Anna O.

Anna O. was the pseudonym of a patient of Josef Breuer, who published her case study in his book Studies on Hysteria, written in collaboration with Sigmund Freud.

Anna O was, in fact, Bertha Pappenheim (1859-1936), an Austrian-Jewish feminist and the founder of the Jüdischer Frauenbund, treated by Breuer for severe cough, paralysis of the extremities on the right side of her body, and disturbances of vision, hearing, and speech, as well as hallucination and loss of consciousness. She was diagnosed with hysteria. Freud implies that her illness was a result of the grief felt over her father's real and physical illness that later led to his death.

Her treatment is regarded as marking the beginning of psychoanalysis. Breuer observed that whilst she experienced 'absences' (a change of personality accompanied by confusion), she would mutter words or phrases to herself. In inducing her to a state of hypnosis, Breuer found that these words were "profoundly melancholy phantasies...sometimes characterized by poetic beauty". Free Association came into being after Anna/Bertha decided (with Breuer's input) to end her hypnosis sessions and merely talk to Breuer, saying anything that came into her mind. She called this method of communication "chimney sweeping", and this served as the beginning of free association.

Anna's/Bertha's case also shed light for the first time on the phenomenon called transference, where the patient's feelings toward a significant figure in his/her life are redirected onto the therapist. By transference, Anna imagined to be pregnant with the doctor's baby. She experienced nausea and all the pregnancy symptoms. After this incident, Breuer stopped treating her.

Historical records since showed that when Breuer stopped treating Anna O. she was not becoming better but progressively worse. In fact she was ultimately institutionalised: "Breuer told Freud that she was deranged; he hoped she would die to end her suffering".

She later recovered over time and led a productive life: the West German government issued a postage stamp in honour of her contributions to the field of social work.

According to current research, "examination of the neurological details suggests that Anna suffered from complex partial seizures exacerbated by drug dependence." In other words, her illness was not, as Freud suggested, psychological, but neurological. Many believe that Freud misdiagnosed her, and she in fact suffered from temporal lobe epilepsy, and many of her symptoms, including imagined smells, are common symptoms of types of epilepsy.

Pappenheim under her real name translated the diary of her ancestor Gluckel of Hameln.