"Why," Freud once asked, "did it [psychoanalysis] have to wait for an absolutely irreligious Jew?" Why, indeed? Sigmund Freud was born in Freiberg in the Austrian Empire on May 6, 1856. Three years later his family moved to Vienna. There the cultural, political and scientific mix of forces not only made the birth of psychoanalysis possible; I'd argue it could not have been created by anyone else in any other time or place. Medicine had been a Jewish profession par excellence for 1,000 years in the Islamic and Christian worlds. So too in late 19th-century Vienna, where a disproportionate number of physicians were Jews contributing mightily to the explosive development of modern medical science. But the Austrian political climate was souring. Several decades of liberalism (in the European sense of individual freedom) were followed by a reactionary wave of Austro-Germanic nationalism and anti-Jewish politicking. Medical specializations were coming into vogue and Jewish medical students were being turned away from the prestigious mainstream fields of internal medicine and surgery toward marginalized speciality areas: dermatology, ophthalmology - and psychiatry. Yet if some Jewish doctors were being pushed into psychiatry, others felt voluntarily drawn to it. The Jews of late 19th-century Vienna were facing new forms of mental pressure. Diaspora Jewish physicians and philosophers such as Maimonides had for centuries written about a way to attain spiritual well-being in a sea of hostile humanity. Their reference point was Jewish religious and cultural values. Now, however, Jews had been set adrift in an era of modernity which they themselves had done so much to create. And nowhere more so than in Vienna, at the dawn of the 20th century. It was here that Josef Popper-Lynkeus and Ludwig Wittgenstein were developing their radical philosophies of science and technology, where Arnold Schoenberg would soon experiment with daringly atonal music. Little wonder that the pioneering psychiatrist-anthropologist Cesare Lombroso, author of Man of Genius, attributed the apparently high rates of insanity among his fellow Jews to "intellectual overactivity." SUCH WAS the atmosphere in which Sigmund Freud found himself. No longer a Jew in the religious sense, he considered himself a follower of rationalist tradition in Judaism "free from many prejudices which restrict others in the use of their intellect." Freud first made important, though not revolutionary, contributions to our understanding of aphasia - major speech impairment due to physical trauma or stroke. By the 1890s, however, he had become intrigued by cryptic language disturbances as signs of neurotic conflicts caused by hypothesized unconscious forces: slips of the tongue in wakefulness, and the largely imaginative and apparently nonsensical, but in fact symbol-laden, "language" of dreams at night. Freud famously called dreams "the royal road to knowledge of the unconscious." And his own dreams and their analysis revealed to him a whirl of conflicts about his Jewish identity. He dreamt that he sat almost in tears beside a fountain at the Porta Romana in Italy (the gateway to Rome and, by implication, the Roman Catholic Church). Children had to be moved to safety, and a boy who was - but wasn't - Freud's son said to him in farewell the nonsensical "Auf Ungeseres" (instead of the usual Auf Wiedersehen). Among a labyrinth of free associations next morning, Freud recalled his actual viewing of the Porta Romana during a recent visit to Siena, where a Jewish director at a mental hospital had been forced to resign. Returning to Vienna, Freud attended a play on the Jewish question called The New Ghetto. FREUD LINKED the dream fountain to the refrain "By the waters of Babylon... yea, we wept when we remembered Zion." The seemingly nonsensical farewell "Auf Ungeseres" derived from the German word for unleavened bread, and to a Hebrew word for imposed suffering. Life for Jews like Freud in fin-de-si cle Vienna was indeed one of exile, full of professional barriers and social burdens. And such encumbrances could perhaps be relieved with a splash of baptismal water or assimilation into Austria's Roman Catholic majority. But Freud would have none of that. "I considered myself German intellectually, until I noticed the growth of anti-Semitism. Since that time, I prefer to call myself a Jew," he defiantly declared. "A Jew ought not to get himself baptized... it is essentially dishonest." If Freud's view of dreams had been limited to analyzing them for various personal and cultural conflicts lurking below the level of consciousness, it would have been a significant but not particularly revolutionary contribution to psychology. But, to employ Lombroso's term, the "intellectual overactivity" characteristic of so many modern Jews was part and parcel of Freud's genius. Thus he went on to develop his psychoanalytic model with its Oedipus and Electra sexual complexes, supposedly laid down in early childhood and which continued to dominate the unconscious id of the adult mind. The libido, Freud theorized, ultimately supplies the driving force behind all dreams. A task of civilization was to channel such forces to higher goals. This, too, was part of millennia of Jewish tradition. "In his inner being the Jew, the true Jew, feels only one eternal guide, one lawgiver, one law," Freud proudly declared. "That is morality." Such radical theories faced a long, uphill battle against the conservative medical establishment. But as Freud told his B'nai B'rith lodge brothers: "What bound me to Judaism was, I must confess, not belief and not national pride.... Other considerations... made the attractiveness of Judaism and Jews irresistible.... Because I was a Jew I found myself free from many prejudices which limited others in the use of their intellect, and being a Jew, I was prepared to enter opposition and to renounce agreement with the 'compact majority.'" Psychoanalytic theory ultimately did gain much acceptance. And it was Freud's international reputation which allowed him to flee Vienna after the Nazis took control of Austria in 1938. When Freud died in London the following year, he felt more of an exile than even he would ever have dreamt as he developed the Freudian model of the mind. Meanwhile, some of his disciples were already in the Land of Zion pursuing a Jewish dream that would become reality. The writer's most recent book is Jews and Medicine: An Epic Saga (KTAV).