My latest reading in the history of psychology is Freud’s Patients: A Book of Lives, by Mikkel Borch-Jacobsen (2021). This book is a biography of the 38 known patients of Freud who experienced psychoanalysis. Each client gets a chapter summarizing the known events of their life, with an emphasis on the reasons they entered therapy and their interactions with Freud.
Borch-Jacobsen (2021) writes as a historian, presenting known facts about events, the context of people’s lives, and quoting often from primary sources. There is no embellishment in the book at all, and sometimes the book feels more like a reference work than a historical narrative. Borch-Jacobsen trusts his reader to make their own interpretation of the events he accounts.
What is most amazing about Freud’s Patients: A Book of Lives (Borch-Jacobsen, 2021) is how ineffectual Freud’s therapies were. Depending on the preferred definition of “patient” (some of Freud’s clients did not have any symptoms of mental health problems) and how generous one’s definition of “cured” is, Freud’s success rate was somewhere between 0% and 8.6%.
Indeed, most of Freud’s patients were far worse off after psychoanalysis. In his wake, Freud left a trail of suicide, divorce, drug addiction (including at least one fatal overdose), institutionalization, financial exploitation, and broken lives. The lucky patients escaped from Freud with just some lost time and money.
What is most infuriating with reading Freud’s Patients is that Freud knew that his patients weren’t getting better. But that did not stop him from touting these patients as examples of a successful cure. Bertha Pappenheim (“Anna O.”), Anna von Lieben (“Cäcilie M”), Fanny Moser (“Frau Emmy von N.”), and many others were held up as examples of people cured of their mental health problems, when in reality Freud knew the problems had not improved — and often were worse. Yet, he would lie, often repeatedly, about how healthy his former patients were in order to increase his fame and stature.
Freud’s lies about the success rate of his therapies are not news (e.g., Cioffi, 1998; Eysenck, 1985; Webster, 1995). But reading page after page about people whose lives Freud ruined reveals the depth of Freud’s mendacity, egoism, and unethical behavior. If Freud were a modern practitioner, his license would have been quickly revoked, and he would have been driven out of therapeutic practice in abject shame. Instead, he was celebrated for most of the 20th century and is still seen as a luminary in some circles. Even though Borch-Jacobsen (2021) plainly narrates facts without judgment or interpretation, I came away from the book with a taste of how profoundly evil Freud was.
The biggest drawback to Freud’s Patients: A Book of Lives (Borch-Jacobsen, 2021) is that nothing besides Freud himself ties the chapters together. The chapters can be read more-or-less in any order (though they are arranged chronologically) because few events from one patient’s lives had any impact on other patients. The result is that most people mentioned in a particular chapter (e.g., family members of a patient) never appear again in the book. The author really can’t avoid this problem with the book, but it does get tedious to read about a parade of now-obscure members of the Viennese upper class at the turn of the 20th century.
Borch-Jacobsen (2021) also assumes that the reader is already familiar with the outline of Freud’s life, the development of his ideas, and the important people in his orbit. I found myself periodically having to look up a name of a person that Borch-Jacobsen implied was important.
Freud’s Patients: A Book of Lives (Borch-Jacobsen, 2021) isn’t for everybody. I would not recommend it to a non-expert with a causal interest in psychology. But it is an important book and is essential reading for anyone interested in the history of psychology or psychoanalysis or who wants a picture of Freud the clinician — or Freud the liar.
Borch-Jacobsen, M. (2021). Freud’s patients: A book of lives. Reaktion Books.
Cioffi, F. (1998). Freud and the question of pseudoscience. Open Court.
Eysenck, H. J. (1985). Decline and fall of the Freudian empire. Routledge.
Webster, R. (1995). Why Freud was wrong: Sin, science, and psychoanalysis. Basic Books.