[11] Spielrein is increasingly recognized as an important and innovative thinker who was marginalized in history because of her unusual eclecticism, refusal to join factions, feminist approach to psychology, and her murder in the Holocaust.

Following the sudden death of her only sister Emilia from typhoid, Spielrein's mental health started to deteriorate, and at the age of 18 she suffered a breakdown with severe hysteria including tics, grimaces, and uncontrollable laughing and crying.

Its director was Eugen Bleuler, who ran it as a therapeutic community with social activities for the patients including gardening, drama and scientific lectures.

[15] She made a rapid recovery, and by October was able to apply for medical school and to start assisting Jung with word association tests in his laboratory.

[8] Her diaries show a very broad range of interests and reading including philosophy, religion, Russian literature and evolutionary biology.

She lived in several different apartments, mixing in a social circle of predominately fellow Russian Jewish women medical students.

[19] Spielrein completed her medical school dissertation, supervised first by Bleuler then by Jung, a close study of the language of a patient with schizophrenia.

"[24] Lance Owens further summarized the documentary evidence in his 2015 study, Jung in Love: The Mysterium in Liber Novus,[26] Zvi Lothane, a Freudian psychoanalyst and scholar of psychoanalytic history, makes the most robust and well-supported case against a consummated sexual relationship between the pair.

However, the sexual myth dies hard, providing sensational material for a number of theatrical productions and a plethora of articles in the popular press and professional journals.

Sabina saw in reality how totally impossible it was, how it would ruin her chance of finding another love and destroy her scientific and professional ambitions: With a baby I would be accepted nowhere.

And having taken that step, "our pure friendship would be destroyed by the intimate relationship...." Written shortly before her departure from Zürich, those words seemingly imply that whatever the nature of their physical "poetry", Jung and Spielrein had not engaged in sexual intercourse.

[31] Some commentators have seen Jung's conduct as a professional boundary violation, while others have seen it as an unintended and forgivable consequence of early experimentation with psychoanalytic techniques.

The historian and Freudian psychoanalyst Bruno Bettelheim commented on her treatment and the apparently beneficial result, noting that, "However questionable Jung's behaviour was from a moral point of view...somehow it met the prime obligation of the therapist towards his patient: to cure her".

[32] By contrast, Peter Loewenberg (among others) has argued that it was in breach of professional ethics, and that it "jeopardized his position at the Burghölzli and led to his rupture with Bleuler and his departure from the University of Zurich".

She continued to yearn for him for several years afterwards, and wrote to Freud that she found it harder to forgive Jung for leaving the psychoanalytic movement than for "that business with me".

[39] Freud explicitly mentioned her paper in a famous footnote to Beyond the Pleasure Principle, acknowledging that it started the train of thought which led him to conceptualize the death drive: "A considerable part of this speculation has been anticipated in [her] work".

[49] However, Otto Fenichel singled out for special mention her 1923 article on voyeurism, where "Sabina Spielrein described a peeping perversion in which the patient tried to overcome an early repression of genital and manual erotogeneity, provoked by an intense castration fear".

In the event, she never returned to western Europe, and the papers remained undiscovered until they were identified nearly sixty years later by the Jungian analyst Aldo Carotenuto, who published a selection of them.

The archive remains in the possession of the heirs of Édouard Claparède, and although further selections have been published in a number of books and journals, it has never been fully examined or catalogued.

The accusations were possibly made in response to attempts by Leon Trotsky to proletarianize the school's intake[6] : 214  During Spielrein's time in Moscow, both Alexander Luria and Lev Vygotsky came to work at the Psychoanalytic Institute and "Dyetski Dom" and studied with her.

As well as probably being disillusioned by her experience in Moscow, Spielrein may have been impelled to return because her husband by now was in a relationship with a Ukrainian woman, Olga Snetkova (born Aksyuk), and they now had a daughter, Nina.

[53] The paper also made it clear that she was up-to-date with developments in the west, and included sympathetic comments on the approach of Sandor Ferenczi, who was advocating a more emotional engaged role on the part of the therapist.

She also talked of the importance of clinical supervision for psychological work with children, and described an approach to short term therapy that could be used when resources did not allow for extensive treatment.

Spielrein and her two daughters, aged 29 and 16, were murdered[55] by an SS death squad, Einsatzgruppe D, in Zmievskaya Balka, or "Snake Ravine" near Rostov-on-Don, together with 27,000 mostly Jewish victims.

[8] : 294–302 [56] Although most of the members of the Spielrein family were murdered in the Holocaust, the wives and children of her brothers all survived, and there are currently around 14 of their descendants living in Russia, Canada, and the United States.[7]: 246–7 [when?]

Despite her closeness to the central figures of both psychoanalysis and developmental psychology in the first part of the twentieth century, Spielrein was more or less forgotten in Western Europe after her departure for Moscow in 1923.

In recent years, however, Spielrein has been increasingly recognized as a significant thinker in her own right, influencing not only Jung, Freud and Melanie Klein, but also later psychologists including Jean Piaget, Alexander Luria and Lev Vygotsky.

The first scholarly biography of her in German, by Sabine Richebächer,[8] places her relationship with Jung in its proper context of a lifelong career of involvement with psychoanalysis and psychology.

Lance Owens suggests that the importance of Spielrein's relationship with Jung should not be historically discounted, but seen as an additional part of her legacy and broad creative influence.

He challenges the presumption that Jung psychoanalyzed Spielrein in any systematic way, reciprocated her feelings for long, saw her as his 'anima', or regarded her as a more significant figure than his other female partners of the time.