Hektoen International

A Journal of Medical Humanities

Book review: The Guru, the Bagman and the Sceptic: A story of science, sex and psychoanalysis

Robert Kaplan
Sydney, Australia


Sigmund Freud (lower left, seated) and his “Committee,” including Ernest Jones (far right, standing). Becker & Maass, Berlin. Library of Congress, Marsh Agency/Sigmund Freud Copyrights. Via Wikimedia. Public domain.

As a cultural icon of the twentieth century, psychoanalysis has loomed large in the public imagination. What makes it unique is the focus on the central figure, who set up a movement to promote it while constantly proclaiming it a science. Sigmund Freud is inextricable from psychoanalysis, which bears his imprimatur to this day.

Freud (with Josef Breuer) wrote his first psychoanalytic work in 1885. Fame came with The Interpretation of Dreams in 1900, and by 1910 the basic groundwork of the discipline had been laid down. Initial growth was slow. A group of disciples formed but many were troublesome, if not outright disturbed,1 and the international breakthrough came when Eugen Bleuler and Carl Jung from Zurich joined the movement. Unlike a true science, psychoanalysis was entirely a reflection of the personality and attitudes of the founder, who assumed all the characteristics of a charismatic, messianic figure establishing a cult-like movement with acolytes who required a period of induction to take up its precepts, to say nothing of regular expulsion of heretics.

In the early twentieth century, to proclaim it as an ineluctable fact that three-year-old boys wish to have sex with their mothers and kill their fathers (the equivalent concept for girls was something of an afterthought) was not an idea destined to find easy acceptance. That it originated from a Jewish neurologist in fin-de-siécle Vienna did not make it any easier.

Charismatic leaders are held by their followers to have unique—even magical—qualities. Freud, as would any charismatic cult leader, required his followers to unquestionably accept the dogma, with no tolerance for deviation. But, despite tribulations, schisms, rejections, and historical turmoil (the fall of the Habsburg Empire, the Anschluss, the Holocaust), psychoanalysis persisted and received grudging acceptance into mainstream psychiatry and (not necessarily to Freud’s delight) became a hit in America, where lying on a couch to fix your inner demons chimed with the national positivity.

With the passing of time, changes were inevitable. Psychiatry, post-DSM, distanced itself, but this was more than compensated by “lay” professionals (psychologists, social workers, welfare workers) who took it up with abandon. It also shifted from a clinical treatment—research having shown that it was no better than placebo—to what could be called a metaphilosophy, touted by those in the postmodern humanities. It is notable how intellectual superstars like Sartre and Lacan cite the Oedipal complex as an accepted scientific fact when in fact a century of research has not managed to confirm its existence.

Inevitably, there were those who challenged its precepts, including philosophers, historians, rhetoricians, and clinicians, becoming something of a counter-movement in the eighties after the travesties of the false memory epidemic. Notable figures include Frank Cioffi, Frederick Crews, Richard Webster, and Peter Swales. The analysts, as would anyone facing convincing challenges to their central dogma, reacted badly, calling them “Freud-bashers.” Anyone reading the Freud critics may take a contrary view, but would see the pejorative term as arising from petulance, not reason.

Which brings us to Seamus O’Mahony’s The Guru, the Bagman and the Sceptic: A story of science, sex and psychoanalysis. O’Mahony is no dilletante. His writings on the current and disturbing state of medicine are well worth reading. His approach is to establish a triangular narrative following the paths of Freud, Ernest Jones, and Wilfred Trotter. Freud (the guru) requires no introduction, but few will know much about Jones (the bagman), and even less about Trotter (the skeptic).

Psychoanalysis, as O’Mahony tells it, was a dud from the start, a pseudo-scientific concept driven by the ambitions of its founder and only perpetuated by its appeal to self-indulgent members of the elite. It was nothing less than a gigantic con game (to channel Peter Medawar) that ended up as an extended party trick for the self-obsessed worried well. The examples he cites of its adoption by the more effete members of the Bloomsbury set (Virginia Woolf being an exception) are especially damning.

Freud needed people to run the organization he set up, and Jones proved ideal. His behavior shows just how devious, manipulative, and cunning he was—hitman may have been a better title than bagman. His baiting of party heretics was rebarbative, as was his settling of personal scores—for example, telling Isidor Sadger that he should die in a concentration camp, which is exactly how Sadger’s life ended.2

While his superb organizing skills were highly valued by the master, his acceptance into the inner Vienna circle was always qualified. He was not Jewish (despite constantly dropping Yiddishisms) and reservations about whether he could be trusted were always held, even in Vienna. Being Welsh was considered a drawback. Back in London, Jones ran the British Psychoanalytic Association with an iron rod and controlled potential dissidents by restricting access to cases.

Jones’s personal life went far beyond what the analysts called “neurotic,” being much closer to a personality disorder with psychopathic traits. He had a series of relationships with younger women, most of which did not end well, and took couch-hopping with patients to new levels—in that, he was not different from many of the early analysts. From Jung down, they seemed to regard an attractive woman lying on their couch as a heaven-sent invitation for defloration. Some of them, such as Ferenczi, even managed to seduce a mother, daughter, and cousin.

The allegations against Jones of exposing himself to children during examinations in London and Toronto ruined his career as a neurologist, and he was lucky not to be jailed. Psychoanalysis provided a perfect escape, and he never looked back.

Freud gets equally short shrift from O’Mahony. He was authoritarian, controlling, obsessive, hypocritical, and dogmatic. To his dying day he maintained the adamantine insistence that he had discovered the unconscious (ignoring that it had been recognized by the Greek philosophers two millennia ago), that the Oedipal complex was irrefutable, and that psychoanalysis was a science. He was utterly intolerant of dissent, yet the ideas of the early heretics, such as Jung and Adler, were later adopted by many analysts as mainstream practice. He could, at times, be utterly callous. Witness his response to the suicide of Viktor Tausk after refusing to analyze him: “I confess that I do not really miss him; I had long realized that he could be of no further service; indeed that he constituted a threat to the future.”

Wilfred Batten Lewis Trotter. Wellcome Collection. CC BY 4.0.

There is a hero in this story, largely forgotten, but of a kind seen far too seldom. Medicine has produced very few men like Wilfred Trotter. One of the greatest surgeons of his day, he was a polymath interested also in psychology, sociology, and literature. A neurosurgical pioneer, he had trained under Victor Horsley. He severed some of his own peripheral nerves to prove a point about regeneration. Unlike the god-like surgeons of his day, Trotter was a man of considerable humility, treating the rich and poor alike with consideration and care. Money meant nothing to him, and he refused a baronetcy for saving King George V’s life.3 He was later to tell the dying Freud that nothing more could be done for his jaw cancer.

For those outside of medicine, Trotter’s greatest contribution was the book Instincts of the Herd in Peace and War, a classic study of crowd psychology that is still read. Trotter studied beehives, sheep flocks, and wolf packs to show that gregariousness was an instinct that played a big part in irrational behavior and intellectual weakness, a prescient finding in view of what was to follow in Germany.

Trotter had an early interest in Freud’s treatment of hysteria and directed Jones towards it. However, over time, he became deeply skeptical about its precepts and distanced himself. His acute mind rejected hypotheses not based on solid facts. Jones had, in fact, started his medical career under the aegis of Trotter and regarded him as a mentor for many years. Their lives were intertwined, as Trotter married Jones’s sister. When Freud came into the picture, Trotter was shifted to the side, which he accepted with characteristic grace—something not reciprocated by Jones, who could not have been unaware of Trotter’s contempt for medical careerists.

Never a healthy man, Trotter’s early death robbed us of someone who had so much to offer. A remarkable person, quite free of the petty flaws of great men and, as much as a secular figure can be so considered, a true saint. We will not see his like again.

Can psychoanalysis be written off in O’Mahony’s simplistic manner? All great men have their flaws, and Freud was no exception. Long after his creation is forgotten, people will still read his writing. He dreamed of getting the Nobel Prize, which would have been inappropriate, but instead won the Goethe Prize as a worthy substitute.

What psychoanalysis did for psychiatry is more nuanced, but certainly not to be understated. Patients had feelings, thoughts, and desires, which was not always evident. The understanding that not all was on the surface was a critical advance. Just how much psychoanalysis has benefitted the humanities in their postmodern mendacious thrashing is a debatable point, but that is the least of the concerns in their post-Enlightenment denial of rationalism and truth.

Ultimately, Freud was a signpost on which many circulating ideas entangled themselves. What he did was to embody a particular zeitgeist with his own romantic, Viennese style. Modernism, a new way of looking at the world, was waiting to burst forth, and his name must be added to other thinkers and artists of the day such as those of Picasso, Joyce, and Nijinsky. For many he became the cultural equivalent of Daisy’s green light at the end of the pier at a time when the old ideas were losing their valence. There are worse things to be remembered for, considering other competing ideologies in the murderous twentieth century.

O’Mahony’s style is unashamedly gossipy, at times reaching tabloid level. This is a shame, considering his fine earlier work, and even the most hardy anti-analytic skeptic would agree that this detracts from his case. The odd error also creeps in, such as the date and location of Freud saying there would be a plaque erected where he first understood the basis of dreams. This should not deter anyone who wishes to get beyond the aura surrounding psychoanalysis to see how its origins were driven by the exigencies and whims of the messianic Freud and his scheming, wheeler-dealing first lieutenant.


The Guru, the Bagman and the Sceptic: A story of science, sex and psychoanalysis
Seamus O’Mahony
Head of Zeus Publishing, 2023
ISBN 1804548529


End notes

  1. At least 12 of the early followers committed suicide.
  2. Sadger, who died at Theresienstadt, was the only one of the Viennese analysts to be killed by the Nazis.
  3. He operated on the king’s empyema in 1929.



ROBERT M. KAPLAN is a forensic psychiatrist, writer and historian based in Australia. He has published widely on the history of medicine and psychiatry, crime, genocide, and biography. His books include Medical Murder: Disturbing Tales of Doctors Who Kill (2009); The Exceptional Brain and How it Changed the World (2011); and Prophet of Psychiatry: In Search of Reg Ellery (2015). His latest work The King Who Strangled His Psychiatrist and Other Dark Tales is currently in press.


Winter 2023  |  Sections  |  Psychiatry & Psychology

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