Anna O. - Conclusion of Treatment

Conclusion of Treatment

A legend arose about the conclusion of Pappenheim‘s treatment by Josef Breuer. It was handed down in slightly different versions by various people; one version is contained in a letter from Freud to Stefan Zweig:

I was in a position to guess what really happened with Br’s patient long after we parted company when I recalled a communication from Br dating from the time before our joint work and relating to another context, and which he never repeated. That evening, after all her symptoms were overcome, he was again called to her, and found her confused and writhing with abdominal cramps. When asked what was the matter she responded, "Now the child I have from Dr. Br. is coming". At that moment he had in his hand the key which would open the way to the Mothers, but he dropped it. With all his intellectual talents he was devoid of anything Faustian. He took flight in conventional horror and passed on the patient to a colleague. She struggled for months in a sanatorium to regain her health./ I was so sure of my reconsruction that I published it somewhere. Br’s younger daughter (who was born shortly after the conclusion of that therapy, which is not irrelevant as to a meaningful connection) read my portrayal and asked her father about it (this was shortly before his death). He confirmed my analysis, which she later relayed to me.

As nothing is known of such a publication by Freud, it is not clear where Breuer’s daughter could have read it. In the version by Ernest Jones, after his flight Breuer quickly goes on a second honeymoon to Vienna with his wife Mathilda, who actually conceives a child there—in contrast to the imaginary child of Bertha Pappenheim. There is no evidence for any of this, and most of it has been proved false. Breuer did not flee but rather referred his patient to Kreuzlingen. He did not go to Venice but with his family on a summer vacation to Gmunden, and he did not conceive a child (either in Venice or in Gmunden), since his youngest child—Dora Breuer—was born on 11 March 1882, three months before the alleged conception.

Freud’s purpose in describing the conclusion of treatment in a way that contradicts some of the verifiable facts is unclear. The assumption that he wanted to make himself the sole discoverer of psychoanalysis at Breuer’s expense is contradicted by the description of the discovery in Freud’s writings, in which he does not minimize Breuer’s role, but rather emphasizes it. Freud’s behavior is compared by some authors with his conduct in the so-called "cocaine affair". There, too, he gave false representations not only privately, but also several times in published form, without there being any advantage to offset the risk of lasting damage to his scientific reputation.

Breuer later described the therapy as "a trial by ordeal", probably in the sense of an examination. It claimed of him over 1,000 hours in the course of two years.