Fragment of an Analysis of a Case of Hysteria" (Dora/Ida Bauer) (International Dictionary of Psychoanalysis)
Freud's case history for Ida Bauer, alias Dora (1905), covers approximately seventy hours of treatment. The eighteen-year-old adolescent was forced to go to Freud by her father, Philip Bauer, who was allegedly most concerned by her fainting spells and recent suicide note. Her presenting symptoms included dysponoea, tussis, nervosa, aphonia, depression, and hysterical unsociability. Combining anamnestic data, reconstruction, and an extensive analysis of two dreams, Freud portrays his patient as a young child observing the primal scene and falling sick from related masturbation. Her subsequent psychic disorder was directly related to her father's liaison with Frau K. (Peppina Zellenka). Philip denied the liaison and, in his own version of Dora's analysis, wanted Freud "to talk Dora out" of her belief. Furthermore, Dora had been traumatized twice by Herr K. (Hans Zellenka). Until therapy she had kept the first traumatic occasion to herself, and the second was denied by Hans, who, with his wife and Philip, accused Dora of fabrication. Mrs. Bauer's "housewife psychosis" and self-absorption further increased Dora's alienation and desperation.
Freud attempted to demonstrate to Dora that her reproaches toward her adulterous father were self-reproaches, rooted in her unacknowledged love for Hans, who continued to solicit her. Surprisingly, Freud also wanted Dora to stop resisting and to accept Hans, for it "would have been the only possible solution for all parties concerned." Dora, however, abruptly terminated treatmentn action Freud considered as another manifestation of her vengeance. Freud pointed out two other shortcomings of his handling of the case: he neglected Dora's transference, and he overlooked Dora's homosexual strivings, found at her deepest unconscious level.
Freud's case history was an organizing clinical experience for him and for the psychoanalytic movement and stands as a paradigmatic record of both psychoanalysis and contemporary culture. It is Freud's longest text on a female patient and also one of Freud's memorable trilogy including The Interpretation of Dreams (1900a) and Three Essays on Sexuality (1905d). It is the first of Freud's great analytic cases and the first involving an adolescent. Ernest Jones called the case "a model for students of psychoanalysis," and for Erik Erikson, it was "the classical analysis of the structure and the genesis of a hysteria." Other critics have described the case as a canonical specimen of conversion hysteria, as Freud's most graphic demonstration of psychosomatics, and as the case of Freud's most discussed in psychiatry and psychoanalysis as well as in sociology, anthropology, history, and literary criticism.
Granted, Freud's various theoretical discoveries in the Dora case, from a practical point of view, must be reevaluated. Freud either downplayed or entirely disregarded Dora's triple burden of being a woman, a Jew, and an adolescent victimized by two pairs of adults. In his quest to genetically reconstruct the psychic truth, Freud dismissed Dora's concern about current historical truth and her need to validate her experience. The case lacks indispensable desiderata of psychoanalysis in that there is virtually no interpretation involving transference and in that indoctrination and forced association replace free association.
Even as a case of therapy, Freud's treatment of Dora was disastrous. By bullying his patient and even wanting her to return to the middle-aged adulterous pedophile who twice traumatized her, Freud subjected her to a third, iatrogenic trauma. There are further indications of Freud's counter-transferential perturbation: he lied twice and misdated the case twice in his prefatory remarks; he repeatedly errs about Dora's age and refers to her at different developmental levels ("girl," "child," "woman," "female person," "lady"); he confusedly traces Dora's coughing and aphonia to ages eight and twelve; he attributes to Dora an adult-like love of Hans during her "first years" in Merano, Italy (she was there from age six to age seventeen); and he grossly misinterprets Dora's silence as agreement when he mistakenly tells her that at age seventeen (she was really fifteen), she was committed to her traumatizing seducer, much like her mother at the age of seventeen.
According to his own words, he wrote up the case "during the two weeks immediately following" termination; his correspondence with Wilhelm Fliess contains explicit statements that he was writing the case history between January 10 and 24, a two-week period in 1901. The implications of the duration of Freud's composition have gone completely unnoticed. When Dora decided to quit therapy two weeks before she actually did, Freud irritably charged that she was reacting like a maid who gives a two-week notice before leaving her employer. But Freud himself unconsciously behaved immaturely during his composition of the case, which partially took on the character of an acting out, or better yet, a writing out. His two weeks of writing up the case was a way of dismissing it and of trying to rid himself of Dora.
As a follow-up to Dora's treatment, Freud proceeded to write up her case history. Pertinently, Freud never considered Dora's bisexuality and transference together; his defensive typographic separation of these two dynamics enabled him to ward off any notion of maternal transference. However, far from dissolving his countransference toward Dora, Freud re-enacted it with the reader, whom he tried to seduce into agreement.
See also: Acting out/acting in; Adolescence; Bauer, Ida; Cruelty; Flight into illness; Free association; Hysteria; Identification; Latent dream thoughts; Oedipus complex; Psychoanalytic treatment; Resolution of the translation. Secret; Somatic compliance.
Freud, Sigmund. (1905e). Bruchstück einer Hysterie-Analyse. Mschr. Psychiat. Neurol., XVIII, p. 285310, 408-467; G.W., V, p. 161-286; Fragment of an analysis of a case of hysteria. SE, 7: 1-122.
Erikson, Erik H. (1964). Insight and responsibility. New York: W. W. Norton.
Freud, Sigmund. (1900a). The interpretation of dreams. SE, 4: 1-338; 5: 339-625.
Jennings, Jerry. (1986). The revival of "Dora": Advances in psychoanalytic theory and technique. Journal of the American Psychoanalytic Association, 34, 607-634.
Laurent,ic (1986). Lectures de Dora. In Fondation du champ freudien, Rencontre internationale, Hystérie et obsession (pp. 29-42). Paris: Navarin.
Mahony, Patrick. (1996). Freud's Dora: A historical, textual, and psychoanalytic study. New Haven: Yale University Press.