Henri Ellenberger’s 1970s magnum opus has long been recognised as a classic. An encyclopaedic account of the emergence of dynamic psychiatry, it begins in the early pre-scientific era of primitive medicine, examines the advent of mesmerism in the 18th century, depicts the amazingly fertile culture of 19th-century Europe, and concludes in the mid-20th century with the rise of psychoanalysis. When I first became aware of the book as a trainee at the Royal Edinburgh Hospital, I have to admit I was not immediately taken with it. For a start, it was nearly a 1000 pages long and it seemed to focus entirely on dynamic psychiatry to the exclusion of other approaches. However, closer acquaintance with it over the years has revealed its great merits.
Henri Ellenberger (1905-1993) was an interesting individual. Born in southern Africa into a French-speaking Swiss family, he studied medicine in Paris, trained in psychiatry and moved to Switzerland where he became acquainted with Manfred Bleuler, Ludwig Binswanger and Carl Jung, before relocating to North America to work in the Menninger Clinic and latterly in Montreal. He spoke six languages, studied philosophy and literature, and was immersed in European culture.
As the historian Mark Micale reveals, Ellenberger was something of a man out of time. He was not based at a university department and, as a result, was isolated and deprived of institutional support to carry out his research. He used his holidays to visit historical archives and wrote The Discovery of the Unconscious at home in the evenings after the clinical day. Ellenberger’s book came out when the tide had turned against psychodynamic approaches; by this stage his psychiatric contemporaries were more interested in biological treatments. In addition, few of them saw the value of the historical perspective. Nevertheless, Ellenberger produced a pioneering and enduring work. For me, he demonstrated the importance of a knowledge and understanding of the cultural context in which psychiatric ideas emerge. Psychiatry is not something separate from culture: it is part of it. Ellenberger’s chapters on Europe in the 19th century are a tour de force. With his references to the novelists and playwrights of the day, such as Dostoyevsky, Stevenson and Schnitzler, and to thinkers like Nietzsche, Schopenhauer, Marx and Darwin, Ellenberger vividly evokes the hotbed of ideas out of which psychoanalysis was borne. He also establishes that Freud, despite his personal mythology, was very much influenced by the writings of his time.
Indeed, a key aspect of the book is Ellenberger’s portrayal of the founder of psychoanalysis in terms of the ‘hero myth’. In this myth, the hero is the lone figure arising de novo, boldly introducing revolutionary ideas which are initially greeted with hostility by his uncomprehending contemporaries, but who is vindicated in the end when his theories are acclaimed. In this mythological version, the scientific and cultural context out of which the ‘hero’ arises is obliterated. Ellenberger’s great contribution has been to reinstate this lost context and to provide us with a much deeper understanding of Freud and the origins of his thought.
To someone, like myself, who has written about the history of psychiatry, Ellenberger’s work has proved exemplary. He showed the value of being sceptical of the received narratives of psychiatric progress, and his book demonstrated the importance of going back to primary sources to attain a truer picture of the past. Ellenberger is also a model of the clinician-historian, working outside the academy, whose isolated position nevertheless affords him independence and an original outlook, unrestrained by sectarian dogma.
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