–
forensic study, it, too, would have been of interest to the judiciary),
which regularly used Ulrichs’s terminology, and explained the
claim that gender was not bound to physiology in terms of an
Urning being an anima muliebris in corpore virili inclusa (Krafft-Ebing,
1886, p. 58).
After his deterioration in February 1894, Schreber not only
regarded his wife as a phantom, but he thought his whole environ-
ment was a world of appearances. He believed that nowhere in
the world could be worse, and, in June, he was transferred to the
private Lindenhof clinic near Dresden, run by Dr Reginald Pierson,
after attendants suspected he was trying to leave. When these
approached him, Schreber did not bother to ask where he was being
brought, because he regarded them, too, as only fleetingly im-
provised men. Leaving the clinic, he even wondered if the streets of
Leipzig were not just theatre props, although the people he saw at
the railway station in Dresden did seem to him to be real passengers
(DW, pp. 99–100; M, pp. 101–102). His short time at Pierson’s clinic,
too, was dominated by fleetingly improvised men, although he
characterized their appearance as nonsense miracles and empty
playing about. Not only human forms were miracled-up there, but
lifeless objects, too. In addition, he believed that “souls” from the
Leipzig clinic had followed him to Lindenhof, especially the
Flechsig soul (DW, pp. 102, 107, 109; M, pp. 103, 107–108). After
10 FREUD’S SCHREBER BETWEEN PSYCHIATRY AND PSYCHOANALYSIS

twelve days—on 29th June 1894—he was transferred to Sonnen-


stein, where he would spend eight years under Guido Weber.
Sonnenstein Castle is situated on a hill overlooking the river
Elbe at Pirna, near Dresden. First mentioned in the thirteenth
century, it was used as a military fortress until 1811, when it became
an asylum under Dr Ernst Gottlob Pienitz. It was briefly used again
as a fortress in the Napoleonic wars. But, more recently, it became
infamous for having participated in the Nazi euthanasia
programme (Böhm, 2001; Böhm & Schulze, 2003, pp. 11–15). While
its older patient files have been lost, extracts from Schreber’s file,
contained in the Leipzig-Dösen records, mentioned a hereditary
burden again (KG, p. 1 [1]). As for Schreber’s illness as such,
Weber’s first expert witness report for the Dresden Amtsgericht,
written on 9th December 1899, described how his condition had
worsened from initial hallucinatory insanity to an ever more fixed
paranoid clinical picture (Weber, 1899; DW, p. 385; M, p. 271). In the
beginning, the report stated, he had suffered from anxiety and
discontent, hallucinations, mood swings, and various pathological
ideas. He withheld his stools, and complained of “loss of rays”. He
believed that the world had been destroyed, and that his body had
been transformed. He heard the birds talking to him, and he used
to shout at the sun—”the sun is a whore” (Hüre). He endlessly
called out, as we have seen, the name of Flechsig. He was convinced
that Flechsig was present in Sonnenstein, and he felt oppressed by
him. He used to bellow out of the window at night in a way that
disturbed the people of the town, and this meant night-time isola-
tion for him (ibid., DW, pp. 380–386; M, pp. 267–272). There was also
evidence, according to Weber, of a particular pathological idea,
namely that he had female breasts. He used to look at and draw
pictures of naked women, and he had his moustache removed.
And, finally, Weber stated, the pinnacle of his pathological system
became the idea that he was called to redeem the world, and to
restore to humanity its former bliss, this mission having been
communicated to him directly by God as to the prophets.
According to Schreber himself, his nerves had the capacity to
attract God, although this was very difficult to explain and had
been revealed exclusively to him (DW, p. 11; M, p. 48). Interestingly,
his father had written about the nervous system as the connec-
tion between the mind and the body (Schreber, D. G. M., 1839,
FREUD’S EXEMPLARY CASE OF PSYCHOSIS: DANIEL PAUL SCHREBER 11

pp. 13–14). In the Denkwürdigkeiten, divine nerves could enter into


contact with the nerves of highly gifted people. This involved a
certain danger for God, since excited human nerves possessed a
power of attraction over God’s own nerves, and God could be
threatened by not being able to break free again, and this was why
God related to human beings only “from without”, as Schreber
put it. Moreover, he maintained that, as a rule, God’s presence
did not extend to living people, but only souls and corpses (DW,
pp. 30; 319–20; M, pp. 59–60, 230). Likewise, his “nerve-language”
(Nervensprache), in which words were repeated just as a child learns
a poem by heart for recitation at school, was set in motion from
without (DW, pp. 46–47; M, p. 69). We will see later that Freud’s
theory of paranoia speaks of reproaches returning from without,
and that Lacan believes that it was a signifier imposing itself
on Schreber from without that precipitated the collapse of his
world.
According to Weber, the essential thing in Schreber’s redeeming
mission was that he had to be changed into a woman. As the report
put it, it was not that he wanted to be transformed into a woman,
but it was more a matter of a must (Weber, 1899, DW, p. 387; M,
p. 272). This was based on Schreber’s not being able to go against
what he called the “order of things” (Weltordnung), even though he
would have preferred to retain his honourable and masculine posi-
tion in life. Only if he was transformed into a woman, he believed,
by way of divine miracles, over years or decades, could he and the
rest of humanity ever reach the world beyond. As the singular
object of these divine miracles, he regarded himself as the most
unusual human being that ever lived. Weber’s report revealed that,
in the first years of his illness, Schreber experienced the destruction
of various bodily organs, from which he thought others would have
died. He had lived for a long time, he imagined, without a stomach,
intestines, almost without lungs, with a torn oesophagus, no blad-
der and shattered ribs. Divine miracles, however, had always
restored what was destroyed. But in the final stage of his illness,
which Weber considered paranoia (ibid., DW, p. 389; M, p. 274) (the
1907 diagnosis in Leipzig-Dösen would repeat his opinion, the
question mark reproduced by Baumeyer not being original (KG,
p. 1 [1])), these threatening phenomena had long since disappeared,
and his femininity had entered the foreground. In fact, Schreber had
12 FREUD’S SCHREBER BETWEEN PSYCHIATRY AND PSYCHOANALYSIS

the feeling that a great deal of female nerves had already entered
his body, and that a new humanity would come forth from them
through impregnation by God. Only then, he thought, could he die
a natural death. In the meantime, the sun, trees, and birds spoke to
him, although he understood these to be miracled remains of earlier
human souls. In addition, he used to enjoy female toiletries, and he
had a penchant for sitting more or less undressed in front of a
mirror, adorning himself with coloured ribbons and necklaces in a
female way.
On the other hand, Weber referred to a certain change in
Schreber’s condition caused by his desire to have his committal
lifted. The wish for freer movement and more contact with the
outside world appeared to have pushed the pathological ideas
listed above into the background to an extent. Letters to his wife
and other relatives were free from pathology, although the halluci-
nations and the delusions connected with them were still there to a
considerable extent. Likewise, in a medical report dated 28th
November 1900, Weber could mention that Schreber had been
eating with the Weber family for the last three quarters of a year.
His table conversation had indicated the retention of a lively inter-
est in matters of State and justice, politics, art and literature, that his
memory and judgement were good, and that his ethics were
unquestionable (Weber, 1900, DW, p. 397; M, p. 279). Weber’s son,
a neurologist in Dresden, would later recall that, after Schreber’s
condition improved, he was an entertaining conversationalist at
their table (Baumeyer, 1956, p. 524, 1957, pp. 68–69). Furthermore,
in so-called lighter conversation with the ladies, he had been pleas-
ant and charming, tactful and decent. But Weber himself pointed
out that there was still some evidence of distraction due to halluci-
natory processes, and of Schreber’s having to make an effort not to
allow himself to bellow, which, once he had left the table, he did
(Weber, 1900, p. 398; M, p. 280). The old threats and insults against
imaginary figures disturbing his happiness also remained, and
Weber mentioned Flechsig in particular. In a second expert witness
report on 5th April 1902, Weber went further to speak of his friendly
relationship with Schreber, of his patient being a daily guest at the
table, his having greater freedom of movement, and his being able
to have more money at his disposal (Weber, 1902, DW, pp. 452–454,
462–465; M, pp. 315–316, 321–323). Weber had not changed his
FREUD’S EXEMPLARY CASE OF PSYCHOSIS: DANIEL PAUL SCHREBER 13

medical opinion on Schreber’s condition, but, as he put it, the con-


dition itself had changed for the better. There was a great difference,
to his mind, between the earlier time of hypochondriacal ideas,
hallucinatory stupor, and negative behaviour, and the present,
when the pathological system had crystallized and restricted itself
to the religious domain without overly affecting the rest of
Schreber’s thinking and feeling.
The Amtsgericht in Dresden had decided on 13th March 1900 to
make the committal permanent, but Schreber argued in writing
against every point of the decision (Schreber, 1903c), and success-
fully defended his case in person before the court. In the judgement
of the Oberlandesgericht, he remained dominated by the pathologi-
cal idea that he had a mission to redeem the world, a mission that
could be fulfilled only if he were changed into a woman. But, on
14th July 1902, it overturned the decision of March 1900, and
Schreber had his liberty restored to him (Oberlandesgericht Dres-
den, 1902, DW, pp. 473–474; M, pp. 329–330). In explaining the
verdict that he was capable of an independent life, the judges
thought that not every case of paranoia deserved committal. Nor
did they accept the medical view of the time on the unity of psychi-
cal activity, which meant that pathological ideas affected the whole
of the patient’s mental functioning. Rather, while recognizing that
Schreber was convinced of his delusions, they argued for what they
called earlier medical views on the possibility of partial insanity,
and they noted that Weber seemed to recognize this in Schreber
(ibid., pp. 498–499, 503; Weber, 1902, p. 457; M, pp. 344–345). While
Weber’s first expert witness report had stated that Schreber could
only function in a limited way outside the asylum, the judges recog-
nized that things had improved by the time of the second report,
and that he was now used to greater freedom of movement and
more contact with relatives and others. They were impressed by his
intelligence and clarity of thought, the way he struggled against the
committal, the sharpness of his logical and legal operations, the col-
lected way in which he proceeded, and, not least, by his measured
stance in opposing witnesses and the public prosecutor. Weber’s
opinion was accepted that the pathological ideas were restricted to
the religious domain and not otherwise noticeable. In this regard,
the judges took account of the meals with Weber’s family, and the
fact that Schreber no longer needed to be accompanied on trips
14 FREUD’S SCHREBER BETWEEN PSYCHIATRY AND PSYCHOANALYSIS

outside the asylum. He was no danger to himself or others, they


held, and there was no question of him not being able to manage
his finances, as evidenced by the use he made of his pocket money.
His marriage was not thought to be put at risk by his release, either.
Nor was the intended publication of the Denkwürdigkeiten con-
sidered sufficient grounds for detaining him (ibid., pp. 511–513;
M, pp. 353–354). The court agreed with Schreber that the worst
thing that could result from its publication was that the reader
might think him mad, and people already thought that anyway. As
for the strong expressions in the text, the judges contended that no
one should take offence at them, since they stemmed from the
earlier time of his worst hallucinations. This should be borne in
mind, they stated, in relation to Flechsig’s being accused of soul-
murder and worse. Finally, they argued that protecting him from
any financial risk due to the publication of the Denkwürdigkeiten
was not the task of a committal. The court concluded that the
petitioner was capable of all the demands of daily life, and that
this had to lead to his discharge. Schreber left Sonnenstein on 20th
December 1902 at the age of sixty, and, after briefly staying with his
mother in Leipzig, he returned to Dresden, to his wife, Sabine, and
their later to be adopted daughter, Fridoline.

Admission to the Leipzig-Dösen Asylum


After his release from Sonnenstein, Schreber’s condition was reas-
onably stable. According to reports from his sister recorded in the
Dösen patient file, the shouting gradually faded away and only
occasionally broke his sleep. The moods never completely disap-
peared, but he learned to live with them, and he never spoke of his
delusion. He kept himself busy—he set about building a house—
and even wanted to work for the Ministry again (KG, p. 7 [13]). The
fact that he was able to give a speech at a family baptism in 1904,
and write poems for his mother’s ninetieth birthday in 1905, and
his wife’s fiftieth in June 1907 (Israëls, 1988, pp. 204–214, 215–283),
suggests that his condition had considerably stabilized. All this
changed, however, when his wife had a stroke on 14th November
1907, six months after the death of his mother. The sleepless nights
returned and he looked worn-out. He felt that he was going to
FREUD’S EXEMPLARY CASE OF PSYCHOSIS: DANIEL PAUL SCHREBER 15

become ill again, and the old noises returned. He was admitted to
the Heil- und Pflegeanstalt in Leipzig-Dösen, and there he ex-
perienced severe hallucinations again that he was a dead body, as
well as mood swings from one extreme to the other. He remained
closed in on himself and barely communicated with the outside
world except in scraps of conversation or unreadable writing (KG,
pp. [14]–13 [25]). These notes are preserved in the Leipzig Stadt-
archiv, and one interpretation of a more legible scribble gives “bin
ewig verdammt”—am eternally damned. Schreber’s last days were
spent in a severe catatonic state. In early 1911, he suffered a chest
infection, and the only means of saving him would have been
surgery, but, given his completely desolate condition, it was
decided that this would be pointless. He died on 14th April from
chronic pleurisy.
The historian of psychiatry, Edward Shorter, has claimed that
Schreber’s illness was due to neurosyphilis (Shorter, 1997, p. 80).
But Zvi Lothane has rightly remarked that not only was this not
mentioned in the case files, but the post mortem the day after he
died found no evidence of it (Lothane, 2001, pp. 127–128). In fact,
the university clinic notes from 8th December 1884 do speak of him
having been given a “Jodkali Kur” because of the suspected presence
of syphilis (KG, p. 14 [27]). But this was only a suspicion and it is
not strengthened by the fact that syphilis was extremely common
among men of Schreber’s class at that time.1 The three-page post
mortem report found no pathology in his organs other than pleuri-
tis exsudativa chronica, pyothorax sinister, contraction of the left lung,
atelectasis of the left upper lung lobe, pericarditis fibrinosa acuta,
myodegeneratio cordis, and sclerosis of the coronary arteries. And
while it did find multiple bleeding in the pons, it found no abnor-
mality in the brain as such (KG, p. 20 [31]). A 1926 letter from the
Dösen medical director confirmed that he died of pleurisy.

Schreber’s delusion
The two salient features of Schreber’s delusion were his becoming
a woman, which was accompanied by transsexual pleasure (Wol-
lust, Wollustgefühl, wollüstigen Empfindungen, Seelen-wollust), and his
being God’s sexual partner, which was related to his expectation of
16 FREUD’S SCHREBER BETWEEN PSYCHIATRY AND PSYCHOANALYSIS

divine impregnation for the procreation of a new humanity. The


way the Dresden court put this was that his delusion consisted of
his having a mission to redeem the world, and that he had to be
transformed into a woman for that purpose (Oberlandesgericht
Dresden, 1902, DW, p. 475; M, p. 330). We saw above, however, that
in Weber’s first expert witness report, it was the delusion of be-
coming a woman that had appeared first—even during his sec-
ond admission to Flechsig’s clinic, he believed that he already had
a woman’s body (KG, p. 2 [3])—and that the redeeming mission
only materialized in the final stages of his illness (Weber, 1899, DW,
pp. 384, 386; M, pp. 270, 272). When he had the thought in June 1893
that it must be beautiful to be a woman submitting to the act of
intercourse (DW, p. 36; M, p. 63), he did not even associate this with
God, let alone a redeeming mission.
As the idea of feminine enjoyment developed in Flechsig’s
clinic, Schreber began to associate it with ideas of persecution. He
began to experience the “miracle of emasculation” (Entmannung),
which he spoke about in terms of his being transformed into a
woman by the pure rays of his “lower God”, Ariman. On the other
hand, he believed that this process was being hindered by the pres-
ence of other rays, rays of impure—also called “tested” in his “basic
language”, which was characterized by a wealth of euphemisms—
souls such as Flechsig’s. There is a difficulty here with the word
“emasculation”. Is it the same as becoming a woman? Ida
Macalpine and Richard Hunter (M, p. 398) have translated it as
“unmanning”, in the sense of transformation into a woman, rather
than “castration”, and they do so because they do not accept the
homosexual component of Freud’s aetiology. Freud himself is more
nuanced, however, and we will see in the next chapter that while
he interprets Schreber’s Entmannung as the castration implied by
passive homosexuality, he understands the delusional transforma-
tion into a woman as the fulfilment of the feminine phantasy of
June 1893 (Freud, 1911c, pp. 50, 56).
Flechsig was initially the main persecutor with regard to this
emasculation. He had been able, Schreber believed, with all or part
of his soul, to swing up to heaven and, without undergoing death
or purification, make himself the guide of rays. According to
Schreber, this enabled a conspiracy against him, in which he was to
be handed over to a human being—Flechsig himself—in such a
FREUD’S EXEMPLARY CASE OF PSYCHOSIS: DANIEL PAUL SCHREBER 17

way that his soul was to be entrusted to this person, his body trans-
formed into a female one, to be given over to the same person for
sexual abuse, and, finally, left aside to decay (DW, p. 56; M, p. 75).
Schreber had no doubts about this conspiracy to emasculate him, or
about Flechsig’s intentions, although, as he put it, it was not
Flechsig as a human being, but as a soul, that had them. It had been
this soul that had revealed the plot to him in nerve-language. The
way he felt treated by Flechsig corresponded to what had been
revealed to him. The Denkwürdigkeiten spoke about this in terms of
his being bound naked in bed for weeks on end to make him more
open to voluptuous feelings due to female nerves entering his body,
and open to being given medication for the same purpose (DW,
pp. 56–57; M, pp. 75–76).
In the early stages of this persecution, Schreber claimed that his
whole manly honour, his sense of self and morality, rose up against
the indecent plan to turn him into a woman. To die in any other
terrible way, he thought, would be preferable to such a disgraceful
end, and he decided to starve himself to death, although this only
led to his being force-fed. In the bath, inner voices—souls called the
“Cassiopeia brothers”—ridiculed him as lacking in masculine cour-
age, something which made him hold his head under the water. He
also asked Flechsig—by way of “nerve-connection”—for cyanide or
strychnine with which to poison himself, something which the
Flechsig soul did not reject (DW, pp. 58–59; M, p. 77). In all this,
Schreber regarded Flechsig, or Flechsig’s soul, as his enemy, and
God as his ally. Later, he would realize that God was an accomplice
in, if not the instigator of, the plot to murder his soul and have his
body sacrificed as a female sex-object. However, towards the end of
Chapter V, the Denkwürdigkeiten revealed that every attempt at
murdering his soul or emasculating him for purposes against the
order of things (weltordnungswidrigen), or for the satisfaction of a
human being’s sexual desire—the context suggests Flechsig—as
well as attempts to destroy his reason, had failed, because the order
of things was on his side in his unequal struggle with God. But
he would later come to see his becoming a woman as consistent
with the order of things (weltordnungsmässig) (DW, pp. 61, 94–95;
M, pp. 78–79, 99).
While still in Flechsig’s clinic, at the beginning of his second
illness, the idea came to him that the world had come to an end.
18 FREUD’S SCHREBER BETWEEN PSYCHIATRY AND PSYCHOANALYSIS

This was due, he thought, to a withdrawal of the sun, an earth-


quake, or the work of a magician in the person of Flechsig. The last
two hundred and twelve years of the earth’s life had run out, he
believed, and he was the only real human being left, the rest being
only fleetingly improvised men (DW, pp. 71, 91; M, pp. 85, 97).
Conversely, he saw his own death notice in a newspaper, which, as
we will see, has been variously interpreted. He even called himself
a leprous corpse leading another leprous corpse (DW, pp. 81, 92;
M, pp. 91, 97–98), something which is significant to Lacan, who
holds, as we will see, that Schreber’s world had been reduced to a
relation with his psychical double. But the persecutory ideas of
being transformed into a woman, and being sexually abused and
left aside, continued to oppress him. Hence, when he was finally
being transferred from Flechsig’s clinic to Pierson’s private clinic,
he was indifferent to where he was being taken, because he thought
that things could not get worse.
He learned from his voices to call Pierson’s clinic “Devil’s
Kitchen”, although the hallucinations in Lindenhof were mainly of
divine miracles. He believed that this place, too, was populated by
fleetingly improvised men. Souls had also followed him from
Leipzig, especially Flechsig’s, which had split into forty to sixty
small soul-parts, and two larger ones, upper Flechsig and middle
Flechsig (DW, pp. 100–102, 111; M, pp. 102–104, 109). Likewise, the
soul of the senior warden in Lindenhof, von W, had split into
twenty to thirty soul-parts. Von W, Schreber thought, had been
given the punishment of looking after him—as a fleetingly im-
provised man—for falsely accusing him of masturbation. We will
see later how this has been interpreted by Katan. The Flechsig soul
was now responsible for leading two suns, and the von W soul
another. However, when Schreber was transferred to Sonnenstein
shortly afterwards, the miracles became more frightening and
threatening, at least in the first part of his stay, to the extent that
he feared for his life, and, again, for his manhood (DW, p. 119;
M, p. 114).
The hallucinations in Sonnenstein were such that, to Schreber’s
mind, hardly a single limb or organ of his body was left intact
because of miracles. In addition, little men placed in his feet were
trying to pump out his spinal cord. In Leipzig, these had been
departed souls. Only a few millimetres in height, they had led a
FREUD’S EXEMPLARY CASE OF PSYCHOSIS: DANIEL PAUL SCHREBER 19

brief existence on top of his head, having dripped down from the
stars (DW, pp. 69–70, 154; M, pp. 83–84, 135), a detail which, we will
see, has been taken up by both Katan and Lacan (Katan, 1950a,
pp. 32–35; Lacan, 1993, p. 211). In Sonnenstein, however, the little
men were mainly little Flechsig and little von W. Here, a smaller
sun, which was originally led by the Flechsig soul, came to be led
by the soul of Weber (DW, p. 135; M, p. 124). Here, too, Schreber
was surrounded by fleetingly improvised men, and souls which
tried to take away his power to attract divine rays. This, he
believed, was the point of the attacks on his manhood. The emas-
culation he feared was not in keeping with the tendency underly-
ing the order of things, but so that he would lose his power to
attract divine rays. Hence, smaller Flechsig soul-parts would often
ask him if he was not emasculated yet. On the other hand, the rays
of God—it was their nature to speak—would mockingly call him
“Miss Schreber” because of his forthcoming emasculation (DW,
p. 127; M, p. 119), and speak about his being devoted to voluptuous
orgies. And when he was privileged to see behind what he called
the “anterior realms of God” to the splendour of his lower God,
which was also identified with the sun and reflected itself on his
inner nerve system, what he heard, having learnt God’s basic
language, was far from friendly. Unlike the other voices, the voice
of the lower God was violent. It filled him with fear and called him
a “slut” (Luder) (DW, p. 136; M, p. 124), an important word to which
we shall return. In addition, an upper God, Ormuzd, described as
a sun surrounded by a radiant sea of rays, but more distant than the
sun identified with the lower God which lit and warmed the earth,
communicated the miracled urge in him to shit. Again, the point of
this was to destroy his reason so as to make possible a withdrawal
of divine rays (DW, pp. 137–138, 226; M, pp. 125, 177). At the same
time, while strong feelings of voluptuousness were produced by his
passing stools, he thought that God was also trying to undo the
miracled urge to defecate. He was certain that God was deliberately
sending others to the toilet every time the need was miracled up in
him. But the silliness of these persecutions were due, he concluded,
to God’s not understanding living beings. It was the same lack of
infallibility on God’s part—not knowing how to deal with living
people, but only corpses—that explained for him God’s ability to
instigate the conspiracy against him in the first place (DW, pp. 55,
20 FREUD’S SCHREBER BETWEEN PSYCHIATRY AND PSYCHOANALYSIS

141, 227, 264; M, pp. 75, 127, 178, 198). On the one hand, he found
it ridiculous, but he expressed reverence for God at the same time,
an ambivalence that would not be lost on Freud.
Schreber believed that miracled birds, laden with ptomaine
poison, were sent to destroy his reason and so enable a withdrawal
of rays. They were speaking birds, which could only rhyme off
phrases they had learnt. Once they had dropped their load of
poison, that is, delivered their phrases, they would articulate their
enjoyment of soul-voluptuousness in Schreber’s body with expres-
sions like “hell of a lad”. We will see that Lacan has interpreted this
positively, as a comment on Schreber’s attempt to stabilize himself.
But the birds did not understand what they said, and they were
surprised at the similar sound of words, such as Santiago and
Carthago, Chinesentum and Jesum Christum. Again, this is of impor-
tance to Lacan, as we will see, who regards their messages as pure
signifiers. To counteract the loss of reason, Schreber had to commit
himself to constant thinking. If he stopped thinking, he would
immediately hear a noise in the vicinity, or the rising of the wind.
Alternatively, a bellowing miracle would take place to make him
howl, or he would hear the nerves of God calling for help because
they had become detached from other ones when God drew further
back (DW, pp. 205–214; M, pp. 165–171). Not thinking, on the other
hand, would make God think that he was exhausted, he imagined,
and this would enable a withdrawal of rays (DW, p. 320; M, p. 231).
These rays would speak to him, or throw short phrases into his
nerves, such as “why only?”; “oh yes”; “now I want to”, and these
interrupted sentences were left to his nerves to complete (DW,
p. 217; M, p. 172). What Lacan has made of this, too, we shall see in
Chapter Nine.
During the first period of his stay in Sonnenstein, he was still
rejecting the idea of becoming a woman. He found the idea of emas-
culation and being sexually abused a disgrace. He was able at that
stage to defend himself with a manly sense of honour against the
female or voluptuous nerves (Wollustnerven) entering his body, and
they could not gain influence over his behaviour and thought. He
used to hold his feet out of the window at night to make them cold
so that the rays would be diverted away from his head and be
unable to affect him. He admitted, however, that his willpower was
FREUD’S EXEMPLARY CASE OF PSYCHOSIS: DANIEL PAUL SCHREBER 21

not able to ward off the voluptuous feeling (Wollustgefühl) which


gripped him in bed and strengthened his power of attracting rays
(DW, pp. 128–129, 172; M, pp. 120, 146). And after nearly a year and
a half in Sonnenstein, in November 1895, he began to come to terms
with the threatened emasculation. The signs of his transformation
into a woman had become so evident on his body, he thought, that
he expected the miracled change to occur immanently. His sexual
organ would have been drawn inwards, he claimed, if he had not
resisted it. Nevertheless, the feelings of voluptuousness were so
strong that he felt that his body was already that of a woman. After
a number of days came the full transformation of his will, as the
Denkwürdigkeiten put it. He now had no doubt that the order of
things demanded his emasculation, whether he wanted it or not,
and reason told him that there was nothing else for it but to
befriend the idea of being transformed into a woman. This change
of will was made easier by his belief that there was no real human-
ity left—the world had come to an end—apart from himself, but
only fleetingly improvised human forms. It meant that there was no
disgrace in his emasculation. At the same time, however, the voices,
which were of one being with the rays threatening to destroy his
reason, returned to reproach him: “are you not ashamed in front of
your wife?” and “some Senatspräsident who lets himself be f—d”
(DW, pp. 176–177; M, p. 148). Nevertheless, he now devoted himself
to cultivating femaleness, preferring to be a clever woman, rather
than a stupid man. He imagined that his body was endowed—
by way of drawing—with female breasts, genitals, and bottom
(DW, p. 233; M, p. 181). And he occasionally wore female frills,
such as ribbons and false necklaces, when alone in front of the
mirror with his upper body half-naked (Weber, 1899, DW, p. 388;
M, p. 273). He believed he could feel female nerves under his skin
when he touched his body, and if he did this while thinking of
something feminine, voluptuous feelings were produced which he
thought were those experienced by women (DW, pp. 277–278;
M, pp. 205–206). Whenever he saw flying insects being immediately
created by the lower God, a miracle would be worked on the direc-
tion of his gaze so that the rays would see something female and
their voluptuous feelings would be excited (DW, pp. 241–243;
M, pp. 185–187). But his own soul-voluptuousness was so strong
22 FREUD’S SCHREBER BETWEEN PSYCHIATRY AND PSYCHOANALYSIS

when lying in bed that he needed very little imagination to create


the voluptuous contentment he imagined anticipated female sexual
pleasure during intercourse. Moreover, after the permanent com-
mittal decision of March 1900, he declared himself ready to have a
medical examination to confirm that this was not a pathological
idea. He insisted that an examination would prove that his body
was interspersed from head to toe with voluptuousness-nerves, as
was the case, he thought, in the female body, whereas in a man they
were found only in the penis and its vicinity (DW, pp. 269, 274;
M, pp. 201, 204). In short, Schreber became dominated by the idea
of becoming a woman and this was accompanied by what he imag-
ined female sexual pleasure to be.
While God had originally succeeded Flechsig in being his perse-
cutor (God had mocked him over his intended emasculation and
called him a “slut”), Schreber had come to think that his becoming
a woman was what God wanted. In fact, what he had experienced
as persecution became his project. He now felt compelled to give
God’s rays the impression that he was a woman burning with
voluptuous feelings. Not only was female soul-voluptuousness no
longer against the order of things, but he started to believe that God
demanded it for his own enjoyment. If some pleasure accrued to
himself, as he put it, he felt justified in accepting it, after all the
suffering he had been through (DW, pp. 281, 283, 320; M, pp. 207–
209, 230–231). Furthermore, he thought that worldly voluptuous-
ness was experienced more intensely in the world beyond as
the state of heavenly bliss. The nerves of the dead, he imagined,
returned and were grafted on to (angegliedert) God. We will return
to this idea later, but for the moment, we should note that the
German angegliedert contains Glied, which can refer to the male
sexual organ. The nerves of the dead even became parts of God, and
made up what he called forecourts (Vorhöfe) of heaven. These
nerves enjoyed the state of bliss in the anterior realms of God,
whereas living beings experienced this as voluptuousness (DW,
pp. 12; 18–19, 51, 281; M, pp. 49, 52–53, 72, 208; 1903c, DW, p. 442;
M, p. 308). He believed that the male state of heavenly bliss was
superior to the female one, although, interestingly, given Lacan’s
understanding feminine jouissance as unlimited, he thought the
latter consisted of uninterrupted voluptuousness. But this is what
FREUD’S EXEMPLARY CASE OF PSYCHOSIS: DANIEL PAUL SCHREBER 23

Schreber himself began to strive for, and with God’s blessing. While
he still maintained that voluptuousness was usually only per-
missible if it was made holy by marriage and for the purpose of
reproduction, the voices emanating from the lower God told him
that voluptuousness had become God-fearing, and that he should
consider it the means of resolving his earlier conflict with the order
of things (DW, pp. 18, 285; M, pp. 52, 210).
Schreber had come to believe that God wanted enjoyment for
himself and that it was his task to provide it. As long as he cul-
tivated female voluptuousness, he reasoned, God would be satis-
fied and would not withdraw his rays. In other words, he had
become God’s sexual partner. He believed that God would never
withdraw from him as long as he played the part of a woman
lying in his own sexual embrace, forever looking at female things
and images (DW, pp. 285, 320; M, pp. 210, 231). He had not only
become a woman, but the singular woman of God. He had already
thought that the tendency underlying the order of things was a
renewal of the human race, and, back in Flechsig’s clinic, he had
imagined that the nerves of God, corresponding to male semen, had
impregnated him (DW, p. 4; M, pp. 42–43). Now he could come to
the conclusion that becoming a woman was for the procreation of
a new humanity after impregnation by God’s rays. Nevertheless,
we would still argue that his delusion was not primarily religious.
It needs to be recognized that the Denkwürdigkeiten was completed
from the vantage point of the delusion having reached its full crys-
tallization, when Schreber had become God’s woman. If the fore-
word and the introduction explained that it was written for the
recognition of religious truths (DW, pp. III, 1; M, pp. 31, 41), these
would have been written last. In fact, the idea of a redeeming
mission emerged only late in the day. What was integral to his
thinking from the start, however, was his transformation into a
woman.

Conclusion

Schreber said in the Denkwürdigkeiten that his two illnesses were due
to overstrain, the first from his election campaign, the second from
24 FREUD’S SCHREBER BETWEEN PSYCHIATRY AND PSYCHOANALYSIS

working as a new Senatspräsident. When he was first admitted to


Flechsig’s university clinic, he was thought to be suffering from
hypochondria. When he was readmitted, there was more hypochon-
dria, but ideas of persecution were also present. In Sonnenstein,
however, what was initially diagnosed as hallucinatory insanity
developed into classical paranoia. According to Weber, he had a
fixed delusional system, which was restricted to the religious
domain, but his other mental faculties were unaffected. This diag-
nosis of paranoia was repeated in Dösen at the beginning of his third
illness, the question mark after it—Paranoia ?—not being original,
and the Dösen file also agreed with the Leipzig and Sonnenstein
files that he was hereditarily burdened.
The Denkwürdigkeiten traced the evolution of Schreber’s patho-
logical thinking. It was in June 1893, after his nomination to
Dresden, that the first indications of femininity appeared in the
form of the phantasy he had one morning in bed. When he was
readmitted to Flechsig’s clinic, he started to fear the threat of emas-
culation as a persecution, initially by Flechsig and then by God,
and continued to resist this when he was transferred to Sonnen-
stein. But while he had spoken in Leipzig of having to resist the
Urningsliebe of certain persons, and had hallucinated his having a
female body, he developed the delusion in Sonnenstein that he was
being transformed into a woman. When reason told him that there
was nothing else for it but to befriend this, he began to make the
cultivation of femininity his project. Having initially rejected the
1893 phantasy about female sexual enjoyment, he began to make
this his goal, not only because it was no longer against the order of
things, but because God wanted it. And, finally, at the height of his
delusional thinking, his transformation into a woman was for copu-
lation with God for the procreation of a new humanity. But, if
Weber and the court thought that this was central, it developed
only late in the day. What was central from the beginning was his
femininity. The purpose of this sketch has been to uncover the orig-
inal data of the Schreber case. What various commentators have
made of the data will become apparent as we proceed.We will first
see how Freud has interpreted Schreber, although we will concen-
trate on the aetiology he articulates in his Schreber text.
FREUD’S EXEMPLARY CASE OF PSYCHOSIS: DANIEL PAUL SCHREBER 25

Note
1. I am grateful to Professor Shorter for his personal communication on
this (7th July 2007). When Shorter’s History of Psychiatry was translated
into German, the Schweizer Gesellschaft für Psychiatrie und Psychotherapie
took exception to his remark that (Max) “Müller was as anti-Semitic as
any of the Swiss of his day” (Hubschmid, 2000, p. 123; Shorter, 1997,
p. 384).
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