The Secret Mind of Bertha Pappenheim: The Woman Who Invented Freud's Talking Cure

by Gabriel Brownstein

The extraordinary life of a brilliant woman whose contributions to science have been lied about and misused—the Henrietta Lacks of psychoanalysis—and whose mental health struggles look different in light of newly emerging research.

In 1880, young Bertha Pappenheim got sick—she lost her ability to control her voice and her body. She was treated by Sigmund Freud’s mentor, Josef Breuer, who diagnosed her with “hysteria.”  Together, Pappenheim and Breuer developed what she called “the talking cure”—talking out memories so that symptoms go away—and this, Freud acknowledged, became the basis for what would become the theory of psychoanalysis.

In Freud’s mythology Pappenheim was renamed “Anna O,” and as he got older his stories about her became more extreme.  For over a century, scholars have   Was she really sick?  Was talking cure really a cure?  Amid all this argument a persistent absence has the actual woman, Bertha Pappenheim. Brownstein's book fills this void, and more.

Brownstein gives us the real Pappenheim--a brilliant feminist thinker, a crusader against human trafficking, and a pioneer in her own right--in the hustling and heady world of 19th century Vienna. At the same time, he tells a parallel story that is playing out in leading medical centers today, about patients who suffer symptoms very much like Pappenheim’s, and about the doctors who are trying to cure them—the story of the neuroscience of a condition now called FND.
 
This is a book about science and history and psychology, about the relations of men and women, of body and mind, but perhaps most of all it's about the medical art of listening, attending to patients long enough to acknowledge the reality of their pain.
 

Genres: Nonfiction, History, Psychology, Biography

336 pages, Hardcover

Published April 16, 2024

Reviews

[Erin · Rating 3 out of 5]

As I read this book, I tried to do so with an understanding that the author had pieced this book together during a time in his life that was filled with loss and grief. The author Gabriel Brownstein becomes enraptured by the life of Bertha Pappenheim due to the interest of his late father. As he comes to terms with the recent loss in his life, he weaves this book through his personal memories and information about the life of Bertha.

While reading this book, I felt as though the chapters about the author’s personal life were the strongest. These passages were filled with emotion as the author reflects on life’s fragility and the suddenness of death. As the author recounts the history of individuals struggling with medical diagnoses, there seems to be common thread of people being told their physical symptoms are ‘in their head’ . The life of Bertha, who’s life was filled with men such as Freud and Breuer, was filled with sickness and mental health struggles. Bertha is perhaps one of their first individuals that was examined by the medical world so publicly. Her symptoms, which seemed to defy explanation, brought awareness to how trauma causes physical symptoms. This book was filled with detailed accounts of Bertha’s life during the birth of psychological treatments that were tried with people. While reading this book, the reader can tell the author compiled a great amount of research to this subject.

However, the academic portions of the book ran for long times and seemed disconnected from the memoir portions of the book. The way the book was structured was not as fluid as I would have liked. Just as reader starts to connect emotionally with the author, the reader is swept along to another long chunk of historical facts and excerpts.

I would recommend this book to those who are studying the early approaches of psychological treatments or the life of Bertha Pappenheim. The author provides a lot of areas that one could delve into with more comprehensive research. It also provides a modern perspective on woman’s psychological health and the continued pattern of individuals being abandoned by the medical field when their symptoms cannot be explained.

[Mark Gallagher · Rating 3 out of 5]

Gabriel Brownstein tries to illuminate an interesting subject but loses himself in an ambitious buffet of adjacent, tenuously connected topics. I won't even try to give a brief catalogue of all the things discussed, but I will offer the observation that there are throughout the book, too many voices in the conversation. Professor Brownstein has clearly done his homework, and generally has a lucid prose style. This would be a great two-semester course, but as a book it is unwieldy and messy.

[Cass Chloupek · Rating 1 out of 5]

This book was written in a very strange way. I did not like the way the story was laid out. For a book that promotes itself to be a quasi biography I find the use of the word "I" to be highly inappropriate. There is no use for such a word in this type of book. Instead it should have been marketed as a personal dive into a topic because his father shared an intellectual interest in the subject. Because that is what this is. It is paramount when writing a biography that the reader believes that the author is a certain authority on the topic. Either through academic credentials or through the breadth and quality of the research. I did not believe that this author really knew anything about what he was writing about. Much of the book read like a textbook with large swashes of it being literal direct quotes from a cacophony of other people. In the end the story felt like a rather feeble and pathetic attempt to understand Bertha Pappenheim without a whole lot of actual effort taken to do so. Instead the book is really about Josef Breuer and his work with Bertha Pappenheim and his disjointed connection to Freud. And then thrown it at the most random of times were the disjointed clunky discussions of modern science that felt like they had no bearing at all on the conversation at hand. This book was God-awful. But ultimately I don't believe the author was attempting to truly write a narrative story. The way this story is approached leaves me convinced that this was a personal endeavor meant to feel closer to his father. For his sake I hope he at least achieved that endeavor because the attempt to write a coherent story has so disastrously missed the mark.

[Lily]

In this complex book about science, psychology, and history, Gabriel Brownstein explores the life, health, and history of Bertha Pappenheim and her connections to a modern illness, FND, which medical professions are still trying to understand and treat. Using history in conversation with modern medical science, Brownstein alternates between Pappenheim and people alive today to try and understand the nature of FND and how medical professionals treat those with complex illnesses, both then and now. With so many factors at play, this book juggles them all brilliantly to create a series of case studies about FND to inform readers in the know and those just learning of the disease. Brownstein’s prose style is straightforward and engaging, and he focuses on building readers’ understanding through Pappenheim’s life and diagnosis over a century ago and through more recent cases from the twenty-first century, all while humanizing the subjects of study. Striking a difficult balance between history and memoir as well as multiple centuries, this is a complex, often sad, but interesting read for those interested in medicine and the history of science and mental health. Brownstein’s book provides an interesting and accessible avenue into the subject and FND for readers with his commitment to research and education.

Thanks to NetGalley and PublicAffairs for the advance copy.

[Cynthia Marcus · Rating 1 out of 5]

This book is a sloppy mess. It is part discussion of Freud's life and some of his work, although it is not a biography. It explores the life of Bertha Pappenheim and her medical problem, but neither is done adequately and certainly Bertha's secret life is never revealed. The most interesting part of Bertha's life, her work with Jewish women's groups and her run in with the Nazi's, is barely mentioned. This book is part elegy for the author's late father and wife, although again neither is dealt with in any detail. Brownstein's father sounds like a jerk and he portrays his wife as a saint, although I suspect neither is the case, nor was that the author's intent. Then there is the examination of hysteria or Functional Neurological Disorder, as it is called today. Through a series of case studies and clinical papers, FND is described as a glitch between the hardware and the software in the brain. That is the most cogent thing I learned from this book, so I guess it was not a complete loss. The rest is just a jumble.

[FND Together · Rating 5 out of 5]

This book is a jewel! FND has been described under multiple different names (including hysteria), along with many false theories for at least 3,000 years, it has more recently been described by FND experts as a “silent epidemic” and “a crisis in neurology”. Few dare to dive into this complex medical blind spot. The secret mind of Bertha Pappenheim is a fearless pursuit of the truth, evidenced by Gabriel Brownstein’s meticulous research into an important medical blind spot.

[James Junke · Rating 5 out of 5]

A fascinating, if difficult read. Well researched and written. Very personal and honest. Chapter headings would have help to guide the reader, especially one with modest understanding of psychology. The real revelation was what a truly loathsome human being Freud was. A misogynist at best, a sexual pervert at worst. Pappenheim’s resilience is all the more remarkable.

[Hugh J McKenna · Rating 1 out of 5]

Gave up. Not what I thought.

[Sherry · Rating 4 out of 5]

An interesting look at the origins of talk therapy. Pretty sure I can't stand Freud...

[Flora · Rating 4 out of 5]

I really liked the chapters about FND but really disliked the parts about Freud. I hated part 1, really liked part 2, part 3 I didn't like and part 4 was ok.

[Bilal Haque · Rating 4 out of 5]

A fascinating look into the world of a very misunderstood yet common illness. I enjoyed how much the author went back-and-forth between the life of Bertha Pappenheim and modern day treatment for FND. The patient perspectives were particularly insightful. I hope this book sheds light to the general public about the suffering of so many people who are afflicted with this illness.