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Famous schizophrenic patient reevaluated

Schreber’s account of his own schizophrenia continues to be a source of psychoanalytic study

While great scientists are remembered for their fields of study, patients whose illnesses are the basis for that research only rarely reach that level of fame.

Schizophrenic patient Daniel Paul Schreber is immortalized by his memoir — “the most written about text in modern psychoanalysis,” said Orna Ophir, a postdoctoral associate at DeWitt Wallace Institute for the History of Psychiatry at Weill Cornell Medical College.

Ophir spoke at Pembroke Hall last night, giving a lecture entitled “The Many Faces of Schreber as the Faces of Postwar American Psychoanalysis (1960-2000).” The talk traced Scheber’s role in informing psychoanalytic literature from 1960 to 2000 and touched on the major controversies and shifts in psychoanalysis over that 40-year span.

Born in Germany in 1842, Schreber married and became a judge before suffering his first bout of mental illness at age 42, Ophir said. Though an intelligent man, Schreber believed in his schizophrenic state that he would be transformed into a woman and impregnated by God’s son. Schreber believed he would give birth to the next generation of his family and a new generation of humans.

Schreber was treated at a sanitarium, and later, when his chance for recovery faded, he was transferred to an asylum.

Sigmund Freud wrote a case study in 1911 based on “Memoirs of My Nervous Illness,” Schreber’s account of his illness, which Ophir referred to as “the most tedious book ever.” In the 1960s, psychoanalysts looked at the Schreber case with “a renewed analysis of the memoir in the pre-Oedipal spirit.”

“Turning God into a radiant being was seen as an envy for his mother’s absence,” Ophir said. She added that the aspect relating to pregnancy was seen as longing for his mother’s womb.

During the 1970s, advances in psychiatry suggested schizophrenia was based in genetics, Ophir said. Psychoanalysts focused on biological components of mental illness, with neurotransmitters, brain waves and neural anatomy featured in psychoanalysis journals.

In his book, “Soul Murder: Persecution in the Family,” psychoanalyst Morton Schatzman “compared Schreber to a victim of a concentration camp and his father to a Gestapo,” Ophir said.

The publication of the third edition of the “Diagnostic and Statistical Manual of Mental Disorders” in 1980 led to increased prescription of psychiatric drugs, she said. At the same time, psychoanalysis began looking at schizophrenia as a biological disease and psychoanalysts began wondering whether psychoanalysis belongs “with the natural sciences or as a purely analytical discipline.” Psychoanalysts looked for “meaning” behind mental illnesses like schizophrenia, while medical professionals treated such afflictions strictly as diseases, she said.

In 1990, President George H. W. Bush declared it the “decade of the brain,” marked by research initiatives to treat psychiatric diseases. The “decade of the brain” also involved the repetition of the “Freud Wars” — the arguments between psychoanalysis and psychiatry.

Psychiatrist Zvi Lothane published “In Defense of Schreber: Soul Murder and Psychiatry” in 1992, in which he argued that psychoanalysis was for patients who wished to remember their mental illnesses, while psychiatry was for patients who wished to forget their mental illnesses, Ophir said. Frederick Crews, professor emeritus of English at the University of California at Berkeley and famed critic of psychoanalysis wrote an article in the New York Review of Books in 1993 entitled “The Unknown Freud,” which referred to psychoanalysis as “pseudoscience.”

Many books have been written about the subject since, Ophir said, noting that Schreber “haunts modern psychoanalysis.”

Ophir defended psychoanalysis, arguing for the importance of treating patients “not as biological subjects” but as people who have lived lives.

“I thought (the lecture) was interesting in that it highlights some of the tensions within psychoanalysis in the United States because of its confinement within psychiatry,” said Billy Brennan, a psychoanalyst and supervisor of psychotherapy in the adult psychiatry residency program at Alpert Medical School.



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