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:''This article is concerned with Bertha Pappenheim as the patient Anna O. For her life before and after her treatment, see Bertha Pappenheim.'' Anna O. was the pseudonym of a patient of Josef Breuer, who published her case study in his book ''Studies on Hysteria,'' written in collaboration with Sigmund Freud. Her real name was Bertha Pappenheim (1859–1936), an Austrian-Jewish feminist and the founder of the ''Jüdischer Frauenbund'' (League of Jewish Women). Anna O. was treated by Breuer for severe cough, paralysis of the extremities on the right side of her body, and disturbances of vision, hearing, and speech, as well as hallucination and loss of consciousness. She was diagnosed with hysteria. Freud implies that her illness was a result of the resentment felt over her father's real and physical illness that later led to his death.〔Sigmund Freud: ''Five Lectures on Psychoanalysis''.〕 Her treatment is regarded as marking the beginning of psychoanalysis. Breuer observed that whilst she experienced 'absences' (a change of personality accompanied by confusion), she would mutter words or phrases to herself. In inducing her to a state of hypnosis, Breuer found that these words were "profoundly melancholy fantasies...sometimes characterized by poetic beauty". Free association came into being after Anna/Bertha decided (with Breuer's input) to end her hypnosis sessions and merely talk to Breuer, saying anything that came into her mind. She called this method of communication "chimney sweeping", and this served as the beginning of free association. Historical records since showed that when Breuer stopped treating Anna O. she was not becoming better but progressively worse.〔Ellenberger (1972), cited in ''When Good Thinking Goes Bad'', Todd Riniolo, Prometheus Books 2008〕 She was ultimately institutionalized: "Breuer told Freud that she was deranged; he hoped she would die to end her suffering".〔Schultz and Schultz (2004), cited in ''When Good Thinking Goes Bad'', Todd Riniolo, Prometheus Books 2008〕 She later recovered over time and led a productive life. The West German government issued a postage stamp in honour of her contributions to the field of social work.〔''When Good Thinking Goes Bad'', Todd Riniolo, Prometheus Books 2008〕 According to one perspective, "examination of the neurological details suggests that Anna suffered from complex partial seizures exacerbated by drug dependence."〔http://www.pep-web.org/document.php?id=APA.035.0387A〕 In this view, her illness was not, as Freud suggested, psychological, but neurological. While some believe that Freud misdiagnosed her, and she in fact suffered from temporal lobe epilepsy, and many of her symptoms, including imagined smells, are common symptoms of types of epilepsy, others meticulously refute these claims.〔"Freud Evaluated", Malcolm Macmillan, Elsevier, 1991, pg. 631〕 == Illness == Bertha’s father fell seriously ill in mid-1880 during a family holiday in Ischl. This event was a turning point in her life. While sitting up at night at his sickbed she was suddenly tormented by hallucinations and a state of anxiety.〔The details of her illness are taken from the case history published by Freud and Breuer in ''Studien zur Hysterie'', as well as from her medical records found by Albrecht Hirschmüller in the papers of Bellevue Sanatorium and published in his ''Physiologie und Psychoanalyse im Leben und Werk Josef Breuers''〕 Her illness later developed a wide spectrum of symptoms: * Language disorders (aphasia): on some occasions she could not speak at all, sometimes she spoke only English, or only French, or Italian. She could however always understand German. The periods of aphasia could last for days, and sometimes varied with the time of day. * Neuralgia: she suffered from facial pain which was treated with morphine and chloral and led to addiction. The pain was so severe that surgical severance of the trigeminus nerve was considered. * Paralysis (paresis): signs of paralysis and numbness occurred in her limbs, primarily on only one side. Although she was right-handed, she had to learn to write with her left hand because of this condition. * Visual impairments: she had temporary motor disturbances in her eyes. She perceived objects as being greatly enlarged and she squinted. * Mood swings: Over long periods she had daily swings between conditions of anxiety and depression, followed by relaxed states. * Amnesia: when she was in one of these states she could not remember events or any of her own actions which took place when she was in the other state. * Eating disorders: in crisis situations she refused to eat. During one hot summer she rejected liquids for weeks and lived only on fruit. At first the family did not react to these symptoms, but in November 1880 a friend of the family, the physician Josef Breuer, began to treat her. He encouraged her, sometimes under light hypnosis, to narrate stories, which led to partial improvement of the clinical picture, although her overall condition continued to deteriorate. Starting on 11 December Bertha Pappenheim was bedridden for several months. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Anna O.」の詳細全文を読む スポンサード リンク
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