On Rereading the Case of Anna O.: More About Questions That are Unanswerable

There is something seductive about the story of Anna O., and today she continues to be a source of interest and curiosity, even though a century or so has passed since the critical events took place. In part, this is because she was “the first,” the patient who opened the way for psychoanalytic thinking — but there is much more. She moved the imaginations not only of Breuer and Freud but of many who followed them. Breuer obviously was captivated by her and spent more time with her than he had previously with any other hysterical patient — or ever would again. Freud (1893, 1905, 1910, 1914, 1923, 1925a, 1925b, 1926, 1932), who never treated her, mentioned her more often than any of his own patients and he came back to her case in his writings again and again. She stands out most vividly among the patients in Studies on Hysteria (Breuer and Freud, 1893-1895) and her personality has a special luster that the other patients lack, even though her history was deliberately curtailed by Breuer. There is drama, courage, idealism, and the liveliness of a bright, strong-minded, but difficult young woman whose conflicts were intense enough to cause a major breakdown. Finally, after prolonged illness, which included six hospitalizations, recovery came and stability of a sort, based on a spartan life style, unremitting hard work, and dedicated altruism.

Curiosity about Anna O. has produced a large literature — many articles and several books (Edinger, 1963; Ellenberger, 1970; Freeman, 1972; Hirschmüller, 1978, 1989; Jensen, 1984; Rosenbaum and Muroff, 1984; Slavney, 1990; Thornton, 1983) that have attempted