On this basis, I have formulated the following ideas:
- a study of ‘hysterical’ patients of the 19th century to identify and further explore those with gynaecological co-morbidities
- a qualitative analysis comparing the lived experiences of 19th-century ‘hysterical’ patients manifesting gynaecological symptoms and those of present-day endometriosis sufferers
- a historical investigation over several millennia designed to find evidence in support of the Nezhat theories.
The amount of new primary material which I obtained from the von Lieben family archive would in itself be sufficient for a number of researchers. Added to this is the substantial bank of archival information which I have built up in the course of my own research. I would like therefore to offer the above ideas as a ‘provocation’ to stimulate further investigation. I will not be undertaking any more substantial academic activity myself, but I would be happy to act as a facilitator for others, putting my knowledge and resources at their disposal, and passing the baton on to the next generation of researchers.
My methods and findings are summarised in the Abstract of my doctoral thesis, In her own words: Exploring the subjectivity of Freud’s ‘teacher’ Anna von Lieben (see below). The thesis itself can be accessed at https://theses.gla.ac.uk/82795/
If you would like further information, or to engage in some exploratory discussion, please contact me at firstname.lastname@example.org
*Nezhat, C., Nezhat, F., & Nezhat, C. (2012). Endometriosis: Ancient disease, ancient treatments. Fertility and Sterility, 98(6), 1-62.
This project is inspired by the work of Roy Porter (1985), who draws attention to the patient-shaped gap in medical history, and Rita Charon (2006), who emphasises the need to bring the patient’s narrative to the fore in the practice of medicine. The principal aim of the project was to devise a means of accessing the lived experience of a patient who is no longer alive in order to gain an understanding of her narrative.
Anna von Lieben was identified as a suitable subject as she wrote a substantial quantity of autopathographical poetry suitable for analysis and her status as Freud’s patient makes her a person of significant interest to the history of medicine.
The poems were analysed using Interpretative Phenomenological Analysis (IPA), an idiographic and inductive method of qualitative research, based on Heideggerian hermeneutic phenomenology, which explores the lived experience of individuals and is committed to understanding the first-person perspective from the third-person position.
The main findings from the IPA study reveal that Anna experienced a prolonged period of malaise, starting in late adolescence which she believed to result, at least partly, from a traumatic experience which occurred at that time. The analysis also indicates that Anna suffered from deep and lasting feelings of guilt and shame.
The discovery of a significant quantity of additional family documentation enabled me to contextualise and give added substance to the findings of the IPA study. The diaries which Anna’s husband kept throughout their marriage reveal that:
- she had a severe and longstanding gynaecological disorder
- she suffered from severe morphinism
- she did not benefit from Freud’s treatment which seemed neither to ease her symptoms nor identify any cause
- she was treated in Paris, not by Charcot as previously supposed, but by a French hydrotherapist, Theodore Keller, who appears to have become a person of considerable significance in her life.
The study overall presents a three-stranded account of the illness and treatment of one of Freud’s patients, combining the narratives of the patient herself, her husband, and Freud. As such, this study is likely to be the first of its kind.