Hysteria - History

History

For at least two thousand years of European history until the late nineteenth 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), such as when a neonate emerges from the female birth canal. 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. The "wandering womb" theory persisted in European medicine for centuries.

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 began 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 unconscious mind's attempt to protect the patient from psychic stress. Unconscious 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 unconsciously to display a symptom because of the desires of others (as when a controlling spouse enjoys the docility of his or her sick partner).

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.