Agony of Emma Eckstein, the First Female Psychoanalyst

Emma Eckstein was 'one of Sigmund Freud's most important patients and, for a short period of time around 1897, became a psychoanalyst herself': she has indeed been described as 'the first woman analyst....Emma Eckstein became both colleague and patient' for Freud. She came from a prominent socialist family and was active in the Viennese women's movement.

An exploration into the messy baby steps of psychoanalysis



Eckstein underwent disastrous nasal surgery, undertaken by Freud's friend and confidant, Wilhelm Fliess. 

When she was 27, she came to Freud seeking treatment for vague symptoms including stomach ailments and slight depression related to menstruation. Freud diagnosed Eckstein as suffering from trauma, secondary to childhood sexual abuse. Freud suspected, in addition, a "nasal reflex neurosis," a condition popularized by Fliess, an ear, nose and throat specialist. Fliess had been treating the nasal reflex neurosis in his own patients with local anesthesia, specifically cocaine, and found that the treatment yielded positive results, in that his patients became less depressed. Fliess conjectured that if temporary cauterization was temporarily useful, perhaps surgery would yield more permanent results. He began operating on the noses of patients he diagnosed with the disorder, including Eckstein and even Freud himself.

Eckstein's surgery was a disaster. She suffered from terrible infections for some time, and profuse bleeding. Freud called in a specialist who removed a mass of surgical gauze that Fleiss had not removed. Eckstein's nasal passages were so damaged that she was left permanently disfigured. Freud initially attributed this damage to the surgery, but later, as an attempt to reassure his friend that he shouldn't blame himself, Freud reiterated his belief that the initial nasal symptoms had been due to hysteria. The incident provided source material for Freud's dream of "Irma's injection".




In 1904, 'Eckstein had published a small book on the sexual education of children', although in it 'she does not mention Freud'. A few years later, however, in his open letter on "The Sexual Enlightenment of Children", Freud refers to her book approvingly, highlighting 'the charming letter of explanation which a certain Frau Emma Eckstein quotes as having been written by her to her son when he was about ten years old'.

Ernest Jones placed her with such figures as Lou Andreas-Salomé and Joan Riviere as a 'type of woman, of a more intellectual and perhaps masculine cast...[who] played a part in his life, accessory to his male friends though of a finer calibre'.

Emma Eckstein (1895)
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