Aim, Object and Fictional Strategy: Freud and Case Study Narrative

Abstract

Here in his prefatory remarks to ‘Fragment of an Analysis of a Case of Hysteria’, Freud expresses an anxiety about the reception and use of the case study. It may be easy to overlook the most basic condition of this anxiety—that the case study can be read as novelistic. That is, it contains development of character, a particular structure of narrative, invitations to reader identification and signal components of content common to popular fictions contemporary with it. One of these was its central female character, who is the subject of diseased fantasies and unpleasant family secrets. Freud’s worry that local readers might recognise the disguised patient is mediated by a strict opposition of use, the novelistic/popular and the medical/scientific. The psychoanalytic case study appeared at the fin de siècle amid the fictional structure of feeling elucidated in the previous chapters—one which built a sense of self around a suspended object-relation radically fractured through gender. In the fin de siècle novel, the romance plot and a continued deployment of the structure of aesthetic relation figure a mechanism for problems of will and desire, of the self in the social world.

I am aware that—in this city at least—there are many physicians who (revolting though it may seem) choose to read a case history of this kind not as a contribution to the psychopathology of the neuroses, but as a roman a clef designed for their private delectation.

(Freud, 1905, p. 9)