A compromise between illness and health by Sigmund Freud


Vienna, 16. 4. 1900. IX. Berggasse 19.

Dr. Sigm. Freud,
Lecturer in Nervous Diseases in the University.

My dear Wilhelm,

Herewith greetings, as arranged, from the land of sunshine.
Once more I have failed to get there….

E. at last concluded his career as a patient by coming to supper in my house. His riddle is almost completely solved, he feels extremely well, and his nature is entirely changed; for the moment a residue of symptoms remains. I am beginning to see that the apparent endlessness of the treatment is something of an inherent feature and is connected with the transference.*

I am hoping

that this residue will not detract from the practical success. I could have continued the treatment if I had wanted to, but it dawned on me that such prolongation is a compromise between illness and health which patients themselves desire, and that the physician must therefore not lend himself to it. I am not in the least worried by the asymptotic conclusion of the treatment; it is more a disappointment to outsiders than any thing else. In any case. I shall keep my eye on the man. As he had to participate in all my technical and theoretical mistakes, I think that another similar case would take only half the time.
May the Lord send it soon…. At the moment I feel some stirrings towards synthesis, I am holding them down.

Otherwise Vienna is Vienna, that is to say extremely revolting. If I closed with “Next Easter in Rome”, I should feel like a pious Jew.**

So until we meet in the summer or autumn, in Berlin or where you will,
Cordial greetings,

Your Sigm.

Mon cher Wilhelm,

Je te salue, comme prévu, du pays du soleil.
Une fois de plus, je n’ai pas réussi à m’y rendre. ….

E. a enfin terminé sa carrière de malade en venant souper chez moi. Son énigme est presque entièrement résolue, il se sent extrêmement bien, et sa nature est entièrement changée ; pour le moment, il reste un résidu de symptômes. Je commence à voir que l’apparente infinité du traitement est une caractéristique inhérente et qu’elle est liée au transfert.*


que ce résidu ne nuira pas au succès pratique. J’aurais pu continuer le traitement si je l’avais voulu, mais je me suis rendu compte qu’une telle prolongation est un compromis entre la maladie et la santé que les patients eux-mêmes désirent, et que le médecin ne doit donc pas s’y prêter. La conclusion asymptotique du traitement ne m’inquiète pas le moins du monde ; c’est plus une déception pour les étrangers que toute autre chose. En tout cas. Je garderai un œil sur l’homme. Comme il a dû participer à toutes mes erreurs techniques et théoriques, je pense qu’un autre cas similaire ne prendrait que la moitié du temps.
Que le Seigneur l’envoie bientôt…. En ce moment, je ressens quelques élans vers la synthèse, je les retiens.

Sinon, Vienne est Vienne, c’est-à-dire extrêmement révoltante. Si je terminais par “Pâques prochain à Rome”, je me sentirais comme un juif pieux.

Donc, jusqu’à ce que nous nous rencontrions en été ou en automne, à Berlin ou où vous voulez,

* This is the first insight into the role of transference in psycho-analytic therapy. Freud had been familiar with the difficulties arising from transference pheno mena ever since the days when he still practised hypnotic therapy (see An Auto biographical Study, 1925 d). We know from the Fragment of an Analysis of a Case of Hysteria (1905 e), which gives us information about Freud’s technique during the period when this letter was written, that he had not yet learned technically how to overcome the transference. Freud for the first time developed the theory of the transference in the postscript to that paper. The lack of a complete under standing of the dynamics of the transference accounts for the personal contacts with several of his patients which Freud was having at about this time.

** [At the end of the Passover service orthodox Jews wish each other: “Next year in Jerusalem!”]

Letter from Sigmund Freud to Wilhelm Fliess of the 16th april 1900.

Sigmund Freud, Marie Bonaparte, The Origins of Psychoanalysis: Letters to Wilhelm Fliess, Drafts and Notes, 1887-1902, Basic Books, New-York, 1954

Sigmund Freud, La naissance de la psychanalyse, PUF, Paris, 2009