5 ideas
When the affect bound to that memory was never discharged, the memory stays pathogenic and turns into a bodily symptom. Individual symptoms disappear once the patient recalls the originating event in vivid detail and puts the attached emotion into words.
Bertha Pappenheim, Breuer's patient from 1880 to 1882, fell ill while nursing her dying father. She developed paralyses, a squint, an inability to drink water, and a loss of her native German. Her symptoms eased when, in evening self-hypnotic states, she traced each one back to its first occurrence, which she called the 'talking cure' and 'chimney sweeping'. One example: her refusal to drink ended after she recalled, with disgust, seeing a governess's dog drink from a glass.
Every experience carries a quantity of affect that is normally worn away through action, tears, revenge, or speech. When that reaction is blocked by social circumstance, by the nature of the loss, or by a deliberate wish to forget, the affect stays 'strangled' and attached to the memory. Catharsis means belatedly reliving the event in words with its full emotion, which lets the affect drain away.
An idea incompatible with a person's moral self-image is pushed out of consciousness, and the excitation attached to it is rerouted into the body. The resulting symptom often symbolizes the idea itself.
Freud dropped hypnosis in favor of the pressure technique and free recollection. He found that patients actively resist remembering, and that the strength of the resistance measures how close the analysis is to the repressed material. Pathogenic memories are arranged in layers around a central nucleus, so the therapist works through them in order, treating each point of reluctance as a signal of what matters.