Hysteria, Identification, and the Family: A Rereading of Freud's Dora Case

Introduction

Freud's first major case history, Fragment of an Analysis of a Case of Hysteria (1905), has long been recognized as one of the classic texts of psychoanalysis.¹ While analysts have been inclined to mine the Dora case for its description and treatment of hysteria, feminists have reframed it as an illustration of the gender conflicts in Victorian Europe. From this standpoint, Freud is seen as a typical patriarch who, by using his position of power in the analytic situation, suppressed a woman's desperate attempt to extricate herself from a stifling role and reinforced the inequality that had caused her distress in the first place. Romanticizing hysteria, some feminists regard Dora as a heroine whose "illness" is a form of revolt against societal norms, while others tend to pity her as a victimized figure who constitutes her subjectivity around a pathological narrative that renders her protest impotent.

In the present essay, I seek to reexamine Dora's hysteria in the context of her "extended family," comprising both members of the family and close friends, which I conceptualize as a system. Grounding my interpretation in Christopher Bollas's (2000) theory of hysteria as a form of identification, I shall argue that hysteria was the preferred mode of communicative interaction governing this system. Thus, I shall present Dora's hysterical symptoms as emanating from and representing her relations with family members, especially her father, all of whom manifested illnesses. I shall conclude with an analysis of Dora's two dreams that shows them to express her evolving recognition of the role that disease played within her familial environment and her ambivalent attitude towards this "family law" of hysteria.²

Hysteria and the Family

The family was allotted a prominent position in Freud's most distinctive vehicle for representing his theory and practice—the case history, which had evolved from the genre of the medical case study. The case study, employed in the practice of neuropathology, had viewed familial heredity as a determinative category in the etiology of disease, comparable in status to organic causation. Although Freud was critical of the notion of the neuropathic family and the clinical practices it entailed, believing that admitting heredity as a causative agent impeded understanding how nervous illness could be acquired, he did not relinquish the family as an etiological category. Upon developing the genre of the psychoanalytic case history, he reintroduced the family in an amended form, conceptualizing its influence as mainly social rather than biological. No longer a vehicle for the hereditary transmission of illness, the family in Freud's case histories creates a circumstantial setting in which a symptomatology is developed in common by the co-resident members. Illness is thus situated within a social network of object relations. In the Dora case, Freud delineated the methodological principles, derived from his conception of the family's function in the development of hysteria, which should guide the psychoanalyst's work:

It follows from the nature of the facts which form the material of psychoanalysis that we are obliged to pay as much attention in our case histories to the purely human and social circumstances of our patients as to the somatic data and the symptoms of the disorder. Above all, our interest will be directed towards their family circumstances—and not only, as will be seen later, for the purpose of enquiring into their heredity.

(1905, 18)

Building on Freud's fundamental premise, Christopher Bollas, in Hysteria (2000), describes the family as a small "world" governed by its own conventions and laws, which are evoked through countless negotiations and interactions among its members. It thus forms a type of "primary object."³ Bollas views maturation as a movement through the family world, during which the child learns the prevailing conventions. These are internalized to form an inner object, which...