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The famous memoirs of the German high court judge, Daniel Paul Schreber (1903), have attracted enormous interest, mainly due to Freud’s brilliant and controversial analysis of them in his 1911 work. Fortunately the voluminous literature (including Katan, 1959; Niederland, 1951, 1959a, 1959b, 1960; Santner, 1996; White, 1961) is ably reviewed and summarised by Lothane (1992) and shows that both the Schreber’s memoirs and Freud’s paper continue to make rewarding study.
If we look at them now, roughly 100 years later, we may ask ourselves to what extent psychiatry and psychoanalysis have changed in that time. Psychoanalysis has certainly changed a great deal. In this chapter I focus on some areas of contemporary interest that seem to me to have a relevance to the Schreber case. First I will make use of advances in the understanding of depression and its relationship with paranoia on the one hand, and with grandiose narcissistic states on the other. Here I shall argue that Schreber’s illness began and remained fundamentally depressive but rapidly developed persecutory elements that escalated until he became grossly disorganised and paranoid. Finally, the chaotic fragmentation became organised through the dominance of an omnipotent narcissistic organisation. This led to a clinical improvement without Schreber relinquishing any of his delusional beliefs.
I will also consider the role that gaze played in Schreber’s delusional object relations. There is a considerable literature on the role of gaze,
particularly from the point of view of the development of a sense of self, which many writers relate to the experience of being observed. As mentioned in Chapter 1, both Winnicott and Kohut (1971) emphasise the importance of the mother’s approving gaze to the child’s selfesteem, and some Kleinians are slow to accept the importance of this kind of mirroring. However, I believe that it is important to recognise that these affirmative views of the self reflected in the