8 Hysteria as Communication

In his Introduction to Wittgenstein’s Tractatus, Russell declares that “the essential business of language is to assert or deny facts.”1 Only a logician, mathematician, or natural scientist, or someone having these enterprises in mind, could make such a statement. In ordinary life, language is used far more often for purposes other than to assert or deny facts than it is for it: in advertising, in friendly conversation, in religion, politics, psychiatry, and the so-called social sciences—in all these fields and situations and in many others language is used to express emotions, influence actions, and make some sort of verbal contact with other persons. These distinctions point to still another criterion for classifying languages, namely their discursiveness.

Discursive and Nondiscursive Languages

Discursiveness is a measure of the degree of arbitrariness in the symbolization. When a mathematician says “Let x stand for a bushel of apples,” or “Let g stand for the force of gravity,” he is using fully discursive symbols: that is, symbols at once completely arbitrary and completely conventional. Any symbol may be used to denote the force of gravity; its actual use depends on agreement among scientists on that particular symbol.

On the other hand, when a painter uses certain colors or forms to express his despair, or when a housewife uses certain bodily signs to express hers, the symbols they use are not conventional but idiosyncratic. In short, in art, dance, and ritual—and in so-called psychiatric illness—the characteristic symbols are lawful rather than arbitrary, and yet personal rather than social.

Many philosophers have contended, and continue to contend, that when communications do not convey facts, they are mere “noises” expressing the inner feelings of the speaker. In Philosophy in a New Key, Langer criticizes this view and asserts her belief in the necessity of “a genuine semantic beyond the limits of discursive language.”2 One of my aims in this book is to do just this: namely, to provide a systematic semiotical analysis of a language form hitherto regarded as purely expressive—that is, of the language of certain bodily signs.

In contrast to the arbitrariness of the symbols of discursive languages, one of the most important characteristics of the symbols of nondiscursive languages is their nonarbitrariness. This is best illustrated by means of the picture as a symbol: as Langer points out, the photograph of a man does not describe the person who posed for it but rather presents a replica of him.3 Nondiscursive symbolism is hence often called presentational. Further, while discursive symbols are typically abstract, having general referents, nondiscursive symbols are characteristically concrete, having specific objects or persons as their referents. For example, the word “man” refers to every conceivable man—and even woman!—in the universe, but points to no specific person. On the other hand, the photograph of a man represents and identifies a particular person.

In the earliest forms of written language, representation was achieved by means of iconic signs—that is, by hieroglyphs, which are a form of picture writing. According to Schlauch,4 the two simplest elements in written language are pictographs and ideographs. Both express their messages by means of pictures that resemble the object or idea to be conveyed. They are the earliest prototypes of what we now call the analogic type of codification. Psychoanalysis and “kinesics”5 are modern attempts to explore and understand the hieroglyphics that a person writes, not on marble tablets, but on and with his own body.

The advantages of discursive symbolism for transmitting information are obvious. The question is whether nondiscursive symbolism has any function besides that of expressing emotions? As I shall now show, it has several such functions.

Since verbal symbols describe the objects they denote in a relatively general, abstract fashion, the identification of a specific object requires much circumlocution (unless it has a name, which is a very special kind of discursive sign). Because of this, Langer notes that

… the correspondence between a word-picture and a visible object can never be as close as that between the object and its photograph. Given all at once to the intelligent eye, an incredible wealth and detail of information is conveyed by the portrait, where we do not have to stop to construe verbal meanings. That is why we use a photograph rather than a description on a passport or in the Rogue’s Gallery.6

Similarly, so-called hysterical body signs are pictures which bear a much greater similarity to the objects they depict than do words describing the same objects.* To exhibit, by means of bodily signs—say, by paralyses or convulsions—the idea and message that one is sick is at once more impressive and more informative than simply saying: “I am sick.” Body signs portray—they literally present and represent—in exactly what way the sufferer considers himself sick. In the symbolism of his symptom, the patient could be said to present his own complaint and—albeit in a highly condensed form—even his autobiography. This is tacitly recognized by psychoanalysts who often treat the patient’s presenting symptom—if he has one—as if it contained the whole history and structure of his “neurosis.” When psychoanalysts say that even the simplest symptom can be understood fully only in retrospect, they mean that in order to understand the patient’s “symptom” we must be acquainted with all the historically unique aspects of his personal development and social circumstances.

The situation in regard to cases of typical organic disease is quite different. The patient’s symptom—say, chest pain due to coronary insufficiency—is not autobiographical. The symbolism is, in other words, not personal and idiosyncratic, but anatomical and physiologic. Chest pains cannot, for example, be the sign of, say, a fractured ankle. Knowledge of pathological anatomy and physiology thus makes it possible to interpret the medical “meaning” of certain bodily symptoms. To interpret iconic symbols, however, it is of no use to be familiar with the language of medicine. What is needed, instead, is familiarity with the personality of the sign user, including his personal history, religion, occupation, and so forth.

Because so-called psychiatric problems have to do with difficulties which are, by their very nature, concrete human experiences, presentational symbolism lends itself readily to the expression of such problems. Human beings do not suffer from Oedipus complexes, sexual frustration, or pent-up anger, as abstractions; they suffer from their specific relationships with parents, mates, children, employers, and so forth. The language of psychiatric symptoms fits this situation perfectly: iconic body signs point to particular persons or events.

The Nondiscursiveness of Hysteria

To better appreciate just why the communicative aspects of hysterical symptoms are incomprehensible in terms of the logic of everyday speech, let us reconsider some of Freud’s clinical observations, cited earlier. Remarking on the differences between organic and hysterical pains, Freud states:

I was struck by the indefiniteness of all the descriptions of the character of her pains given me by the patient, who was nevertheless a highly intelligent person. A patient suffering from organic pains will, unless he is neurotic in addition, describe them definitely and calmly. He will say, for instance, that they are shooting pains, that they occur at certain intervals, that they seem to him to be brought on by one thing or another. Again, when a neurasthenic describes his pains, he gives an impression of being engaged in a difficult intellectual task to which his strength is quite unequal. He is clearly of the opinion that language is too poor to find words for his sensations and that these sensations are something unique and previously unknown, of which it would be quite impossible to give an exhaustive description.7

Freud’s account shows how exceedingly difficult it is for the patient to find words for his so-called sensations. The same holds true for patients expressing bodily feelings associated with psychiatric syndromes other than hysteria. This loss for words by the psychiatric patient has been attributed either to the patient’s having unusual experiences which are difficult to articulate precisely because of their peculiarity, or to the patient’s being generally impoverished in the use of words. I would like to suggest still another possible reason for it— namely, that the patient’s experience—for example, a bodily feeling—is itself a symbol in, or a part of, a nondiscursive language.8 The difficulty in expressing such a feeling in verbal language would then be due to the fact that nondiscursive languages do not lend themselves to translation into other idioms, least of all into discursive forms. The referents of nondiscursive symbols have meaning only if the communicants are attuned to each other. This is consistent with the actual operations of psychoanalysis: the analytic procedure rests on the tacit assumption that we cannot know—in fact, must not even expect t? know—what troubles our patients until we have become attuned to them.

The Informative Function of Iconic Body Signs

In what way can nondiscursive languages be used to transmit information? This question has occupied philosophers and students of signs for a long time. The informative function of a particular nondiscursive language, namely, of so-called hysterical body signs, has been of special interest to psychiatrists. Although hysteria has been approached as if it were a language, it has never been systematically so codified. Let us therefore consider the informative uses of iconic body signs as a system of nondiscursive language. The following remarks will, of course, apply not only to hysteria but also hypochondriasis, schizophrenia, and many other “mental illnesses,” insofar as the patient exhibiting them makes use of body signs. Where traditional psychiatric nosology emphasizes “diagnosis,” I emphasize here the use of iconic symbols in a medical or psychiatric context.

The informative use of language depends generally on the referents of its symbols. The radical positivist view, rarely held any more, maintains that nondiscursive languages have no referents at all: messages framed in this idiom are considered to be meaningless. A more balanced and today more widely accepted philosophical position regards the difference between discursive and nondiscursive languages as a matter of degree rather than kind: nondiscursive languages, too, are considered to have referents and cognitive meaning.

Rapoport has suggested that the referents of nondiscursive symbols are the “inner states” of the communicants.9 While acknowledging that nondiscursive languages have referents, he has continued to adhere to a traditional “out there-in here” distinction between them. Although nondiscursive communications tend to be simple and concrete, they are often not just expressions of the sender’s inner experience. Let us consider, in this connection, the example of people fleeing a burning theater. The panicky behavior of some members of the audience may signify—even to someone who neither sees flames nor hears anyone shout “Fire!”—more than mere panic. At first, perhaps, one may respond to the purely affective function of body language: “People around me are panicky: I, too, feel panicky.” But closely connected with this, there is also a communication of a quasi-cognitive message: “I am in danger! I must flee to save myself!”

I cite this case to show that the referent inside a communicant—say, his affect—cannot be completely severed from the experiencing person’s relationship to the world about him. This is because affects are at once private—”inner referents”—and public—indices of relationships between ego and object(s), self and others.10 Affects are thus the primary link between inner, private experiences and outer, publicly verifiable occurrences. Herein lies the ground for assigning more than only subjective, idiosyncratic meanings to the referents of nondiscursive languages. Accordingly, the limitation of iconic body signs does not lie only in the subjectiveness of the experience and its expression—that is, in the fact that no one can feel another’s pain; it lies, also, in the fact that such signs present a picture—say, of a person writhing in pain—which, standing alone, has a very limited cognitive content.

The role of gestural communication is pertinent in this connection. Gesture is the earliest faculty of communication, the “elder brother of speech,”11 which is consistent with the relatively primitive cognitive use to which it may be put, and with the equally primitive learning—by imitation or identification—which it subserves. In semiotical terms, gesture is a highly iconic system of signs, verbal speech is only slightly iconic, while mathematics is completely noniconic.

Hysteria, Translation, and Misinformation

When hysterical body signs are used to transmit information, they exhibit the same limitations as do nondiscursive languages generally. Weakly discursive languages cannot be readily translated into more strongly discursive ones. When such translation is attempted, the possibilities for error are enormous, since virtually any discursive rendition of the original message will, in a sense, be false. There are two basic reasons, then, why hysterical symptoms so often misinform: one is the linguistic difficulty, just noted, of rendering nondiscursive symbolism into discursive form; the other is that the message may actually be intended for an internal object and not for the recipient who actually receives and interprets it.

To be sure, misinformation—whether it be a mistake or a lie—may be communicated by means of ordinary language as well as by iconic body signs. We speak of a lie when the misinformation serves the speaker’s interests and when we believe that he has sent the false message deliberately. And we speak of a mistake when the misinformation appears to be indifferent and when we believe that the speaker has not sent the false message deliberately. Hence, there can be no such thing as a “deliberate mistake,” but mistakes out of accident, ignorance, or lack of skill are possible.

In formulating this distinction between lies and mistakes I have deliberately avoided the concept of consciousness. The traditional psychoanalytic idea that so-called conscious imitation of illness is “malingering” and hence “not illness,” whereas its allegedly unconscious simulation is itself “illness,” that is, “hysteria,” creates more problems than it solves. I think it is more useful to distinguish between goal-directed and rule-following behavior on the one hand, and indifferent mistakes on the other. In psychoanalytic theory there is no room for indifferent mistakes—because it is tacitly assumed that all action is goal-directed. It then follows that a person’s failure to perform adequately cannot be due to his ignorance of the rules of the game or to his lack of skills in playing it. Instead, the failure itself is regarded as a goal, albeit an unconscious one. This perspective is useful for the therapeutic attitude it inspires. But it is obvious that not all human error is of this purposive kind. To insist on this view is to deny the very possibility of genuine error.

Furthermore, when discovered, people caught in a lie usually utter more lies or say they were merely mistaken (which itself may be lie), whereas people caught in a mistake usually apologize for it. From a cognitive point of view, of course, both lies and mistakes are simply falsehood; from a pragmatic point of view, lies are acts for which we hold persons responsible, whereas mistakes are occurrences for which we do not hold them responsible. Accordingly, whether a particular communication is considered to be a lie or a mistake depends in part on the observer’s attitude toward the speaker and his judgment of the speaker’s character and conduct. In short, we have a choice between regarding hysteria as a lie or as a mistake. I believe it is cognitively more accurate, and morally more dignified, to regard it as a lie than as a mistake: empirical evidence favors this view as description or theory; and the desirability of treating persons as responsible agents rather than as inert things favors this view as prescription or strategy.

Language as a Means of Making Contact with Objects*

The study of hysteria, and of psychiatric problems generally, places Donne’s famous utterance “No man is an island, entire of itself” in a fresh perspective. Human beings need other human beings. This need cannot be reduced to other, more elementary needs. Freud himself went far in elucidating the young child’s immense need for and dependence on his parents, especially his mother or mother surrogate. The theory of object relationships—so central to contemporary psychoanalytic theory—presupposes the need for objects. The essential task of psychoanalysis may even be said to be the study and clarification of the kinds of objects people need, and the exact ways in which they need them. Indeed, much of recent psychoanalytic literature deals with the various mechanisms for seeking and maintaining object relationships. This perspective has made it possible to interpret such things as touching, caressing, cuddling, and, of course, sexual intercourse itself as various means of making contact with objects.

There is no reason to assume that what is true for gestural communications is not also true for verbal language. Since all communicative behavior is addressed to someone, it has, among other functions, also the aim of making contact with another human being. We may call this the object-seeking and relationship-maintaining function of language. The significance and success of this function varies with the discursiveness of the language used. If the principal aim of the communication is to establish human contact, the language used to achieve it will be relatively nondiscursive—for example, small talk, dancing, “schizophrenic” bodily symptoms. Because of this, we are justified in treating relatively slightly discursive communications mainly as methods of making contact with people rather than as methods of communicating information to them.

This viewpoint is especially relevant to the interpretation of such things as the dance, music, religious ritual, and the representative arts. In all of these, one person can enter into a significant relationship with another by means of a nondiscursive sign system. Using a pharmaceutical analogy, it is as if the language—dance, art, etc.—were the vehicle in which the active ingredient—human contact—is suspended and contained. Many things that people do together have mainly this function, whether it be playing tennis, going hunting with a friend, or attending a scientific meeting.

The object-contacting function of language is most important during the early years of life. With psychological development, its significance is replaced by the informative function of communication. This transformation is shown in condensed form in Table 4. The foremost aim of the child’s earliest communications is often to seek objects and to maintain contact with them. Gradually, this “grasping” function of language diminishes. Children then learn to use language abstractly. Serious psychological commitment to reading and writing implies an orientation to persons not physically present. While verbal language, as well as the special languages of science, retain an object-seeking aspect, this becomes increasingly less personal.

Abstract symbol systems, such as mathematics, are especially valuable for object-seeking for schizoid personalities. By means of such symbolizations, object contact may be sought and obtained, while at the same time a psychological distance may be maintained between self and other; it is virtually impossible to have a personal relationship and at the same time to maintain such distance.

Table 4. Development of the Object-seeking Function of Language

Hysteria as Indirect Communication

Highly discursive languages, such as mathematics, permit only direct communications. Mathematical signs have clearly defined referents, accepted by the mutual agreement of all who engage in “conversation” in this idiom. Ambiguity and misunderstanding are thus reduced to a minimum.

The principal linguistic cause of misunderstanding is ambiguity. In ordinary language many signs are employed in several different senses, a circumstance that allows for much ambiguity and hence misunderstanding. At the same time, referential ambiguity allows one to make indirect communications intentionally, by employing expressions known to be interpretable in more than one way.

The difference between indirectness and nondiscursiveness may now be stated. A language is called nondiscursive not because its signs have a multiplicity of well-defined referents, but rather because the referents are idiosyncratic and, hence, poorly defined. Directness and discursiveness overlap at one end, in that highly discursive expressions are also direct. They do not overlap at the other end, for nondiscursiveness itself is no guarantee that the language is useful for indirect communications. For this purpose a language of some discursiveness, such as ordinary language, is more useful than one that is completely nondiscursive, such as music.

There are many terms for various kinds of indirect communications—such as hinting, alluding, speaking in metaphor, double talk, insinuation, implication, punning, and so forth. Significantly, while hinting is neutral in regard to what is being alluded to, insinuation refers only to depreciatory allusions. Moreover, insinuation has no antonym: there is no expression to describe insinuating something “good” about someone. Although flattery might at times be communicated by allusion, the fact that no special word exists for it provides linguistic support for the thesis that hinting serves mainly to protect a speaker who is afraid of offending.

When the relationship between two people is emotionally significant but uncertain—or when either one feels dependent on or threatened by the other—then the stage is set for the exchange of indirect messages between them. There is good reason for this—namely, that indirect messages serve two important functions—to transmit information and to explore and modify the relationship between the communicants. The exploratory function may include the aim of attempting, however subtly, to change the other person’s attitude to make him more receptive to the speaker’s needs and desires.

Dating and courtship provide many examples of indirect communications. The young man may want sexual intercourse. The young woman may want marriage. In the initial stages of the dating game neither knows just what the other wants. Hence, they do not know precisely what game they are going to play. Moreover, in our culture direct communications about sexual interests and activities are still felt to be discouraged, even prohibited. Hinting and alluding thus become indispensable methods of communication.

Indirect messages permit communicative contacts when, without them, the alternatives would be total inhibition, silence, and solitude on the one hand, or, on the other, communicative behavior that is direct, offensive, and hence forbidden. This is a painful choice. In actual practice, neither alternative is likely to result in the gratification of personal or sexual needs. In this dilemma, indirect communications provide a useful compromise. As an early move in the dating game, the young man might invite the young woman to dinner or to the movies. These communications are polyvalent: both the invitation and the response to it have several “levels” of meaning. One is the level of the overt message—that is, whether they will have dinner together, go to a movie, and so forth. Another, more covert, level pertains to the question of sexual activity: acceptance of the dinner invitation implies that sexual overtures might perhaps follow. Conversely, rejection of the invitation means not only refusal of companionship for dinner but also of the possibility of further sexual exploration. There may be still other levels of meaning. For example, acceptance of the dinner invitation may be interpreted as a sign of personal or sexual worth and hence grounds for increased self-esteem, whereas its rejection may mean the opposite and generate feelings of worthlessness.

Freud was a master at elucidating the psychological function of indirect communications. Speaking of the patient’s associations to neurotic symptoms, he writes: “The idea occurring to the patient must be in the nature of an allusion to the repressed element, like a representation of it in indirect speech.”12 The concept of indirect communication occupies a central position in Freud’s theory of dream work and neurotic symptom formation. He compared dream formation to the difficulty which confronts “the political writer who has disagreeable truths to tell those in authority.”13 The political writer, like the dreamer, cannot speak directly. The censor will not allow it. Each must avail himself of “indirect representations.”14

Indirect communication is also a frequent source of jokes, cartoons, and humor of all sorts.16 Why is the story of the rich playboy asking the aspiring actress to come to his apartment to view his etchings funny? It is evident that the man is not interested in showing his etchings, nor the woman in looking at them, but that both are interested in sex. The man is interested because it will give him pleasure, the woman perhaps because she will be rewarded in some material way. The same message conveyed in direct language—that is, telling of a man offering a woman, say, fifty dollars to go to bed with him—would be informative but not humorous.

A linguistic interpretation of humor would thus attribute its pleasurable effects to the successful mastery of a communicative task. If a joke is taken literally—as it often is by children, persons who do not speak the language well, or so-called schizophrenics—it is no longer funny.

The Protective Function of Indirect Communications

The protective function of indirect communications is especially important when they convey embarrassing or prohibited ideas or wishes, such as sexual and dependency needs and problems about money. Faced with such “delicate” matters, indirect communications permit the expression of a need and its simultaneous denial or disavowal. A classic example from medical practice is the physician’s avoidance of discussing fees with patients and his assigning this task to a secretary or nurse. The physician communicating through his employee is simultaneously asking for money and not asking for it. The first message is contained explicitly in the secretary’s request; the second is contained implicitly in the doctor’s avoidance of the subject. Since the secretary acts as the physician’s agent, the physician is, in effect, asking for money. However, by not discussing financial matters openly, the physician is implying that money is of no importance in his relationship with the patient. Much of what is called hypocrisy is this sort of indirect communication, serving, as a rule, the interests of the speaker and infringing correspondingly on the interests of the listener.

Whether a person considers bodily diseases and personal problems acceptable or unacceptable will depend on his particular problems as well as on his system of values. In today’s health-conscious atmosphere, most bodily diseases are acceptable, but most problems in living—lip service to the contrary notwithstanding—are not. Indeed, they are especially unacceptable in a medical setting. Both patients and physicians are thus inclined to deny personal problems and to communicate in terms of bodily illnesses: for example, a man worried about his job or marriage may seek medical attention for hyperacidity and insomnia; and his physician is likely to treat him with antacids and tranquilizers.

Dreaming and Hysteria as Hinting

The main advantage of hinting over more direct forms of communication is the protection it affords the speaker by enabling him to communicate without committing himself to what he says. Should the message be ill received, hinting leaves an escape route open. Indirect communications ensure the speaker that he will be held responsible only for the explicit meaning of his message. The overt message is thus a sort of vehicle for the covert message whose effect is feared.

Any reported dream may be regarded as an indirect communication or a hint. The manifest dream story is the overt message, while the latent dream thoughts constitute the covert message to which the dreamer alludes. This function of dreaming—and of dream communication—is best observed in the psychoanalytic situation, since in it the recounting of dreams is a fully acceptable form of social behavior. Analytic patients often produce dreams that refer to the analyst. Frequently, such dreams reveal that the analysand has some feelings or knowledge about the analyst which he finds distressing and is afraid to mention lest the analyst become angry. For example, the analyst might have been late or might have greeted the patient absentmindedly. The patient now finds himself in the difficult position of wanting to talk about this, to restore a more harmonious relationship with the analyst, yet being afraid to do so, lest by mentioning it he alienate the analyst still more. In this dilemma, the patient may resort to a dream communication. He might then report a dream alluding to the distressing occurrence, omitting perhaps the person of the analyst from it. This makes it possible for the patient to make the dangerous communication while keeping himself protected, since the analyst can interpret the dream in many different ways.16

If the analyst is able and willing to accept the patient’s reproach, he can so interpret the dream. Its covert communicative aim will then have been achieved: the embarrassing message was dispatched, the relationship to the analyst was not further endangered, and a more harmonious relationship between patient and analyst was established. On the other hand, if the analyst is upset, defensive, or otherwise unresponsive to the dream’s hidden message, he might interpret the communication in some other way. Although this is clearly less desirable for the course of the analysis, it is preferable for the patient to making an overt accusation and being reprimanded for it. The misunderstanding at least does not place an additional burden on an already disharmonious relationship.

The idea that dreams are allusions is not new, Freud himself having suggested it.17 However, he paid less attention to dream communications as interpersonal events than he did to the mental or intrapsychic aspects of dreaming. Ferenczi went further: in a short paper provocatively titled “To Whom Does One Relate One’s Dreams?”18 he dealt with dreams explicitly as indirect communications.

Just as any reported dream may be regarded as a hint, so may any reported hysterical symptom. Freud attributed the multiplicity of meanings characteristic of hysterical and other psychiatric symptoms and of dreams to a “motivational overdetermination”—that is, to the multiplicity of instinctual needs which the symptom satisfied. I approach the same phenomena here from a semiotical rather than from a motivational point of view: accordingly, instead of an “overdetermination of symptoms,” I speak of a diversity of communicational meanings.

The hinting function of hysterical symptoms may be illustrated by the following example. Freud’s patient Frau Cäcilie M. suffered from hysterical facial pain, which had at least two distinct meanings.

1. Its overt meaning, directed to the self, significant objects, physician, and others, might be stated as follows: “I am sick. You must help me! You must be good to me!”

2. Its covert meaning, directed principally to a specific person (who may have been either an actual person, or an internal object, or both), might be paraphrased as follows: “You have hurt me as if you had slapped my face. You should be sorry and make amends.”

Such communicational interactions, common between husbands and wives and between parents and children, are fostered by situations which make people closely interdependent, requiring that each person curb some of his desires in order to satisfy any of them. Moreover, having curbed some of his needs, the person then demands that his partner(s) do likewise. Thus, the open, undistorted expression of needs is discouraged, and various types of indirect communications and need-satisfactions are encouraged. This sort of arrangement must be contrasted with those situations in which one person supplies the needs of another because of his special knowledge or skills, rather than because of a special relationship between them.

Institutionally based, restrictive relationships, such as those among family members or professional colleagues, must thus be contrasted with instrumentally based, nonrestrictive relationships serving the aims of practical pursuits, such as those between freely practicing experts and their clients or between sellers and buyers. In instrumentally structured situations it is not necessary for the participants to curb their needs, because the mere expression of needs in no way compels others to gratify them, as it tends to do in the family.19 Indeed, not only is the frank expression of needs not inhibited, but it is often encouraged, since it helps to identify a problem or need for which someone might have a solution or satisfaction.

Two proverbs illustrate these principles. “Honesty is the best policy” is a familiar English saying. In Hungarian, an equally familiar saying is “Tell the truth and get your head bashed in.” The contradiction between these two proverbs is more apparent than real. In fact, each refers to a different social situation; and each is valid in its own context. Honesty is the best policy in instrumentally oriented relationships, but is dangerous in institutional settings. Einstein was rewarded for telling the truth in the open society of science; Galileo was punished for it in the closed society of the Church.20

Hysteria: From Illness to Idiom

Although the idea that psychiatry deals with the analysis of communications is not new, the view that so-called mental illnesses are idioms rather than illnesses has not been adequately articulated, nor have its implications been fully appreciated.

I submit that hysteria—meaning communications by means of complaints about the body and bodily signs—constitutes a special form of sign-using behavior. This idiom has a twofold origin: first, the human body—subject to disease and disability, manifested by means of bodily signs (for example, paralysis, convulsion, etc.) and bodily feelings (for example, pain, fatigue, etc.); second, culture and society—in particular the seemingly universal custom of making life easier, at least temporarily, for those who are ill. These two basic factors account for the development and use of the special language of hysteria—which is nothing other than the “language of illness.” People use this language because they have not learned to use any other, or because it is especially useful for them in their situation.

The implications of viewing and treating hysteria—and mental disorders generally—as confronting us with problems like those presented by persons speaking foreign languages rather than like those presented by persons suffering from bodily diseases are briefly as follows. We think and speak of diseases as having “causes,” “treatments,” and “cures.” However, if a person speaks a language other than our own, we do not look for the “cause” of his peculiar linguistic behavior. It would be foolish—and fruitless—to search for the “etiology” of speaking French. To understand such behavior, we must think in terms of learning and meaning. Accordingly, we might conclude that speaking French is the result of living among people who speak French:

It follows, then, that if hysteria is an idiom rather than an illness, it is senseless to inquire into its “causes.” As with languages, we shall be able to ask only how hysteria was learned and what it means. It also follows that we cannot meaningfully talk about the “treatment” of hysteria. Although it is obvious that under certain circumstances it may be desirable for a person to change from one language to another—for example, to discontinue speaking French and begin speaking English—we do not call this change a “cure.” Thus, speaking in terms of learning rather than in terms of etiology permits one to acknowledge that among a diversity of communicative forms each has its own raison d’être, and that, because of the particular circumstances of the communicants, each may be as “valid” as any other.

Finally, while in treating a disease the physician does something to a patient, in teaching a language the instructor helps the student do something for himself. One may get cured of a disease, but one must learn a (foreign) language. The perennial frustration of psychiatrists and psychotherapists thus comes down to the simple fact that they often try to teach new languages to persons who have not the least interest in learning them. When his patients refused to profit from his “interpretations,” Freud declared them to be “resistant” to “treatment.” But when immigrants refuse to speak the language of the country in which they live and stick to their old habits of speech, we understand their behavior without recourse to such mysterious pseudomedical explanations.

* Treating certain forms of behavior as pictures, used to communicate messages, also helps us to comprehend such everyday acts as wearing certain distinctive articles of clothing, such as caps or jackets. Uniforms are used deliberately to bestow a specific identity or role on a person. In all these situations we deal with the social uses of iconic signs.

* I use the term “object” here in the psychoanalytic sense to refer to persons or to objects invested with personal qualities, such as dolls.