Anna O.

Anna O. was the name given to a patient of the psychiatrist Joseph Breuer in his book "Studies on Hysteria", written in collaboration with Sigmund Freud. Her actual name was Bertha Pappenheim. Her sister, Marie Pappenheim, as a medical student, wrote the libretto, depicting a woman's mental breakdown, for Arnold Schoenberg's Erwartung.

She suffered from hysterical paralysis, where one of her arms was paralyzed even though there was nothing medically or physically wrong with it. After study, it was discovered this was the arm she had cradled her dying father with. It was theorised that she was unconsciously stopping the use of the arm as punishment because she blamed herself for her Father's death.

Anna O. was Joseph Breuer's patient from 1880 through 1882. Twenty one years old, Anna spent most of her time nursing her ailing father. She developed a bad cough that proved to have no physical basis. She developed some speech difficulties, then became mute, and then began speaking only in English, rather than her usual German.

When her father died she began to refuse food, and developed an unusual set of problems. She lost the feeling in her hands and feet, developed some paralysis, and began to have involuntary spasms. She also had visual hallucinations and tunnel vision. But when specialists were consulted, no physical causes for these problems could be found.

If all this weren't enough, she had fairy-tale fantasies, dramatic mood swings, and made several suicide attempts. Breuer's diagnosis was that she was suffering from what was then called hysteria (now called conversion disorder), which meant she had symptoms that appeared to be physical, but were not.

In the evenings, Anna would sink into states of what Breuer called "spontaneous hypnosis," or what Anna herself called "clouds." Breuer found that, during these trance-like states, she could explain her day-time fantasies and other experiences, and she felt better afterwards. Anna called these episodes "chimney sweeping" and "the talking cure."

Sometimes during "chimney sweeping," some emotional event was recalled that gave meaning to some particular symptom. The first example came soon after she had refused to drink for a while: She recalled seeing a woman drink from a glass that a dog had just drunk from. While recalling this, she experienced strong feelings of disgust...and then had a drink of water! In other words, her symptom -- an avoidance of water -- disappeared as soon as she remembered its root event, and experienced the strong emotion that would be appropriate to that event. Breuer called this catharsis, from the Greek word for cleansing.

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