Some of Freud’s colleagues, one of them the Austrian doctor Otto Gross, took these ideas to extremes, encouraging people to throw off what he considered to be the out-of-date moral prejudices that caused sickness: “Repress nothing!”45 Freud held Gross in high esteem, and thought he had the most original mind among his followers (according to Ernest Jones, who befriended Gross and considered their conversations to have constituted his first analysis, Gross was “the nearest approach to a romantic genius I ever met”), though Gross’s morphine and cocaine addiction made him a paranoid and a particularly wild analyst.46 In September 1907, Jung wrote to Freud of Gross’s radical ideas: “Dr. Gross tells me that he puts a quick stop to the transference by turning people into sexual immoralists. He says the transference to the analyst and its persistent fixation are mere monogamy symbols and as such symptomatic of repression. The truly healthy state for the neurotic is sexual immor ality.”47 (Jung would treat Gross in Switzerland the following year for his drug addiction.)
In his paper “ ‘Civilized Sexual Morality and Modern Nervousness,’ ” published in 1908, Freud criticized the puritanical sexual mores that so often lead to neurosis and sadism, such as enforced monogamy and abstinence. Freud implied that a lack of sex was as degenerative to the species as inbreeding, and that further repressions of the sexual instincts might endanger the very existence of the human race. “I have not gained the impression,” Freud wrote, “that sexual abstinence helps to shape energetic, self-reliant men of action, nor original thinkers, bold pioneers and reformers; far more often it produces ‘good’ weaklings who later become lost in the crowd.”48 Freud posed the question: Is civilized sexual morality worth the sacrifice it imposes upon us? It was this fundamental question that Reich took up.
Reich thought he noticed the same sex-deprived weakness in his patients and, like Gross, celebrated sexual immorality as a cure. Reich followed Freud in believing that a core of dammed-up sexual energy acted as a reservoir for neuroses to sprout up. Adopting Freud’s hydraulic notion of the libido, he came to believe that a healthy sex life, full of orgasms— at least one a day if possible— would deprive these symptoms of the sustenance that they needed to grow by maintaining a healthy flow of sexual energy. (The writer Arthur Schnitzler, a caddish bachelor, former doctor, and a friend of Freud’s, kept a diary in which he recorded his orgasms, sometimes as many as eight a night, and drew up monthly totals subdivided by each mistress; he omitted tallying theirs.)
However, by the time Reich first visited him at Berggasse 19, Freud was moving away from such a sexually radical solution to mental health problems. In 1920, the year after Reich met him, Freud published Beyond the Pleasure Principle, which set Thanatos against Eros, the death drive against the sex drive, and marked a decisive shift away from his early thinking about repression. In that essay he argued that the drive for gratification, love, and life is always overshadowed by a self-destructive urge toward aggression and death.
Freud’s theory of anxiety evolved in parallel with this shift in his thinking. In his Introductory Lectures on Psychoanalysis (1917), Freud regarded anxiety, like hysteria, as an outgrowth of sexual repression, caused by unsatisfied libido, which— like wine turning to vinegar— seeks discharge in palpitations and breathlessness, dizziness and nausea. However, Freud now asserted that anxiety was a cause rather than an effect of repression: “It was not the repression that created the anxiety,” Freud wrote in Inhibitions, Symptoms and Anxiety (1926). “The anxiety was there earlier; it was the anxiety that made the repression.”49 Freud now suggested that repression wasn’t something that could be thrown off, as Reich would maintain, but was an intrinsic part of the human condition. To Freud, misery came from within; to Reich, it was imposed from without.
Reich claimed to have kept his discovery of the therapeutic powers of the orgasm to himself at first, because he thought that the world of psychoanalysis wasn’t yet ready for his theory: “The actual goal of therapy,” he recalled, “that of making the patient capable of orgasm, was not mentioned in the first years of the seminar. I avoided the subject instinctively.”50 In fact, Reich did air his theory quite early, at a meeting of the Vienna Psychoanalytic Society in November 1923, where it met with a frosty reception:
During my presentation, I became aware of a growing chilliness in the mood of the meeting. I was a good speaker and had always been listened to attentively. When I finished, an icy stillness hung over the room. Following a break, the discussion began. My contention that the genital disturbance was an important, perhaps the most important symptom of the neurosis was said to be erroneous . . . Two analysts literally asserted that they knew any number of female patients who had a “completely healthy sex life.” They appeared to me to be more excited than was in keeping with their usual scientific reserve.51
The only member of the older generation to support him on that occasion (and only privately) was his boss at the Ambulatorium, Eduard Hitschmann, who told him afterward, “You hit the nail on the head!”52 Reich had evolved his ideas under Hitschmann’s supervision. Hitschmann, the expert in curing frigidity and impotence, was famous for treating sexual disturbances with a calm practicality; when the analyst Fritz Perls, who later went back into analysis with Reich to be treated for impotence, lay on Hitschmann’s couch and told him of the anxieties he had about his manhood, Hitschmann said, “Well, take out your penis. Let’s have a look at the thing.”53 According to the Minutes of the Vienna Psychoanalytic Society, Hitschmann “always advocated searching for ‘organic factors’ as a background of the neurosis,” which is just what Reich thought he’d discovered in the orgasm.54
Encouraged by Hitschmann, and desperate to prove the universality of his theory, Reich began to collect case histories that same month, grilling patients at the Ambulatorium about the minutiae of their sex lives. In 1924 he was promoted to assistant director, and could incorporate in his study information from the weekly written summaries his colleagues were required to submit to him (patients were assigned case numbers to protect their privacy); statistics were collected on 410 individuals, 72 of them Reich’s own patients.
At the congress in Salzburg later that year, Reich, armed with this data, insisted that there was now no doubt that “the severity of neurotic disturbance is directly proportionate to the psychogenital disturbance.”55 Reich maintained that the majority of the people who came to the Ambulatorium had some form of genital problem. The incidence of impotence at the clinic, where it was reported to be the most common condition, might have been so high, the historian Elizabeth Danto has suggested, because impotence was one of the most prevalent effects of shell shock. But it might equally be understood in terms of Reich’s own diagnostic agenda: according to Hitschmann’s report on the clinic, cases of impotence slumped in 1930, when Reich left for Berlin. Furthermore, Reich claimed that the problem afflicted not just patients. He estimated that 80 to 90 percent of all women and about 70 to 80 percent of all men were sexually sick, victims of libidinal stasis.56 He warned that, as well as neurosis, such genital stagnation could bring about “heart ailments . . . excessive