In his entire fabled career — which really is mostly a fable — Freud wrote up detailed case histories of only six patients, all of them heavily spun, revised, and embellished to make Herr Doktor look like a genius. In the intervening century or more, scholars have dug up documentation — such as letters and contemporaneous case notes — which demonstrate Freud's inability to meaningfully help his patients, falling light years short of the incredible cures he claimed.
Let's start by looking at the proto-case, “Anna O.” Though she wasn't Freud's patient, students of the old man study the case because Anna was treated by his mentor, Josef Breur, and the case was later written up by Freud (though both of them attached their names to it). This is the founding case of psychotherapy — it supposedly validated hypnosis, “talking cures,” repression, oedipal desire, and other pillars of this approach. The official story is that Anna was intensely neurotic and Breur completely rid her of her “hysteria” through hypnosis.
In actuality, one month after therapy ended, Breur had her committed to an insane asylum, a place she would stay three more times over the next five years. Breur considered her hopeless; in a letter to his fiancée, Freud related his mentor's thoughts on Anna: “Breur is constantly talking about her, says he wishes she were dead so that the poor woman could be free of her suffering. He says that she will never be well again, that she is completely shattered.” (It turns out that Breur was wrong, because Anna did recover in the very late 1880s, around six or seven years after her therapy ended.) Not only did Breur and Freud keep these facts from the public, at Freud's insistence years later they fabricated the case history to make it fit with psychoanalysis, presenting this failure as a rousing success and attributing this nonexistent triumph to approaches and theories that weren't around at the time.
Now let's consider Freud's six detailed case histories, whose pseudonyms are household names to students of psychology.
The first case that Freud publicly presented as a cure — though it was far from his first case — was that of “Rat Man” (don't you love these psychiatric soubriquets?). Rat Man was obsessively afraid that something terrible would happen to his father and girlfriend; these morbid thoughts had started after he heard about a hideous form of torture involving rats. Freud's conclusion? Rat Man was repressing his desire to buttfuck his dad and future wife because — and this was an unconfirmed guess on the shrink's part — Ratty's dad had severely punished him for masturbating as a toddler.
In the case history, Sigmund claimed to have treated Rat Man for close to a year, but from his notes we know that the length was actually six months. Though Rat Man broke off the therapy, Freud boasted that he'd perfectly cured the fellow (“the complete restoration of the patient's personality”). But immediately after writing the case history, Freud told Jung in a letter that Rat Man was still messed up.
Five-year-old “Little Hans” suddenly became deathly afraid of horses. Though considered one of Freud's meager half-dozen case histories, Hans actually was treated by his father, a Freud disciple. Sigmund supervised the case from afar, seeing Hans only once. Young Hans was pretty sure that his horse phobia was due to trauma from seeing a horse fall down in the street, but his father and Freud would have none of this poppycock. It was obvious to them that big-dicked horses represented the lad's threatening father, whom Hans believed wanted to castrate him. Meanwhile, Hans also wanted to nail his mother and kill his kid sister. When pressed about his supposed desire toward mommy, Hans repeatedly said no way. But his dad kept hectoring him and, naturally, Little Hans eventually broke down and told him what he wanted to hear. “Success!” screamed the inquisitors. Actually, Hans did slowly lose his fear of horses during the treatment, but no one has to been able to produce a shred of evidence that the nutty therapy had anything to do with it, that it wasn't just Hans slowly recovering from his scary equestrian encounter.
Two of Freud's principal case histories are barely worth mentioning. Regarding Sigmund's treatment of an unnamed eighteen-year-old lesbian, MIT cognitive scientist Frank Sulloway — author of Freud: Biologist of the Mind — writes that it “terminated after a short time and involved no therapeutic improvement or even real treatment.” In the other case, Freud diagnosed a psychotic — whom he never met — strictly through the man's published memoir. Whether his conclusions were correct or not is impossible to say, but we do know that to arrive at them Freud ignored parts of the memoir that contradicted his diagnosis and purposely misrepresented the man's dad (in the case history, Freud lauded him as an “excellent father,” while simultaneously admitting that he was a “despot” in a letter to a pupil).
“Dora” was a depressed and “hysterical” seventeen-year-old (not eighteen, as Freud claimed) who reluctantly came to Sigmund because of problems involving friends of the family, Mr. and Mrs. K. Dora was upset because 1) Mr. K. obviously wanted a piece of her and had even made passes at her when she was thirteen and sixteen, and 2) she rightly believed that her father and Mrs. K. were getting it on. The good doctor immediately sussed what was really happening: Not only was Dora in love with Mr. K., she also wanted to give her father a blowjob and hop into the sack with Mrs. K. Not surprisingly, Dora thought this was a load of crap and abruptly quit seeing Freud after eleven weeks. She was still a mess when she died.
The obsessive “Wolf Man” is Freud's best-known case, most often pointed to as a shining example of psychoanalysis. The entire thing hinges on a dream that the patient had as a child: He saw white wolves sitting on top of a tree in front of his bedroom window, then woke up terrified. From this, Freud deduced that Wolfie had seen his parents humping doggie-style when he was 18 months old.
It took Freud four years to treat this poor sap, who was eventually discharged as being fully cured. Decades later, an Austrian reporter tracked him down to find out how he'd been doing since his legendary headshrinking sessions. Wolf Man called Freud's dream interpretation “terribly farfetched”; the sex-peeping scenario, which he never remembered, was “improbable”; and the universal belief that he'd been cured was “false.” Turns out that he continually saw a phalanx of therapists for the rest of his life. The psychoanalysis industry actively tried to hide the miserable failure of Freud's greatest so-called success by pressuring and financially inducing Wolf Man to stay in Vienna, instead of going to the US, as he wanted, because his status as a living piece of history would bring publicity and the truth would come out. He remained a bundle of neuroses and obsessions until his death.
As leading academic Freud debunker Frederick Crews writes: “Freud was unable to document a single unambiguously efficacious treatment.” 