Freud famous cases from practice. Z

Preface

Currently, scholars studying Freud's scientific and creative legacy have direct information about 43 patients who were analyzed by Freud. The contribution that the description of these cases made to the development of psychoanalytic theory is, of course, unequal. Thanks to some of them, such phenomena of the therapeutic process as transference and countertransference, negative therapeutic reaction, etc. were discovered, which formed the basis of Freud’s most important theoretical postulates; others are rather visual illustrations of his theoretical positions. Be that as it may, all these cases served as factual material that allowed Freud to defend his theory with all conviction and not be in a state of uncertainty and uncertainty from speculative reasoning.

Among the cases to which Freud was involved in one way or another, six stand out in this volume. As a matter of fact, only three of them relate to the direct therapeutic work of Freud himself - the cases of Dora, Wolfsmann and Rattenmann (“the wolf man” and the “rat man”, as other authors call these patients, without really thinking about how incorrect and offensive and even these names sound absurd). Freud was indirectly related to three other cases - Anna O., “little Hans” and Schreber: Anna O. was treated by Freud’s senior colleague J. Breuer, “little Hans” was treated by the boy’s father, Freud’s student, and the analysis of the Schreber case was carried out on the basis of the patient’s memoirs.

The case of Anna O., which is rightly recognized as the first step taken on the path to the development of psychoanalysis, continues to attract the attention of various authors to this day - both orthodox psychoanalysts and representatives of modern trends in psychoanalysis. The reader can find new and unexpected approaches to the interpretation of this case in Summers (1999), Tolpin (1993), Hirschmuller (1989), and others.

There is probably no need to dwell in detail on the cases described in this book. The reader will find all the necessary information in the preliminary notes to each chapter, as well as in the article by Martin Grotjahn, which tells about the further fate of the patients.

Considering these works from a modern perspective, we see that not everything in Freud’s approach to analysis is correct. We notice that along with absolutely amazing insights there is a tendency to squeeze the received material into prepared diagrams. We are aware that numerous interpretations, which for Freud are beyond doubt, are now outdated and hardly correspond to reality. All this is true. But let's not forget that at that time it was an uncharted path, which often had to be groped. And we can only be grateful to the founder of psychoanalysis for the fact that he dared to follow this path and enriched us with a wealth of knowledge about the driving forces and internal conflicts of the human psyche.

The most famous case among psychoanalysts is that of Anna O. The pseudonym Anna O. was given to Bertha Pappenheim (1859-1936), who fell ill while caring for her father, who had cavernous tuberculosis. The patient was “exposed” by E. Jones, the author of the famous three-volume biography of Freud (1953). Freud learned about the patient's treatment from Breuer a few months after its completion (November 1882). Freud was so fascinated by the story of her illness that he could not understand why Breuer did not want to publish it, nor talk about the new treatment method he had created - “cathartic psychotherapy.” And only a year later, Breuer openly admitted to a young colleague that he was so closely involved in the treatment of Anna O. that he aroused his wife’s jealousy. He had to tell the patient that he was stopping treatment forever. In the evening of the same day, he was urgently called to a patient who was lying in “labor pains” from a false pregnancy and shouting: “Dr. Breuer’s child will be born!” Breuer put the patient into a hypnotic state and tried to calm her down, and the next day he and his wife left for Venice. In the same year, a month after the completion of Breuer's treatment, the patient's condition deteriorated so much that she was forced to be admitted for inpatient treatment to the famous Bellevue nervous sanatorium in Kreuzlingen on Lake Constance, where she remained from mid-July to the end of October 1882. There Anna O. was treated for various somatic symptoms (including trigeminal neuralgia), and large doses of morphine were used for this. In the evenings she lost the ability to speak German and switched to English or French. In a letter to Stefan Zweig, Freud wrote: “What actually happened to Breuer’s patient, I was able to unravel only many years after our breakup with him... At the last meeting with the patient, he had in his hands a key with which he could open the door to the secrets of life, but he allowed him to fall out. With all his spiritual talent, Breuer had nothing of Faust in his character. Horrified by what he had done, he fled, leaving the care of the patient to one of his colleagues" (Freud S. Briefe 1873-1939. Frankfurt a. . M., 1968, S. 427). And this was not the end of the matter, as Jones writes in the first volume of his biography of Freud: “About ten years later, while Freud was treating patients in collaboration with Breuer, the latter invited Freud to see another hysterical patient of his. Before going to see her , Breuer described her symptoms in detail, after which Freud said that this was very typical of an imaginary (false) pregnancy. This repetition of the previous situation was difficult for Breuer to bear. Without saying a word, he took his hat and cane and quickly left Freud" (Jones E. Das Leben und Werk von Sigmund Freud. Bern, 1960. S. 269). For some time, Anna O. abused morphine. Later, without without any medical help, she devoted herself entirely to social activities. She was quite famous as a fighter for the emancipation of women, especially Jews. The famous Jewish philosopher Martin Buber (1878-1965) once said: “There are people of spirit, there are people of passion. , both are not very common to find, but even more rare are people who combine spirit and passion. This is the kind of person with a passionate spirit that Bertha Pappenheim was" (1939). With her personal savings, she founded the "Shelter for abused girls and illegitimate children." Caring for the unfortunate children completely replaces the absence of her own children. But the memories of the time spent cathartic treatment continues to haunt her later, she strictly prohibits any type of psychoanalytic treatment of people in the institutions she founded. Anna Freud also recalls that Bertha Pappenheim was “hostile to analysis” throughout her life (see. . article “Episodes from the life of Bertha Pappenheim (Anna O.)”, published by Bernd Nitzschke in the leading German psychoanalytic journal “Psyche” S. 819). Bertha Pappenheim herself says the following about psychoanalysis: “Psychoanalysis in the hands of a doctor is the same. that confession is in the hands of a Catholic priest; it will depend only on their personality and skill in mastering their method whether their instrument turns out to be good or a double-edged sword" (see collection edited by D. Edinger, Bertha Pappenheim. Leben u. Schriften. Frankfurt a. M., 1963. S. 12-13). And Anna O. described her general life position as follows: “Everyone, regardless of whether he is a man or a woman, must do what he must do, using either his strength or his weakness.” Understanding the power of transference and countertransference revealed in this case history became the starting point for the transition from cathartic therapy to psychoanalysis. In his obituary on Breuer’s death (1925), Freud wrote: “Breuer was confronted with the inevitable transference of the patient to the doctor and was unable to understand the extrapersonal. nature of this phenomenon." Mistaking the transference feelings for the patient's real feelings, Breuer responded to them with a massive reaction of unconscious countertransference, which, even years later, did not allow him to recognize the sexual nature of Anna O's symptoms. , Breuer, in a letter dated November 21, 1907, writes to the famous psychiatrist August Forel: “I must confess to you that my taste disgusts me to dive into the field of sexuality, both in theory and in practice. But what does my taste and my feelings have to do with it if it is a matter of truth, of discovering what we are actually encountering. The case of Anna O. proves that a sufficiently severe case of hysteria can arise, persist and be eliminated without sexual elements playing any role in it. My merit lies in. Basically, I was able to understand that fate had placed in my hands an unusually instructive case, important for science, which I was able to observe carefully and for quite a long time, without disturbing its simple and natural flow with any biased approach. Then. I learned a lot, I learned a lot of amazingly valuable things for science. But I also learned what it is necessary to pay primary attention to in practical work. It is impossible for a private practitioner to treat such cases without completely destroying his work and life. way of life I praise myself for the decision I made then not to allow such inhuman tests to happen again. If I had patients who had excellent indications for analytical treatment, whom I myself could not treat, then I referred them to Dr. Freud, who acquired rich practical experience in Paris and the Salpêtrière, to a doctor with whom I was on the most friendly terms. relationships, as well as in fruitful scientific contacts" (1907).

Incredible facts

Sigmund Freud's ideas and theories may look outdated, but there is no doubt that he had a huge influence on the development of psychology and methods of psychoanalysis.

Below we talk about the most fascinating cases with Freud's patients.

10. Mathilde Schleicher

Mathilde Schleicher was one of Freud's first patients when he in 1886 he began his practice as a "nervous doctor".

Her story is heartbreaking.

Schleicher was a musician, and serious problems She started after her fiancé left her. She had always been prone to migraines, and after she lost control of her mental health, the woman fell into deep depression.

She was sent to Freud for treatment, and he began a series of hypnotherapy treatments. It all started in April 1886. By June 1889, Matilda had recovered from her depression and was so grateful for the help she received that she gave Freud a beautiful signed notebook.

However, after a month, her depression turned into mania and insomnia. She constantly talked about the fame and fortune that would come from her music career. At the same time, she was regularly tormented by convulsions.

Freud referred her to the private clinic of Dr. Wilhelm Svetlin, where she was not only diagnosed with what later became known as manic depression or bipolar disorder, but also discovered that she is a nymphomaniac because she regularly exposed herself and demanded Freud.

According to other accounts, her problems ran even deeper. She apparently believed that each of her bowel movements was a birth, so she tried to hide her "children" under her pillow.

The woman spent the next seven months using sedatives, such as opium, morphine, chloral hydrate and even hemp. Gradually, the manic episodes subsided. In May 1890, she left the hospital.

Freud continued to treat her depression with chloral hydrate and a new drug called sulfonal. However, in September of the same year she died. Nobody noticed until it was too late that there was a lot of blood in her urine. This indicated liver damage caused by drug use.

9. Little Hans

Freud worked with a five-year-old boy whom he called "Little Hans." The baby was brought to him by his father. His father wanted Freud to help Hans overcome his fear of horses. The baby was only five years old, and he had no experience with horses, so it was not surprising that he was afraid of them.

They were big and terrified him. He was especially horrified by the horses that pulled the carts, in no small part due to the fact that he witnessed an accident involving one of these carts.

Then the horse was forced to pull a cart overloaded with people; it did not cope with its task, fell and died right before the boy’s eyes.

The boy's fear was, first of all, justified by what happened before his eyes. tragic death animal. However, Freud certainly found other explanations. He said that Hans was especially afraid of horses with black muzzles; they supposedly reminded him of his father's mustache.

He didn't like horses that wore blinders. Freud interpreted this as a connection with his father's glasses.

After all, Freud diagnosed fear little boy as a feature of his Oedipus complex. The horse represented his father because of the mustache-glasses comparison. Little Hans, according to Freud, developed a strong, sexually charged love for his mother and viewed his father as a rival, depriving her of her love and attention.

His father, of course, seemed bigger and stronger to him than he really was. This led to the development of fear not only towards the father, but also towards the horses.

Since most of the therapy with Hans was carried out with his father as an intermediary, Freud decided that his fear of horses isn't going away anytime soon because therapy depends on who he's afraid of.

After Freud had a close conversation with the boy, he reported that all his fears were correct, and Hans was indeed developing an Oedipus complex.

However, there is no need to worry about the baby. Freud observed him until he was 19 years old. The boy not only grew up absolutely normal, he could not even remember the fears that tormented him at the age of five.

The Practice of Sigmund Freud

8. Bertha Pappenheim or Anna O (Bertha Pappenheim)

For many years, this patient of Dr. Josef Breuer and Freud was referred to as Anna O in order to hide her real name - Bertha Pappenheim. The woman began treatment with Breuer when her father’s illness caused her A strange hysteria developed.

The situation worsened after the father died. She suffered from a wide range of symptoms, including mood swings, hallucinations, a nervous cough, and partial paralysis. Sometimes she forgot how to speak her native language German, and was only able to speak and read English and French.

Breuer spent hundreds of hours with her, trying to get to the root of her problem through conversations. At first she spoke exclusively in "fairy tales" writing stories about what she thinks or feels about a particular issue.

Gradually, the doctor was able to put her into a state of hypnosis in order to still find out her problems and “talk” the woman. Thus, he created the basis of a method of therapy that is quite well known to us today.

However, her mental illness has always been questioned, and it has been suggested that she simply wanted to gain the therapist's attention. Freud, who was a colleague and close friend of Breuer (Freud even called youngest daughter in honor of Breuer's wife) argued that the sexual innuendo was obvious.

Freud said that Anna O's problem was her crazy infatuation with her therapist. He was so convinced of this that the friendship came to a sudden and bitter end.

Freud used the Pappenheim case as the basis for his work on psychoanalytic therapy. At the same time, he criticized Breuer in front of his students, using the case as an example of what can happen when a therapist ignores what are clearly sexual fantasies.

The psychoanalyst argued that Bertha's grief over her father's death was primarily due to her sexual fantasies towards her parent. She soon found a new “authority figure.” Breuer became it.

Breuer, Anna O and Freud

Sigmund talked about one of the episodes of Bertha’s treatment, which Breuer told him about. One day he caught her in a hysterical attack of false labor. She said she was pregnant by Breuer.

7. Irma's injection

Freud had difficulty diagnosing himself when it came to proving his theories, however, one of his studies of dreams was based on on the analysis of one of his own dreams.

He called it "Irma's Injection." In the dream, one of Sigmund's patients, Irma, was visiting him. He noticed that she looked sicker than usual and scolded her for not listening to his diagnoses and not following his recommendations.

Other doctors also appeared in the dream and, after looking at Irma, came to the same diagnosis as Freud. The psychoanalyst notes that in a dream he knows the reason - the source of the problem is an injection that was prescribed by another doctor, and the use of which Freud himself believed irresponsible and frivolous act.

He says that it is likely that even the needle used to give the injection was not clean.

The dream dug into all the hidden drawers when it came to own desires Freud. He said that his main wish was to be able to prove that the illness came from someone else.

He accused other doctors of treating her incorrectly (using dirty needles), he accused the patient of not following the doctors' recommendations. Freud emphasized that he was quite satisfied with his arguments, and that thus abdicated responsibility for her further suffering.

Analyzing Freud's thoughts about his dream, some have suggested that Irma's injection was actually a case of Freud's guilt over Emma Eckstein.

Emma Eckstein

Emma was Sigmund's patient. He revealed hysterical symptoms in her, which arose against the background of childhood trauma. The woman had some pathologies of the nasal turbinates, so Freud prescribed her an operation, which was extremely unsuccessful. After her, Emma required additional surgical interventions, which brought her a lot of suffering.

6. Ernst Lanzer

The story of Ernest Lanzer helped Freud understand whether psychoanalytic methods, used to treat hysteria, on patients suffering from other problems. In the case of Ernest, it was constantly haunted by his thoughts.

When Lanzer came to Freud, the psychoanalyst was amazed at the huge assortment obsessive thoughts. Lanzer feared for his life due to the fact that his throat was allegedly getting smaller and smaller. He also has an absolutely paralyzing fear that something will happen either to his father or to the girl he has imagined.

Among other things, he was terribly afraid of rats after he overheard a story in the army about terrible torture using these rodents. Since then, there has been a fear in him that he, his father, or the aforementioned lady might be subjected to such torture.

He also spoke about the torture in question. The rats are placed in a bucket, then the offending person is placed on it, thereby allowing rats "eat" their way through the anus of the culprit. The picture is not pleasant.

One of Freud's first observations was the expression on Lanzer's face, which seemed to be to some extent even inspired by the idea of ​​rats looking for an exit/entry through the anus. The man was diagnosed with an Oedipus complex.

This complex led to an emotional imbalance between love, hatred and fear, directed in varying degrees at the fictional lady, father and rats.

Freud also brought into psychoanalysis what he considered the powerful symbolism of "anus rats." It includes concerns about cleanliness, comparisons between money and excrement, and comparisons between rats and children. The latter is due to the childhood belief that babies are born through the anus.

Freud was also able to find out that at about the age of five, Lanzer's father often spanked him. At the same time, the boy's nanny allowed him to touch her naked body. Freud believes that It was then that these two things turned out to be tightly connected with each other in the baby’s subconscious.

Lanzer's case is unique in that this is the only patient of his about whom, in addition to official conclusions, Freud's thematic notes have also been preserved. These notes made it clear that there were some things that he excluded from the final conclusions. For example, Freud did not maintain neutrality in relations with clients, and sent them postcards while on vacation.

Freud's psychoanalysis: practice

5. Ida Bauer

Ida Bauer's problems began long before her father brought her to Freud in the hope of curing his daughter's hysteria. The parents took their daughter seriously when the cleanliness-obsessed mother (who contracted a sexually transmitted disease after catching it from her husband) caused a seven-year-old girl to have breakdowns.

Her parents treated her with hydrotherapy and electric shock.

Years later, Ida was proposed to by a family friend - the father of the children for whom she was a nanny. Moreover, he was the husband of her father's mistresses. Ida refused, which subsequently led to deep depression, which went so far that the woman threatened to commit suicide.

Freud, who was treating her father for a venereal disease, was asked to help Ida as well. Freud's diagnosis was as follows: Ida did not suffer because she had no time an exemplary family man and a family friend suddenly showed this kind of sympathy for her, and due to suppressed lesbian attraction to the wife of a failed lover.

Her attraction to the woman was further complicated by the fact that she was already her father's mistress. Because of this, Ida’s relationship with her father was strained.

Freud also deciphered Ida's dream: her family's house is on fire, and while her father just wants to get out of it, her mother begins to look for a safe with jewelry. Sigmund said that this symbolizes her father's failure to protect her.

Freud's treatment was very short: Ida herself wanted it that way. She continued to struggle with mental illness for the rest of her life, which ended in 1945.

Over the years, Ida actually turned into her mother, becoming the same crazy fan of cleanliness. Ironically, she remained in touch with the family that started it all, especially her father's mistress, who became her favorite bridge partner.

Psychology according to Freud: cases from practice

4. Fanny Moser

At first glance, Fanny Moser had everything a person could only dream of. She had happy marriage, two children, she was the heiress of an aristocratic family, and when she got married, she became related to a family famous for the production of exquisite Swiss watches.

Just a few days after the birth of their second daughter, her husband died of a heart attack, and his son from a previous marriage began to spread rumors that Fanny had killed her husband.

After a long, scandalous battle in court, Fanny, having cleared her name of accusations, sold the Moser watch company, gave most of money to build several hospitals, but nervous system it malfunctioned.

She went from one doctor to another, taking more and more medications, but nothing helped.

She initially consulted Breuer, and during her treatment in a sanatorium in Vienna, Freud also took part in her rescue. Suffering from severe depression and nervous tics, she was hypnotized by Freud, who tried to get all her worries out of her with ultimate goal liberation from them.

There were many traumas, starting from a terrible toad that she once saw, and ending with the death of her husband. Her condition improved, but not for long. Less than a year later, she returned to the clinic.

Sigmund Freud: Famous Cases from Practice

ISBN: 5-89353-219-8

"Sigmund Freud: Famous Cases from Practice": Cogito Center, 2007

Annotation

The book contains descriptions of the six most famous therapeutic cases to which S. Freud was involved. The presentation of the dramatic circumstances of life and the course of treatment of patients, commented by the creator of the new science, still serves as an indispensable tool for studying the foundations of psychoanalysis. The book will be of interest to both specialist psychologists and a wide range of readers.

Translation from German by V.I. Nikolaeva, A.M. Bokovikov.

Sigmund Freud:

Famous cases from practice

Preface

Fräulein Anna O. D. Breuer

Fragment of the analysis of hysteria. (Dora's medical history). 1905

Analysis of a phobia of a five-year-old boy (Little Hans). 1909

From the history of a childhood neurosis. (The Case of the Wolf Man). 1914-1915

Notes on a case of obsessional neurosis. (The Case of the Rat Man). 1909

Psychoanalytic notes on an autobiographical description of a case of paranoia. (Schreber case). 1911

Classic Freudian cases. The further fate of the patients Martin Grotjahn

LITERATURE

Preface

Currently, scholars studying Freud's scientific and creative legacy have direct information about 43 patients who were analyzed by Freud. The contribution that the description of these cases made to the development of psychoanalytic theory is, of course, unequal. Thanks to some of them, such phenomena of the therapeutic process as transference and countertransference, negative therapeutic reaction, etc. were discovered, which formed the basis of Freud’s most important theoretical postulates; others are rather visual illustrations of his theoretical positions. Be that as it may, all these cases served as factual material that allowed Freud to defend his theory with all conviction and not be in a state of uncertainty and uncertainty from speculative reasoning.

Among the cases to which Freud was involved in one way or another, six stand out in this volume. As a matter of fact, only three of them relate to the direct therapeutic work of Freud himself - the cases of Dora, Wolfsmann and Rattenmann (“the wolf man” and the “rat man”, as other authors call these patients, without really thinking about how incorrect and offensive and even these names sound absurd). Freud was indirectly related to three other cases - Anna O., “little Hans” and Schreber: Anna O. was treated by Freud’s senior colleague J. Breuer, “little Hans” was treated by the boy’s father, Freud’s student, and the analysis of the Schreber case was carried out on the basis of the patient’s memoirs.

The case of Anna O., which is rightly recognized as the first step taken on the path to the development of psychoanalysis, continues to attract the attention of various authors to this day - both orthodox psychoanalysts and representatives of modern trends in psychoanalysis. The reader can find new and unexpected approaches to the interpretation of this case in Summers (1999), Tolpin (1993), Hirschmuller (1989), and others.

There is probably no need to dwell in detail on the cases described in this book. The reader will find all the necessary information in the preliminary notes to each chapter, as well as in the article by Martin Grotjahn, which tells about the further fate of the patients.

Considering these works from a modern perspective, we see that not everything in Freud’s approach to analysis is correct. We notice that along with absolutely amazing insights there is a tendency to squeeze the received material into prepared diagrams. We are aware that numerous interpretations, which for Freud are beyond doubt, are now outdated and hardly correspond to reality. All this is true. But let's not forget that at that time it was an uncharted path, which often had to be groped. And we can only be grateful to the founder of psychoanalysis for the fact that he dared to follow this path and enriched us with a wealth of knowledge about the driving forces and internal conflicts of the human psyche.

The most famous case among psychoanalysts is that of Anna O. The pseudonym Anna O. was given to Bertha Pappenheim (1859-1936), who fell ill while caring for her father, who had cavernous tuberculosis. The patient was “exposed” by E. Jones, the author of the famous three-volume biography of Freud (1953). Freud learned about the patient's treatment from Breuer a few months after its completion (November 1882). Freud was so fascinated by the story of her illness that he could not understand why Breuer did not want to publish it, nor talk about the new treatment method he had created - “cathartic psychotherapy.” And only a year later, Breuer openly admitted to a young colleague that he was so closely involved in the treatment of Anna O. that he aroused his wife’s jealousy. He had to tell the patient that he was stopping treatment forever. In the evening of the same day, he was urgently called to a patient who was lying in “labor pains” from a false pregnancy and shouting: “Dr. Breuer’s child will be born!” Breuer put the patient into a hypnotic state and tried to calm her down, and the next day he and his wife left for Venice. In the same year, a month after the completion of Breuer's treatment, the patient's condition deteriorated so much that she was forced to be admitted for inpatient treatment to the famous Bellevue nervous sanatorium in Kreuzlingen on Lake Constance, where she remained from mid-July to the end of October 1882. There Anna O. was treated for various somatic symptoms (including trigeminal neuralgia), and large doses of morphine were used for this. In the evenings she lost the ability to speak German and switched to English or French. In a letter to Stefan Zweig, Freud wrote: “What actually happened to Breuer’s patient, I was able to unravel only many years after our breakup with him... At the last meeting with the patient, he had in his hands a key with which he could open the door to the secrets of life, but he allowed him to fall out. With all his spiritual talent, Breuer had nothing of Faust in his character. Horrified by what he had done, he fled, leaving the care of the patient to one of his colleagues" (Freud S. Briefe 1873-1939. Frankfurt a. . M., 1968, S. 427). And this was not the end of the matter, as Jones writes in the first volume of his biography of Freud: “About ten years later, while Freud was treating patients in collaboration with Breuer, the latter invited Freud to see another hysterical patient of his. Before going to see her , Breuer described her symptoms in detail, after which Freud said that this was very typical of an imaginary (false) pregnancy. This repetition of the previous situation was difficult for Breuer to bear. Without saying a word, he took his hat and cane and quickly left Freud" (Jones E. Das Leben und Werk von Sigmund Freud. Bern, 1960. S. 269). For some time, Anna O. abused morphine. Later, without without any medical help, she devoted herself entirely to social activities. She was quite famous as a fighter for the emancipation of women, especially Jews. The famous Jewish philosopher Martin Buber (1878-1965) once said: “There are people of spirit, there are people of passion. , both are not very common to find, but even more rare are people who combine spirit and passion. This is the kind of person with a passionate spirit that Bertha Pappenheim was" (1939). With her personal savings, she founded the "Shelter for abused girls and illegitimate children." Caring for the unfortunate children completely replaces the absence of her own children. But the memories of the time spent cathartic treatment continues to haunt her later, she strictly prohibits any type of psychoanalytic treatment of people in the institutions she founded. Anna Freud also recalls that Bertha Pappenheim was “hostile to analysis” throughout her life (see. . article “Episodes from the life of Bertha Pappenheim (Anna O.)”, published by Bernd Nitzschke in the leading German psychoanalytic journal “Psyche” S. 819). Bertha Pappenheim herself says the following about psychoanalysis: “Psychoanalysis in the hands of a doctor is the same. that confession is in the hands of a Catholic priest; it will depend only on their personality and skill in mastering their method whether their instrument turns out to be good or a double-edged sword" (see collection edited by D. Edinger, Bertha Pappenheim. Leben u. Schriften. Frankfurt a. M., 1963. S. 12-13). And Anna O. described her general life position as follows: “Everyone, regardless of whether he is a man or a woman, must do what he must do, using either his strength or his weakness.” Understanding the power of transference and countertransference revealed in this case history became the starting point for the transition from cathartic therapy to psychoanalysis. In his obituary on Breuer’s death (1925), Freud wrote: “Breuer was confronted with the inevitable transference of the patient to the doctor and was unable to understand the extrapersonal. the nature of this phenomenon."

Sigmund Freud: Famous Cases from Practice

ISBN: 5-89353-219-8

“Sigmund Freud: Famous Cases from Practice”: Cogito Center, 2007.

Annotation

The book contains descriptions of the six most famous therapeutic cases to which S. Freud was involved. The presentation of the dramatic circumstances of life and the course of treatment of patients, commented by the creator of the new science, still serves as an indispensable tool for studying the foundations of psychoanalysis. The book will be of interest to both specialist psychologists and a wide range of readers.

Translation from German by V.I. Nikolaeva, A.M. Bokovikov.

Sigmund Freud:

Famous cases from practice

Preface

Fräulein Anna O. D. Breuer

Fragment of the analysis of hysteria. (Dora's medical history). 1905

Analysis of a phobia of a five-year-old boy (Little Hans). 1909

From the history of a childhood neurosis. (The Case of the Wolf Man). 1914-1915

Notes on a case of obsessional neurosis. (The Case of the Rat Man). 1909

Psychoanalytic notes on an autobiographical description of a case of paranoia. (Schreber case). 1911

Classic Freudian cases. The further fate of the patients Martin Grotjahn

LITERATURE

Preface

Currently, scholars studying Freud's scientific and creative legacy have direct information about 43 patients who were analyzed by Freud. The contribution that the description of these cases made to the development of psychoanalytic theory is, of course, unequal. Thanks to some of them, such phenomena of the therapeutic process as transference and countertransference, negative therapeutic reaction, etc. were discovered, which formed the basis of Freud’s most important theoretical postulates; others are rather visual illustrations of his theoretical positions. Be that as it may, all these cases served as factual material that allowed Freud to defend his theory with all conviction and not be in a state of uncertainty and uncertainty from speculative reasoning.

Among the cases to which Freud was involved in one way or another, six stand out in this volume. As a matter of fact, only three of them relate to the direct therapeutic work of Freud himself - the cases of Dora, Wolfsmann and Rattenmann (“the wolf man” and the “rat man”, as other authors call these patients, without really thinking about how incorrect and offensive and even these names sound absurd). Freud was indirectly related to three other cases - Anna O., “little Hans” and Schreber: Anna O. was treated by Freud’s senior colleague J. Breuer, “little Hans” was treated by the boy’s father, Freud’s student, and the analysis of the Schreber case was carried out on the basis of the patient’s memoirs.

The case of Anna O., which is rightly recognized as the first step taken on the path to the development of psychoanalysis, continues to attract the attention of various authors to this day - both orthodox psychoanalysts and representatives of modern trends in psychoanalysis. The reader can find new and unexpected approaches to the interpretation of this case in Summers (1999), Tolpin (1993), Hirschmuller (1989), and others.

There is probably no need to dwell in detail on the cases described in this book. The reader will find all the necessary information in the preliminary notes to each chapter, as well as in the article by Martin Grotjahn, which tells about the further fate of the patients.

Considering these works from a modern perspective, we see that not everything in Freud’s approach to analysis is correct. We notice that along with absolutely amazing insights there is a tendency to squeeze the received material into prepared diagrams. We are aware that numerous interpretations, which for Freud are beyond doubt, are now outdated and hardly correspond to reality. All this is true. But let's not forget that at that time it was an uncharted path, which often had to be groped. And we can only be grateful to the founder of psychoanalysis for the fact that he dared to follow this path and enriched us with a wealth of knowledge about the driving forces and internal conflicts of the human psyche.

The most famous case among psychoanalysts is that of Anna O. The pseudonym Anna O. was given to Bertha Pappenheim (1859-1936), who fell ill while caring for her father, who had cavernous tuberculosis. The patient was “exposed” by E. Jones, the author of the famous three-volume biography of Freud (1953). Freud learned about the patient's treatment from Breuer a few months after its completion (November 1882). Freud was so fascinated by the story of her illness that he could not understand why Breuer did not want to publish it, nor talk about the new treatment method he had created - “cathartic psychotherapy.” And only a year later, Breuer openly admitted to a young colleague that he was so closely involved in the treatment of Anna O. that he aroused his wife’s jealousy. He had to tell the patient that he was stopping treatment forever. In the evening of the same day, he was urgently called to a patient who was lying in “labor pains” from a false pregnancy and shouting: “Dr. Breuer’s child will be born!” Breuer put the patient into a hypnotic state and tried to calm her down, and the next day he and his wife left for Venice. In the same year, a month after the completion of Breuer's treatment, the patient's condition deteriorated so much that she was forced to be admitted for inpatient treatment to the famous Bellevue nervous sanatorium in Kreuzlingen on Lake Constance, where she remained from mid-July to the end of October 1882. There Anna O. was treated for various somatic symptoms (including trigeminal neuralgia), and large doses of morphine were used for this. In the evenings she lost the ability to speak German and switched to English or French. In a letter to Stefan Zweig, Freud wrote: “What actually happened to Breuer’s patient, I was able to unravel only many years after our breakup with him... At the last meeting with the patient, he had in his hands a key with which he could open the door to the secrets of life, but he allowed him to fall out. With all his spiritual talent, Breuer had nothing of Faust in his character. Horrified by what he had done, he fled, leaving him in charge.