Between 1880 and 1882, Dr. Josef Breuer, an eminent physician whose protégé was, famously, Sigmund Freud – treated a young Viennese woman called Anna O. (whose real name was Bertha Pappenheim). Anna O. could be regarded as the founding patient of psychoanalysis, or as she termed it in her sessions with Breuer, the ‘talking cure’ (she also referred to it, jokingly, as ‘chimney sweeping’).
In Studies on Hysteria, a collection of case histories and theoretical papers that Freud and Breuer published jointly in 1895, the case history of Anna O. is laid out. At the time of her symptoms appearing in 1880, Anna O. was 21 years old. She was an exceptionally intelligent young woman, with great poetic gifts and a strong imagination. Due to her sharp critical thinking skills, she was, in Breuer’s words ‘[…] completely unsuggestible. She was only influenced by arguments, never by mere assertions.’ The extremely intelligent Anna O. was profoundly bored and intellectually under-stimulated in her puritanical household, leading to her constructing a fantasy life, which she systematically retreated to through day-dreaming.
Amongst other things, Anna O. manifested a number of symptoms, such as severe disturbances of vision, and paralyses. After the death of her beloved father, there was also a period of persistent somnambulism. Breuer found that Anna O.’s symptoms could be alleviated through talking – specifically, when the relevant traumatic memories that may have had a role to play in the formation and manifestation of symptoms, as well as the intense feelings that accompanied them, were brought to light and articulated. This method of treatment was the starting point of modern psychotherapy.
Does the ‘talking cure’ continue to hold relevance today, not just on an individual, but on a collective level as well? Psychoanalysis has been subject to criticism – not least of which that it is a bourgeois conceit, in which mainly affluent clients – so-called analysands – reach out to a therapist to indulge in solipsistic, narcissistic, and self-serving navel-gazing. Moreover, Western psychotherapeutic models have also been accused of not being culturally sensitive enough, to the exclusion of other models of wellbeing, such as Aboriginal models of holistic health, for example.
Analysis has also been criticized as being too focused on the individual as the source of pathology, at the expense of, for example, socio-economic circumstances or unequal power dynamics in society at large. Trying to find the causes for someone’s unhappiness over their chronic unemployment through an individual’s childhood history and unconscious landscape, for example, may not be of much help when the more accurate area of concern should be a poor job-market or systemic discrimination. Some psychiatric disorders may also not be entirely amenable to being ‘talked away’, although in some cases, such as anxiety and depressive disorders, there is evidence that antidepressants combined with psychotherapy may be more effective than each of these treatments alone.
The above are all valid criticisms, but dismissing the talking cure entirely would be a mistake, because to do so would be to ignore the manner in which the individual is inextricably a part of the social and vice-versa. One cannot have one without the other. Consider the process of socialization, for example, which begins when we are infants and continues for the rest of our lives. During this process, we are all introduced to ‘human culture’ – in itself not a static concept and liable to change in accordance to context and time-periods – and taught how to behave appropriately so that peaceful co-existence with others can take place. Social norms are internalized and we learn that certain things cannot be done, or said. We learn to control our impulses, not just out of respect for social convention, but also because we learn that other people exist, and they have feelings and boundaries that must be respected. Freud, in his designation of the dynamics of the mind such as in The Ego and the Id, would have regarded this as the tension between the id, which refers to that part of ourselves that is driven by instinct and which functions in service of the pleasure principle – and the ego, the secondary mental process which is governed by the reality principle. The super-ego, on the other hand, refers to the internalization of moral and social principles that are learned in childhood. The super-ego is like an internalized parent.
Moreover, in such a schema one can also locate the unconscious. The unconscious is always already imbued in a social, political and cultural context – the unconscious, as the French psychoanalyst Jacques Lacan put it, is structured like a language. That is to say, the unconscious is inextricable and composed of the same ‘stuff’ as the Symbolic – the larger socio-symbolic network in which we are all imbued from the time of our birth. Everything is mediated through language, or the Symbolic. Our unconscious could, at the very least, be regarded as all that which we have repressed in order to conform to the socialization process, or because it is too painful to retain within conscious reach, for example.
Of what value then could psychoanalysis be in our day-to-day lives, and even on a political level and in terms of social justice? Firstly, the act of talking with a therapist can allow for an exchange that gives rise to the development of richer, multi-layered narratives of people’s lives and experiences – narratives that may have, up until that point, been quite limited. For example, narratives of victimization can be reconstructed as more accurately reflecting an exceptionally strong survivor who has overcome horrific events, thus giving back to the individual in question a degree of agency and self-empowerment. Through talking, one can also formulate a strategy or strategies of how to best move forward and how to learn to live with what has occurred.
Secondly, the talking cure can bring to light that not all socialization is necessarily always in the best interests of a particular person. For example, socialization into specific gender roles may have caused considerable harm to a young trans person. Talking to a therapist in a safe, trusting environment may allow that young trans individual to increasingly and confidently assert that the gender socialization process into a particular gender role is not right for them, and that they want to live differently. In such and similar cases, analysis becomes not just a place of self-assertion, self-awareness, and self-empowerment – but also a place of resistance to normative standards that claim to represent the ‘truth’. These moments and acts of resistance can then have repercussions and effects in society at large, helping to mobilize society towards more positive or necessary changes.
A young woman or man who was sexually harassed or sexually assaulted may divulge to the analyst his or her story. Over a period of time, and again, within a safe and trusting environment, the act of talking may allow the individual to vent his/her emotions and to construct a coherent narrative that not only habituates them to the trauma, thus reducing anxiety, but that also allows them to gain a sense of control over what happened. An analyst can also provide the crucial role of listener – survivors of trauma can find in the analyst an attentive, non-judgemental listener that makes them, rightfully, feel like they and their experiences matter, and validates both.
In a recent article in The Guardian, Nesrine Malik has made similar arguments on a collective level in relation to the #metoo movement. Malik praises Christine Blasey Ford for her decision to come forward with her sexual assault accusations against US Supreme Court nominee Brett Kavanaugh. As she argues, what Ford has done is possibly
‘[…] trigger an excavation of all the things that they had buried and tried to minimise because they wanted to forget and rebuild, because they were young, and because it was such a long time ago […]. The excavation to me, at least, is beginning to reveal how the strength is sometimes not in forgetting, but in remembering, and reclaiming. In unfreezing that young frightened girl who you could not help for all these years and animating her in the body of an older, more certain woman.’
To be clear, the talking cure may not always necessarily be the best option for everyone. If talking was to occur, however, one must be aware and ready that it may need to be more than a one-off occurrence. Consistent support must be provided to the individual so that s/he habituates him/herself to the anxiety that reliving the trauma could cause, until it no longer has a hold on him/her. Moreover, it is without question that the larger social context must also be taken into account at all times – something that Freud was also clear about.
Linda Roland Danil completed her PhD studies in the School of Sociology and Social Policy at the University of Leeds in 2015. Prior to that, she obtained an LLB Law (Hons) from the University of Bristol (2009) and an MA in Gender Studies (Research) from the University of Leeds (2010). She has since published sole-authored articles in Law and Critique; Law, Culture and the Humanities; and Critical Studies on Security, as well as acted as guest editor for an Interventions special issue for Critical Studies on Security. She presently lives and works in London.[book-strip index="1" style="display"]