Jefferson Journal of Psychiatry Volume 5 Issue 1 Article 8 January 1987 Masson's Assault on Truth: A Critique Emmanuel E. Garcia, MD Institute of Pennsylvania Hospital, Philadelphia Follow this and additional works at: https://jdc.jefferson.edu/jeffjpsychiatry Part of the Psychiatry Commons Let us know how access to this document benefits ouy Recommended Citation Garcia, MD, Emmanuel E. (1987) "Masson's Assault on Truth: A Critique," Jefferson Journal of Psychiatry: Vol. 5 : Iss. 1 , Article 8. DOI: https://doi.org/10.29046/JJP.005.1.006 Available at: https://jdc.jefferson.edu/jeffjpsychiatry/vol5/iss1/8 This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in Jefferson Journal of Psychiatry by an authorized administrator of the Jefferson Digital Commons. For more information, please contact: [email protected]. Masson's Assault on Truth: A Critique Emanuel E. Garcia, M.D. In his book , Th e Assault on Truth, j. M. Masson (I) proposes to challe nge the very fo unda tio ns ofpsych oan alysis by showing how Freud 's abandonment o f the so-ca lled sed uc tion th eo ry of th e etio logy of neurosis was erroneously pred i­ ca ted. Masson's argument, in essence, ma y be summarized as foll ows. Fr eud, while studying with the eminent neurologist Charcot in Paris (from O ctober 1885 to February 1886), fo und himself exposed to th e prevalent horrors o f ch ild abuse, whi ch were co piously detailed in the Frenc h medical literature at th e tim e , and which were very probably demonstrated to h im at the Pa ris morgu e. T he impression ofth ese revelati ons would contr ibute profoundly to Freud's fo rmula­ tion of his sed uction theory of the etiology of th e ne uroses in a trio of pap ers publish ed in 1896. Masson's in terpretati on of this theory is tha t a sexual act of cruelty and violence perpetrat ed by an ad ult upon an unwilling chi ld represents th e fundamental ca use of every neurosis. Freud's em phasis is purportedly on realistic ex te rnal factors in th e ge nes is of ment al illness. Culling dat a from Freud's co rrespondence wit h otorhinolaryngologist Wil­ helm Fliess, Masson presents an elaborate scenario upo n whi ch he bases his case. T he princip als are Fr eud, his fr iend Fliess, and Emma Eckstein. Eckstein , at approximate ly 27 yea rs of age, u nderto ok ana lysis with Freud. She appa rently suffered from painful and irregular menstruat ion, which Masson specul ates Freud att ributed to masturbation.T h is might have partiall y explaine d Freud's havin g recru ited fri end Fliess's aid. Accord ing to Masson , Fliess believed th at masturbati on ca use d dysm enorrheic sym pto ms an d also led to a transfo rmati on of th e left middle tu rbinate in the nose. He advocated abstinence and surgical removal of th e altered nasal str ucture. Freud was hesitant to entr ust th e nas al surgery to Fliess alone. Masson notes Freud's recommendation th at a se nior Viennese su rgeon, Robert Gersuny, assist Fliess. Freud nevertheless overcame his doubts and allowed Fliess to operate on his own in February 1895. T he results we re far from satisfactory. As it turned out, Fliess inadvertently left hal f a meter of iodoform ga uze in the nasal cavi ty, which became th e ca use of Eckstein's seemi ngly inexplicable pain, edema, and bleedi ng after th e proce­ dure. It was the Viennese su rgeon Rosan es wh o discovered thi s oversight wh ile Dr. Garcia is a first-year resident at the In stitute of Penn sylvania Hospital, Philad elphia, Pennsylva nia. 67 68 J F.FFERSO N JO URNAL OF PSYCHIA TRY investi gating, at Freud's request, Eckste in's post-su rgical complaints. Unfortu­ nately, th e surprise of this discovery must have ca used a suspens ion of cr itic al medical j udgment. U nthin kingly, Rosan es withdrew th e gauze and a massive hemorrhag e ensued. Eckstein went temporarily into shock, but recovered after Rosan es repacked th e nasal cavi ty with fresh ga uze to effect hemosta sis. T he da y afte r, Rosan es and Gersuny together repeated the opera tion under co ntrolled co ndi tions. All was not well, however, and ten da ys after the seco nd operation, the pain, swelling and hem o rrhages returned. Eckstein's nose was packed again, but bleeding co ntinue d to oc cur sporad ica lly nevertheless. Several months lat er she experienced another massive hem orrhage as th e packi ng was being removed. Freud, gloomy and sha ke n, ventured to sound a reproach ful note in his lett ers to Fliess, but this was quickl y drowned by renew ed protestati ons of allegi an ce and confidence. Presumably, Fliess' continue d friends h ip was all-important. Fliess ex plaine d Eckstein's hemorrhages as manifestati ons of a biological periodicity which was wholly independent of any ac tua l external trau ma. This explanation was in accordance with ce r ta in numerological hypoth eses he was th en elaborating.Masson conte nds that Freud , wanting to protect h is friend from an y culpability, turned away fr om implicating Fliess' operative er ror as the immediat e ca use of Eckstein's bleeding. Masson highlights Fr e ud's later clai m th at Eckstein " bled out of longing ... as an un failing means of rearousin g my [Freud's] affec tion" (p. 101 ). Believin g th at Eckstein hersel f was th e patient who inspired Freud to form ulate the sed uc tion th eor y in th e first place, Masson asse rts that Freu d 's attributio n of Eckstei n's hemorrhages to se xual fan tas y, rather th an to th e rea lity of th e operation's trauma, ultimately extended to her accounts o f ch ild hood sed uc tion. Freud came to co ns ider the se accounts as fantasies ra ther th an real events. T h is, in effec t, marked Freud's renunciation of the sed uction h ypothesis, th e rewards for wh ich would be an end to h is ostracism by th e medical establish ment for ha vin g acknowl edged th e reali ty of the se xua l abuse of ch ild ren, as well as a co ntinuation of his fri endsh ip wit h Fliess. Masson levels an eloquent attack o n Fr eud and his " science": . by shift ing th e emphasis from an ac tual world of sadness, misery, and cr ue lty to an internal stage on whi ch ac tors performed invented dramas for an invisibl e audience of th eir o wn creation, Fr eud began a trend away from th e real world that, it seems to me , is at the root of th e present-day sterility of psychoanalysis and psychi atry through ou t the world. (p. 144) Furthermore , he claims th at th e survival of psych oan al ysis is mad e possible on ly by a conspiracy of its ad herents to suppress th e truth about its origins in Fr eud's fateful fa lse ste p, in a stubbo rn refusal to acknow ledge the real traumas at th e heart o f mental illn ess. T he ana lytic setting, with its implacable deprecati on of reali ty and exalta tio n o f fa ntas y, merely subject s pat ients to a repet ition of th e MASSON'S ASSAULT ON TR UTH 69 traumatic abuse suffered in childhood. Thus, for Masson, even suc h time­ honored concepts as transference and th e unconscious must be meaningless. A co mprehensive examination of Freud's seduction th eory is obviously beyond our sco pe here , but a brief account is required to address Masson 's argument. In three pape rs published in 1896 (2-4), Freud promulgated th e view th at in each of the ne uroses he had ana lyzed (hys terical, obsessional, or mixed hysteria­ obsessiona l), accounts of sed uctio n were reported to wh ich the symptoms of the neurosis co uld be traced. Freud regarded these as actual memories. The sed uc tio ns co nsiste d o f a n excite ment of th e genita ls, a coitus-like process, th e memory o f whi ch exe rted th e traumatic pathologi cal effect. T he seductions, whi ch were th ought to occur before the ages of eigh t to te n, were presumabl y submitted to with ind ifference or a littl e fr ight. Freud boastfully regarded th e discovery of th is distal etio logic event as a capu t Nili of neuropathology.