In 1895, Joseph Breuer and Sigmund Freud, two Viennese doctors, published a work in which they gave detailed descriptions of some new experimental technique they stumbled upon. During Freud's time, almost every non-classifiable disturbance was termed a neurological disease, and women were deemed to be especially prone to such disorders - hence the term histeria (from the Greek 'hystera' - the word for uterus). The symptoms with which these 'patients' came to clinics such as that of Breuer and Freud were very variable: loss of feeling in limbs, depression, dissociations, hallucinations, insomnia, etc.
Now, mostly these patients were treated with contemporary medicine - electrical stimulation, warm baths, retreats, drugs. Mostly, without much result. Freud and Breuer tried to tackle the problem from a different angle.
According to them, human beings form ideas about the things we experience, and these ideas are accompanied by emotions. Normally, when dealing with experiences, specifically negative ones, we find a way to process them. So when something bad happens, or someone offends us, we scoff at the other person or situation; we associate other ideas with the experience and hence nuance our experience; etc. In other words: we process the experience and that's that.
But sometimes things can go wrong. When a situation happens that we, unconsciously, are ashamed of or feel really bad about, we might try mentally to suppress the formation of the idea. But this is impossible. The idea is formed, complete with associated emotion, but it will live in a mental space divided from our consciousness. It's still there though. And when new events happen, that our unconsciousness associates with the past (suppressed) event, our body jams and this is translated into bodily failings, i.e. hysterical symptoms - or rather: symbols, as Freud calls them.
The task of the therapist, when dealing with a patient suffering from hysteria, is to integrate the suppressed ideas (which linger in our unconsciousness) into our consciousness. This can be done by making the patient recall the past event. The patient lies down, is hypnotized (or not), and then the psychotherapist asks the patient intimate questions about the symptoms, and especially the origin of these symptoms. And so the patient will integrate the repressed ideas into his or her consciousness, the hysteria will disappear, and everything's fine.
According to Freud.
The most interesting part of the book is Part 2, in which Breuer and Freud (mostly Freud) describe five case studies of patients with hysteria and how they applied the above mentioned therapy - which was at that time experimental. They call it the 'cathartic method' (from the Greek katharsis: cleansing/purging), which - of course - is the proto-psychoanalysis of Freud's later work.
There are various interesting remarks to be made on these case studies:
1. All of the patients are women, and from the language Breuer, but especially Freud, uses it is easy to note a sort of obsession with women. So when Freud describes his patients, he notes peculiar things like: it's a young, beautiful woman. One wonders what this has to do with the medical treatment.
2. All the patients that are described suffer from the same wide range of symptoms: loss of sense, loss of feeling in limbs, sleeping disorders, hallucinations, anxiety disorders, symptoms of depression/mood disorder, etc.
3. Initially treatment fails, and it is only when the psychotherapist starts to ask intimate questions that the symptoms seem to lessen. And it is only when the psychotherapist has finally unearthed the true, original event that led to the hysteria, that the patient (almost instantaneously) recovers.
4. The original event that is being repressed, is almost in each case a sexual one. Freud calls this erotic ideas.
An example will illustrate the absurdity of these theories (although now I give away my own position on the case...).
Freud sees a patient (a young, lively, although typical hysterical girl of 24 years of age) who suffers from severe nerve pains in hips and legs. Hypnosis doesn't work on her, so Freud starts to ask questions. Initially the treatment doesn't really work; the pains don't stop appearing and she doesn't fell well.
Luckily, Freud knows why: the patient is not honest when explaining the true traumatic experiences that led to these symptoms of hysteria. In the end, Freud probes her some more and she reveals that she secretly was in love with her brother-in-law. Her erotic longing for this prince on his white horse, coupled with the feeling of shame and guilt (especially since her sister, the wife of this man, died), is the true reason why she suffers. She recovers and that's that.
Freud ends his description of the case of Fraulein Elisabeth von R. with the following peculiar, but typical passage:
"In the spring of 1894, I heard that she was going to a private ball for which I was able to get an invitation, and I did not allow the opportunity to escape me of seeing my former patient whirl past in a lively dance. Since then, by her own inclination, she has married someone unknown to me." (p. 160)
(A smilar case study, on a certain 'Katharina' explains how, when Freud is walking in the mountains, the daughter of the woman who rents the room of the inn where Freud stays asks for a doctor. She explains she has hysterical symptoms; Freud asks her intimate questions: and lo and behold! the reason for the hysteria is discovered - the girl was sexually assaulted by her uncle, who she later saw raping her cousin, and the repressed ideas about these experiences are treated and the girl is healed.)
It is very hard to give a fair hearing when reading such ridiculous nonsense. And I think we should rather treat it like that: nonsense.
Freud was an oversexed fantast; an intellectual who couldn't rid himself of the Victorian upper-class view on women; and a pseudo-scientist who saw the unconsciousness as the cause of almost every detail of our mental world. The unconsciousness either respresses or accepts ideas; and this either leads to hysteria or to a healthy learning experience. The problem with all this is that it makes for good literature, but bad science. Freud's theories are so vague, all-encompassing and (especially) untestable that it is very hard to see why they have been so influential....
To end this review: I have to credit Joseph Breuer for intellectual honesty. When Freud started to interpret hysteria in a primarily sexual way, Breuer parted with Freud. So one has at least to give Breuer credit for trying to develop a new experimental method of treating patients with neurological symptoms - a noble goal. Freud took it and ran off with it.
So, read this book as a historical (and hysterical) document, and keep in mind that hysteria isn't a classified diagnosis anymore; psychoanalysis isn't a legitimate treatment anymore; Freud's theories aren't scientifically accepted anymore.