Demolishing the myths that have arisen round Sigmund Freud (most of which were sedulously created by him) has become somewhat of a parlour game. The latest player is Mikkel Borsch-Jacobsen. In a closely argued and well-documented book, he demonstrates that almost everything believed by psychoanalysts about the case of Anna O is false, an important finding since Freud himself always maintained that this case "was the foundation of psychoanalysis".
Anna O, a pseudonym, was treated not by Freud but by his friend and mentor, Josef Breuer. She had a hotch-potch of symptoms including over-convergence of the eyes, terrifying hallucinations, inability to speak her native language while being able to talk in others and long-lasting muscle contractions. According to Breuer, she recovered from each symptom when she remembered the event that triggered it. When all her symptoms had disappeared, she developed pregnancy cramps in front of Breuer, declaring "Now Dr B's child is coming", whereupon Dr B fled the room. This mythical tale fits Freud's theory well - he thought hysteria was caused by repressed libido and could be "cured" by uncovering the traumatic events that precipitated the repression. Remembering Anna O takes the myth to pieces point by point.
It was already known that, despite Freud's claims, Breuer did not effect a cure. Indeed, within a month of ending her treatment, Anna entered a sanitorium where she remained for over a year with many of her symptoms persisting even after her discharge from hospital. So far from her illness being due to her libido, Breuer wrote more than once that she was peculiarly sexless. Outrageously but not atypically Freud appears to have invented the story of the phantom pregnancy several years later. The tale grew with the telling, for Freud informed Jung that he had been present when Breuer fled, but elsewhere Freud admits that he never met Anna, an admission confirmed by other sources.
Borch-Jacobsen argues that the disappearance of symptoms was not necessarily caused by the recall of precipitating events. The material recalled could have been purely imaginary: indeed, it may have been the recall of previous hallucinations, for Breuer himself refers to some of Anna's outpourings as fantasies. Breuer and Anna may even have been playing a game with one another, in which at least some of her symptoms were suggested by him under hypnosis: compare the recent surge in multiple personalities, surely in part due to suggestions made to patients by psychotherapists and psychiatrists. Furthermore, Breuer himself thought some of her symptoms were simulated: he wrote that on one occasion Anna reproached herself for "the idea that she had not been ill at all and that the whole business had been simulated". It is today accepted that hysteria is at least in part a method of gaining attention or of evading unwelcome responsibilities.
That Breuer was not happy with the case is suggested by the fact that he did not publish anything on it for 11 years, and then only at Freud's instigation. His own case notes, however, written in 1882, survive, but bear only a tangential resemblance to the later report. Freud acclaimed the case, asserting that it had revealed the role of repressed traumatic events in producing neurosis and the possibility of cure effected by recovering them. In fact since these ideas only appear in the published paper of 1893 and had in the meantime been put forward by Janet, the claim that they were discovered as a result of the Anna O case is yet another fabrication.
Borch-Jacobsen does not mention any modern medical findings on hysteria. One study examining patients who had already been diagnosed as hysterics, found that 66 per cent of them actually had brain lesions: the greater prevalence of hysteria in Freud's day may simply have been caused by mistaking organic symptoms for psychological ones. Nor does he mention E. W. Thornton's thesis that Anna O was suffering from brain damage, possibly caused by meningitis, from which recovery occasionally takes place.
This does not detract from his enjoyable exposure of Freud's lies and tergiversations nor his vitriolic attack on Freud's latter-day disciples, several of whom refuse to release documents that would discredit this disreputable man even further.
Stuart Sutherland is emeritus professor of experimental psychology, University of Sussex.
Remembering Anna O
Author - Mikkel Borch-Jacobsen
ISBN - 0 415 91776 X and 91777 8
Publisher - Routledge
Price - £35.00 and £11.99
Pages - 118