Hilda Reilly's Blog: The Writing of Guises of Desire - Posts Tagged "psychoanalysis"

“Dear Hilda R., I`m sorry but I just can`t stand biographical novels. For the historian, they are a pollution, plain and simple. So I do not see I can be of any help to you. Sincerely, ------------”

I received the above email from a well-known Freud historian in response to a request I had made for help while researching Guises of Desire,a biographical novel based on the life of Bertha Pappenheim, the 'founding patient' of psychoanalysis. Interestingly, it homed straight in on the essence of my project. When I set out to write the book my aim was as much investigatory as creative. I wanted to find out what kind of picture would emerge if the account provided by her doctor, Josef Breuer, was brought to life. I was also curious to see if this picture would be credibly consistent with the ideas which Breuer and his friend Sigmund Freud developed on the basis of that account. In the event, I found that the process of narrativisation turned out to be a research tool in itself.
My primary sources were two case histories written by Breuer:
• the 1882 Case History, addressed to the director of the clinic where Bertha was hospitalised after Breuer stopped treating her
• the 1895 Case History, which appeared in Studies on Hysteria, published jointly by Breuer and Freud.
I decided to focus primarily on the 1882 history as the 1895 one was produced more than ten years after the events. Moreover, appearing in the public domain, it would have avoided any features which might identify the patient. A third consideration was that, consciously or unconsciously, it may have been massaged to fit the theories being developed by Freud and Breuer.
My first obstacle was the style of the 1882 history. I found it garbled and rambling, and the terminology imprecise. Although it is true that the case history as a genre was still undeveloped in the 19th century, I have read a number of medical articles from the period from journals such a Brain, The Lancet and The British Medical Journal without encountering any of those problems.
At a more practical level I found that the work of dramatising the case history forced me to examine it from a perspective which had possibly never been brought to it before. The following are just a few examples:
• Breuer (1882) refers to his observations of Bertha’s behaviour during the Hannukah festival of 1880. Because I needed to incorporate details of Jewish daily life in my narrative, I consulted a Jewish calendar for the years in question. In doing so I found that Hannukah, which is a moveable festival, occurred in November of 1880, before Breuer’s treatment of Bertha was underway.
• At times Bertha spoke only in English. Breuer (1895) claimed to have communicated with her in this language, and described her English as ‘admirable’ and ‘excellent’. Yet there is no evidence from Breuer’s educational records, listed in detail by his biographer Albrecht Hirschmuller, of his ever having learned English although his study of other languages is noted.
• The presenting symptom was a severe cough, one which lasted during Bertha’s illness until the original problem (hearing dance music while she was caring for her sick father) was discovered. This cough, diagnosed as hysterical, was reportedly triggered every time Bertha heard rhythmic music. But given that Bertha was housebound for much of this period, in a pre-gramophone/radio era, it is difficult to see how she could have been exposed to the sound of music, apart perhaps from the occasional barrel organ in the street. How, I wondered, could the cough have occurred with such frequency in these circumstances that it was judged severe and requiring medical attention?
• Bertha apparently reported 15 instances of deafness brought on by shaking. Breuer claimed it stemmed from her being shaken by her brother on one occasion when she was listening at the door of her father's sickroom. Again it is difficult to see how she could have had the experience of being shaken at all subsequently when she was ill and housebound.
It is interesting to consider those findings in light of the view expressed in the email above. It would suggest that, in the case of Bertha Pappenheim at least, the ‘historical’ version has no right to claim the veridical high ground.
David Lodge, in The Practice of Writing, discusses the novelist’s struggle between ‘a desire to claim an imaginative and representative truth for their stories’ and ‘a conviction that the best way to secure and guarantee that truthfulness is by a scrupulous respect for empirical fact’. Those were my two guiding principles.

A recent Good Reads reviewer wrote that she had some problem with the ending of Guises of Desire. Her difficulty was that, although the Author’s Note at the end had explained what my thinking had been regarding the causes of Bertha’s illness, the explanation had not been clear in the novel itself. In other words, she felt that readers would not be able to work out a diagnosis for themselves, or guess at the kind of diagnosis I had based my interpretation on.
I can understand why the reviewer felt this and I’ve been wondering what I could have done to avoid this kind of dissatisfaction – if dissatisfaction it is.
Perhaps the explanation can be found in the views of another reader who has commented that I never slip into a contemporary frame of reference, that the setting is pre-Freudian and that nothing of Freudian theory creeps into my character’s words or reflections. I would add that the setting is also pre-modern-neurology and that the kind of diagnosis I have in mind would therefore not form part of it. It’s difficult therefore to see how, while remaining resolutely in the 19th century and with the narrative perspective being that of the characters rather than omniscient, I could have created a picture which would have led the reader, unless a medical professional, to think: Oh yes, Bertha Pappenheim clearly has such and such a condition. As it is, readers are drawn rather into the world of Bertha herself, experiencing the same confusion as Bertha, her family and her doctors, totally perplexed as to what’s going on and trying to figure out their own explanation.
Of course, I could have written a different kind of book, one which would have demonstrated quite clearly where I was coming from. I’d thought, for example, of doing one of those split-time novels which are popular now in historical fiction, with perhaps the parallel story of a modern neurological researcher working on the Anna O case, or something similar. Or I could have done something more avant-garde, interspersing the narrative with fragments of contemporary analysis of the case, with excerpts from case studies of later patients displaying similar syndromes, and so on.
It’s interesting to compare Guises of Desire with the novel Lying Awake by Mark Salzmann which tells the story of a contemplative Catholic nun who has mystical experiences associated with temporal lobe epilepsy. Because the setting is a contemporary one, a full depiction of her condition, both subjective and medical is possible. Of course, this could give rise to a whole new set of questions. Does the corresponding electrical activity of the brain create the content of the mystical experiences or does it provide a conduit to a supernatural dimension. The answer to this is likely to depend on the religious views, or lack thereof, of the reader. And it’s still pretty much true that one’s interpretation of the Bertha Pappenheim case depends on which school of psychological thought one subscribes to.
Guises of Desire