Free Freud - Complete Works by Sigmund Freud

beginning to end of the illness all the
stimuli arising from the secondary state, together with their
consequences, were permanently removed by being given verbal
utterance in hypnosis, and I have only to add an assurance that
this was not an invention of mine which I imposed on the patient by
suggestion. It took me completely by surprise, and not until
symptoms had been got rid of in this way in a whole series of
instances did I develop a therapeutic technique out of it.
       The final cure of the hysteria
deserves a few more words. It was accompanied, as I have already
said, by considerable disturbances and a deterioration in the
patient’s mental condition. I had a very strong impression
that the numerous products of her secondary state which had been
quiescent were now forcing their way into consciousness; and though
in the first instance they were being remembered only in her
secondary state, they were nevertheless burdening and disturbing
her normal one. It remains to be seen whether it may not be that
the same origin is to be traced in other cases in which a chronic
hysteria terminates in a psychosis.
     
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    Studies On Hysteria
    46
     
    CASE
2
     
    FRAU EMMY VON N., AGE 40, FROM
LIVONIA   (Freud)
     
    On May 1, 1889, I took on the case of a lady
of about forty years of age, whose symptoms and personality
interested me so greatly that I devoted a large part of my time to
her and determined to do all I could for her recovery. She was a
hysteric and could be put into a state of somnambulism with the
greatest ease; and when I became aware of this I decided that I
would make use of Breuer’s technique of investigation under
hypnosis, which I had come to know from the account he had given me
of the successful treatment of his first patient. This was my first
attempt at handling that therapeutic method. I was still far from
having mastered it; in fact I did not carry the analysis of the
symptoms far enough nor pursue it systematically enough. I shall
perhaps be able best to give a picture of the patient’s
condition and my medical procedure by reproducing the notes which I
made each evening during the first three weeks of the treatment.
Wherever later experience has brought me a better understanding, I
shall embody it in footnotes and interpolated comments.
     
       May 1, 1889 . - This lady,
when I first saw her, was lying on a sofa with her head resting on
a leather cushion. She still looked young and had finely-cut
features, full of character. Her fact bore a strained and painful
expression, her eyelids were drawn together and her eyes cast down;
there was a heavy frown or her forehead and the naso-labial folds
were deep. She spoke in a low voice as though with difficulty and
her speech was from time to time subject to spastic interruptions
amounting to a stammer. She kept her fingers, which exhibited a
ceaseless agitation resembling athetosis, tightly clasped together.
There were frequent convulsive tic-like movements of her face and
the muscles of her neck, during which some of them, especially the
right sterno-cleido-mastoid, stood out prominently. Furthermore she
frequently interrupted her remarks by producing a curious
‘clacking’ sound from her mouth which defies
imitation.¹
     
       ¹ This ‘clacking’ was made up of
a number of sounds. Colleagues of mine with sporting experience
told me, on hearing it, that its final notes resembled the call of
a capercaillie.
     
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    Studies On Hysteria
    47
     
       What she told me was perfectly
coherent and revealed an unusual degree of education and
intelligence. This made it seem all the more strange when every two
or three minutes she suddenly broke off, contorted her face into an
expression of horror and disgust, stretched out her hand towards
me, spreading and crooking her fingers, and exclaimed, in a changed
voice, charged with anxiety: ‘Keep still! - Don’t say
anything! - Don’t touch me!’ She was probably under the
influence of some recurrent