The physician and physiologist Josef Breuer he is best known for having used the cathartic method for the first time in the famous case of Anna O., who would inspire his disciple Sigmund Freud to create psychoanalysis. However, Breuer’s conceptions differed from Freud’s in essential points.
Breuer is an important figure in the history of neurophysiology and psychoanalysis. In this article, we will review his biography, his contributions to these two fields and his relationship with Freud; this is why it must also be described Anna O.’s leading role in the realm of hysteria.
Biography of Josef Breuer
Josef Breuer (1842-1925) studied medicine at the University of Vienna and during his early years of professional practice worked as an assistant to Johann von Oppolzer and later to Karl Hering, a physiologist known for his studies of visual perception and eye movements.
Breuer made it important contributions in the field of neurophysiology. During his collaboration with Hering, he described the role of the vagus nerve in the respiratory response; this would give rise to the concept of the “Hering-Breuer reflex”, still in force today.
He was also one of the first to propose that balance depends on the movement of fluid in the semicircular canals of the inner ear and the information the brain receives in relation to these movements.
For much of his life, Breuer worked as a family physician and personal physician for many intellectuals living in Vienna, including the philosopher and psychologist Franz Brentano. He was also professor of physiology at the University of Vienna, where he commissioned Sigmund Freud, with whom he would later collaborate.
The case of Anna O.
In 1880, Breuer began treating Bertha von Pappenheim, a hysterical patient who played a central role in the emergence of psychoanalysis. He would go down in history as “Anna O.” for such was the pseudonym given to it by Breuer and Freud in their joint work Studies on Hysteria, the cornerstone of primitive psychoanalysis.
According to Breuer, Pappenheim had two increasingly differentiated personalities as the treatment progressed. While the first was sad and worried, the second had a more childish and explosive character. This case is one of the earliest recorded examples of dissociative identity disorder (or “multiple personality”).
Breuer noted that Pappenheim’s symptoms, which consisted mainly of partial paralysis, mutism and blindness, temporarily subsided. when he talked about it under hypnosis and attributed a cause to them. The patient also felt relieved when she spoke about her dreams or hallucinations, and it was her own preferences that guided Breuer.
Pappenheim called this type of intervention “Speech Care” or “Chimney Cleaning”; thus was born the cathartic method, consisting in hypnotizing the patient to remember the traumatic event that triggered the symptom (or invent such a memory) and thus eliminate the associated negative emotions, and therefore the symptom.
Freud and the “Studies on Hysteria”
The case of Anna O. inspired Sigmund Freud to write the book Studies on Hysteria in collaboration with his master Breuer. This work, published in 1895, describes the treatment of Bertha von Pappenheim and four other women by hypnosis and the cathartic method.
Theoretically, Freud and Breuer defended two different hypotheses in the book: while the former believed that hysteria was always due to traumatic memories related to sexuality, according to Breuer, neurophysiological causes could also exist.
Contrary to what is explained in “Studies on Hysteria”, Anna O. did not fully recover from Breuer’s treatment but ended up being hospitalized. However, over time her symptoms eased and she became a leading figure in German feminism at the time, as well as a staunch opponent of psychoanalysis.
The relationship between Breuer and Freud is deteriorating rapidly. Freud not only showed his confidence in the cathartic method that Breuer considered unjustified, but he mythologized the case of Anna O. to promote what would become psychoanalysis. Towards the end of his life, Breuer saw Freud in the street and made a gesture to greet him, but his disciple ignored him.
The “speech care” that Breuer developed with the precious collaboration of Bertha von Pappenheim will become the germ of Freud’s psychoanalysis and, consequently, of conventional psychotherapy of the following century.
Breuer’s assumptions regarding the Anna O. case sparked interest in unconscious processes, particularly around the etiology of hysteria and other neuroses. However, Breuer distanced himself from Freud because he disagreed with the emphasis on psychosexual trauma as the sole cause of these disorders.
Breuer considered hypnosis and the cathartic method they could facilitate the creation of false memories, Even though this was felt by patients to be true. Many subsequent critics of Freud would agree with Breuer and his more cautious approach.
- Breuer, J. and Freud, S. (1893-1895). Studies on hysteria. In Complete Works, Volume II. Buenos Aires: furious.
- Leahey, TH (2004). History of psychology, 6th edition. Madrid: Pearson Prentice Room.