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Sigmund Freud

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Beschreibung

Sigmund Freud was an Austrian neurologist and the founder of psychoanalysis, a clinical method for treating psychopathology through dialogue between a patient and a psychoanalyst. Freud was born to Galician Jewish parents in the Moravian town of Freiberg, in the Austro-Hungarian Empire. He qualified as a doctor of medicine in 1881 at the University of Vienna. Upon completing his habilitation in 1885, he was appointed a docent in neuropathology and became an affiliated professor in 1902. Freud lived and worked in Vienna, having set up his clinical practice there in 1886. In 1938 Freud left Austria to escape the Nazis. He died in exile in the United Kingdom in 1939.
In creating psychoanalysis, Freud developed therapeutic techniques such as the use of free association and discovered transference, establishing its central role in the analytic process. Freud's redefinition of sexuality to include its infantile forms led him to formulate the Oedipus complex as the central tenet of psychoanalytical theory. His analysis of dreams as wish-fulfillments provided him with models for the clinical analysis of symptom formation and the mechanisms of repression as well as for elaboration of his theory of the unconscious. Freud postulated the existence of libido, an energy with which mental processes and structures are invested and which generates erotic attachments, and a death drive, the source of compulsive repetition, hate, aggression and neurotic guilt. In his later work Freud developed a wide-ranging interpretation and critique of religion and culture.
Psychoanalysis remains influential within psychology, psychiatry, and psychotherapy, and across the humanities. As such, it continues to generate extensive and highly contested debate with regard to its therapeutic efficacy, its scientific status, and whether it advances or is detrimental to the feminist cause. Nonetheless, Freud's work has suffused contemporary Western thought and popular culture. In the words of W. H. Auden's 1940 poetic tribute, by the time of Freud's death, he had become "a whole climate of opinion / under whom we conduct our different lives."

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TABLE OF CONTENTS

COVER
THE AUTHOR
TITLE
COPYRIGHT
INTRODUCTION
DREAM PSYCHOLOGY
I - DREAMS HAVE A MEANING
II - THE DREAM MECHANISM
III - WHY THE DREAM DISGUISES THE DESIRES
IV - DREAM ANALYSIS
V - SEX IN DREAMS
VI - THE WISH IN DREAMS
VII - THE FUNCTION OF THE DREAM
VIII - THE PRIMARY AND SECONDARY PROCESS—REGRESSION
IX - THE UNCONSCIOUS AND CONSCIOUSNESS—REALITY

THE AUTHOR

Sigmund Freud (born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for treating psychopathology through dialogue between a patient and a psychoanalyst. Freud was born to Galician Jewish parents in the Moravian town of Freiberg, in the Austro-Hungarian Empire. He qualified as a doctor of medicine in 1881 at the University of Vienna. Upon completing his habilitation in 1885, he was appointed a docent in neuropathology and became an affiliated professor in 1902. Freud lived and worked in Vienna, having set up his clinical practice there in 1886. In 1938 Freud left Austria to escape the Nazis. He died in exile in the United Kingdom in 1939.

In creating psychoanalysis, Freud developed therapeutic techniques such as the use of free association and discovered transference, establishing its central role in the analytic process. Freud's redefinition of sexuality to include its infantile forms led him to formulate the Oedipus complex as the central tenet of psychoanalytical theory. His analysis of dreams as wish-fulfillments provided him with models for the clinical analysis of symptom formation and the mechanisms of repression as well as for elaboration of his theory of the unconscious. Freud postulated the existence of libido, an energy with which mental processes and structures are invested and which generates erotic attachments, and a death drive, the source of compulsive repetition, hate, aggression and neurotic guilt. In his later work Freud developed a wide-ranging interpretation and critique of religion and culture.

Psychoanalysis remains influential within psychology, psychiatry, and psychotherapy, and across the humanities. As such, it continues to generate extensive and highly contested debate with regard to its therapeutic efficacy, its scientific status, and whether it advances or is detrimental to the feminist cause. Nonetheless, Freud's work has suffused contemporary Western thought and popular culture. In the words of W. H. Auden's 1940 poetic tribute, by the time of Freud's death, he had become "a whole climate of opinion / under whom we conduct our different lives."

Freud was born to Jewish parents in the Moravian town of Freiberg, in the Austro-Hungarian Empire (later Příbor, Czech Republic), the first of eight children. Both of his parents were from Galicia, in modern-day Ukraine. His father, Jakob Freud (1815–1896), a wool merchant, had two sons, Emanuel (1833–1914) and Philipp (1836–1911), by his first marriage. Jakob's family were Hasidic Jews, and although Jakob himself had moved away from the tradition, he came to be known for his Torah study. He and Freud's mother, Amalia Nathansohn, who was 20 years younger and his third wife, were married by Rabbi Isaac Noah Mannheimer on 29 July 1855. They were struggling financially and living in a rented room, in a locksmith's house at Schlossergasse 117 when their son Sigmund was born. He was born with a caul, which his mother saw as a positive omen for the boy's future.

In 1859, the Freud family left Freiberg. Freud's half brothers emigrated to Manchester, England, parting him from the "inseparable" playmate of his early childhood, Emanuel's son, John. Jakob Freud took his wife and two children (Freud's sister, Anna, was born in 1858; a brother, Julius born in 1857, had died in infancy) firstly to Leipzig and then in 1860 to Vienna where four sisters and a brother were born: Rosa (b. 1860), Marie (b. 1861), Adolfine (b. 1862), Paula (b. 1864), Alexander (b. 1866). In 1865, the nine-year-old Freud entered the Leopoldstädter Kommunal-Realgymnasium, a prominent high school. He proved an outstanding pupil and graduated from the Matura in 1873 with honors. He loved literature and was proficient in German, French, Italian, Spanish, English, Hebrew, Latin and Greek.

Freud entered the University of Vienna at age 17. He had planned to study law, but joined the medical faculty at the university, where his studies included philosophy under Franz Brentano, physiology under Ernst Brücke, and zoology under Darwinist professor Carl Claus. In 1876, Freud spent four weeks at Claus's zoological research station in Trieste, dissecting hundreds of eels in an inconclusive search for their male reproductive organs. He graduated with an MD in 1881.

In 1882, Freud began his medical career at the Vienna General Hospital. His research work in cerebral anatomy led to the publication of a seminal paper on the palliative effects of cocaine in 1884 and his work on aphasia would form the basis of his first book On the Aphasias: a Critical Study, published in 1891. Over a three-year period, Freud worked in various departments of the hospital. His time spent in Theodor Meynert's psychiatric clinic and as a locum in a local asylum led to an increased interest in clinical work. His substantial body of published research led to his appointment as a university lecturer or docent in neuropathology in 1885, a non-salaried post but one which entitled him to give lectures at the university.

In 1886, Freud resigned his hospital post and entered private practice specializing in "nervous disorders". The same year he married Martha Bernays, the granddaughter of Isaac Bernays, a chief rabbi in Hamburg. The couple had six children: Mathilde (b. 1887), Jean-Martin (b. 1889), Oliver (b. 1891), Ernst (b. 1892), Sophie (b. 1893), and Anna (b. 1895). From 1891 until they left Vienna in 1938, Freud and his family lived in an apartment at Berggasse 19, near Innere Stadt, a historical district of Vienna.

In 1896, Minna Bernays, Martha Freud's sister, became a permanent member of the Freud household after the death of her fiancé. The close relationship she formed with Freud led to rumours, started by Carl Jung, of an affair. The discovery of a Swiss hotel log of 13 August 1898, signed by Freud whilst travelling with his sister-in-law, has been presented as evidence of the affair. Freud began smoking tobacco at age 24; initially a cigarette smoker, he became a cigar smoker. He believed that smoking enhanced his capacity to work and that he could exercise self-control in moderating it. Despite health warnings from colleague Wilhelm Fliess, he remained a smoker, eventually suffering a buccal cancer. Freud suggested to Fliess in 1897 that addictions, including that to tobacco, were substitutes for masturbation, "the one great habit."

Freud had greatly admired his philosophy tutor, Brentano, who was known for his theories of perception and introspection, as well as Theodor Lipps who was one of the main contemporary theorists of the concepts of the unconscious and empathy. Brentano discussed the possible existence of the unconscious mind in his Psychology from an Empirical Standpoint (1874). Although Brentano denied its existence, his discussion of the unconscious probably helped introduce Freud to the concept. Freud owned and made use of Charles Darwin's major evolutionary writings, and was also influenced by Eduard von Hartmann's Philosophy of the Unconscious (1869).

He read Friedrich Nietzsche as a student, and analogies between his work and that of Nietzsche were pointed out almost as soon as he developed a following. In 1900, the year of Nietzsche's death, Freud bought his collected works; he told his friend, Fliess, that he hoped to find in Nietzsche's works "the words for much that remains mute in me." Later, he said he had not yet opened them. Freud came to treat Nietzsche's writings "as texts to be resisted far more than to be studied." His interest in philosophy declined after he had decided on a career in neurology.

Freud read William Shakespeare in English throughout his life, and it has been suggested that his understanding of human psychology may have been partially derived from Shakespeare's plays.

Freud's Jewish origins and his allegiance to his secular Jewish identity were of significant influence in the formation of his intellectual and moral outlook, especially with respect to his intellectual non-conformism, as he was the first to point out in his Autobiographical Study. They would also have a substantial effect on the content of psychoanalytic ideas "particularly in respect of the rationalist values to which it committed itself."

In October 1885, Freud went to Paris on a fellowship to study with Jean-Martin Charcot, a renowned neurologist who was conducting scientific research into hypnosis. He was later to recall the experience of this stay as catalytic in turning him toward the practice of medical psychopathology and away from a less financially promising career in neurology research. Charcot specialized in the study of hysteria and susceptibility to hypnosis, which he frequently demonstrated with patients on stage in front of an audience.

Once he had set up in private practice in 1886, Freud began using hypnosis in his clinical work. He adopted the approach of his friend and collaborator, Josef Breuer, in a use of hypnosis which was different from the French methods he had studied in that it did not use suggestion. The treatment of one particular patient of Breuer's proved to be transformative for Freud's clinical practice. Described as Anna O., she was invited to talk about her symptoms while under hypnosis (she would coin the phrase "talking cure" for her treatment). In the course of talking in this way these symptoms became reduced in severity as she retrieved memories of traumatic incidents associated with their onset.

Freud's clinical work eventually led him to the conclusion that more consistent and effective symptom relief, compared to that achieved by using hypnosis, could be obtained by encouraging patients to talk freely, without censorship or inhibition, about whatever ideas or memories occurred to them. In conjunction with this procedure, which he called "free association", Freud found that patients' dreams could be fruitfully analyzed to reveal the complex structuring of unconscious material and to demonstrate the psychic action of repression which underlay symptom formation. By 1896, Freud had abandoned hypnosis and was using the term "psychoanalysis" to refer to his new clinical method and the theories on which it was based.

Freud's development of these new theories took place during a period in which he experienced heart irregularities, disturbing dreams and periods of depression, a "neurasthenia" which he linked to the death of his father in 1896 and which prompted a "self-analysis" of his own dreams and memories of childhood. His explorations of his feelings of hostility to his father and rivalrous jealousy over his mother's affections led him to fundamentally revise his theory of the origin of the neuroses.

On the basis of his early clinical work, Freud had postulated that unconscious memories of sexual molestation in early childhood were a necessary precondition for the psychoneuroses (hysteria and obsessional neurosis), a formulation now known as Freud's seduction theory. In the light of his self-analysis, Freud abandoned the theory that every neurosis can be traced back to the effects of infantile sexual abuse, now arguing that infantile sexual scenarios still had a causative function, but it did not matter whether they were real or imagined and that in either case they became pathogenic only when acting as repressed memories.

This transition from the theory of infantile sexual trauma as a general explanation of how all neuroses originate to one that presupposes an autonomous infantile sexuality provided the basis for Freud's subsequent formulation of the theory of the Oedipus complex.

Freud described the evolution of his clinical method and set out his theory of the psychogenetic origins of hysteria, demonstrated in a number of case histories, in Studies on Hysteria published in 1895 (co-authored with Josef Breuer). In 1899 he published The Interpretation of Dreams in which, following a critical review of existing theory, Freud gives detailed interpretations of his own and his patients' dreams in terms of wish-fulfillments made subject to the repression and censorship of the "dream work". He then sets out the theoretical model of mental structure (the unconscious, pre-conscious and conscious) on which this account is based. An abridged version, On Dreams, was published in 1901. In works which would win him a more general readership, Freud applied his theories outside the clinical setting in The Psychopathology of Everyday Life (1901) and Jokes and their Relation to the Unconscious (1905). In Three Essays on the Theory of Sexuality, published in 1905, Freud elaborates his theory of infantile sexuality, describing its "polymorphous perverse" forms and the functioning of the "drives", to which it gives rise, in the formation of sexual identity. The same year he published ‘Fragment of an Analysis of a Case of Hysteria (Dora)' which became one of his more famous and controversial case studies.

In 1902, Freud at last realised his long-standing ambition to be made a university professor. The title "professor extraordinarius" was important to Freud for the recognition and prestige it conferred, there being no salary or teaching duties attached to the post (he would be granted the enhanced status of "professor ordinarius" in 1920). Despite support from the university, his appointment had been blocked in successive years by the political authorities and it was secured only with the intervention of one of his more influential ex-patients, a Baroness Marie Ferstel, who had to bribe the minister of education with a painting.

With his prestige thus enhanced, Freud continued with the regular series of lectures on his work which, since the mid-1880s as a docent of Vienna University, he had been delivering to small audiences every Saturday evening at the lecture hall of the university's psychiatric clinic.

From the autumn of 1902, a number of Viennese physicians who had expressed interest in Freud's work were invited to meet at his apartment every Wednesday afternoon to discuss issues relating to psychology and neuropathology. This group was called the Wednesday Psychological Society (Psychologische Mittwochs-Gesellschaft) and it marked the beginnings of the worldwide psychoanalytic movement.

Freud founded this discussion group at the suggestion of the physician Wilhelm Stekel. Stekel had studied medicine at the University of Vienna under Richard von Krafft-Ebing. His conversion to psychoanalysis is variously attributed to his successful treatment by Freud for a sexual problem or as a result of his reading The Interpretation of Dreams, to which he subsequently gave a positive review in the Viennese daily newspaper Neues Wiener Tagblatt.

The other three original members whom Freud invited to attend, Alfred Adler, Max Kahane, and Rudolf Reitler, were also physicians and all five were Jewish by birth. Both Kahane and Reitler were childhood friends of Freud. Kahane had attended the same secondary school and both he and Reitler went to university with Freud. They had kept abreast of Freud's developing ideas through their attendance at his Saturday evening lectures. In 1901, Kahane, who first introduced Stekel to Freud's work, had opened an out-patient psychotherapy institute of which he was the director in Bauernmarkt, in Vienna. In the same year, his medical textbook, Outline of Internal Medicine for Students and Practicing Physicians, was published. In it, he provided an outline of Freud's psychoanalytic method. Kahane broke with Freud and left the Wednesday Psychological Society in 1907 for unknown reasons and in 1923 committed suicide. Reitler was the director of an establishment providing thermal cures in Dorotheergasse which had been founded in 1901. He died prematurely in 1917. Adler, regarded as the most formidable intellect among the early Freud circle, was a socialist who in 1898 had written a health manual for the tailoring trade. He was particularly interested in the potential social impact of psychiatry.

Max Graf, a Viennese musicologist and father of "Little Hans", who had first encountered Freud in 1900 and joined the Wednesday group soon after its initial inception, described the ritual and atmosphere of the early meetings of the society:

The gatherings followed a definite ritual. First one of the members would present a paper. Then, black coffee and cakes were served; cigar and cigarettes were on the table and were consumed in great quantities. After a social quarter of an hour, the discussion would begin. The last and decisive word was always spoken by Freud himself. There was the atmosphere of the foundation of a religion in that room. Freud himself was its new prophet who made the heretofore prevailing methods of psychological investigation appear superficial.

By 1906, the group had grown to sixteen members, including Otto Rank, who was employed as the group's paid secretary. In the same year, Freud began correspondence with Jung who was then an assistant to Eugen Bleuler at the Burghölzli Mental Hospital in Zürich. In March 1907, Jung and Ludwig Binswanger, also a Swiss psychiatrist, travelled to Vienna to visit Freud and attend the discussion group. Thereafter, they established a small psychoanalytic group in Zürich. In 1908, reflecting its growing institutional status, the Wednesday group was renamed the Vienna Psychoanalytic Society.

In 1911, the first women members were admitted to the Society. Tatiana Rosenthal and Sabina Spielrein were both Russian psychiatrists and graduates of the Zürich University medical school. Prior to the completion of her studies, Spielrein had been a patient of Jung at the Burghölzli and the clinical and personal details of their relationship became the subject of an extensive correspondence between Freud and Jung. Both women would go on to make important contributions to the work of the Russian Psychoanalytic Society founded in 1910.

Freud's early followers met together formally for the first time at the Hotel Bristol, Salzburg on 27 April 1908. This meeting, which was retrospectively deemed to be the first International Psychoanalytic Congress, was convened at the suggestion of Ernest Jones, then a London-based neurologist who had discovered Freud's writings and begun applying psychoanalytic methods in his clinical work. Jones had met Jung at a conference the previous year and they met up again in Zürich to organize the Congress. There were, as Jones records, "forty-two present, half of whom were or became practicing analysts." In addition to Jones and the Viennese and Zürich contingents accompanying Freud and Jung, also present and notable for their subsequent importance in the psychoanalytic movement were Karl Abraham and Max Eitingon from Berlin, Sándor Ferenczi from Budapest and the New York-based Abraham Brill.

Important decisions were taken at the Congress with a view to advancing the impact of Freud's work. A journal, the Jahrbuch für psychoanalytische und psychopathologishe Forschungen, was launched in 1909 under the editorship of Jung. This was followed in 1910 by the monthly Zentralblatt für Psychoanalyse edited by Adler and Stekel, in 1911 by Imago, a journal devoted to the application of psychoanalysis to the field of cultural and literary studies edited by Rank and in 1913 by the Internationale Zeitschrift für Psychoanalyse, also edited by Rank. Plans for an international association of psychoanalysts were put in place and these were implemented at the Nuremberg Congress of 1910 where Jung was elected, with Freud's support, as its first president.

Freud turned to Brill and Jones to further his ambition to spread the psychoanalytic cause in the English-speaking world. Both were invited to Vienna following the Salzburg Congress and a division of labour was agreed with Brill given the translation rights for Freud's works, and Jones, who was to take up a post at the University of Toronto later in the year, tasked with establishing a platform for Freudian ideas in North American academic and medical life. Jones's advocacy prepared the way for Freud's visit to the United States, accompanied by Jung and Ferenczi, in September 1909 at the invitation of Stanley Hall, president of Clark University, Worcester, Massachusetts, where he gave five lectures on psychoanalysis.

The event, at which Freud was awarded an Honorary Doctorate, marked the first public recognition of Freud's work and attracted widespread media interest. Freud's audience included the distinguished neurologist and psychiatrist James Jackson Putnam, Professor of Diseases of the Nervous System at Harvard, who invited Freud to his country retreat where they held extensive discussions over a period of four days. Putnam's subsequent public endorsement of Freud's work represented a significant breakthrough for the psychoanalytic cause in the United States. When Putnam and Jones organised the founding of the American Psychoanalytic Association in May 1911 they were elected president and secretary respectively. Brill founded the New York Psychoanalytic Society the same year. His English translations of Freud's work began to appear from 1909.

Some of Freud's followers subsequently withdrew from the International Psychoanalytical Association (IPA) and founded their own schools.

From 1909, Adler's views on topics such as neurosis began to differ markedly from those held by Freud. As Adler's position appeared increasingly incompatible with Freudianism, a series of confrontations between their respective viewpoints took place at the meetings of the Viennese Psychoanalytic Society in January and February 1911. In February 1911, Adler, then the president of the society, resigned his position. At this time, Stekel also resigned his position as vice president of the society. Adler finally left the Freudian group altogether in June 1911 to found his own organization with nine other members who had also resigned from the group. This new formation was initially called Society for Free Psychoanalysis but it was soon renamed the Society for Individual Psychology. In the period after World War I, Adler became increasingly associated with a psychological position he devised called individual psychology.

In 1912, Jung published Wandlungen und Symbole der Libido (published in English in 1916 as Psychology of the Unconscious) making it clear that his views were taking a direction quite different from those of Freud. To distinguish his system from psychoanalysis, Jung called it analytical psychology. Anticipating the final breakdown of the relationship between Freud and Jung, Ernest Jones initiated the formation of a Committee of loyalists charged with safeguarding the theoretical coherence and institutional legacy of the psychoanalytic movement. Formed in the autumn of 1912, the committee comprised Freud, Jones, Abraham, Ferenczi, Rank, and Hanns Sachs. Max Eitingon joined the committee in 1919. Each member pledged themselves not to make any public departure from the fundamental tenets of psychoanalytic theory before they had discussed their views with the others. After this development, Jung recognised that his position was untenable and resigned as editor of the Jarhbuch and then as president of the IPA in April 1914. The Zürich Society withdrew from the IPA the following July.

Later the same year, Freud published a paper entitled "The History of the Psychoanalytic Movement", the German original being first published in the Jahrbuch, giving his view on the birth and evolution of the psychoanalytic movement and the withdrawal of Adler and Jung from it.

The Committee continued to function until 1927 by which time institutional developments within the IPA, such as the establishment of the International Training Commission, served to allay some of Freud's anxieties about the transmission of psychoanalytic theory and practice.

The final defection from Freud's inner circle occurred following the publication in 1924 of Rank's The Trauma of Birth which other members of the committee read as, in effect, abandoning the Oedipus Complex as the central tenet of psychoanalytic theory. Abraham and Jones became increasingly forceful critics of Rank and though he and Freud were reluctant to end their close and long-standing relationship the break finally came in 1926 when Rank resigned from his official posts in the IPA and left Vienna for Paris. His place on the committee was taken by Anna Freud. Rank eventually settled in the United States where his revisions of Freudian theory were to influence a new generation of therapists uncomfortable with the orthodoxies of the IPA.

After the founding of the IPA in 1910, an international network of psychoanalytical societies, training institutes and clinics became well established and a regular schedule of biannual Congresses commenced after the end of World War I to coordinate their activities. Freud attended his last Congress in Berlin in 1922.

Abraham and Eitingon founded the Berlin Psychoanalytic Society in 1910 and then the Berlin Psychoanalytic Institute and the Poliklinik in 1920. The Poliklinik's innovations of free treatment, and child analysis and the Berlin Institute's standardisation of psychoanalytic training had a major influence on the wider psychoanalytic movement. In 1927 Ernst Simmel founded the Schloss Tegel Sanatorium on the outskirts of Berlin, the first such establishment to provide psychoanalytic treatment in an institutional framework. Freud organised a fund to help finance its activities and his architect son, Ernst, was commissioned to refurbish the building. It was forced to close in 1931 for economic reasons.

The 1910 Moscow Psychoanalytic Society became the Russian Psychoanalytic Society and Institute in 1922. Freud's Russian followers were the first to benefit from translations of his work, the 1904 Russian translation of The Interpretation of Dreams appearing nine years before Brill's English edition. The Russian Institute was unique in receiving state support for its activities, including publication of translations of Freud's works. Support was abruptly annulled in 1924, when Joseph Stalin came to power, after which psychoanalysis was denounced on ideological grounds.

After helping found the American Psychoanalytic Association in 1911, Ernest Jones returned to Britain from Canada in 1913 and founded the London Psychoanalytic Society the same year. In 1919, he dissolved this organisation and, with its core membership purged of Jungian adherents, founded the British Psychoanalytical Society, serving as its president until 1944. The Institute of Psychoanalysis was established 1924 and the London Clinic of Psychoanalysis established in 1926, both under Jones's directorship.

The Vienna Ambulatorium (Clinic) was established in 1922 and the Vienna Psychoanalytic Institute was founded in 1924 under the directorship of Helene Deutsch. Ferenczi founded the Budapest Psychoanalytic Institute in 1913 and a clinic in 1929.

Psychoanalytic societies and institutes were established in Switzerland (1919), France (1926), Italy (1932), the Netherlands (1933), Norway (1933) and in Jerusalem (1933) by Eitingon, who had fled Berlin after Adolf Hitler came to power. The New York Psychoanalytic Institute was founded in 1931.

Freud used pseudonyms in his case histories. Some patients known by pseudonyms were Cäcilie M. (Anna von Lieben); Dora (Ida Bauer, 1882– 1945); Frau Emmy von N. (Fanny Moser); Fräulein Elisabeth von R. (Ilona Weiss); Fräulein Katharina (Aurelia Kronich); Fräulein Lucy R.; Little Hans (Herbert Graf, 1903–1973); Rat Man (Ernst Lanzer, 1878–1914); Enos Fingy (Joshua Wild, 1878–1920); and Wolf Man (Sergei Pankejeff, 1887–1979). Other famous patients included H.D. (1886–1961); Emma Eckstein (1865–1924); Gustav Mahler (1860–1911), with whom Freud had only a single, extended consultation; Princess Marie Bonaparte; Edith Banfield Jackson (1895 – 1977); and Albert Hirst (1887-1974).

In February 1923, Freud detected a leukoplakia, a benign growth associated with heavy smoking, on his mouth. Freud initially kept this secret, but in April 1923 he informed Ernest Jones, telling him that the growth had been removed. Freud consulted the dermatologist Maximilian Steiner, who advised him to quit smoking but lied about the growth's seriousness, minimizing its importance. Freud later saw Felix Deutsch, who saw that the growth was cancerous; he identified it to Freud using the euphemism "a bad leukoplakia" instead of the technical diagnosis epithelioma. Deutsch advised Freud to stop smoking and have the growth excised. Freud was treated by Marcus Hajek, a rhinologist whose competence he had previously questioned. Hajek performed an unnecessary cosmetic surgery in his clinic's outpatient department. Freud bled during and after the operation, and may narrowly have escaped death. Freud subsequently saw Deutsch again. Deutsch saw that further surgery would be required, but did not tell Freud that he had cancer because he was worried that Freud might wish to commit suicide.

In 1930 Freud was awarded the Goethe Prize in recognition of his contributions to psychology and to German literary culture. In January 1933, the Nazis took control of Germany, and Freud's books were prominent among those they burned and destroyed. Freud quipped: "What progress we are making. In the Middle Ages they would have burned me. Now, they are content with burning my books."

Freud continued to maintain his optimistic underestimation of the growing Nazi threat and remained determined to stay in Vienna, even following the Anschluss of 13 March 1938, in which Nazi Germany annexed Austria, and the outbreaks of violent anti-Semitism that ensued. Ernest Jones, the then president of the International Psychoanalytical Association (IPA), flew into Vienna from London via Prague on 15 March determined to get Freud to change his mind and seek exile in Britain. This prospect and the shock of the detention and interrogation of Anna Freud by the Gestapo finally convinced Freud it was time to leave Austria. Jones left for London the following week with a list provided by Freud of the party of émigrés for whom immigration permits would be required. Back in London, Jones used his personal acquaintance with the Home Secretary, Sir Samuel Hoare, to expedite the granting of permits. There were seventeen in all and work permits were provided where relevant. Jones also used his influence in scientific circles, persuading the president of the Royal Society, Sir William Bragg, to write to the Foreign Secretary Lord Halifax, requesting to good effect that diplomatic pressure be applied in Berlin and Vienna on Freud's behalf. Freud also had support from American diplomats, notably his ex-patient and American ambassador to France, William Bullitt.

The departure from Vienna began in stages throughout April and May 1938. Freud's grandson Ernst Halberstadt and Freud's son Martin's wife and children left for Paris in April. Freud's sister-in-law, Minna Bernays, left for London on 5 May, Martin Freud the following week and Freud's daughter Mathilde and her husband, Robert Hollitscher, on 24 May.