Saturday, May 17, 2008

The Interpretation of Dreams 8 - Irma's Injection Revisited

From my own experience, dreams of their very nature have multiple layers and many possible denotations and connotations.  Likewise the Irma dream has many layers.  Here are some of the associations that Freud states in The Interpretation that sprang automatically to his mind: - a tragic case in which a drug he had prescribed in good faith had led to a patient's death; another case in which he exposed a patient to needless risks; his wife's suffering from her veins during her recent pregnancy; an illness of his eldest daughter, Mathilde and many more, we're sure, which Freud did not allude to in this foundational work on dreams.  Freud's interpretation of this dream, as Gay points out in his magisterial biography of the pioneer was simply to vindicate himself as a sincere doctor and healer.  Hear are Gay's words:

The burden of the wish the dream portrayed was, then, that Irma's sufferings should be truly seen as not his fault but the fault of others.  "In short I am conscientious."  (Peter Gay, Freud: A Life for Our Time, Max, 2006,  83)

Oftentimes, too, dreams admit of several meanings as in layers of meaning - they do, in all likelihood, have one over-riding meaning for the dreamer, but this in no way rules the other layers or strata out of court.  I have often found in my own dreams that characters can blend into one another, even change from one persona to another quite fluidly and easily.  We may refer to this phenomenon as the prevalence in dreams of "composite characters."

Here, interpreters, through vast research and reading, are convinced that Irma is one such composite character.  This composite character of Irma in this dream is not alluded to by Freud.  In a previous post I have mentioned that Freud himself equated Irma with Anna Hammerschlag, daughter of Freud's Hebrew teacher Samuel Hammerschlag and a close friend of Freud's wife Martha.  However, there is one other glaringly obvious equation which is possible.  Anna (Lichtheim) Hammerschlag resembled another of Freud's patients, namely, Emma Eckstein.  Here is Gay again on this possibility, indeed some would say probability:

And it was Emma Eckstein who figured as a principle in a medical melodrama of early 1895 (The year in which, of course, Freud had his famous dream - my parenthesis - TQ) in which Freud, and far more Fliess, played unenviable roles.  In Freud's unconscious, making up his dream, the figure of Emma Eckstein and that of Anna Lichtheim seem to have merged to become Irma. (Op. cit., 84)

Indeed two pages previously Gay tells us in far from flattering terms about Freud's cunning as it were:

What Freud did not tell Fliess on July 24, 1895, or the readers of The Interpretation of Dreams, was that the dream of Irma's Injection was a carefully constructed, highly intricate scenario designed at least in part to rescue Freud's idealized image of Fliess in defiance of some damning evidence.  A fuller, less protective interpretation of this dream than the one Freud published leads to what must be the most dismaying episode of his life. (Ibid., 82)

Dr Wilhelm Fliess, for whom Freud admitted feelings bordering on the homosexual (Both Freud and Jung subscribed basically to the theory that all human beings (and all animals one would presume) are by nature bisexual), was a very close friend and colleague of Freud's. Fliess, who was an ear, nose and throat specialist and surgeon had some strange ideas, one of which was the so-called "nasal reflex neurosis," which I have read about in several places, and which one commentator wittily called "the sexual nose."  Fliess had been treating the nasal reflex neurosis in his own patients with local anesthesia, specifically cocaine, and found that the treatment yielded positive results, in that his patients became less depressed. Fliess conjectured that if temporary cauterization was temporarily useful, perhaps surgery would yield more permanent results. He began operating on the noses of patients he diagnosed with the disorder, including Eckstein and even Freud himself.

Anyway, to cut a long story short, Fliess operated on Emma Eckstein on referral from Freud, but the operation was a complete disaster - one great botched job. She suffered from terrible infections for some time, and profuse bleeding. Freud called in another specialist who removed a mass of surgical gauze that Fliess had failed to remove during his botched operation. Eckstein's nasal passages were so damaged that she was left permanently disfigured. Freud initially attributed this damage to the surgery, but later, as an attempt to reassure his friend that he shouldn't blame himself, Freud reiterated his belief that the initial nasal symptoms had been due to hysteria. Many competent interpreters and scholars suggest that in all likelihood this incident provided source material for Freud's dream of "Irma's injection".

Above I have uploaded a picture I took of a "dreamy" sunset July 2006.

Sunday, May 11, 2008

The Interpretation Of Dreams 7

The Irma Dream or Irma's Injection

Irma's Injection is the name Freud gave one of his most famous dreams.  This is the dream with which he opens The Interpretation of Dreams, and which essentially forms the linchpin of the analysis in that book.  Hereunder I give verbatim Freud's own account of that famous or infamous dream from my Oxford edition of this book:

A large hall - many guests, whom we were receiving. - Among them Irma, whom I take aside at once, as it were to answer her letter and reproach her for not having yet accepted my 'solution' . I say to her: 'If you are still having pain it is really only your own fault.' She replies: 'If you only knew what pain my throat and stomach and abdomen are giving me. - I feel I am choking.' - I am startled and look at her. She looks pale and puffy. I think perhaps I have overlooked something organic after all. I take her to the window and look down her throat.  At this she shows some reluctance, like women who wear dentures. I think to myself : but she has no need to. - Her mouth then opens wide and on the right I discover a big white patch; at another place I see large, greyish-white scabs upon some remarkable curly structures which were evidently modelled on the turbinal bones of the nose. - I quickly call Dr M over, who repeats the examination and confirms it .... Dr M looks quite different from usual; he is very pale, he walks with a limp and his chin has no beard .... My friend Otto is now also standing beside her, and my friend Leopold is percussing her through her bodice and saying: 'She has an attenuation low down on the left.' He also points out that a portion of the skin on her left shoulder is infiltrated. (I noticed this, just as he did, in spite of her dress.) .... M says: 'There's no doubt it,  it is an infection, but it doesn't matter; dysentery will set in and the poison will be eliminated. .... We also know where the infection originated. Not long before, when she was feeling unwell, my friend Otto gave her an injection of a propyl preparation, propylene... propionic acid...trimethylamine ( I see its formula before me printed in bold type) .... Such injections are not given so lightly .... Probably the syringe was not clean either  (The Interpretation of Dreams, Oxford World's Classics, 1999, 85)

The endnotes reveal that Irma is a pseudonym for Anna Hammerschlag, daughter of Freud's Hebrew teacher Samuel Hammerschlag and a close friend of Freud's wife MarthaOtto corresponds to Dr Oskar Rie (1863-1931), a life-long friend of Freud's and paediatrician to his children.  Dr M. is Josef Breuer (1842-1925) who was Freud's close colleague for some ten years and was his collaborator on the famous Studies on Hysteria (1895).  By the late 1890s their friendship had cooled and Freud had transferred his devotion to Fliess; hence Breuer figures in this dream as a blunderer.  Leopold refers to Dr Ludwig Rosenberg, another paediatrician, colleague and friend of Freud's. 

It is important to note also that Freud entitles this dream by its date, namely "Dream of 23-24 July 1895".

This account of Freud's dream of Irma's Injection is the classic and fundamental text of a dream which Freud interprets as fully as possible in The Interpretation.  Freud offers it and its interpretation as the exemplar par excellence as to how dream interpretation is done.  There has been much written about this dream and about Freud's interpretation of it to fill a virtual library on psychoanalysis, but such an exploration of such critical commentary is beyond my goal here in this simple summary.  Consequently, I will return to Freud's own text.  

Freud points out to the reader, immediately after revealing the above text that "It is immediately clear which events of the previous day it is connected to and what subject it deals with." (Op. cit., 85).  In his preamble to this dream Freud tells us that he had had a visit from a younger colleague and a very close friend, namely Otto whose real name I have given above.  They both knew this young woman, a patient of Freud's called Irma, who was a close friend of his family.  Freud does admit the problems associated with treating friends. (ibid., 84)  However, Irma's health had not been good despite Freud's professional intervention.  Otto reports to Freud that she is better, but not fully recovered.  He takes Otto's comments as implying a criticism as the tone was distinctly ambiguous. Freud also tells us that he felt disturbed and uneasy about his treatment of Irma in case he might have missed something.  These feelings provoked him to write out at length Irma's clinical history for Dr. Breuer, then one of the most eminent medical men in Vienna.  It was exactly that night, following these events, that he had this famous or infamous dream.

Freud then proceeds to analyse his dream line by line, or phrase by phrase:

"A large hall - many guests, whom we were receiving."  Freud comments that it is his wife's birthday and he and his wife Martha Bernays are receiving their guests in the large hall at their summer residence in Bellevue.

He then analyses every single phrase in like manner with such explanatory notes as "I speak to Irma in my dream that above all I am refusing to be blamed for all the pain she still has." (86)  Freud also notes his preoccupation with eliminating any organic causes to any neurosis. (87)  This, then, is the doctor's recurrent fear of missing some obvious fact of some physical source for the complaint. Freud also admits all his other associated fears and memories with this dream, viz., a serious illness suffered by his eldest daughter, a problem he had with his own health, his use of cocaine to "suppress bothersome swellings in his own nose." (88)  He also reveals that two characters can be condensed into one in the dream.(89)

Then, in summary, we are lead on inevitably to Freud's one and only conclusion and his main thesis as regards the nature of dreams and dreaming - that they are essentially wish-fulfilment.  I will quote this passage in full as I believe it is very important to The Interpretation:

For the outcome of the dream is that I am not to blame for the pain Irma continues to suffer, and that Otto is to blame for it.  Otto annoyed me by his comments on Irma's incomplete recovery, and the dream takes revenge on him for me as it turns the criticism back on him.  The dream exonerates me of responsibility for Irma's condition in tracing it back to other factors...The dream represents a state of affairs as being as I would wish it to be: Its content is thus a wish-fulfilment, its motives a wish.

(Opus citatum supra, 95.  The italicisation is Freud's own.)

It is also interesting to state that Freud does not claim to have explained the dream to its fullest extent in all its various connotations and denotations:

I do not claim that I have uncovered all the meaning of this dream or that its interpretation is without any gaps.  I could linger much longer over this dream, extract from it further elucidations and discuss fresh puzzles that it has thrown up. (Ibid., 96)

Freud indicates that there is a "broader raw material" in any specific dream with multiple layers of connotations along with what may be determined with analysis as "the narrower subject of the dream." (ibid., 96)

Freud finishes this chapter once again by repeating his main thesis which he wishes to be carved in stone as it were:

After the work of interpretation has been completed the dream reveals itself as a wish-fulfilment.

(Once again the italics are Freud's; ibid., 97)

Above I have uploaded another picture I took from inside the cupola at St Peter's Basilica, Rome, last week.