"All sorrows can be borne," the great Danish writer Karen Blixen once said.
However, the most important stories can sometimes not be talked about. People don't have the words. Maybe nobody ever helped them to talk about their experiences. They are out of touch with their feelings, trapped in some unhappiness or fear; frightened, anxious, in pain. But they may insist everything is fine. Psychoanalysis, according to Stephen Grosz, is 'about the thing beneath notice: the daydream, the nightmare. Often it's actually about saying: there is a meaning, this doesn't come from nowhere.'
That's psychoanalysis in a layman’s language.
Psychoanalysis is simultaneously a form treatment, a theory, and an “investigative tool”
(Lothane, 2006). Freud used each of these three prospects of psychoanalysis iteratively to change our understanding of human mental functioning. Among Freud‘s unique insight was the historically new idea that humans are primarily driven by instinct. This was in
opposition to the prevailing view of his time that humanity was God’s highest creation. Everything we did, everything we thought, was attributed to this.
Freud essentially challenged the belief that humans are rational and always guided by reasons. He believed that we have repressed beliefs which are at a constant war with the ‘civilized self’ we portray ourselves to be.
Freud himself and Freud scholars consider that the Studies on Hysteria (Breuer & Freud, 1893) mark the beginning of psychoanalysis as a theory and a treatment. Hysteria was the term given to the presentation, mostly by women, of a constellation of unexplained physical
symptoms that included paralysis, muscle contractures, pseudoseizures, pain and fatigue. Charcot believed that the symptoms arose as a result of an emotional response to a
traumatic incident in their past. He called hysteria with an emotionally traumatic origin ‘traumatic hysteria’.
These early papers place the causes of the symptoms of hysteria firmly in the psychological, not the neurological domain. There was the shift- the causes were ascribed to a problem with the mind and not the brain.
Freud’s psychoanalytic theory is based on the concept of unconsciousness from which he derived two sub-concepts- hidden meaning and repression. Repression is a defence mechanism whereby mental content is removed from awareness and hidden meaning, is exactly what you think it means.
The hysteria and treatment of Anna O are one of the cases studies most closely associated with the Austrian psychoanalyst Sigmund Freud and his psychoanalytic theory. Her case was first discussed in Studies on Hysteria (Freud and Breuer, 1895), a joint work published by Freud and his friend, Josef Breuer, a fellow Austrian physician.
Anna O was born in 1859. The age and society within which she lived limited women’s opportunities and she left school to take up leisurely activities such as sewing, rather than continuing her education. In 1880, Anna’s father contracted tuberculosis and Anna devoted herself to caring for him. Unfortunately, her father’s illness was fatal and he died in April of the following year. However, it was whilst he had been ill that his daughter also fell ill, albeit with different symptoms. Anna began to consult Josef Breuer for the symptoms relating to her illness.
Freud noted that, prior to her illness, Anna had lived a healthy life, with an active imagination, regularly daydreaming as she undertook household chores. Her devotion to caring for her sick father began to take its toll on her, until a point where Anna was prevented from seeing him.
Eventually, Anna was declared hysteric. She spent much of her day in a state of anxiety- experiencing hallucinations, awake from naps with discomfort, crying, and going into fits of rage. After sunset, however, Anna entered a deep state of hypnosis. Freud noted that if she was able to describe the hallucinations of the day in her ‘trance-like’ evening state, she would be able to wake up normally and spend the rest of the day at ease.
Noticing the benefit that the release of anxious thoughts had on Anna, Breuer began treatment with what would eventually be described as “talking therapy”- engaging in daily conversations, talking to her about her problems in search of a psychological basis for the hysteria.
Anna’s habit of storytelling provided Breuer with an intriguing insight into her state of mind. These fairytale-like tales were generally of an unhappy nature. Many of the stories that she would tell involved sitting by a sick person’s bedside, echoing Anna’s experience in caring for her father.
She also relayed a dream similar in subject matter, in which a black snake approached the person in the bed. Anna felt paralysed in the dream and was unable to protect the bed-bound patient from the creature. Freud concluded that the paralysis that she experienced, in reality, was linked to that which she had experienced in an anxious state during the dream.
Breuer and Freud believed that by bringing unconscious anxieties, such as hallucinations and traumatic experiences, to conscious attention, Anna could overcome any related symptoms. Anna's treatment led both to emphasise the impact of previous traumas and subconscious ideas on the conscious mind and gave rise to the use of “talking therapy”, along with hypnosis and regression, to identify the possible causes of mental illnesses.
This was the starting point for Freud. He decided to challenge the traditional studies of psychology- he developed his theories on the id, ego and superego, went deeper into defence mechanisms and compared the structure of the mind to ‘an iceberg’- The unconscious part being below the surface level.
This utterly delicate and compelling way of understanding people has definitely changed the way we perceive the world around us. Everyone has their own stories, their own experiences-Although they may not define you completely, they still make up a small part of who you are. Psychoanalysis opened up a new view on mental illness, suggesting that talking about problems with a professional could help relieve symptoms of psychological distress. Freud did that. In his words- “Psychoanalysis in essence is a cure through love.” Sharing your story was the start.. Even if the solution and response took time, the way Freud understood and made relations about the cause and effect of actions and behaviour was something other psychologists could only dream of doing.
- By Arohi Sachar
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