The relation between

emotion work and

hysteria: a feminist
reinterpretation of Freud's
Studies on Hysteria.
JENNIFER L. PIERCE

INTRODUCTION

IN 1925,Sigmund Freud published an article "Some Psychological

Consequences of the Anatomical Distinction Between the Sexes," The
essay represents Freud's first comprehensive attempt to account for
the differences in male, and female psychosexual development by
emphasizing the crucral roiethat'iiie'ncasiriiiion complex" and penis
envy~~t~e-deve!~pmemJiUetrtii1iiiiiy. Ii also provided the issues
and concepts for the beginning of an intense and controversial debate
in the early twenties and thirties on the psychology of women. Early
psychoanalysts such as Karen Horney, Ernest Jones, and Otto Feni-
chel sought to corrc:ct and modify the problematic aspects they found
in Freud's theory of femininity, while others such as Helene Deutsch
acc~pted and confirmed Freud's formulation, "

In her historical reconstruction of Ihis early psychoanalytic

controversy on the psychology of women, Zenia Fliegel (1973) argues
that Freud effectively closed the debate with the publication of his
1931 essay, "Female Sexuality," Nevertheless, Freud's writings on
women have continued to be a subject of controversy. Each decade
has seen attempts by more prominent Freudian analysts to confront
the more doubtful aspects of Freud's position: Fenichel (1934) and
. 'n,is ankle has hrlle~..d from Ihe careful reading and edi,orial soggestion. of .<,..alll<°l'l<:
1I0h Freeland, Karta lIachl;llf. ~Iarlilroh Kelsey. Eli S.gan and Nancy Schep<r-Hoghcs, Their
."i"ance alld ,uppun is grrady apprrcia..d.
C 1989GUrdOIland llreach. Science !'uhlishe... Ille
i "01.
11'...,.',$'0.",.1989
16, PI" 255-270 I'rimed ill Grea, IIril;lill
It..,,;n', ",;Iil.hl< dire",!) Irum Ihe I'"hlish..
!'holocol'ying p<rmiucd hy Ii-,IKe Ollly
256 J.L. PIERCE

Jones (1933; 1935) in the thirties; Zilboorg (1944) in the forties;

(;rt'enacre (1950) in the fifties and Stoller (1968; 1976) in the sixties
ami seventies. More recently, psychoanalytic feminist thinkers such as
Nancy Chodorow (1978) and Dorothy Dinnerstein (1976) have also
en~aged in this debate.
What is common to these works as well as most general works on
Freud's psychology of women is their treatment of his 1925 and 1931
essays as the distillation of his thought on this subject. frelJ~'s work
o[UY.Qmen-spanned alm.ost fifty years; and these essays, writte~-near
Ihe end of his life, represeni oiily'asmall part of his entire writings on
the topic: His early work on women and hysteria began in the 1880's
and culminated in his first book - -
Studies on HystLria which was
written in collaboration with Joseph Breuer in 1893. In the early
1900's Freud wrote two extensive case studies on women - the now
famous case oJD.!>raand the less well-known case of the female homo-
sexual. He also developed an important theoretical framework foe
understanding infantile sexuality and psychosexual development in
Thrtt Contributionsto a Thtory of Stx. And yet, much of this earlier work
has bee letel neglected in studies of Freud's writings on

women I and 0
We thus b~ ~erve
psychoana y~
a curious phenomena: there is a difference
between what's been treated as the distillation of Freud's ideas on-
,,-;OmenamI what Freud actually wrote. In rtlls paper, I would like to
~the balance by looking aTil1e earliest and most frequently
ne~lected period of Freud'.s work which began in 1886 and ended in
111<>6. I have chosen to examine this period for two reasons. First, I will
ar~ue that his work has important sociological and feminist impli-
cations for theorizing about women's mental health. Second, in
contrast to certain simplistic feminist accounts, such as the work of -
Mary Daly (1978) and Betty Friedan (1963), this period of work illus-
trates that Freud was not a simple misogynist, but that his position vis-
a-vis women was more comp~e~_~.I1_~most of all extremely ambivalent.

THE AETIOLOGY OF HYSTERIA (1886-1896)

TIH' earliest period of Freud's work began in 1886 when he first started
his career as a neurologist in Vienna and it ended in 1896 after the
pulJlicatinn of his article, "The Aetiology of Hysteria." Freud's main
inl<.rest during this time lay in explaining the causes of hysteria. The
 EMOTION WORK AND HYSTERIA 257

major works that he wrote during this period - Studieson Hyslroa and
"The Aetiology of Hysteria" - renect this intellectual concern.
Although neither work attempts to formulate an explicit theol)' of
women's psychological development, they both present case histories
of women to support a theory which explains hysteria. I will argue char
th:iM(u~.Q[t~es.eearlystudies lies not so much in the theories they
generate, but in the detailed observations they provide of the lives of
thesemm"of~the~cetltury'Viennese, middle-das.s 'NOnlen. in a sense,
Freud 'knew' moreaboutwomen, than his theories suggest. Implicit
-in his discussion is a description and partial understanding of the
factors.~I)!CI1 .c()!1.mtmte:.f.C5:woiiieri'soppressionand of the psychic
cost which such systematic oppression entails: For exam pie, Freud
recognizedthaUh~~Jiijses of hysteria in women were often rooted in
~he tYRes_~o_bs. that. women in ninteenth century Vienna typically
traditionally held, e.g., sick-nursing.
In the following section, I will critically examine the theorelical
positions and case histories in Studies on Hysten"aand in "The Aeliol-
ogy of Hysteria." These early works on hysteria were selected because
of their implications for Freud's psychology of women. For a clearer
understanding of the developmenl of Freud's theol)' of hysteria, il will
be helpful first to look at the historical context in which he wrote.
Freud began his career as a neurologist in the late nineleenlh
century when hysteria was the chief subject in medical publications
both in Europe and England (Hunler 1983, p.466). At the time,
prevalent medical opinion held that hysteria was a woman's disorder
- a psychologic~resi~iiori-of"theemoiioris -rlsing- from the
ww.!i" (Mitchell 1974, p. 4~). Although Freud's extensive medical
training in the Helmholtz school and his work in Ernest Briicke's
laboratol)' had taught him to look for the physical and chemical orig-
ins of illness, he !!i.<Lno!,believe.that all hysterical symptoms had an
orgaEic basistl°! did he believe that all hysterics were women.2
This was because Freliahiid the 0 ortunity to study in Paris wilh
arco w 0 was one 0 t e ea In s ecialists on neuropat 0 ogy <It
.the ti~. Unlike many 0 IS contemporaries, arcot t ought t 1<1t
hysterical paralysis and contractions were often determined by trau-
matic experiences. Thus, men as well as women could suITer from
nervous illness. Through the use of hypnotic suggestions, Charcot
helped relieve his patients of their symptoms. Following Ch~rcot,
Freud's early "therapeutic arsenal consisted of only two weapons,
258 J.L. PIERCE

electroshock and hypnotism" (Freud 1925a:27).

Unlike Charcot, however, Freud made use of hypnosis in "another
manner," apart from hypnotic suggestions. He describes this other
manner in An AutobiographicalStudy as "... questioning the patient
upon the origin of his symptoms, which in his waking state he could
often describe only very imperfectly or not at all ... this method
seemt'd more effective than bald suggestive commands or prohibi-
tions" (1925a, p.33). This was later called the 'cathartic' method.
Freu~ first learned of this procedure when he was working in Ernest
IIrikke's laboratory and met Dr. Joseph Breuer, a respected family
physician in Vienna.
Brt'uer had told Freud about a case of hysteria which he had
treated between 1880 and 1882. In this case - which has come to be
known as the classic case of hysteria, that of Frln. Anna O. - he had
come upon an unusual method that allowed him to penetrate deeply
into the cause and significance of hysteria. The patient had been a
young woman who had fallen ill while nursing her sick father. When
llreuer took over the case, she was suffering from "paralysis of three
limbs with contractions and anesthesia, severe and complicated
disturbances of sight and speech, and a distressing nervous cough. . ."
Uones 1961, p. 147). On one occasion, under Breuer's hypnosis, the
patient related how a particular symptom had arisen and, to Breuer's
astonishment, this resulted in its complete disappearance. After that,
the patient continued with one symptom after another, terming the
procedure "t~e talking cure" or "chimney sweeping." As it turned
out, all her symptoms could"be traced back to traumatic events which
she had experienced while nursing her father:

ITlhal is 10 say, her symploms had a meaning and were residues or reminiscences of
these emotional stales. It lurned oul in most instances Ihat there had been some
Ihou~hl or impluse which she had to suppress while she was by her falher's sick"bed,
and Ihal, in place of it. as a substitule for ii, the symplom had aflerwards appeared
(Frell,lt925a. p. 36).

Freud began to use this technique with much success in his own
{"ases. After having accumulated a considerable amount of material
with observations analogous to those of Breuer, Freud suggested that
Ihey put together a joint publication. Although Breuer was initially
relu('tant to publish this study, Freud linally managed to convince his
colleague to do so, and in 1893 they issued a preliminary communic-
 EMOTION WORK AND HYSTERIA 259

ation entitled, "Some Psychical Mechanisms of Hysterical Pheno-

mena."! The joint paper was followed two years later by the book,
Studies on Hystm'a which included a reprint of the initial joint paper,
five case studies on women patients, a theoretical essay by Breuer and
a concluding chapter on psychotherapy by Freud.
The main theoretical position adopted by Freud and Breuer in Ihe
~Prelimina!)' Communication' is, on the surface, a simple one. They
hold that, if an experience is accompanied by a large amount 01
'alIect,' this 'alIect' is either 'discharged' through a variety of conscious
acts - a process that Freud termed abreaction - or it is gradually
worn aw~y by association with other conscious mental material. In the
case of hysterieaT paIie.-rts;-trowever, neither of these (rungs happen.
The reaction to the traumatic experience is suppressed and "the affect
remains attached to the memo!)'" (Freud 1893-1895, p. 8). As Freud
and Breuer point out:

An injury Ihat has been repaid, even if only in words, is recollecled qui Ie differentl)'
from one Ihal has had 10 be accepled. ... The injured person's reaction 10 the Irau"",
only exercises a complelCly 'calharlic' effect if il is an adequale reaclion as in Ihe GlSe
of revenge. . .. If Ihere is no such reaclion whelher in deeds or words, or in Ihe mild.."
cases in lears, any recolleclion oflhe evenl relains its affeclive lone 10 begin wi,h (IM'n.
1895, p. 8).

The t.':Vome~. further discovered that in h sterics the "affective

force" ched to it are not su ressed temporan y.
but a com Ie e nned from the atient's consciousness. Ie
alIective memo!)' was thereafter converted into b I Yennervatlo~ -
paralysIs and contractions ~ and other hysterical symptoms which
Freud and Breuer regarded ~s "mnemi~mbols" or symbols of the
suppressed memo!)' (1893-1895, p.9O). In their fonnulation, then,
"hysterics sulIer mainly from reminiscences" (1893-1895, p. 7).
Breuer and Freud suggest two explanations which they believe can
account for such a pathological outcomes. The first is that the original
experience took place in a state of mind described by Breuer as "hyp'
noid." Breuer thought that these twilight states grew out of "day.
dreams wmch are so common even in healt eo Ie and 10 which'
needlework and embroidery render women especially prone" (18 -
~. In these cases, it is the nature of the hypnoid state which
precludes sufficient abreaction of the traumatic event. The second
explanation is that patients have not reacted to a physical trauma
260 J.l. PIERCE

""..ause Ihe "nalure of Ihe trauma excluded a reaction" (1893-1895,

p. \II). Here Freud points 10 examples of situations such as, "The
apparently irreparable loss of a loved person!,I.. .social circumstances
which matle a reaction impossible. . . or it was a question of things the
patient wished to forget, and therefore intentionally repressed.. .'"
(I H93-95, p. 10). For either the first or second case, the therapeutic
effecliveness of the 'cathartic' procedure is explained on the same
basis: if th~_origjnaLexperience,along with its affect, can be brought to
consci°lJsness,- the affect - is by-that very fact -'discharged'- or
'abre~cI: The force that has maintained the symptom ceases to
operate, and the symptom itself disappears.
S~udies on Hysteria is usually regarded as the starting point for
psychoanalysis Oones 1961, p. 164). The technique that it describes
(die 'caihiirtic method' and 'free association') and the clinical findings
(Ihe imporlance of repression, resistance, unconscious symptom form-
alion and transference) have paved the way for the theoretical found-
ation and practice of psychoanalysis. The use of psychoanalytic
concepts such as "repression" and "defence" have led many scholars
10 l'Onsider this book as one of the earliest, major contributions to
psychoanalysis. Although 1 do not disagree with this assertion, 1 will
argile that there is ana/her important contribution in this oeuvre, one
whidl is often overlooked by scholars and historians of the psycho-
analytic movement - that is, the value of the case studies themselves.
Freud himself did not recognize the-Importance orihii-case hisio-
lies. He maintained that ..tI~YJc:~d like short sto.ries and. . . lack the
,en-pus standard of science" (1893- 1895, p. 160). He was able to console him-
self with "the reneciion that the nature ofthe subject is evidently respon-
sible for this, rather than any preference of my own" (1893-1895, p. 160).

. -. ,II<' fact is Ihat local diagnosis and clectrical reaclions lead nowhere in the Sludy of
hyslnia, whereas a delailed descriplion of menIal processes such as we are accus.
",med 10 find in the works of imaginalive wrilers enables one, wilh Ihe use of a few
psrdlOlogical formulas, to oblain 01 £lasl ,omt kind of insighl inlo Iht count of Ihal affte-
,.."- (:ase histories of this kind arc intended to be judged like psychi,..ric ones; they
have. howev,'r, one advantage over the latter", an intimale conneclion between the
slory of the palienl's sulTerings and the symploms of Ihe illness - a connection for
whi..h we will search in vain in Ihe biographies of other psychoses (lH93-IH95, PI'. 160-
161; emphasis added),

It is in these 'short stories" that we find a rich and provocative

~y-to-day lives of Freud and Breuer's women .
 EMOTIONWORK AND HYSTERIA 261

patients. 1 will argue that the case histories rovide a anial under-
standing of the consequences I at women's social and !:!:onom~
powerlessness had for their psychic health. First, I will briefly describe
tl>..fiy.. .-" in the Studies. Nexl, I will examine in delail the case of
Elizabeth Von R. ~are it 10 the other case hislories. finally,
the shorlcomings of freud's analysis will be highlighted.
The first case history in Studil!Son Hysuria, by Breuer, is that of Frln.
Anna 0, who has been mentioned above. The remaining four cases
are by Freud. His first case - Frau Emmy Von N - is about a
widowed mother of two. Freud finds Ihal her symptoms arose from
the suppressed emotions associated with her husband's untimely
heart attack and death, subsequent public scrutiny and the burdens of
raising Iwo daughters alone. The second case is Ihat of an English
Governess in Vienna, Miss lucy, whose symptoms turned OUIto be
the repression of a forbidden attachment to her employer. The third
case hislory describes Ihe story of a girl of 18, Katharina, whom Freud
mel while on vacalion in the Alps. learning that he was a doctor, she
appealed 10 him 10 help her, since she suffered from anxiety symp-
toms. In a single interview, he was able to discover the genesis of her
troubles - several altempted se~ions by her uncle.; The remain-
ing case history, Frau Elizabeth Von R., is about a young girl who has
fallen ill after a long period of sick-nursing her father, which was
followed by another long period of performing the same task for her
mother. Freud located the origins of her symptoms in her role as sick-
nurse and in her f..!=liog..of
powedcssness.
There are many similarities in the social circumstances and
personal qualities of Breuer and Freud's women patients. As rhe
authors point out in their preface to the first edition of Studieson HYSlt-
ria, "our experience is derived from private practice in an educated
and literate social class..." (1893-1895, p. xxix). Thus, these women
came from predominantly middle-class to upper-middle class Vien-
nese backgrounds. Their class background is funher reflected in Ihe
extent of their knowledge; the two physicians make many remarks
about the intelligence, the precocity and the moral developmen I of
Iheir patients. For example, Breuer describes Anna O. as
... markedly intelligent with an a..onishingly quick grasp of things and pcnclra'in~
inluilion. She possessed a powerful inlellect which would have Ix:en capable of diges,.
ing solid menial pabulum. and whi<:hftootl In nutl of it- though without receivingi,
alter leaving school. She had great poetic and imaginative gilts, which were uncle.
262 J.l. PIERCE

WIllfUluf a sharp and crilical common sellse '" she was only innuenced by argu.
me,IIs, IIcver by mere assenions, ller willpowcr was cnergelic, "'nac'ious and persist.
c'nI; somelimes il reached Ihe poinl 01 ob5linacl' which only gave way OUIof kindness
alld regard lor other people (1893.IH9S, p, 21; emphasis added),

Similarly, Freud regards Frau Emmy Von N, as an "admirable"

woman.

The moral ,trIOUIn'" wilh which she viewed her duties, her inlelligence and energy wm
no 1"!lhan a man 's, and her high degree of educalion .\IId love of InJlh impressed bolh
of IIi greall)' while her benevolen. care for Ihe welface of all her dependents, her
humilil)' of mind and Ihe relinemenl of her manners revealed her qualilies as a/rUt
lad)'as well (IH93.IH9S, pp, 103.104; emphasis added),

Freud describes Frln. Elisabeth Von R. in a similar manner. He

praises

'" her gifl"dness, her ambilion, Iwr moral Itn,iMlily, her demand for love which 10
hc'~in wilh, luund satis",clion in h"r family, and mdtrtndinCt 01 nalurt which wenl ht.
yond Ihe Itm,nmt .dtal and found c'xpression in a consideraule amounl of ob5linacy,
pll~nadly alld reserve (IH93.189S, p. 161; emphasis added),

Freud and Breuer did not always find their \V()ll1en patients' intel-
lig~!1£~~lI,,-h_~n-attractive qUiiHiY~iiowever:-ln fact, theyofien express
a great deal of ambivalence about the appropriateness of such a gift in
women, For example, when Freud remarks that Frau Emmy "is no
less mteRigent than a man," he is quick to add that it is her "benevo-
lent care" for others, "her humility of mind and her refinemenr' of
manners," and not her intelligence which makes her a "true lady"
(1893-]895, pp. ]03-104). Thus, in 'Freud's view, intelligence alone
does not make one a "true lady." A similar attitude is expressed in the
case of Elisabeth Von R. On the one hand, Freud praises "the unsel-
fishness with which she put her mother and older sisters first," and on
the other he judges her ambition and intelligence as "the harsher side
of her nature" (1893-1895, p. 140). That Freud was not entirely
comfortable witb this "harsher side" of his women patients is best
expressed in Ihis passa~e from the case of Elisabeth Von R.:

IJllring Ihe lirs! pari of her Irealmenl she never ",iled 10 repeal Ihal her pains were as
h.III 'IS ever; 'Illd when she IlIokc'd al me she said this with a ,Iy look01JaluJac/lon al my
du"""!,'u,,, I could nul hell' being reminded 0/ uld Ilcrr Von R.'sjudgemcnl about his
Ia,u,ite daughtcr - that she was 'cheeky', '" But I was ouliged 10 admit Ihat she was
in thc righl (IK93.IH95, PI" 144-145; emphasis .IIlded),
 EMOTION WORK AND HYSTERIA 263

As these examples suggest, Freud's turn of the century sexism

innuenced his attitude about Ine appropriateness of intelligence in
women.
Freud returns to a discussion of these prominent features of his
patients' characters in yet another context. In the conclusion to Ihe
case of Frau Emmy, he nOles, on the basis of his observations on this
case as well as others, that" hysteriaof the severest type can existin con-
junction with gifts of the richest and most original kind -
a conclusion
which is, in any case, made plain beyond a doubt in the biographies 01
women eminent in history and literature" (1893-1895, p. 103; empha-
sis added). Freud does not stop to ponder this curious fact, however.
Instead, he goes on to urge that we should not describe such women as
"degenerate" (1893-1895, pp. 103 & 161). While such a refusal to label
illness may be considered 'liberal' or even 'radical' in comparison 10
the views of his contemporaries, it avoids the original question why -
doesjJysteria exist in conjun.ction with intelligence, a high degree of
moral sensibility and so on? Though Freud does not explicitly address
this question, we can find some answers within the descriptions in Ihe
case histories themselves.
For example, 24 year old Elisabeth Von R. first came to Freud
because she had been suffering for the past five years from pains in her
legs which had caused her difficulty in walking. Her doctor had
referred her to Freud because he suspected that her case was one of
hysteria. He told Freud that her family had suffered from several
misfortunes in the last five years. In the course of therapeutic treat-
ment, Freud discovered that Frln. Elisabeth had been especially close
to her father - she had been her father's favorite. In many ways, she
took the place of a son with whom her father could exchange intellec-
tual ideas. As Freud points out, her father

. .. did nol rail to observe thai her menial constitution was on Ihal accounl d'pa,'wg
from Ihe ;a,al which people like to see realized in a girl. He called her 'cheeky' allli
'cocksure,' and warned her againsl being 100 positive in her judgemenls ... and he
often said Ihat il would be hard fur her lu get a husband. She was in lacl greall)"
disconlented with lJeing a girl. She was lull 01 ambitious plans. She wanled to slud)" 01
have musicallrainins... (lti93-lti9S, p. 140; emphasis added).

Her happy relationship with her father was broken, however, when
her father fell ill with a heart ailment. For 18 months Frln. Elisabeth
played the main role in sick-nursing him. After his death, circumstances
264 J.L. PIERCE

forred her to give up many of her ambitions and plans. She attempted
10 help her mother and her sisters get established again. However,
jllst as the period of mournin~ for hedatherwasending both ofhersisters
got married, leaving their mother in the care of Frln. Elisabeth. Her
mother's bad health put Elisabeth in the role of sick-nurse again. Several
months aher her mother's recovery, her older sister Iell ill and died of a
heart ailment.
In recounting these episodes to Freud, Frln. Elisabeth complained
th;~t they had made the attempt at "standing alone" painful to her. In
each of her attempts to help establish a new life for her family -
after
her father's death and her mother's illness -
she repeated that what
was painful about them had been "her feelin~ of helplessness, the feel-
ingJhat she could not take 'asingle s1ep forwardnT (1893-1895, p. 152).
Freud "could not help thinking that the patient had done nothing
more or less than look for a symbolic expression of her thoughts and
that she had found it in the intensification of her sufferings." (1893-
1895, p. 152). In other words, her symplo[TI~ -
Ihe p"ins in her legs
aJ:ld her inability to walk -
were symbolic of her suppressed memory
of the painfulness which she associated with the inability to sland on
her own and become independent. "... IBly means of symbolization
. .. she had found a somatic expression for her lack of independenl
position and her inability to make any alteralion in her circumstances
..." (1893-1895, p. 176).
Freud did not think Ihis situation alone led to the formation of her
s)'mptoms. Following his dictum that symptoms are overdetermined,
he looked for other possible causes and came up with her long vigil as
a sick-nurse. He argued that anyone involved in sick-nursing had 10
focus so much attention on another person for such a sustained length
of time that slhe could only, "on the one hand adopt a habit of
suppressing every sign of his emolion, and on the other.. . will soon
di\'(~rt his attention away from his own impressions, since he has
nt"ither the time nor strength to do justice 10 Ihem" (1893~1895,
p. 1(,)). As a result, the sick-nurse will accumulate a mass of impres-
sions which are capable of "affect, which are hardly sufficiently
pern'i\'ed and which in any case, have not been weakened by abreac-
tion" (1893-95, p. 162). Sick-nursing, then, provides one of the condi-
lions which Freud and Breuer said prt"cluded sufficient abreaction of
alkct. Th~ result, as in the ('..se of Frhl. Elisabeth, is the suppression of
111<'painful memOlY which later becomes converted into symptoms.
 EMOTION WORK AND HYSTERIA 295

What is particularly striking about the case of Frln. Elisabeth is that

the specilic circumstances of her illness characterize the social condi-
tions whic!Jled to hysteria in all' ihe women discussed in Ihe Studltf.
AI! 0/ the women found themselves in situations much like that of a
sick-nurse - they were obliged to suppress their own feelings, needs
and ambitions in order to' care for someone else. The most obvious
c~~;;-is-Frin.-Anna 0., who was a sick-nurse t~her father, just as Frln.
Elisabeth had been. Similarly, Miss Lucy was a governess whose job
was to minister to the needs of her employer's children. And finally,
Frau Emmy was a mother who, upon her husband's death, was
obliged to continue caring for her infant daughter rather than tending
to her feelings about her husband's death. Furthermore, like Frln.
Elisabeth, the£" women lacked any kind of independent position in
their lives. At 21 Anna O. wassillremoiionaily and economically tied
to her family. In her job as a governess, Miss Lucy did not feel any
"independence" towards her employer (1893-1895, p. 117). After her
husband's death, Frau Emmy depended on her husband's family for
her precarious financial support.
Freud did recognize the significant part that sick-nursing played in
"the pre-history of hysteria" (1893-H!95, p. 161). Whal he failed to
realize, however, was that the "emotion work"" which women's sick-
nursing eniiiiied and the-~od~i ~nireconomic poweriessness thaI they
experienced were not simply characieiisik -'of liis' patieni's pmonal
histories, but were Ihe sina qua non of the educated and literate bour-
geoi~- woman's social experience' in . turn-of-the-century Vienna.
Thus,-hysieria can be seen rioislmpiyasa personal ii-auble, bulas a'
syndrome refatedTo'tne-sociiircoiidiiions of. middle-dass women ill
tum:or:me:century Vienna. Breuer half-acknowledges this problem in
the case or Anna O. He maintains that "her mono!9l1Qusfamily life
and her absence of any intellectual occupation left her with an un~mploy~d
surplus of mefitalliveliness" (1893-1895, p. 41). Her "powerful intellen
which wouid have been capable of digesting solid mental pabulum
and stood in need of it" (1893-1895, p. 21). What Breuer does not
mention is that "intelleclual occupations" were not part of work that
middle-class Viennese women were traditionally permitted 10 do
outside the home. So, Anna O. may have "stood in need of iI," but
she certainly wasn't going to get it!
Similarly, Freud recognized the ambitions 0/ Elisabelh Van H...
who was well aware of the restriclions of her female role. Family
266 J.l. PIERCE

circumslances forced her to give up her ambitions, but even if they

had not done so, Cewoccupations were available to such a precocious
and intelli!\ent young woman in that era. The only legitimate form oC
actidty that middle-class Viennese women were traditionally permit-
led outside the home was charity work (Hunter 1983, p. 467). This
kind oC activity was simply an extension oC the kind of work they were
expected to do in the home - ministering and catering to the needs oC
others. These women did not have access to the public realm, either in
thl economic, political or legal arenas (Schorske 1980). As a result, the
constraints of these socially prescribed roles left few, iCany, outlets Cor
the "mental liveliness" of Freud and Breuer's patients. Perhaps
hecause they had no access to legitimate Corms of political protest
ag;}inst their social and economic oppression,they_wJl.g~.d__~]Jsychic
one which expressed itself symbolically in hysterical symptoms.
That both Freud and Breuer Caiied to see that ihdr women patients'
seemingly personal troubles were intimately linked to a larger social,
cultural and historical context may explain partially Freud's reluct-
anct" to delve Curtherinto the relationship be~wee.!lhyst_eria, preE()mi-
Qantly a women's diso~de!, andjntelligence, an "unladylike quality."
1Ie was simply unable to see the constraints that his ciiliure created
Cur all- womerj;panlculariy exceptIOnally mtelligent and ambitious -
ones. Freud., tUn! of the century altitude toward women further
clouded his ability to make this connection. He seemed to find it
p~matic-when- women ",ere very intelligent. In a sense, Freud
knew more than it appears, because intelligenu was problematicCor
Viennese middle-class women at the turn of the century -
not simply
because they were perceived as "unl.!!.dy-like" as a consequence,
but because, I hav_e~glJe~, they had no"autiet" for their "mental
liveliness." -

heud and Breuer's cooperation came to an end in the summer oC

1894. As ErnestJones points out in his biography of Freud, "This was
hrought about by Breuer's unwillingness to follow Freud in his inves-
ti!\ation oC his patient's sexual liCe, or rather the Car-reaching conclu-
sion Freud was drawing from it" Uones 1961, p. 165). In Studies on
J/)'sltria Freud hinted at these Car-reaching conclusions, that is, that
disturbances in sexual liCewere factors in the aetiology oChysteria and
ot11('r neuroses. These ideas culminated in a lecture which Freud gave
to the Society Cor Psychiatry and Neurology in )896. It was entitled
"The Aetiology oCHysteria."
 EMOTION WORK AND HYSTERIA 267

In this lecture, Freud reports with great clarity and direclness Ih"l
in all eighteen cases of hysterical illness treated by him (six were mell,
twelve were women) he discovered in the course of analytic work
repression of sexual abuse by an adult or by an older sibling who h"d
in - turn previously been abused by an adult. None of the eighteell
palients was aware of Ihe facl when they first came to see Freud, "lid
Freud contends that their symptoms would nol have appeared if thest"
early memories had remained conscious. In his words:

I therefore put forward Ihe Ihesis Ihal at th- bollom of eveI)' case of hysteria IIocr..
are on, or m..o!'_""",",nm of prtma/urt /lxuat ;xptn,nCi;"ul:t:urrencc. wloichbelong to tl...
earliesl yean oCel~i!d_hc;(iiJ,'~!i1
width eanbe reproduced through Ihe work of ps)'d,u'
amily,i, iii"piir,oCils intel"cning,dccades. I believe ihat ihis is an importanl findill~,
Ihe'discovel)' oCthe capu/hlli in neuropalhology... (18%, p- 203)

Freud's discovery of "the source of Ihe Nile" was tremendousl)

important for several reasons. First, he openly and publicly acknowl-
edged the ~J!.i£tence.Dfthe ~exual abuseorcfi.laren.'Thls was Clearly"
shQcking topic and fact to maliy or his contemporaries - one Ih"l
many would have preferred to ignore. Morover, Freud did not juS!
acknowledge the existence of sexual abuse; he also recognized Iht"
gross power imbalance implicit in such situations and the gr"l't"
psychoiogicai consequences it h~ldfor th.. <:hild. Freud 'wdies ihat ill
this -

. -, iII-malehed pair. il is Ihe adult who is armed wilh eomplele authority and 11111-'
righllO punish. ,oodIwho(can exchangeone role Corthe OIherto the uninhibited salis-
Caclionof his whims and... lit is) the child (typicallya girll. who in his (siclhelpless-
ness is althe merey of Ibis arbilral)' use oCpowcr... allthes<: grotesque and yet tra~i,
disparities distinctly mark Ihe later development oCthe individual and oChis Isi,I
neurosis, with COUlltiesspermanct'll effectswhich deS<:lVeto be Iraced in the greatest
delail (t8%. p- 2t5).

Freud's work had theoretical as well as social significance. II marks

a modification of his theorelical model for Studies on Hysteria. Rather
than traumatic events or 'hypnoid states' leading to hysteria, in Ihis
newer formulation il is speci~cally sexual traumas or what Frelld
called 'infantile sexual scenes' that iead io hysteria. Moreover, Ihis
focus on the psychologicariiriportance of sexuai experiences was 10
recur again, albeit in a modified form, in Freud's laler work.
In this paper, I have examined two of Freud's early works - Stud-
iu on Hys/t!ria and "The Aeliology of Hysteria" -
and considered
268 J,l. PIERCE

,heir importance for Freud's views on the psychology of women, In

bolh works, Freud seriously studies hysteria, an ailment that other
""lIrolo!\ists rhose to discount as a "women's disorder," and seeks to
discover its aetiologic,,1 factors, Although neither work formulates a
syslematic theory of female psydlOlogy pa u, in b.Q!tLwOrksit is pn'-
manly womtn 's ~xp~rimc~s which s~~ as Ih~ basis for Ih~ Ih~oriesthat l-!cud
"",.,lops, ~Ioreover, these works principally -~ddr~~~l'!1en's
piohlc~ls and experiences: Hysteria was predominantly a women's
illness, and sexual abuse by adults was more common among girls
Ihan among boys.
In my feminist re-reading of Freud his theoretical position locates
Ihe causes of hysteria in specific social circumstances -
circumstances
which preclude abreaction in the first study and that involve "infantile
sexual scenes" in the second. He attempts to help his women patients
ill analysis by tracing their symptoms back to their origin in an effort
10 abreact the original a/fect. In this manner he hopes to "transform
hysteriral misery into common unhappiness" (1893-1895, p. 305),
In lIoth works, Freud descri,b,es _women's powerlessness either in
lerms of socially prescrii;ed r~iesor in terms of their roles as victims of
se~lIai abuse as children. Moreover, a~ i have-argued,-he provides a
pa~tial understanding of the psychic consequences that such power-
lessness inay bring about. -'---, ' -,
This, in my view, is what makes his work an important contribution
10 feminist and sociological theorizing about women's mental health,
For Freud describes the conditions under which women's traditional
care «,r others or "emotion work" leads to a neglect of their own
",ell-I>eing and a consequent deteriorization of their emotional health,
Ai we have seen, however, he fails -
in the example of intelligence
alld hysleria - to see the link' b~tween his patient's iipers()naltrol,l-
hies" and the larger historical "nd social context in which he \HOtC.
B,'cause he does not abandon the "patriarchal spectacles" of his
nll1un\ his ambivalence about women, particularly their intelligence,
prrdudes a fuller underst"ndin~ of the psychological consequences of
Ih...female role in fin-de-siecle Vienna,

Notes
I"lie! ~Iil< 1"'11(1974) i, one or Ihe lew wrilns III address l>olh Freud's lalcr and
<;..lier works 01 Women,
 EMOTION WORK AND HYSTERIA 269

2. In Ihe IH90's, Freud was al a halfway slage in Ihe process of moving from php;o.
logical 10 psychological explanations of psychopalhological states. On the one
hand he was proposing whal was, broadly speaking, a chemical explanation 01
"aetoal" neuroses - neuraslhenia and anxielY neurosis - while on Ihe olher
h,md he was pmllOsing an essenlially psychological explanalion, in lerms of "d,'I.
encc" and "repression," of hysteria. See Siraehey's inlroduClion 10 .he 197511",i.
lIooks reissue of Slud", on lIy,"';o for a delailed discussion.
3. The reason Breuer was reluclanl 10 publish Ihe book had 10 do wilh Ihe case 01
Frln. Anna O. who had fallen in love wilh Breuer while she was under his coore.
/\1 one poinl, she manufaelured an hysterical pregnancy when she though I .h",
Breuer was going 10 end Ihe treatmen!. He was shocked and embarrassed by her
(lvertures and "lamed himself for eausing them. Freud told him thai such beh",.
ior was aclually a typical response IowaI'd the physician on Ihe part of patiellls
under Irealment; Freud called il "Iransference." Thus, Anna O. had experielllTd
a "transference" wilh Breuer Oones 1961, PI'. 147-149). However, Breun h'HI
also experienced a "counlertr.msfercncc" wilh Anna 0.: lie ...as so engrossed b)
his palientlhal his wife had l>ecome bored listening 10 him discuss the easc, '"HI
finally became ,icalous. Anna's "hysterical pregnancy" occurred when Breucr
p,,'malurely broke ole Irealmen!.
4. This is Ihe firsl appe..rance of the term "repressed" in whal was 10 be its psjeho-
,malytic sense. See Slraehey's discussion in the 1975 reissue of Slud.., on Hysl"",
5. In a 1924 footnote which Freud added in a later edilion of Ihe Slud.." he "'lint
th... Kalharina's "uncle" in Ihe case study was, in reality, her father.
6. "Emolion work" is a phrase coined by sociologist Arlie Hoehschild (1979; 19M3)
II refers to Ihe nurturing and caring thai women Iradilionally do in our cuhure.
7. Although Freud did wrile an essay on male hyslerics, women were much more
likely 10 suffer from Ihis neurosis Ihan men were (H ulller 1983).

References
Chodorow, Nancy. Tnt Rtp,oduclion of Molh"'ng: Psychoanalysu and Iht SoCIologyoj
Gmdtr. Berkeley: U,C. Press. 197H.
Oaly, J\1..ry. GynlEcology: Mdadhlu of Radical F,min;,m. Boston: Beacon P,ess, 1978.
Oinnerslcin, OorOlh)'. Th, .lttrmald and tJ" MmollJu" New York: Harper and RO\,'.
1976, .
Fenichcl, 0110. (1934), "Further Light upon the Pre-Oedipal Phase in Girls." In Th, '
ColUcltd Pap", of 0110 Ftn"ht~ Fin' S";'" Ed. H. Fenichd and 0, Rapaport :-':e,,'
York: W.W. Norton and Co., 1953.
Fliegel, Zenia Odes. "Feminine Psychosexual Oevelopmelll in Freudian Theory: ,\
lIistorical Reconstruction," P,ychoanalyll<Qua"trly, 42: 3H5-4UH,1973.
Freud, Ernst, Ed" Tnt UII", of Sigmund F"ud. New York: Basic Books, 1960.
Freud, Sigmund and Breuer,joseph (IH93-1895), Sludi" on HY'lma, New York: Basi,
Books, 1975.
Freud. Sigmund. (1896), "The Actiology of Hysteria," Sianda,d Ed;tion, 3: 189.nl
London: Hogarlh Press, 1953,
-, (1900), Tht Inl"",dal;on of D"am" New York: Basic Books, 1965,
-. (1905a), "Fragment of an Analysis of a Case of Ilysteria," In Do,a: An Anu'y'"
.f a CaSt of Hy,/tria, Ed. I'hilip Rieff. New York: Collier Books, 1963,
-. (1905b), Thrtt ConlClbulaon,10Ih, Th<aryof Sa, New York: LP. [Jullon & Co ,
1962,