Hysteria

Evolution of a concept

Psychiatry

The term of hysteria comes from the Greek Médecin Hippocrates, which invented this word to describe a concept that he learned from the Égyptiens.

The term is derived from the Greek word will hystera , meaning the Utérus. Hysteria, until work of the neurologist Charcot, was indeed regarded as closely related to the Utérus; the allowed theory being that this one moved in the body, creating the symptoms.

Studies on hysteria

Hysteria was related to Freud before even as the psychoanalysis is not born; it is the hysteria which revealed in Freud the neurosis.

As of 1883, Joseph Breuer tells with Sigmund Freud, then Neurologue, how it had dealt with one of its patients, Anna O., which suffered from hysterical disorders. The interest of Freud is waked up, and in 1885, it goes to Paris in the service of Charcot, which proposes already several theoretical projections as for hysteria.

In 1893, Freud and Joseph Breuer publish preliminary Communications ; the approach is that of pathogenic memories which would start hysteria, and which can be neat by the application of the Cathartic therapy. Freud works out the concepts of libido or defense neuro-psychosis. Two years later are published the Études on hysteria .

If the psychoanalytical model is not really places from there, since it misses then essential concepts, a whole theoretical corpus is however formulated, together conceptual which will be taken again and worked again throughout the history of the psychoanalysis.

The current psychoanalysis always uses the concept of hysteria, although a certain work of delimitation took place.

Psychosomatic

The psychoanalysis, thereafter, will be brought to differentiate hysteria from others turbid Psychosomatique S. If the principle of conversion seems with the first glance the same one, there are several essential differences.

The principal difference is structural and essential according to the point of view of the psychoanalytical Psychopathologie. If hysteria is a Névrose, others turbid psychosomatic cannot be included/understood while referring only to the nevrotic structure. They are limiting cases of pathologies, being located between neurosis and Psychose, without none of these two structures being satisfactory when it is a question of describing the psychic operation of the patient.

It is guessed, the model of the passage of psychic to body is not the same one. In hysteria, it is the hysterical Conversion, which implies a psychic history and a form symbolic system of expression. The body symptom, such as the Paralysis, is let analyze and revealed the psychic past.

In the psychosomatic disorders, the symptom implies much more one rejection of the psychic life. What psychic, the even unconscious one, does not take charges some, the representations thus which are Déni ées, foreclosed of the psychic life, will cause medical disorders, but without unconscious significance. The analysis in this case, will have to pass, according to Joyce McDougall, by a hysterisation of the symptoms .

In psychoanalysis, hysteria thus does not recover any unexplainable physical disorder by a medical affection other only psychic. It is about a structure with whole share.

Disorder somatoforme

The Psychiatrie evolved/moved in its approach of the Psychopathologie. If it employed a time the term of hysteria, this concept fell recently in disuse, showing the blow of a grid of reading fundamentally different.

Psychiatry henceforth recognizes a Trouble somatoforme which is not synonymous with hysteria, and it is a question of hearing the differences of them.

In the international Classification of the diseases (CIM), there is thus a Trouble somatoforme. This disorder is then included/understood like hoop net nevrotic, and put at the sides of anxious disorders such as the phobia. This classification, phenomenologic, thus preserves certain aspects of psychopathology in progress in the psychoanalysis.

But in DSM-IV, the Trouble somatoforme constitutes a category with whole share, gathering as well the disorder somatoforme itself as, for example, the Hypocondrie. The disorder somatoforme is not thus located in the same category as the obsessional-compulsive personality disorder: the disorder somatoforme is not, in the DSM, a Trouble of the anxiety - but it is, simply, a disorder somatoforme.

The DSM could not thus be criticized as for a factitious abandonment of the term of neurosis: what he proposes wants a atheoric and really different approach.

Hysteria and femininity

The error of Hippocrates and the Egyptians was to restrict the symptoms only with the woman, from where the word hysteria ( uterus in Greek).

The fact is that pathology remained strongly associated with femininity and, in particular, at the 19th century when she was studied by Jean-Martin Charcot and Sigmund Freud which gave the most visible image of it today.

The psychoanalysts considered that hysteria was probably a pathology strongly associated to the women not because the women would be more sensitive there than the men but because, in companies where the woman is oppressed and where femininity is repressed, the women use it as medium to express their psychological faintness deep under the influence of the company which directs their sorrow towards expression of a hysterical type. This assumption although seeming supported on a tempting explanation, is however not shown. She would explain why there seem to be effects of mode or epidemics of hysteria in certain companies and at certain times, and why hysteria regressed much in Occident.

Today, being given the fact that one finds indeed men “hysterical”, one prefers to use the term histrionic ( histrio , Latin actor); bringing back the symptom to a set of actors, an explosive exaggeration of emotions.

Model metapsychologic

Hysteria was the historical model of the neurosis. Which is the Métapsychologie?

Real traumatism and hysterical conversion

Freud starts by raising that the physical symptom, if it is connected to a mental health disorder, more precisely enracine in the psychosexual history of the subject. Hysteria would be the body answer to a sexual traumatism; in their childhood, the hystericals would have been allured ; and in the Après-coup they develop a hysteria.
It is the first theory, that of a real event causes of a psychic traumatism: the Neurotica.

As for hysterical conversion, it supposes that a tension nelle Pulsion Inconscient E does not find, to discharge, that the body; but it is then about an expression symbolic system of the sexual Représentation driven back. In Impulse and destiny of the impulses , Freud specifies that this instinctual destiny, not only eliminates the unbearable representation, irreconcilable with the requirements of the conscious one, but moreover succeeds in making conceal the Affect: it is the beautiful indifference of the hystericals .

The repression of the affect would thus succeed better in hysteria than in other pathologies; for example in the Phobia, if the representation is driven back, the affect is him only moved on another representation quite as worrying.

psychic Traumatism

Of a traumatism really lived by the hysterical, Freud will describe a psychic traumatism thereafter; it thus gives up describing a real event - what seems impossible to him within so many families. But he concedes that the psychoanalyst does not have any means to make the difference between a Fantasme and a real memory.

Freud will thus describe memories screen. It will work out especially a Fantasme of seduction, one of the primal phantasies, in which the hysterical thinks of recognizing the origin of sexuality. The hysterical would thus base his sexuality on the Fantasme to be allured.

However, Sándor Ferenczi will reproach Freud the abandonment of this neurotica. In Confusion of the languages , it will tackle the question of a real seduction of a child by an adult, including/understanding this seduction like the confusion of two registers: that of the genital sexuality, which is specific to the adult, and that of the infantile Sexualité. It is the " Theory of seduction restricted and généralisée" given up by Freud, certain American currents reproach Freud for having yielded on its theory because of social suitabilities.

Oedipus and bisexuality

Hysteria seems revealing Oedipus complex : the future hysterical, then child, phantasm the sexual relationship with his/her father. The hysterical enters the Oedipus complex with the castration: discovering that it does not have the Phallus, discovering the difference between girls and boys, it seeks this phallus in her father, wants to obtain it from him. It is there what Freud names the Penis envy, and which can also take the form of a desire of child.

The Oedipus complex , suitable for hysteria deserves to be differentiated from that of the obsessional neurotic, since that it is initially the mother who is invested, then, following the discovery of castration and with the threat a kind of primitive fusion with the mother, the father.

But hysteria always keeps trace of the bisexuality; as she did not see, in hysteria, that like phantasm, it is a question well of specifying it like psychic bisexuality. This psychic bisexuality will be one of the essential foundations of the behavior; it remains however driven back.

Hysteria, theatricalness and sublimation

Whereas the cold experiments of Charcot in Salpêtrière are on the point of initiating a theoretical reflection on the hysteria which left modern psychology, a poet, Baudelaire, include/understand what the artist can draw from the application conscious of the phenomena which thus draw the attention of the scientists of its time:

Hysteria! Why this physiological mystery make wouldn't the bottom and the tuff of a literary work, this mystery that the Academy of medicine did not solve yet, and which, being expressed in the women by the feeling of a ball ascending and asphyxiating (I speak only about the principal symptom), is translated at the nervous men by all the impotences and also by the aptitude for all excesses?

The hybrid figure of the hysterical poet makes well-sure echo with the novels of the time (famous “the Mrs Bovary it is me” of Flaubert) but Baudelaire, by thus defining the project of a voluntary experimentation of a symptomatology then included/understood like primarily female, breaks with the simple known conversion of romantic and the former generations, inaugurating a practice whose trace is found in all later art, of literary excesses of Lautréamont to those of Hobby-horse, until some of its most contemporary demonstrations.

Hysteria, theatricalness and religion

A long time one confused the Hysteria and the cases of individual had by possible a " demon" interior. Hysteria is a neurosis and thus resulted it from an interior conflict.

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