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On January 24, 1895, in a letter that was kept unpublished for nearly 90 years, Sigmund Freud wrote nervously about a dangerous experiment he was planning to embark upon. “Now only one more week separates us from the operation,” he wrote to his friend Wilhelm Fliess, who would be performing the surgery. “My lack of medical knowledge once again weighs heavily on me.”

The patient who would be undergoing the procedure, Emma Eckstein, came from a well-regarded family in Vienna and began analysis with Freud when she was about 27. She complained of stomach and menstrual issues that made even walking a pain. Freud and Fliess believed that Eckstein’s suffering was related to her masturbation, which she discussed with Freud during their psychoanalytic sessions. It was a dubious logical path, but Freud and Fliess’s solution was almost comically unfounded. “Girls who masturbate normally suffer from dysmenorrhea,” Fliess later wrote in reference to Eckstein’s menstrual pains. “In such cases, nasal treatment is only successful when they truly give up this aberration.”

Freud believed that the sexual organs were connected to the nose, and sexual “issues,” particularly masturbation, were principle causes of neurotic maladies, and that they could sometimes be solved by nasal surgery. With the exception of Fliess, Freud’s contemporaries mostly found this theory to be bizarre and potentially harmful; and, as is evidenced by his 1895 letter, even Freud began to think that he might be out of his medical depth. Nonetheless, his convictions outweighed his doubts.

The operation failed. On March 4, 1895, a little more than a month after Eckstein’s surgery, Freud wrote to Fliess of the surgery’s complications: “Eckstein’s condition is still unsatisfactory … she had a massive hemorrhage, probably as a result of expelling a bone chip the size of a Heller [a small coin]; there were two bowls full of pus.” Eckstein survived, but in sticking to his scientifically unfounded theory, Freud nearly killed her.

Perhaps unsurprisingly, for nearly a century, nearly every mention of this surgery — and of Emma Eckstein in general — had been purged from the official collections of Freud’s letters. It wasn’t until Anna Freud, Freud’s daughter and a staunch protector of his legacy, hired Jeffrey M.

Masson to create a more complete edition of Freud’s and Fliess’s correspondence (an abridged version had been published in 1954) that the letters began to come to light.

Anna Freud provided Masson access to more than 75,000 documents to complete his task, but Masson quickly saw that something was awry in the history. “I began to notice what appeared to be a pattern in the omissions made by Anna Freud in the original, abridged edition,” he wrote in The Atlantic in 1984. “In the letters written after September of 1897 … all the case histories dealing with the sexual seduction of children had been excised. Moreover, every mention of Emma Eckstein … had been deleted.” When he asked Anna Freud why she had deleted certain sections, she said, according to Masson, that she “no longer knew why” and that “she could well understand” his interest, but that “the letter should nevertheless not be published.”

“In conversations with other analysts close to the Freud family,” Masson added, “I was given to understand that I had stumbled upon something that was better left alone.” After bringing these letters to the attention of Anna Freud, Masson, who had been set to succeed Kurt Eissler as director of the Freud Archives, was fired.

The hidden history of Emma Eckstein, ideas about repressed childhood memories of sexual abuse, and nasogenital theories were just the beginning of the unraveling of Freud’s legacy. In the early 1970s, the so-called “Freud wars” — a virulent academic debate over Freud’s legitimacy — began with psychiatrist Henri Ellenberger, philosopher Frank Cioffi, and historian Paul Roazen. “There were plenty of doubters before then,” says outspoken Freud critic Frederick Crews, an emeritus professor of literary theory at the University of California, Berkeley, and author of the recent Freud: The Making of an Illusion. “Some of the keenest ones were Freud’s contemporaries. But only in the ’70s did the whole Freudian edifice begin to crumble.” Crews’s own 1980 essay, “Analysis Terminable,” in Commentary and his 1993 follow-up essay in The New York Review of Books, called “The Unknown Freud,” further made the case that Freud was a fraudulent and unethical scientist, and together acted as the final bullet in the heart of his legacy.

And yet, although Freudian theories are no longer a part of mainstream science, Freud is still incredibly well-known, a figure with name recognition on par with Shakespeare. Just think of how his theories have entered into the contemporary vernacular: Mommy and Daddy issues. Phallic symbols. Death wishes. Freudian slips. Arrested development. Anal retentiveness. Defense mechanisms. The psychologist and Freud critic John Kihlstrom has written that “more than Einstein or Watson and Crick, more than Hitler or Lenin, Roosevelt or Kennedy, more than Picasso, Eliot, or Stravinsky, more than the Beatles or Bob Dylan, Freud’s influence on modern culture has been profound and long-lasting.”

The question, then, is how? How does a man whose ideas have been widely debunked by his successors hold onto this much cultural influence?

Part of the answer is that the link between Freud’s theories and historical and literary trends gives them an extra dose of gravitas, making his ideas seem like the unearthing of centuries-old truths. Think of Sophocles’s Oedipus plays or Shakespeare’s King Lear or Hamlet, for instance, and you’ll see how Freud took the underlying psychologies that had long been a part of foundational texts and turned them into “science.”

In doing so, he gave scientific license for these ideas to continue to undergird culture. The theory of the Oedipus complex later showed up in D.H. Lawrence’s Sons and Lovers; Freud’s theories of trauma and pleasure became a critical part of Virginia Woolf’s character Septimus Smith in Mrs. Dalloway. In literary criticism, Peter Brooks applied Freud’s claims about dream symbolism to his idea of how all novels are plotted in Reading for the Plot; Harold Bloom used the Oedipus complex to explore poetic rivalries in The Anxiety of Influence. In the 1940s, literary critic Lionel Trilling noted the “poetic quality” of Freud’s theories. His theories descended from “classic tragic realism,” Trilling wrote in his book Freud and Literature, “a view which does not narrow and simplify the human world for the artist, but, on the contrary, opens and complicates it.” Freud was a master of words and socio-cultural insights. His genius was to bend science toward them.

He also had a crackerjack public relations team defending his name long after his death. How else could his name continue to survive after a statement like this from Crews in Psychological Science in 1996: “There is literally nothing to be said, scientifically or therapeutically, to the advantage of the entire Freudian system or any of its component dogmas”? Or after the 1975 statement from Peter Medawar, a medical biologist with a Nobel Prize, calling Freudian psychoanalysis “the most stupendous intellectual confidence trick of the 20th century”? Or the fact that, by 1980, nearly every mention of Freudianism had been deleted from the Diagnostic and Statistical Manual of Mental Disorders? Over the past century, a team of family members, friends, and those with “financial” or “emotional” interests, as Crews puts it in The Making of an Illusion, spent significant time redacting letters, making savvy donations, and writing histories that portrayed Freud as a noble scientist — liberating humankind from their sexual hang-ups and repressed memories.

But his reputation is a tautological loop — and one that has proven difficult to escape. Because Freud is well-known, one reasons that he must also be important; because he is important, he must have made great and lasting contributions to science and psychology. Freud “is destined to remain among us as the most influential of 20th-century sages,” Crews writes; but he also argues that Freud’s apparent importance was more the result of historical trends than anything Freud himself actually did.

For those who want to protect Freud’s legacy, the most compelling argument might rest not on Freud’s specific theories but rather on his way of thinking. His innovative marriage of culture and science opened up a fundamentally new way of understanding the world. “His theories provided a foundation upon which the most important new knowledge was built,” says Mark Solms, the chair of neuropsychology at the University of Cape Town and a founding figure of a combined neuroscientific-psychoanalytical approach to therapy. “The fact that 100-year-old theories are disproven does not diminish their importance. In this respect, Freud is no different from, say, Newton.”

“Freud was one of the great ‘master thinkers,’” agrees Samuel Moyn, a professor of history and law at Yale. “He wasn’t a ‘psychologist,’ so much as the first interdisciplinary theorist of humanity, straddling the boundary between nature and culture, and all fields of intellectual life.”

“Nobody is that ambitious anymore,” he adds. “Our age prefers specialists, for the sake of sure results, rather than grander visions that integrate what we know, notwithstanding the risk of mistake.” Freud, Moyn and his ilk argue, was one of history’s greatest public intellectuals, someone who was willing to span a dizzying number of disciplines to find answers to humanity’s most pressing questions — which is why, despite the fact that Freudian theories have been kicked to the far fringes of science, Freud still deserves the cultural sway he holds.

“Did Freud get some things wrong?” says Lee Jaffe, the president-elect of the American Psychoanalytic Association. “Sure. But he also got many things right too.” Freud’s theories on unconscious mental processes, the importance of behavioral ambivalence and conflict, the origins of adult personality in childhood, mental representations as a moderator of social behavior, and stages of psychological development are all still relevant today. Freud also changed the public’s understanding of sex and desire, perhaps more than anyone else, by equating female desire with male desire. And, just by placing sexual desire and perversions into a “scientific” context, Freud freed sexuality from the largely religious context that focused on its moral degeneration or inherent criminality. His theories, therefore, often allowed people to feel more comfortable with their sexuality, and to view it as separate from their core identity.

But it’s tricky to claim that the theories for which Freud is best known were all originally his. The French psychiatrist Pierre Janet, for instance, pioneered the theory of the unconscious mind. There were also plenty of things that Freud got plain wrong or discovered unscientifically. His diagnosis and surgery on Eckstein is an obvious oversight that his protectors had long tried to cover up; more famously, his ideas on dreams have essentially no basis in scientific rigor. “Every dream will reveal itself as a psychological structure, full of significance, and one which may be assigned to a specific place in the psychic activities of the waking state,” Freud wrote in The Interpretation of Dreams. Today, very few would believe in this untestable hypothesis.

Freud often worked backward, finding “scientific” excuses for various behaviors and then working to “prove” those theories. This logic is also a typical argument against psychoanalysis’s efficacy — that it works mostly by placebo effect, with people responding simply because they feel like they’re being listened to, not because of any more scientific explanation. But Jaffe says the cultural decline of psychoanalysis, a practice Freud helped to bring into the mainstream, is not due to faulty science or wholesale disbelief in its founder, but, more banally, thanks to economic reasons. “Psychoanalysis is not quick and often more expensive,” he says, “and we live now in a time of instant messages and an understandable desire for quick fixes.”

It’s true that with relatively inexpensive medications for anxiety and depression, it’s hard to continue to justify hundreds of billable hours spent in psychoanalysis. And “simply because it failed to heal psychosis or because … quicker and more reliable remedies exist,” Moyn says, doesn’t mean that “psychoanalysis [has] been disproven.” Still, just because something hasn’t been fully disproven doesn’t mean that it’s correct, and it seems a little too easy to pin the precipitous decline of psychoanalysis — so in vogue in the middle of the 20th century — on economics. Changing ideas about its validity have no doubt played a role as well.

Even as Freudian theories and Freud himself have been placed under almost unbearable scrutiny and criticism, the apparatus has not caved in. Perhaps it’s forever impossible to entirely discredit Freud, hard as some might try. Even Crews was once a Freudian before he became disenchanted with Freud’s lack of empiricism and the fact that psychoanalysis permits any number of interpretations, all of them valid. Crews says that anyone who gives credence to Freud today does so because they are exempting themselves from a rigorous “evaluation of his claims,” uniformly granting him “the benefit of the doubt,” and blaming the “evidence of his illogicalities and ethical lapses” on “the autonomous operations of his unconscious mind.”

“My belief is that if high schools did their job, most high-school graduates would be capable of seeing through Freud,” says Crews. “It’s a question of asking for the evidential goods to be produced.” He adds: “I don’t consider myself a radical. My point of view is garden-variety empiricism.”

It is true that many people seem to want to believe in Freud — to an extent that, if it were anyone else, would seem crazy. It’s easy to understand the appeal of his story: a seemingly miraculous worker of the mind valorized by modern culture; a revolutionary public intellectual who barely escaped the Nazis; an architect of dreams and sexuality, who was, for a time, a walking and talking Rosetta Stone, unlocking every facet of the psyche. But because he is so beloved, it is also fair to argue that we’ve been collectively blinded.

After all of the criticism, “‘balance,’ then, is supposedly called for,” says Crews. “But I say no: just follow the evidence wherever it leads.”