Combining the dynamics of depression, psychological conflict, real and transferential, and reaction to stress (rift with Flechsig and transfer to Sonnestein), offers an alternative interpretation of soul murder as a traumatic defense neuropsychosis within the psychotic depression.

So far all the writings about Schreber have focused heavily on Paul Schreber's father, although no documents about the father son relationship have survived. Freud said nothing about Schreber's mother Pauline, while Niederland only mentioned her in a cursory fashion. However, Pauline was a pillar of strength in the family after the death of Moritz Schreber when Paul was barely 19 years old. The other person who has not received the attention she deserves is Schreber's wife Sabine. Schreber himself mentioned his parents in passing, but devoted many passages to his wife. The documented facts of the wife's miscarriages and stillbirths, and the relationship with Paul, are very important aspects of the Schreber story.

The relationships with the women in his life are also important for the understanding of Schreber's only self-described sexual problem, that of wanting to be a woman and of cross dressing. Schreber's identification with woman led him to act out his fantasies, which he found to be a way to self healing. At the same time, they offer a prophetic glimpse into our current interest, both in the psychoanalytic writings as well as in literature, theater, film, and the arts, in the endlessly fascinating topic of gender, gender identity, and crossing of gender boundaries. The text follows.