“A chance observation”: Freud's introduction to psychoanalysis

“Anna O” had problems. Not the least of her problems was that the medical sciences of her day could neither cure her, nor explain what was causing her suffering. Anna O (real name Bertha Pappenheim) developed a number of troubling symptoms between July 1880 and June 1882. Many of these seemed to be physical in nature. Anna suffered rigid paralysis on the right side of her body, then her left arm. Her vision was impaired. The posture of her head was disturbed, and she had a nervous cough. Anna suffered from a kind of eating disorder – or, more precisely, a “drinking problem”. For six weeks, she could not drink water, despite suffering tormenting thirst. Anna's capacity to speak was severely disturbed. She could speak only English for eighteen months, although her mother tongue was German, and she could understand others' speech. Finally, Anna would lapse into periods of delirium or “absences”, during which she would abuse and throw cushions at her carers (AO: 21–33). Yet medical examinations could reveal no physical causes for these symptoms.

European medicine in the nineteenth century had a word to describe the condition of women suffering from such strange symptoms as Anna O's: “hysteria”. Yet, as French philosopher Michel Foucault (and others) has documented (Foucault 1990), the understandings and treatments for mental illnesses such as hysteria available at that time were scientifically – and ethically – very questionable.