In March 1885 Freud obtained a travelling grant to go to study for four months under the celebrated French neurologist Jean Martin Charcot (1825-93). He duly arrived in Paris in October and soon gained an interest in hypnosis and hysteria from attending Charcot's lectures. Charcot rejected the traditional view of hysteria as an imaginary condition invented by feeble-minded women and instead treated it as a genuine illness that could be diagnosed in males also (1). Like Brucke, Charcot was a devoted Mechanist, so he was not particularly receptive to the notion (later so important to Freud) that hysteria might have a sexual motive, as this would have meant finding a psychological cause. However, he admitted the connection in private.

1886 was an important year for Freud as he opened his own private practice for nervous diseases in Vienna in April and married Martha Bernays in September. Considering that he was later so well remembered for his "obsession" with sex, it is interesting to note that he was probably still a virgin on his wedding night: he did not practice what he (somewhat erroneously) was believed to preach! However, there is a possibility that Freud had an affair with Minna, his sister-in-law, who lived with the family from 1896 - (near) incest clearly ran in the family. As spirited as she may have been in resisting Freud's demands during their engagement, Martha quickly became subordinated to his will as she threw herself wholeheartedly into the business of housework and raising a family. Martha proved to be as fertile as Freud's mother as their first nine years of marriage produced six children - Mathilde in October 1887, (Jean) Martin in December 1889, Oliver in February 1891, Ernst in April 1892, Sophie in April 1893, and Anna (pictured with her sisters right), later Freud's greatest disciple, in December 1895 (2). His daughter's support was a long way off though - 1886 was also the year that Freud read a paper on male hysteria to the Vienna Imperial and Royal Society of Physicians, which was (in the oversensitive Freud's opinion at least), somewhat badly received. In attendance was his old teacher, the psychiatrist Theodor Meynert, who challenged Freud to find a case of male hysteria in Vienna and present him before the society, which he duly did the following month.

In the autumn of 1887 Freud embarked on the most significant relationship of his working life when he first encountered Wilhelm Fliess (1858-1928 - left), an ear, nose and throat specialist from Berlin. History has not been kind to Fliess: his bizarre ideas about how life operates on periodic cycles of 23 and 28 and his insistence upon the prominence of the nose as a sexual organ are now long discredited, but in the 1880's they had more support than many of Freud's theories. Fliess became Freud's most intimate friend for the next decade, and hence the sole witness to the birth of psychoanalysis and its first reader, analyst, and critic as he and Freud met regularly in what they called "Congresses" to discuss their views. He supplied Freud with many of his key ideas, including the notions of infantile sexuality and bisexuality, so made a very valuable contribution to the development of the Freudian ethos (3). Freud was somewhat (irrationally) dependent on him, to an almost homoerotic degree. He praised his friend to the point of hero worship and managed to suppress much of the less savoury matter relating to him. When Fliess nearly killed a patient of Freud's (Emma Eckstein) by leaving a strip of gauze in her nose during an operation performed in February 1895 to "cure" her of masturbation, Freud dismissed her haemorrhaging as "hysterical bleeding caused by sexual longing", so keen was he to exonerate his friend (4).

At some time during the winter of 1887 Freud began to use a new hypnotic system in treating hysteria developed by Josef Breuer (on Anna O) that became known as the cathartic (or "purging of affect") method. The cathartic method tried to discover the traumatic affect which normally underlay neurotic symptoms. As had been the case with Anna, Breuer and Freud usually found that the neurosis developed in reaction to an unpleasant event (or events) in the subject's life that had been purposely forgotten - or "repressed", as Freud later said. Continued repression of this unpleasant experience caused a build up of emotional energy that was transformed into hysterical symptoms by unconscious stimulus. It was the task of the analyst to discover the origin of this event and raise it to consciousness by making the patient "re-live" it by discussion, usually under hypnosis. This created a "purging" of affect and the energy was released (or "abreacted") and thus divested of its traumatic potency. This involved making the unconscious conscious, the fundamental rule of all psychoanalytical treatment. The cathartic method relied largely on suggestion by the analyst - the analysand became a mere passive receptacle for his opinions.

Freud was becoming increasingly convinced that repression had a sexual motive that his patients did not want to admit to. The more cautious Breuer refuse to agree that this could be the cause of every case of hysteria, but proved more accommodating to Freud's theories than Charcot had been (5). Freud published his ideas in print in The Neuro Psychoses of Defence (1894). Despite various differences, Freud persuaded Breuer to write a book with him outlining the cathartic method. This was published in 1895 as Studies in Hysteria.

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ã Robin Tamblyn, 2000.

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