When Nietzsche Wept is a 1992 novel written by Stanford University Professor of Psychology Irvin D. Yalom. Set in Vienna in 1882, the novel imagines a working relationship between the famous German philosopher Friedrich Nietzsche and the eminent physician Josef Breuer. Breuer believes that Nietzsche’s physical ailments have psychological causes, and he embarks on his newly invented “talking cure”—effectively a precursor to talk therapy and psychoanalysis. Eventually, through an agreement between the two men, it is Nietzsche, the “doctor of despair” (150), who becomes the doctor to Breuer. As such, both men discover as much about themselves as about each other. The novel examines the origins of psychoanalysis and the influence Nietzsche’s philosophy had on its development.

The novel was adapted into a film in 2007, directed by Pinchas Perry.

This guide uses the Kindle Edition of the source text.

Plot Summary

On vacation in Venice, Dr. Josef Breuer receives a letter from a woman named Lou Salome, whom he has never met. In the letter, Salome begs Breuer to meet with her to discuss a friend of hers, a philosopher who she claims will bring great ideas to the world. As Breuer considers the letter, the narrative shifts its focus to Breuer’s restlessness and frustration. He has been struggling to check his intrusive and obsessive thoughts about one of his patients, Anna O., also called Bertha Pappenheim. As he contends with his frustration, Salome arrives for the scheduled meeting. The visit comes as a relief to him, as it temporarily disrupts his intrusive thoughts. Salome eventually persuades Breuer to meet with her friend, Friedrich Nietzsche. The caveat is that he can never reveal to Nietzsche that it was she who arranged the meeting, nor can Breuer reveal to Nietzsche that his ultimate purpose is to heal his despair.

On the counsel of his friend, Franz Overbeck, Nietzsche travels to Vienna, where he meets with Dr. Breuer. Breuer attempts to persuade Nietzsche to check in at the Lauzon Clinic so that Breer can better treat him, but Nietzsche refuses to commit. After their initial meeting, Breuer is confronted by a visitor from a local guesthouse where Nietzsche has been staying. Nietzsche is unconscious and in serious condition. Breuer rushes over to the guesthouse and provides Nietzsche with care until he comes around the following day. After this episode, Breuer finally convinces Nietzsche to check into the clinic, under the condition that while he provides Nietzsche with care, Breuer likewise receives informal treatment from Nietzsche to rid him of his increasing despair.

Nietzsche initially takes on the role of the confessor, and the sessions begin with Breuer revealing what he thinks is the source of his despair: an ongoing and obsessive desire for his former patient, Bertha. Breuer feels powerless to stop or limit his obsession, and at first, Nietzsche is unsure how to proceed. Ever the quick study, he eventually decides upon strategies that he feels will be useful in helping Breuer overcome his obsession and therefore his despair.

Meanwhile, Breuer does what he can to subversively turn the tables on Nietzsche and likewise provide him with the talking cure that he provided Bertha. Helping him through this unique set of circumstances is his friend, Sigmund Freud. Their discussions about Breuer’s new patient reveal some of the origins of psychoanalytic theory. Freud contends that what drives a person’s behavior is not just what they are consciously aware of. Instead, there is another aspect of consciousness, as yet unexplored, that is most likely the wellspring of mental illness. Breuer himself agrees with much of what Freud has to say on the matter, yet he struggles to break through Nietzsche’s self-defense mechanism of keeping himself closed off and emotionally distant from everyone around him.

As the session between Breuer and Nietzsche continues, the narrative sometimes shifts to focus on Breuer’s troubled marriage. In a dissociated fit, Bertha falsely claims to the public that she is pregnant with Breuer’s child. Though Breuer denies it, his wife, Mathilde, is not entirely convinced. The whispers of infidelity add to the tension that Breuer’s all-consuming work has already created between them. He is rarely home, and when he is, he is often preoccupied and emotionally distant from his family. Breuer also feels a high degree of guilt about his obsession with Bertha, which only reinforces his desire to remain distant from his wife.

Ultimately, Nietzsche and Breuer become closer and at times behave as friends. It is at this point where the real breakthroughs begin. Nietzsche, who often refers to some of his famous aphorisms throughout his dialogues with Breuer, finally introduces him to his idea of eternal recurrence. Essentially, Nietzsche tells Breuer that the only way to conquer his fear of death, which he views as the true source of Breuer’s despair, is to live as though every moment will be repeated eternally. Breuer understands the idea, but initially he sees it as too fanciful to be of real use to him.

Breuer seems to regress as the novel progresses. Under hypnosis, he imagines an alternative life where he leaves everything behind and pursues Bertha. All is not what he thinks it will be. Mathilde is disgusted with him, and when he finally arrives at the institution where Bertha is residing, he witnesses her enacting the same mannerisms as she did while he was her doctor. The hypnosis episode, conducted under his friend Freud’s supervision, reveals to Breuer that running from his life would not be the fantasy he thinks it would be. Instead, the experience, coupled with Nietzsche’s suggestions and proclamations, provides Breuer with a fresh outlook on life. He immediately begins to value Mathilde again, and he has accepted his place in his own life. It is no longer a prison.

In the final chapter, Breuer thanks Nietzsche for helping him to understand and conquer his despair. Their sessions are coming to an end, and he expresses gratitude to Nietzsche. Their final conversation turns personal, and finally, after weeks of trying, Breuer gets Nietzsche to open up and reveal some of his innermost fears. Just as Breuer’s obsessive thoughts about Bertha were ultimately driven by a fear of death, Nietzsche comes to realize that his own obsession with Lou is also a distraction from his deepest fear, which is to die alone. Nietzsche also expresses his gratitude for the friendship that blossomed between the two men, although, in keeping with his self-made identity, he insists that it must come to an end. Both men have been transformed, and the novel concludes with Nietzsche boarding a train and departing from Breuer.