‘How very interesting…’

We all know the characters described by Freud in his case studies: 'Emmy von N.', 'Elisabeth von R.', 'Dora', 'Little Hans', the 'Rat Man', the 'Wolf Man', the 'Young Homosexual Woman'. But do we know the real people behind these illustrious pseudonyms – respectively, Fanny Moser, Ilona Weiss, Ida Bauer, Herbert Graf, Ernst Lanzer, Sergius Pankejeff, Margarethe Csonka? More generally, do we know all those many patients on whom Freud never wrote anything, or at least not directly: Pauline Silberstein (who committed suicide by throwing herself from the top of her therapist's building), Olga Hönig (the mother of 'Little Hans'), Bruno Veneziani (the novelist Italo Svevo's brother-in-law), Elfriede Hirschfeld, Albert Hirst, the architect Karl Mayreder, Baron Victor von Dirsztay, the psychotic Carl Liebmann and so many others? Do we know that Bruno Walter, the great conductor, was one of Freud's patients, as was Adele Jeiteles, the mother of Arthur Koestler? And that Freud also hypnotized his own wife, Martha Bernays, before analysing his daughter Anna?

In Freud's Patients: A Book of Lives, I have tried to reconstruct the sometimes comical, most often tragic and always captivating stories of these patients who have long been nameless and faceless: in total, 38 sketchy and necessarily incomplete portraits, drawn from the documents available today and told without prejudging revelations that, in the future, might emerge from those which are still closed to researchers within the Freud Collection at the Library of Congress in Washington, DC. Thirty-eight portraits, and that is it: I have selected only those of Freud's patients on whom we already have enough information to justify a biographical note, however brief. Those about whom we know little apart from their names or initials have been excluded – for now. The collection, therefore, does not claim to be exhaustive, merely representative. As partial as it is, this sample should at least allow the reader to get an idea of Freud's actual clinical practice, over and above the fabulous narratives he himself drew from it.

I have limited myself to Freud's patients, without including the many people who lay down on Freud's couch mainly to train as analysts (such as Anna Guggenbühl or Clarence Oberndorf, for example) or out of simple intellectual curiosity (such as Alix and James Strachey, or Arthur Tansley). This survey includes only people who came to see Freud for symptoms from which they sought to be cured or existential difficulties from which they could not extricate themselves. It is for this reason that I have included Anna Freud, Horace Frink and Monroe Meyer, even if it is clear that in their cases the analysis was also a training one. All three of them were, first and foremost, in need of care, and it is as therapy that their treatments should be evaluated, as in the case of the other patients cited here.

Finally, I have refrained as far as possible from taking into account Freud's interpretations, which are what make his case histories so fascinating and interesting. By comparison, the stories the reader will find here are prosaic and quotidian. No theory, no commentary: I have kept to the surface of the facts, documents and testimonies available, without speculating on the motivations, conscious or unconscious, of any of the people involved. Those who seek in these stories a confirmation of Freud's stories may therefore be disappointed, as they will not find 'their' Freud here. On the other hand, they will find another Freud, the Freud of his patients and their entourage. I am not sure whether we can reconcile these two Freuds or these two ways of telling stories. I apologize in advance to those whom this history-based approach will confuse or shock. The reader will find the sources on which I have relied at the end of the volume. Some are primary, as historians say, others are secondary.

An earlier incarnation of this book came out in French ten years ago and has been significantly augmented and updated, based on new material that has emerged in the meantime. Seven newly identified patients have been added. These additions do not, however, change much the overall conclusion that can be drawn from these informal follow-up studies: with a few ambiguous exceptions, such as the treatments of Ernst Lanzer, Bruno Walter and Albert Hirst, Freud's cures were largely ineffectual, when they were not downright destructive.

Margarethe Csonka (1900-99)

Margarethe Csonka seemed destined for a dream life. Her father, Arpad Csonka, was the biggest oil importer in the Austro-Hungarian Empire, as well as being a partner of the Rothschild bankers. Of Jewish origin, but converts to Catholicism, the Csonkas were part of the Austrian upper classes. Margarethe's mother was far from indifferent to the attentions of men; it was rumoured that Paul Csonka, one of Margarethe's brothers, was the illegitimate son of Emperor Franz Joseph. Margarethe and her three brothers led the carefree life of the Viennese gilded youth: parties, beautiful cars, castles and palaces. In summer, they gathered in Brioni or in Semmering with the Wittgensteins, the von Sturgkhs, the von Ruesslers or the von Ferstels (one of Margarethe's friends, Ellen von Schoeller, would marry the nephew of Marie von Ferstel). Paul Csonka, however, escaped from this world and became a renowned composer and conductor, the friend of Karajan, Toscanini and Klemperer.

Margarethe had always been attracted to women. She fell in love with them one after another, ideally and platonically. It was female beauty that fascinated her, not carnal intercourse (for instance, she rejected the advances of her friend Christl Kmunke, who was an open lesbian). At seventeen, she fell in love with the sulphurous Baroness Leonie von Puttkamer. Leonie was a member of the Prussian nobility, a demimondaine who lived off men while flaunting her liaisons with women. In the early 1920s, she was to have a rowdy affair with the nude dancer Anita Berber, and she was accused by her husband, David Gessmann, the president of the Austrian Chamber of Agriculture, of trying to poison him (she was released after spending some time in prison, where Margarethe went to visit her). Margarethe had a real relationship of courtly love with her, serving her as her 'lady' without hoping for anything in return. For her part, Leonie tolerated this young admirer and dragged her along to cafés and shops, much like one drags along a poodle.

Margarethe's parents, especially her father, were worried about this infatuation, which might damage their daughter's reputation. One day when Margarethe and Leonie were walking arm in arm in the street, Margarethe saw her father on the pavement opposite, talking to a colleague. In the article he devoted to the case of Margarethe Csonka ('Psychogenesis of a Case of Homosexuality in a Woman'), Freud writes that the father 'passed them with an angry glance which boded no good', whereupon the young girl, distraught, 'rushed off and flung herself over a wall down the side of a cutting on to the suburban railway line which ran close by'. 

In reality, according to the story told later by Margarethe Csonka to her biographers Diana Voigt and Inès Rieder, she had moved away from Leonie as soon as she saw her father and started running in the opposite direction to escape his gaze. Glancing over her shoulder, however, she realized that her father had not noticed her and was getting on a tram. She then returned to the baroness, but Leonie, annoyed that the young girl had not had the courage to show herself with her, dryly told her that she did not want to see her anymore. It was only then that Margarethe made her suicide attempt, which was thus not motivated by shame at having been discovered by her father but by a desire to prove to the baroness the depth of her love. 

Alarmed by his daughter's suicide attempt, Arpad Csonka decided to send her to Freud to put her back on the straight and narrow path of heterosexuality. Freud did not promise anything, well aware that such a goal was unlikely to be achieved, but he nevertheless agreed to take Margarethe on for treatment for a certain time. In those times of political and economic breakdown, inflation had become rampant and Arpad Csonka could pay in foreign currency ($10 an hour). Freud made Margarethe promise that she would no longer see Leonie von Puttkamer during the treatment period (Leonie, moved by the girl's suicide attempt, had in the meantime agreed to resume relations with her). Margarethe went along to please her father, but she obviously had no intention of respecting the contract that had been imposed on her.

Every day, in the middle of the afternoon, she went to 19 Berggasse and politely bowed to the ritual of analysis: 'The analysis went forward almost without any signs of resistance, the patient participating actively with her intellect, though absolutely tranquil emotionally. Once when I expounded to her a specially important part of the theory, one touching her nearly, she replied in an inimitable tone, "How very interesting," as though she were a grande dame being taken over a museum and glancing through her lorgnon at objects to which she was completely indifferent.' After which, Margarethe met up with her dear Leonie in a Kaffeehaus and the two friends cheerfully chortled over the doctor's absurd oracles: Margarethe, he claimed, had turned away from men out of spite because her beloved father had given a child to her mother, whom she unconsciously hated!

Margarethe was later to tell Kurt Eissler how she had led Freud down the garden path during the treatment. One day when she had inadvertently mentioned one of her illicit meetings with Leonie, she corrected herself and with aplomb pretended that it was a dream. Freud had not seen through her game, and so Margarethe had continued – though she never dreamed – to serve him custom-made dreams in order to be left alone. After a while, Freud still ended up suspecting that there was something wrong with these too-perfect dreams: 'At a certain period, not long after the treatment had begun, the girl brought a series of dreams which, distorted according to rule and couched in the usual dream-language, could nevertheless be easily translated with certainty. Their content, when interpreted, was, however, remarkable. They anticipated the cure of the inversion through the treatment, expressed her joy over the prospects in life that would then be opened before her, confessed her longing for a man's love and for children, and so might have been welcomed as a gratifying preparation for the desired change.' These dreams, continued Freud, were 'false or hypocritical, and . . . she intended to deceive me just as she usually deceived her father'.

Freud did not deduce from this, however, that he had been deliberately fooled by the girl. A good unconscious cannot lie: these deceptive dreams, according to him, were due to a positive transfer to his person and to Margarethe's unconscious desire to please the father-analyst. This positive transfer was not, however, sufficient to overcome the negative transfer that the patient simultaneously fostered towards him. She had transferred to him 'the sweeping repudiation of men which had dominated her ever since the disappointment she had suffered from her father' and suddenly resisted treatment. Freud, therefore, decided to end the analysis, much to Margarethe's relief. The treatment had failed, but at least the clinical material gleaned from it would allow the analyst to write a brilliant article on the psychogenesis of female homosexuality.

As for Margarethe, happy to get off the analytic hook, she resumed her frivolous life. After Leonie, she fell in love with many other women and even sometimes with men, always in the same ideal and aesthetic fashion. The flesh disappointed her most of the time. She made two more suicide attempts, again for reasons of love. In 1930 she married Baron Eduard Rzemenowsky von Trautenegg, an ex-fighter pilot more interested in the fortune of the Csonkas than in his wife. Heterosexual respectability was well worth a mass – or, in this case, conversion from Catholicism to her husband's Protestantism.

Margarethe Csonka paid no attention to the dark clouds coming from Germany. She lived in her enchanted world and was not particularly interested in politics. When her husband, nostalgic for the Austro-Hungarian Empire, flirted with the National Socialists, she saw nothing to complain about. She herself, although of Jewish origin, was spontaneously antisemitic: 'We have nothing to do with these people!' After the Anschluss, the Nazis undertook to enlighten her on the reality of her situation. 

Her marriage to the Aryan Eduard von Trautenegg was annulled on the grounds of race, and her ex-husband took control of her property and her fortune. Her Jewish and homosexual friends were arrested and deported one after the other. Her mother joined her younger brother Walter in Paris. Paul Csonka and her other brother took refuge in Cuba, like so many other Jews at the time (Paul assumed the direction of the National Opera of Havana, as well as that of the National Orchestra, before fleeing again in the United States in 1963 after Castro's takeover).

Margarethe, meanwhile, waited until the very last moment to leave Austria. In August 1940, using with sangfroid her passport in the name of Baroness von Trautenegg, she went to Berlin and from there took one of the last trains to Moscow. After a five-month journey through Russia, Manchuria, Japan, Honolulu and San Francisco, she finally arrived in Havana, where Paul welcomed her in the house he had built.

There thus began a long existence of permanent exile. She was at home nowhere. Her world was gone, engulfed by the war and the camps. As the Csonka fortune had evaporated, she had to work the rest of her life as a lady companion or governess for wealthy families. In 1947 she left Cuba for the United States, then returned in 1949 to Europe and finally to Vienna. She had a great love affair with Wjera Fechheimer, a friend whose husband had died in Dachau, but who eventually left her. Then, from 1960 onwards, she went to Thailand, Spain, the United States (again), Spain (again), Brazil and finally Vienna, where she returned to settle in 1973. 

She died during the summer of 1999 in the twelfth district of Vienna, in the retirement home where she ended up at the close of a century that she had lived through from start to finish. Meanwhile, several researchers had finally discovered that this lively and distinguished old lady was none other than the famous case of female homosexuality immortalized by Freud. During the 1990s Diana Voigt and Ines Rieder collected the story of her life as a 'lesbian in the world' and wrote a richly documented and illustrated book on her, which came out in 2000. 

Others, such as Kurt Eissler and the psychoanalyst August Ruhs, were primarily interested in her analysis with Freud. The problem is that she had little to say about this. A year before her death, she confided to Ruhs: 'Yes, well, I didn't really think much of Doctor Freud. It didn't help either, I thought he was an uninteresting old man . . . One day, he said to me: "I am putting you in touch with the deepest motions of your soul and you behave as if I was just reading out something from the newspaper . . ."'