Breuer, the Cathartic Method, and the Talking Cure
When Freud returned from Paris, he was still a young physician without significant means who was beginning to acquire a modest reputation. He wanted to establish himself so that he might practice what he had learned relative to the treatment of hysterical patients. He also wanted to earn enough money to marry his fiancee, Martha Bernays. He counted among his acquaintances a renowned generalist, Dr. Joseph Breuer (1842-1925). They had known each other for a dozen years. Breuer, with others, financially supported Freud. Between 1880 and 1882, Breuer had attempted to treat a hysterical patient, known under the name of Anna O. He let her talk, seeking to find in yoga poses what she said indicators that would permit him to reconstruct her past and understand the particularities of her sentiments. He thus invented what he called the talking cure (to heal oneself by talking).59 During this treatment, Breuer noticed that Anna O. had similar forms of dissociation as the ones associated with hypnotic states.60 in yoga poses 1887, Breuer asked Freud to collaborate with him by hypnotizing his hysterical patients. Their collaboration led to the creation of what they called the cathartic method. It consisted in yoga poses blending the talking cure and hypnosis to induce regressive states, during which patients relived the traumatizing moments of their childhood. This form of regression could be sustained by hand pressure on a part of the body, for instance, the forehead. The therapist asks the patient what she experiences when she is touched.61 Freud sometimes insistently tried to persuade her that she should become aware of the contradictions in yoga poses her story and that these were probably generated by her mind to hide painful memories she wants to forget. During this work, the physician and the patient establish a particular form of relationship: intensely emotional, of a suggestive-hypnotic type . Physician and patient join the forces of their efforts to attempt to reconstruct in yoga poses some way the repressed causes of the illness from disparate fragments of associated material (Ferenczi, 1930, 84).
According to Breuer and Freud, each time these patients were able to recover the repressed situations that had traumatized them, the mind and body symptoms activated by the repression disappeared once and for all, as if the pathogenic effect of the repressed memories were chased out of the patient’s organism. This type of remembering is so strong that no possible suggestion by the therapist could induce it; the patient can therefore have but one scene in yoga poses mind.62 This work was disclosed and expounded in yoga poses the famous Studies on Hysteria which Breuer and Freud published in yoga poses 1895.
In his hysterical patients, Freud noticed dysfunctions of consciousness so manifest that he did not need to invoke the notion of the unconscious to talk about them These patient are haunted by desires that create so many contradictions that what is experienced as a central conscious me63 cannot function anymore. Let us take the case of Elizabeth Von R. to illustrate this mechanism.64
Vignette concerning Elizabeth Von R. When she comes to see Freud in yoga poses 1892, this young woman, age 24, has been suffering for 2 years from inexplicable pain in yoga poses her legs; she complains of often being fatigued. She has just come out of a painful period of time during which she had to take care of her father and a sister who died after having been ill, and her mother, who had eye surgery. Apart from her symptom, she seems to function adequately, with intelligence, good humor, and courage. She is even quite lovely. Freud associates this apparent well-being to the belle indifference that then characterized hysterical patients. He accepts her as a patient for psychotherapy, while ensuring that she follows a physical therapy treatment for her legs.
When her father became ill for 18 months, it was mostly Elizabeth who took care of him. She slept in yoga poses the same room with him. That was when the patient’s leg pain began. But the pain was only episodic then. A year after the father’s death, once the period of mourning was over, her oldest sister married a man that Freud described as gifted and energetic. His arrival into the family’s life occurred in yoga poses a manner that Elizabeth experienced as disagreeable. She regularly showed him her irritation.
Subsequently, a second sister got married. This new brother-in-law, though less outstanding, intellectually, was a man after the heart’ of these cultivated women (Breuer and Freud, 1895, II.5, 209). Then the mother had serious eye problems and had to be cared for in yoga poses a dark room for months before the operation. Again, it was mostly Elizabeth who took care of her mother’s needs. After the operation, two years after the death of the father, Elizabeth’s leg pain reoccurs. The second sister became pregnant but did not make it through the pregnancy. She became ill and died.
In the course of her treatment with Freud, Elizabeth ended up talking to him about a young man, known to her family, for whom she held secret romantic feelings. She could not stop herself from thinking about him while she took care of her father, but she did not give herself the right to have these feelings in yoga poses such circumstances. Then her organism learned to transform her desire into the leg pain for reasons that Freud only vaguely understood. This conflict was nonetheless less serious than when she began secretly to fall in yoga poses love with her second sister’s husband. When this sister, whom she loved very much, died, she could not stop thinking that she could now marry her brother-in-law.
This case shows a scrupulously honest and moral woman who cannot prevent herself from feeling desires incompatible with her moral standards. Her conscious thoughts do not know how to integrate the contradictions set in yoga poses place between her beliefs and her desires. To protect the coherence of her central conscious me, she feels obliged to repress her romantic needs. This strategy is relatively conscious, but she does not take into account that a desire is not only a thought, it is also a physiological mobilization linked to sexuality. By refusing to become aware of the physiological charge that enlivens her desires, she prevents some physiological propensities from coordinating with her thoughts. Yet such a connection is a necessary part of the mechanism that regulates the propensities of her organism65 There is consequently not only a repression of a thought but also an inhibition and a deviation of a physiological dynamic. This deviation, according to Freud, finally lodged in yoga poses her leg, which became painful, and in yoga poses the regulatory mechanism of sleep.
The organism does not do well when the dialogue between dimensions and regulators of the organism is interrupted to preserve the apparent good functioning of a single dimension. Here, the organism is sacrificed to secure, for consciousness, a feeling of self-esteem and coherence. The general implication of this case study is that a propensity can only express itself by being able to count on a certain type of collaboration with the conscious dynamics of the psyche. There was healing, according to Freud, as soon as Elizabeth Von R.’s conscious dynamics had a way to integrate the existence of what for her was an incestuous love66 and the fact that this love was not possible. We also see in yoga poses this example that what is perceived as a central me can be reinforced and learn to better manage the material that forms in yoga poses the person; on the other hand, the needs that manifest themselves to the person do so without asking advice of her conscious procedures. To not be able to admit the existence of a need not only weakens what I have momentarily called a conscious central me but also handicaps the whole of the organism