Late Nineteenth into Twentieth Century 323for numerous disabling somatic symptoms. He found that
Anna went readily and often spontaneously into trance states,
during which she recalled the circumstances in which a par-
ticular symptom first appeared, accompanied by an emotional
reaction that had not occurred at the time, after which the
symptom improved or even disappeared. Throughout his ca-
reer, Freud continued to claim that Breuer had achieved a
great therapeutic success with Anna O. However, research un-
dertaken by Ellenberger (1972) revealed that this was not the
case; almost immediately after Breuer ended her treatment,
Anna O. was hospitalized in a sanitarium where she spent
some time under medical treatment. She finally recovered and
subsequently achieved recognition in the feminist movement
in general and with her social work with unwed mothers in
particular.
In 1895 Breuer and Freud publishedStudies on Hysteria
(1895/1955), which included five case histories of hysteria (the
case of Anna O. and four treated by Freud) and hisPsychother-
apy of Hysteria.In the preface to the book’s first edition,
Breuer and Freud stated that “Our view is that sexuality seems
to play a principal part in the pathogenesis of hysteria as a
source of psychical traumas and as a motive for defense, that is,
for repressing ideas from consciousness” (p. xxix). But in
order to protect the confidentiality of their patients they did not
publish details of their observations in support of this view.
The Psychoanalytic Theory of Psychopathology,
Second Version—Freud’s Seduction Theory
In 1896, Freud published The Aetiology of Hysteria(Freud,
1896/1950a), in which he stated unequivocally that the un-
conscious memories that generate hysterical symptoms are
inevitably of one or more premature actual sexual experi-
ences in early childhood (stimulation of the genitals, coitus-
like activities, etc.). Freud asserted that he could recognize
the connection between an infantile sexual experience and
every symptom in 18 cases of hysteria that he had treated,
and that this was confirmed by therapeutic success with each
patient when he brought them to recall the pathogenic mem-
ory. His discovery that infantile sexual experience is the
origin of neuropathology, Freud claimed, was a revelation as
momentous as the discovery of the source of the Nile. The
alleged sexual experience was either an isolated instance of
abuse by strangers or, much more frequently, seduction by a
caretaker, near relation, or siblings who initiated the child
into sexual intercourse and maintained a regular love-relation
with him, often for years.
Freud had had great difficulty in eliciting memories of
early sexual experience from his patients. He referred to the
fact that his patients would reproduce the scenes only under
the strongest compulsion, trying to hide the most violent sen-
sations while doing so, and claiming that they had no real
feeling of recollecting these scenes. However, he asserted that
the incidents must have been real because the recollections by
different patients displayed uniformity in certain details that
must have followed identical experiences. Uniformity of rec-
ollection is, unfortunately, more consistent with the simple
explanation that Freud’s conviction of what the memory
ought to be was determining the content of the memory.
Not long after publishing his seduction theory, Freud
began to realize that some of his patients had not in fact
actually been seduced, and in 1897, he discarded both the
theory and his pressure technique. He substituted instead the
method of free association and the procedure of interpreta-
tion, including the interpretation of dreams.
Freud claimed in hisOn the History of the Psychoanalytic
Movement (1914/1950b) that he knew of no influence
that drew “my interest to [dreams] or inspired me with any
helpful expectations.” He was, however, familiar with J.
Hughlings Jackson’s theory that during sleep, the higher men-
tal processes no longer “keep down” the processes of the lower
brain centers. He had quoted Jackson’s statement, “Find out all
about dreams, and you will have found out all about insanity.”
In Freud’s view, dreams, like neurotic symptoms, provide a
conduit for the indirect discharge of accumulated nervous ex-
citations. In sleep, although the body is no longer attuned to
external stimulation, internal stimulation continues since or-
ganic needs are always signaling their presence.The Third Version of Freud’s Psychoanalytic Theory
of PsychopathologyWhen Freud discarded his seduction theory, he recognized
that his patients had been right in expressing their disbelief in
the recollections he had forced upon them. However Freud
did not relinquish his belief in a universal sexual etiology for
the neuroses; instead he modified his theory. “Analysis had
led by the right paths back to these sexual traumas and yet
they were not true. At that time I would gladly have given up
the whole thing... perhaps I persevered only because I had
no choice and could not then begin at anything else....”
(Freud, 1914/1950b, p. 299). If Freud’s theory of the sexual
etiology of neurosis, with its accompanying concepts of re-
pressed memories and resistance to recovery of repressed
memories, was invalid, it followed that his psychoanalytic
method of treating patients by retrieving repressed memories
was invalid. In that event, Freud would have had to abandon
both his method of analysis and of therapy.