The Viennese physician Josef Breuer
(1842-1925) has a unique and prominent place in the history of
psychotherapy. From 1880-82, while treating a patient known as Anna O.,
Breuer developed the cathartic method, or talking cure,
for treating nervous disorders. As a result of that treatment, he
formulated many of the key concepts that laid the foundation for modern
psychotherapy. This month marked the 90th anniversary of Breuer’s death,
offering an opportunity to reflect on the value of his contributions.
Breuer is best known for his collaboration with Sigmund Freud and for
introducing Freud to the case of Anna O. (whose real name was Bertha Pappenheim).
The ideas emerging from that case so fascinated Freud that he devoted
the rest of his career to developing them, in the form of
psychoanalysis. The two men co-authored Studies on Hysteria,
published in 1895, which is considered the founding text of
psychoanalysis. However, the significance of Breuer’s contributions goes
well beyond his role as Freud’s mentor and collaborator. In fact,
Breuer laid the groundwork for modern talk therapy by, for example,
considering all aspects of his patients's life and personality and
focusing on emotional expression as opposed to the Freudian emphasis on
insight and interpretation.
I discovered Breuer early in my training as a therapist, after I
realized that helping my clients gain insight into their problems, as
the principal focus of treatment, was rarely effective in causing
fundamental change. I found Freud’s technique of free association
unhelpful, because many clients who are anxious or depressed have
difficulty associating freely. The most therapeutic sessions were the
ones that elicited an emotional response from my clients. If I could
guide them to access feelings and memories, relevant to their area of
concern, they would often report a sense of something shifting inside
them, which dramatically accelerated the process of growth and change. [...]
If we compare Breuer’s theory with Freud’s formulation of
psychoanalysis, there are three main differences: psychic trauma
(Breuer) vs. sexual conflict (Freud) as the primary cause of
psychopathology, hypnoid states (dissociation) vs. repression (defense)
as the primary mechanism, and emotional expression (catharsis) vs.
interpretation (analysis) as the primary means of recovery. Ironically,
in each of those points, the modern view of psychotherapy has
increasingly come to favor Breuer.[...]
Setting aside personal details, the key question is whose ideas were
more valid, and in that regard history is squarely on the side of
Breuer. Freud’s emphasis on sexuality as the dominant factor shaping
human development and causing psychopathology is no longer taken
seriously today. Instead, the role of dissociation due to trauma is
increasingly recognized as more fundamental. Also, most therapists today
realize the importance of helping clients access and integrate painful
emotions due to past trauma, which is the essence of Breuer’s cathartic
method. [...]
This is true. In fact, many ideas of Freud can be traced back to an earlier concept, eg the unconscious was already discussed by Hegel. It has also been argued that Freud's ideas also have sources in the Talmud . eg someone who questions the yichus of a kosher person, we suspect himself of having that bad yichus.
ReplyDeleteBertha P. Was a descendant of the famous Gluckel of Hamelin.
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