Who was Emma Eckstein and what contributions did she make to psychoanalysis?

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Emma Eckstein could very well serve as a study in the bizarre, tragic, and surprisingly shocking. Her name is often a source of dark humor for it involves the intellectual reputation of Sigmund Freud with mundane stamps of life: sex, an overactive nose, cocaine...and the women's movement.  One of the...

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Emma Eckstein could very well serve as a study in the bizarre, tragic, and surprisingly shocking. Her name is often a source of dark humor for it involves the intellectual reputation of Sigmund Freud with mundane stamps of life: sex, an overactive nose, cocaine...and the women's movement.  One of the historical vestiges still preserved to this day is a letter from Freud, who was Emma's therapist to Emma's nose surgeon Wilhem Fliess. The title, "Emma's Nose", sort of takes away in jest what the woman certainly must have suffered, however, is one of those historical inevitable moments where someone's misgivings tend to produce both sympathy and a bit of comic relief in those who read it.

Emma was born in 1865. She was affluent, which means that she must have been kept abreast about the latest trends in the booming field of behavior. As a woman who was suffering from depression related to her menses, she also complained to deep anxiety and frequent nosebleeds. Freud, as an up and coming therapist believed, at that time, that all of Emma's symptoms were merely imaginary and caused by inner causes, mainly related to sexual repression or over-indulgence. In a very unfortunate juncture, Freud calls on his friend Wilhem, a doctor with his own ideas. One of these ideas was that the nose was a whisperer for sexual malfunctions. He also treated his patients with cocaine and claimed that his operations were a success. Hence, in his opinion, any nosebleed was a result of some form of sexual malfunction, and it should be referred to as nasal reflex neurosis. In Wilhem's idea, this neurosis was caused by masturbation on Emma's part.

Any operation performed under a crazy idea, with no real need, and using no antiseptics would bring Hades upon any patient. This is what happened to Emma, who had terrible reactions to this unnecessary operation of the nose. Surprisingly, Emma remained faithful to Freud, even recommending one of her nephews to him for therapy. Emma had relapses so bad that she eventually died bedridden, perhaps of some form of cancer. Sadly for the annals of history, Freud continuously blamed Emma for her own misgivings and defended staunchly the participation of Wilhem in the operation. Moreover, Freud declared Emma his most successful case, although he dropped her as a patient for her having gone to another doctor for a second opinion, which was the doctor who opted to give her a hysterectomy. Nevertheless, the legacy of Emma is that is showed one side of Freud that the letters that were exchanged with Wilhem allows us to see: any clinician, when involved in a "fad" can cause great harm no matter how good the intentions are. Moreover, it warns the world against hip treatments and modern alternative cures that have not been sufficiently tested. Perhaps Emma's biggest contribution to psychoanalysis, which she herself became a psychoanalyst in her own right, is that it has the power to convince many that they are doing the right thing, even when they are not. Could this have been a case of a mesmerized patient, or Emma's own dysfunctional self seeking for some form of control. Could it be that psychoanalysis provided her such control, even when it involved a needless operation? That is the question that many ask to this day.

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