On a Patient in Therapy

Bertha, like most girls of her family’s tax bracket, received an above-average education. She was born in the late ‘50s to parents who had inherited their wealth. In school, Bertie studied languages, took piano lessons, became a proficient horsewoman, and was, according to all who met her, a lively and bright young person.

Yet, despite her life advantages, Bertie felt suffocated and confined in her life. She struggled with depression and a host of other mental issues. By the ‘80s, as a young woman, she felt she could not cope with life any longer. Adding to the stress was the fact that her beloved father had been diagnosed with a fatal illness.

Bertie began to hallucinate, experience physical pain, and would even display violent behavior that she would later not be able to remember. Not surprisingly, the family suggested that she see a therapist. The doctor she saw became her lifeline of a sort. She began to see him every day in lengthy sessions where she would tell of her “private theater” of life. The sessions helped her somewhat, but her emotional state was further disturbed when her father died. Bertie refused to eat much at all, and her physical health began to deteriorate.

Her doctor called in another specialist for a second opinion on how they could help Bertie. At that time, smoking in office and public was still a “thing” and this new doctor lit a cigarette in front of Bertie. She exploded in anger. It was decided that she should be institutionalized. There, Bertie received drugs designed to keep her calm. Again, as you can probably guess, she developed a dependency on these drugs.

Then, a breakthrough. Bertie began to discuss the roots of what troubled her. She spoke in sessions with the doctors about issues of her childhood, which, while not unpleasant, had caused her to harbor resentment and fear for all those years. After several months of intensive give and take with her doctors, Bertie had worked through her issues. Many of her physical symptoms were gone as were most of the hallucinations. Her appetite returned. And, exactly one year after she was admitted, she was released from the hospital. She was transferred to an outpatient home for wealthy patrons, a cushy, relatively independent care facility that included such things as equestrian activities—which Bertie loved, of course.

The dependence on her meds continued, and there were lapses in her condition, of course, but overall she continued to improve. Finally, in the late ‘80s, Bertie left the facility and began life again on the outside of both treatment and hospitals. She and a friend collaborated on a series of children’s stories based on her hallucinations, even. She became a charitable matron of many social causes as rich people often do. She became a champion for the feminist movement and translated several books written by pioneers in women’s rights. Bertha Pappenheim completed the transition from being a severely disturbed person and addict into a writer, publisher, activist, and a leader of a political movement.

While this success story of analysis and treatment is surely wonderful (and not without controversy), that is not the only thing interesting about Bertie’s story. You see, her doctors called her Anna O. in their notes and publications. Anna O. is often called the first patient of the psychological treatment known as psychoanalysis. Her treatment by Dr. Josef Breuer not only influenced one of Breuer’s protégés but it also caused the protégé to create an entire psycho-sexual theory around Bertha’s treatment.

You know that protégé as Dr. Sigmund Freud.

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