Hysteria

1886

Jean-Martin Charcot (1825–1893), Sigmund Freud (1856–1939)

The earliest descriptions of what can be recognized as hysteria date back to ancient Egyptian papyri (c. 1900 BCE). The Hippocratic treatises from the fifth century BCE include passages on disorders of the hystera (Greek for “uterus”). Symptoms related to the hystera included a sense of suffocation caused by an ascending uterus. The most common patients were widows deprived of sexual intercourse.

Medical writers across the centuries and across cultures described similar symptoms and added others. By the mid- to late nineteenth century, hysteria was reconceptualized as a nervous disease. It became the so-called grand neurosis, and hundreds of theories and investigations into its causes and treatment filled literature across Europe.

In 1862, neurologist Jean-Martin Charcot became the director of Hôpital de la Salpêtrière in Paris. Initially Charcot believed that hysteria was caused by a hereditary predisposition to nervous illness. He offered rich, complex descriptions of hysteria and saw its presence in even the most innocuous expressions of daily life. In his weekly grand rounds, the public was invited to observe him invoke and resolve hysterical fits at will in patients. Physicians and researchers from across Europe, including Sigmund Freud, came to learn from him.

It was the failure of the typical therapies of the time that led to Freud’s theory and practice of Psychoanalysis. After studying with Charcot in the winter of 1885–1886, he returned to Vienna, where his clinical case work led him to reject heredity and organic causes of hysteria. Instead, he developed a model in which hysteria represented the conversion of psychological distress into physical expression—tics, convulsions, and fits. Psychoanalysis emphasized the psychological basis of symptom formation; consequently hysterical symptoms were symbolic of repressed psychological experiences. Psychoanalytic treatment sought to bring these forbidden or traumatic experiences to light and thus deprive them of their power.

SEE ALSO Anna O. (1880), Psychoanalysis (1890), Shell Shock (1915), Psychosomatic Medicine (1939), Stress (1950)

A Clinical Lesson at the Salpêtrière, by French painter André Brouillet, 1887, shows Charcot demonstrating hypnosis on Blanche Wittman, one of his hysterical patients.