Table of ContentsView AllTable of ContentsAnna O’s Significance in PsychologyAnna O.’s SymptomsImpact on FreudWhat Happened to Anna O?Contemporary Views

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Anna O’s Significance in Psychology

Anna O.’s Symptoms

Impact on Freud

What Happened to Anna O?

Contemporary Views

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Anna O., aka Bertha Pappenheim, was the pseudonym given to one of the patients of physician Josef Breuer. Her case was described in the book that Breuer wrote with Sigmund Freud,Studies on Hysteria.

Bertha Pappenheim (February 27, 1859 - May 28, 1936) was her real name, and she had initially sought Breuer’s help with a series of symptoms that included visual disturbances, hallucinations, partial paralysis, and speech problems. Breuer diagnosed the young woman withhysteriaand later discussed her case with Freud, who developed his own ideas of what lay at the root of Anna O.’s condition.

Her treatment played an important role in the establishment and development ofpsychoanalysis.

At a GlanceAnna O. was a patient of physician Josef Breuer, one of Sigmund Freud’s colleagues and collaborators. She was responsible for coining the phrase “talking cure” to describe the talk therapy process that Breuer used to treat her condition. In addition to her impact on psychoanalysis, Pappenheim became an influential figure in the field of social work in Germany.

At a Glance

Anna O. was a patient of physician Josef Breuer, one of Sigmund Freud’s colleagues and collaborators. She was responsible for coining the phrase “talking cure” to describe the talk therapy process that Breuer used to treat her condition. In addition to her impact on psychoanalysis, Pappenheim became an influential figure in the field of social work in Germany.

Bertha Pappenheim, referred to as Anna O. in the case history, came to Josef Breuer for treatment for what was then known as hysteria.

At the time, hysteria was described as a mental condition affecting women that led to symptoms such as blindness, emotional outbursts, hallucinations, and histrionic behavior.

While Freud never actually saw her as a patient, her case had a significant impact on the development of psychoanalysis. Freud was fascinated with her case and consulted with Breuer during her treatment.

While caring for her dying father, Pappenheim experienced a range of symptoms, including:

During the course of treatment, which lasted from 1880 to 1882,Breuer found that talking about her experiences seemed to offer Pappenheim some relief from her symptoms. She dubbed the treatment the “talking cure.”

Freud’s insistence on sexuality as a cause eventually led to a rift with Breuer, who did not share this view on the origination of hysteria. “The plunging into sexuality in theory and practice is not to my taste,” Breuer explained.While the friendship and collaboration soon ended, Freud would continue his work in the development oftalk therapyas a treatment for mental illness.

Pappenheim’s case also influenced the development of the free association technique. Breuer used hypnosis during treatment sessions, but he found that allowing Pappenheim to talk freely about whatever came into her mind was often a good way to improve communication.

Freud himself once described Anna O. as the true founder of the psychoanalytic approach to mental health treatment. Five years later, Freud published his bookThe Interpretation of Dreams, which formalized much of his psychoanalytic theory.

While Breuer and Freud may have painted the picture that Breuer’s treatment cured Anna O. of her symptoms, records indicated that she became progressively worse and was eventually institutionalized.

“So the famous first case he treated together with Breuer and which was vastly praised as an outstanding therapeutic success was nothing of the sort,” Carl Jung, a former Freud disciple, noted in 1925.

Pappenheim eventually did recover from her illness and went on to become an important force in German social work. She also published a number of texts under a pseudonym as well as her own name, including plays, poems, and novellas.

In 1954, Germany issued a postal stamp bearing her image in recognition of her many accomplishments.

Jung’s Theory of Personality and Learning Styles

How would Anna O.’s condition be diagnosed and treated today? Hysteria is no longer seen as a valid condition. Today, people exhibiting such symptoms might be diagnosed with some type of dissociative or somatic disorder. Such disorders includedissociative identity disorderorsomatic symptom disorder.

13 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Madva EN, Ross DA, Cooper JJ.What’s all the hysteria about? A modern perspective on functional neurological disorders.Biol Psychiatry. 2019;85(2):e3-e4. doi:10.1016/j.biopsych.2018.11.003American Psychological Association.Hysteria.Museum of the Jewish People at Beit Hatfutsot.The story of Bertha Pappenheim – Anna O.Koole SL, Tschacher W.Synchrony in psychotherapy: A review and an integrative framework for the therapeutic alliance.Front Psychol.2016;7:862. doi:10.3389/fpsyg.2016.00862Janssen DF.Krankung and erkrankung: Sexual trauma before 1895.Med Hist.2019;63(4):411-434. doi:10.1017/mdh.2019.42Grubin D.Young Dr. Freud.Public Broadcasting Service.Library of Congress.Sigmund Freud: Conflict & culture.Jung CG, McGuire W, Egner H.Analytic Psychology: Notes on the Seminar Given in 1925.Dusseldorf: Walter-Verlag; 1995.Kolling H.[Bertha Pappenheim (1859-1936) and her role in nursing care].Pflege.2000;12(6):341-345.Blechner MJ.The three cures of Bertha Pappenheim (Anna O): The talking cure, the writing cure, and the social cure.Contemporary Psychoanalysis. 2022:58(1):3-25. doi:10.1080/00107530.2022.2078178Psychology Today.Bertha Pappenheim (1859-1936).Armocida E, Martini M.Neurotuberculosis at the time of Anna O.: Life prospects.Journal of the Neurological Sciences. 2019;402:86-87. doi:10.1016/j.jns.2019.05.013Orr-Andrawes A.The case of Anna O.: A neuropsychiatric perspective.J Am Psychoanal Assoc. 1987;35(2):387-419. doi:10.1177/000306518703500205Additional ReadingFreud S, Breuer J. Studies on hysteria. In: Strachey J, Freud A, eds.The Standard Edition of the Complete Psychological Works of Sigmund Freud.24 vols. London: 1953-1964.

13 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Madva EN, Ross DA, Cooper JJ.What’s all the hysteria about? A modern perspective on functional neurological disorders.Biol Psychiatry. 2019;85(2):e3-e4. doi:10.1016/j.biopsych.2018.11.003American Psychological Association.Hysteria.Museum of the Jewish People at Beit Hatfutsot.The story of Bertha Pappenheim – Anna O.Koole SL, Tschacher W.Synchrony in psychotherapy: A review and an integrative framework for the therapeutic alliance.Front Psychol.2016;7:862. doi:10.3389/fpsyg.2016.00862Janssen DF.Krankung and erkrankung: Sexual trauma before 1895.Med Hist.2019;63(4):411-434. doi:10.1017/mdh.2019.42Grubin D.Young Dr. Freud.Public Broadcasting Service.Library of Congress.Sigmund Freud: Conflict & culture.Jung CG, McGuire W, Egner H.Analytic Psychology: Notes on the Seminar Given in 1925.Dusseldorf: Walter-Verlag; 1995.Kolling H.[Bertha Pappenheim (1859-1936) and her role in nursing care].Pflege.2000;12(6):341-345.Blechner MJ.The three cures of Bertha Pappenheim (Anna O): The talking cure, the writing cure, and the social cure.Contemporary Psychoanalysis. 2022:58(1):3-25. doi:10.1080/00107530.2022.2078178Psychology Today.Bertha Pappenheim (1859-1936).Armocida E, Martini M.Neurotuberculosis at the time of Anna O.: Life prospects.Journal of the Neurological Sciences. 2019;402:86-87. doi:10.1016/j.jns.2019.05.013Orr-Andrawes A.The case of Anna O.: A neuropsychiatric perspective.J Am Psychoanal Assoc. 1987;35(2):387-419. doi:10.1177/000306518703500205Additional ReadingFreud S, Breuer J. Studies on hysteria. In: Strachey J, Freud A, eds.The Standard Edition of the Complete Psychological Works of Sigmund Freud.24 vols. London: 1953-1964.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Madva EN, Ross DA, Cooper JJ.What’s all the hysteria about? A modern perspective on functional neurological disorders.Biol Psychiatry. 2019;85(2):e3-e4. doi:10.1016/j.biopsych.2018.11.003American Psychological Association.Hysteria.Museum of the Jewish People at Beit Hatfutsot.The story of Bertha Pappenheim – Anna O.Koole SL, Tschacher W.Synchrony in psychotherapy: A review and an integrative framework for the therapeutic alliance.Front Psychol.2016;7:862. doi:10.3389/fpsyg.2016.00862Janssen DF.Krankung and erkrankung: Sexual trauma before 1895.Med Hist.2019;63(4):411-434. doi:10.1017/mdh.2019.42Grubin D.Young Dr. Freud.Public Broadcasting Service.Library of Congress.Sigmund Freud: Conflict & culture.Jung CG, McGuire W, Egner H.Analytic Psychology: Notes on the Seminar Given in 1925.Dusseldorf: Walter-Verlag; 1995.Kolling H.[Bertha Pappenheim (1859-1936) and her role in nursing care].Pflege.2000;12(6):341-345.Blechner MJ.The three cures of Bertha Pappenheim (Anna O): The talking cure, the writing cure, and the social cure.Contemporary Psychoanalysis. 2022:58(1):3-25. doi:10.1080/00107530.2022.2078178Psychology Today.Bertha Pappenheim (1859-1936).Armocida E, Martini M.Neurotuberculosis at the time of Anna O.: Life prospects.Journal of the Neurological Sciences. 2019;402:86-87. doi:10.1016/j.jns.2019.05.013Orr-Andrawes A.The case of Anna O.: A neuropsychiatric perspective.J Am Psychoanal Assoc. 1987;35(2):387-419. doi:10.1177/000306518703500205

Madva EN, Ross DA, Cooper JJ.What’s all the hysteria about? A modern perspective on functional neurological disorders.Biol Psychiatry. 2019;85(2):e3-e4. doi:10.1016/j.biopsych.2018.11.003

American Psychological Association.Hysteria.

Museum of the Jewish People at Beit Hatfutsot.The story of Bertha Pappenheim – Anna O.

Koole SL, Tschacher W.Synchrony in psychotherapy: A review and an integrative framework for the therapeutic alliance.Front Psychol.2016;7:862. doi:10.3389/fpsyg.2016.00862

Janssen DF.Krankung and erkrankung: Sexual trauma before 1895.Med Hist.2019;63(4):411-434. doi:10.1017/mdh.2019.42

Grubin D.Young Dr. Freud.Public Broadcasting Service.

Library of Congress.Sigmund Freud: Conflict & culture.

Jung CG, McGuire W, Egner H.Analytic Psychology: Notes on the Seminar Given in 1925.Dusseldorf: Walter-Verlag; 1995.

Kolling H.[Bertha Pappenheim (1859-1936) and her role in nursing care].Pflege.2000;12(6):341-345.

Blechner MJ.The three cures of Bertha Pappenheim (Anna O): The talking cure, the writing cure, and the social cure.Contemporary Psychoanalysis. 2022:58(1):3-25. doi:10.1080/00107530.2022.2078178

Psychology Today.Bertha Pappenheim (1859-1936).

Armocida E, Martini M.Neurotuberculosis at the time of Anna O.: Life prospects.Journal of the Neurological Sciences. 2019;402:86-87. doi:10.1016/j.jns.2019.05.013

Orr-Andrawes A.The case of Anna O.: A neuropsychiatric perspective.J Am Psychoanal Assoc. 1987;35(2):387-419. doi:10.1177/000306518703500205

Freud S, Breuer J. Studies on hysteria. In: Strachey J, Freud A, eds.The Standard Edition of the Complete Psychological Works of Sigmund Freud.24 vols. London: 1953-1964.

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