The Three Cures of Bertha Pappenheim (Anna O): the Talking Cure, the Writing Cure, and the Social Cure

Abstract

Bertha Pappenheim was the real name of Anna O, the first psychoanalytic patient. In her treatment with Joseph Breuer, Pappenheim invented what she called “Chimney-sweeping,” the procedure of tracing a symptom back to its origins using free association. After her treatment and several subsequent hospitalizations, Pappenheim went on to become a pioneer of German-Jewish social work, a leading feminist, campaigner for women’s rights, and protector of unwed mothers and orphans. I have obtained multiple documents that reveal aspects of her life that have been unappreciated. She was cured not just by her psychoanalytic treatment, but also by realizing her intellectual gifts via her writing and by changing the society that was making her ill. In these ways, she resembled Harry Stack Sullivan, the founder of interpersonal psychoanalysis. Both faced a major crisis in late adolescence and went on to create environments that insulated victims of prejudice and allowed them to flourish.

Keywords:

• Pappenheim
• psychoanalysis
• prejudice
• Sullivan
• feminism
• prostitution

Notes

1 I have benefited from presenting the dream to several groups of colleagues, using a modified form of group dream analysis (Blechner, 2011, 2018; Ullman, 1994).

2 In 1925, 82.9 per cent of Jewish housewives did not work outside the home (Kaplan, 1976).

3 In the 1950s, Frantz Fanon conducted related research at the hospital of Blida-Joinville in Algiers. He tried to create an environment that ameliorated the anti-Muslim and racist attitudes of colonial Algeria in order to enhance the recovery of psychiatric patients damaged by societal discrimination. In this attempt, Fanon discovered problems that ensue when a well-meaning psychiatrist incorrectly understands a different culture (Robcis, 2020).

4 In 2014, I proposed five guidelines for treating sexual minorities experiencing prejudice:

1.  Always consider how what is called psychopathology could be societal pathology.

2. Avoid grand theories that give sweeping explanations of sexual matters, or at least stay skeptical of them.

3. Respect the uniqueness of everyone’s sexual pattern, and the profound damage that may result from trying to extinguish a sexual desire.

4. Do no harm. Avoid premature closure, and be cautious about doing anything irreversible.

5. Watch for and analyze your countertransference. When you think the patient is being resistant, consider analyzing your own countertransference and counterresistance to what the patient wants.

Additional information

Notes on contributors

Mark J. Blechner

Mark J. Blechner, Ph.D. is Training and Supervising Analyst at the William Alanson White Institute and adjunct Clinical Professor at New York University. He has published four books: The Mindbrain and Dreams: Explorations of Dreaming, Thinking, and Artistic Creation (2018), Sex Changes: Transformations in Society and Psychoanalysis (2009), The Dream Frontier (2001), and Hope and Mortality: Psychodynamic Approaches to AIDS and HIV (1997). He established scholarships to fund the training of candidates of color and transgender candidates at the White Institute. He practices psychoanalysis and psychotherapy in New York City, where he also leads private dream groups.