During her treatment, Dora tells Freud of an earlier episode with Herr K. When she was fourteen, Herr K. arranged for his wife and Dora to meet him at his office. However, he persuaded his wife to stay home without Dora knowing. When she arrived at his office, Herr K. embraced and kissed her. Dora felt disgusted at what Herr K. had done and ran out of his office.
Freud finds it odd that Dora was repulsed by an experience that (in his opinion) should have elicited sexual excitement. He believes that this reversal of affect is crucial to understanding Dora’s condition and neuroses in general. Along with reversal of affect, Freud argues that Dora experienced a displacement of sensation. Instead of feeling genital stimulation, Dora was overcome by disgust, a feeling localized in the mucous membrane of the mouth.
As Dora tells Freud about this traumatic experience, she says that she can still feel the pressure of Herr K.’s embrace on her upper body. Again, Freud believes that displacement is at work. He conjectures that when Herr K. hugged her, Dora felt the pressure of his erect penis against her body. The memory of this sensation was repressed and replaced by the pressure that she now felt in her chest.
Dora continues her narrative. Because of her encounters with Herr K., Dora urged her father to break off relations with him and his wife. However, Dora’s father felt particularly indebted to Frau K., who helped to take care of him during his sickness, and refused to end his friendship with her. Dora became embittered by her father’s relationship with Frau K., which she suspected of being a love affair. There was a lot of evidence to confirm this suspicion. Dora’s father and Frau K. found every opportunity to be alone together. On a family trip, they arranged to stay in adjoining rooms away from everyone else. When he was back at home, Dora’s father would cough and complain until he suddenly left for B—, where he would meet Frau K.
Although Freud acknowledges that there is some truth to Dora’s accusations, he believes that her reproaches against her father are intended to mask her own faults. Dora claims that her father was feigning illness to further his own interests, but Freud asserts that she is guilty of doing the same thing. Dora had learned from Frau K. that pretending to be ill could be useful in getting what one wants. When her husband would return home, Frau K would pretend to be sick so that she could avoid having sex with him. Freud claims that Dora’s coughing and loss of voice are also connected with Herr K. Dora would lose her voice for a period of three to six weeks, the same length of time that Herr K. would spend away from B—. Freud concludes that Dora’s illness was demonstration of her love for Herr K. When he left her, speech had no value because she could not talk to the person that she loved.
Freud does not want the reader to conclude that grief over a missing loved one is the cause of all cases of aphonia (loss of voice). He asserts that hysterical symptoms cannot occur without what he calls somatic compliance. There must be something wrong with one of the bodily processes or organs to give rise to physical ailments. However, Freud also argues that hysterical symptoms cannot occur more than once without having some psychological significance or meaning.
Freud returns to Dora’s accusation that her father was pretending to be ill to further his own interests. Again, he finds a self-reproach underneath Dora’s criticism of someone else. Dora was also guilty of feigning sickness. She pretended to be sick to pry her father away from Frau K. Freud asserts that faking illness is a powerful means for gaining the attention of loved ones and has been used frequently by both children and neglected wives.
Freud notices that Dora’s cough has continued as she repeatedly criticizes her father. He wonders whether this symptom may be connected with him. Freud also asserts that hysterical symptoms are often the realization of a sexual fantasy. Freud finds out from Dora that her father is impotent. Dora realizes the contradiction between insisting that her father and Frau K. are having an affair and acknowledging his impotence, but she says that there are multiple ways to get sexual gratification, specifically oral sex. Freud concludes that her irritated throat results from her imaging Frau K. and her father having oral sex.
Freud next looks at Dora’s preoccupation with her father’s love life. He argues that Dora acted more like a jealous wife than a concerned daughter in her interactions with her father. Dora identified with both Frau K., her father’s current love interest, and with her mother, his past one. This leads Freud to claim that Dora is in love with her father. Freud argues that this attraction between child-parent is sparked during childhood. He receives confirmation of this idea when Dora tells him of something she said at age 7. Dora told her cousin that she hated mother and when she was dead, she was going to marry her father.
Freud wonders why Dora revived this passion for her father after ignoring it for years. He considers the fact that Dora may have feelings for Herr K. and may be reinforcing her old affection for her father to avoid these feelings. Freud also believes that Dora may be unconsciously attracted to Frau K. In his view, Dora is concealing a feeling of jealousy in her concern over her father’s affair. The object of this feeling is Frau K. During her therapy sessions, Dora speaks of Frau K. in erotic language, praising her “adorable white body.” She also does not criticize Frau K. although she is deeply angry about her relationship with her father. Freud asserts that when the sexual libido towards men is suppressed, a hysterical patient often directs her affection to someone of the same sex. He believes this theory fits in well with Dora’s case.
This section of the case study gives the reader an extensive look at Freud’s approach to curing hysteria. While others, such as Jean-Martin Charcot, used hypnosis to get patients to reveal the causes of their illness, Freud believed that the cure to hysteria could only be found in the patients’ stories. By listening to the patient, the psychoanalyst would arrive at the repressed memories that were manifesting themselves as hysterical symptoms.
Freud thus takes on the role of a psychological detective, constantly probing Dora’s memory to find out the motive for her symptoms. Like a detective, Freud does not take Dora’s description of events at face value and assumes that there may be a hidden meaning to what she says. In this part of the case study, Freud introduces the concepts “reversal of affect” and “displacement,” two psychological processes, in which the true significance of events is concealed from the patient’s consciousness.
Reversal of affect occurs when a person feels one emotion but expresses its opposite. According to Freud, Dora experienced a reversal of affect because she reacted to Herr K.’s advances with disgust instead of sexual excitement. Freud believes that Dora had a romantic interest in Herr K. and her unexplained rejection of him is pivotal to understanding her hysteria. Freud also claims that the feeling of pressure that Dora felt on her upper body was a displaced sensation. He guesses that Dora felt the pressure of Herr K.’s erect penis on her lower body when he embraced her and that the feeling was later expressed on her chest.
The concept of displacement shows how hysterical symptoms may develop. Displacement involves the redirection of an emotion from one part of one’s life to another, or from one body part to another. In Freud’s view, hysterical symptoms develop when a traumatic event improperly dealt with by mind is acted out on the body.
Although Freud did much to advance the treatment of mental illness, the reader should take a critical look at his psychoanalysis. At various times, Freud appears to insist that events have a hidden meaning. Freud’s assertion that Dora experienced a displacement of sensation is purely conjecture. There is no evidence to confirm that Dora indeed felt Herr K.’s erect penis when he embraced her. The feeling of pressure that Dora felt on her chest may thus have nothing to do with her incident with Herr K or may have an explanation that is different than one Freud offers.
At the end of second section, Freud shows how sexual fantasies may develop into hysterical symptoms. Fantasy symbolizes the fulfillment of a wish in a distorted way, because the consciousness cannot allow the wish to be fulfilled in reality. Freud believes that Dora’s throat irritation stems from her imagining her father and Frau K. engaged in oral sex. In Freud’s view, Dora has unconsciously identified with Frau K. and her sexual fantasy has manifested itself on her throat.
Dora’s unconscious identification with Frau K. as her father’s lover is an example of the Oedipal complex. Freud believes that it is common for a child to develop a sexual attraction for the parent of opposite sex and a hatred for the same-sex parent, whom he or she sees as a rival lover. According to Freud, most children redirect their sexual energy from their parent to other members of the opposite sex during adolescence. An inability to let go of this feeling can lead to the formation of neuroses.
Freud thinks that Dora’s overreaction to her father’s suspected affair is evidence of her amorous feelings for him. At the same time, he believes that Dora may be unconsciously attracted to Frau K. Dora’s seemingly sexual infatuation with Frau K. brings up Freud’s theory of perversion. Freud regards perversions as sexual activities that do not involve the reproductive organs or that do not aim to achieve reproduction. For Freud, homosexuality is an abnormality, which arises when the normal heterosexual libido is blocked.