Hysteria is a state of emotional extreme. Today we know it as an uncontrolled frenzy or excitement, that may stem from intense happiness, spirituality or even grief. Attendees of a pop-concert often become hysterical, and this emotion often consumes spiritual congregations. The range of emotions is wide, from a hysterical laugh to a cry. All these descriptions are literary, and it is no longer a disease. However, history of hysteria is strange, and makes us wonder how for centuries, everyone got it so wrong ?
Origins of the word hysteria
The word hysteria comes from Greek hystera, which means uterus. In medical lingo, hysterectomy is removal of the uterus. For centuries hysteria was a disease of the uterus. This mistaken belief was perpetuated by luminaries such as Hippocrates, Galen, and Avicenna. By their logic only women could have hysteria, and it was probably due to a displaced uterus. For years therapies focussed on how to get uterus back to its original place.
Till 18th century, hysteric emotional state was demonised. It may be an act of the devil, evil spirits and even witches. Many a women, labelled as witches were burned and executed. Many societies believed that all ill that plagues them, is doing of a sinister witchcraft. To the contrary, anyone who questioned social norms in medieval times, asked for their rights, became angry, agitated and needed to be persecuted could be labelled as a demon or witch. Many such individuals were confined to mental asylums.
Freeing the insane in the courtyard of the Salpêrière
Salpêrière, was commissioned as a hospice for women in Paris in 1656. This was a place to incarcerate the “undesirables“. The inmates were often chained, and these included those with a variety of behavioural conditions. In September of 1792, during uncertain period following French revolution, many of its inmates were killed by a mob.
Phillip Pinel was a physician, with a keen interest in diseases of the mind. In 1793 he was appointed as a physician of the infirmaries, and this brought him to Salpêrière. He was a torchbearer of reform movement, freeing many of those confined to mental asylums from chains and restraints. While he also believed hysteria was a disease of the women, a new therapy was in evolution.
Anton Mesmer (1734-1815), a German physician in Paris developed a new technique to treat hysteria. He would use his hands, bring them close to a patient. A magnetic action of “energy from the hand” would calm the nerves. This ‘trance” technique was named “mesmerism”, a precursor of hypnosis. While Mesmer was eventually banished from Paris, he helped to show that it is a disease of the mind.
Hysteria a leading diagnosis of the 19th century
Jean Martin Charcot, was born in Paris in 1825, and we know him as father of neurology. He worked for more than 30 years at Salpêtrière, he established a neurology clinic in 1882. It is here, he got interested in hysteria and its treatment through hypnosis. His famous students included Freud, Babinski, Janet, Tourette and Bouchard.
Charcot popularised both hysteria and hypnotism. He used to have “hysteria demonstration clinics” where he would induce hysteria, usually in women, and show how hypnosis could treat it. These clinics became so popular, that hysteria became a leading diagnosis in his times. He argued that an extreme emotional stated can be induced in susceptible individuals. These individuals would often adopt weird postures, faint, develop fit-like states, may inconsolably cry or laugh. He would then use verbal suggestion (or hypnosis) and show response to treatment.
Charcot and his school of medicine put forth various theories of hysteria. They believed that it is due to a mental trauma, and seen both in men as well as women. It is a subconscious thought, that is represented in physical symptoms. His student Pierre Janet recognised its five manifestations as anaesthesia, amnesia, abulia, motor control diseases and modification of character. He firmly moved these symptoms from uterus to the realm of neurology. He said “The studies of my student Janet confirm the thinking often expressed in our lessons, namely that hysteria is largely a mental illness. This is one aspect of the disease that we must never neglect if we wish to understand and treat it.”
Jean Charcot’s most famous student – Sigmund Freud
Born in 1856, in Austria Freud began his medical career as a physician in 1882. Three years later, in 1885 he went to Paris on a short fellowship to study Charcot’s hysteria and hypnosis. Charcot’s demonstration clinics stimulated him to study and practice psychoanalysis. He eventually abandoned hypnosis, but popularised concepts, that shaped our understanding of hysteria.
Hysteria, was touted as the commonest behavioural condition in the 19th century. While, Freud concluded that such unexplained symptoms affect both men and women, he linked these all these to sexuality. His explanation of these emotional states was focussed around childhood abuse, upbringing and interactions boys and girls had with their mothers and fathers. While Freud clearly established hysteria as a disease of the mind, his theories were controversial, and were abandoned in coming years.
Hysteria goes away
Hysteria is no longer a medical diagnosis. It was deleted from a list of medical diagnoses in 1980. Further, the instances of hysteria that were so popular in the 19th and early 20th century, somehow diminished in the later years. Slowly depression and anxiety took over as the most common ‘mind-disease’ diagnoses.
Hysteria was probably never a singular disease. It was a skewed medical explanation for ‘everything that men found mysterious or unmanageable in women’. So if it was anxiety, panic, breathlessness, seizures, or any emotional outburst – all was labelled as Hysteria. Surprisingly, same symptoms in men were acceptable. Gendered stereotypes, like the ideas that women should be submissive, even-tempered, and inhibited led any such deviation to be labelled as a disorder. It doesn’t seem so coincidental then that most modern treatments for hysteria involved regular (marital) sex, marriage or pregnancy and childbirth, all ‘proper’ activities for a ‘proper’ woman.
Epilogue
So probably, hysteria was a disease, that never was. Changes in social perception made it go away from medical texts. However, stereotypes remain. It is interesting to note, that luminaries of their times, including Charcot and Freud, devoted their careers to this disease….which no longer is or never was one !!!!
Very interesting history.