Submitted by Zvi Lothane, M. D., Feb 4, 2007 08:04

I have not read the book, and if the review is accurate, then Peter Kramer's book is the latest in the genre: bash the man, then bash his contribution. The assertion, that just from a few cases Freud theorized that hysteria is caused by child abuse, is both false and tendentious. Freud got the theory of traumatic hysteria, of traumatic neurosis, from many such cases studied by his Paris teacher Charcot. Trauma is ubiquitous, most clearly seen in acute and chronic posttraumatic stress disorders seen in the practices of psychiatrists and psychoanalysts. What Freud elaborated subsequently was the inner, psychological, and unsconscious dynamics of the hysterical reaction: the role of fantasy, of identification, imitation, dependency conflicts, and anger. The narrow formula of Dworking is just a red herring.

As to the prevalence of child abuse, there is now a very sizable non-psychoanalytic literature on the subject, the writings of Philippe Aries and Lloyd de Mause. Child abuse was also dealt with in world literature, e.g., the molestation episode in Dostoievskii's Crime and Punishcment and Stavrogin's Confession in The Possessed.

Zvi Lothane

Associate Professor of Psychiatry

Mount Sinai School of Medidine

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