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tional case history illustrating the effectiveness of hypnosis in clear–
ing up symptoms of hysteria. This was unproblematic since the case
merely illustrated a relatively common medical procedure and
appeared to validate a theory. In
Studies on Hysteria,
however, Freud
and Breuer were admitting the lack of medical and physiological
authority over hysteria and, by implication, attributing to the
patients the knowledge and power to cure themselves. As Freud
noted, their cases also had more of a literary than a scientific charac–
ter. And that, taken in conjunction with the fact that Freud and
Breuer were using their cases to illustrate yet nonexistent theory,
made
Studies on Hysteria
an anomalous book on an anomalous
subject.
In
Studies on Hysteria,
the two authors carefully bracketed their
detailed case studies by theoretical statements, giving their cast the
appearance of mere illustrations. This was an obligatory formality
dictated by the norms of scientific reporting, to which Breuer and
Freud naturally subscribed. Nevertheless, the theoretical portions of
Studies on Hysteria
were its tentative aspects, and the case studies the
real substance . Only in the case studies were the authors sure of
their ground. That hysteria was a poorly understood but notorious
class of nervous disorders is what interested Freud, who wanted to
define its nature to clear up some of the mysteries in neuro–
pathology. As Freud put it, "We have still to await the directing
hand which shall set up boundary marks in the region of the com–
monly occurring neuroses and which shall bring out the features
essential for characterization." In the meantime, however, he was
"still accustomed to diagnosing a hysteria, . .. from its similarity to
familiar typical cases." Thus Freud explains the necessity of
reporting case studies: the "directing hand," implicitly his own,
would define the distinctive features of hysteria, bringing the
disorder under the umbrella of medical science and rendering case
studies eventually unnecessary.
In another passage in
Studies on Hysteria,
Freud explicitly stated
his anxiety as a neuropathologist doing a narrative analysis of a case
of a nervous disorder . In his discussion of the case of Fraulein
Elisabeth von R ., he confessed:
I have not always been a psychotherapist. Like other neuro–
pathologists, I was trained to employ local diagnoses and electro–
prognosis, and it still strikes me myself as strange that the case
histories I write should read like short stories and that, as one
might say,
they lack the serious stamp of science.
I must console myself
