Helene Deutsch (1884-1982) was a fantastically successful clinical psychiatrist and psychoanalyst who felt guilty about nothing quite so much as her fantastic success. As she grew older, and her circle of friends began contracting as her own position in the psychoanalytic tradition came increasingly under fire, Deutsch increasingly came to doubt the value of the family sacrifices she had made in the name of her early career even as she knew that, given her early life’s story, she could hardly have chosen other than she did.
The woman who, of all that robust roster of early psychoanalysts, did the most to attempt to reconcile Freudian theory with the actual lived experience and development of women, grew up in circumstances that could not have been more Freudian in scope. Helene Rosenbach was born in 1884 in a far-flung formerly Polish corner of the Austro-Hungarian Empire to a respected lawyer father who looked upon her lovingly as the realization of high intellectual hopes beyond the capacity of her feckless older brother, and a mother who, by Helene’s account, hated everything about her, and would spring into violent rages almost at the sight of her. The dynamic of wanting to please her idealized father through professional achievement, while at the same time wanting to separate herself from the respectable expectations of her mother, drove Deutsch into the arms of medical study in the first instance, and into those of an older married man in the second.
Herman Lieberman (1870-1941) was a socialist-leaning Polish attorney who both devoted all of his waking hours and resources to the cause of workers, and privately despaired of workers’ ability to ever truly raise themselves above their reduced station in life. Some fourteen years Deutsch’s senior, and married, he was the object of her early adolescent fantasies, and formed a romantic attachment with him at the age of sixteen to the undying shame of her mother, a connection that gave Deutsch unique insights into the grey regions between fantasy and action that she would so famously later elucidate in the first volume of her The Psychology of Women.
While frustrating her mother, and breathing in the heady atmosphere of early Austrian socialism and Polish nationalism, young Deutsch had to decide for herself where to apply her intellectual gifts. Her first choice would have been to follow her father into the legal profession, but as a legal education was entirely out of the question for a woman of her place and time, she settled upon medicine, attending the University of Vienna beginning in 1907, and early switching her field of study from pediatrics to psychiatry. For the next four years, she managed balancing her studies with Lieberman’s demands to perform various errands for him in the city, and to meet him surreptitiously in a scattering of safe locations when he had the opportunity to slip away from his professional and family responsibilities. In 1910 she scored an “excellent success” on her first round of medical examinations, thereby convincing her mother that her studies were something more than an act of rebellion, and represented an actual possible career path.
In 1911, she ended her relationship with Lieberman, realizing that he would never leave his wife, and that she deserved something more than the intense but occasional scraps of attention he was capable of giving her. She soon found Lieberman’s antithesis in the form of Felix Deutsch, an emotionally supportive, single, and stable doctor her own age who held out the prospect of a long-term and loving relationship that she craved after a decade of tumultuous life as The Other Woman, but that she would denigrate, as the years passed, as a poor substitute to the flawed but passionate relationship she had given up. They were married in 1912, and as much to escape a Vienna that had so many complicated memories as to deepen her knowledge base of clinical psychiatry, Helene left Felix behind in that city while she went to Munich in 1914 to work with Emil Kraepelin, a foundational figure in the establishment of a scientific psychiatry that had as its underlying premise the biological origin of most psychiatric disorders.
Kraepelin had been, like so many key figures in early psychiatry and psychology, a student of Wilhelm Wundt, and was skeptical of the work of Sigmund Freud, which Helene had been introduced to a few years prior to her arrival at his clinic, and which favorably impressed her. Kraepelin set her on a research project which had as its goal the disproving of one of Freud’s assertions, and on familiarizing herself with the work he was doing studying cases of dementia praecox (what we now call schizophrenia). Initially bursting with enthusiasm at working in a new city, with one of her field’s greatest minds, in an institution that had scientific standards much more rigorous than those prevailing in Vienna, Helene’s notes home to Felix soon expressed disillusionment. Next to the monolithic sureness of Freud, the scientific research process reigning in Munich seemed “fumbling and searching.” If she was to become a great psychiatrist, she felt (for she was not yet contemplating becoming a psychoanalyst), she would need to find a working clinic that brought before her regularly the whole spectrum of psychiatric disorders, in their full diversity and complexity, rather than burying herself in a specialized research institution.
To realize this new ambition, Helene returned to Vienna, where the outbreak of World War I would afford her a unique opportunity to oversee the entire women’s division in the psychiatric clinic of future Nobel Laureate Julius Wagner-Jauregg (1857-1940). Wagner-Jauregg was also not convinced of the validity of Freud’s work, but knew of Deutsch’s growing Freudianism and affably tolerated it, particularly as the personnel drain wrought by the war made un-draftable trained psychiatrists as herself so valuable. Privately, Deutsch’s study of, and belief in, psychoanalysis was growing, as publicly she received plaudits and admiration for her deft and sure handling of a clinical division in wartime, and particularly for her nuanced and sympathetic approach to those suffering psychological damage as a result of their war experiences.
In 1918, Deutsch made the fateful decision to officially join the psychoanalytic movement, becoming a member of the Vienna Psychoanalytic Society and undergoing an analysis with Freud himself (albeit a truncated one) while taking on her first patient, another psychoanalyst by the name of Victor Tausk. It was an unfortunate first case, as she ended up squarely in the middle of the cannonades of jealousy and accusation volleying back and forth between Freud, who was uncomfortable around Tausk and felt that the younger man was trying to steal his ideas, and Tausk, who was desperate for Freud’s approval but also felt the great man had stolen his ideas. Tausk used his sessions to try and talk to Freud through Deutsch, an untenable situation which Freud brought to an end after only three months. Later that year, Tausk committed suicide.
Deutsch’s star, meanwhile, was on the rise. She filled her schedule with psychoanalytic work, and in 1923 left Vienna again to undergo analysis in Berlin with Karl Abraham, remaining there a year while Felix raised their six year old son, Martin (born 1917). Felix had a natural way with children, and his bond with Martin was always a strong one, and a source of both guilt and jealousy for Helene, whose instincts and priorities simply didn’t lie along those lines, as much as she might wish they did. While in Berlin, she carried on a brief affair with Sandor Rado, who brought some of the Lieberman-like zest and dash that she had been missing in the less sexually adept Felix, and wrote Psychoanalysis of the Sexual Functions of Women, the first full length book by a woman psychoanalyst, which was published the following year.
This was not her first published work in the psychoanalytic tradition - three years previously, in 1921, she had written an interesting paper, “On the Pathological Lie,” which investigated people who compulsively lie, even when there is no advantage to themselves in doing so. Rather than the opportunistic lie of the charlatan, the deceptions of the pathological liar she described as creative acts that were either sources of pleasure as instances of spontaneous imaginative play, or sources of defense as the creation of a public alter-ego character that is free of attachments to the subject’s real past traumas. Sexual Functions, however, was the work that put her well and truly on the map, presenting an image of women, psychoanalytically considered, that stayed within the technical confines of Freudian theory, while exploring realities of biology and circumstance thereto neglected by traditional Freudians.
Sexual Functions kept some of Freud’s basic categories about masculine and feminine traits, while quietly passing over others, like penis envy, in order to get at Deutsch’s real interest, which was the question of how women’s biological development shapes their psychological destiny. Given that so many uniquely feminine biological events happen in the course of a woman’s life, she argued, it is natural to assume that they have unique impacts on how women interpret the world around them, engage with it, and defend themselves from it. Like Melanie Klein, she argued that the role of the mother should be given a larger place in psychoanalysis than it had traditionally been in Freud’s more patriarchal scheme. She also looked at the birth event as one that has unique psychological meaning for women that are not fully accessible to men, arguing that a mother’s child is an ego ideal for the mother in a way that it qualitatively can’t be for the father. Further, she was some decades ahead of her time in focusing on menopause not as a tragic boundary and end to normal and healthy biological functioning, but rather as a time of potential rebirth for women, a chance to rewrite the script of their lives and choose exciting new directions unavailable to them before.
Upon her return to Vienna, Deutsch assumed the directorship of the Vienna Training Institute, a position she would retain until her relocation to the United States in 1935. This was an attempt to import to Vienna the successful training regimen for prospective psychoanalysts that had been erected in Berlin. Freud wanted it led by a person with experience in both clinical practice and psychoanalytic theory, and Deutsch, with her time at Kraepelin’s and Wagner-Jauregg’s clinics, was a natural choice for the position. She played a key role in shaping the Institute along minimally invasive lines. While others argued that prospective analysts should have set rules to follow for the situations that they might encounter, Deutsch felt that analysis was a much more creative and artistic process that each individual had to approach on their own terms and with their own strengths, figuring out their own style along the way without too much pressure to fit one particular mold. In 1930 she published Psychoanalysis of the Neuroses as an extension of her Institute work. It was a collection of lectures designed to show, through examples, how different situations that arise in analysis could be observed and interpreted, without laying out strict and monolithic protocols for practice.
As the 1930s dawned, Deutsch’s satisfaction in Vienna waned. The old guard clustering themselves around Freud’s faltering body were engaged in bitter mutual battles for recognition and status, while Freud himself was positioning his daughter Anna as his heir apparent, with responsibilities that gradually crept into Deutsch’s realm of responsibility. Through contacts with the psychoanalytic community in Boston and New York, and her own travels there, Deutsch was inspired by the United States as a land free from the musty tradition and frantic back-biting of Europe generally and Vienna particularly, where somebody of her talents could construct a new and engaging professional life. Against Freud’s wishes, she moved to Boston in 1935, the year after she presented the Vienna Society with her first paper on the “as-if” personality.
Next to The Psychology of Women, Deutsch’s development of the “as-if” character ranks as one of her most enduring achievements. Presented in its final form in “Some Forms of Emotional Disturbance and Their Relationship to Schizophrenia (‘As-If’)” (1942), the As-If individual is characterized by their capacity to act as normally, intelligently, and carefully as a situation requires, but without any actual connection to what they are doing. Such people, due to the lack of an early identification with and internalization of their parents, are prone to changing the structure of their personality on a dime to fit whatever the dominant paradigm around them happens to be, and while performing competently whatever they are given, never perform with genius or inspiration. They are masters of acting As If they are emotionally engaged with, and satisfied by, their actions in life, but no activity, no relationship, is able to do more than glance off their surface as they remake themselves in the image of the strongest personality in the room.
With the success of her As-If paper at her back, and her long experience in analyst training to recommend, her, Helene was an instant hit in Boston psychoanalytical circles, even as Felix never fully found his feet in the new nation that didn’t know what to do with somebody who was half physician and half psychoanalyst. Her greatest achievement of her American years was undoubtedly the two volume The Psychology of Women (1943, 1945), which delved into aspects of women’s lived psychological existences still untapped after nearly a half century of psychoanalytic practice. Eschewing the speculation about the psychological forces shaping children as infants which the public so associated with Freudian theory, Deutsch concentrated on the unique challenges she had seen girls have to overcome as they navigated adolescence on their way to motherhood. One of the most interesting aspects of these volumes was the light they shone on a hitherto entirely neglected aspect of adolescent girls’ development, the role of strong friendship.
As young girls assert themselves to gain independence from their parental figures (and particularly their mothers), friendship takes on a new weight, whereby an adolescent girl is keenly aware of the precise level of connection she has with her best friends, and feels profound pain when she senses any diminutions in those relationships. Through her fantasy life, which can include masochistic elements she must learn to overcome, and through her social life, which provides her with alternate role models she can attach herself to as she attempts to navigate the seas of coming adulthood without the liferaft of her parents’ rejected example, she attempts to establish herself as worthy of adult status and freedom. It is observations like these, of important but hitherto ignored aspects of women’s early lives pulled from her decades of experience with both her own patients and those of the analysts she was training, that gave The Psychology of Women its staying power in the face of attacks (primarily by Karen Horney) that Deutsch did not go far enough in repudiating Freud’s entire approach to gender.
After the Second World War, Deutsch turned increasingly away from her focus on women’s psychology, and produced influential work on narcissism, which she characterized as the result of individuals having experienced a shattering blow to their self-image which compelled them to then place all of their sense of value in how others view them. In 1963, Felix died after years of steady decline that saw him drummed out of the Boston Society as mentally unfit to continue his practice. Deutsch lived on until 1982, publishing her memoirs in 1973 and being elected a Fellow of the American Academy of Arts and Sciences in 1975. For years, her reputation remained largely where Karen Horney had left it - as an important early Freudian whose legacy was tarnished by her unwillingness to split from Freud, but she was in truth much more than that. Disgusted by the in-fighting of the early psychoanalysts, she became an expert in absorbing the best of their thought, and folding into it the fruits of her own keen insights that challenged old conceptions without blowing those challenges into dramatic civil wars, quietly discarding what she didn’t need, while advancing into the unexplored darkness of her predecessors with a sure-footed but understated instinct that moved psychoanalysis forward without breaking it apart.
FURTHER READING: For biographies, Paul Roazen’s Helene Deutsch: A Psychoanalyst’s Life (1985) is your best full-length treatment, though I’ve always thought it was written under some sort of sudden deadline pressure - the beginning is expansive in its treatment of every single detail of Deutsch and Lieberman’s life, but the last forty years of her life, including some of her most important works, are rushed through at a gallop with The Psychology of Women stuffed somewhat unceremoniously into the Epilogue. It’s just odd. Deutsch also makes up a quarter of a book I’ll be bringing up again later, Janet Sayers’s Mothers of Psychoanalysis (1991) which for my money does a better job of talking about The Psychology of Women though it necessarily gives much less detail about her early life. So, best probably to play it safe and get both. Meanwhile, for Deutsch’s own writings, The Psychology of Women is available in more expensive modern printings, but you can also pretty easily find cheap copies of the mass market paperback 1973 printing, so I’d say start there.
And if you want to read about more great women in the history of psychology and neuroscience, keep your eyes peeled for my History of Women in Psychology and Neuroscience, which is coming in the Spring of 2024 from Pen and Sword books!