Hilda Reilly's Blog: The Writing of Guises of Desire
October 26, 2013
Hysteria - The Illness That Won't Go Away
The diagnosis applied to Bertha Pappenheim – hysteria – is no longer in use. Many of the patients labelled as hysterical in the past would now be found to have an organic illness such as multiple sclerosis, epilepsy or brain tumour. Yet there still remain cases of patients whose symptoms defy all physical investigation. These patients are diagnosed as suffering from ‘conversion disorder’, ‘somatisation syndrome’ or ‘functional neurological disorder’ – in other words, hysteria under less pejorative names. Although, as with many of the 19th century hysterics, a possible physical cause for these conditions may be uncovered in the future there is a hard core of cases for which this is considered unlikely. The following are some of the criteria used to identify these ‘hard cases’:
Anatomical impossibility
An example of this is ‘glove anaesthesia’ where a patient complains of numbness in the hand, stopping at the wrist. This is invariably diagnosed as conversion syndrome because the sensory nerve that supplies the hand also supplies the arm and would not allow for this specific area of anaesthesia. Other localised areas of numbness occurring in the foot or leg (‘shoe anaesthesia’ and ‘stocking anaesthesia’) encounter the same problem.
Include symptoms which are known to occur in given circumstances
A classic example of this is whiplash injury, the neck injury often related to vehicle accidents. This is found to be more prevalent in countries where people are aware of the condition and how you are likely to get it. It is also found that membership of a support group or engaging in compensation claims for the injury tends to make it harder to get better, possibly because the symptoms are then constantly on the patient’s mind.
Susceptible to the placebo effect
Muscle cramping resulting in limb contracture (dystonia) can be treated with Botox injections. These take about 24 hours to have an effect. Sometimes, however, the Botox is found to work immediately, indicating a case of functional dystonia.
Can any of this help to throw light on the Bertha Pappenheim case?
The question of what is anatomically impossible is relevant to Bertha’s first visual disorder, a convergent squint. An eye specialist diagnosed this as due to a paresis of the abducens(sixth cranial nerve). Breuer discounted this, putting it down rather to hysteria. It has been suggested* that a psychogenic explanation would be impossible. As the abducens controls the external rectus muscle of the eye, a lesion to it makes it impossible to turn the eye outwards. At the same time, the now unopposed internal rectus muscle pulls the eye inward, causing the squint. This could not occur psychogenically as the voluntary motor pathways operated by the upper motor neurons govern entire movements and not individual muscles. So here it is the psychogenic explanation rather than the physical one which is an anatomical impossibility.
On the basis of the ‘whiplash’ scenario, we might expect hysterical symptoms to correspond with symptoms which the patient is already familiar with. It’s interesting to consider Bertha’s prosopagnosia (inability to recognise people’s faces) in relation to this criterion. Although now, thanks to Oliver Sacks, most people know what prosopagnosia is, there was so little awareness of it in the 1880s that not even Bertha’s doctor recognised it. It’s not likely then that she did and therefore even less likely that her subconscious would manage to conjure it up.
There’s no evidence that Breuer ever tried placebos with Bertha. But for contractures of the limb, use of a placebo is not the only means of revealing whether or not the problem is physical. In functional dystonia the muscles will usually relax during sleep or sedation. In a report discovered almost a century after the events, Josef Breuer describes Bertha’s contracture of the arm and leg. They would, he wrote, ‘relax neither when she was asleep nor under intoxication with 5.00 chloral’.
Three more nails in the coffin of Bertha’s hysteria diagnosis, I think.
Anatomical impossibility
An example of this is ‘glove anaesthesia’ where a patient complains of numbness in the hand, stopping at the wrist. This is invariably diagnosed as conversion syndrome because the sensory nerve that supplies the hand also supplies the arm and would not allow for this specific area of anaesthesia. Other localised areas of numbness occurring in the foot or leg (‘shoe anaesthesia’ and ‘stocking anaesthesia’) encounter the same problem.
Include symptoms which are known to occur in given circumstances
A classic example of this is whiplash injury, the neck injury often related to vehicle accidents. This is found to be more prevalent in countries where people are aware of the condition and how you are likely to get it. It is also found that membership of a support group or engaging in compensation claims for the injury tends to make it harder to get better, possibly because the symptoms are then constantly on the patient’s mind.
Susceptible to the placebo effect
Muscle cramping resulting in limb contracture (dystonia) can be treated with Botox injections. These take about 24 hours to have an effect. Sometimes, however, the Botox is found to work immediately, indicating a case of functional dystonia.
Can any of this help to throw light on the Bertha Pappenheim case?
The question of what is anatomically impossible is relevant to Bertha’s first visual disorder, a convergent squint. An eye specialist diagnosed this as due to a paresis of the abducens(sixth cranial nerve). Breuer discounted this, putting it down rather to hysteria. It has been suggested* that a psychogenic explanation would be impossible. As the abducens controls the external rectus muscle of the eye, a lesion to it makes it impossible to turn the eye outwards. At the same time, the now unopposed internal rectus muscle pulls the eye inward, causing the squint. This could not occur psychogenically as the voluntary motor pathways operated by the upper motor neurons govern entire movements and not individual muscles. So here it is the psychogenic explanation rather than the physical one which is an anatomical impossibility.
On the basis of the ‘whiplash’ scenario, we might expect hysterical symptoms to correspond with symptoms which the patient is already familiar with. It’s interesting to consider Bertha’s prosopagnosia (inability to recognise people’s faces) in relation to this criterion. Although now, thanks to Oliver Sacks, most people know what prosopagnosia is, there was so little awareness of it in the 1880s that not even Bertha’s doctor recognised it. It’s not likely then that she did and therefore even less likely that her subconscious would manage to conjure it up.
There’s no evidence that Breuer ever tried placebos with Bertha. But for contractures of the limb, use of a placebo is not the only means of revealing whether or not the problem is physical. In functional dystonia the muscles will usually relax during sleep or sedation. In a report discovered almost a century after the events, Josef Breuer describes Bertha’s contracture of the arm and leg. They would, he wrote, ‘relax neither when she was asleep nor under intoxication with 5.00 chloral’.
Three more nails in the coffin of Bertha’s hysteria diagnosis, I think.
September 29, 2013
A Feminist Take on the Anna O Case
"Hysteria is not a pathological phenomenon, and can, in all respects,
be considered as a supreme means of expression."
Sigmund Freud, Studies in Hysteria, 1895
Feminists are keen to claim Bertha Pappenheim as one of their own, and rightly so. She would be happy to consider herself such. After recovering from her illness she was active for the rest of her life in the field of women’s rights – a prolific feminist writer and polemicist, the founder of the League of Jewish Women, and a pioneering social worker, fighting against white slavery and founding a home for Jewish prostitutes and unmarried mothers. As well as all this she even found time to translate Mary Wollstonecraft’s A Vindication of the Rights of Woman into German and to write a play called Women’s Rights.
Perhaps she would not be so happy, though, with the lengths to which some feminists go in justifying their claim.
In Hysteria Beyond Freud, Elaine Showalter tells us that ‘In her hysterical seizures, Anna became unable to speak her native German, and instead spoke either Yiddish, which she called “the woman’s German,” or a jumble of English, Italian and French.’ While it is true that Bertha’s aphasic disturbances resulted in her being unable to speak German, resorting instead to English, Italian and French, nowhere in the case reports does Breuer mention her speaking Yiddish.
Showalter uses this claim about Bertha’s Yiddish to bolster up a feminist theory about ‘the repression of women’s language or its impossibility within patriarchal discourse’. She quotes psychoanalyst Juliet Mitchell who calls hysteria ‘"the daughter's disease," a syndrome of physical and linguistic protest against the social and symbolic laws of the Father’. Then, in an egregious example of post hoc, ergo propter hoc thinking, she states that in the case of Bertha Pappenheim ‘the connections between hysteria and feminism seemed particularly clear because after her analysis with Breuer in 1882, she went on to become a feminist’.
In Hysteria, Psychoanalysis, And Feminism: The Case Of Anna 0, Dianne Hunter expresses similar views. Although she makes no mention of Yiddish she still puts a feminist gloss on Bertha’s linguistic difficulties. Bertha, she says, refused to speak German because to do so would mean that she accepted ‘integration into a cultural identity [she] wished to reject’ and concludes that her hysteria was a ‘discourse of femininity addressed to patriarchal thought’. Hunter also reads a psychological significance into Bertha’ agrammatism, in particular the fact that she ceased for a while to conjugate verbs, using only infinitives or past participles which, she points out do not specify a person. She seems not to be aware that this is typical of people suffering from Broca’s agrammatic aphasia, often found in people suffering from strokes or other damage in the left cerebral hemisphere. The condition is characterised by, among other things, an inability to inflect verbs or to use subject pronouns.
Hunter goes on to analyse Breuer’s own use of language: ‘Breuer refers to the pauses in Pappenheim's speech by the French term absence.’ Not quite. Breuer was not referring to her aphasic symptoms when he used this term, but rather to the petit mal seizures which she experienced (although he did not recognise them as such). For Hunter, however, Breuer’s use of this term ‘suggests that for Breuer as well as for Pappenheim, the abnormal states of consciousness represented foreign parts of the self. Parts of Anna O were alien to signification in her native tongue.’
As for Bertha’s Yiddish, given that this would have been one of the languages with which she, as an Orthodox Jewish woman, must have been familiar, it’s perhaps of significance that she didn’t resort to it in her aphasia. But the explanation is more likely to lie in neural disturbances in the speech centres of her brain than in any kind of gender frustration.
August 27, 2013
Diagnosing Bertha
A recent Good Reads reviewer wrote that she had some problem with the ending of Guises of Desire. Her difficulty was that, although the Author’s Note at the end had explained what my thinking had been regarding the causes of Bertha’s illness, the explanation had not been clear in the novel itself. In other words, she felt that readers would not be able to work out a diagnosis for themselves, or guess at the kind of diagnosis I had based my interpretation on.
I can understand why the reviewer felt this and I’ve been wondering what I could have done to avoid this kind of dissatisfaction – if dissatisfaction it is.
Perhaps the explanation can be found in the views of another reader who has commented that I never slip into a contemporary frame of reference, that the setting is pre-Freudian and that nothing of Freudian theory creeps into my character’s words or reflections. I would add that the setting is also pre-modern-neurology and that the kind of diagnosis I have in mind would therefore not form part of it. It’s difficult therefore to see how, while remaining resolutely in the 19th century and with the narrative perspective being that of the characters rather than omniscient, I could have created a picture which would have led the reader, unless a medical professional, to think: Oh yes, Bertha Pappenheim clearly has such and such a condition. As it is, readers are drawn rather into the world of Bertha herself, experiencing the same confusion as Bertha, her family and her doctors, totally perplexed as to what’s going on and trying to figure out their own explanation.
Of course, I could have written a different kind of book, one which would have demonstrated quite clearly where I was coming from. I’d thought, for example, of doing one of those split-time novels which are popular now in historical fiction, with perhaps the parallel story of a modern neurological researcher working on the Anna O case, or something similar. Or I could have done something more avant-garde, interspersing the narrative with fragments of contemporary analysis of the case, with excerpts from case studies of later patients displaying similar syndromes, and so on.
It’s interesting to compare Guises of Desire with the novel Lying Awake by Mark Salzmann which tells the story of a contemplative Catholic nun who has mystical experiences associated with temporal lobe epilepsy. Because the setting is a contemporary one, a full depiction of her condition, both subjective and medical is possible. Of course, this could give rise to a whole new set of questions. Does the corresponding electrical activity of the brain create the content of the mystical experiences or does it provide a conduit to a supernatural dimension. The answer to this is likely to depend on the religious views, or lack thereof, of the reader. And it’s still pretty much true that one’s interpretation of the Bertha Pappenheim case depends on which school of psychological thought one subscribes to.
Guises of Desire
I can understand why the reviewer felt this and I’ve been wondering what I could have done to avoid this kind of dissatisfaction – if dissatisfaction it is.
Perhaps the explanation can be found in the views of another reader who has commented that I never slip into a contemporary frame of reference, that the setting is pre-Freudian and that nothing of Freudian theory creeps into my character’s words or reflections. I would add that the setting is also pre-modern-neurology and that the kind of diagnosis I have in mind would therefore not form part of it. It’s difficult therefore to see how, while remaining resolutely in the 19th century and with the narrative perspective being that of the characters rather than omniscient, I could have created a picture which would have led the reader, unless a medical professional, to think: Oh yes, Bertha Pappenheim clearly has such and such a condition. As it is, readers are drawn rather into the world of Bertha herself, experiencing the same confusion as Bertha, her family and her doctors, totally perplexed as to what’s going on and trying to figure out their own explanation.
Of course, I could have written a different kind of book, one which would have demonstrated quite clearly where I was coming from. I’d thought, for example, of doing one of those split-time novels which are popular now in historical fiction, with perhaps the parallel story of a modern neurological researcher working on the Anna O case, or something similar. Or I could have done something more avant-garde, interspersing the narrative with fragments of contemporary analysis of the case, with excerpts from case studies of later patients displaying similar syndromes, and so on.
It’s interesting to compare Guises of Desire with the novel Lying Awake by Mark Salzmann which tells the story of a contemplative Catholic nun who has mystical experiences associated with temporal lobe epilepsy. Because the setting is a contemporary one, a full depiction of her condition, both subjective and medical is possible. Of course, this could give rise to a whole new set of questions. Does the corresponding electrical activity of the brain create the content of the mystical experiences or does it provide a conduit to a supernatural dimension. The answer to this is likely to depend on the religious views, or lack thereof, of the reader. And it’s still pretty much true that one’s interpretation of the Bertha Pappenheim case depends on which school of psychological thought one subscribes to.
Guises of Desire
August 22, 2013
Anna O – whose patient was she?
There is no record of Sigmund Freud ever having met Bertha Pappenheim, certainly not in a professional capacity. However, this has proved no obstacle to the common misapprehension that she was his patient.
Often when I mention that I’ve written a book about Anna O, people will say something along the lines of: ‘Oh, yes, she was one of Freud’s patients, wasn’t she?’ This isn’t really surprising as she is so intimately connected with the history of psychoanalysis. In a sense, she was, as she is sometimes described, ‘Freud’s Anna O’. Her case is the foundation stone on which Freud started to build his theories; and without Freud, Bertha Pappenheim would be known only for her later success as a pioneering feminist and social worker.
Some people may think that it doesn’t matter whether or not Freud was her doctor, in the same way that some people think that it doesn’t matter whether Shakespeare or someone else wrote his plays and sonnets. It matters very much, in fact, and this is why it’s surprising that the misconception about Anna O even extends to the psychotherapy community.
A cursory Google search threw up a few interesting items.
A webpage titled Student Resources in Context has Bertha being treated by both Freud and Breuer simultaneously. In this version the collaboration starts with Breuer telling Freud about Bertha. It goes on to say that ‘during daily visits to Freud and Breuer, the doctors discovered that some of her symptoms were alleviated merely by discussing her memories and the feelings they created in her’. Finally, Freud alone is given credit for the cure with the claim that: ‘When Freud encouraged Anna O to recall a given situation and express the reaction she had earlier repressed, her symptoms vanished.’
Psychotherapist Humair Hashmi goes further. Anna O, he claims, began to express affection for Breuer and tried to put her arms round him. This so alarmed Breuer that he passed the case on to Freud. Nothing daunted, Freud, ‘the fearless pioneer that he was’, regarded this as a challenge and interpreted it as a manifestation of transference which could be used as a means of effecting a cure. Hashmi goes on to say:‘This is what Freud did in Anna’s case.’
An even more surprising misrepresentation is one I discovered when I came across a Wall Street Journal review of a show called Dr Freud’s Cabaret in which Freud takes to the boards with a number of his most famous patients. The show starts with an Anna O number called Chimney Sweeping (Bertha Pappenheim’s term for the talking she did with Breuer) and the review describes how ‘Anna O would hold Freud’s hand while she told him fairy stories and dark fantasies that helped alleviate her psychosis.’ Investigating this further I found that the idea for the show had germinated when the writer was reading Studies in Hysteria as research for a novel. So far so good, but the fact that she had done this research makes it even more puzzling that she could then flout the truth by portraying Anna O’s treatment as being with Freud rather than with Breuer. Artistic licence, you might say. Perhaps. But what really takes the biscuit is that the show was put on at the Freud Museum in London which seems to have been quite comfortable with helping to perpetuate the myth that Freud was Anna O’s patient. It would all be so much neater if she had been, after all. The fact that she was not is possibly, for them, what Al Gore might term ‘an inconvenient truth’.
Often when I mention that I’ve written a book about Anna O, people will say something along the lines of: ‘Oh, yes, she was one of Freud’s patients, wasn’t she?’ This isn’t really surprising as she is so intimately connected with the history of psychoanalysis. In a sense, she was, as she is sometimes described, ‘Freud’s Anna O’. Her case is the foundation stone on which Freud started to build his theories; and without Freud, Bertha Pappenheim would be known only for her later success as a pioneering feminist and social worker.
Some people may think that it doesn’t matter whether or not Freud was her doctor, in the same way that some people think that it doesn’t matter whether Shakespeare or someone else wrote his plays and sonnets. It matters very much, in fact, and this is why it’s surprising that the misconception about Anna O even extends to the psychotherapy community.
A cursory Google search threw up a few interesting items.
A webpage titled Student Resources in Context has Bertha being treated by both Freud and Breuer simultaneously. In this version the collaboration starts with Breuer telling Freud about Bertha. It goes on to say that ‘during daily visits to Freud and Breuer, the doctors discovered that some of her symptoms were alleviated merely by discussing her memories and the feelings they created in her’. Finally, Freud alone is given credit for the cure with the claim that: ‘When Freud encouraged Anna O to recall a given situation and express the reaction she had earlier repressed, her symptoms vanished.’
Psychotherapist Humair Hashmi goes further. Anna O, he claims, began to express affection for Breuer and tried to put her arms round him. This so alarmed Breuer that he passed the case on to Freud. Nothing daunted, Freud, ‘the fearless pioneer that he was’, regarded this as a challenge and interpreted it as a manifestation of transference which could be used as a means of effecting a cure. Hashmi goes on to say:‘This is what Freud did in Anna’s case.’
An even more surprising misrepresentation is one I discovered when I came across a Wall Street Journal review of a show called Dr Freud’s Cabaret in which Freud takes to the boards with a number of his most famous patients. The show starts with an Anna O number called Chimney Sweeping (Bertha Pappenheim’s term for the talking she did with Breuer) and the review describes how ‘Anna O would hold Freud’s hand while she told him fairy stories and dark fantasies that helped alleviate her psychosis.’ Investigating this further I found that the idea for the show had germinated when the writer was reading Studies in Hysteria as research for a novel. So far so good, but the fact that she had done this research makes it even more puzzling that she could then flout the truth by portraying Anna O’s treatment as being with Freud rather than with Breuer. Artistic licence, you might say. Perhaps. But what really takes the biscuit is that the show was put on at the Freud Museum in London which seems to have been quite comfortable with helping to perpetuate the myth that Freud was Anna O’s patient. It would all be so much neater if she had been, after all. The fact that she was not is possibly, for them, what Al Gore might term ‘an inconvenient truth’.
June 11, 2013
From Bertha Pappenheim to Paris Brown
Medical historian Roy Porter* draws attention to what he calls a 'patient-shaped gap' in the history of the case study, with accounts of illness being written invariably by doctors rather than patients. In discussing a research agenda to remedy this imbalance, he claims that ‘its real challenges lie in reconstructing patterns of consciousness and action’. For the historical novelist, this involves trying to think oneself into the mindset of the character.
One of the cultural sources I turned to in trying to 'reconstruct the consciousness' of Bertha Pappenheim was The Girl's Own Paper, a magazine first published in 1880, the year in which Bertha's story began. Reading it brings one to the inescapable conclusion that the past is indeed a foreign country. I feel that I could more easily understand a present-day Zulu or Maori than any young 19th-century woman whose mind was formed by the principles governing those moralising texts.
Feminism was still only a speck on a distant horizon, at least as far the GOP was concerned.
An article titled The Girls of Today, written by 'One of Them', while advocating a degree of working activity for women, concluded: '…. there is plenty of work to do, not only for our fathers and brothers but for us girls also. Out of this work we will select that which we can do best, whether it be nursing, teaching, book-keeping, mending, lamp-cleaning, dressmaking, or anything else. At the same time we will endeavour to hold fast by those attributes of modesty, gentleness and patience which belong to good women, and while we enrich the home with our earnings, we will try to be its sunlight and its ornament.'
As for a career in journalism, anyone considering it was advised that the job might require her to be out and about late at night, which would not be seemly, and that she would need 'a bold mien' to work with male reporters 'on whose province she is encroaching'. As a final word of warning GOP cautioned that 'it is not an occupation that tends to the development of feminine graces.'
On a more positive note, the newly invented typewriter was promoted as a solution to the problem of finding employment for ladies, it being 'peculiarly fitted for their nimble fingers'.
Beauty, just as much as health, was considered to be a matter of mens sana in corpore sano. 'Health can make the plainest girl pleasant to behold, if her mind be pure and innocent,' exhorted Medicus in 1884. Readers were encouraged to believe that a good head of hair could be obtained by cultivating 'a calm and unruffled frame of mind'. A daily bath, 'as cold as can be borne', and exercise were judged ideal beauty aids. Powder and 'paint' were anathema, a sign of loose morals.
Overall the texts were saturated with religiosity.
An article titled What Shall We Do With Our Sundays? was accompanied by a poem by Yeats suggesting that the answer was church attendance: 'She prays for father, mother dear, To Him with thunder shod. She prays for every falling tear, In the holy church of God.'
Middle-class girls were encouraged to procure copies of 'the Holy Gospels' and other 'nice little books' and to leave them in appropriate places, such as under the seat cushion in a hired vehicle, where they could be found by 'the lower orders'.
Acting was disapproved of. 'Once on the stage, those wishing to leave it and live religious lives find much prejudice from prospective employers.' The writer wasn't thinking of women wanting to enter a convent, but simply leading a life that wasn't immoral.
Replies to readers' letters were tart and bracing.
A reader with academic aspirations was advised: 'The subjects to be avoided, save in an elementary manner, are mathematics, and possibly science - certainly, however, the former.'
A young woman enquiring about a career as a governess in 1884 was told: 'You seem to think that we keep a registry office. You are not sufficiently educated to take a place as nursery governess. You cannot write; and do not express yourself properly.'
But this was nothing to the scolding doled out to a correspondent from Canada: 'This is the last notice that we shall take of your silly letters. Learn your lessons, read your Bible, and make and mend your own clothes and waste no more time in writing such rubbish.'
It's difficult to believe that only 130 years separates this kind of thing from the tweets of Paris Brown, the seventeen-year-old who recently had to resign from her police job after it was discovered that she had posted homophobic and racist rants and boasted about her binge drinking, drug taking and sex life on Twitter. But then, much as I said at the beginning, I might find it easier to understand a Zulu or a Maori than Paris Brown.
*Porter, Roy, ‘The Patient’s View: Doing Medical History from Below’, Theory and Society, 14 (March, 1985), 175-198
One of the cultural sources I turned to in trying to 'reconstruct the consciousness' of Bertha Pappenheim was The Girl's Own Paper, a magazine first published in 1880, the year in which Bertha's story began. Reading it brings one to the inescapable conclusion that the past is indeed a foreign country. I feel that I could more easily understand a present-day Zulu or Maori than any young 19th-century woman whose mind was formed by the principles governing those moralising texts.
Feminism was still only a speck on a distant horizon, at least as far the GOP was concerned.
An article titled The Girls of Today, written by 'One of Them', while advocating a degree of working activity for women, concluded: '…. there is plenty of work to do, not only for our fathers and brothers but for us girls also. Out of this work we will select that which we can do best, whether it be nursing, teaching, book-keeping, mending, lamp-cleaning, dressmaking, or anything else. At the same time we will endeavour to hold fast by those attributes of modesty, gentleness and patience which belong to good women, and while we enrich the home with our earnings, we will try to be its sunlight and its ornament.'
As for a career in journalism, anyone considering it was advised that the job might require her to be out and about late at night, which would not be seemly, and that she would need 'a bold mien' to work with male reporters 'on whose province she is encroaching'. As a final word of warning GOP cautioned that 'it is not an occupation that tends to the development of feminine graces.'
On a more positive note, the newly invented typewriter was promoted as a solution to the problem of finding employment for ladies, it being 'peculiarly fitted for their nimble fingers'.
Beauty, just as much as health, was considered to be a matter of mens sana in corpore sano. 'Health can make the plainest girl pleasant to behold, if her mind be pure and innocent,' exhorted Medicus in 1884. Readers were encouraged to believe that a good head of hair could be obtained by cultivating 'a calm and unruffled frame of mind'. A daily bath, 'as cold as can be borne', and exercise were judged ideal beauty aids. Powder and 'paint' were anathema, a sign of loose morals.
Overall the texts were saturated with religiosity.
An article titled What Shall We Do With Our Sundays? was accompanied by a poem by Yeats suggesting that the answer was church attendance: 'She prays for father, mother dear, To Him with thunder shod. She prays for every falling tear, In the holy church of God.'
Middle-class girls were encouraged to procure copies of 'the Holy Gospels' and other 'nice little books' and to leave them in appropriate places, such as under the seat cushion in a hired vehicle, where they could be found by 'the lower orders'.
Acting was disapproved of. 'Once on the stage, those wishing to leave it and live religious lives find much prejudice from prospective employers.' The writer wasn't thinking of women wanting to enter a convent, but simply leading a life that wasn't immoral.
Replies to readers' letters were tart and bracing.
A reader with academic aspirations was advised: 'The subjects to be avoided, save in an elementary manner, are mathematics, and possibly science - certainly, however, the former.'
A young woman enquiring about a career as a governess in 1884 was told: 'You seem to think that we keep a registry office. You are not sufficiently educated to take a place as nursery governess. You cannot write; and do not express yourself properly.'
But this was nothing to the scolding doled out to a correspondent from Canada: 'This is the last notice that we shall take of your silly letters. Learn your lessons, read your Bible, and make and mend your own clothes and waste no more time in writing such rubbish.'
It's difficult to believe that only 130 years separates this kind of thing from the tweets of Paris Brown, the seventeen-year-old who recently had to resign from her police job after it was discovered that she had posted homophobic and racist rants and boasted about her binge drinking, drug taking and sex life on Twitter. But then, much as I said at the beginning, I might find it easier to understand a Zulu or a Maori than Paris Brown.
*Porter, Roy, ‘The Patient’s View: Doing Medical History from Below’, Theory and Society, 14 (March, 1985), 175-198
May 13, 2013
Sigmund Freud's oxymoronic stance on aphasia
"Hysterical a[phasia]…. is characterized by its completeness or, rather, by its absolute character. It is not that the patients are restricted to the use of individual words, but that they are completely speechless, indeed voiceless; not a sound, not a cry comes about."
Sigmund Freud, Aphasie 1888
In my post of 3 May I quoted Josef Breuer's description of Bertha Pappenheim's aphasia. It was of a complex nature and varied over the course of her illness, ranging from the typical telegrammatic speech of Broca's aphasia to the complete loss of her mother tongue, at which stage she could only express herself in other languages, mainly English. How then, in view of Freud's already published view about hysterical aphasia, could he and Breuer be subscribing to the idea that her aphasia was hysterically induced?
Freud was clearly enchanted by his own theories about hysteria, so much so that it seems almost to have constituted a default diagnosis for him. Once convinced that a patient suffered from hysteria nothing would budge him from that conclusion.
In the case of Frau Emmy von N (the second of the cases reported in Studies on Hysteria) the patient displayed, in addition to depression and insomnia, a set of symptoms which would nowadays be recognised as associated with Tourette's syndrome: random interjections and clacking sounds, agitated finger movements, convulsive facial tics and neck spasms. Freud, treating her with the cathartic method developed in discussion with Breuer, elicited from his patient a number of traumatic childhood memories, after which her vocal tics 'were strikingly improved' although they 'were not completely relieved'. This limited success turned out to be 'not a lasting one'. There is nothing surprising in this. Tourette's symptoms are well known to wax and wane, quite independently of any treatment.What is surprising is that Freud didn't even consider the possibility of a neurological cause here as he had known Gilles de Tourette while working with Charcot in Paris, at the very time when de la Tourette first published a paper on the disorder which was to bear his name.
A later, and much more serious, misdiagnosis was made in the case of a fourteen-year-old girl, known only as M-l, who suffered from abdominal pains. Freud diagnosed her as an 'unmistakable' case of hysteria, which he claimed cleared up 'quickly and radically' under his care. The girl died two months later of sarcoma of the abdominal glands.
Freud was still loath to relinquish the hysteria diagnosis. The girl had indeed been a hysteric, he maintained. The hysteria, instead of creating its own symptoms, had simply appropriated for itself the existing pains produced by the sarcoma.
This 'mixed aetiology' explanation has served on other occasions as a get-out clause in the history of hysteria. We see it too in the case of Frau Emmy von N. Finding that the neck spasms were continuing unabated Freud declared that they did not form part of the hysterical picture but were a form of migraine, therefore of organic origin and not susceptible to the cathartic treatment.
It's difficult to see how the mixed-aetiology explanation could be applied to solve the question I started this post with but given Freud's belief in his ability to wriggle Houdini-like out of any diagnostic bind he found himself in he would surely have come up with some rationale.
Sigmund Freud, Aphasie 1888
In my post of 3 May I quoted Josef Breuer's description of Bertha Pappenheim's aphasia. It was of a complex nature and varied over the course of her illness, ranging from the typical telegrammatic speech of Broca's aphasia to the complete loss of her mother tongue, at which stage she could only express herself in other languages, mainly English. How then, in view of Freud's already published view about hysterical aphasia, could he and Breuer be subscribing to the idea that her aphasia was hysterically induced?
Freud was clearly enchanted by his own theories about hysteria, so much so that it seems almost to have constituted a default diagnosis for him. Once convinced that a patient suffered from hysteria nothing would budge him from that conclusion.
In the case of Frau Emmy von N (the second of the cases reported in Studies on Hysteria) the patient displayed, in addition to depression and insomnia, a set of symptoms which would nowadays be recognised as associated with Tourette's syndrome: random interjections and clacking sounds, agitated finger movements, convulsive facial tics and neck spasms. Freud, treating her with the cathartic method developed in discussion with Breuer, elicited from his patient a number of traumatic childhood memories, after which her vocal tics 'were strikingly improved' although they 'were not completely relieved'. This limited success turned out to be 'not a lasting one'. There is nothing surprising in this. Tourette's symptoms are well known to wax and wane, quite independently of any treatment.What is surprising is that Freud didn't even consider the possibility of a neurological cause here as he had known Gilles de Tourette while working with Charcot in Paris, at the very time when de la Tourette first published a paper on the disorder which was to bear his name.
A later, and much more serious, misdiagnosis was made in the case of a fourteen-year-old girl, known only as M-l, who suffered from abdominal pains. Freud diagnosed her as an 'unmistakable' case of hysteria, which he claimed cleared up 'quickly and radically' under his care. The girl died two months later of sarcoma of the abdominal glands.
Freud was still loath to relinquish the hysteria diagnosis. The girl had indeed been a hysteric, he maintained. The hysteria, instead of creating its own symptoms, had simply appropriated for itself the existing pains produced by the sarcoma.
This 'mixed aetiology' explanation has served on other occasions as a get-out clause in the history of hysteria. We see it too in the case of Frau Emmy von N. Finding that the neck spasms were continuing unabated Freud declared that they did not form part of the hysterical picture but were a form of migraine, therefore of organic origin and not susceptible to the cathartic treatment.
It's difficult to see how the mixed-aetiology explanation could be applied to solve the question I started this post with but given Freud's belief in his ability to wriggle Houdini-like out of any diagnostic bind he found himself in he would surely have come up with some rationale.
May 3, 2013
Bertha Pappenheim's peculiar form of aphasia
"Mrs Pappenheim stopped in the doorway. She saw Bertha’s features crease into fretful petulance, her finger pointing to the untouched breakfast tray lying beside the bed.
‘No voglio petit-déjeuner. Enleve. Tired. Voglio dormir. Ne dors pas noche. Je veux dormir adesso.’
Italian, French, English. Bertha knew all those languages. But why should she want to start speaking them now? And why jumble them all together like this? Mrs Pappenheim clenched her hands and stepped further into the room. ‘Bertha, what’s all this nonsense? Speak German, please.’
‘I am speaking German,’ Bertha said in English. She closed her eyes."
From Guises of Desire by Hilda Reilly
"For alongside of the development of the contractures there appeared a deep-going functional disorganization of her speech. It first became noticeable that she was at a loss to find words, and this difficulty gradually increased. Later she lost her command of grammar and syntax; she no longer conjugated verbs, and eventually she used only infinitives, for the most part incorrectly formed from weak past participles. And she omitted both the definite and indefinite article. In the process of time she became almost completely deprived of words. She put them together laboriously out of four or five languages and became almost unintelligible."
From Studies in Hysteria by Sigmund Freud and Josef Breuer
The disruption of Bertha's speech faculty was undoubtedly complex and it's perhaps not surprising that Breuer was at a loss to explain it in anything other than psychogenic terms. In addition to the difficulties described above, she went on to lose her command of German completely and for a while could speak only in English.
One of the obstacles to arriving at a neurological interpretation of Bertha's symptoms may have been the theory of retrograde amnesia formulated around the same time by French neurologist Theodule Ribot. According to this, any damage to memory areas of the brain would result in newer memories being affected before older ones. Extending this to the language function, it was therefore expected that languages learned later in life would be affected before earlier ones and that the mother tongue would be the last to suffer.
However, subsequent cases of multilingual patients affected by strokes and the like have not borne this out. American neuropsychologist Laurence Miller reports that the order in which languages are recovered in such cases is variable, and that individual patients can even exhibit different types of aphasic syndrome in their different languages. Research carried out by neurosurgeon George Ojemann while operating on bilingual patients indicated that, although some brain areas were common to both languages, there were also peripheral areas involving only one of the languages. This kind of anatomical distribution of language function makes it easier to see how language disruption could manifest itself in seemingly aberrant and arbitrary ways.
Perhaps the most fascinating writing on the subject is to be found in the reports of those who have had personal experience of language impairment as it gives insight into what the condition feels like.
In Stroke: A Diary of Recovery, Douglas Ritchie describes it thus:
"I could day-dream……. I could think, actively, without using words, and coming down to earth, I rehearsed speeches silently. But there was the blank wall. The minute I rehearsed speeches with my tongue, even though I kept silent, the words would not come……
It was like starting a motor car. The engine ticked over and speeded up, but the moment one sought to put the car into gear, something went wrong with the clutch, the gear crashed with an ugly sound the engine stopped."
In Auto-Observation of Aphasia by French doctor Jacques Lordat, written in the 19th century, Lordat describes being at times in a state of what he called paramnesia "a faulty use of known and remembered sounds. Thus when I wanted to ask for a book, I pronounced the word for handkerchief. However, immediately after having uttered this word, I retracted it, feeling that another was indicated."
Equally intriguing is The Man Who Lost His Language by Sheila Hale in which she writes of the aftermath of her husband's stroke. John Hale never recovered his power of speech, or at least as the term is generally understood, yet he managed a form of communication based on constant repetition of the syllables da woahs, modulated and infused with emotion as if in normal conversation, apparently believing that the sounds he was uttering were making perfect sense to his listeners.
Works such as these were of more help to me than the case history in getting to the raw feel of what Bertha's experience must have been like. The personal perspective is invaluable as a complement to the medical one.
‘No voglio petit-déjeuner. Enleve. Tired. Voglio dormir. Ne dors pas noche. Je veux dormir adesso.’
Italian, French, English. Bertha knew all those languages. But why should she want to start speaking them now? And why jumble them all together like this? Mrs Pappenheim clenched her hands and stepped further into the room. ‘Bertha, what’s all this nonsense? Speak German, please.’
‘I am speaking German,’ Bertha said in English. She closed her eyes."
From Guises of Desire by Hilda Reilly
"For alongside of the development of the contractures there appeared a deep-going functional disorganization of her speech. It first became noticeable that she was at a loss to find words, and this difficulty gradually increased. Later she lost her command of grammar and syntax; she no longer conjugated verbs, and eventually she used only infinitives, for the most part incorrectly formed from weak past participles. And she omitted both the definite and indefinite article. In the process of time she became almost completely deprived of words. She put them together laboriously out of four or five languages and became almost unintelligible."
From Studies in Hysteria by Sigmund Freud and Josef Breuer
The disruption of Bertha's speech faculty was undoubtedly complex and it's perhaps not surprising that Breuer was at a loss to explain it in anything other than psychogenic terms. In addition to the difficulties described above, she went on to lose her command of German completely and for a while could speak only in English.
One of the obstacles to arriving at a neurological interpretation of Bertha's symptoms may have been the theory of retrograde amnesia formulated around the same time by French neurologist Theodule Ribot. According to this, any damage to memory areas of the brain would result in newer memories being affected before older ones. Extending this to the language function, it was therefore expected that languages learned later in life would be affected before earlier ones and that the mother tongue would be the last to suffer.
However, subsequent cases of multilingual patients affected by strokes and the like have not borne this out. American neuropsychologist Laurence Miller reports that the order in which languages are recovered in such cases is variable, and that individual patients can even exhibit different types of aphasic syndrome in their different languages. Research carried out by neurosurgeon George Ojemann while operating on bilingual patients indicated that, although some brain areas were common to both languages, there were also peripheral areas involving only one of the languages. This kind of anatomical distribution of language function makes it easier to see how language disruption could manifest itself in seemingly aberrant and arbitrary ways.
Perhaps the most fascinating writing on the subject is to be found in the reports of those who have had personal experience of language impairment as it gives insight into what the condition feels like.
In Stroke: A Diary of Recovery, Douglas Ritchie describes it thus:
"I could day-dream……. I could think, actively, without using words, and coming down to earth, I rehearsed speeches silently. But there was the blank wall. The minute I rehearsed speeches with my tongue, even though I kept silent, the words would not come……
It was like starting a motor car. The engine ticked over and speeded up, but the moment one sought to put the car into gear, something went wrong with the clutch, the gear crashed with an ugly sound the engine stopped."
In Auto-Observation of Aphasia by French doctor Jacques Lordat, written in the 19th century, Lordat describes being at times in a state of what he called paramnesia "a faulty use of known and remembered sounds. Thus when I wanted to ask for a book, I pronounced the word for handkerchief. However, immediately after having uttered this word, I retracted it, feeling that another was indicated."
Equally intriguing is The Man Who Lost His Language by Sheila Hale in which she writes of the aftermath of her husband's stroke. John Hale never recovered his power of speech, or at least as the term is generally understood, yet he managed a form of communication based on constant repetition of the syllables da woahs, modulated and infused with emotion as if in normal conversation, apparently believing that the sounds he was uttering were making perfect sense to his listeners.
Works such as these were of more help to me than the case history in getting to the raw feel of what Bertha's experience must have been like. The personal perspective is invaluable as a complement to the medical one.
April 19, 2013
Bertha Pappenheim's inability to recognise faces
"Mamma was coming – Bertha could feel the heat already – and she wasn’t alone; she was talking. Bertha didn’t want to see anyone. She just wanted to get back into her bedroom, on her own. Now they were hugging her, kissing her. A man – it must be a man, he had a beard – and a woman. A confusion of speech. The man’s voice and the woman’s voice. And beside them Mamma. Yes, that was Mamma, because that was where the stream of heat was coming from. But who were the other two? Faces like tailor’s dummies. She thought she recognized the man’s voice. It sounded like Cousin Fritz. And the woman sounded like Mamma, but she couldn’t be Mamma because Mamma was where the heat was coming from. Then she remembered. Cousin Fritz and Aunt Bella had arrived yesterday, and of course Aunt Bella sounded like Mamma because she was Mamma’s sister. Bertha wished they would all stop talking. It was so confusing to hear those familiar voices coming from faces which she didn’t recognize."
From Guises of Desire by Hilda Reilly
"She complained of not being able to recognize people. Normally, she said, she had been able to recognize faces without having to make any deliberate effort; now she was obliged to do laborious ‘recognizing work’ and had to say to herself ‘this person’s nose is such-and-such, his hair is such-and-such, so he must be so-and-so’. All the people she saw seemed like wax figures without any connection with her."
From The Case History of Bertha Pappenheim (Anna O.) by Josef Breuer
One of the visual disorders afflicting Bertha Pappenheim for a short period was the inability to recognise faces. Instances of patients suffering from this condition are recorded from the mid-19th century on but there is no indication that Bertha's own doctor, Josef Breuer, was familiar with it. Indeed, the way he describes her symptom suggests that he considered it rather as an idiosyncrasy unique to Bertha, merely another behavioural oddity which bolstered the diagnosis of hysteria.
The first known account dates from 1844. For a long time it was believed to be part of a more complex visual disorder and it wasn't until a century later that it was isolated as a condition in its own right and given a name - prosopagnosia.
Prosopagnosia is much more than a matter of not being able to put a name to a face. It involves not being able to recognise the identity of the person owning the face. So, for example, you might meet a former teacher in the street and not remember his name. If you realise that the person used to be your history teacher whose name momentarily escapes you, you are not suffering from prosopagnosia. If, on the other hand, you have no idea who he is until he speaks and you then realise that it's the same voice which bored you with information about people and events long gone, it's more likely to be due to prosopagnosia. If the face also strikes you as being an amorphous blob, pretty well indistinguishable from the multitude of other faces in the street, it's definitely prosopagnosia.
Prosopagnosia can be either congenital or acquired, in which case it results from damage to the associated, highly specific, part of the brain. In Bertha's case, such damage could have been caused by seizures of temporal lobe epilepsy, a diagnosis which could equally account for a number of her other symptoms.
People are now much more familiar with prosopagnosia, largely thanks to The Man Who Mistook His Wife for a Hat by Oliver Sacks. It would be interesting to know what Sacks would make of Bertha Pappenheim's case. I'm sure the account he would be come up with would be very different from that put together by Josef Breuer.
From Guises of Desire by Hilda Reilly
"She complained of not being able to recognize people. Normally, she said, she had been able to recognize faces without having to make any deliberate effort; now she was obliged to do laborious ‘recognizing work’ and had to say to herself ‘this person’s nose is such-and-such, his hair is such-and-such, so he must be so-and-so’. All the people she saw seemed like wax figures without any connection with her."
From The Case History of Bertha Pappenheim (Anna O.) by Josef Breuer
One of the visual disorders afflicting Bertha Pappenheim for a short period was the inability to recognise faces. Instances of patients suffering from this condition are recorded from the mid-19th century on but there is no indication that Bertha's own doctor, Josef Breuer, was familiar with it. Indeed, the way he describes her symptom suggests that he considered it rather as an idiosyncrasy unique to Bertha, merely another behavioural oddity which bolstered the diagnosis of hysteria.
The first known account dates from 1844. For a long time it was believed to be part of a more complex visual disorder and it wasn't until a century later that it was isolated as a condition in its own right and given a name - prosopagnosia.
Prosopagnosia is much more than a matter of not being able to put a name to a face. It involves not being able to recognise the identity of the person owning the face. So, for example, you might meet a former teacher in the street and not remember his name. If you realise that the person used to be your history teacher whose name momentarily escapes you, you are not suffering from prosopagnosia. If, on the other hand, you have no idea who he is until he speaks and you then realise that it's the same voice which bored you with information about people and events long gone, it's more likely to be due to prosopagnosia. If the face also strikes you as being an amorphous blob, pretty well indistinguishable from the multitude of other faces in the street, it's definitely prosopagnosia.
Prosopagnosia can be either congenital or acquired, in which case it results from damage to the associated, highly specific, part of the brain. In Bertha's case, such damage could have been caused by seizures of temporal lobe epilepsy, a diagnosis which could equally account for a number of her other symptoms.
People are now much more familiar with prosopagnosia, largely thanks to The Man Who Mistook His Wife for a Hat by Oliver Sacks. It would be interesting to know what Sacks would make of Bertha Pappenheim's case. I'm sure the account he would be come up with would be very different from that put together by Josef Breuer.
March 12, 2013
Choosing a title
As I neared the end of my novel, the need to decide on a title grew pressing. I had already been through several working titles: Bertha P (unlikely to attract attention, in fact, guaranteed not to); The Story of Bertha P (not much better); A.K.A. Anna O (well, I suppose the name Anna O is more recognizable than Bertha P, but not widely so, and there was also the problem of punctuation: should it be aka, AKA, a.k.a., A.k.a or A.K.A?).
Then the phrase The Various Guises of Desire came to me out of the blue. Now this I really liked. Pleasingly euphonious, with subtle hints of eroticism; perhaps the thinking woman's Fifty Shades of Grey. But could I be accused of misrepresentation? After all, my novel isn't a bodice ripper.
I didn't think so. In fact, it seemed to me highly apt. I don't agree with a lot of Freud's thinking but I do believe he was onto something with his ideas about what he unfortunately termed 'polymorphous perversity', which looms large in my version of the Bertha Pappenheim story. It also chimed with my thesis that Bertha's absence states were associated with a form of temporal lobe epilepsy and that during them she experienced states of mystical rapture.
I put it to the vote on my blog and on facebook. To my disappointment, no one came out in favour of The Various Guises of Desire. On the other hand, several people suggested Guises of Desire as a better alternative.
In the meantime, I had been toying with other ideas.
The Viennese Patient. Catchy enough but what about its significance? Bertha Pappenheim was undoubtedly Viennese - or was she? Her mother was born in Germany and her father in Hungary - but so too were most of the patients of early psychoanalysis. Bertha does not stand out particularly by virtue of her Viennese-ness. Once I'd realised this, the title lost its attraction for me.
I next considered Becoming Anna O. Incorporating Anna O into the title would make it meaningful to a wider range of readers and throw it up more frequently on Google searches. Then I discovered a book titled Becoming Anna. It's not a good idea to give a book a title which is the same as, or similar to, that of another book. Plus, this title was open to the same arguments made against the following one, suggested by a blog reader:
From Bertha P to Anna O.
I thought carefully about this one before deciding that it only covered part of the story. Yes, it summarises Bertha's passage from normal (for the time, place and social setting) young woman to patient treated for a multi-stranded medical condition as depicted by Breuer. But the novel goes beyond that, postulating more than is suggested in the case study and ending when Bertha is nearing the end of her later, and highly successful, professional life. I didn't want her identity to be subsumed into that of the case study.
At the same time I was thinking about the kind of artwork I'd like to see on the cover. That, along with the title, is crucial to getting a book noticed.
The first idea that came to mind was Klimt, a Viennese artist of about the same period as Bertha. I started looking at his paintings. Much as I liked them I felt that they were too well known and too 'strong' in a way which would risk eclipsing the image of the novel itself. Then I came across his sketches. I knew at once that here I would find something which encapsulated the essence of my story. Most of all it was the eroticism conveyed by many of his drawings of naked or semi-nude young women. It struck me that this, above all, is what my novel is about. I was reminded of writer Terri Marie's advice on choosing a title, that it was awaiting discovery and when recognized would instill you with confidence and catalyse the energy of the book - 'like a light shining through the window'. So it was with the Klimt sketches.
I hadn't realised until this point how important the undercurrents of eroticism in my novel are. I had seen it more as simply a many-faceted story. Now I could see that the main driving force is the steadily increasing erotic charge (albeit not always in guises which we would immediately recognise) which leads to the dramatic culmination.
The whole process of searching for title and artwork was like subjecting the content of my novel to study under a microscope. It homed in on what it is principally about, clarified it and enabled me to sum it up.
And in the end I went with the crowdsourced option:
Guises of Desire
Then the phrase The Various Guises of Desire came to me out of the blue. Now this I really liked. Pleasingly euphonious, with subtle hints of eroticism; perhaps the thinking woman's Fifty Shades of Grey. But could I be accused of misrepresentation? After all, my novel isn't a bodice ripper.
I didn't think so. In fact, it seemed to me highly apt. I don't agree with a lot of Freud's thinking but I do believe he was onto something with his ideas about what he unfortunately termed 'polymorphous perversity', which looms large in my version of the Bertha Pappenheim story. It also chimed with my thesis that Bertha's absence states were associated with a form of temporal lobe epilepsy and that during them she experienced states of mystical rapture.
I put it to the vote on my blog and on facebook. To my disappointment, no one came out in favour of The Various Guises of Desire. On the other hand, several people suggested Guises of Desire as a better alternative.
In the meantime, I had been toying with other ideas.
The Viennese Patient. Catchy enough but what about its significance? Bertha Pappenheim was undoubtedly Viennese - or was she? Her mother was born in Germany and her father in Hungary - but so too were most of the patients of early psychoanalysis. Bertha does not stand out particularly by virtue of her Viennese-ness. Once I'd realised this, the title lost its attraction for me.
I next considered Becoming Anna O. Incorporating Anna O into the title would make it meaningful to a wider range of readers and throw it up more frequently on Google searches. Then I discovered a book titled Becoming Anna. It's not a good idea to give a book a title which is the same as, or similar to, that of another book. Plus, this title was open to the same arguments made against the following one, suggested by a blog reader:
From Bertha P to Anna O.
I thought carefully about this one before deciding that it only covered part of the story. Yes, it summarises Bertha's passage from normal (for the time, place and social setting) young woman to patient treated for a multi-stranded medical condition as depicted by Breuer. But the novel goes beyond that, postulating more than is suggested in the case study and ending when Bertha is nearing the end of her later, and highly successful, professional life. I didn't want her identity to be subsumed into that of the case study.
At the same time I was thinking about the kind of artwork I'd like to see on the cover. That, along with the title, is crucial to getting a book noticed.
The first idea that came to mind was Klimt, a Viennese artist of about the same period as Bertha. I started looking at his paintings. Much as I liked them I felt that they were too well known and too 'strong' in a way which would risk eclipsing the image of the novel itself. Then I came across his sketches. I knew at once that here I would find something which encapsulated the essence of my story. Most of all it was the eroticism conveyed by many of his drawings of naked or semi-nude young women. It struck me that this, above all, is what my novel is about. I was reminded of writer Terri Marie's advice on choosing a title, that it was awaiting discovery and when recognized would instill you with confidence and catalyse the energy of the book - 'like a light shining through the window'. So it was with the Klimt sketches.
I hadn't realised until this point how important the undercurrents of eroticism in my novel are. I had seen it more as simply a many-faceted story. Now I could see that the main driving force is the steadily increasing erotic charge (albeit not always in guises which we would immediately recognise) which leads to the dramatic culmination.
The whole process of searching for title and artwork was like subjecting the content of my novel to study under a microscope. It homed in on what it is principally about, clarified it and enabled me to sum it up.
And in the end I went with the crowdsourced option:
Guises of Desire
March 3, 2013
The Pleasure of Researching Historical Fiction
Researching a historical novel is a wonderful learning experience, far more so than the cramming of facts, theories and ideas for an exam.
While researching Guises of Desire I needed to explore the kind of literature which could have contributed to the formation of Bertha Pappenheim's cultural mindset. I knew from Breuer's case history that she had studied Shakespeare and was familiar with the fairy tales of Andersen and the Grimms. But what of adult German literature? I had never read anything earlier than Thomas Mann and had always felt that it would be turgid and hard work.
I started with Goethe's The Sorrows of Young Werther, an epistolary novel about a young man driven to suicide by unrequited love. I found it a strange piece of writing - emotionally self-indulgent, the style rambling and the hero unlikeable. Its astonishing success only made me feel that readers at the time (late 18th century) must have been a different species from what they are now.
Goethe's second novel, Wilhelm Meister's Apprenticeship, was more readable, a bildungsroman which provided some interesting ideas for me to incorporate into Bertha's thinking and for her conversations with Dr Breuer.
I then tried Indian Summer by Adalbert Stifter, published in 1857, another bildungsroman. Its excessive wordiness made me sympathise with writer Friedrich Hebbel, a contemporary of Stifter, who apparently offered the crown of Poland to anyone who could finish it. I couldn't finish it. Yet here too I found material of relevance to Bertha.
In a letter which she writes to her cousin Anna while doing voluntary work with the poor I have her write:
Since I started this work I have been giving much thought to something which Heinrich’s father said to him in Indian Summer. He believed that man was not on Earth primarily for society, but for himself. This may seem at first glance a selfish idea but he goes on to say that if a person were here for himself in the best way possible, then it follows that he would also be here in the best way possible for society. If a person is born with a talent and a desire to paint, for example, he will be rendering best service to society by becoming a painter, rather than a barrister or a doctor or any other profession. He believed also that we each have an inner impulse which leads us in the direction of this innate calling. Do you believe that this is so, Anna? Did you feel this impulse when you decided to take up the teaching of literature? Do you think Rebekka felt it when she joined the Elisabethverein?
The other day I came across the following quote by psychologist Abraham Maslow on Pinterest:
A musician must make music, an artist must paint, a poet must write, if he is to be ultimately happy. What one can be, one must be. This need we may call self-actualization.
It struck me that this was exactly what Stifter had said a century earlier.
This serendipitous discovery alone has made my dip into classical German literature worthwhile. For the rest, while I can't say I enjoyed the reading experience, I still feel the better for having explored it.
While researching Guises of Desire I needed to explore the kind of literature which could have contributed to the formation of Bertha Pappenheim's cultural mindset. I knew from Breuer's case history that she had studied Shakespeare and was familiar with the fairy tales of Andersen and the Grimms. But what of adult German literature? I had never read anything earlier than Thomas Mann and had always felt that it would be turgid and hard work.
I started with Goethe's The Sorrows of Young Werther, an epistolary novel about a young man driven to suicide by unrequited love. I found it a strange piece of writing - emotionally self-indulgent, the style rambling and the hero unlikeable. Its astonishing success only made me feel that readers at the time (late 18th century) must have been a different species from what they are now.
Goethe's second novel, Wilhelm Meister's Apprenticeship, was more readable, a bildungsroman which provided some interesting ideas for me to incorporate into Bertha's thinking and for her conversations with Dr Breuer.
I then tried Indian Summer by Adalbert Stifter, published in 1857, another bildungsroman. Its excessive wordiness made me sympathise with writer Friedrich Hebbel, a contemporary of Stifter, who apparently offered the crown of Poland to anyone who could finish it. I couldn't finish it. Yet here too I found material of relevance to Bertha.
In a letter which she writes to her cousin Anna while doing voluntary work with the poor I have her write:
Since I started this work I have been giving much thought to something which Heinrich’s father said to him in Indian Summer. He believed that man was not on Earth primarily for society, but for himself. This may seem at first glance a selfish idea but he goes on to say that if a person were here for himself in the best way possible, then it follows that he would also be here in the best way possible for society. If a person is born with a talent and a desire to paint, for example, he will be rendering best service to society by becoming a painter, rather than a barrister or a doctor or any other profession. He believed also that we each have an inner impulse which leads us in the direction of this innate calling. Do you believe that this is so, Anna? Did you feel this impulse when you decided to take up the teaching of literature? Do you think Rebekka felt it when she joined the Elisabethverein?
The other day I came across the following quote by psychologist Abraham Maslow on Pinterest:
A musician must make music, an artist must paint, a poet must write, if he is to be ultimately happy. What one can be, one must be. This need we may call self-actualization.
It struck me that this was exactly what Stifter had said a century earlier.
This serendipitous discovery alone has made my dip into classical German literature worthwhile. For the rest, while I can't say I enjoyed the reading experience, I still feel the better for having explored it.
The Writing of Guises of Desire
In this blog I discuss thoughts I've had while researching and writing about Bertha Pappenheim, the subject of my biographical novel Guises of Desire. Bertha Pappenheim is better known as Anna O, the
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