The seductions of history: sexual trauma in Freud's theory and historiography.

The rise of Freud's seduction theory can be illuminated by contextualising aspects of this theory with regard to nineteenth-century trauma theory, germ theory, degeneration theory and sexology. The author argues that Freud, by putting forth his seduction theory, defined himself within a number of registers that organised one's identity within the medical community in late nineteenth-century Vienna. Freud's first historical accounts of his rejection of the seduction theory also point to factors that were of great importance to his medical community, issues of epidemiology. However, in 1914 Freud wrote a different history of these events for a different community. No longer a doctor struggling for recognition from the Viennese medical establishment, Freud was now the leader of the psychoanalytic movement, writing a history of the movement with the defections of Adler and Jung in mind. Hence, the author argues that Freud's 1914 version of the fall of the seduction theory served to tie the rejection of the seduction theory to the acceptance of libido theory, a sexual libido theory that Adler and Jung had rebelled against.

Dora's hysteria and the maturation of Sigmund Freud's transference theory: a new historical interpretation.

The emergence of Freud's 1905 revision and elaboration of transference theory is situated within the context of his emerging understanding of neurosogenesis. Immediately after the seduction theory lost its credibility in the fall of 1897, Freud maintained a traumatic model for hysteria and increasingly hypothesized that repressed childhood masturbation was fundamental to the creation of hysteria. Following this interest in masturbation, Freud--influenced in part by Havelock Ellis's concept of autoerotism--put forth his first post-seduction theory model of neurosogenesis in December 1899. In this model two different developmental stages of psychosexual object relatedness-the "autoerotic" and the "alloerotic"--determined and differentiated later psychoneurotic symptomatology. This etiological schema organized the next psychopathological writing Freud did, his "Fragment of an Analysis of a Case of Hysteria," in which Ida Bauer's hysteria was seen as due to oral zone autoerotic overstimulation and, later, to her object-directed genital masturbation. Freud in a postscript reasoned that in the analytic situation the production of neurotic symptoms ceases and is replaced by the creation of transferences. Hence it is argued that Freud, following his new two-tiered understanding of neurosis, expanded his formal description of transference by creating two analogous forms of transference, the "reprint" and the "revised edition."

Interpersonal relatedness and paranoid schizophrenia.

A 33-year-old man presented with a 10-year history of psychosis and an imaginary companion; he carried a past diagnosis of chronic schizophrenia. He responded quickly to neuroleptic and was noted to be an easily engageable person. It is argued that despite his first-rank Schneiderian symptoms, the patient may not best be conceptualized as having schizophrenia. Specific treatment recommendations are made, predicated on this man's developmental history, his attachment and separation behavior, and his response to a structured social milieu.

Psychiatric complications in a patient with complex partial seizures.

This case highlights the complexities of evaluating and treating psychiatric symptoms that are concurrent with a seizure disorder. Interictal and postictal psychoses, affective disorders, personality changes, and cognitive deficits are common problems that require modified psychiatric treatments.

Toward an intellectual history of transference. 1888-1900.

Freud's concept of transference was not the discovery of a solitary genius, but was an inspired, creative synthesis deeply rooted in the prevailing discourses of his time. In the nineteenth century, transference started out as a neurologic term; Freud used that concept of displaceable energies in his neurologic writings as early as 1888. Then in Studies in Hysteria, Freud explicated the basis by which ideas dissociated and made for a mésalliance with the physician. False connections such as transference were conceptualized along lines drawn by Charcot's school, and the concept of auto-suggestion that they used to explain the inherent suggestibility of a hysteric. In developing this 1895 model of transference, Freud strove to tame disquieting concerns about the epistemologic status of hysteria and hypnosis. It is the epistemologic anxiety created by accusations of iatrogenic suggestion as much as the sexual anxiety Szasz pointed to that prodded Freud to focus exclusively on the intrapsychic. It also may be the legacy of this epistemologic anxiety that accounts for the fact that until recently, psychoanalytic theoreticians have been hesitant to explore the effect that the real person of the analyst might have on the manifestations of transference. In the last years of the nineteenth century, Freud modified his theory of transference and built a place for it in his topographic model of mind. In the Interpretation of Dreams, Freud integrated the biologic and psychologic possibilities inherent in prior usages of übertragung. By 1900, transference could theoretically refer to both a hypothesized displacement of quantifiable neuronal energies as well as the psychological phenomena Freud observed occurring between him and his patients. Perceptual theories of illusion like Helmholtz's provided Freud with a model that by analogy helped re-define transference as a central facet of irrational inner life. Transference in 1900 accounted for a patient's possible distortion of the person of the physician, but it also postulated a more general subjectification of consciousness and perception. In transference, a conscious perception could be as distorted by unconscious wishes as a day residue was in dreams. When Ida Bauer (a.k.a "Dora") stalked out of Freud's office, this newly empowered theory was in the metapsychological wings waiting to make meaning of her failed treatment. No longer was transference an unimportant mishap, a nuisance, or a theoretical aside. By 1900, transference was ready to stand, as it does today, at the core of psychoanalytic theory.

In the eye of the beholder: Helmholtzian perception and the origins of Freud's 1900 theory of transference.

Freud's 1900 theory of transference was indebted to the convergence of philosophy and physiology found in nineteenth-century theories of visual perception. The author maps out the post-Kantian philosophical and German physiological currents that gave rise to Hermann von Helmholtz's influential work on perception, and proposes that Freud's 1900 theory of transference was a creative synthesis of novel notions like unconscious wishing and psychic defense with a Helmholtzian model of visual illusion.

A linguistic model of psychotherapeutic listening.

Linguistic principles can be employed to formalize the ways in which we register unconscious communication in the psychodynamic psychotherapeutic process. The authors describe this process of gathering unconscious data as one of attention to narrativity, idiosyncratic semanticity, form, and interactive discursive elements. Based on this framework, the authors propose some fundamental tenets of psychodynamic listening.

Educated insane: a nineteenth-century psychiatric paradigm.

In the 1830s the time-honored notion that excess study could lead to madness underwent a significant change in America. Under the influence of Enlightenment pedagogy and phrenology, influential superintendents like Amariah Brigham and Isaac Ray feared that the "unnatural" overstimulation of children in schools would ruin their development. In the second half of the nineteenth century, as belief in environmental determinism waned and assumptions about what is "natural" changed, this psychiatric etiology was debated; then, overthrown. By the turn of the century, education was thought to aid, not harm, the mentally ill.

On psychoanalytic listening: language and unconscious communication.

The authors review past and recent perspectives on psychoanalytic listening, then present a synthetic model founded on psycholinguistics and semiotics. They argue that the analytic listening process can be broken down into nonlinguistic communications and--most important--linguistic categories pertaining to narrativity, symbolic reference, form, and interactive conventions. In each of these areas of signification, the authors present the ways in which the technique of psychoanalytic listening attends to unconscious meanings, thereby differing from ordinary listening which "hears," at best, only denotative and connotative meanings.

German philosophy, Freud, and the riddle of the woman.

After Kant's critique of empiricism, subjectivist epistemologies cropped up in 19th-century German philosophy. Schopenhauer argued that the true essence of every object was an irrational and sexual will. This underlying will distorted a subject's knowledge of the world. Schopenhauer's notion of this true essence was analogous to his portrayal of women; they too were natural, irrational, and instinctual. Nietzsche postulated a will-to-power that structured and hence distorted a chaotic world. That structureless "real" world Nietzsche symbolized as the essential "truth of a woman," a truth which for Nietzsche was unknowable to the desirous male philosopher. Freud, while maintaining belief in empirical truth, developed a psychology of mis-knowledge which had much in common with Schopenhauer's epistemology. His theory of transference grew from a need to explain how female patients libidinally distorted the reality of their male analysts. Conversely, Freud's later writings on women are hampered by the author's realization of his own precarious and subjective position as man trying to know woman. These counter-transferential concerns ultimately made the woman's psychological essence an unknowable riddle for Freud.

Neuropsychologic impairment in children with sickle cell anemia.

In this study, the neuropsychologic functioning of 21 children with sickle cell anemia and 21 sibling controls, age range 7 through 16 years, with no history of neurologic disease, was examined. Outcome measures included tests of intelligence, constructional praxis, memory, and academic learning. On the Wechsler Intelligence Scale for Children--Revised, the sickle cell group had a mean Full Scale IQ of 77.7 (SD 12.4) compared with 94.3 (SD 11.0) for the control group. The profile of test scores was similar for the two groups, with the sickle cell group scoring significantly lower than the control group on almost all cognitive measures. Both groups showed academic achievement to be commensurate with their measured intellectual ability. These results suggest that subtle but significant and widespread neuropsychologic deficits are associated with sickle cell anemia even in the absence of neurologic complications. When and by what process this neuropsychologic impairment is caused needs to be determined.

Autonomic dysfunction and adrenocortical unresponsiveness to ACTH.

A child is reported with adrenocortical unresponsiveness to ACTH and autonomic dysfunction. The latter consisted of cold extremities, progressive loss of tear production, the development of achalasia of the esophagus, pupillary dysfunction, and an abnormal histamine skin test. These findings suggest progressive parasympathetic denervation as a cause for the adrenocortical abnormality.

Recovery of parasites at different stages of migration following infection of rats with Schistosoma mansoni.

The technique of tail amputation is utilized as a method for interrupting the migration process of Schistosoma mansoni schistosomula from the skin of Fischer rats infected by exposure of the tail to cercariae. The yields of schistosomula recovered from the lungs at different times post-infection are compared, using rats with or without tail amputation. Residence times of schistosomula in skin and lungs, as well as their transit time and efficiency of migration between these sites, are estimated. At least one-third of the infecting cercariae migrate from skin to lung in rats. Amputation of the tail on days 4 or 5 post-infection isolates a definable number of schistosomula in the lung and their migration to the portal circulation can be followed. The kinetics of this migration in rats and mice is compared and a significant difference is revealed.