Anna O and the ‘talking cure’

Abstract

‘At the time of her falling ill (in 1880) Fraulein Anna O was twenty-one years old’. Thus begins one of the most famous of all case histories.1 Its author was Dr Josef Breuer. A kind, cultivated and generous man, Breuer was one of the most distinguished physicians of his time, and he counted the great surgeon Theodor Billroth among his patients. He was also an eminent neurophysiologist and discovered the action of the vagus nerve on respiration, as well as the function of the semicircular canals. For some years he engaged a young man named Sigmund Freud to work in his laboratory at the university of Vienna, and it was Freud who eventually managed to persuade him to publish the details of Anna's illness and treatment. Anna, according to Breuer, ‘had hitherto been consistently healthy and had shown no signs of neurosis during her period of growth. She was markedly intelligent, with an astonishingly quick grasp of things and penetrating intuition. She had great poetic gifts, which were under the control of a sharp and critical common sense.’ In spite of these attributes, Breuer reported, Anna fell prey, during her father's final illness and in the months after his death, to the most appalling symptoms of hysterical paralysis and anaesthesia in three out of her four limbs, together with a succession of other distressing psychiatric symptoms. At different times these included weakness, inability to turn her head, diplopia, a nervous cough, loss of appetite, hallucinations, agitation, mood swings, abusive and destructive behaviour, …