HILDA REILLY
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Diagnosing Bertha

27/8/2013

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    A recent Good Reads reviewer wrote that she had some problem with the ending of Guises of Desire. Her difficulty was that, although the Author’s Note at the end had explained what my thinking had been regarding the causes of Bertha’s illness, the explanation had not been clear in the novel itself. In other words, she felt that readers would not be able to work out a diagnosis for themselves, or guess at the kind of diagnosis I had based my interpretation on. 

    I can understand why the reviewer felt this and I’ve been wondering what I could have done to avoid this kind of dissatisfaction – if dissatisfaction it is. 

    Perhaps the explanation can be found in the views of another reader who has commented that I never slip into a contemporary frame of reference, that the setting is pre-Freudian and that nothing of Freudian theory creeps into my character’s words or reflections. I would add that the setting is also pre-modern-neurology and that the kind of diagnosis I have in mind would not form part of it. It’s difficult therefore to see how, while remaining resolutely in the 19th century and with the narrative perspective being that of the characters rather than omniscient, I could have created a picture which would have led the reader, unless a medical professional, to think: Oh yes, Bertha Pappenheim clearly has such and such a condition. As it is, readers are drawn rather into the world of Bertha herself, experiencing the same confusion as Bertha, her family and her doctors, totally perplexed as to what’s going on and trying to figure out their own explanation. 

    Of course, I could have written a different kind of book, one which would have demonstrated quite clearly where I was coming from. I’d thought, for example, of doing one of those split-time novels which are popular now in historical fiction, with perhaps the parallel story of a modern neurological researcher working on the Anna O case, or something similar. Or I could have done something more avant-garde, interspersing the narrative with fragments of contemporary analysis of the case, with excerpts from case studies of later patients displaying similar syndromes, and so on.

    It’s interesting to compare Guises of Desire with the novel Lying Awake by Mark Salzmann which tells the story of a contemplative Catholic nun who has mystical experiences associated with temporal lobe epilepsy. Because the setting is a contemporary one, a full depiction of her condition, both subjective and medical is possible. Of course, this could give rise to a whole new set of questions. Does the corresponding electrical activity of the brain create the content of the mystical experiences or does it provide a conduit to a supernatural dimension. The answer to this is likely to depend on the religious views, or lack thereof, of the reader. And it’s still pretty much true that one’s interpretation of the Bertha Pappenheim case depends on which school of psychological thought one subscribes to.
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Anna O - Whose patient was she?

19/8/2013

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There is no record of Sigmund Freud ever having met Bertha Pappenheim, certainly not in a professional capacity. However, this has proved no obstacle to the common misapprehension that she was his patient. 

Often when I mention that I’ve written a book about Anna O, people will say something along the lines of: ‘Oh, yes, she was one of Freud’s patients, wasn’t she?’ This isn’t really surprising as she is so intimately connected with the history of psychoanalysis. In a sense, she was, as she is sometimes described, ‘Freud’s Anna O’. Her case is the foundation stone on which Freud started to build his theories; and without Freud, Bertha Pappenheim would be known only for her later success as a pioneering feminist and social worker. 

Some people may think that it doesn’t matter whether or not Freud was her doctor, in the same way that some people think that it doesn’t matter whether Shakespeare or someone else wrote his plays and sonnets. It matters very much, in fact, and this is why it’s surprising that the misconception about Anna O even extends to the psychotherapy community.

A cursory Google search threw up a few interesting items. 

A webpage titled Student Resources in Context has Bertha being treated by both Freud and Breuer simultaneously. In this version the collaboration starts with Breuer telling Freud about Bertha. It goes on to say that ‘during daily visits to Freud and Breuer, the doctors discovered that some of her symptoms were alleviated merely by discussing her memories and the feelings they created in her’. Finally, Freud alone is given credit for the cure with the claim that: ‘When Freud encouraged Anna O to recall a given situation and express the reaction she had earlier repressed, her symptoms vanished.’

Psychotherapist Humair Hashmi goes further. Anna O, he claims, began to express affection for Breuer and tried to put her arms round him. This so alarmed Breuer that he passed the case on to Freud. Nothing daunted, Freud, ‘the fearless pioneer that he was’, regarded this as a challenge and interpreted it as a manifestation of transference which could be used as a means of effecting a cure. Hashmi goes on to say:‘This is what Freud did in Anna’s case.’

An even more surprising misrepresentation is one I discovered when I came across a Wall Street Journal review of a show called Dr Freud’s Cabaret in which Freud takes to the boards with a number of his most famous patients. The show starts with an Anna O number called Chimney Sweeping (Bertha Pappenheim’s term for the talking she did with Breuer) and the review describes how ‘Anna O would hold Freud’s hand while she told him fairy stories and dark fantasies that helped alleviate her psychosis.’ Investigating this further I found that the idea for the show had germinated when the writer was readingStudies in Hysteria as research for a novel. So far so good, but the fact that she had done this research makes it even more puzzling that she could then flout the truth by portraying Anna O’s treatment as being with  Freud rather than with Breuer. Artistic licence, you might say. Perhaps. But what really takes the biscuit is that the show was put on at the Freud Museum in London which seems to have been quite comfortable with helping to perpetuate the myth that Freud was Anna O’s patient. It would all be so much neater if she had been, after all. The fact that she was not is possibly, for them, what Al Gore might term ‘an inconvenient truth’. 
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    hilda reilly



    This blog discusses questions related to Guises of Desire, my biographical novel based on the life of Bertha Pappenheim, aka Anna O, the 'founding patient' of psychoanalysis.
    As the posts up to the end of August 2013 have been imported from my previous site the comments associated with them are no longer accessible.

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