Behavior: Freud and Death

It was Sept. 21, 1939. Taking the hand of the physician at his bedside, Sigmund Freud said, “My dear Schur, you certainly remember our first talk. You promised me then not to forsake me when my time comes. Now it is nothing but torture and makes no sense any more.” Schur reassured his patient that he had not forgotten. “When he was again in agony, I gave him a hypodermic of two centigrams of morphine. He soon felt relief and fell into a peaceful sleep. I repeated this dose after about twelve hours. He lapsed into a coma and did not wake up again.”

Thus the death of the founder of psychoanalysis is recalled by his physician Max Schur in a new book, Freud: Living and Dying (International Universities Press; $20), completed just before Schur’s own death in 1969. Addressed to both laymen and professionals, the book is at the same time a portrait of Freud’s last 16 years, when he was waging a losing battle with cancer, and a study of his views on death as they developed throughout his life.

Freud was a man unusually preoccupied with death. His concern stemmed partly from the painful heart attacks he suffered when he was still in his 30s. The ailment, never definitively diagnosed, was the cause of continuing anxiety. Indeed, Psychoanalyst Ernest Jones, Freud’s most authoritative biographer, thought that the symptoms themselves were due to “anxiety hysteria,” while Schur believed that Freud may actually have had a coronary thrombosis. Freud was also profoundly affected by the deaths in his own family, beginning with that of his brother Julius when Freud was only 19 months old. When his daughter Sophie died, he spoke of “the monstrous fact of children dying before their parents.” On the death of Sophie’s son at the age of four, he mourned: “Everything has lost its meaning for me.”

Oedipal Conflict. Yet to Freud, a father’s death was always “the most important event, the most poignant loss, of a man’s life.” His own father died when Freud was 40. The complexity of his grief was related to his work at that period: just after his father’s last illness, Freud became aware of the Oedipal conflict and the “ambivalence in man’s relationship to beloved and revered parents.”

Today, thanks to Freud, most people may not be overly shocked when they find themselves harboring occasional death wishes toward their parents. But to Freud the idea was new and guilt-laden. It accounted in part for his obsession with his own death, for he believed that the fear of death is usually the result of guilt feelings. At the same time, it was this kind of theorizing —the treatment of death not as an inner, emotional preoccupation but as an external, scientific problem—that helped him to master his anxiety.

Freud believed that “it is impossible to imagine our own death,” and that “this may even be the secret of heroism.” He also attributed the birth of religion to “illusions projected outward” by those who were living in the face of death. According to Freud, the ambivalence that men still feel at the death of someone close must have been experienced by primitive man. “It was beside the dead body of someone he loved,” wrote Freud, “that he invented spirits, and his sense of guilt at his satisfaction, mingled with his sorrow, turned these newborn spirits into evil demons that had to be dreaded. His persisting memory of the dead became the basis for assuming other forms of existence and gave him the conception of life continuing after apparent death.”

Perhaps the best known of Freud’s theories about death is the concept of a death instinct, which he formulated in 1920. Freud was certain that “the aim of all life is death.” But he also believed that the death wish was balanced by Eros, a loving, positive drive that seeks to preserve life. “Could it be,” Schur asks, “that uncovering a ‘death instinct’ permitted Freud to live with the reality of death?”

If so, the theory of the death instinct must have been especially helpful to Freud after the spring of 1923. On April 25 of that year, he wrote Jones: “I detected two months ago a leucoplastic growth on my jaw and palate which I had removed on the 20th. I was assured of the benignity of the matter. My own diagnosis had been epithelioma”—or cancer. He was right. In all, there were to be 33 operations on his mouth, most done with anesthetics that did not entirely eliminate pain; in one case, the usually stoic Freud interrupted his surgeon, Hans Pichler, with the words, “I cannot take any more.” In 1926, “a ‘typical’ year with no major surgical procedures, just the unceasing attempt to achieve a bare minimum of comfort,” Schur reports, there were 48 office visits to Pichler, one biopsy, two cauterizations of new lesions, and continual experiments to improve three different prostheses.

These devices replaced tissues removed in Freud’s mutilating operations. His once eloquent speech was impaired, and he wrote to a colleague, “My way of eating does not permit any onlookers.” The close fit of the prostheses produced sores and pain, relieved only by aspirin and locally applied analgesics. Freud was opposed to drugs that might cloud his mind.

His ability “to love, to give, to feel stayed with him to the end,” and his creativity endured; in his last years he wrote some of his most significant papers, most of them not noticeably influenced by his illness. An exception was Civilization and Its Discontents. Its tone is profoundly pessimistic, reflecting, Schur says, Freud’s suffering, “which was draining his resources” and “depleting his capacity to enjoy life.” Schur’s belief is reinforced by a letter of Freud’s admitting that “since I myself no longer have much vital energy, the whole world seems to me doomed to destruction.” That feeling never tempted Freud to turn to God. On the contrary, a paper written in 1932 reaffirmed his disbelief in religion and his faith in science because it “takes account of our dependence on the real, external world.” Still very much a part of that world, Freud saw patients in London until a few weeks before he died at 83.

For anyone who suffered as Freud did, Schur observes, the wish to die was bound to be “in a precarious balance” with the wish to live. When the Nazis entered Vienna and prospects for the Freud family to escape appeared dim, his daughter Anna asked whether it might not be better to kill themselves. Freud’s reply: “Why? Because they would like us to?” Eventually the longing to end the struggle became uppermost, but Schur did not see that as defeat. His book ends with words that Freud himself had written many years earlier: “Toward the person who has died we adopt a special attitude: something like admiration for someone who has accomplished a very difficult task.”