Breuer, Freud and the Case of Anna O: A Re-Examination

In the Paper I want to reconsider an episode from the earliest history of psychoanalysis, and in so doing to celebrate a centenary of sorts. Just one hundred years ago this Summer Dr. Josef Breuer concluded the treatment of the twenty three year old Bertha Pappenheim, more familiar under the pseudonym, Anna O. Shortly afterwards, on November 18th 1882, he communicated his findings to his young colleague and protégé, Dr. Freud, and thereby through a chain of consequence the case came to have such a profound influence on subsequent psychoananalytic theory and practice. However, my reason for wishing to re-examine this episode is not simply to record an anniversary, however noteworthy. I hope to show that there is much to merit careful scrutiny about the case itself, and about the reflections Breuer and Freud made upon it in the decade and a half before its publication as the first Case History in their joint Studies on Hysteria (Freud 1895d).

If there is one thing which being a Child Psychotherapist in daily communication with the mental life of small children constantly teaches, it is the realisation of how richly informative a guide can be the way thoughts, feelings and impulses are dealt with in the earliest stages of life for understanding the complexities of adult mental processes. One learns far more about adult mental life from the study of children than about the children's mental life from the study of adults. Similarly with the history of psychoanalysis: to understand current concepts and controversies one must look to the past. Unfortunately, psychoanalysts who have turned to historical research have too often tended to view the past in terms of the present rather than the other way about.

Instead, I propose taking seriously Freud's own dictum in the preface written years later for a new edition of Studies on Hysteria:

“I can give no better advice to anyone interested in the development of catharsis into psychoanalysis than to begin with … (this wo