Studies in hysteria by Sigmund Freud and Josef Breuer
Studies in Hysteria by Sigmund Freud and Josef Breuer pdf
Never Done, Never to Return
Near the start of the Studies in Hysteria, Breuer and Freud describe what they have newly understood to be the sequence by which hysterical symptoms are cured:
The psychical process that had originally taken place has to be repeated in as vivid a way as possible, brought to its status nascendi, and then ‘talked through’. This makes any phenomena involving stimuli – cramps, neuralgias, hallucinations – appear once more at full intensity and then vanish [schutinden] forever.
The order outlined here involves a return to a point of origination; a repetition or rereaction; and a final ending. Past, present and future interfere with one another and reconnect; a painful ‘return’ of or to a past, resurrected and relived, makes possible a future ‘forever’ free of the symptom. ‘Hysterics suffer for the most part from reminiscences’ , in Breuer and Freud’s resonant phrase; for their suffering to be relieved, the sore past must be allowed to emerge into the present, its pressure relieved.
What happens in this is dramatic. A performer makes a final appearance, a reprise for one last time, charged with the built-up emotion (‘at full intensity’) of the finale. A rebirth (going back to the ‘status nascendi’) is followed by sudden death. This is a twofold drama, made up of the patient’s retrospective telling or reliving, now, during the therapeutic conversation, and the recovered history, now seen by the patient for what it was: for its subsequent significance. This recalls, or anticipates, what was to be the future role in psychoanalysis of an actual play: Sophocles’ Oedipus Rex.
Oedipus’ story gives Freud the model of (male) childhood development in the structure of the Oedipus complex, but this is not all that the play suggests. Its action, as Freud points out in The Interpretation of Dreams (1900), consists of nothing other than dialogues that ultimately rewrite Oedipus’ history by showing it up in a completely different light: the combination of present conversation coupled with a reinterpretation of the past is exactly what happens in psychoanalysis.
The theatrical language of Breuer and Freud’s exposition points to both a connection with and a departure from the treatment of hysteria at the time. In the mid-1880s, Freud had spent six months in Paris following the work of Charcot, the renowned psychiatrist who gave public presentations of hysterical patients at the Salpetriere hospital. The patients were exhibited before an audience; their illness was seen in the form of a repeatable performance, in the four characteristic ‘phases’ of a hysterical attack.
Charcot used hypnosis to induce hysterical acts and attacks as a means of demonstrating their typical features. The effect was also to suggest that the illness, if it could be stimulated artificially in this way, was not primarily organic or hereditary. Breuer and Freud followed him in this theoretical postulate, but their treatment took a different course. The stress fell on the auditory not the visual; not on the patient as a bodily spectacle for assembled observers, but on her words to a single trusted interlocutor. Here the rehearsal of the symptoms is not didactic (for an audience) but therapeutic (for the patient). The theatre, as in the first quotation, is no longer a real one, in which symptoms are made to appear, but an analogical one in which they spontaneously perform for one last time.
The move from the real to the analogical theatre is also a passage from public to private space. In one of her many striking verbal inventions, Breuer’s patient ‘Anna O.’ speaks of her ‘private theatre’. She is referring to the sometimes painful daydreaming through which she drifts away from the here and now into what the (German) text calls (in French) her absences. In this ‘double consciousness’ she is carried to another place and time, imagined or past. This other world is set apart from present reality, but not inaccessible to it. It is described as occurring through a form of self-hypnosis, in which Anna O. creates for herself the second consciousness that Breuer’s use of hypnosis in treatment was meant to bring about. But the private theatre worked quite differently when it was presented to someone else: instead of being the sign of the illness, the second mental state could be made the means of the cure. Anna O. got into the habit of regularly describing the scenes she saw.
The one-woman show with the same person doubling as audience thus changed its register, taking on a restricted public form through the communication of words and feelings to another. Another patient, Frau Emmy von N., instantly produces a whole set of parallel memories ‘in such swift succession that it was as if they were a single episode in four acts’ . Continuing the dramatic analogy, the traumatizing moments in the past that return, eventually, to Miss Lucy R. are described by one-woman show with the same person doubling as audience thus changed its register, taking on a restricted public form through the communication of words and feelings to another. Another patient, Frau Emmy von N., instantly produces a whole set of parallel memories ‘in such swift succession that it was as if they were a single episode in four acts’ .
Continuing the dramatic analogy, the traumatizing moments in the past that return, eventually, to Miss Lucy R. are described by Freud as ‘scenes’. When they have appeared to her in their relatedness, and she has reported on them to Freud, she is freed of their impact. She becomes the spectator and critic of these extracts from her history that, in being represented, can be both recognized and set at a distance; setting them out in words could operate as a form of relief. It was Anna O. herself who, famously, named this the ‘talking cure’, surely the mother of all soundbites, and as telling a catchphrase for what was not yet psychoanalysis as anyone could have dreamt up….