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Josef Breuer - Studies physiological processes, The story of Anna O.

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1842-1925
Austrian physician, physiologist, and a founder of psychoanalysis.

Josef Breuer made the crucial observations upon which early psychoanalytic theory was based. He discovered that neuroses could arise from unconscious processes and, furthermore, that the neurotic symptoms could disappear when these underlying causes became part of the conscious mind. He communicated these findings to Sigmund Freud and the two men entered into a collaboration. Breuer emphasized hypnosis. He also believed that differing levels of consciousness are very important in both normal and abnormal mental processes. Although Freud eventually rejected this concept, it is now believed to be of great significance. Breuer also was among the most important physiologists of the nineteenth century.

Breuer was born in Vienna, Austria, in 1842. His father, Leopold Breuer, taught religion in Vienna's Jewish community. Breuer's mother died when he was quite young, and he was raised by his maternal grandmother and educated by his father until the age of eight. He graduated from the Akademisches Gymnasium of Vienna in 1858 and then studied at the university for one year, before enrolling in the medical school of the University of Vienna. He passed his medical exams in 1867 and went to work as assistant to the internist Johann Oppolzer at the university.

Studies physiological processes

Breuer's first important scientific work was published in 1868. With Ewald Hering, a physiology professor at the military medical school in Vienna, he demonstrated the reflex nature of respiration. It was one of the first examples of a feedback mechanism in the autonomic nervous system of a mammal. Their experiments changed the way scientists viewed the relationship of the lungs to the nervous system, and the mechanism is still known as the Hering-Breuer reflex.

In 1868, Breuer married Matilda Altmann, and they eventually had five children. Following Oppolzer's death in 1871, Breuer entered private practice. Still, he found time for scientific study. He worked in his home, with funds derived from his medical practice. Turning his attention to the physiology of the ear, he discovered the function of the semicircular canals. This work provided the foundation for our modern understanding of how sensory receptors detect position and movement. In all, Breuer published approximately 20 papers on physiology over a period of 40 years. Although he joined the faculty of internal medicine at the University of Vienna in 1875, his relationships there were strained; he resigned his position in 1885.

The story of Anna O.

It was in 1880 that Breuer first observed the development of a severe mental illness in one of his patients, "Anna O." Breuer found that he could reduce the severity of Anna's symptoms by encouraging her to describe her fantasies and hallucinations. He began using hypnosis to facilitate these sessions. He found that when she recalled a series of memories back to a traumatic memory, one of her many symptoms would disappear, a process that Breuer called cathartic. Soon, Breuer was treating Anna with hypnosis twice a day and eventually all of her symptoms were gone. Breuer drew two important conclusions from his work with Anna: that her symptoms were the result of thoughts that were buried in her unconscious and that when these thoughts were spoken and became conscious, the symptoms disappeared. Breuer's treatment of Anna O. is the first example of "deep psychotherapy" carried out over an extended time period.

Breuer did not publish the results of Anna's treatment. However, he taught his methods to Sigmund Freud and, together, they began to develop this new form of psychotherapy. Breuer did not continue to treat patients such as Anna. Although he claimed that the demands of his busy medical practice prevented him from pursuing psychotherapy, Freud believed that he was upset by the strong attachment that Anna developed for Breuer towards the end of her treatment, a phenomenon that became known as transference. When Freud began to use Breuer's methods of psychoanalysis, Breuer and Freud discussed Freud's patients and the techniques and results of their treatments. In 1893, they published an article on their work and, two years later, the book which marked the beginning of psychanalytic theory, Studien über Hysterie. At about the same time, their collaboration—and their friendship—came to an end. Apparently Breuer's ambivalence concerning the value of their work fueled their discord. However their final break came about over the question of childhood memories of seduction. At the time, Freud believed that most of his patients had actually been seduced as children. Only later did he realize that Breuer was correct in believing these to be memories of childhood fantasies.

Breuer dropped his study of psychoanalysis, whereas Freud continued to develop his theories independently. However, among other concepts, Breuer usually is credited with having first suggested that perception and memory are different psychic processes and with having developed a theory of hallucinations. Breuer's background in physiology had a profound influence on the development of his theories and it is likely that his influence on the work of Sigmund Freud has been underestimated. Some physicians, the "Breuerians," continued for a time to use Breuer's original cathartic techniques without adopting Freud's modifications and amplifications.

Breuer was regarded as one of the finest physicians and scientists in Vienna. In 1894, he was elected to the Viennese Academy of Science. Breuer died in Vienna in 1925. His daughter Dora later committed suicide rather than be deported by the Nazis. Likewise, one of his granddaughters died at the hands of the Nazis. Other members of his family emigrated.

Margaret Alic

Further Reading

Cranefield, Paul F. "Breuer, Josef." In Dictionary of Scientific Biography, edited by Charles Coulston Gillispie, vol. 2. New York: Charles Scribner's Sons, 1970.

Hirschmüller, Albrecht. The Life and Work of Josef Breuer: Physiology and Psychoanalysis. New York: New York University Press, 1989.

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