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Revealing secrets
“If it is true that the causes of hysterical
disorders are to be found in the intimacies of
the patient‟s psycho-sexual life, and that
hysterical symptoms are the expression of their
most secret and repressed wishes, then the
complete exposition of a case of hysteria is
bound to involve the revelation of those
intimacies and the betrayal of those secrets”
(Dora 2).
-- See also (Dora 69)
Female sexuality as secret
“We know less about the sexual life of little girls
than of boys. But we need not feel ashamed of
this distinction; after all, the sexual life of adult
women is a „dark continent‟ for psychology.”
(Question of Lay Analysis (1926))

“Throughout history people have knocked their
heads against the riddle of the nature of
femininity.” (“Femininity” 100)
“… the enigma of women…” (“Femininity” 116)
Freud as archaeologist
He claims he has brought “to the
light of day after their long burial
the priceless though mutilated
relics of antiquity,” filling in
what is missing through
knowledge from other analyses
(Dora 7)
From Wikimedia commons, licensed CC-BY

How is he digging up the remains of antiquity,
uncovering secrets? (sexual secrets, since hysteria has
to do with these (Dora 2, 29))
Introduction to the Dora text
Freud‟s letter to Fleiss: “…I have a new
patient, a girl of eighteen; the case has
opened smoothly to my collection of
picklocks” (Introduction to Dora vii) (see
Dora 61, 89).
The facts Freud uncovered about Dora took
“their life from the precise truth of Freud‟s
multiple analytic thrusts into her
unconscious” (Rieff, Ibid., xvii).
Re-telling Dora‟s secrets
Freud can‟t keep a secret: he publishes this case
history for the sake of science (Dora 2).
He recognizes it may seem he is publishing a “roman à
clef,” inviting others to try to figure out who it‟s about
(Dora 3).

• Does feel a bit like a novel—gives fictional names to
characters & places, tells a story (S. Marcus, “Freud
and Dora: Story, History, Case History” (1974)).
• He is re-telling parts of Dora‟s life, filling in the gaps;
psychoanalysis allows for a coherent life story
(Marcus; Dora 10-11)
Others can‟t keep the
secret
Including me:
“Dora” was Ida Bauer
(1882-1945)

Age 8, with brother
Otto

Wikimedia commons, public domain
Sigmund Freud, 1856-1939

Circa 1905
Wikimedia commons, public domain

1921
1921
Wikimedia commons, public domain
History of Hysteria
Hippocrates
(c. 460-370 BCE,
Athens)
Plato
(c. 427-347 BCE,
Athens)
Hippocrates at
Wikimedia
Commons, public
domain

Galen
(2nd century CE,
Roman)
Plato at Wikimedia
commons, public
domain

Galen at Wikimedia
commons, public
domain
History of Hysteria
Hysteria in late 19th & early 20th century

Dora’s symptoms: migraine, dyspnoea
(difficulty breathing), coughing spells,
aphonia (loss of voice), fits of
unconsciousness w/amnesia, dragging foot,
threatened suicide
Other common symptoms of hysteria: paralysis,
loss of feeling in limbs, hallucinations,
delusions, convulsions
History of Hysteria
Rachel P. Maines, The Technology of Orgasm:
“Hysteria,” the Vibrator, and Women’s Sexual
Satisfaction (1999); Now a movie: Hysteria (Dir.
Tanya Wexler, 2011)
One fairly common treatment for hysterical symptoms in
women was “genital massage” by doctors or nurses,
especially patients not able to have sex through
intercourse.
Chapter 1 of Maines‟ book:
http://www.nytimes.com/books/first/m/maines-technology.html
Jean-Martin Charcot (1825-1893)
Neurologist,
Salpêtrière Hospital,
Paris
-- Freud visited his
clinic for four
months, 1885-1886
Charcot & patient, by
André Brouillet, 1887

From wikimedia commons, public domain
Images of
hysterical
patients from
Salpêtrière
hospital
Wikimedia commons (Italy),
public domain

Wikimedia commons,
Public domain
Freud and Hysteria
• Repression: Particular memories, feelings, desires,
fantasies (always having some sexual component
(Dora 39)) are pushed out of consciousness into the
unconscious
• Return of the repressed: But these repressed
contents seek to emerge into consciousness some
other way: they “speak” one‟s inner secrets through a
different language, in dreams or bodily symptoms
• Role of analyst is to translate this language, re-tell
the patient‟s own secrets to him/her. Once brought to
consciousness, symptoms resolve.
Hysterical symptoms
•

“Conversion” (Dora 46): psychological energy is
converted, translated into physiological expression,
a symptom
•

•

Symptoms repeat because the unconscious material
still striving for expression

“Somatic compliance” (Dora 33-34): psychological
energy attaches to a physiological experience or
symptom that the patient already had.
•
•

e.g., physiological basis of Dora‟s cough (74)
psychological meanings of it (74, 31-32, 41, 48)
Dreams and Hysteria
Dreams are another way for unconscious material to be
expressed
“…the dream is one of the roads along which
consciousness can be reached by the mental
material which, on account of the opposition aroused
by its content, has been cut off from consciousness
and repressed, and has thus become pathogenic.
The dream, in short, is one of the détours by which
repression can be evaded ….” (Dora 9)
How unconscious speaks
through dreams & symptoms
1. Condensation: one symptom can be linked to
many different unconscious thoughts,
desires, etc. (Dora 41)
-- e.g., the “house on fire” in Dora‟s first dream
linked to brother‟s room (57), fear of fire at K‟s
house (57), bedwetting (63), erotic love (64),
desire of kiss from Herr K & Freud (65-66)
-- e.g., the various psychical meanings of Dora‟s
cough (75)
How unconscious speaks
through dreams & symptoms
2. Displacement: unconscious thoughts, desires,
etc. are displaced onto different physical
sensations or symptoms
-- e.g., mother wants to save her “jewel-case” in
first dream—displacement of wish for her own
“jewel-case” to be saved (61) (though also
another displacement on p. 62)
-- e.g., Herr K‟s embrace (Dora 22-23): displaces
pressure from lower body to memory of upper
body
How unconscious speaks
through dreams & symptoms
3. Reversal of affect: unconscious feelings,
desires can only be accepted into
consciousness as their opposite
-- e.g., Dora‟s desire for Herr K emerges as
disgust when he tries to kiss her (22)
4. Projection: projecting one‟s own feelings or
thoughts onto someone else

-- e.g., Dora reproaching father for relationship
with Frau K. (28-29)
Psychoanalytic treatment
The psychoanalyst must interpret the language of
symptoms and dreams, to bring unconscious material
into consciousness, thereby filling in gaps in memory
and resolving symptoms (Dora 11)
• “…the whole effectiveness of the treatment is based
upon our knowledge that the affect attached to an
unconscious idea operates more strongly and …
more injuriously than the affect attached to a
conscious one” (Dora 42).
Psychoanalytic treatment
Patient: Communicate everything that comes to mind, in
relation to events, thoughts, dreams, etc., without
criticism or omitting what might seem irrelevant
(Interpretation of Dreams (1899), 101)
Analyst: Listen & interpret w/o preconceived purpose,
try not to let your own unconscious affect your
interpretations; be like a “mirror” for patient‟s
unconscious (“Recommendations to Physicians
Practicing Psycho-analysis” (1912))
From An Outline of
Psychoanalysis (1938-1939)
Pact with patient: “complete candour on one side and
strict discretion on the other. This looks as though we
were only aiming at the post of a secular father
confessor. But there is a great difference, for what we
want to hear from our patient is not only what he knows
and conceals from other people; he is to tell us too what
he does not know…. He is to tell us not only what he
can say intentionally and willingly, what will give him
relief like a confession, but everything else as well that
his self-observation yields him, everything that comes
into his head, even if it is disagreeable for him to say it,
even if it seems to him unimportant or actually
nonsensical.
Psychoanalytic treatment
Transference: Where the patient treats the doctor like
some other person in his/her life, transferring feelings
s/he has for other person to the doctor (Dora 106-107)
• “What are the transferences? They are new editions or
facsimiles of the tendencies and phantasies which are
aroused and made conscious during the progress of the
analysis; … they replace some earlier person by the
person of the physician” (106)
-- another way that unconscious material comes out—
useful for making these feelings conscious
Psychoanalytic treatment
Counter-transference: where the doctor
transfers his/her unconscious feelings, desires
towards something or someone else to the
relationship with the patient; or the
unconscious elements in the doctor that can
affect their interpretations, keep them from
being objective (Freud doesn‟t discuss this in
Dora text).

How much of this may be in evidence in Dora?
Freud‟s secrets
The “Dora” case history seems an invitation for readers
to uncover Freud‟s own unconscious secrets
•

It is a “fragment,” it is incomplete (6-7); it contains
gaps itself
o

•

Freud draws attention to how case was recorded
from memory (4); there may be gaps in his own
memory

The case history reads like a psychoanalytic
session: not organized linearly but more by
association, stream of consciousness at times (e.g.,
66, 87)
Freud‟s secrets
The treatment failed b/c he didn‟t see the
“transference” early enough (108)
•

Invites us to ask: what in his own
unconscious kept him from seeing this?

Might we engage in “analytic thrusts” into the
dark, hidden recesses of his psyche to
uncover his secrets?
Hysteria in the

st
21

century

Conversion disorder: psychological distress,
trauma, conflict is converted into physical
symptoms (no physiological cause can be
found)

Sample symptoms: paralysis in an arm or leg,
numbness, inability to speak, seizures or
convulsions, fainting, hallucinations,
Tourette‟s syndrome-like “tics”

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Telling and Re-telling Secrets with Freud and Dora

  • 2. Revealing secrets “If it is true that the causes of hysterical disorders are to be found in the intimacies of the patient‟s psycho-sexual life, and that hysterical symptoms are the expression of their most secret and repressed wishes, then the complete exposition of a case of hysteria is bound to involve the revelation of those intimacies and the betrayal of those secrets” (Dora 2). -- See also (Dora 69)
  • 3. Female sexuality as secret “We know less about the sexual life of little girls than of boys. But we need not feel ashamed of this distinction; after all, the sexual life of adult women is a „dark continent‟ for psychology.” (Question of Lay Analysis (1926)) “Throughout history people have knocked their heads against the riddle of the nature of femininity.” (“Femininity” 100) “… the enigma of women…” (“Femininity” 116)
  • 4. Freud as archaeologist He claims he has brought “to the light of day after their long burial the priceless though mutilated relics of antiquity,” filling in what is missing through knowledge from other analyses (Dora 7) From Wikimedia commons, licensed CC-BY How is he digging up the remains of antiquity, uncovering secrets? (sexual secrets, since hysteria has to do with these (Dora 2, 29))
  • 5. Introduction to the Dora text Freud‟s letter to Fleiss: “…I have a new patient, a girl of eighteen; the case has opened smoothly to my collection of picklocks” (Introduction to Dora vii) (see Dora 61, 89). The facts Freud uncovered about Dora took “their life from the precise truth of Freud‟s multiple analytic thrusts into her unconscious” (Rieff, Ibid., xvii).
  • 6. Re-telling Dora‟s secrets Freud can‟t keep a secret: he publishes this case history for the sake of science (Dora 2). He recognizes it may seem he is publishing a “roman à clef,” inviting others to try to figure out who it‟s about (Dora 3). • Does feel a bit like a novel—gives fictional names to characters & places, tells a story (S. Marcus, “Freud and Dora: Story, History, Case History” (1974)). • He is re-telling parts of Dora‟s life, filling in the gaps; psychoanalysis allows for a coherent life story (Marcus; Dora 10-11)
  • 7. Others can‟t keep the secret Including me: “Dora” was Ida Bauer (1882-1945) Age 8, with brother Otto Wikimedia commons, public domain
  • 8. Sigmund Freud, 1856-1939 Circa 1905 Wikimedia commons, public domain 1921 1921 Wikimedia commons, public domain
  • 9. History of Hysteria Hippocrates (c. 460-370 BCE, Athens) Plato (c. 427-347 BCE, Athens) Hippocrates at Wikimedia Commons, public domain Galen (2nd century CE, Roman) Plato at Wikimedia commons, public domain Galen at Wikimedia commons, public domain
  • 10. History of Hysteria Hysteria in late 19th & early 20th century Dora’s symptoms: migraine, dyspnoea (difficulty breathing), coughing spells, aphonia (loss of voice), fits of unconsciousness w/amnesia, dragging foot, threatened suicide Other common symptoms of hysteria: paralysis, loss of feeling in limbs, hallucinations, delusions, convulsions
  • 11. History of Hysteria Rachel P. Maines, The Technology of Orgasm: “Hysteria,” the Vibrator, and Women’s Sexual Satisfaction (1999); Now a movie: Hysteria (Dir. Tanya Wexler, 2011) One fairly common treatment for hysterical symptoms in women was “genital massage” by doctors or nurses, especially patients not able to have sex through intercourse. Chapter 1 of Maines‟ book: http://www.nytimes.com/books/first/m/maines-technology.html
  • 12. Jean-Martin Charcot (1825-1893) Neurologist, Salpêtrière Hospital, Paris -- Freud visited his clinic for four months, 1885-1886
  • 13. Charcot & patient, by André Brouillet, 1887 From wikimedia commons, public domain
  • 14. Images of hysterical patients from Salpêtrière hospital Wikimedia commons (Italy), public domain Wikimedia commons, Public domain
  • 15. Freud and Hysteria • Repression: Particular memories, feelings, desires, fantasies (always having some sexual component (Dora 39)) are pushed out of consciousness into the unconscious • Return of the repressed: But these repressed contents seek to emerge into consciousness some other way: they “speak” one‟s inner secrets through a different language, in dreams or bodily symptoms • Role of analyst is to translate this language, re-tell the patient‟s own secrets to him/her. Once brought to consciousness, symptoms resolve.
  • 16. Hysterical symptoms • “Conversion” (Dora 46): psychological energy is converted, translated into physiological expression, a symptom • • Symptoms repeat because the unconscious material still striving for expression “Somatic compliance” (Dora 33-34): psychological energy attaches to a physiological experience or symptom that the patient already had. • • e.g., physiological basis of Dora‟s cough (74) psychological meanings of it (74, 31-32, 41, 48)
  • 17. Dreams and Hysteria Dreams are another way for unconscious material to be expressed “…the dream is one of the roads along which consciousness can be reached by the mental material which, on account of the opposition aroused by its content, has been cut off from consciousness and repressed, and has thus become pathogenic. The dream, in short, is one of the détours by which repression can be evaded ….” (Dora 9)
  • 18. How unconscious speaks through dreams & symptoms 1. Condensation: one symptom can be linked to many different unconscious thoughts, desires, etc. (Dora 41) -- e.g., the “house on fire” in Dora‟s first dream linked to brother‟s room (57), fear of fire at K‟s house (57), bedwetting (63), erotic love (64), desire of kiss from Herr K & Freud (65-66) -- e.g., the various psychical meanings of Dora‟s cough (75)
  • 19. How unconscious speaks through dreams & symptoms 2. Displacement: unconscious thoughts, desires, etc. are displaced onto different physical sensations or symptoms -- e.g., mother wants to save her “jewel-case” in first dream—displacement of wish for her own “jewel-case” to be saved (61) (though also another displacement on p. 62) -- e.g., Herr K‟s embrace (Dora 22-23): displaces pressure from lower body to memory of upper body
  • 20. How unconscious speaks through dreams & symptoms 3. Reversal of affect: unconscious feelings, desires can only be accepted into consciousness as their opposite -- e.g., Dora‟s desire for Herr K emerges as disgust when he tries to kiss her (22) 4. Projection: projecting one‟s own feelings or thoughts onto someone else -- e.g., Dora reproaching father for relationship with Frau K. (28-29)
  • 21. Psychoanalytic treatment The psychoanalyst must interpret the language of symptoms and dreams, to bring unconscious material into consciousness, thereby filling in gaps in memory and resolving symptoms (Dora 11) • “…the whole effectiveness of the treatment is based upon our knowledge that the affect attached to an unconscious idea operates more strongly and … more injuriously than the affect attached to a conscious one” (Dora 42).
  • 22. Psychoanalytic treatment Patient: Communicate everything that comes to mind, in relation to events, thoughts, dreams, etc., without criticism or omitting what might seem irrelevant (Interpretation of Dreams (1899), 101) Analyst: Listen & interpret w/o preconceived purpose, try not to let your own unconscious affect your interpretations; be like a “mirror” for patient‟s unconscious (“Recommendations to Physicians Practicing Psycho-analysis” (1912))
  • 23. From An Outline of Psychoanalysis (1938-1939) Pact with patient: “complete candour on one side and strict discretion on the other. This looks as though we were only aiming at the post of a secular father confessor. But there is a great difference, for what we want to hear from our patient is not only what he knows and conceals from other people; he is to tell us too what he does not know…. He is to tell us not only what he can say intentionally and willingly, what will give him relief like a confession, but everything else as well that his self-observation yields him, everything that comes into his head, even if it is disagreeable for him to say it, even if it seems to him unimportant or actually nonsensical.
  • 24. Psychoanalytic treatment Transference: Where the patient treats the doctor like some other person in his/her life, transferring feelings s/he has for other person to the doctor (Dora 106-107) • “What are the transferences? They are new editions or facsimiles of the tendencies and phantasies which are aroused and made conscious during the progress of the analysis; … they replace some earlier person by the person of the physician” (106) -- another way that unconscious material comes out— useful for making these feelings conscious
  • 25. Psychoanalytic treatment Counter-transference: where the doctor transfers his/her unconscious feelings, desires towards something or someone else to the relationship with the patient; or the unconscious elements in the doctor that can affect their interpretations, keep them from being objective (Freud doesn‟t discuss this in Dora text). How much of this may be in evidence in Dora?
  • 26. Freud‟s secrets The “Dora” case history seems an invitation for readers to uncover Freud‟s own unconscious secrets • It is a “fragment,” it is incomplete (6-7); it contains gaps itself o • Freud draws attention to how case was recorded from memory (4); there may be gaps in his own memory The case history reads like a psychoanalytic session: not organized linearly but more by association, stream of consciousness at times (e.g., 66, 87)
  • 27. Freud‟s secrets The treatment failed b/c he didn‟t see the “transference” early enough (108) • Invites us to ask: what in his own unconscious kept him from seeing this? Might we engage in “analytic thrusts” into the dark, hidden recesses of his psyche to uncover his secrets?
  • 28. Hysteria in the st 21 century Conversion disorder: psychological distress, trauma, conflict is converted into physical symptoms (no physiological cause can be found) Sample symptoms: paralysis in an arm or leg, numbness, inability to speak, seizures or convulsions, fainting, hallucinations, Tourette‟s syndrome-like “tics”

Notas del editor

  1. I think the top one is Augustine; bottom one is taken by Albert Londe in 1885 at Salpetriere