Hysteria

This article is about the state of mind. For other uses, see Hysteria (disambiguation).

"Hysterical" redirects here. For the film, see Hysterical (1983 film).

File:Hysteria.jpg

Women under hysteria.

Hysteria, in its colloquial use, describes a state of mind, one of unmanageable fear or emotional excesses. The fear is often 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. People who are "hysterical" often lose self-control due to the overwhelming fear.

Psychiatrists and other physicians have in theory given up the use of "hysteria", replacing it with more accurate terms such as somatization disorder. In 1980 the American Psychiatric Association officially changed the diagnosis of "hysterical neurosis, conversion type" to "conversion disorder".

History

Main article: Female hysteria

Until the seventeenth century, hysteria was regarded as of uterine origin (from the Greek ὑστέρα "hystera" = uterus) in the Western world. Hysteria referred to a medical condition, thought to be particular to women, caused by disturbances of the 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 refer to a variety of illness symptoms, such as suffocation and Heracles' disease, that are caused by the movement of a woman's uterus to various locations within her body when it has become 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. Originally defined as "a neurotic condition peculiar to women and thought to be caused by a dysfunction of the uterus" ("Hysterical").

The same general definition, or under the name female hysteria, came into use in the middle and late 19th century to describe what is today generally considered to be sexual dysfunction. Typical treatment was massage of the patient's genitalia by the physician and later vibrators or water sprays to cause orgasm.

The modern knowledge of hysterical processes was advanced by the work of Jean-Martin Charcot, a French neurologist. In 1893 Sigmund Freud attributed the rediscovery of hysteria to Charcot from the medieval conception in which a hysteric person suffers from "dissociation of consciousness". In a controversial move Charcot replaced the medieval religious terminology of demons (which had fallen out of favour with the experts at the time) with a "scientific" one. Charcot came to his theory on the mechanism of hysteria through his investigations of "nervous diseases" with outpatients in France in 1887 and 1888. Later, Charcot fully turned his attention to hysteria while working at the Salpetriere in France where he claimed that the cause of hysteria is "heredity... which is therefore a form of degeneration". Charcot employed hypnotic methods for therapy.

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.

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 disorders in DSM-IV-TR include dissociative amnesia, dissociative fugue, dissociative identity disorder, depersonalization disorder, and dissociative disorder NOS. Somatoform disorders include conversion disorder, somatization disorder, chronic 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.

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.

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.

Mass hysteria

Main article: 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 UFO reports, crop circles, and similar examples. Also, when information, real or fake, becomes misinterpreted but believed, e.g. penis panic. 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.

See also

• Histrionic Personality Disorder
• Female hysteria
• Hysterical contagion

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 Before 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

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