When Nietzsche Wept by Irvin D. Yalom
My rating: 4 of 5 stars

The Doctor of Despair

The fin de siecle Viennese satirist, Karl Kraus, took a dim view of the emerging field of psychiatry: “Psychoanalysis is that mental illness for which it regards itself as therapy.” And, somewhat surprisingly, this is the main theme of this novel by an eminent psychotherapist. Psychiatry is indeed a field of Byzantine relationships. Perhaps that is Yalom’s point.

Friedrich Nietzsche and Josef Breuer never really met; but Yalom puts them in an intense relationship of mutual therapy, each believing that the other is the patient and he the therapist. Breuer, Freud’s mentor and the discoverer of the psychoanalytic ‘talking cure’, is acutely depressed; Nietzsche, the as yet unknown philosopher, suffers from debilitating migraines.

Nietzsche seeks to teach Breuer about ‘freedom’ by which he means a sort of resignation to one’s fate. Breuer sees his task as revealing Nietzsche’s emotional reality to himself. Neither succeeds. But in their failures they accomplish remarkable psychological things with themselves by trying to help the other. Breuer frees himself from his obsession with a patient and Nietzsche learns how to reduce the severity of his migraines.

It appears, then, that Karl Kraus was on to something important as far as Yalom is concerned. Kraus summarised the situation thus: “My unconscious knows more about the consciousness of the psychologist than his consciousness knows about my unconscious.” Psychoanalysis is Byzantine indeed. Does anyone really understand its mechanism and effects? Yalom seems to doubt it.

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