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Throughout the novel, there is an undercurrent of antisemitism. Both Breuer and Freud openly discuss it, as does Mathilde toward the end of the novel when Breuer is under hypnosis. Breuer says to Freud, “Every day the anti-Semites grow more shrill” (33). This points to an increasing sentiment in Vienna at the time, when Jewish people were openly scorned and discriminated against. This conversation takes place in 1882, but it shows the catalyzing of a movement that would eventually lead to the rise of the Nazi Party.
During one of their conversations, Freud says to Breuer, “I should have succeeded him. Everyone knew that. But a gentile was chosen instead. And I, like you, was forced to settle for less” (33). Freud is discussing why he was passed over for a position as a research scientist at the university. Breuer responds by saying, “Anti-Semitism would ultimately destroy your university career” (33). Both Breuer and Freud point to how antisemitism has created conditions whereby their freedom to make their own lives what they want is limited. Breuer is a physician by default, and Freud does not want to experience the same fate. Breuer then describes the myriad forms antisemitism takes, both the insidious and overt. Against this backdrop, when Freud initially begins his investigations into his theory of the subconscious, Breuer warns him against speaking openly about it for fear of public ridicule, mockery, and eventual embarrassment for the blunt fact that people will automatically associate him being Jewish with something they can’t understand. In spite of this discrimination, both Breuer and Freud worked toward developing a better understanding of how the brain operates and what consciousness is.
Misogyny is overt in the novel, especially when Nietzsche speaks his mind on women. Breuer also tends toward misogynistic views, though his are more subtle. His obsession with Bertha is also an objectification of her. One of his primary struggles is that he tries to separate his lust from empathy and finds that he cannot do it consistently. When he obsesses on her, he does not see Bertha as a person with her own struggles; instead, he mythologizes her and sexualizes her.
By contrast, Nietzsche has a much more hateful view toward all women. Toward the end of the novel, Nietzsche speculates that this could come from early childhood trauma. After his father died, Nietzsche says, “I was surrounded by cold, distant women—my mother, my sister, my grandmother and aunts. Some deep noxious attitudes must have been laid down because ever since I have regarded with horror a liaison with a woman” (285). The early experiences create a suspicion of all women. He often employs pejorative terms when describing women. Often, he sees them as predators whose sole purpose in life is to inflict pain on him. For example, in one instance, Nietzsche says to Breuer, in a bitter one, “It’s my wish to avoid them. Women corrupt and spoil. Perhaps it is simply enough to say that I am ill suited for them, and leave it at that” (298). Unlike Breuer, Nietzsche does not eventually come around to a different posture toward women. His rejection at the hands of Lou Salome is too much for him to fully overcome; however, once Breuer understands that his objectification of Bertha was actually a distraction to his real fears of aging and death, he sees her finally as a person, and his lust is replaced by empathy.
The fiacre, a horse drawn coach-style cabin, is Breuer’s primary method of transportation in the novel. He uses the fiacre to make home visits for his patients. Significantly, Breuer does not realize just how much time he spends in the fiacre until his friend Freud becomes “aghast” at the sheer number of hours Breuer spends in it (235). In one day alone, Freud points out that Breuer had spent six hours in it (30). When Breuer takes Nietzsche to the cemetery, Breuer remarks that the fiacre is his “second office” and tells Nietzsche of Freud’s comments on the amount of time he spends in the fiacre.
Breuer struggles with obsessive thoughts of Bertha. These thoughts create feelings of guilt, which serve to further distance him from his wife, Mathilde. Spending as much time as he does in the fiacre, this symbolizes a kind of distraction or even escape. Mathilde mentions how Breuer never seems to have time for his family and that he often becomes fully absorbed in his work. In so doing, she is pointing to his tendency toward being a workaholic. The complete submersion in his work, as represented by the amount of time he spends in the fiacre, is an escape from his guilt and from his increasing feelings of despair. The fiacre literally transports him away from his family, and symbolically, it provides him emotional distance from his wife.



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