Review by Tad Beckman (copyright 1995) Harvey Mudd College, Claremont, CA 91711
In order to bring Breuer and Nietzsche together, however, Yalom was forced to create a purely fictitious meeting of Lou Salom‚ and Breuer and to give Lou an uncharacteristic burden of care toward Nietzsche's health and feelings. While none of this ever happened, it is not forbidden by the facts; that is, Nietzsche undoubtedly did pass through Vienna, during this period, and we don't know when or for how long.
Before leaving the subject of Lou Salom‚, we should observe that she was certainly the striking and charismatic figure that Yalom describes in this novel. Her brief relationship with R‚e and Nietzsche was merely the beginning of a long series of relationships with intellectual giants of the period. A far more significant affair was with the great poet Rainer Maria Rilke. And furthermore, as an older woman, she became involved in Freud's school of psychoanalysis and knew Freud himself very well. Lou wrote several books, including her own Remembrances, which described Nietzsche and his philosophical thought.
The novel offers its readers interesting insights into Nietzsche's personality, occupations, and health. Equally, it presents interesting views of Freud and the early development of psychoanalysis in Breuer's work. Freud and Breuer eventually collaborated on a book, Studies on Hysteria. But, by far the most interesting aspects of the novel, are the carefully worked relationships between early ideas in psychoanalysis and psychotherapy, on one hand, and Nietzsche's philosophical thinking, as it had developed through his works up to The Gay Science. The action takes place at an especially fortuitous time in the lives of all these characters.
While psychoanalytic therapy was developing in relation to the condition called hysteria, the novel explores its relationship with another condition, the existential despair of Nineteenth Century Western Civilization. This condition of despair had already been identified and discussed in the writings of Kierkegaard and Dostoyevsky and in the poems of Hoelderlin. Beginning with his book Human, All-to-Human, Nietzsche, too, was exploring existential despair. The novel's basic formula, then, brings together the future doctor of hysteria with the future doctor of despair. As it turns out, however, the doctor of hysteria is suffering from despair as well. The formula allows Yalom to ask a number of extremely interesting questions about the relevance of existential philosophy to psychoanalysis and the place of science in human life. These questions are posed and answers are suggested in a series of hospital interviews between Breuer and Nietzsche, in which Breuer has devised to trick Nietzsche into believing that he, Nietzsche, is treating Breuer's despair. Of course, Breuer discovers little-by-little that his despair is, indeed, something that needs treatment and that Nietzsche's thought is relevant. Doctor and patient become lost in a massive counter-transference phenomenon that, itself, has interesting historical links with the period.
What are the questions? And are there answers? The chief symptom of Breuer's despair is his intruding possession with his former patient Bertha. Nietzsche, on the other hand, never accepts the symptom's importance and asks Breuer to look beyond it. At the level of plot, this causes a funny turn-of-events because Breuer intentionally chose this possession in order to create a path for his hidden agenda, to lead Nietzsche into revealing his own obsession with Lou Salom‚. Nietzsche, instead, focuses on the question of realities that lie behind symptoms. This is the natural home of philosophy and, of course, it is the future home of psychoanalysis. Breuer's cure must lie in discovering the true nature of despair --- his despair and collective human despair.
As the discussions deepen, it becomes clear that moral choice is really at issue here. Despair lies, ultimately, in the recognition that one has made poor choices, perhaps never even chosen at all. Together, Nietzsche and Breuer surgically examine Breuer's life and the manifold ways in which it has been orchestrated by archetypal themes and other's needs. Bertha-as-symptom plays a role of suggesting choice. But life-with-Bertha is unimportant, perhaps even unreal; what is important is grasping the necessity of choice.
And on what grounds does one really choose one's life? Nietzsche directs Breuer's scrutiny toward his inner self. What really drives him? It is a difficult question to answer. No sooner does Breuer offer up a program but Nietzsche cuts his way underneath to demonstrate the program's "bad faith," the ways that it mediates and orchestrates control by external and inauthentic factors. Nietzsche's dissection of values seems unending.
Is there any way to turn such nihilism around in its tracks, to give meaning to "the sacred, Yes" that Nietzsche himself has posited toward life? Nietzsche reveals one of the leading messages of his forthcoming opus,Zarathustra. The concept of eternal recurrence presents us with a mortal challenge --- embrace life because you are stuck with it for eternity. Therefore, choose only what you can embrace fro eternity. Take choice seriously. Doesn't that just mean take life seriously? Perhaps in the sphere of psychoanalytic therapy this becomes the challenge that we should get beyond mere symptoms or otherwise suffer the fate of a reckless and incoherent life of symptoms alone, a life that wil surely destroy us within its extravagances.
The end of this book seems somewhat counter-productive. Breuer has Freud hypnotize him and lead him on a task of discovery, attempting to embrace his interpretations of Nietzsche's thinking. The exercise mistakes Nietzsche's thought but, nevertheless, results in a miraculous cure of Breuer's despair. Unfortunately, Yalom doesn't take the time to work through this conflict; that is, what "task" would Nietzsche have actually wanted Breuer to work his way through. Instead, the novel's action moves swiftly to a close with a culminating chapter in which Breuer and Nietzsche confide their hidden agendas. Everyone comes out honest, in the end, and the two friends part with a general sense that the philosophy of despair and the psychoanalysis of hysteria move on common ground.