When Nietzsche Wept by Irvin Yalom

I recently wrote a very favorable review of the most recent novel by Irvin Yalom, The Spinoza Problem, which was written in 2012 and is probably the best book that I read in 2014, fiction or nonfiction. When Nietzsche Wept was written 20 years earlier. The book may not play to as wide as audience as his latest novel, but, as a psychiatrist and psychoanalyst, I loved this book too. This book is the only one of Yalom’s which was made into movie, in 2007.

The story is one of a fictional encounter between Josef Breuer and Friedrich Nietzsche in 1882. Breuer was an eminent Viennese physician in the 1870s and 1880s, and was a mentor to Sigmund Freud. Like Freud, Breuer’s further rise in academic medicine was blocked because he was a Jew in a time of rising anti-Semitism. Although Breuer discovered the “talking cure” which led to Freud’s creation of psychoanalysis, he was mostly a neurologist. The concept of the unconscious was not yet well understood, and no one had yet talked about issues such as transference, or as was so important in this book, countertransference.

Nietzsche was a German philosopher known for nihilism and the phrase “God is dead” (philosophy being only one of his many talents), was ill for much of his life until his early death in 1900 at the age of 55. In the book, as proposed to Breuer by a beautiful Russian woman, Lou Salome, even though Nietzsche could not know of her behind-the-scenes involvement, Breuer undertook the treatment of Nietzsche for both his horrendous migraines and his unacknowledged despair. Meanwhile Breuer was tormented by his own obsessional love for a patient, Bertha Pappenheim, who as the result of Breuer’s papers about his treatment of her, became the famous Anna O. Yalom paralleled the struggle that Nietzsche had with his thoughts and feelings toward Lou Salome while Breuer had similar struggles with Bertha Pappenheim. In an attempt to lure the resistant Nietzsche into treatment, Breuer violated the boundaries of the doctor-patient relationship when Breuer realized that Nietzsche could help him with his own obsessions. Yalom writes of an intense psychic intimacy between doctor and patient. Written by a master clinician in today’s world, the treatment arrangement by Breuer was wildly unconventional by the standards of 1882 and would certainly be grounds for malpractice in current times.

I loved the brilliant and emotive dialogue between the two principals, and meanwhile, I got to learn more about Nietzsche. This work of historical fiction is not an easy and quick read, but the story of the mutual therapy between Breuer and Nietzsche was incredible. If you’re a student of psychology, then read this book.

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