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Theories: Sexuality
Josef Breuer
Josef Breuer
(Sigmund Freud Copyrights)
Josef Breuer was a highly regarded physician with a thriving practice in Vienna. Nearly 15 years older, Breuer had befriended Freud when Freud was still a student, lent him money, and shared his ideas. The two men grew so close that Freud named his oldest daughter after Breuer's wife.

Breuer had once shared with Freud the story of one of his patients - a young woman he would later call, to guard her identity, Anna O. Her real name was Bertha Pappenheim, a twenty-one-year old, beautiful, clever and marked with what Breuer described as a highly poetic temperament. Freud never met her, but Breuer's account of her treatment helped convince him that hysteria was connected to the slumbering imagination. Bertha would be the first person to experience what she herself called "the talking cure."

FREUD: "The patient had been a young girl of unusual education and gifts, who had fallen ill while she was nursing her father, of whom she was devotedly fond."

As her father grew weaker, Bertha rarely left her room, except to sit by his bedside. In her distress, she developed increasingly bizarre symptoms; a nervous cough, headaches, blurred vision, paralysis in an arm or leg and, worst of all, horrifying hallucinations.

Terrified by the thought of her father's death, she conjured up images of fear and mortality. Overwhelmed, she turned to Breuer for help. To treat her hysteria, Breuer put her into a hypnotic trance. Then, he questioned her about her feelings, rather than commanding her to overcome her illness. "Breuer arrived at a new method of treatment," Freud remarked. "He made her tell him what it was that was oppressing her mind." Remarkably, her symptom disappeared.

The thought of her father's death and her passionate love for him had been too much for Bertha to bear. Hypnosis, Breuer discovered, seemed to free her to explore her suffering. Bertha described talking to Breuer as "chimney sweeping."

Bertha Pappenheim (Anna O)
Bertha Pappenheim (Anna O)
(Sigmund Freud Museum Vienna)
GAY: When she talked freely, and he encouraged her, the symptoms would disappear. They might come back and then you did it again and they would go away. It's something that was unheard of that you might get rid of certain symptoms by talking them out.

EAGLE: There is a thought that is so unacceptable to her that she has to banish it from consciousness. But even though it's banished, it does its dirty work anyway in producing symptoms. Hysterical symptoms are linked to specific traumatic events that have been not accessible to normal states of consciousness. Therefore, you hypnotize the person, put them in a state where they can gain access to these traumatic memories, and they disappear. That was the rationale for Breuer's treatment.

After further struggle, Bertha's symptoms eventually subsided. From the case of Anna O., Freud learned that recapturing the past promised hope for the future. Freud continued to work on the problem of hysteria with Breuer. They elaborated their ideas in professional journals and finally, in a book, Studies in Hysteria, published in 1895. But their collaboration and their friendship was coming to an end over a highly charged issue:

FREUD: "Whatever case and whatever symptom we take as our starting-point, in the end we infallibly come to the realm of sexual experience."

Freud kept noting the sexual material peeping out from behind the symptoms of his patients.
Freud kept noting the sexual material peeping out from behind the symptoms of his patients. Freud grew convinced that the cause of hysteria lay not just with any early traumatic experience but with early traumatic sexual experience.

GAY: Respectable people in the 19th Century… were very squeamish about the matter of sexuality. They didn't talk about it, if they talked about it at all they used euphemisms, they went into marriage uninformed. This was a kind of unacceptable subject. And Freud argues that what's unacceptable… will then be repressed. It will be put into that invisible compartment in your mind. And this is something that Freud thought Breuer had failed to see.

Breuer objected that Freud had collapsed the complex lives of his patients into one, sweeping theme - sexuality.
"The plunging into sexuality in theory and practice," Breuer wrote, "is not to my taste." Breuer objected that Freud had collapsed the complex lives of his patients into one, sweeping theme - sexuality.

EAGLE: He did not accept Freud's theory and I suspect with good reason. But he's more careful, he needs more data, he's more cautious.

YOUNG-BRUEHL: Freud's scientific training was to look for the single cause behind a multiplicity of phenomena, which could produce reductive explanations. The single-minded attention to sexual desire did obscure other desires. But, you have to be single-minded when you are going against great forces of opposition and centuries of different understanding and you're trying to lever your way into something novel. Freud's theory is a very frightening one. It's very frightening to think that people are as moved around by their sexual desire as Freud held them to be.

The collaboration between Freud and Breuer ended abruptly, the bond between the two men broken, never to be mended. The end of the relationship saddened him, but he could not deny the evidence of his theory that he saw in his patients.

FREUD: "The development of psycho-analysis afterwards cost me his friendship. It was not easy for me to pay such a price, but I could not escape it."

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