Origins of Psychoanalysis and Psychology Part 2

About the origins of psychoanalysis, psychology, psychiatry, history of Anna O. and Dr. Josef Breuer, not Sigmund Freud.

FIRST PERSON ON THE COUCH--THE BEGINNING OF PSYCHOANALYSIS

WHEN: 1880-1882

Almost every evening, Breuer came to see the young patient, whom he later called Anna O. (a pseudonym to protect her identity). While she was in a hypnotic state, she would tell him a story from what she called her "private theater." The story was usually sad, somewhat like one of Andersen's fairy tales, and almost always involved a sick father who was being saved by a young girl's devoted care, a reflection of her feelings while nursing her own sick father. In telling the story, she was able to express her hidden emotions, and usually was calm the next day. If she did not get a chance to tell her story, she was likely to be moody or violent.

The treatment continued. There was a great setback when her father died. For 3 days after that, Anna could not speak at all. Then she told Breuer that she could not recognize faces until she had done "recognizing work." To figure out who family members or friends were, she had to note separately each feature--long, dark hair or a certain facial shape--then assume it was so-and-so, who had those features. Everyone except Breuer looked like a wax figure to her. It was like a nightmare, but so were many of her hallucinations. In the terrifying world of her unconscious, there were snakes, death's heads, and other horrors. She and Breuer discovered that when they were able to identify the incidents in her life during which the hallucinations had 1st appeared and to link them to her physical symptoms, the hallucinations and physical symptoms both disappeared.

In every case, there were complexes of incidents, each of which had to be brought from the unconscious to the conscious level. Most had 1st occurred during her father's illness. For instance, one night she had been sitting by her father's bedside and had fallen asleep, her arm hanging over the back of her chair. When she woke, she saw a snake about to attack her father. She could not move her arm because, held in an awkward position, her arm had gone numb. Looking down, she saw each finger as a little black snake and each fingernail as a death's head. When she tried to pray, all she could remember was a nursery rhyme in English, "All the King's horses and all the King's men couldn't put Humpty Dumpty together again." This incident had frightened Anna so much that she had buried it deep in her unconscious mind, and her arm had become paralyzed. However, once she remembered what had happened and talked about it with Dr. Breuer, she stopped seeing snakes and death's heads and could move her arm again.

At last, in June of 1882, Anna seemed cured. The treatment over, she and Breuer said good-bye, supposedly for the last time. However, a day later, Breuer was called again to the apartment. When he arrived, Anna's mother told him the girl was suffering from cramps. It was more than cramps. When Breuer entered Anna's room, he heard her saying, "Now Dr. Breuer's baby is coming." She was acting out childbirth. Shocked by this openly sexual display that involved him, Breuer hypnotized Anna and told her that the incident was imaginary. He made it a point never to see her again.

It was probably because of this final incident that Breuer waited for a long time before publishing anything about the case and did not carry his study of hysteria much further. Later he heard that Anna, treated by another doctor, had become a morphine addict and had been committed to a sanitarium.

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