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In Madness and Civilization Foucault saw psychoanalysis as a part of the power game with patients. He argued that the shift from virtual incarceration of mental patients in asylums, to the treatment of mental illness, was merely a revision in the power relationship between doctor and patient, but not a real change in attitude. The physician was still the dominating figure in the relationship, the omnipotent and omniscient participant in their interactions. In Foucault's very convincing presentation, this dominance was depicted as a virtual apotheosis of the physician.
Lorenzer disagrees with Foucault and feels that he did not note the major differences in Freud's approach, and the way Freud diverged from Janet, Charcot, and Liebeault. He points out that in the pivotal case of Anna O. came a major shift in the doctor-patient relationship. This time the patient led the way, both in showing the physician how the treatment should be conducted and in setting the theme and topic of their interaction. Now the doctor simply sat by and listened, and it was the patient's feelings and recollections, not physical complaints, that were of utmost importance.
But the question arises whether Freud's accomplishment cannot be reduced to his readiness to recognize the nature of the subject. Was Freud's decisive contribution to the new "science of understanding" merely his sensitivity? Certainly not, as a comparison with the equally sensitive Breuer will show. The proclivity to sensitivity and the willingness to learn were alone not enough to solve the riddle of the unconscious. As a comparison, Lorenzer considers the devotion of Clemens Brentano to Anna Katharina Emmerich, who occasionally exhibited the stigmata; or the interest of the physician, Justinus Kerner, in the visions of the psychic, Fredericke Hauffe, about whom he wrote the book, The Prophetess of Prevorst.