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Bertha Pappenheim, ‘Anna O’ (1859-1936)

Bertha Pappenheim of Vienna is the patient whose case history launched psychoanalysis. She was treated under the pseudonym ‘Anna O’. Pappenheim developed bewildering nervous symptoms shortly after turning 20. These included sporadic hearing loss, muscular spasms, paralysis and periods when she could not understand her native German but could still communicate in English and French. Pappenheim was diagnosed with hysteria. Her private physician, Dr. Josef Breuer was a mentor of Viennese neurologist Sigmund Freud. Freud’s mentor found several of Pappenheim’s symptoms disappeared when she reconstructed, under hypnosis, the detailed memory of a painful emotional experience linked to those symptoms. Pappenheim christened this therapy the ‘talking cure’.

In 1895, after persuasion from Freud, they both published Anna O’s case as evidence that hysteria was rooted in painful buried memories. This theory challenged neurologist Charcot, who had argued hysteria came from degenerate biology. However, Breuer and Freud soon parted ways based on their increasingly different ideas. Freud thought his mentor ignored the erotic tension inherent in such an intimate relationship between a respected doctor and an attractive, intelligent young female patient. He privately hinted his mentor’s ‘cure’ had not been entirely successful.

Both Freud and Breuer protected Pappenheim’s identity by never making public what he knew about her later history. Historians decades later established Pappenheim’s illness was only temporarily cured by the ‘talking cure’. She battled hysteria for almost a decade, spent several years in an asylum, and only recovered years later after relocating from Vienna to Germany. She then crusaded for women’s education and rights in the German Jewish community. Her role as Anna O only became public years after her death.

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H F Ellenberger, '‘The story of ‘Anna O.’: A critical review with new data', Journal of the History of the Behavioral Sciences, 8/3 (1972), pp 267-79

D Edinger, Bertha Pappenheim: Freud’s Anna O (Highland Park, Ill.: Congregation Solel, 1968)

AHirschmüller, Physiologie und Psychoanalyse in Leben und Werk Josef Breuers (Bern and Tübingen: Hans Huber, 1978)

E M Jensen, Streifzüge durch das Leben von Anna O./Bertha Pappenheim: Ein Fall für die Psychiatrie—Ein Leben für die Philanthropie (Frankfurt am Main: ZTV, 1984)