ABSTRACT
When Freud began to work on developing his theory of psychoanalysis, he did so in an intellectual climate that Ellenberger,1 in his great book, has beautifully outlined. One of the principal ideas forming this climate is what Ellenberger has called the pathogenic secret. He traces the story of this model of psychological healing through a number of cultures. The patient is conceived as if he has within himself a bad experience that rots within him like a malignancy. It must be removed for cure to occur. In some cultures the badness is concretized as a foreign body. The shaman, at the end of the healing ritual, demonstrates to the sick person the thing that had been in his body and had been causing the illness. In other cultures the evil within is less concretized, perhaps as a spirit that has to be expelled through exorcism. In our own culture, confession has been one of the means of voidance of the secret. In Vienna, Moritz Benedict published a series of papers from 1864 to 1895 in which he suggested that neurotic illness was often caused by secrets, often pertaining to sexual life, and that cure came within their removal through catharsis. When Breuer and Freud produced Studies in Hysteria, which Brill2 called the ``fons et origo of psychoanalysis,'' they described a hidden experience, characteristically sexual, which was at the bottom of the illness. It had to be removed, in their words, ``like a foreign body.''3
