[Special Feature: Infectious Diseases in History] Freud and the Spanish Flu

2020/11/05

The global pandemic of COVID-19 is often compared to the global outbreak of the Spanish flu about 100 years ago. The Spanish flu is the common name for a new type of influenza that originated in the United States and Europe around March 1918 and spread worldwide. At the time, the virus had not been identified and was treated as an unknown viral infection. Consequently, infection control measures included patient isolation, behavioral restrictions for contacts, personal hygiene, disinfection, postponement of gatherings, and the wearing of masks. These measures are almost identical to those we are taking against COVID-19 today. The difference is that in the Spanish flu, 99% of deaths occurred in people under the age of 65, with the highest number of fatalities among young adults aged 15 to 35. While the cause is not certain, it is not difficult to imagine that this was partly because the Spanish flu pandemic began in the midst of World War I and caused many infections on the battlefield.

However, in a place far removed from the battlefield, Sophie, the beloved daughter of Freud—the founder of psychoanalytic theory (and therapy)—died of the Spanish flu at the young age of 26. This occurred on January 25, 1920. According to "The Life and Work of Sigmund Freud," a biography written by Freud's closest confidant, Ernest Jones, her death was a bolt from the blue for Freud and a major psychological blow. In a letter to his associate Eitingon, he reportedly wrote, "(Sophie's death) has paralyzed me to the point where I do not know what to say."

In the summer of the same year, Freud completed a paper titled "Beyond the Pleasure Principle." This paper was a departure from his previous works based on clinical experience, being more speculative and philosophical. In it, he mentioned and discussed the "death drive" for the first time.

According to Jones, Freud made a strange request to Eitingon, asking him to "be a witness that (this paper) was already half-finished when Sophie was still in the best of health." On the other hand, it is also said that the first time he mentioned the "death drive" to Eitingon was on February 20, 1920 (James Strachey, "The Standard Edition of the Complete Psychological Works of Sigmund Freud"). Furthermore, it appears that the first time Freud mentioned the "death drive" to Jones was two weeks after Sophie's death. Jones stated, "If it were not for the fact that (in a letter two weeks after Sophie died) he accidentally mentioned that he had been writing about the 'death drive' for some time, there might have been a suspicion that his new ideas were a sign of an internal rejection of the influence of his disappointment over losing his daughter."

Even if the "death drive" theory was conceived before Sophie's death, as their testimony suggests, I cannot help but feel that her death had some influence on the construction of that theory. This is because I sense something like a protest against "unreasonable death" in Freud's "death drive" theory.

In the aforementioned paper, Freud fundamentally reformulated his theory of drives. Specifically, he divided drives into two main categories: the "death drive (ego drive)" and the opposing "life drive (sexual drive)."

As a premise for the "death drive," he considered that "living things are derived from inanimate matter," and stated, "If we may assume that living things die and return to inorganic matter for internal reasons, we can only say that the goal of all life is death." He further noted that "the fact that higher animals have a fixed, average lifespan certainly proves death from internal causes."

While some researchers consider this "death drive" to affirm the existence of "aggression directed toward oneself," this is not necessarily the case. This is because Freud believed that the "death drive," also known as the "ego drive," included the "self-preservation instinct." He stated, "The organism wishes to die in its own fashion, and these sentinels of life were originally sentinels in the service of death. Thus, a paradox arises where the living organism resists most violently those actions (dangers) that might help it reach the goal of life via the shortest path (a so-called short circuit)." In other words, the "death drive" attempts a literal life-or-death resistance to protect the self from external threats (dangers). At that time, the Spanish flu that took his beloved daughter's life may have been on Freud's mind.

On the other hand, Freud considered the "life drive (Eros)" to be the drive to pass on traits to the next organism through the joining (reproduction) of organisms. Since it is a drive to maintain "infinite life," so to speak, it stands in opposition to the "death drive."

Psychoanalyst Symington stated, "(American sociologist) Talcott Parsons pointed out that this binding substance (Eros) in Freud's thought is similar to Durkheim's concept of society as an organic unit in which individuals are integrated into the whole organism through a value system with a bonding effect. ... It is likely through Eros that people working in a company or institution have some form of group identity."

In that sense, I feel that Freud's "death drive" theory could be seen as an unconscious voice of protest saying "no" to the group identity of a society that caused and continued the war. Thinking of it this way, Freud's words about having "conceived it before Sophie's death" might also be true.

Furthermore, in the aforementioned paper, Freud hypothesized that the human mind has a "stimulus barrier" to prevent it from being overwhelmed by stimuli from the outside world (emotions caused by stressors). He considered "psychological trauma" to be the breakdown of this stimulus barrier caused by sudden exposure to intense external stimuli (energy) without the anticipation of anxiety. When a large amount of energy flows in from the outside due to such a breakdown, the mind falls into great chaos. In any case, it tries to mobilize internal energy to control (push back) the flood of energy invading from the outside. He thought that as a result, energy that normally floats freely in the mind becomes bound to the single destroyed location and fails to reach other parts of the mind, leading to emotional paralysis or an inability to think. Freud immediately after Sophie's death seems to have been in exactly this state.

By the way, Freud's phrase "dreams are wish-fulfillments" is famous, but in the aforementioned paper, he presented a different view of dreams. This arose while understanding the dreams of patients with war neurosis. They repeatedly reproduced traumatic experiences in their dreams. Regarding this, Freud came to believe that "...since the failure of anxiety to develop was the cause of the traumatic neurosis, these dreams are an attempt to restore control of the stimulus by developing anxiety... following the repetition compulsion..."

Repetition compulsion refers to the tendency to repeatedly experience similar stressful situations due to various motives. In other words, their traumatic dreams were understood as an attempt to repair the "psychological trauma" by activating the defensive mechanism of "anxiety" while repeatedly reproducing the traumatic experience.

The paper "Beyond the Pleasure Principle," completed after Sophie's death, seems to me to be Freud's attempt to approach the "essence of life and death" by gaining understanding from the treatment of people scarred by war, even while carrying the grief of his beloved daughter's death.

Freud used the word "Instinkt (instinct)" for animals and "Trieb (drive)" for humans. However, when translating Freud's works into English, "Trieb" was also translated as "instinct," so some literature in Japan also uses the translation "instinct (honno)." In this article, citations from such literature have been unified to "drive (yokudo)."

Infectious Disease Surveillance Center, National Institute of Infectious Diseases: Q&A on Influenza Pandemics.

Ernest Jones, "The Life and Work of Sigmund Freud" (Translated by Yasuhiko Taketomo and Haruhiko Fujii), Kinokuniya Shoten, 1982

Sigmund Freud, "Beyond the Pleasure Principle" in "Collected Works of Freud" Vol. 6 (Translated by Keigo Okonogi et al.), Jimbun Shoin, 1970

James Strachey, "The Standard Edition of the Complete Psychological Works of Sigmund Freud" (Supervised and edited by Osamu Kitayama), Jimbun Shoin, 2005

Laplanche / Pontalis, "The Language of Psychoanalysis" (Supervised translation by Jin Murakami), Misuzu Shobo, 1977

Neville Symington, "The Analytic Experience: For the Clinics" (Supervised translation by Yoshihiro Narita), Sogensha, 2006