A Dream of Undying Fame: How Freud Betrayed His Mentor and Invented Psychoanalysis, and: Sigmund Freud and the History of Anna O.: Reopening a Closed Case (review)

Every student of psychoanalysis is familiar with the riveting story of how Breuer fled in a panic as his patient Anna O. revealed her "pregnancy," naming him as the father of her baby. Supposedly realizing that her new hysterical symptom was the result of their intense relationship, he made the decision precipitously to end her treatment. Legend has it that Breuer quickly embarked on a vacation with his wife, whereupon she became pregnant with their next child. Breuer's intense relationship with the "hysterical" Anna O., whose real name was Bertha Pappenheim, subsequently held sway as evidence of the power of erotic transference and countertransference, though those terms were not applied at the time. Perhaps more importantly, Anna O's purported pregnancy fantasy served to validate Freud's belief in the sexual etiology of hysterical symptoms. Referenced countless times as a cautionary tale for analysts who become involved with challenging patients, the story suffers from one important liability: much of it is false.

The required corrections are numerous. First, Breuer did not end Anna O.'s treatment upon observing her hysterical pregnancy. Indeed, the whole story concerning this fantasy is called into question by some authors (Gilhooley 2002) since it was reported third-hand by Freud biographer Ernest Jones, who received the information from Freud. The veracity of Freud's statements about Breuer can be called into question given his vitriolic dismissal of him. What is known to be true is that Anna O. brought up the issue of termination and set a date. That she apparently suffered separation anxiety after their last meeting and called Breuer back to her bedside does not negate her initiation of the ending of the treatment.

It is also untrue that Breuer and his wife planned their vacation in response to his involvement with Anna O. There is no question that Breuer eventually felt burdened by treating such a demanding patient. He came to the conclusion that he would no longer treat hysterical patients because of the emotional strain involved. However, there is no evidence that he "fled the house in a cold sweat," as reported by Jones (1953, 225). Nor is there any basis in fact for the notion that he left suddenly on his trip to Venice, which had been planned well in advance of Anna O.'s termination. Finally, it is also untrue that Breuer's daughter Dora was conceived on this vacation, since Breuer's wife had already given birth to her three months prior to the end of Anna O.'s treatment.

Why are there so many distortions and misrepresentations in the case of Anna O., and why are they important? The answer to these questions lies in the multiple issues surrounding the treatment itself, including those centered on the case report created by Breuer and Freud—both what was included and what was excluded—and on how the subsequent course of Anna O.'s life served to support or refute both the clinical narrative and the psychoanalytic theory of hysteria.

Discrepancies in reporting by Breuer and Freud as well as their theoretical differences furnish reasons why Freud might have needed to purge Breuer from his personal and professional life shortly after their collaboration. To what extent was their relationship strained by what may have been a fictionalized case history, surrounded by mystery and suggestions of exploitation?

These issues form the core of the two books reviewed here. Louis Breger's Dream of Undying Fame focuses on Freud's betrayal of Breuer, describing how Freud hijacked Breuer's ideas and his patient's story for his own personal gain. Breger goes beyond Anna O., examining the other cases reported in Studies on Hysteria, to argue that Freud was...