Even before I went to Paris, Breuer had told me about a case of hysteria
which, between 1880 and 1882, he had treated in a peculiar manner which
had allowed him to penetrate deeply into the causation and significance
of hysterical symptoms. This was at a time, therefore, when Janet’s
works still belonged to the future. He repeatedly read me pieces of the
case history, and I had an impression that it accomplished more towards
an understanding of neuroses than any previous observation. I determined
to inform Charcot of these discoveries when I reached Paris, and I
actually did so. But the great man showed no interest in my first
outline of the subject, so that I never recurred to it and allowed it to
pass from my mind.
When I was back in Vienna I turned once more to Breuer’s observation and
made him tell me more about it. 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. When Breuer took over her
case it presented a variegated picture of paralyses and contractures,
inhibitions and states of mental confusion. A chance observation showed
her physician that she could be relieved of these clouded states of
consciousness if she was induced to express in words the affective
phantasy by which she was at the moment dominated. From this discovery,
Breuer arrived at a new method of treatment. He put her into deep
hypnosis and made her tell him each time what it was that was oppressing
her mind. After the attacks of depressive confusion had been overcome in
this way, he employed the same procedure for removing her inhibitions
and physical disorders. In her waking state the girl could no more
describe than other patients how her symptoms had arisen, and she could
discover no link between them and any experiences of her life. In
hypnosis she immediately revealed the missing connection. It turned out
that all of her symptoms went back to moving events which she had
experienced while nursing her father; that is to say, her symptoms had a
meaning and were residues or reminiscences of those emotional
situations. It turned out in most instances that there had been some
thought or impulse which she had had to suppress while she was by her
father’s sick-bed, and that, in place of it, as a substitute for it, the
symptom had afterwards appeared. But as a rule the symptom was not the
precipitate of a single such “traumatic” scene, but the result of a
summation of a number of similar situations. When the patient recalled a
situation of this kind in a hallucinatory way under hypnosis and carried
through to its conclusion, with a free expression of emotion, the mental
act which she had originally suppressed, the symptom was wiped away and
did not return. By this procedure Breuer succeeded, after long and
painful efforts, in relieving his patient of all her symptoms.
Public-domain text, read in full here on John Shaqi.
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