Hysteria
Encyclopedia
Hysteria, in its colloquial use, describes unmanageable emotion
al excesses. People who are "hysterical" often lose self-control due to an overwhelming fear that may be caused by multiple events in one's past that involved some sort of severe conflict; the fear can be centered on a body part, or, most commonly, on an imagined problem with that body part. Disease
is a common complaint; see also Body dysmorphic disorder
and Hypochondriasis.
Generally, modern medical professionals have given up the use of "hysteria" as 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
".
, until the seventeenth century, hysteria referred to a medical condition thought to be particular to women
and caused by disturbances of the uterus
(from the Greek ὑστέρα "hystera" = uterus). The origin of the term hysteria is commonly attributed to Hippocrates
, even though the term isn't used in the writings that are collectively known as the Hippocratic corpus
. The Hippocratic corpus refers to a variety of illness symptoms, such as suffocation and Heracles' disease, that were supposedly caused by the movement of a woman's uterus to various locations within her body as it became light and dry due to a lack of bodily fluids. One passage recommends pregnancy to cure such symptoms, ostensibly because intercourse will "moisten" the womb and facilitate blood circulation within the body.
By the mid to late 19th century, hysteria (or sometimes female hysteria
) came to refer to what is today generally considered to be sexual dysfunction
. Typical treatment was massage of the patient's genitalia by the physician and, later, by vibrators or water sprays to cause orgasm
.
A more modern understanding of hysteria as a psychological disorder was advanced by the work of Jean-Martin Charcot
, a French neurologist. In his 1893 obituary of Charcot, Sigmund Freud
attributed the rehabilitation of hysteria as a topic for scientific study to the positive attention generated by Charcot’s neuropathological investigations of hysteria during the last ten years of his life. Freud questioned Charcot’s claim that heredity is the unique cause of hysteria, but he lauded his innovative clinical use of hypnosis to demonstrate how hysterical paralysis could result from psychological factors produced by non-organic traumas (psychological factors that Charcot believed could be simulated through hypnosis). To Freud, this discovery allowed subsequent investigators such as Pierre Janet
and Josef Breuer
to develop new theories of hysteria that were essentially similar to the medieval conception of a split consciousness, but with the non-scientific terminology of demonic possession replaced with modern psychological concepts.
In the early 1890s Freud published a series of articles on hysteria which popularized Charcot's earlier work and begun the development of his own views of hysteria. By the 1920s Freud's theory was influential in Britain
and the USA. The Freudian psychoanalytic school of psychology
uses its own, somewhat controversial, ways to treat hysteria. Freudian psychoanalytic theory attributed hysterical symptoms to the subconscious mind's attempt to protect the patient from psychic stress. Subconscious motives include primary gain, in which the symptom directly relieves the stress (as when a patient coughs to release energy pent up from keeping a secret), and secondary gain, in which the symptom provides an independent advantage, such as staying home from a hated job. More recent critics have noted the possibility of tertiary gain, when a patient is induced subconsciously to display a symptom because of the desires of others (as when a controlling husband enjoys the docility of his sick wife). There need be no gain at all, however, in a hysterical symptom. A child playing hockey may fall and for several hours believe he is unable to move, because he has recently heard of a famous hockey player who fell and broke his neck.
Many now consider hysteria to be a legacy diagnosis (i.e., a catch-all junk diagnosis), particularly due to its long list of possible manifestations: one Victorian physician cataloged 75 pages of possible symptoms of hysteria and called the list incomplete.
in DSM-IV-TR include dissociative amnesia, dissociative fugue, dissociative identity disorder
, depersonalization disorder
, and dissociative disorder not otherwise specified. Somatoform disorders include conversion disorder
, somatization disorder
, pain disorder
, hypochondriasis, and body dysmorphic disorder
. In somatoform disorders, the patient exhibits physical symptoms such as low back pain or limb paralysis, without apparent physical cause. Additionally, certain culture-bound syndromes such as "ataques de nervios" ("attacks of nerves") identified in Hispanic populations, and popularized by the Almodóvar
film Women on the Verge of a Nervous Breakdown
, exemplify psychiatric phenomena that encompass both somatoform and dissociative symptoms and that have been linked to psychological trauma
. Recent neuroscientific research, however, is starting to show that there are characteristic patterns of brain activity associated with these states. All these disorders are thought to be unconscious, not feigned or intentional malingering.
Jungian psychologist Laurie Layton Schapira explored what she labels a "Cassandra Complex
" suffered by those traditionally diagnosed with hysteria, denoting a tendency for those with hysteria to be disbelieved or dismissed when relating the facts of their experiences to others. Based on clinical experience, she delineates three factors which constitute the Cassandra complex in hysterics: (a) dysfunctional relationships with social manifestations of rationality, order, and reason, leading to; (b) emotional or physical suffering, particularly in the form of somatic, often gynaecological complaints, and
(c) being disbelieved or dismissed when attempting to relate the facticity of these experiences to others.
reports, crop circles, and similar examples. Hysteria was often associated with events like the Salem Witch Trials
, or slave revolt conspiracies, where it is better understood through the related sociological term of moral panic
.
Emotion
Emotion is a complex psychophysiological experience of an individual's state of mind as interacting with biochemical and environmental influences. In humans, emotion fundamentally involves "physiological arousal, expressive behaviors, and conscious experience." Emotion is associated with mood,...
al excesses. People who are "hysterical" often lose self-control due to an overwhelming fear that may be caused by multiple events in one's past that involved some sort of severe conflict; the fear can be centered on a body part, or, most commonly, on an imagined problem with that body part. Disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
is a common complaint; see also Body dysmorphic disorder
Body dysmorphic disorder
Body Dysmorphic Disorder is a type of mental illness, a somatoform disorder, wherein the affected person is exclusively concerned with body image, manifested as excessive concern about and preoccupation with a perceived defect of his or her physical features...
and Hypochondriasis.
Generally, modern medical professionals have given up the use of "hysteria" as a diagnostic category, replacing it with more precisely defined categories such as somatization disorder
Somatization disorder
Somatization disorder is a psychiatric diagnosis applied to patients who persistently complain of varied physical symptoms that have no identifiable physical origin...
. In 1980, the American Psychiatric Association
American Psychiatric Association
The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...
officially changed the diagnosis of "hysterical neurosis, conversion type" to "conversion disorder
Conversion disorder
Conversion disorder is a condition in which patients present with neurological symptoms such as numbness, blindness, paralysis, or fits without a neurological cause. It is thought that these problems arise in response to difficulties in the patient's life, and conversion is considered a psychiatric...
".
History
In the Western worldWestern world
The Western world, also known as the West and the Occident , is a term referring to the countries of Western Europe , the countries of the Americas, as well all countries of Northern and Central Europe, Australia and New Zealand...
, until the seventeenth century, hysteria referred to a medical condition thought to be particular to women
Woman
A woman , pl: women is a female human. The term woman is usually reserved for an adult, with the term girl being the usual term for a female child or adolescent...
and caused by disturbances of the uterus
Uterus
The uterus or womb is a major female hormone-responsive reproductive sex organ of most mammals including humans. One end, the cervix, opens into the vagina, while the other is connected to one or both fallopian tubes, depending on the species...
(from the Greek ὑστέρα "hystera" = uterus). The origin of the term hysteria is commonly attributed to Hippocrates
Hippocrates
Hippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...
, even though the term isn't used in the writings that are collectively known as the Hippocratic corpus
Hippocratic Corpus
The Hippocratic Corpus , or Hippocratic Collection, is a collection of around 60 early Ancient Greek medical works strongly associated with the physician Hippocrates and his teachings...
. The Hippocratic corpus refers to a variety of illness symptoms, such as suffocation and Heracles' disease, that were supposedly caused by the movement of a woman's uterus to various locations within her body as it became light and dry due to a lack of bodily fluids. One passage recommends pregnancy to cure such symptoms, ostensibly because intercourse will "moisten" the womb and facilitate blood circulation within the body.
By the mid to late 19th century, hysteria (or sometimes female hysteria
Female hysteria
Female hysteria was a once-common medical diagnosis, made exclusively in women, which is today no longer recognized by modern medical authorities as a medical disorder. Its diagnosis and treatment were routine for many hundreds of years in Western Europe. Hysteria was widely discussed in the...
) came to refer to what is today generally considered to be sexual dysfunction
Sexual dysfunction
Sexual dysfunction or sexual malfunction refers to a difficulty experienced by an individual or a couple during any stage of a normal sexual activity, including desire, arousal or orgasm....
. Typical treatment was massage of the patient's genitalia by the physician and, later, by vibrators or water sprays to cause orgasm
Orgasm
Orgasm is the peak of the plateau phase of the sexual response cycle, characterized by an intense sensation of pleasure...
.
A more modern understanding of hysteria as a psychological disorder was advanced by the work of Jean-Martin Charcot
Jean-Martin Charcot
Jean-Martin Charcot was a French neurologist and professor of anatomical pathology. He is known as "the founder of modern neurology" and is "associated with at least 15 medical eponyms", including Charcot-Marie-Tooth disease and amyotrophic lateral sclerosis...
, a French neurologist. In his 1893 obituary of Charcot, Sigmund Freud
Sigmund Freud
Sigmund Freud , born Sigismund Schlomo Freud , was an Austrian neurologist who founded the discipline of psychoanalysis...
attributed the rehabilitation of hysteria as a topic for scientific study to the positive attention generated by Charcot’s neuropathological investigations of hysteria during the last ten years of his life. Freud questioned Charcot’s claim that heredity is the unique cause of hysteria, but he lauded his innovative clinical use of hypnosis to demonstrate how hysterical paralysis could result from psychological factors produced by non-organic traumas (psychological factors that Charcot believed could be simulated through hypnosis). To Freud, this discovery allowed subsequent investigators such as Pierre Janet
Pierre Janet
Pierre Marie Félix Janet was a pioneering French psychologist, philosopher and psychotherapist in the field of dissociation and traumatic memory....
and Josef Breuer
Josef Breuer
Josef Breuer was an Austrian physician whose works laid the foundation of psychoanalysis.Born in Vienna, his father, Leopold Breuer, taught religion in Vienna's Jewish community. Breuer's mother died when he was quite young, and he was raised by his maternal grandmother and educated by his father...
to develop new theories of hysteria that were essentially similar to the medieval conception of a split consciousness, but with the non-scientific terminology of demonic possession replaced with modern psychological concepts.
In the early 1890s Freud published a series of articles on hysteria which popularized Charcot's earlier work and begun the development of his own views of hysteria. By the 1920s Freud's theory was influential in Britain
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
and the USA. The Freudian psychoanalytic school of psychology
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...
uses its own, somewhat controversial, ways to treat hysteria. Freudian psychoanalytic theory attributed hysterical symptoms to the subconscious mind's attempt to protect the patient from psychic stress. Subconscious motives include primary gain, in which the symptom directly relieves the stress (as when a patient coughs to release energy pent up from keeping a secret), and secondary gain, in which the symptom provides an independent advantage, such as staying home from a hated job. More recent critics have noted the possibility of tertiary gain, when a patient is induced subconsciously to display a symptom because of the desires of others (as when a controlling husband enjoys the docility of his sick wife). There need be no gain at all, however, in a hysterical symptom. A child playing hockey may fall and for several hours believe he is unable to move, because he has recently heard of a famous hockey player who fell and broke his neck.
Many now consider hysteria to be a legacy diagnosis (i.e., a catch-all junk diagnosis), particularly due to its long list of possible manifestations: one Victorian physician cataloged 75 pages of possible symptoms of hysteria and called the list incomplete.
Current theories and practices
Current psychiatric terminology distinguishes two types of disorder that were previously labelled 'hysteria': somatoform and dissociative. The dissociative disordersDissociative disorders
Dissociative disorders are defined as conditions that involve disruptions or breakdowns of memory, awareness, identity and/or perception. See also dissociation. People with dissociative disorders are able to escape from reality involuntarily...
in DSM-IV-TR include dissociative amnesia, dissociative fugue, dissociative identity disorder
Dissociative identity disorder
Dissociative identity disorder is a psychiatric diagnosis and describes a condition in which a person displays multiple distinct identities , each with its own pattern of perceiving and interacting with the environment....
, depersonalization disorder
Depersonalization disorder
Depersonalization disorder is a dissociative disorder in which the sufferer is affected by persistent or recurrent feelings of depersonalization and/or derealization. Diagnostic criteria include persistent or recurrent experiences of feeling detached from one's mental processes or body...
, and dissociative disorder not otherwise specified. Somatoform disorders include conversion disorder
Conversion disorder
Conversion disorder is a condition in which patients present with neurological symptoms such as numbness, blindness, paralysis, or fits without a neurological cause. It is thought that these problems arise in response to difficulties in the patient's life, and conversion is considered a psychiatric...
, somatization disorder
Somatization disorder
Somatization disorder is a psychiatric diagnosis applied to patients who persistently complain of varied physical symptoms that have no identifiable physical origin...
, pain disorder
Pain disorder
Pain disorder is when a patient experiences chronic pain in one or more areas, and is thought to be caused by psychological stress. The pain is often so severe that it disables the patient from proper functioning. Duration may be as short as a few days or as long as many years. The disorder may...
, hypochondriasis, and body dysmorphic disorder
Body dysmorphic disorder
Body Dysmorphic Disorder is a type of mental illness, a somatoform disorder, wherein the affected person is exclusively concerned with body image, manifested as excessive concern about and preoccupation with a perceived defect of his or her physical features...
. In somatoform disorders, the patient exhibits physical symptoms such as low back pain or limb paralysis, without apparent physical cause. Additionally, certain culture-bound syndromes such as "ataques de nervios" ("attacks of nerves") identified in Hispanic populations, and popularized by the Almodóvar
Pedro Almodóvar
Pedro Almodóvar Caballero is a Spanish film director, screenwriter and producer.Almodóvar is arguably the most successful and internationally known Spanish filmmaker of his generation. His films, marked by complex narratives, employ the codes of melodrama and use elements of pop culture, popular...
film Women on the Verge of a Nervous Breakdown
Women on the Verge of a Nervous Breakdown
Women on the Verge of a Nervous Breakdown is a 1988 Spanish black comedy film written and directed by Pedro Almodóvar, starring Carmen Maura and Antonio Banderas...
, exemplify psychiatric phenomena that encompass both somatoform and dissociative symptoms and that have been linked to psychological trauma
Psychological trauma
Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event...
. Recent neuroscientific research, however, is starting to show that there are characteristic patterns of brain activity associated with these states. All these disorders are thought to be unconscious, not feigned or intentional malingering.
Jungian psychologist Laurie Layton Schapira explored what she labels a "Cassandra Complex
Cassandra complex
The Cassandra Complex is a psychological phenomenon in which an individual's accurate prediction of a crisis is ignored or dismissed.Cassandra Complex may also refer to:* The Cassandra Complex , an electronic music band...
" suffered by those traditionally diagnosed with hysteria, denoting a tendency for those with hysteria to be disbelieved or dismissed when relating the facts of their experiences to others. Based on clinical experience, she delineates three factors which constitute the Cassandra complex in hysterics: (a) dysfunctional relationships with social manifestations of rationality, order, and reason, leading to; (b) emotional or physical suffering, particularly in the form of somatic, often gynaecological complaints, and
(c) being disbelieved or dismissed when attempting to relate the facticity of these experiences to others.
Mass hysteria
The term also occurs in the phrase mass hysteria to describe mass public near-panic reactions. It is commonly applied to the waves of popular medical problems that "everyone gets" in response to news articles. A similar usage refers to any sort of "public wave" phenomenon, and has been used to describe the periodic widespread reappearance and public interest in UFOUnidentified flying object
A term originally coined by the military, an unidentified flying object is an unusual apparent anomaly in the sky that is not readily identifiable to the observer as any known object...
reports, crop circles, and similar examples. Hysteria was often associated with events like the Salem Witch Trials
Salem witch trials
The Salem witch trials were a series of hearings before county court trials to prosecute people accused of witchcraft in the counties of Essex, Suffolk, and Middlesex in colonial Massachusetts, between February 1692 and May 1693...
, or slave revolt conspiracies, where it is better understood through the related sociological term of moral panic
Moral panic
A moral panic is the intensity of feeling expressed in a population about an issue that appears to threaten the social order. According to Stanley Cohen, author of Folk Devils and Moral Panics and credited creator of the term, a moral panic occurs when "[a] condition, episode, person or group of...
.
See also
- Histrionic Personality DisorderHistrionic personality disorderHistrionic personality disorder is defined by the American Psychiatric Association as a personality disorder characterized by a pattern of excessive emotionality and attention-seeking, including an excessive need for approval and inappropriately seductive behavior, usually beginning in early...
- Female hysteriaFemale hysteriaFemale hysteria was a once-common medical diagnosis, made exclusively in women, which is today no longer recognized by modern medical authorities as a medical disorder. Its diagnosis and treatment were routine for many hundreds of years in Western Europe. Hysteria was widely discussed in the...
- Hysterical contagionHysterical contagionHysterical contagion occurs when a group of people show signs of a physical problem or illness, when in reality there are psychological and social forces at work....
- Body-centred countertransferenceBody-centred countertransferenceBody-centred countertransference or 'somatic countertransference refers to feelings that a psychological practitioner has about a client. Referring to the psychologists sensation in the gut, changes to breathing, to heart rate and to tension in muscles'....
- Somatization disorderSomatization disorderSomatization disorder is a psychiatric diagnosis applied to patients who persistently complain of varied physical symptoms that have no identifiable physical origin...
Further reading
- Halligan, P.W., Bass, C., & Marshall, J.C. (Eds.) (2001) Contemporary Approach to the Study of Hysteria: Clinical and Theoretical Perspectives. Oxford University Press, UK.
- Sander Gilman, Roy Porter, George Rousseau, Elaine Showalter, and Helen King (1993). Hysteria Beyond Freud (Berkeley, Los Angeles, and Oxford: University of California Press).
External links
- Is Hysteria Real? Brain Images Say Yes at the New York Times.
- The H-Word, Guardian Unlimited, 2002-09-02