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Lecture Notes: Freud, "Fragment of an Analysis of a Case of Hysteria ('Dora')"

I. Background:

A. Published 1905; Freud's motivation = to substantiate his earlier work on hysteria ("Studies in Hysteria,"
written together with J. Breuer and published in 1895; "Aetiology of Hysteria") and defend his theory on
the origin of hysteria in sexual, infantile material. The treatment of Dora dates back to 1900-01.

B. "Dora" = Ida Bauer (1882-1945); she came to Freud in Oct. 1900, when she was
18 years old. (To view a picture of Dora, age eight, with her brother Otto, click
here.) Her case history is the history of a failure: Dora broke off her treatment
before a cure was effected.
-- Freud learned a great deal about his own analytical methods and their
weaknesses from this case. In particular, he came to appreciate more the impact of
the phenomenon known as transference for the therapeutic project.

1. Transference = the projection by the patient of the cause of his or her symptoms
onto the analyst. The interaction between the patient and the analyst is structured
or constructed by the patient as one in which the cause of the hysterical symptoms
is transferred to the relationship with the physician.

C. The original working title of this essay was "Dreams and Hysteria": The
functional or strategic purpose of the essay hence was to demonstrate the
importance of dream interpretation for the work of analysis.
-- Freud thus conceived this essay as a companion piece to the Interpretation of
Dreams, which had just appeared shortly before Dora came to Freud. Hence the aim
of the essay is to demonstrate the practical application of the theory Freud
developed in Interpretation of Dreams.

II. The Clinical Picture of "Dora's" Case: (to view a diagram that graphs the pattern
of Dora's hysteria onto the structure of hysteria Freud developed in the essay "The
Aetiology of Hysteria," click here.)

A. Dora comes from a typical upper-middle-class family, composed of father and

mother, son and daughter = "classical" configuration of bourgeois family.

1. In terms of personality and familial status, the father is the dominating figure in the
family circle. Dora exhibits an extreme emotional attachment to her father.
2. Mother suffers from "housewife psychosis" = she is confined largely to the household,
obsessed with order and cleanliness in the household sphere.
-- Note Freud's derogatory, demeaning attitude toward this position of the mother in the
family; he seems to have no sense that this role might be enforced upon the woman as a
function of her demeaning status in the family or the limitation of her activities (by
society) to the sphere of the home.
3. Dora's brother has nothing but a distant emotional attachment to his father. On the
contrary, he tends to side in all familial disputes with the mother, while Dora defends her
-- For Freud this set of alliances, fatherñdaughter; motherñson, confirms what he sees as
the typical pattern for the establishment of familial allegiances: The generations join
together in a pattern that crosses gender lines since the core motive of this alliance is
sexual in nature.
4. Dora also displays a peculiar emotional attachment to a paternal aunt = her father's
sister. Her identification with this aunt runs not only through association with the father
she loves, but is also reinforced by the fact that this aunt shows signs of psycho-neurosis.
Freud's implication = Dora identifies with her symptoms.
5. Family K as distorting mirror: also constituted as a typical bourgeois "nuclear" family,
2 parents, 2 children, equal gender balance.
-- Doraís father and Frau K have a (sexual) liaison;
-- Herr K attracted to Dora as sexual substitute for a frigid wife.

B. Dora's Symptoms:

1. dyspnoea = difficulty breathing; hysterical choking

2. depression
3. avoidance of social contact; threatens suicide
4. fainting spells
5. aphonia = loss of voice

C. "Trigger" that unleashes Dora's hysterical symptoms:

1. The sexual advances made to her by a certain Herr K., a good friend of the family, while
on vacation at Herr K's residence on a lake.
2. When Dora later confronts Herr K. about this sexual liberty, he asserts that Dora merely
imagined it; she fantasizes this presumptive act of sexual seduction. (For Herr K, the
best defense is a strong offense! He turns the tables on Dora's accusation.) See. Freud
Reader 182.
3. Dora's father sides completely with Herr K in this; he also asserts that Dora has imagined
these sexual advances. (See Freud Reader 194) In Dora's world, the men take sides
against her and construe Herr K's illicit advance as something she imagines or
projects onto him. The victim of real sexual advances is thereby transformed into their
perpetrator in the imagination. The men, at any rate, are absolved of all guilt.

D. Complication of the relationship between Dora and Herr K

1. Dora's father does not receive sexual satisfaction in his home life, from Dora's mother.
Their relationship has become asexual.
2. This gives rise to a long-term sexual relationship between Dora's father and Herr K's
wife, Frau K.
3. This, in turn, causes Dora to importune her father to abandon the relationship with Frau
K. Moreover, she believes her father's willingness to take Herr K's side and interpret his
sexual advance as Dora's imagination is motivated by his desire to protect his relationship
with Frau K. He acts, in other words, out of selfish motives.
-- Dora interprets this as her father's willingness to barter her off to Herr K in return for
Herr K's wife: the father thinks (she believes): you can have my daughter as a sexual
compensation for the fact that I have a sexual relationship with your wife. We have
regressed, in short, to the act of primitive woman-trading.

E. The events related to Dora's hysteria that are uncovered by Freud's analysis.
Freud recognizes the impudent advance by Herr K as the trigger, but realizes also
that this event itself does not suit the criterion of suitability for the hysterical
symptoms. He must therefore seek in his analysis for memories that have a
connection to coughing, aphonia, etc.

1. The sexual advance of Herr K at the lake, which occurred when Dora was 16 years old, is a screen
memory for another, related event that happened when Dora was 14. Herr K arranges to meet Dora at his
office, tells his wife not to come, and sends all his office staff home so he can be alone with Dora. He then
kisses Dora passionately.

a. Freud's prejudice: he believes that such a kiss by a mature man must elicit sexual
excitement in a girl of 14. It must be pleasurable to her. Freud has no understanding for
the possibility that Dora might not feel attracted to Herr K.
b. Dora's reaction to the kiss is not pleasure, but rather disgust. Freud identifies hysteria
with precisely this reversal of the pleasure of sex into a negative emotion.
c. This, then, gives a partial explanation of Dora's symptoms: her choking, her nausea are
connected to the disgust she feels when confronted by Herr K's lust. But she displaces
the genital pleasure of a "healthy" girl in a two-fold manner:

1. She displaces it from the lower to the upper body, from the genital region to the
mouth and throat;
2. She displaces the pleasure by transforming it into disgust.

a. Freud also suggests that Dora was revolted by the sensation of Herr K's erect member
when he pressed up against her to embrace her. Dora's reaction to this: She avoids all
men who are in a state resembling sexual excitement.
b. This also explains why Dora rejects her father's love for Frau K: it is disgusting not
simply because it is her father, but because all male sexual expression is disgusting.

2. Dora acted as a babysitter for Herr and Frau K's children: Freud's interpretation
= Dora displaces her feelings of affection for Herr K onto his children.

a. There is a parallel to this in the story of the governess in Dora's own family whose affection for Dora is
interpreted as displaced love for Dora's father.

3. Dora's aphonia. This occurred, Freud is able to discover, when Herr K. was away
from home on business. At a time when she can only have written contact with the
person with whom she is secretly in love, Dora reflexively loses her voice. Loss of
voice is a symptom of the value added to written communication in Herr K's

4. Note that Freud takes over the position of the other two men, Dora's
father and Herr K: he assumes that Dora is secretly in love with Herr K.

5. Dora insists that Frau K is only attached to her father because he is "wealthy" =
"well endowed" [ein vermoegender Mann]; but Freud turns this into its opposite:
Dora's father is not "well endowed" but in fact "unendowed" [ein unvermoegender
Mann]. That is, he is sexually impotent.

a. Dora hence must assume that Frau K. and her father arrive at sexual satisfaction by
means of oral sex.
b. This, then, explains Doraís hysterical symptom, her coughing: the woman's throat is the
area of sexual gratification for her father and is also the place where her symptoms occur.
c. Dora's cough, according to Freud, derives from the fact that she imaginatively places
herself in the situation of Frau K. gratifying her father sexually.
d. Conclusion: Dora secretly loves her father erotically, has a strong erotic attachment to
e. But Dora is also jealous of her father's love for Frau K. This explains her strong
attachment to Frau K, who played the role of a kind of surrogate mother and friend for
f. Freud thus interprets Dora's obsession with her father's love for Frau K as a cover-up, a
diversion, a displacement of Dora's own attraction both to her father and to Herr K. In
fact, her love for her father is an infantile impulse that is revived in order to deceive
Dora herself about her love for Herr K (see Freud Reader, p. 202).

F. Analysis of Dora's two dreams and the information they reveal.

1. First dream: Dora awakened by father at night because of fire: must rescue her
jewelry box.

2. Herr K had once given Dora a jewelry box. The position of the father in the dream
reveals that he is a displacement of Herr K. The latent dream idea thus is: Dora
must return Herr K's favor and give him her jewelry box = have sex with him.

3. Extinguishing the fire: Freud associates this with Dora's bed-wetting as a child;
for him, this is a reference to masturbation on her part and her attempts to repress

4. Freud asserts that Dora is more afraid of this truth (her desire to have sex with
Herr K) than she is of his advances themselves.

5. Freud turns the tables on the woman: he makes the victim of sexual
advances into their perpetrator, but the woman must punish herself for
these wishes. This punishment, this repression, creates Dora's hysterical

6. Dora's hysteria = self-inflicted. It is caused by her self-repression of her own

sexual desires, not by her disgust with Herr K's intentions.

7. Second Dream: Dora is in a strange town and receives a letter from her mother
reporting her father's death. Dora can't reach the train station [Bahnhof] and hence
comes to late to the cemetery [Friedhof] for her father's funeral. Freud goes through
a complex interpretation of this dream from which he concludes that Dora's dream
is one of defloration (Bahnhof and Friedhof as symbols of the female genitalia).
Dora's dream is a fantasy of forced seduction.

8. Again Freud turns the tables on Dora: he transforms her into the willing victim,
the lecherous woman who desires rape. The Dora analysis is like a rape case in
which the male perpetrator is declared innocent because he was "led on" by the
woman to expect consensual sex. (See Freud Reader, p. 195)

To view a diagram of the complex character configurations of Dora's case that

outlines her love of her father and Herr K, on the one hand, and her identifications
with other women, on the other, click here.

III. Freud's Postscript:

A. Freud emphasizes the technique of his analysis.

1. He insists on the scientific empiricism of his method. It is based, he claims, on

pure observation. That is, he ascribes to his conclusions the status of absolute
objectivity, as though his interpretive work merely uncovered what was always
there but remained hidden. He refuses to acknowledge that the scenario he
has derived is a wholly constructed one, based on questionable

2. Freud stresses how this case analysis demonstrates the usefulness of dream
interpretation for the pragmatic side of psychoanalysis. (Does it not in fact show the

3. A patient's symptoms do not disappear during analysis; they occur only afterward
and are postponed by transference. Transferences = facsimiles, "reprints" of the
symptomatic impulses and fantasies in which the physician replaces other persons.
(Doesn't this presume that the analyst will always be a male, his patient a female?
Or vice versa?)

4. Transference = the most recent manifestation of the disease itself: past psychic
experiences are projected onto the physician in the present.

5. Only once the transference is overcome can the patient be cured and the
symptoms dissolve. In Dora's case this never occurred because she broke off the
treatment prematurely. (Who can blame her!?)

IV. Critical Conclusions:

A. The "Dora case" reveals psychoanalytic treatment to be a process of coercion of

the female patient by the male analyst. The message is: the woman should admit her
sexual desires, confront the fact that she has led the male on to believe she wants to
have sex with him, and submit herself freely and without pangs of conscience to the
male's sexual advances.

B. Psychoanalysis is a strategy for male (sexual) mastery over the female, a

theory that proclaims the duty of the woman to embrace sexual submission. It
goes so far as to identify such submission with the woman's "pleasure principle":
This is what she "really wants"!

C. The analytical situation models this relationship of mastery and submission.

What is "transferred" are not so much the sexual desires of the (woman) patient
onto the (male) analyst, as the power-politics of the (male) analyst onto his (female)
patient. "Transference" is a theory that displaces and disguises this strategic
mastery of the (male) analyst (to turn Freud's interpretive strategies against him).

Last Updated: 12/09/09