Abstract
Integer vitae scelererisque purus [upright in life—free from wickedness]
Karl Abraham’s life and work stand as a seminal chapter in the early history of psychoanalysis. He was closely connected to other important figures in our field, whose lives intersected with his: patients, colleagues, and collaborators, as well as competitors vis-à-vis Freud and occasionally outright adversaries. His pioneering work influenced the lives and work of analysts including Melanie Klein, Sándor Radó, Alix and James Strachey, Karen Horney, the Glover brothers, Helene and Felix Deutsch, Bertram Lewin (Thompson 2010), and Edith Jacobson. Given the contemporary interest in building connections between Kleinians, British Middle School followers, object relations theorists, and ego psychologists, we can trace commonalities back to the analyst-teacher Abraham, as well as divergences as they unfolded.
Before this biography of Abraham, little was available in English. We had the oft-quoted obituary by Ernest Jones (1926), a chapter by Martin Grotjahn in the volume Psychoanalytic Pioneers (1966), an incomplete biographical sketch by Abraham’s daughter, the psychoanalyst Hilde Abraham (1974), Abraham’s Clinical Papers and Essays on Psychoanalysis (1955), the Letters of Sigmund Freud and Karl Abraham (Abraham and Reud 1965), The Complete Correspondence of Sigmund Freud and Karl Abraham (Falzeder 2002), and a handful of papers on Abraham. One of those papers is Serge Lebovici’s presidential address to the International Psychoanalytical Association in Jerusalem in 1977 (Lebovici 1978) on the centenary of Abraham’s birth. That paper praises his contributions to theory and practice and reminded the audience of Abraham’s leadership role in the IPA. But that address was given almost forty years ago.
Anna Bentinck van Schoonheten, in preparing this biography of Abraham, was able to access sources previously unavailable, especially the complete letters of Abraham to Freud (see a review of the English translation by Axel Hoffer [2004]). These letters were apparently buried among the papers of the Eitingon estate in Israel. Van Schoonheten also consulted primary and secondary sources available only in German (e.g., Cremerius 1999). Her portrayal of Abraham and his world is presented in chronological sequence, as she carefully delineates factual details apart from her dynamic speculations. She builds a portrait of Abraham the person and family man, interwoven with his writings and professional activities. As she provides specific details about all that is known about Abraham, she gives readers the opportunity to make their own conclusions alongside the author.
Abraham’s parents, Orthodox Jews from an old Bremen family, were first cousins. His older brother Max was sickly as a child. Supposedly because of Max’s frailty, both brothers were isolated from other children and forbidden strenuous physical exercise. Feeling confined by these restrictions, Abraham later became a lifelong hiker, even when he gradually lost his depth perception, making hiking in the mountains dangerous for him. A driven man, both physically and in his work, he would push himself to the limit of his capacities. For instance, he insisted on running the meeting of the International Psychoanalytical Association in the fall of 1925, while still recovering from a severe illness. This overexertion may have triggered complications leading to his death soon thereafter.
A traumatic event occurred when Abraham was a toddler: his mother fell down a flight of stairs, precipitating a miscarriage late in her pregnancy with a baby girl. She lost the baby, having lost her father and a sister around the same time. These events triggered a severe depression. From early childhood onward, Abraham remained solicitous of his mother for the rest of her life. Van Schoonheten attributes the depth of Abraham’s attachment to a good early experience with his mother, after which her sudden emotional unavailability in his toddlerhood must have evoked feelings of disappointment and rage toward her. In reaction to these unacceptable feelings, he became even more solicitous. In later life, though Abraham was known for his even temper by family, colleagues, and patients, he remained given to rare instances of sudden rage that passed quickly.
To illustrate his enviable traits, the young Abraham was a brilliant student and an accomplished linguist. By the age of fifteen he had written a linguistic treatise on the Abiponish language of what is now Paraguay and collected the word father in over three hundred languages. Out of practicality, he studied medicine and psychiatry, and during WWI his work as a psychiatrist and surgeon broadened his clinical experience. Indeed, he was one of the first analysts to write about wartime psychological trauma from the psychoanalytic point of view.
To show the depth of his reaction to his mother’s depression during his infancy, van Schoonheten relates an incident during Abraham’s young married life, a clear example of revival of the old trauma with his mother. Abraham, who was never analyzed, took his very pregnant wife on a moonlight hike. When the moon set, the trail became pitch dark and Hilda had to crawl down from the mountain on hands and knees to avoid injury, only narrowly escaping her mother-in-law’s fate of losing a baby in a fall. The incident suggests a dramatic, unconscious symptomatic enactment by Abraham of his early childhood trauma, in which he turned passive into active and showed a compulsion to repeat. Although Jones considered Abraham the healthiest of the first generation of analysts, this story about his reaction to his wife’s pregnancy features a concerning neurotic symptom. Not only this enactment, but filial guilt, characterized Abraham’s youth. When he studied medicine abroad, it became impossible to observe Orthodox religious practices, for which he felt guilty in relation to his beloved parents. His marriage to Hedwig solidified this change, as hers was a decidedly secular background. Later, when Abraham begun to practice psychoanalysis, he kept a photograph of his parents on the desk in his office and looked at it often. He wrote to Freud that he considered this a symptomatic act. He experienced this looking, van Schoonheten speculates, as a gesture of seeking approval and forgiveness from his parents for abandoning their faith and turning to psychoanalysis.
But turning to psychoanalysis did not free him from deep pain at the loss of his father. Abraham was a family man. By all accounts, his marriage was a happy partnership, notwithstanding the incident during Hilda’s first pregnancy. He was attentive to his children as well. But when he lost his father in 1915, Abraham turned gray overnight. He wrote about this as a personal example illustrating the depth of the process of introjection of the lost object in situations of mourning (Abraham 1924). Eventually his hair color returned.
These personal accounts connect well to van Schoonheten’s detailing of Abraham’s theoretical contributions to the field, including those antedating Freud’s or differing from them. We learn that Abraham built his contributions piecemeal, based on empirical experience with many clinical cases. In a seminal contribution, Abraham was the first analyst to emphasize the importance of the early bond with the mother. He connected the infant’s rage upon experiencing emotional abandonment by the mother (e.g., from sudden maternal depression), in contrast to a previously gratifying mother-infant bond, with vulnerability to depression in adulthood. Specifically, Abraham was the first analyst to understand the revival of early infantile rage during psychoanalysis as a common root of negative transference. He understood this rage, accepted it, and worked with it. While Abraham and Freud worked along similar lines, Abraham emphasized more the oral rage and ambivalence toward the primary object, whereas Freud focused more on identification with the lost object (Freud 1926b; Radó 1928).
A case of applied psychoanalysis led to his illustrating the dynamics of manic-depressive mood swings—a key contribution to the field. After delays, he completed a monograph on Segantini (Abraham1911), a well-known Swiss landscape painter of the era. Van Schoonheten examines the personal dynamics of Abraham as they relate to his work on the painter. especially given that Abraham wrote to Freud that the Segantini paper was delayed for personal reasons, implying that he experienced emotional turmoil stirred up by his subject. Giovanni Segantini (1858–1899 ) had a severely traumatic childhood, his mother having died after a lengthy illness when the painter was five, and his father abandoning him shortly afterward. He suffered from extreme mood swings. Segantini’s paintings depict idealized mother-infant pairs, as well as haunting, evil witch-mother type figures. In what seems to be displacement from his mother love, Segantini worshiped nature and the high Alps with an intense passion usually reserved for a lover. Abraham’s monograph follows Segantini’s mood fluctuations as reflected in the themes of his paintings and as related to his fantasy relationship with his lost mother. Segantini’s intense connection with nature expressed a longing to reunite in death with his lost mother, even while denying the existence of death.
Abraham’s subtle exploration of Segantini’s moods led to a model for the dynamics of manic-depressive mood fluctuations in relation to feelings about the yearned-for idealized mother image and the dark terror of hatred when the idealization collapses (see May 2001). Abraham had an affinity for the plight of Segantini, and van Schoonheten suggests that he identified with certain aspects of his subject: Abraham too loved the outdoors, and like Segantini specifically sought to climb the high Alps. Abraham had also suffered a sudden loss of his mother’s attention as a toddler, when his mother became depressed. Although Abraham was regarded as staunchly optimistic, van Schoonheten hypothesizes the presence of a well-concealed but definitely depressive undercurrent that she connects to this disruption in the mother-son bond.
Although van Schoonheten does not explicitly draw this conclusion, the poignant parallel in the two men’s lives may indicate an underlying death wish beneath an optimistic facade, as both men were perhaps complicit in their own early deaths. Segantini drove himself to work when ill and feverish, in the throes of an intense creative outburst, and then died rather suddenly in a hut on a high mountaintop. Abraham too drove himself intensely, and as he could not let himself convalesce fully before resuming his IPA responsibilities, that drive may have tragically contributed to his death.
Because Abraham was an empirical observer, many of his reports ring true to this day, even if one might express them in more contemporary language. For instance, taken in isolation, his paper on the female castration complex (Abraham 1920) might be considered outdated, even sexist. Yet I find convincing his description of aspects of his women patients’ reaction to their perceived differences from men, and of how those resentments interfered with intimacy. Abraham writes with equally close attention about men’s difficulties with intimacy, as in his paper on premature ejaculation (Abraham 1917).
While in research conducted independently of Freud, Abraham investigated infantile rage as a root of negative transference and manic-depressive mood swings, he also benefited from his exchanges with Freud. Van Schoonheten examines in detail the nuances of Abraham’s correspondence and other contacts with Freud. The volume shows the character of both men framed in the context of the vicissitudes each faced at the time.
Examples from their correspondence illustrate Abraham’s and Freud’s mutual respect and admiration. However, when Freud became unfairly angry with Abraham on a few notable occasions, Abraham stood his ground. That was brave of him, knowing that Freud could turn on his favorites and that his reputation and livelihood depended in large measure on getting along with Freud. Abraham’s independence, and his ability to express it tactfully, can be seen both in theoretical discussions and in claims regarding priority, as well as in their disagreements about colleagues like Jung and Rank.
There are a number of reasons that Abraham’s reputation may have suffered relative to other early analysts. First was the fierce rivalry among Freud’s disciples, to which Freud inadvertently contributed. For instance, in 1907–1908 he asked Jung and Abraham to write on the same topic: libido theory in relation to dementia praecox. Once feathers were ruffled sufficiently, Freud let his disciples fight it out among themselves. Eventully he took Jung’s side against Abraham, hoping that Jung, one of the few non-Jewish leaders in the field, would rescue psychoanalysis from the moniker “the Jewish profession.” On another occasion Freud, feeling protective of Rank, showed him a private letter from Abraham critical both of Rank’s The Trauma of Birth (1924) and of Ferenczi and Rank’s The Development of Psychoanalysis (1924). The letter of course enraged Rank, and though Freud later came to agree with Abraham and others critical of Rank, the damage had been done. At the time, Freud had accused Abraham of being jealous of Rank, one of several criticisms he would later retract.
Another challenge involved the wealthy and influential Max Eitingon, who curried favor with the Freud family. Eitingon, a benefactor to psychoanalysis as the financial backer of the first free psychoanalytic clinic in Berlin, seldom missed an opportunity to sideline Abraham, the brilliant scholar, teacher, and clinician. This was damaging to Abraham and to his posthumous reputation.
Abraham’s legacy also lies in his analysands and his students. Van Schoonheten describes how Karen Horney, one of his early analysands, and Helene Deutsch were both helped in their analyses with Abraham for symptoms of depression. Deutsch reportedly was helped by Abraham more than by Freud (personal communication, Nellie Thompson).
Van Schoonheten, addressing Abraham’s formative effect on Melanie Klein, speculates that Klein gave more credit to Freud than to Abraham partly because of Freud’s renown. Still, Klein dedicated her first book to Abraham and Ferenczi (Klein 1932). She in fact was in analysis with Abraham at the time of his rather precipitous decline and death. The author suggests that in her state of acute grief Klein could not clearly separate her ideas from those of her analyst. For instance, Abraham’s conviction regarding an innate early aggression, dating to the second oral stage of biting, bears a similarity with Klein’s paranoid-schizoid position. Perhaps Klein incorporated Abraham’s ideas unconsciously as a way of dealing with the loss of her analyst. As both Abraham and Klein were focused on the early emotional life of infants, it may be valuable to trace more closely the influence of Abraham on Klein. This biography and Abraham’s contributions, then, should be of particular interest to students of Melanie Klein.
Jones’s 1926 obituary of Abraham gives a comprehensive summary of the latter’s contributions to psychoanalytic theory and practice, as well as his organizational contributions. Van Schoonheten describes these chronologically as they unfolded in the context of his everyday professional and personal life. She also writes about Abraham’s friendship with Wilhelm Fliess, Freud’s onetime intimate. Van Schoonheten’s conclusion is that Abraham’s staunch image mostly holds up to the close scrutiny of her research. She sees him indeed as a admirable character, albeit overly idealized by Jones, with some small chinks in his armor. One was that his optimism was at times expressed at the cost of diminished empathy for those close to him—likely he was fighting off an underlying core of depression, which he hid from the world and possibly from himself. She also traces the roots of some unfairly negative appraisals of Abraham as jealous and overcritical of others, starting with Rank, including Eitingon’s eagerness to take Abraham’s place.
Abraham remains an inspiring individual, and a psychoanalyst worth emulating. Though keenly interested in the earliest stages of development, he never neglected the later transformations of sexuality, including the oedipus complex. Indeed, Abraham could be regarded as a synthesizer of oedipal and preoedipal conflicts. Because his life was cut short, Abraham was unable to elaborate this synthesis.
Reading the von Schoonheten biography inspired me to reacquaint myself with Abraham’s writings and to appreciate their current clinical relevance. I was impressed by the breadth of his contributions, and especially impressed by his writings on the dynamics of depression.