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This is a story that mixes fact with fiction. It tells the tale of an attempt by Josef Breuer to help an ailing Friederich Nietzsche. The story begins with a young Louise Salome, an erstwhile pupil of Nietzsche, making an urgent referral to Breuer because her mentor is beginning to plummet into madness. “The future of German philosophy hangs in the balance” reads her note to Breuer as she attempts to persuade him to offer a consultation to Nietzsche. She has heard that Breuer has developed a new talking therapy and she thinks that it might be this therapy that may save Nietzsche. But Nietzsche is a reluctant patient and tests Breuer's new “talking cure” to the limit. During the course of several weeks of “philosophic analysis” Breuer finds it necessary to put himself in the role of the patient in order to prompt Nietzsche to self disclosing about the root of his problems.
The art of therapy is brought alive in the drama of the analysis as Yalom speculates about the genesis of the accoutrements of psychoanalysis, for instance Breuer is encouraged by Nietzsche to “chimney sweep” or free associate as we know it now. This chimney sweeping leads to some insight about the blind spot or repression that Breuer has about his paraphasic patient “Anna O” (Bertha). We discover Breuer has hastily referred “Anna O” to a colleague following her hysterical announcement that she was having his baby. It is Nietzsche who interprets the material noting how she becomes a container for Breuer's projections, “… the obsession involves not Bertha, or not only her, but a series of meanings folded into Bertha, we agree on this?” (p. 247)