Freud and Binswanger: An Asymptotic Relationship

*Philippe Veysset*

#### **Abstract**

The relationship between Freud and Binswanger can be thought as a productive misunderstanding. In search of institutional recognition, Freud sees in Binswanger above all a representative of classical psychiatry, moreover director of a prestigious institution, while the latter aspires to shatter this same psychiatry which seems to him marked by the discrediting of the patient. This misunderstanding will take the form of a doctrinal rather than a practical disagreement, centered on the notion of drive - too biological according to Binswanger - and in particular on the latter's refusal of the drive origin of the ego and of the censorship. For Binswanger, psychiatry can renew itself from the inside by opening up to a philosophical, phenomenological, approach to the patient and his world, a world in which it is first necessary to enter through a patient-doctor co-journey in order to reconstitute the conditions for living together. For Freud, the therapeutic imperative proscribes such recourse to an external authority, the world of the philosopher being itself, by its closure on itself, suspect. In the end each of the respective thoughts of the two men will progress in contact with the other without ever a perfect agreement being able to take place.

**Keywords:** Freud, Binswanger, phenomenology, psychiatry, drive, ego, psychoanalysis

#### **1. Introduction**

The relationship between Sigmund Freud and Ludwig Binswanger began in 1907, when at the invitation of C.G. Jung, then medical director of the Bürghölzli and heir-apparent of E. Bleuler, Binswanger accompanied this one to Vienna, to the famous Berggasse, 19, both residence and study of the master.

At the age of fifty-one, Freud was already famous at the time, notably through *Studies on Hysteria*, co-authored with J. Breuer, published in 1895, and *The Interpretation of Dreams*, published in 1900. Famous but not recognized. He′is the subject of disputes which, often, concern more the mood or the emotion than of a solid scientific test, of a clinical or theoretical order, thus on behalf of the German psychiatrists. He also suffered ruptures (Breuer, Fliess).

Suddenly, to spread, his thought takes the path of local (national1 ) associations. He also shows himself more and more in favor of what he calls "wild analysis" (that is to say layman = carried out by non-doctors).

<sup>1</sup> They will eventually come together in an international Association, whose first president will be C.G. Jung.

However, its need for institutionalization remains great. He knows that this can only take place by associating himself - who moreover is not a psychiatrist but a neurologist - with "constituent bodies", bodies whose institutionality does not exclude a certain degree openness to new methods of investigation and therapy. Institutions, too, where he could test, life-size, the veracity of his medical doctrine. Of course, with Abraham, Jung and Bleuler, won over to his ideas, the Bürghölzli, famous Zurich institution, both asylum and hospital which, at the time, was at the forefront of research in the treatment of mental disorders, is not inaccessible, but Freud perceives resistance.

It is here that the meeting with Binswanger will prove to be crucial for him. From Freud's point of view, Binswanger embodies both traditional and institutional psychiatry. These two terms have a different meaning. Binswanger certainly embodies the institutionality that Freud needs to affix an official seal to his work. But he also embodies, by that very fact, a way of thinking that he tries to shake up with his incredible theoretical fecundity and inventiveness.

Binswanger is, vis-à-vis his interlocutor (twenty-five years his senior), in a different posture. Heir to several generations of psychiatrists (his uncle Otto, installed in Jena, treated Nietzsche), he is preparing to take over the management of the Bellevue clinic, located in Kreuzlingen, Switzerland, what that unfortunately will happen sooner than he thinks (his father died in 1910, when he was barely thirty). His interest is therefore more of an intellectual nature - he has not completed his thesis - and undoubtedly, therapeutic. It is important to underline that, in parallel with medicine, he studied philosophy at the University of Lausanne and Heidelberg. But, perhaps precisely because of this double formation, Binswanger will also try to "recover" Freud, obviously not at the level of any institutional basis but, one could say, symmetrically, at the level of the elaboration of his own doctrine which would later become existential analysis, Daseinsanalyse. He would later write: *"The struggle with psychoanalysis as a science and branch of psychiatry runs through my life. I can say that all my scientific development, in its positive as well as negative aspects, has been played out on the basis of the philosophical and scientific controversy with psychoanalysis..."* [1]*.*

Although built in chiasmus, a strong link will therefore be established from this meeting, a link which will last until Freud's death without experiencing any interruption (despite the war) and to which regular correspondence testifies, if not nourished, between the two men, correspondence partly lost - the medical files in which certain letters were slipped have disappeared or remain inaccessible, and partly published in french language (Calmann-Lévy, 1995). This strong bond should not however leave in the shade the rough edges to which it was able to give rise. Binswanger, for example, will ask Freud why it is his most brilliant students who abandon him (Jung, Adler ...) and openly reproach him for his will to power while Freud writes to Ferenczi that Binswanger, decidedly, "is not gifted,"

The doctrinal dissensions between Freud and Binswanger which will end, in the latter, in a virtual silence until the death of the former, therefore inform us first of all about the internal economy of the relationship between the two men and, if we are to understand it. Let us approach first, this does not mean that its place is less important. It is clear that, if Binswanger hoisted the flag of phenomenology in 1922,2 he only really formulated his doctrine with the *Grundformen... (Fundamental* 

<sup>2</sup> *AboutÜber Phänomenologie*), presentation given at the 63rd meeting of the Swiss Psychiatric Association in Zurich, testifies to the interest shown by Binswanger, from 1922, in (Husserlian) phenomenology. Binswanger met Husserl in 1923 (possibly following treatment from Madame Husserl, the couple having lost a son during the war). It is also important to note that both Husserl and Binswanger had in common the fact that they came from a family of Jewish origin converted to Protestantism, Freud having preferred an atheism which he explains in the last section of his work ("En matter of religion, I cannot help you" he will say to Binswanger in 1927).

*Freud and Binswanger: An Asymptotic Relationship DOI: http://dx.doi.org/10.5772/intechopen.94882*

*shapes and knowledge of human Dasein*) which appeared in 1942 and did not announce his method until the first International Congress of Psychiatry which was held in Paris in 1950, twelve years after Freud's death.

Echoing this late statement, we must underline the apparent continuity of clinical and therapeutic practice, but here again, this continuity informs us first of all about a conception of the relationship between theory and praxis, what Binswanger calls the "understanding" of the patient, a "understanding" which does not mean the abandonment of the therapeutic action (this accusation will be addressed to him after the suicide of Ellen West) but that a new understanding of the disease as an existential experience cannot be without consequences on the concept of care and "healing".

#### **2. Doctrinal disagreement**

#### **2.1 The unconscious and the conscious**

The Freudian doctrine of the unconscious received a formulation completed - if not definitive - in 1915 [2]*.* We will not enter here either into the history of the notion which from Leibniz leads to Maine and Lipps [3, 4]*,* to which Freud explicitly refers in his Letter to Fliess of 27-IX 1898, nor into the content - necessarily random - of its definition being a question, Freud will not stop repeating it, of a concept released from the very practice of the cure. What matters here is to remember that, for Freud, the Ucs originated in the genesis of the psyche and that it is from it that consciousness is constituted, including in its more evolved form which is the ego.

We find for example in his letter to Binswanger of July 4, 1912 this affirmation (literally taken from Lipps): "The Cs is only a sensory organ" on the margin of which Binswanger notes: "*I was never able to rally to this conception, resulting from the primacy of id."* [5].

This consciousness, which Freud prefers to call conscious, this ego, are labile phenomena, evolving at the same time as dynamic: *"Thanks to the work of interpretation which transforms the unconscious into conscious, the ego expands to the detriment of the unconscious"*, notes Freud in his *Introduction to psychoanalysis* [6]*.* Initially suspicious of libido, "puny and infantile", this ego, which has become "stronger", feels, through the treatment, capable of subsequently welcoming this same libido. The functional success of the treatment attests to the primacy of Ucs over Cs, it is this success which is first of all a success for the body, a calm and happy body, which remains the touchstone.

For Binswanger, language is the key to both illness and cure (and cure). *"The phenomena whose content Daseinsanalyse interprets are phenomena of language"* and when Freud thinks he is interpreting dreams, he only interprets the narrative.

He goes further: if language can heal (talk cure) it is precisely because evil, at its origin, is linguistic in nature, that it is, as a process of signification (making "sense towards", therefore), which helps the patient to build his "world project", the only substrate for a solitary freedom which otherwise goes mad. The madman is therefore never "as mad as that" (even if his project is initially incompatible with the common world, that of living together where he must be reintegrated). This is what will bring Binswanger closer to Heidegger, for whom speech, before being a tool of communication, constitutes the fundamental existential, the "house of being" and whose deterioration (chatter) removes Dasein from the Being and stucks it in the One. It is also this position of Binswanger which inspires J. Lacan for whom *"the Ucs is structured like a language"* (including, therefore, in its dislocations: we remember

the "galloping, did you say galloping?" quoted in example by Lacan in the third *Seminar*).

Hence, there is something absurd in claiming that the consciousness which necessarily accompanies speech (not in its meaning - innumerable and proliferating - but in its "signifiance") can come from the Ucs. When Freud listens, he listens to a word, when he makes a diagnosis, it is to the medical lexicon that he resorts to, when he heals and finally cures, it is through the word.

This obviously does not mean that the body is evacuated, but it is no longer the Freudian body, not even a Freudian body subject to (institutional) constraint. Nor is it the body revealed by Goldstein's work, the "organism": even if language cannot be dissociated from the very fine bodily mechanisms revealed by aphasia (an aphasia to which Freud devoted his first work), it is always from him that the impulse for meaning starts. It is a body brought back to its primitive and essential function of focal point of the "directions of meaning" with the help of which space is constructed and ... there is no world, no world-project without space. The debt to the Husserlian doctrine of the body, like *Nullpunkt* (zero point) of space, is important: space is precisely what must cement, what cements, the world and the world-project.

Even if language cannot be entirely related to conscious mechanisms, even if "it speaks in me", it is always in *me* that it speaks. In me and in the other.

To place the precession of the Ucs on the conscious, as Freud does, would lead to therapeutic mutism.

### **3. The drive: how can censorship reside on the drive side? The question of narcissism**

It is somewhat the same circular structure (and therefore the same reproach) that emerges with regard to the drive or even, although its field is more restricted, of the libido.

First there is a libido-ego question. How distinct are they? According to Binswanger, Freud practices here a radical opposition; according to Freud, Binswanger is practicing a radical caesura here.

In his practice, Freud often opposes the two instances. He goes so far as to define the pathological by an outbidding of the libido on the ego. In a letter of July 24, 1913, Binswanger remembers a conversation in which Freud evokes the case of a yawn (compulsive or normal, this is not specified and may be unimportant) where the ego, faced with an invasive libido, "Can no longer exert power on the function". If this opposition, manifestation of life, is made possible by their common origin, the fact remains that the ego must once again become (or rather: become) "the sole master in the dwelling".3

Binswanger, for his part, poses a priori, as we have seen, a radical distinction between the two bodies. For the libido-ego link to be established, they must have a (partially) common nature. This is the point of disagreement, Binswanger defending, at least at the time, the existence of a "transcendental" ego.

However, in practice the opposition is markedly reduced. This attenuation is made possible by the intervention of a concept which rejects, once again at the theoretical level, the traditional dichotomy between consciousness and matter: Dasein, in its fundamental structure of being-to.

<sup>3</sup> Cf this sentence in which Freud comments on Jung's increasingly hurtful attitudes: "I have withdrawn my libido from him" (Letter to Binswanger of July 29, 1912).

#### *Freud and Binswanger: An Asymptotic Relationship DOI: http://dx.doi.org/10.5772/intechopen.94882*

Of course, Binswanger will gradually reintroduce the notion of subjectivity and even consciousness in his reflection and this reintroduction can legitimately be interpreted as a belated reconciliation with the Freudian position. This ego, however, is no longer quite Freud's. In particular, it must be conceived in its relation with another ego, an ego with which it becomes one from the start and that the doctor-patient couple tries to reconstitute (notion of *Miteinandersein, being-which-each-other*):

"The ipseity of this me and this you is therefore not at all founded in Dasein as mine or yours, but in Dasein as ours, in other words in the Being of Dasein.

as nostrity. It is only from nostrity that ipseity takes off" [7]*.*

On the one hand, therefore, a genesical ego, slowly resulting, by federation of drives, from an unconscious structuring. On the other hand, an ego has fallen, through the work of concern, to a We posited as the fundamental structure of a Dasein (the Binswangerian We is not a mediation between an ego and a generic humanity (an "they") but a mediation between an Ego essential to medical practice and a Dasein defined by its presence in the world and not by its consciousness, an unconscious Dasein at bottom. The unconscious is Dasein.

The tension then seems to be loosened. But this is only appearance. It will in fact resurface through therapeutic practice and in particular, censorship: is this really of an instinctual nature, even if, as Freud would say later, a drive which, after having been itself censored, turns against other drives?

Let us note first of all, in order to exonerate Freud from a new accusation of naturalism which Binswanger, later on, will partially withdraw, that the Freudian drive is not exclusively a physiological phenomenon. It is, Freud noted, *"a concept limit between the psychic and the somatic (…) of a chemical or mechanical nature, it aims to bring to the outside world what is necessary of modification to satisfy the internal source of the excitations"* [8]. It is a corrective mechanism.

As a corrective mechanism, censorship emerges from a dynamic identical to that of the drive, even if, obviously, the correction is not carried out according to the same mode (it should be noted, however, that Freud will go towards a progressive unconsciousization of a censorship replaced by repression). However, if censorship, whether or not it operates in consciousness, is endowed with an instinctual nature, *"how is it that it has sufficient authority to censor other drives?"* For Binswanger [5], this authority can only come from an external legitimacy, linked to a device necessarily exceeding the drive flow. For Freud, this exteriority does not exist.

*"Freud,"* Binswanger continues, *"remained of his opinion which he subsequently sought to found in narcissism"*. What is it about?

In the first Freudian conception, Freud defines several types of drives (sexual, hunger, thirst, scopic drive ...) which will finally be organized around a sexual drive/ego-drive or self-preservation pair. In a second conception, an erotic drive/ death drive or destructive pair emerges. The sexual drive retains the preeminence because it carries within it a negativity that others do not carry. Now this point is crucial because it is because of this negativity and the dialecticity that it gives rise to that *"something in the nature of the sexual drive is not favorable to the satisfaction of the sexual drive itself"* (*ibidem*).

What happens in narcissism, the theory of which is precisely worked out after Binswanger's third visit ("To introduce narcissism" dates from 1914)?

Freud begins by recalling the existence of the primitive ("natural") state of the libido that is autoeroticism, which is pure pleasure-taking and dispenses with the mediation of the other (it is not therefore not strictly sexual - any "sexus" induces a separation, a cleavage as the word indicates). Then a choice of object is made,

the first decentration of the libido. Normally, it is the mother or her substitute (for Freud) who constitutes the first object.

However, in certain cases, notably in the absence of a strong father figure, the choice of object turns into a fixation on the mother (for Freud), no longer therefore as an object but as a subject of love. It is the very love of the mother that is desired. We then want to love as the mother loved and in particular by adopting as the object of this love the same object that the mother loved: oneself.

A second step is constituted by the establishment of a choice of homosexual object when, forced all the same to choose an object, one restricts the extent of this choice by adopting an object that has the same characteristics as oneself, in particular the same genitals, those of a boy (who can be the father) if one is a boy, those of a girl if one is a girl (in this case, more intensely because the identification with mother was stronger due to bodily similarity: this process is illustrated by the study on Leonardo da Vinci [9]).

Besides being probably associated with its development, Binswanger immediately perceives the importance of this doctrine - relatively belated. Indeed, narcissism is, as we have seen, a primary stage in the development of the psychic apparatus. As such, its deregulation gives rise to serious disorders which fall within the field of psychosis, precisely the one with which Binswanger is concerned as a matter of priority. Let us remember: the more original a disorder, the more it leaves deep, lasting and, often, indelible traces on the developed psyche of the "adult". The origin remains, she from whom everything comes. We could also take as an example disorders related to orality (anorexia...)

Freud, moreover, laid down his cards and published, in 1917, in his *Introduction to psychoanalysis*, a text which clearly affirmed the link between narcissism and psychosis. Compared to that of 1914, the difference is that it is now a question of libido "of the ego" and no longer of a libido on the body. Self-love is not quite the same as homosexual love (which can let the difference of the object fully subsist)... The reasoning is simple: the strong identity between the loving and beloved subjects leads to an overestimation of the ego through the formation of an ideal ego (role of secondary narcissism: parents idealize their child by projecting on him all kinds of dreams that they have not been able to satisfy for themselves), to an exclusive appropriation of the loved object, the primary form of which will be jealousy and if it grows deeper - in the face of resistance or the inaccessibility of the other but above all, in front of fear/shame/despair inspired by his own tendency - in the certainty of being persecuted (paranoia, at the time qualified as paraphrenia) or, conversely, of being loved in a delusional mode (erotomania). This is the crucible of the circulation between love and hate, so characteristic of the schizophrenic (ambivalence). The perfect illustration of the process is provided by the Schreber case (related by Schreber himself and completed with the deep commentaries by Freud and J. Lacan in *Seminaire*, III).

Why then the skepticism of Binswanger? Precisely because the whole Freudian demonstration aims to show that repression is the result of the drive. What makes it possible to affirm it? The fact that Freud slips without any justification from the normal to the pathological. He does not dare to reveal the central point: the father is never there enough to stop the process. Freud lifts the corner of the veil on the unsaid of something which must remain silent anyway because it is, in fact, anything but natural.

There is therefore a form of irony in this benoît remark in the Letter of January 7, 1920 addressed to Freud by Binswanger: *"The little that you have said about jealousy has all the same infinitely more value than what 'we have been able to say it elsewhere (…) because it is precisely jealousy that seems to me to be able to give us the deepest* 

*Freud and Binswanger: An Asymptotic Relationship DOI: http://dx.doi.org/10.5772/intechopen.94882*

*understanding of psychic life, both normal and pathological."* Indeed, to this date, Freud only published "Psychoanalytische Bemerkungen über einen autobioraphisch beschriebenen Fall von Paranoïa (Dementia paranoïdes)" in the *Jahrbuch* of 1911.

He would later develop his analysis, also related to anality, in *The Ellen West Case*, a borderline personality disorder before the letter, which revolves around the defenses developed against homosexuality and the recovery of a work of working-through by the disease itself (the patient can only be cured when dead and can only die when cured).
