Intended for healthcare professionals


Else Pappenheim

BMJ 2009; 338 doi: (Published 09 April 2009) Cite this as: BMJ 2009;338:b1300
  1. Ned Stafford

    Psychiatrist and member of Freud’s Psychoanalytic Society

    It was March 1938. Else Pappenheim was at a lecture by psychologist Heinz Hartmann at the Vienna Psychoanalytic Society, founded by Sigmund Freud. Pappenheim, 26 years old and in training in neurology and psychiatry, heard shouts outside: “Heil Hitler! Heil Hitler!” She and others looked out the windows to see Nazi supporters marching in the street. Dr Hartmann ended the lecture, warning of danger.

    “They all went home,” according to Bernhard Handlbauer, an Austrian psychotherapist and historian who a half century later interviewed Dr Pappenheim for an oral history project. “It was a very sad situation because they knew that would be the last time they could meet there. Things were going to change.”

    Society shut down

    The next day German soldiers goose stepped into Vienna, and Austria was swallowed into Nazi Germany. Freud’s society was shut down. Most members in the following months fled Austria, including Pappenheim. She reluctantly left her beloved Vienna for the United States, but full of knowledge and memories of top Viennese analysts that she would years later pass to younger generations. Until her death she was widely thought to be the last living member of Freud’s society.

    Pappenheim was born on 22 May 1911 in Salzburg but grew up in Vienna. Her father, Martin Pappenheim, a neurologist and university professor, was a progressive social democrat and member of Freud’s society, although more as a curious observer than advocate. During her childhood and teenage years, Pappenheim met most of the top Viennese analysts.

    As a high school student, she learnt that the German poet Friedrich Hölderlin had been schizophrenic. She wrote a class paper on him and in 2004 published a book in Austria edited by Dr Handlbauer entitled Hölderlin, Feuchtersleben, Freud: Contributions to the History of Psychoanalysis, Psychiatry, and Neurology.

    After completing medical studies in 1935 at the University of Vienna, she interned in neurology and psychiatry. In 1937 she was accepted for training at Freud’s Vienna Psychoanalytic Society. She never met Freud, who by that time was elderly. Neither was she an adherent of psychoanalysis but thought it would be a useful tool for a psychiatrist, Dr Handlbauer says.

    After Nazi Germany annexed Austria, Pappenheim, who had three Jewish grandparents, was expelled from her position at the university and banned from treating non-Jewish patients. “She never felt herself to be Jewish,” Dr Handlbauer says. “She was very assimilated. She became a Jew by Hitler.” She opened a private practice for Jews, but that was closed down by autumn. She left Vienna in November 1938, arriving in New York with little money shortly before Christmas.

    Her mother, unable to leave Europe, moved to Bonn, Germany, into the home of her sister. In early 1942, when they feared they would be shipped to a concentration camp, they committed suicide. “That was certainly a big wound in her heart,” says Dr Handlbauer.

    Pappenheim accepted a position as a psychiatrist at Johns Hopkins University in Baltimore. Upon arriving, she learnt that the appointment was unpaid, so she also obtained a position at a state mental hospital, directing the women’s ward. She was shocked by conditions. “She felt it was like the Middle Ages,” Dr Handlbauer says.

    Stephen Frishauf, an Austrian immigrant who married Pappenheim in 1946 after his return from US military service in the second world war, says that his wife treated all patients with deep respect: “She had an innate sense of humanity, of the sanctity of life and human beings.”

    In 1941 Pappenheim moved to New York, initially setting up a private practice and staying in close contact with other immigrants, such as Heinz Hartmann, Marianne Kris, Annie Reich, Berta Bornstein, and Edith Jacobson. Her husband studied law at the University of Connecticut, beginning in 1947. The couple returned to New York in 1952 and in the ensuing years Pappenheim had a private practice and held positions at Hunter College and the Fashion Institute of Technology, part of the State University of New York (SUNY).

    In 1964 she became an attending physician at Kings County Hospital and associate professor of psychiatry and neurology at SUNY Downstate Medical Center, staying for 14 years of what she described as the “happiest times” of her professional life.

    In 1967 Gary Lefer, a psychiatry resident began making rounds with Pappenheim at Downstate. “She was very caring, very warm, very respectful of the patients she served. She was able to connect with them,” he says.

    Oral history projects

    When Dr Lefer moved to St Luke’s-Roosevelt, she followed him in 1978, staying there until retirement in 1985. She worked on oral history projects of her Vienna and early US experiences with Sanford Gifford, associate clinical professor of psychiatry at Harvard Universities, making presentations at meetings of the American Psychoanalytic Association.

    Dr Lefer says that Pappenheim never stopped missing Vienna. “She would often reminisce about her life then, the people she had met,” says Dr Lefer, who once confided to her about the stresses of his new fatherhood and occasional difficulties with relatives and in-laws. “I remember she said, ‘There is great relief in not having them around, but it also creates a great emptiness.’”

    Pappenheim, who played the piano and loved Bach, travelled regularly to Austria in later years, becoming a frequent guest of younger Austrian analysts and doctors interested in Vienna in the early 20th century. This culminated in a successful book tour in 2004, Dr Handlbauer says, adding, “She became important for us.”

    She leaves her husband, her daughter, Elisabeth Frishauf, a psychiatrist, and her son Peter Frishauf, founder of Medscape.


    Cite this as: BMJ 2009;338:b1300


    • Else Pappenheim, psychiatrist and neurologist (b 1911, q 1935 Vienna), died 11 January 2009 after ill health for several years.

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