Anna O. - Illness

Illness

Bertha’s father fell seriously ill of pleurisy in mid-1880 during a family holiday in Ischl. This event was a turning point in her life. While sitting up at night at his sickbed she was suddenly tormented by hallucinations and a state of anxiety. Her illness later developed a wide spectrum of symptoms:

• Language disorders (aphasia): on some occasions she could not speak at all, sometimes she spoke only English, or only French, or Italian. She could however always understand German. The periods of aphasia could last for days, and sometimes varied with the time of day.
• Neuralgia: she suffered from facial pain which was treated with morphine and chloral and led to addiction. The pain was so severe that surgical severance of the trigeminus nerve was considered.
• Paralysis (paresis): signs of paralysis and numbness occurred in her limbs, primarily on only one side. Although she was right-handed, she had to learn to write with her left hand because of this condition.
• Visual disorders: she had temporary motor disturbances in her eyes. She perceived objects as being greatly enlarged and she squinted.
• Mood changes: Over long periods she had daily swings between conditions of anxiety and depression, followed by relaxed states.
• Amnesia: when she was in one of these states she could not remember events or any of her own actions which took place when she was in the other state.
• Eating disorders: in crisis situations she refused to eat. During one hot summer she rejected liquids for weeks and lived only on fruit.

At first the family did not react to these symptoms, but in November a friend of the family, the physician Josef Breuer, began to treat her. He encouraged her, sometimes under light hypnosis, to narrate stories, which led to partial improvement of the clinical picture, although her overall condition continued to deteriorate. Starting on 11 December Bertha Pappenheim was bedridden for several months.