If the account I have so far given has led the reader to expect that the
_Studien über Hysterie_ must, in all essentials of their material
content, be the product of Breuer’s mind, that is precisely what I
myself have always maintained and what it has been my aim to repeat
here. As regards the theory put forward in the book, I was partly
responsible, but to an extent which it is today no longer possible to
determine. That theory was in any case unpretentious and hardly went
beyond the direct description of the observations. It did not seek to
establish the nature of hysteria but merely to throw light upon the
origin of its symptoms. Thus it laid stress upon the significance of the
life of the emotions and upon the importance of distinguishing between
mental acts which are unconscious and those which are conscious (or
rather capable of being conscious); it introduced a dynamic factor, by
supposing that a symptom arises through the damming-up of an effect, and
an economic factor, by regarding that same symptom as the product or
equivalent of a quantity of energy which would otherwise have been
employed in some other way. (This latter process was described as
_conversion_.) Breuer spoke of our method as _cathartic_; its
therapeutic aim was explained as being to provide that the accumulated
affect used for maintaining the symptom, which had got onto the wrong
lines and had, as it were, become stuck there, should be directed onto
the normal path along which it could obtain discharge (or _abreaction_).
The practical results of the cathartic procedure were excellent. Its
defects, which became evident later, were those of all forms of hypnotic
treatment. There are still a number of psychotherapists who have not
gone beyond catharsis as Breuer understood it and who still speak in its
favor. Its value as an abridged method of treatment was shown afresh in
the hands of E. Simmel in the treatment of war neuroses in the German
army during the Great War. The theory of catharsis had not much to say
on the subject of sexuality. In the case histories which I contributed
to the _Studien_, sexual factors played a certain part, but scarcely
more attention was paid to them than to other emotional excitations.
Breuer wrote of the girl, who has since become famous as his first
patient, that her sexual side was extraordinarily undeveloped. It would
have been difficult to guess from the _Studien über Hysterie_ what an
importance sexuality has in the ætiology of the neuroses.
Public-domain text, read in full here on John Shaqi.
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