International Journal of Clinical and Experimental

Hypnosis

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The cathartic method and the expectancies of

breuer and ANNA O

M. B. Macmillan

To cite this article: M. B. Macmillan (1977) The cathartic method and the expectancies of
breuer and ANNA O, International Journal of Clinical and Experimental Hypnosis, 25:2, 106-118,
DOI: 10.1080/00207147708415970

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 The InterMtionul Journal of Clinical and Experimental Hypnosis
1977,Vol. XXV. No. 2. 106-118

THE CATHARTIC METHOD AND THE

EXPECTANCIES OF BREUER
AND ANNA 0.l
M. B. MACMILLAN2s3
Monash University, Australia
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Abstract: Expectancies about the consequences of the suppression of

behavior and about the effects of expressing emotions are proposed
as sources of the “talking cure” which developed during Breuer’s
treatment of Anna 0.and which later became known as the cathar-
tic method. Although the argument is similar to one proposed by
Ellenberger (1970,1972)it sets out a more rational alternative to his
explanation that the method was partly a creation of the mytho-
poetic unconscious. The analysis of the interaction between Breuer
and Anna 0. makes explicit the expectancies underlying each of the
steps through which the cathartic method developed and traces
these expectancies to the general beliefs and the specific theoretical
interests shared by them.
Authoritative accounts of Breuer’s treatment of Anna 0. claim or
imply that Breuer discovered a genuine, if limited, method for the
treatment of hysterical symptoms (Freud, 1910, 1925; Jones, 1953).
Breuer seemed to have observed that symptoms were acquiredduring
Manuscript submitted April 10, 1976; final revision received October 12, 1976.
Editor‘s Note-This manuscript is of relevance to the International Journal not
merely because it presents a novel historical reconstruction, but rather because it uses a
classic case to illustrate importunt issues of immediate merit. It illustrates how
apparently specific treatments may nonetheless be effective in large part because they
resonate with the s h r e d expectancies of the patient and his therapist. It suggests how
such effects might be best conceptualized as a form of placebo response. The manu-
script shows how even the most astute observer may inadvertently help create the data
t h t he then caremly records as novel evidence to support his evolving theory. The
implications of this manuscript for treatments such as the primal scream or for
observations such as regression beyond birth are worthy of the reader‘s consideration.
It is hoped thut this historical reanalysis of the germinal case from which modern
dynamic psychiatry evolved may serve to make each of us somewhat more cautious
about the kind of observations required to document our hypotheses.
’ An earlier version of the paper was presented at the Annual Conference of the
Australian Psychological Society, 1975.
Reprint requests should be addressed to M. B. Macmillan, Department of Psy-
chology, Monash University, Clayton, Victoria, 3168, Australia.
The author wishes to thank Dr. L. Ryder for her encouragement and critical
assistance in the preparation of this manuscript, Ms. P. J. Weir for the translations,
and Professor R. H. Day and Dr. D. R. F. Irvine for their comments on an early draft
of the paper.
106
 CATHARTIC METHOD AND EXPECTANCES 107
emotionally charged incidents in which the expression of the d e c t
had not taken place. The symptoms disappeared when, during the
patient’s autohypnoses, those incidents were relived and their emo-
tion given belated verbal expression. That expression of d e c t was
later called abreaction and it was the central element of what came to
be known as the cathartic method (Breuer & Freud, 1893, 1895).
In this paper it is argued that the “talking cure” was a type of non-
specific suggestion therapy which derived its therapeutic effective-
ness from the shared expectancies of Breuer and Anna 0. rather than
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from the properties of the method itself. The argument develops h m

Ellenberger‘s (1970)observation that Anna O.’s illness resembled the
classic somnambulistic illnesses of an earlier era in which the treat-
ment methods originated from the initiative of patients and were
fostered by the unaware encouragement of therapists. Analysis of the
treatment shows that the initiative and encouragement, at each of
the steps through which the method developed, was based on identifi-
able expectancies. It is suggested that two beliefs probably shared by
Breuer and Anna 0. are the sources of the expectancies. One belief
was that illness could be caused by the suppression of behavior and
the other was the belief that a calmer mood would follow from the
expression of the emotions of pity and terror. The first of these bdiefs
is identical with what Ellenberger (1966)has called the concept of the
pathogenic secret while the second is a minor adaptation of a central
tenet of Aristotle’s4 theory of the tragedy.
The paper is in three sections: ( a )a description of Breuer’s clinical
observations, ( b ) an attempted identification of the sources of the
talking cure through an analysis of the treatment, ( c ) and a discus-
sion of the implications of the argument.
THE CLINICALOBSERVATIONS
Breuer’s first attendance upon Anna 0. was for a nervous cough
which had developed during a deterioration in physical health attrib-
uted to an over-zealousnursing of her very sick father. Only minimal
signs of hysteria were then present: momentary absences were ob-
served, during which she would stop in mid-sentence, repeat her last
words, pause, and then go on speaking. Anna 0. did not know what
had happened during the absences; indeed, she seemed at first only
partly aware of them. Much later, Breuer was to reconstruct the
events of this period which lasted from mid-July to about December
10,1880.It had begun when Anna O., dozing by her father‘s bedside,
had an hallucination of a snake about to bite him. She had tried to
ward off the snake with her right arm which had gone to sleep and
Ariitotle’s De Poetica is the specific work referred to throughout this paper.
 108 M. B. MACMILLAN

was virtually paralyzed. When she looked at her fingers they had
turned into little snakes with death’s heads. After the hallucination
had vanished, she tried to pray in her native German but could find
only English words. The next day, the hallucination recurred when
she saw a bent branch. That revival was the first absence, and in each
subsequent absence there was a repetition of the hallucination.
Breuer later supposed that around the hallucination a secondary
state of consciousness began to develop. By December llth, Anna 0.
was so ill that she became a bed patient herself.
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The second phase of the illness commenced with an immediate

manifestation of two distinct states of consciousness, headaches, dis-
turbances of vision, a convergent squint, paralysis of the neck mus-
cles, and contractures and anaesthesias of the arms and legs. As the
illness progressed, the absences were extended until the secondary
consciousness became more stable. A complex speech disturbance
manifested itself during this time: Anna 0. gradually lost the power
to speak, initially only in grammatically correct German, but later
she was unable to speak at all for 2 weeks. Breuer (Breuer & Freud,
18951 hypothesized that the speech loss was due to her being Very
much offended over something and [that she] had determined not to
speak about it [p. 251.” As the original case report indicates, she had
been “hurt” by something said or done by her father (Ellenberger,
1972). Once Breuer had “obliged” her to talk about it, she regained
her power of speech completely. Similar observations were made
about her mood changes. During her daytime absences she had been
observed to be “obviously creating some situation or episode to which
she gave a clue with a few muttered words [Breuer & Freud, 1895, Pp.
28-29].’’ When, in the evening, she “woke” from her afternoon sleep
into a spontaneous autohypnosis, she fi-equently repeated the words
“tormenting, tormenting.” An observer, now repeating the mutter-
ings of the afternoon, could get her to elaborate a story in the style of
a fairy-tale, usually involving as the central character a girl sitting
anxiously by a sick bed. At the conclusion of the story she woke up
completely, now feeling “comfortable” in mood. Breuer encouraged
her to tell the stories, for he found that this more normal state lasted
until the following day. Concurrently, her physical symptoms were
somewhat relieved.
After her father’s death in April, 1881, the third phase of the illness
commenced. Not having been allowed to see her father during the
previous 2 months, she was totally unprepared for his death. ’lho
days of stupor followed. More symptoms developed: human beings
appeared wax-like and could not be differentiated from one another; a
pronounced “negative attitude” developed toward her relatives and
 CATHARTIC METHOD AND EXPECTANCIES 109
she now lost the ability to understand German.A consultant who had
been called in was not even perceived until he blew smoke directly
into her face. This forceful breaking down of her negative hallucina-
tion caused her to fall to the ground unconscious. A severe anxiety
attack then ensued. Breuer calmed her down with difficulty, but on
his next visit several days later she was much worse. “She had gone
entirely without food the whole time, was full of anxiety and her
hallucinatory absences were filled with t e d y i n g figures, death’s
heads and skeletons [Breuer & Freud, 1895, p. 271.” Breuer now
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observed that if, during her autohypnoses, she could be persuaded to

talk about her hallucinations she would wake:
clear in mind, calm and cheerful. She would sit down to work and write
or draw far into the night quite rationally. At about four she would go to
bed.Next day the whole series of events would be repeated. It was a truly
remarkable contrast: in the day-time the irresponsible patient pursued
by hallucinations, and at night the girl with her mind completely clear
[Breuer & Freud, 1895, Pp. 27-281.

Over the next 6 or ‘7 weeks as the two states of consciousness became

more separated, Breuer encouraged her to talk about her hallucina-
tions and this ensured a more tolerable mental state for at least a part
of each day. The talking had little other effect on the mental symp-
toms and none on the physical. In fact, her condition so deteriorated
during this period, with suicidal gestures becoming so frequent, that
she was forcibly transferred to the Inzersdorf sanatorium outside of
Vienna on July 12, 1882.
She returned to Vienna itself at the beginning of November. With
the exception of a &week period in July and August, Breuer saw her
daily during the third period. After her return to Vienna, she ex-
tended the talking method to some bizarre behaviors, not reported at
all in the published account of the case, which she called her “fancies”
(Ellenberger, 1972). She appears to have talked first about the origins
of her fancy of stocking wearing. She sometimes woke, quite puzzled,
to find that she was in bed with her stockings on. It transpired that
when her father had been ill and she had been forbidden to see him,
she had put her stockings on to withstand the cold when she got up,
secretly, to listen at his door during the night. She was now putting
the stockings on during an absence before going to bed. This fancy of
stocking wearing ceased after she recalled its origin.Recollecting the
origins of her other symptoms was similarly effective. The first which
was overcome was an inability to drink. She recalled that she had
once been disgusted that her lady-companion’s dog had been allowed
to drink from a glass:
 110 M. B. MACMILLAN
The patient had said nothing as she had wanted to be polite. ARer giving
further energetic expression to the anger she had held back, she asked
for something to drink, drank a large quantity of water without any
difficulty and woke from her hypnosis with the glass at her lips; and
thereupon the disturbance vanished, never to return. A number of
extremely obstinate whims were similarly removed after she had de-
scribed the experiences which had given rise to them [Breuer & Freud,
Pp. 34-35].
The disappearance of this symptom seems to have marked the end of
the third phase of the illness and the beginning of the fourth.
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During the fourth period a quite remarkable, almost unique, fea-

ture of the disorder appeared. Breuer‘s “great surprise” at the relief of
the inability to drink was followed by his systematic exploitation of
Anna O.’s willingness to talk about her fancies and her symptoms.
Endeavoring to clear up the remaining symptoms, he found that most
of her evenings were being spent in reliving the events of that same
day 365 days earlier. According to Breuer, entries in her mother‘s
diary confirmed the absolute accuracy of her recall. The period lasted
for 6 months, until June, 1882,inclusive. Breuer had to contend with
memories of two hinds: those of 1882 and of the corresponding day in
1881. Two sets of recollections were now required in order to recon-
struct the chronology of the many appearances of each symptom.
Because of this complexity, Breuer decided to hypnotize Anna 0. to
obtain, not recollections, but a list of all the circumstances under
which each symptom had manifested itself (Breuer & Freud, 1895,p.
36). Even with the list, the process of recollection was laborious. She
recalled, for example, 303 instances where she had failed to hear
something said to her. These were classified into seven separate
groups: 108 instances when she had not heard someone come into the
room, 27 instances of not understanding when several people were
talking, and so on. Each instance had to be correctly ordered to its
group and then to its correct part of the sequence and relived in
reverse order before the symptom disappeared. Central to these recol-
lections was the hallucinatory image of the snake about to bite her
father. Its recall ended the fourth phase of the illness. According to
the 1895 account she was now cured (Breuer & Freud, 1895).
Within 5 weeks, however, she had relapsed, and a fifh period, not
described in Breuer‘s later account, commenced. On July 12, 1882,
Anna 0.was admitted to the Sanatarium Bellevue in Kreuzlingen,
Switzerland, where she remained until October 29, 1882 (Ellenber-
ger, 1972). Although Breuer‘s original notes had claimed a “great
alleviation,” much pathology was still present during her stay a t the
Bellevue. Hysterical features, speech disorders, alternations of con-
sciousness, and a facial neuralgia described only in the original case
 CATHARTIC METHOD AND EXPECTANCIES 111
notes, were still present. Not surprisingly, she was described as
making “disparagingjudgments against the ineffectivenessof science
in regard to her sufferings [Ellenberger, 1972, Pp. 277-2783.” Her
symptoms were apparently unchanged on discharge. Where she then
went, and by what means she was finally relieved of her symptoms is
not known. However, some time before the end of the 1880’s she was
symptom free. She then commenced a quite notable career; she is now
regarded in Germany as the founder of the profession of social work.
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SOURCES OF THE TALKING CURE

Reliving of the events producing the symptoms, what Anna 0.
named “the talking cure,” has long been recognized as the essence of
Breuer‘s treatment method. Nevertheless, there is much confusion
about the details of the method and, until quite recently, a failure to
appreciate either the nature or implications of Anna O.’s contribu-
tion. As will be seen, Anna 0. not only invented the talking cure: she
dominated and directed treatment from the beginning. After having
been “obliged” to speak of the hurt done to her by her father, she
extended the talking procedure through the fairy-tale stories, to the
hallucinations, and finally to the origins of the fancies and s y m p
toms. Analysis shows that the first two of these steps provided the
foundation for the others.
Breuer (Breuer & Freud, 1895)believed that Anna 0. had deliber-
ately decided not to speak to her father. He assumed that that
voluntary suppression of speech had generalized:
As I knew, she had felt very much offended over something and had
determined not to speak about it. When I guessed this and obliged her to
talk about it, the inhibition, which had made any other kind of utterance
impossible as well, disappeared [p. 25, author‘s italics, M.B.M.I.
His treatment strategy was based upon the expectation that by
overcoming the specifically suppressed behavior a more general effect
would result. Had Breuer not had that expectation there would have
been no point in his obliging Anna 0. to speak. Anna 0. had some-
how communicated to Breuer both her feeling of offense and the
deliberateness of her decision not to speak. Breuer’s response to that
communication set into motion the therapeutic train of events.
Breuer‘s response seems too consistent with what Ellenberger
(1966)has called the concept of the pathogenic secret for it to have
been merely idiosyncratic. From earliest times and in many forms of
society, illnesses of all kinds have been seen both as resulting from
unexpressed, secret ideas and as being curable through the expres-
sion of the secret. By the time Breuer came to treat Anna O., the
concept was well established in religion, literature, and criminology,
 112 M. B. MACMILLAN
as well as in the specialized literature on hypnosis and hysteria.
Ellenberger specifically mentions a recognition of the concept in de
hysegur (cited by Ellenberger, 1966) and its explicit use by the
Viennese physician, Moritz Benedikt (cited by Ellenberger, 19661, as
the fundamental principle of his method of treating hysteria.
Breuer‘s first step in the treatment of Anna 0. was, therefore, con-
sistent with a body of belief that the general speech function would be
restored once the specific secret had been uncovered. Anna 0. may
well have shared this belief, since it was not restricted to medical
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circles; in any case, she created a situation which requested just that
step from Breuer.
The second step in the treatment was Anna O.’s telling of the fairy
stories. Each story was based upon a situation which she had “ob-
viously” created earlier during the day, each required the presence of
another person to repeat some of the words from that earlier situation
if Anna 0. was to elaborate the story, and her general mood was more
“comfortable” afterwards, although her symptoms were unchanged.
Aristotle’s theory of catharsis seems to have been a major influence
upon this step. Ellenberger (1970) cites Dalma as having shown that
an enormous interest in catharsis and the drama had arisen in
Vienna after the publication of a book on catharsis by Bernays in 1880
(cited by Ellenberger, 1970)-the very year Anna O.’s illness had
begun. That general interest together with the specific, and pro-
nounced, theatrical interests of Anna 0. and Breuer could have
created a set of shared beliefs about the effects of story telling. And
those effects would have been to calm only the general mood and not
to alter the symptoms. Partly for this reason, Aristotle’s theory is a
stronger candidate for the source of this second step than for the
cathartic method as a whole, as Ellenberger has proposed.
Aristotle’s theory had required the characters of a tragedy to be
moved by fear and pity so that the watching audience would be
purified of those two emotions. While in the De Poetica Aristotle did
not define what was to be understood by purification, it is clear that it
was taken to mean some kind of vicarious discharge of those emotions
in the audience. Anna O.’s days were filled with hallucinatory fears,
her evening stories with pity for the poor nursing girl. To a theatri-
cally oriented person, it might not have seemed strange that express-
ing or discharging even one of these emotions through a story would
benefit a general emotional state; Breuer was just such a person.
Quite apart from Bernays’ book or his own general cultural back-
ground, Breuer had a special, highly developed, interest in the Greek
drama (Meyer, 1928). He could hardly have been ignorant of Aristo-
tle’s theory. Anna O.’s repetition of the word “tormenting” came to
 CATHARTIC METHOD AND EXPECTANCIES 113
represent a suggestion that she be allowed to follow-up the situation
or episode “obviously created” during the daytime absence. Once the
prompt of the words muttered during the absence was provided, Anna
0. responded with the lines from her “rehearsal.” Breuer’s expecta-
tions then allowed for the elaboration of a calming story.
Anna O.’s own expectationswould at least have matched Breuer‘s.
She was a person of considerable culture (Jensen, 1970)who conceiva-
bly knew of Bernays’ book directly and who had, on the evidence of
her later writing, a pronounced theatrical talent. Long after her
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treatment with Breuer, she wrote stories and plays in which pity for
the central character was the dominant motif (Jensen, 1970; Karpe,
1961).There was,in addition, a more direct connection. In response to
being restricted to an extremely monotonous life by her puritanically-
minded family:
She embellished her life . . . by indulging in systematic daydreaming,
which she described as her ‘private theatre’. While everyone thought she
was attending, she was living through fairy tales in her imagination
[Breuer & Freud, 1895, p. 221.
Her therapeutic story telling was little more than another perform-
ance in this private theatre, this time with herself as audience
watching the melodrama of the pitiful girl fearfully nursing her sick
father.
The medical and other literature of the time devoted to altered
states of consciousness might also have led Breuer to think of the two
states of consciousness- so prominent from the second stage of Anna
O.’s illness onwards- in theatrical terms and therefore as modifiable
by catharsis. For, although the number of cases of what would now be
regarded as instances of multiple personality reported in the litera-
ture was not more than five or six, the amount of discussion gener-
ated by them was considerable (Sutcliffe & Jones, 1962; Taylor &
Martin, 1944).The discussion was not limited to formal case reviews
in the medical literature; in the nineteenth century such cases were
thought to be especially relevant to such questions as the nature of
the self and the structure of the personality. Taine, an enormously
influential French philosopher, cultural historian, and literary critic
devoted a substantial part of his De L’lntellience (1878)to double
consciousnessand multiple personality. He used a striking theatrical
metaphor to s u m up the implications of these cases and the appar-
ently similar ones of mediumistic possession:
The human brain is a theatre where, on several planes, several different
plays are staged simultanwusly,but only one of which is illumined. . . .
Certainly one finds here a doubling of the self (dedoublement du moi),
the simultaneous presence of two series of parallel and independent
 114 M. B. MACMILLAN
ideas, of two centres of action, two psychological persons juxtaposed in
the same brain, each with a different mission, one at centre stage, and
other in the wings naine, 1878, Pp. 16-171.
This particular metaphor was much quoted, in whole or in part, for
example by Ribot (18851,Janet (18861, and Binet (1889, 1892). One
may presume that its central point was in even wider circulation and
that it was possibly known to Breuer. He could have known of the
metaphor directly for he was familiar with other works by Taine
(cited by Meyer, 1928). He almost certainly knew of a similar theatri-
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cal metaphor describing consciousness as a stage and ideas as actors

which had been proposed by his friend and colleague Hering (1895).
Applying the talking method to the hallucinations was simply an
extension of the second step. No more than a calming of mood would
be expected to result from the discharge of emotions and that was
what happened. Anna O.’s symptoms were unchanged and her condi-
tion so deteriorated that she was hospitalized. The treatment proper
began in the fourth and fifth steps when the talking method was
applied first to the origins of the fancies and then to the origins of the
symptoms. The expected result of that application would be a combi-
nation of the expectancy of the first step, that talking would remove
symptoms based on secrets, with the expectancy of the second and
third steps that emotional expression would bring about a general
mood change. Only one fact is not accounted for by t h i s explanation
and that is why it was so long before the last two steps were taken.
Anna O.’s direction of the treatment continued until the end when
she decided upon the date and mode of its termination:
The patient herself had formed a strong determination that the whole
treatment should be finished by the anniversary of the day on which she
was moved into the country. At the beginning of June, accordingly, she
entered into the ‘talkingcure’ with the greatest energy. On the last
day -by the help of re-arrangingthe room so as to resemble her father‘s
sickroom-she reproduced the terrifying hallucination . . . which consti-
tuted the root of her whole illness [Breuer & Freud, 1895, p. 401.

By this re-enactment, Anna 0. nominated the hallucination of the

snake as the cause of her illness and gave Breuer a starting point for
his reconstruction of its evolution.
Ellenberger (1970) seems to have been the first to point out the
significance of Anna O.’s domination of the treatment. H e notes that,
in this and in other respects, Anna O.’s case resembled the classic
mesmeric and magnetic cures from the late eighteenth century. In
those cases, subjects had regularly “instrucW the magnetizer about
 CATHARTIC METHOD AND EXPECTANCIES 115
the caws of the symptom and the methods of The apparently
absolute accuracy of Anna O.’s memory for the events of a year
earlier and the intense personal relation between herself and Breuer
are two other features with parallels in the classic cases. An impor-
tant implication of Ellenberger‘s comparison is that Anna O.’s re-
sponse to Breuer’s method of treatment ought to be regarded as no
more remarkable than the “cures” developed in the earlier cases.

DISCUSSION
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It is only probable that Breuer and Anna 0. did share the beliefs
and expectations attributed to them in this paper; there is no way of
establishing the facts with certainty, nor can one say that the success
of the “talking cure” did derive from the beliefs and expectations
common to Anna 0. and Breuer. But, if it did, and if Anna 0.
dominated the treatment to the extent suggested, Breuer‘s therapeu-
tic method may be placed within a tradition of similar methods and
evaluated accordingly. Almost from the beginning of the modern era,
the details of the treatment methods using hypnosis seem to have
developed from specific sets of beliefs-part social and part personal.
For example, Mesmer’s patients convulsed their way to health proba-
bly because they believed the then current medical opinion that
convulsive crises were a necessary preliminary to the recovery from
any illness-a belief which Doctor Mesmer would hardly have dis-
couraged. In contrast, the method of magnetic sleep, which sup-
planted that used by Mesmer, was stumbled upon by de Puysegur in
mesmerizing his servants and other social inferiors. Sleep, symboliz-
ing the passive submission of servant to master, was an appropriate
response to be made by de Puysegur’s subjects, and they recovered
through sleeping rather than through convulsive crises. Mesmerism
and magnetic sleep clearly resemble the administration of inert
drugs, the use of precious metals, and the performance of sham
operations in having no properties which would explain their mode of
action and in relying for their curative effects on the implicit sugges-
tions of the expectancies surrounding their use. The “talking cure’,
appears to belong to this same sub-class of non-specific suggestive
Such features were regularly reported in the mesmeric press of the nineteenth
century (Dingwall, 1967, Vol. 1) and were not confined to the early period. In about
1900, Edgar Cayce the American medical clairvoyant, diagnosed the cause of his
aphonia by inspecting his own vocal cords. He then instructed the hypnotist to give
him a suggestion to increase the circulation to the affected parts. Cayce’s self-
perception restored his voice. Interestingly, his hypnotist knew of similar self-
diagnosis from the work of de Puysegur (account cited by Cerminara, 1950).
 116 M. B. MACMILLAN
therapies, the members of which sometimes relieved some of the
symptoms of hysteria.
This conceptualization of the “talking cure” has three important
implications. First, even if the mechanism by which suggestion pro-
duces cures is unknown, explaining the effects of Breuer’s method by
the implicit suggestions of the expectancies provides a rational alter-
native to the explanation of Ellenberger (1970) who proposed the
method to be a creation of the mythopoetic unconscious. Second, the
short time between the end of Breuer’s treatment and Anna O.’s
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relapse might require no special explanation; like a number of other

non-specific treatments, the “talking-~ure~’ might have been capable
of producing only evanescent results. Finally, if like some of the other
suggestion methods the effectiveness of Breuer‘s technique also de-
pended partly upon socially determined expectancies shared by thera-
pist and patient, it might be anticipated that its effectiveness would
decline as those social beliefs declined or became unfashionable. The
fact that its use is now rather restricted might index the waning of
common convictions, similar to those of Breuer and Anna O., neces-
sary to keep the method alive.
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Die kathartische Methode und die Erwartungen von Breuer und Anna 0.
M. B. Macmillan
Abstrakt: Erwartungen von den Konsequenzen des unterdriickten Verhaltens und
den Effekten des Ausdrucks von Gefiihlen werden hier als Quellen der “Kur des
Aussprechens” vorgeschlagen, die sich aus Breuers Behandlung der Anna 0.
entwickelte und die spater als die kathartische Methode bekannt wurde. Obgleich
dies Argument dem von Ellenberger (1970) vorgeschlagenen iihnlich ist, gibt es doch
eine rationellere Alternative fiir seine Erkliirung, dass die Methode zum Teil eine
Schopfung dea mythopoetischen Unbewusstseins sei. Eine Analyse der Interaktion
zwischen Breuer und Anna 0. driickt sehr klar die Erwartungen aus, die jedem der
Schritte unterliegen, durch die sich die kathartische Methode entwickelt und leitet
diese Erwartungen von den allgemeinen Ansichten und den speziellen, theore-
tischen Interessen, die sie teilen, her.

La methode cathartique et les attentes de Breuer et d’Anna 0.

M. B. Macmillan
Esume: L’article propose que les attentes concernant (a) les consequences de la
suppression d’un comportement et (b) les effets et l’expression des emotions sont les
sources de la “cure par la parole” qui s’est Claborke durant le traitement d’Anna 0.
 118 M. B. MACMILLAN
par Breuer, traitement plus tard connu sous le nom de mkthode cathartique. Bien
que cette t h b soit semblable a celle que soutient Ellenberger (1970), elle est plus
rationnelle que I’explication d’Ellenberger voulant que la mkthode cathartique fut,
en partie, une d a t i o n de l’inconecient mythopo6tique. L’analyse de I’interaction
entre Breuer et Anna 0. permet d’expliciter lea attentes sous-jacentes chaque
&ape du dhveloppement de la mkthode cathartique, et renvoie ces attentes aux
croyances gknerales et aux intkrt5ts thhriques sp6ciiques qu’ils avaient en com-
mun.

El m6todo cattirtico y las expectativas de Breuer y Anna 0.

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M. B. Macmillan
Resumen: Las expectativas acerca de la eliminacion de ciertos comportamientos y
de 10s efectos de la expmiQnde emociones son presentadas como fuentes de la “cura
por la palabra” (talking cure) que tuvo lugar durante el tratamiento de Anna 0. por
Breuer, procedimiento posteriormente conmido bajo el nombre de mktodo cat&
tico. Este argumento, aunque similar al propuesto por Ellenberger (1970). propor-
ciona una alternativa mas racional a la explicaci6n de dicho autor, el cual pretende
que el mktodo en cuesti6n fue enparte una creacion del inconsciente mitopoktico. El
d l i s i s de la inhracci6n Breuer-Anna 0. explicita Ias expectativas subyacentes a
cada una de las etapas de la evoluci6n del mktodo cat&rtico, y pone dichas expectati-
vas en relacion con las creencias general- y 10s intereses teoricos especificos
comunes a ambos individuos.