This novel medical reading of catharsis influenced Breuer’s treatment with Bertha, finding expression in the 1895 Studies in Hysteria where it played a central but unacknowledged role in describing Freud and Breuer’s pioneering psychotherapy clinic, bequeathing its name to their new treatment. The ‘cathartic method’, and its assumption that neurosis is born of accidental instead of structural trauma, was underpinned by the so-called ‘seduction theory’. As is well known, Freud quickly jettisoned the seduction theory as both improbable and inadequate to account for his clinical experience, a significant development in his thinking accompanied by an equally significant development in his clinical technique.
The process of giving up his supposition that the neuroses owe their existence to the accidental traumas described by the seduction theory was crucial in Freud’s movement towards his mature formulations of psychoanalysis, all of which accorded structural trauma pride of place over accidental trauma. Later I will return to the contrasts between accidental and structural trauma. For the moment, however, let me begin by considering in more theoretical and clinical detail how Aristotelian tragedy interrelates with Freudian drive theory.
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When first listening to the stories of the traumatised, we hear a narrative that is often told along similar lines: a terrible event strikes ‘like a bolt from the blue’, imparting a host of symptoms apparently unattributable to or accounted for by anything antecedent to the event itself. The accidentally traumatised generally present with a sure sense of the origins of their suffering: their symptoms are because they were attacked, violated, exposed to something horrific, and so on. This certainty on their behalf frequently leads to a technical challenge: despite everything appearing to be ‘on the surface’, the persistent and destructively repetitious character of trauma symptoms point beyond themselves, towards something the subject can neither divine nor forsake. In working with trauma the analyst can feel that no amount of talking, associating and feeling on behalf of the patient can exhaust the ferocity of their symptoms or the passion with which they are clung to.