Hysteria

HYSTERIA

Hysteria refers both to a personality type and to a cluster of psychoneurotic symptom formations. Its manifestations—dramatic, physical, and affective—may be viewed as an attempt to express and symbolize a psychosexual conflict and, at the same time, to defend against acknowledging that conflict. Symptoms range from mental anxiety and phobia to the physical signs of conversion disorder.

The term derives from hustera, the Greek word for uterus, and was historically considered a female disorder. Writings on hysteria date to ancient Egypt and the Kahun papyrus (ca.1900 BCE), which described the disturbances caused by the "wandering uterus" that manifested as symptoms in various parts of the body. Greco-Roman doctors continued to associate hysteria with the uterus and to treat it as a female complaint. From the end of antiquity through the Middle Ages and the Inquisition, recourse to supernatural explanations made it possible to consider hysteria a form of demoniacal possession or witchcraft. The theatrical and contagious nature of hysterical symptoms may have been at the root of phenomena such as the "possessed" nuns of Loudun, the convulsionaries of Saint-Médard, and the Salem witches. Hysterics and their putative victims were often burned at the stake.

Identification of hysteria as a distinct entity dates to 1870, when Jean Martin Charcot, a doctor at the largest hospice in France, the La Salpêtrière, segregated hysterics from other mental patients for purposes of research and investigation.

As a concept hysteria acquired several meanings:

1. Conversion hysteria was a convulsive attack characterized by paralysis, muscular contractions and bodily contortions, visual disturbances, including hallucination, pain and anesthesia, and so on.
2. As a psychoneurosis, studied by psychoanalysis, it was manifested by various symptoms and inversion of affect. Thus, Sigmund Freud's patient Dora experienced sexual excitation not as desire but as disgust, a hysterical displacement of a genital sexual conflict (1905e).
3. The term "hysteric" also qualifies, pejoratively, a certain type of distaff personality in which prominent use is made of dramatization, emotional exuberance, colorful and exaggerated language, continuous erotization, and seductiveness.
4. Finally, in everyday language, hysteria is the stuff of "emotional outburst" and "making a scene."

Broadly speaking, conversion hysteria led to the discovery of psychoanalysis as a method of understanding and treating psychopathological symptoms. Freud, who famously attended clinical demonstrations by Charcot, was struck by the indifference that hysterical patients displayed toward their suffering. Although for a time he suspected traumatic childhood seduction to be at the root of hysteria, he came to view such patients suffering "mainly from reminiscences" (1895d, p. 7)—that is, from a repressed traumatic event that remained mnemonically unintegrated, and could therefore only be expressed by conversion—through a corporeal memory, so to speak.

The death of his father in 1897 and subsequent self-analysis with Wilhelm Fliess led Freud to the discovery of his childhood passion for his mother and of his hostile feelings toward his father. Although the Oedipus complex did not appear as part of Freudian theory until later, he abandoned the theory of traumatic seduction; his key discovery was the notion of infantile sexuality, together with the importance of fantasy as a force that was both creative and disorganizing. At the same time he developed the concept of psychic defense and discovered in dreams and dream-work a link with hysteria.

In psychoanalytic theory, a hysterical crisis might be thought of as the embodiment of a dream. Its symptoms included the same mechanisms of condensation, displacement, symbolization, and disguise through censorship. Hysteria expressed a conflict that, incapable of being elaborated mentally, is translated in altogether enigmatic fashion into physical symptoms. The associative method of psychoanalysis could be used to identify the fantasies and symbolic pathways within it. Thus Freud described a hysterical woman who, with one hand, tore off her clothes, and with the other, held them against her body, simultaneously expressing the struggle between impulse and defense, enacting in effect a sexual scene in which she represented partners of both sexes (1908a). Hysterical neurosis and hysterical relationships involve identification, constant repression, and counter-cathexis that uses the Other as the theater of conflict.

Due to the absence of an organic lesion and the tendency for symptoms to disappear without a trace, as mysteriously as they came, hysterical conversion represented a provocative challenge to medicine. In general, hysterics have historically triggered irritation, accusations of lying and malingering, and rejection.

Hysteria has always defied medicine and the social order because sexuality is mixed up in it—in particular, female sexuality and the associated desire for sexual pleasure. Freud, in 1937, referred to the "repudiation of femininity" (p. 252) in both sexes as "bedrock," a stumbling block because of the mental association of the female with castration. Symptomatically, hysteria is an illness of repudiated femininity. More specifically, the anxiety that leads to this repudiation reflects the considerable libidinal energy required by the constant pressure of libido, a pressure that may be destructive of the ego.

Jacqueline Schaeffer

See also: Activity/passivity; Actual neurosis/defense neurosis; Anna O., case of; Anxiety; Archeology, the metaphor of; Autoplastic; Autosuggestion; Breuer, Josef; Cäcilie M., case of; Charcot, Jean Martin; "Claims of Psychoanalysis to Scientific Interest"; Conflict; Defense mechanisms; "Dostoyevsky and Parricide"; Elisabeth von R., case of; Emmy von N., case of; Fantasy; Femininity; Five Lectures on Psycho-Analysis ; "Fragment of an Analysis of a Case of Hysteria" (Dora, Ida Bauer); Freud, the Secret Passion ; Fright; Hypnoid states; Hysterical paralysis; Indications and contraindications for psychoanalysis in adults; Janet, Pierre; Katharina, case of; Lifting of amnesia; Lucy R., case of; Mnemic symbol; Mnemic trace, memory trace; Nervous Anxiety States and their Treatment ; Neurosis; Phobias in children; Phobic neurosis; Proton-pseudos; Psychoanalytical nosography; Psychogenic blindness; Psychological types (analytical psychology); Quota of affect; Reminiscence; Repression; Seduction; Seduction scenes; Sexual trauma; Somatic compliance; Studies on Hysteria ; Symbol; Symptom-formation.

Bibliography

Freud, Sigmund. (1937). Analysis terminable and interminable. SE, 23: 209-253.

Freud, Sigmund, and Breuer, Josef. (1895d). Studies in hysteria. SE,2.

Jeanneau, Augustin. (1985). L'hystérie, unité et diversité. Revue française de psychanalyse, 49 (1), 258-283.

Schaeffer, Jacqueline. (1986). Le rubis a horreur du rouge. Relation et contre-investissement hystériques. Revue française de psychanalyse, 50 (3), 923-944.

——. (1997). Le refus du feminine. Paris: Presses Universitaires de France.

Further Reading

Britton, Ronald. (1999). Getting in on the act: The hysterical solution. International Journal of Psychoanalysis, 80, 1-14.

Halberstadt-Freud, Hendrika. (1996). Studies on hysteria one hundred years on: a century of psychoanalysis. International Journal of Psychoanalysis, 77, 983-996.

Kohon, Gregory. (1984). Reflections on Dora: The case of hysteria. International Journal of Psychoanalysis, 5, 73-84.