Getting in on the act: the hysterical solution

The author recounts the case of Anna O from a contemporary psychoanalytic viewpoint, incorporating the additional information now available to us about Breuer's treatment of Bertha Pappenheim. Now the erotic transference and Anna O's 'oedipal illusion', which culminated in her hysterical pregnancy and labour, is evident to us, as it was to Freud, who did not publicly share his knowledge of Breuer's unhappy experience with this patient. Ernest Jones, in whom Freud did confide, wrongly dated the conception of the Breuer's baby in his biography of Freud describing it as a sequel to Anna O's treatment. In fact Mrs Breuer's pregnancy was concurrent with the treatment and the author suggests that it significantly influenced its course. Using the case of Anna O and one of his own the author postulates that a feature of hysteria is the use of projective identification by the patient to become in phantasy one or other member of the primal couple. A symbolic version of the primal scene between patient and analyst may then be enacted in the context of the erotic transference-countertransference that characterises these cases.