Those Hysterical Women

Liza Perrat reviews Guises of Desire and interviews the author, Hilda Reilly.

Review...
Guises of Desire is a fictionalised account of the three-year illness of Bertha Pappenheim, known as the founding patient of psychoanalysis, mental illness treatment pioneered by the famous Dr. Sigmund Freud. “Anna O”, Bertha Pappenheim’s clinical pseudonym, was a patient of Dr. Josef Breuer, an associate of Freud’s, and one of the cases on which much of Freud's theory was based.  Freud described his patient as cured of "hysteria" with his “talking-cure” method.

 Through the author’s extensive research, Bertha’s Jewish upper-middle class of 19^th century Vienna is excellently portrayed. A sensitive, well-educated child who spoke several languages, Bertha was deeply disturbed by the gender discrimination she saw in her milieu of society. When her father falls ill, Bertha begins to exhibit more and more alarming symptoms such as paralysis, aphasia, blackouts and hallucinations. Through his regular visits to her home, Dr. Josef Breuer uses new methods such as hypnotism and the “talking cure” to try and root out the cause of Bertha’s psychological problems.  As Bertha comes and goes from sanatoriums over the following two years, the author narrates the progress of her illness in a fascinating and horrifying, but truly sympathetic manner that urges the reader onward, to discover what happened to this poor girl, in the end.

I found Guises of Desire an excellent and informative novel and would highly recommend it for readers interested in understanding the history of psychoanalysis.

Interview with author Hilda Reilly...

LP: Can you tell us what made you want to explore the medical concept of “hysteria” in the novel form?

HR: I first got interested in the subject of hysteria and hypnosis and various altered mental states when I was doing a Masters in Consciousness Studies, about 8 years ago. This led on to an interest in the early patients of psychoanalysis and it struck me that some of them may well have had an underlying neurological disorder, unrecognised by their doctors due to the limited state of medical knowledge at the time. I was curious to take a look at what patients’ lived experience of their illness and treatment might have been, and it seemed to me that a biographical novel would be a means of exploring this.

In the case of patients from the past it’s usually only the doctor’s version of events that we receive whereas nowadays there’s more attention being given to the patient’s narrative. Of course, we can only speculate as to what patients who are no longer with us felt and thought. I see the biographical novel as a means of narrativising a hypothesis about what these thoughts and feelings may have been. And after all, this is much what historians do when they interpret facts – they develop their own hypothesis on the basis of their research findings.


LP: When did you first become interested in the life of Bertha Pappenheim, aka Anna O, the ‘founding patient’ of psychoanalysis?

HR: Fraulein Anna O is the first of the cases to appear in Studies on Hysteria, published by Freud and Breuer in 1895. People tend to think of Anna O as Freud’s patient, whereas she was actually the patient of an older friend of his, Dr Josef Breuer. It’s true to say, though, that Freud in a sense appropriated the case as he wrote so extensively about it – hence the subtitle of the novel: The Story of Freud’s Anna O. It was in the course of his discussions with Breuer about this case that Freud began to develop his own theories about the diagnosis of those ‘hysterical’ patients and to devise new methods of treating them. I put the word ‘hysterical’ in quote marks as I think there is a big question mark hovering over the term. I suspected fairly early on that Bertha Pappenheim suffered from some kind of neurological disorder, a belief that grew firmer the more I discovered about the case.

LP: Do you have your own ideas about Anna O’s diagnosis of hysteria? And what do you think of the diagnoses of Drs Freud and Breuer, in terms of what we know today? 

HR: I think that the predominant cause of Bertha’s illness was temporal lobe epilepsy, a form of epilepsy which can result in a wide range of seemingly odd experiences and behaviours. In the case of Bertha, there were hallucinations, paralysis, visual disorders, aphasia, prosopagnosia, to name just some – the kind of thing described by Oliver Sacks, in fact. She was also taking significant amounts of morphine and other drugs which would have aggravated her condition. As well as that she undoubtedly had psychological problems generated by the socio-cultural milieu in which she grew up: for example, resentment about her second-rate status as a Jewish woman in the 19th century, frustration about not being able to develop her intellectual potential, and so on. I think there has been a tendency among commentators, even today, to jump to the conclusion that because she had those psychological problems, there is no need to look any further for a trigger for her illness. I believe, rather, that all those causes co-existed.

LP: What has the general feedback been about your story? 

HR: Very positive on the whole, and I’ve been particularly pleased about the reviews I’ve received from therapists and medical professionals. I had feared that the responses from that quarter might be rather snooty, but not at all. On the other hand, I’ve had some negative responses from people who are more concerned with the historical aspect and who believe that biographical novels are nothing more than a travesty of the biography.

LP: Would you like to tell us a bit about your other novels, and if you are currently working on anything new?

HR: Guises of Desire is my first novel. Before that I wrote a couple of travel books. Prickly Pears of Palestine is an account of six months I spent in the Occupied Palestinian Territories ten years ago. It gives multiple personal perspectives on a momentous period in Palestinian history, covering the death of Yassir Arafat and the election of Mahmoud Abbas. Seeking Sanctuary, which is part reportage and part travel writing, is set in Sudan. It presents the stories of six Western converts to Islam who sought a better life for themselves by moving to a country more in line with their new religion. Their journeys – spiritual, cultural and geographical – told in their own words, are set within the wider context of my own experience as an expatriate in Khartoum.

I’m now in the early stages of researching a second biographical novel, about another patient from the history of psychoanalysis, a patient of Freud’s this time. I don’t really want to say any more about it at the moment, but watch this space!

Bio...
Hilda Reilly is originally from Perth in Scotland and recently returned to live there, after spending most of her adult life abroad. Her occupations have ranged from the stupefyingly dull to the wondrously surreal; when asked that common question: What do you do? She has generally found that the most accurate reply is: I live on my wits.

After graduating from Edinburgh University she started training to become an actuary. Three months later she decided that not even the prospect of belonging to what was then the highest paid profession in the country could induce her to carry on in a career to which she was so unsuited. Subsequent jobs have included oil industry analyst in London, artists’ model in Paris, technical translator in Baghdad, charity worker in Zanzibar, English teacher in Malaysia, journalist in Ho Chi Minh City and director of an educational organization in Khartoum.

In recent years she has returned to academic study, obtaining an MSc in Consciousness Studies, for which she specialised in the neuroscience of religious experience, and an MA in Creative Writing, focusing on the use of narrative to explore the medical concept of hysteria.

Her first novel, Guises of Desire, which draws on both of those areas of interest, deals with the life of Bertha Pappenheim, aka Anna O, the ‘founding patient’ of psychoanalysis. She is also the author of two travel books – Prickly Pears of Palestine: The People Behind the Politics and Seeking Sanctuary: Journeys to Sudan.

Guises of Desire can be purchased here.