THE MILESTONE OF PSYCHOANALYSIS : ANNA.O CASE

Anna O., real name Bertha Pappenheim, is a 21-year-old smart young woman living in Vienna with her wealthy Orthodox Jewish family. She has one brother and two older sisters. When Anna was only eight years old, her older sister died of tuberculosis. Anna's family has no known mental illness, only distant relatives have had psychosis.

Since women were not allowed to be at the forefront and to participate in business and education life during Anna's life, Anna generally started to spend her time at home by sewing and finding occupations. Meanwhile, when her father's tuberculosis disease emerged, Anna O. took care of her father. Anna became very weak and weakened because she did not sleep until late and did not eat much while she was taking care of her father.

The main symptoms seen in Anna were the inability to eat, fear of drinking water, paralysis in partial areas, sleep disorders, speech problems, hallucinations, and visual disturbances. Anna was also experiencing severe muscle aches and excruciating pain on the left side of her head. He could not move his left arm and had serious difficulties in turning his neck. She began to show symptoms that could not be understood by some of her environment, not only physically, but also psychologically.

Anna O., whose symptoms gradually increased and even began to lose her sight, finally went to Dr. He decided to meet with Breuer. The symptoms in Anna O. were thought to arise as a result of identifying herself with her father. One of the first symptoms to appear in Anna O. is a severe coughing fit and blindness resulting from blurred vision. Breuer, who first examined Anna, thought that these symptoms were caused by an organic disease. Later, he decided that Anna's symptoms had a psychological basis and he diagnosed Anna with "hysteria".

After this decision, Breuer first tried to find a solution to the symptoms with the application of hypnosis, but Breuer gave up on this technique when Anna used incomprehensible sentences containing five different languages during hypnosis. He tried to look for clues about his symptoms by asking Anna to say whatever comes to mind. The method he applied here was the birth of ‘’free association’’, which is one of the basic techniques of psychoanalysis. This method helped Anna to remember many things over time and even relieved her symptoms. Anna herself described this method as “chimney cleaning” and “talking cure”.

One of the symptoms that Breuer observed improved through Free Association was the paralysis of Anna's right arm. One day, Anna saw a snake going towards her father in a dream. She felt that her right arm was holding her back as she went to help her father. Shortly after she had the dream, the symptom on her right arm appeared. Another symptom is strabismus and visual impairment. These symptoms arose because her father asked Anna about the time and Anna was crying and trying to look at the clock very closely. All these symptoms disappeared when Anna told Breuer during free association.

While Freud looked at this case from the sexual side, Breuer thought that although Anna's symptoms at the onset of her illness had a psychic basis, they were often caused by organic causes. According to Freud, Anna developed an intense love for her father during her caregiving process, touching her skin to change or dressing her and touching her genitals aroused sexual desires in Anna. caused it to occur. These ideas of Freud caused him to conflict with Breuer. However, as a result, both Freud and Breuer contributed a lot to psychoanalysis through this case, and the Anna O. Case has taken its place in the literature as one of the most striking cases even today.