Hysteria

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Hysteria colloquially means ungovernable emotional excess. Generally, modern medical professionals have abandoned using the term "hysteria" to denote a diagnostic category, replacing it with more precisely defined categories, such as somatization disorder. In 1980, the American Psychiatric Association officially changed the diagnosis of "hysterical neurosis, conversion type" to "conversion disorder".

While the word "hysteria" originates from the Greek word for uterus, hystera (ὑστέρα), the word itself is not an ancient one, and the term "hysterical suffocation" – meaning a feeling of heat and inability to breathe – was instead used in ancient Greek medicine. This suggests an entirely physical cause for the symptoms but, by linking them to the uterus, suggests that the disorder can only be found in women.^[1] Historically, hysteria was thought to manifest itself in women with a variety of symptoms, including: anxiety, shortness of breath, fainting, insomnia, irritability, nervousness, as well as sexually forward behaviour.^[2] These symptoms mimic symptoms of other more definable diseases and create a case for arguing against the validity of hysteria as an actual disease, and it is often implied that it is an umbrella term for an indefinable illness.^[1] Through to the 20th century, however, the label hysteria was applied to a mental, rather than uterine or physical, affliction. Hysteria is no longer thought of as a real ailment.^[3]

In modern usage the term hysteria connotes mass panic. Hysterical, applied to an individual, can mean that he or she is emotional or irrationally upset; applied to a situation, it means that situation is uncontrollably amusing.

Antiquity

In ancient Egypt, the womb was thought capable of affecting much of the rest of the body, but "there is no warrant for the fanciful view that the ancient Egyptians believed that a variety of bodily complaints were due to an animate, wandering womb".^[4] Prolapse was also known.^[4] The theory of a wandering uterus was developed in Ancient Greece, being mentioned in many sections of the Hippocratic treatise "Diseases of Women".^[1] Plato talks of the uterus as a separate being inside women, while Aretaeus described it as "an animal within an animal" (less emotively, "a living thing inside a living thing"), which causes symptoms by wandering around a woman's body putting pressure on other organs.^[1] The standard cure for this "hysterical suffocation" was scent therapy, in which good smells were placed under a woman's genitals and bad odors at the nose, while sneezing could be also induced to drive the uterus back to its correct place.^[1]

While in the Hippocratic texts a wide range of women were susceptible - including in particular the childless - Galen in the 2nd century omitted the childless and saw the most vulnerable group as "widows, and particularly those who previously menstruated regularly, had been pregnant and were eager to have intercourse, but were now deprived of all this" (On the Affected Parts, 6.5).^[1] He also denied that the womb could "move from one place to another like a wandering animal".^[1] His treatments included scent therapy and sexual intercourse, but also rubbing in ointments to the external genitalia; this was to be performed by midwives, not physicians.^[1] While most Hippocratic writers saw the retention of menstrual blood in the womb as a key problem, for Galen even more serious was the retention of "female seed".^[5]

Middle Ages and Renaissance

In Medieval times, this idea of the “wandering uterus” persisted, as did the methods of treatment. There was also the idea that there was a build up of humours, or fluid in the uterus that needed to be purged in order to cure the female patient of the disease. Self-treatment such as masturbation, was not recommended and also considered taboo. Marriage, and therefore regular sexual intercourse was considered the best long-term treatment option.^[2] There was continued debate about whether it was morally acceptable for a physician to remove excess female seed through genital manipulation of the female patient; Pieter van Foreest (Forestus) and Giovanni Matteo da Grado (Gradus) insisted on using midwives as intermediaries, and regarded the treatment as the last resort.^[6]

Through the Middle Ages another cause of dramatic symptoms could be found: possession. It was thought that demoniacal forces were attracted to those who were prone to melancholy, particularly single women and the elderly. When a patient could not be diagnosed, or cured of a disease, it was thought that the symptoms, of what we now know as mental illness, were actually those of someone possessed by the devil.^[3]

In the 16th and 17th centuries, hysteria was still believed to be due to retention of fluids in the uterus, sexual deprivation, or by the tendency of the uterus to wander around the female body causing irritability and suffocation. Marriage, and regular sexual encounters with her husband, was still the most highly recommended course of treatment for a woman suffering from hysteria.^[3] It was thought to purge the uterus of any built up fluid, and semen was thought to have healing properties, ‘In this model ejaculation outside the vagina was conducive to uterine disease, since the female genitalia did not receive the health benefits of male emission. Some physicians regarded all contraceptive practices as injurious to women for this reason’. Giovanni Matteo Ferrari da Gradi cited marriage and childbearing as a cure for the disease. If pleasure was obtained from them then hysteria could be cured.^[2] If a woman was unmarried, or widowed, manual stimulation by a midwife involving certain oils and scents was recommended to purge the uterus of any fluid retention. Lack of marriage was also thought to be the cause of most melancholy in single women, such as nuns or widows. Studies of the causes and effects of hysteria were continued in the 16th and 17th century by medical professionals such as Ambroise Pare, Thomas Sydenham, and Abraham Zacuto who published their findings furthering medical knowledge of the disease, and informing treatment.^[2][3] Physician Abraham Zacuto writes in his Praxis Medica Admiranda from 1637,

'Because of retention of the sexual fluid, the heart and surrounding areas are enveloped in a morbid and moist exudation: this is especially true of the more lascivious females, inclined to venery, passionate women who are most eager to experience physical pleasure; if she is of this type she cannot ever be relieved by any aid except that of her parents who are advised to find her a husband. Having done so the man’s strong and vigorous intercourse alleviated the frenzy.’

— Maines, 29, ^[2]

Industrial era

Previously held ideas surrounding hysteria, its manifestation, and its treatment in women persisted through to the 18th and 19th centuries. It is also during this time that hysteria starts to be thought of as less of a physical ailment and more of a psychological one.^[7] According to Pierre Roussel and Jean-Jacques Rousseau, femininity is a natural and essential desire for women, ‘Femininity is for both authors an essential nature, with defined functions, and the disease is explained by the non-fulfillment of natural desire.’^[3] It is during this era of industrial revolution and the major development of cities and modern life, that this natural tendency is thought to be disrupted causing lethargy or melancholy leading to hysteria.^[3] This melancholy or lethargy is retrospectively thought to have been caused and aggravated by the restrictive views on female sexuality at the time, which held masturbation as something unhealthy and unchaste. This led to a surge in female patients for medical practitioners who were looking for the massage cure to their hysteria. The rate of hysteria was so high in the socially restrictive industrial era that women were prone to carrying smelling salts about their person in case they swooned, reminiscent of Hippocrates’ theory of smells coercing the uterus back into place. For doctors manual massage treatment was becoming tiring, laborious and time-consuming and they were looking for a way to increase productivity.^[2]

Modern implications and feminist theory

Jean-Martin Charcot’s theories of hysteria being a physical affliction of the mind and not of the body led to a more scientific and analytical approach to the disease in the 19th century. He dispelled the beliefs that hysteria had anything to do with the supernatural and attempted to define it medically.^[8] Charcot's use of photography,^[9] and the resulting concretization of women's expressions of health and distress, continue to influence women's experiences of seeking healthcare.^[10]

Freud furthered this research by claiming that hysteria was not anything physical at all but an emotional, internal affliction that could affect both males and females, which was caused by previous trauma that led to the afflicted being unable to enjoy sex in the normal way.^[2][8] This would later lead to Freud's development of the Oedipus Complex, which connotes femininity as a failure, or lack of masculinity.^[8] Though these earlier studies had shown that men were also prone to suffer from hysteria, including Freud himself,^[1] over time, the condition was related mainly to issues of femininity as the continued study of hysteria took place only in women.^[11]

While hysteria was reframed with reference to new laws and was new in principle, its recommended treatment in psychoanalysis would remain what Bernheimer observes it had been for centuries: marrying and having babies and in this way regaining the “lost” phallus’^[8]

This 19th century definition of femininity has far reaching implications in modern thought as it cements the idea of woman as child bearer, and denotes women who do not conform to the established norms of sexuality and psychoanalysis, as wrong or defective.^[8] This definition of femininity as motherhood came at a time when women were fighting for more rights and a larger role in society. Hysteria was often used as a political tool in the media to impede these women’s rights movements and invalidate their arguments and desire for equal rights.

Nevertheless, Charcot had published over 60 "Lessons sur l'hysterie virile".

The most vehement negative statements associating feminism with hysteria came during the militant suffrage campaign.

“One does not need to be against womens suffrage,” the London Times editorialized in 1908, "to see that some of the more violent partisans of that cause are suffering from hysteria. We use the word not with any scientific precision, but because it is the name most commonly given to a kind of enthusiasm that has degenerated into habitual nervous excitement.”’

— Gilman, 320, ^[1]

In the 1980s, feminists began to reclaim hysteria, using it as a symbol of the systematic oppression of women and reclaiming the term for themselves.^[1] The idea stemmed from the belief that Hysteria was a kind of pre-feminist rebellion against the oppressive defined social roles placed upon women. Feminist writers such as Catherine Clément and Hélène Cixous write in The Newly Born Woman from a place of opposition to the theories proposed in psychoanalytical works, pushing against the notion that socially constructed femininities and hysteria are natural to being female.^[1][8] Feminist social historians of both genders argue that hysteria is caused by women’s oppressive social roles rather than by their bodies or psyches, and they have sought its sources in cultural myths of femininity and in male domination.’^[1]

In "Trauma and Recovery: The Aftermath of Violence--from Domestic Abuse to Political Terror", Judith Herman, the proponent of the C-PTSD diagnosis, analyses the history and evolution of the concept.

Mass hysteria

The term also occurs in the phrase "mass hysteria" to describe mass public near-panic reactions. Hysteria was often associated with events such as the Salem witch trials, or slave revolt.

See also

References

• Gilman, Sander L., Helen King, Roy Porter, G.S. Rousseau and Elaine Showalter. Hysteria Beyond Freud. Los Angeles University of California Press, 1993.
• Devereux, Cecily. "Hysteria, Feminism, and Gender Revisited: The Case of the Second Wave". University of Alberta
• Carta, Mauro Giovanni, Bianca Fadda, Mariangela Rappeti and Cecilia Tasca. "Women and Hysteria In Mental Health". Clin Pract Epidemiol Ment Health. 2012; 8: 110–19.

Further reading

• Paul Briquet (1859). Traité clinique et thérapeutique de l’Hystérie from Gallica at BnF
• Chodoff, P. et al. (1982) Hysteria, John Wiley & Sons.
• Halligan, P.W., Bass, C., & Marshall, J.C. (Eds.) (2001) Contemporary Approach to the Study of Hysteria: Clinical and Theoretical Perspectives, Oxford University Press
• Hennefeld, Maggie (December 2016). "Death from Laughter, Female Hysteria, and Early Cinema". differences: A Journal of Feminist Cultural Studies. Duke University Press. 27 (3): 45–92. doi:10.1215/10407391-3696631.
• Sander Gilman, Roy Porter, George Rousseau, Elaine Showalter, and Helen King (1993). Hysteria Beyond Freud, University of California Press
• Andrew Scull (2009) Hysteria. The Biography, Oxford University Press

External links

• Is Hysteria Real? Brain Images Say Yes at the New York Times.
• The H-Word, Guardian Unlimited, 2002-09-02
• Hysteria, BBC Radio 4 discussion with Juliet Mitchell, Rachel Bowlby & Brett Kahr (In Our Time, Apr. 22, 2004)