Story of Psychology - Morton Hunt [108]
Breuer told Freud that he had visited her regularly but could not help her until he accidentally stumbled on a curious method of doing so. During her “absences,” she would mutter words that arose from a train of thought, and Breuer found that by lightly hypnotizing her, he could get her to use these words as a starting point to reproduce for him the images and fantasies in her mind—after which, strangely, she would be free of mental confusion for a number of hours. The next day she might relapse into another absence, but Breuer could again dispel it by another light hypnosis. She called it “the talking cure” or sometimes “chimney sweeping.”
Breuer also told Freud that the talking cure could do much more than temporarily relieve her mental confusion; if he could get her to remember under hypnosis when, and in what connection, a particular symptom first appeared, the symptom would disappear. In one session, for instance, she traced her inability to drink water back to a time when she saw a little dog drink from a water glass and was disgusted by the sight; when she came out of the trance she was able to drink and the symptom never returned. Similarly, the talking cure rid her of the paralysis in her right arm after she recalled that one time, while tending her father, that arm was draped over the back of the chair and became numb, at which point she had had a dream of a black snake approaching and of being unable to use her arm to fend it off.
By this method Breuer tackled her symptoms one by one and brought them all under control. But one evening, he told Freud, he found her confused again and writhing with abdominal cramps. He asked her what was the matter. “Now comes Dr. B.’s child,” she said.10 He realized with alarm that she was undergoing a hysterical pregnancy stemming from fantasies about him. He abruptly referred her to a colleague, went on vacation with his wife, and treated Bertha Pappenheim no more.
She had not, in fact, been cured by the catharsis of the talking cure but only temporarily relieved of her symptoms. It remained for Freud to discover years later that such patients needed to do more than remember the events that triggered each symptom; they had to search for their hidden meanings. In most cases, he would find, these were sexual, as in the episode of “Dr. B.’s child.” But Breuer was uncomfortable with the topic of sexuality, and though at the moment of the hysterical pregnancy he had “had the key in his hand” (as Freud later wrote to a friend), “he dropped it… [and] in conventional horror took to flight.”11
(Bertha Pappenheim spent some time in a sanatorium, where she eventually recovered. She went on to have a successful career, first as housemother in an orphanage, then as head of an institution for unwed mothers and young prostitutes, and the leader of a long-term campaign to protect “endangered girls.” She never married and had no recorded love life; the sexual problems underlying her hysteria were not cured but sublimated—a process Freud would later elucidate—in good works for fallen women.12)
In 1886, four years after Breuer told him about that case, Freud, then thirty-one, opened an office (and later that year married Martha) and began private practice as a specialist in neurological and brain disorders, which he treated with such physical therapies as were then available. But few patients arrived, and he was glad to get Breuer’s referrals of patients suffering from hysteria. Freud had recently taken special training in that subject;