An insightful and witty history of psychoanalysis

What is it about Sigmund Freud? On the most slender basis imaginable, the Austrian neurologist and founder of psychoanalysis spun a baroque theory of the human mind that has endured well beyond the lifespan of most ideas in human history, even good ones. Despite an avalanche of literature undermining his methodology and, to a degree, his intellectual coherence, Freud’s creation still thrives in such diverse fields, such as literary criticism, philosophy, life-coaching, and marketing. The reasons for this are not entirely clear.

Psychoanalysis has fared less well in mainstream medicine, owing chiefly to the lack of evidence to support its systematic use for any identifiable psychological problems or mental illnesses. Notwithstanding this paucity of systematic evidence, Freud’s creation has established a bespoke niche for itself in the multi-coloured pantheon of psychological therapies that crowd the sprawling psychotherapeutic space in Ireland and elsewhere. Given the diversity of human experience and forms of psychological pain, it is little surprise that any therapeutic modality will help at least some people, even when its scientific evidence-base is decidedly sparse.

Against this background, Prof Seamus O’Mahony’s new book, The Guru, the Bagman, and the Sceptic, centres on Freud and some of his associates, and tells a “story of science, sex, and psychoanalysis”. A much needed and immaculately constructed account, O’Mahony’s book is, in the very best sense, a ripping yarn.

O’Mahony will be known to many readers as a regular contributor to the Medical Independent. He previously worked in the NHS and, in 2001, returned to his native Cork where he was a Consultant Gastroenterologist and Clinical Professor until February 2020. O’Mahony’s other books include The Way We Die Now (winner of the British Medical Association’s Council Chair’s choice award in 2017), Can Medicine be Cured? (2019), and – my favourite to date – The Ministry of Bodies (2021).

With admirable industry, O’Mahony’s latest book delves deep into certain aspects of Freud’s life and work, and sheds new light on a bewilderingly odd set of relationships between the great man himself (the “guru” of the book’s title), Ernest Jones (the “bagman”), and Wilfred Trotter (the “sceptic”). These three figures form a peculiar trio. Jones was a Welsh-born psychoanalyst and ardent disciple of Freud. Trotter was a surgeon who attended to both George V and Freud, but was distinctly unimpressed by grand theories, such as Freud’s psychoanalysis. And, at the centre, we find Freud himself: Inscrutable, iconic, odd.

O’Mahony dissects the world of this triumvirate with tolerance, insight, wit, and occasional understated asperity. It is difficult to convey the sheer complexity and strangeness of O’Mahony’s tale. Suffice it is to say that the story of Freud, Jones, and Trotter is as intellectually grisly as it is compelling, as unlikely as it is gloriously, ridiculously true.

Trotter is the least well known of the three and the most interesting. He was, as O’Mahony points out, “a scientific sceptic,” open to new ideas, but also keen on seeing the evidence. The guru and the bagman had other, non-evidence-based fish to fry. This placed Trotter at odds with the emerging world of psychoanalysis.

As O’Mahony notes, the literature about psychoanalysis and Freud is “often deeply partisan with wilful omissions of disobliging facts, or breezy rationalisations of egregious misbehaviour; jaws that should have dropped and eyes that should have popped remained resolutely undropped and unpopped”. O’Mahony helps correct this imbalance in his book. Jaws will drop, eyes will pop.

O’Mahony tells his tale with all the fairness and reasonableness that anyone could conceivably muster when writing about such people and their antics. With characteristic mordant humour, he describes the monstrous egos that surrounded Freud like planets circling the sun, somehow resulting in the perpetuation of psychoanalysis, one of the most inexplicably compelling ideas in human history.

All told, perhaps the greatest strength of this book is its exploration of the messy humanity surrounding Freud with skill, sympathy, and a certain aghastness at the folly of human nature. There is a great deal to enjoy here, much to reflect upon, and even more to feel unsettled about.

If you like diving into a seething cesspit of bitterness, folly, and jealous hatred, tempered with unexpected helpings of love, friendship, and curiosity about human nature, you will love this book. In the end, never was it so much fun to watch the Freudians slip.

Prof Brendan Kelly is Professor of Psychiatry at Trinity College Dublin and author of In Search of Madness: A Psychiatrist’s Travels Through the History of Mental Illness (Gill Books).