FREUD’S CASE STUDIES
ANNA O • Anna O (real name Bertha Pappenheim) was not actually Freud’s patient, she was a patient of Freud’s older friend Josef Breuer. However, Anna O can still claim the distinction of being the founding patient of psychoanalysis because Freud developed the first stages of his theory based on her case. It is, therefore, worth knowing a few details of her case. At the time of her illness, Anna was 21 years old and until the illness struck she had been healthy and intelligent and had shown no signs of neurosis1 . However, her feelings had always been exaggerated and she could be moody and she day-dreamed a great deal. Her illness fell into several phases: 1. Latent incubation - the early signs of her illness began when her father fell ill and she had to nurse him. Gradually her illness became so bad that she could no longer nurse her father. The main symptom at this stage was a severe cough. 2. Manifest illness - Breuer described this as a “psychosis of a peculiar kind” where she had some paralysis of the right arm and leg, a squint, severe disturbances of vision. She began to hallucinate and was abusive, threw things at people and accuse others of doing things to her. Later in the course of her illness she began to speak only in English (she was a native German speaker) but could still understand German! 3. After her Father’s death - sleepwalking added to the other symptoms and she could no longer understand German and began to refuse food.
Neurosis often begins as a response to a stressor and is usually characterised by a generalised anxiety: the person is irritable, jumpy, finds it difficult to concentrate and make decisions, has trouble sleeping and may experience a whole range of physical symptoms. There is a form of neurosis (that Freud called hysteria) where the person experiences physical symptoms for which there is no detectable physical or bodily cause.
Freud and Breuer suggested that her symptoms were a result of a number of events that were buried in her unconscious and were looking for some external expression. Her symptoms lasted about a year and a half and only went very gradually. They went, according to Freud and Breuer, because she was subjected to a “talking cure” where each symptom was taken in turn, from first to last and discussed with her to try to find the origins and the reasons. According to Freud & Breuer “each symptom disappeared after she had described its first occurrence. In this way too, the whole illness was brought to a close”. In fact, it should be noted that even after her socalled “talking cure” Anna O had to spend time in a sanatorium, was addicted to morphine and still experienced loss of her German language. However, eventually she became a prominent social worker and energetic leader in Jewish feminist causes.
If you were asked to evaluate Freud & Breuer’s interpretation, methods and cure of this case, what comments would you make? DORA Dora (real name Ida Bauer) was the first of Freud’s major case histories (some others are Little Hans, Rat Man, Wolf Man). In 1900, when she was 18, she went into analysis with Freud. The analysis lasted 11 weeks and Freud published the case history in 1905. Dora’s father was a rich, highly intelligent man and Dora was very “tenderly attached” to him and looked down on her mother whom she despised. It was Dora’s father who first came to Freud for medical treatment for himself (remember, Freud was a medical doctor by training). It was because of his contact with Freud that he referred Dora to Freud for treatment. In his written case study of Dora, Freud gives many biographical details about her family and interprets many seemingly “normal” family relationships and incidences in psychoanalytical terms. Note, this is all interpretation based simply on Freud’s ideas. Dora came to Freud for treatment because she developed hysteria. She became depressed, suicidal,...