From the pleasure principle to the reality principle

In the decade following Breuer's treatment of Anna, Freud confirmed for himself Breuer's claim about the curative value of analysands' recollections in a number of other cases of female hysteria (Emmy von N, Lucy R, Katherina —, Elizabeth von R) (CH). Eschewing Breuer's reliance on hypnosis, it was in these cases that Freud developed the method of free association and, a fortiori, clinical psychoanalysis. But why might the spoken expression of forgotten traumatic incidents be a therapeutic experience for individuals? It is one thing to do something; another to know what you have done. Such an unexpected clinical finding, Freud saw, could be made sense of only by a far-reaching account of the mind. Yet the categories of Freud's metapsychology did not come to him all at once, by the time of his first theoretical writings in the early 1890s. Freud would continue to revise them until well after the traumas of World War I.

Sigmund Freud was born in 1856, the youngest son of a pious Jewish wool-merchant, and the only son of his father's second wife. At the time of Breuer's treatment of Anna O (1880–82), Freud was beginning his professional life as a physician in Vienna. Freud's training as a physician, as well as the unquestioned cultural prestige the natural sciences enjoyed in late nineteenth-century Europe, pointed him in the direction of his earliest writings.