The Case of Anna O.

Anna O., the pseudonym of Bertha Pappenheim, was a patient of the Viennese physician Josef Breuer beginning in late 1880, whose treatment became the founding case described in Breuer and Sigmund Freud's 1895 book Studies on Hysteria and one of the originating case studies of psychoanalysis. Pappenheim, then about twenty-one years old, developed a range of symptoms that Breuer diagnosed as hysteria, including paralysis, disturbed vision and speech, and periods of altered consciousness, following a period spent nursing her dying father. During sessions of self-induced hypnotic trance in the evenings, Pappenheim recounted emotionally charged memories and stories in vivid detail, a process she herself called the talking cure and, more informally, chimney sweeping. Breuer observed that when a particular symptom's origin was traced and discussed in this way, that specific symptom would often subside afterward, and he and Freud developed this observation into the cathartic method, the idea that a psychological symptom could be relieved by consciously recalling and emotionally reliving the forgotten experience that gave rise to it. The case of Anna O. introduced Freud to the therapeutic potential of verbal, associative treatment and directly shaped the technique that became psychoanalysis, even though later historians have raised significant questions about how completely Breuer's own account reflected the actual course and outcome of Pappenheim's treatment.