SCHREBER, DANIEL PAUL (1842-1911)

Daniel Paul Schreber, the subject of Freud's famous retrospective case history, was born on July 15, 1842, in Leipzig, and died in April 1911 in the state mental asylum at Leipzig-Dösen.

In 1893 Paul was at the zenith of his legal career, having just been promoted to presiding judge at the Dresden Higher Regional Court, when he suffered a severe mental breakdown. Thereafter he spent about thirteen years of his life in mental institutions, and while at the Sonnenstein Asylum he composed his only book, Memoirs of My Nervous Illness (1988), a masterpiece that has since inspired scholars in diverse fields. Freud (1911c [1910]) used the book to illustrate his theory of the causal link between homosexuality and paranoia. This heuristically important essay was an exercise in applied, not clinical, psychoanalysis; it was a hermeneutic, not historical, account of a paradigmatic case of paranoia; it was not about Schreber's life.

Paul's father, the son of Moritz Schreber and Pauline (née Wenck) Schreber, was a physician who specialized in exercise therapy for skeletal and muscular disorders, both with and without appliances. He attained fame with his 1855 book, Illustrated Medical In-Door Gymnastics, which may be considered a forerunner of modern rehabilitation medicine. Moritz also published works on child rearing and education and was posthumously immortalized by the eponym "Schrebergarten," or community garden, which he advocated as part of healthful living.

After completing his studies at the well-known Thomasschule (Thomas school), in 1860 Paul began studying law at the University of Leipzig, obtaining his doctorate in jurisprudence in 1869. Two years earlier he entered the ministry of justice and served as judge in a variety of cities in Saxony. In 1878 he wed Ottilie Sabine Behr (1857-1912), the daughter of operatic director Heinrich Behr. His family considered the bride unsuitable. A diabetic, Sabine suffered six miscarriages or stillbirths.

Schreber was hospitalized three times with depressive illnesses, all following real and symbolically important losses: in 1884, after he was defeated in elections to the Reichstag; in 1892-1893, after he was made presiding judge and his wife gave birth to a stillborn boy; and in 1907, when his mother died and his wife suffered a stroke. He functioned normally after the first (moderate, nonpsychotic) depression, and between the second and third (severe, psychotic) episodes, during which time he raised an adopted daughter.

The second depression (the first psychotic episode) began as a prodrome in the summer of 1893. He experienced anxiety dreams about his illness returning and had a fantasy of what a woman might feel during intercourse. By the fall he had a dramatic explosion of symptoms, including insomnia, agitation, hypochondriacal and nihilistic delusions, and attempts at suicide. He voluntarily returned to the Psychiatric Hospital of Leipzig University, under Paul Flechsig, director of the hospital. Months after admission, his agitated depression evolved into a syndrome that involved prosecutory hallucinations and delusions of sexual abuse and hostile human and divine influences, which Schreber described as soul murder. The human influences he attributed mainly to Flechsig. He also developed elaborate ideas of a fantastic cosmology and religion.

By June 1894, with his wife's consent and collaboration, Schreber was transferred by Flechsig to Sonnenstein. There major depression abated by 1897 but his wishes to be allowed to go home went unheeded. Superintendent Guido Weber (using Emil Kraepelin's taxonomy) diagnosed him with incurable paranoia, and he was declared mentally incompetent, yet his wife remained hesitant. Schreber continued to express rage, and he elaborated fantasies that he was to be transformed into a woman to redeem the world. But he was lucid and able to get along socially. He was also able to write his book and to conduct his own defense in court, setting a legal precedent and regaining his freedom in 1902.

However paranoia and schizophrenia might be parsed in the history of psychiatry, in psychoanalysis the former came to signify a delusional defense against homosexuality. Freud followed Kraepelin's classification but was more interested in syndromes and character than in psychiatric diagnoses. He developed his dynamic formulation in collaboration with Sándor Ferenczi and in 1908 shared his ideas with Carl Gustav Jung, from whom he learned about Schreber in 1910. Locked into his theory, the universality and validity of which have since been challenged, Freud hypothesized that Schreber had a passive-negative oedipal constellation. He suggested that Schreber experienced through transference a passive sexual desire for Flechsig, transformed into the delusion of soul murder. This conflicted wish, Freud claimed, was pathogenic in Schreber's second illness. It had previously appeared in the prodromal fantasy of what a woman feels during intercourse, a fantasy that occurred before Schreber had any personal dealings with Flechsig. In his delusion of soul murder, Schreber intended the soul murder to indicate that Flechsig betrayed him by banishing him to Sonnenstein.

One should differentiate what may be valid in Freud's dynamic ideas from what remains correct in his interpretation of Schreber. Focusing on Schreber's so-called paranoia, Freud did not seem to consider the possibility of what today would be called a mood disorder; his own "Mourning and Melancholia" would not appear until 1917, after analytic contributions by Karl Abraham and Alphonse Maeder.

Subsequent studies of the Schreber case have brought to light much new material. Zvi Lothane (1992) extended work by William G. Niederland (1974) and Hans Israëls (1989). Schreber's fears of sexual abuse were a result of the psychotic process, not the cause; he suffered from repressed and manifest envy, aggression, and rage. In his illness, his real conflicts and transference relationships were decisive. These included conflicts with his mother (not mentioned by Freud), his relationships with the psychiatrists Flechsig and Weber, his career choice and work as a judge, and conflicts with his wife (which included serious disputes over money). In addition, there was the transfer to Sonnenstein and the incompetency ruling, which doomed his legal career.

On the other hand, Freud did acknowledge that the fantasy of being transformed into a woman, completing the trajectory of the prodromal feminine daydream, was a self-healing rediscovery of a lost human relatedness. Lothane discovered that Schreber engaged in nonhomosexual cross dressing, a vehicle for dealing with heterosexual conflicts by means of diffusion of gender identity arising from identification with woman, mother, and wife.

Although Niederland developed a heuristically fruitful formulation, he departed from Freud significantly by reading Schreber's symptoms as determined not by endogenous wishes but by childhood trauma: paternal sadism alternating with physical seduction. These ideas are unsupported by the extant biographical evidence. For Niederland, Schreber's father was a tyrant who tortured his son with terror-inspiring "machines." In reality, these were rather innocuous appliances. Lothane showed a lack of support for Niederland's inference of such trauma taking place when Paul was three to four years old, or for the idea that the father made use of antimasturbation devices. Israëls first pointed out that the father was unduly demonized. Niederland (1974) suggested that some of Moritz Schreber's ideas were "useful in our effort to unravel a few among the many obscure features of the clinical picture and to make the hitherto incomprehensible aspects of Schreber's delusional system accessible to further investigation" (p. 206). A psychoanalytically informed longitudinal case study supports a reappraisal of the basic facts, premises, diagnoses, and dynamics of Schreber's story. Generally, psychoanalytic method, to be clinically valid, must combine hermeneutics and history.

Zvi Lothane

See also: "Psycho-Analytic Notes on an Autobiographical Account of a Case of Paranoia (Dementia Paranoides )."

Bibliography

Freud, Sigmund. (1911c [1910]). Psycho-analytic notes on an autobiographical account of a case of paranoia (dementia paranoides ). SE,12: 1-82.

Israëls, Han. (1989). Schreber, father and son. Guilford, CT: International Universities Press.

Lothane, Zvi. (1992). In defense of Schreber: Soul, murder, and psychiatry. London: Analytic Press.

Niederland, William G. (1974). The Schreber case: Psychoanalytic profile of a paranoid personality. New York: Quadrangle.

Schreber, Daniel Paul. (1988). Memoirs of my mental illness (Ida Macalpine and Richard A. Hunter, Trans.). Cambridge, MA: Harvard University Press. (Original work published 1903)