How one woman overcame trauma: The legacy of Bertha Pappenheim

Anna O and Bertha Pappenheim

Anna O  (pseudonym) is best known as the 'original patient of psychoanalysis'. While most think of her as Sigmund Freud's psychoanalysis patient, Anna O, whose real name was Bertha Pappenheim, never saw Freud. Instead, she received treatment from Josef Breuer, Freud's colleague. Her case is documented in the collaborative work by Freud and Breuer, The Aetiology of Hysteria (1895).

Anna O presented with symptoms of what was then called hysteria: altered states of consciousness (dissociation), unexplainable somatic symptoms, and emotional reactions. Today, she might receive the diagnosis  Post-Traumatic Stress Disorder or psychosis.

Over the course of her therapy, and while treating other female patients, Breuer and Freud concluded that the origins of hysteria lay in premature sexual experiences. In other words, childhood sexual abuse. These conclusions along with 18 case studies were published in The Aetiology of Hysteria.

A century later, this paper still rivals contemporary clinical descriptions of the effects of childhood sexual abuse. 

Judith Herman. Trauma and Recovery.

With this triumph, one would have expected Freud and Breuer to continue their roles as therapists, researchers, and writers on psychological trauma. One would have expected these men to continue to educate society about the connection between hysteria and childhood sexual trauma.

One would have expected that.

The Betrayal

Within one year of publication of The Aetiology of Hysteria, Freud privately recanted the theory of the origins of hysteria.

His correspondence makes clear that he was increasingly troubled by the radical social implications of his hypothesis. Hysteria was so common among women, that if his patients’ stories were true, he would be forced to conclude what he called ‘perverted acts against children’ were endemic.

Judith Herman

Breuer also terminated all connection to the traumatic theory of hysteria. He abruptly terminated his therapeutic relationship with Bertha Pappenheim sending her into a mental health crisis that resulted in her hospitalization and several years of ill health.

The Politics of Sexual Violence

In France, in the late 1800s, interest in hysteria grew alongside the establishment of a new French Republic (1870).

The word 'hysteria' was so well known even the general public understood its meaning.

The political leaders of this new government were men who considered themselves proponents of enlightenment. Their political battlefield was with the church and the aristocracy. They launched an aggressive campaign to secure their power base, which included disproving spiritual experiences such as apparitions, visions, and faith healings. These manifestations resembled the symptoms of psychological hysteria.

These men wanted scientific reasoning to trump religious experience.

However, the investigations into the cause of hysteria went someplace else. No one expected the investigations of hysteria to uncover a societal scandal of unimaginable magnitude.

With that discovery, the men of power and the structures they inhabited abandoned the cause.

By the turn of the century, the political impulse that had given birth to the heroic age of hysteria had dissipated; there was no longer any compelling reason to continue a line of investigation that had led men of science so far from they originally intended to go. . .

As long as the study of hysteria was part of an ideological crusade, discoveries in the field were widely applauded and scientific investigators were esteemed for their humanity and courage. But once this political impetus had faded, these same investigators found themselves compromised by the nature of their discoveries and by their close involvement with their women patients. Judith Herman, M.D.

Judith Herman. Trauma and Recovery.

Bertha Pappenheim

In the midst of the upheaval was Pappenheim. Over several years, she recovered.

And then, Bertha Pappenheim did what many women and marginalized people do. She got up and did something.

She joined other women and became an active voice in the women’s liberation movement of the early 1900s.

She became an activist, a writer, an organizer, and a tireless advocate for women and children.

  • She translated A Vindication of the Rights of Women by Mary Wollstonecraft from English into German.
  • She was a social and political activist.
  • She was a director of an orphanage for girls.
  • She founded of many institutions including community homes and places of education.
  • She was President of the League of Jewish Women, a position she held for 20 years.
  • She traveled extensively speaking against the sexual exploitation of women and children.

Pappenheim's Struggle Continues

Is the age in which we live so different than that of Bertha Pappenheim?

  1. Power structures minimize, deny, dismiss, and suppress the truth of trauma.
  2. When there is no political, economic, or professional gain, issues such as sexual trauma are not taken seriously -if listened to at all.
  3. Vulnerable persons continue to be blamed, slandered, and humiliated by those in power.
  4. Vulnerable persons rarely receive justice.

Today, the tragedy of Anna O is just as relevant as it was over 100 years ago. Today, the triumph of Bertha Pappenheim rings true.

Pappenheim's Legacy

Anna O was a victim. Dismissed by the power structures of her day, she disappeared. Pappenheim was an overcomer. She recovered, arose, and lent her voice to the causes that would bring change. From her, we learn that trauma does not have to define or destroy.

Today, let us look to people like Pappenheim as role models.

Let us continue to gather, to speak, to write, to advocate, to march, and to encourage one another.

Let us not give up.