This article is, in part, a retelling of 'The Heroic Age of Hysteria,' a section from chapter 1, 'A Forgotten History,' in the 1997 book, “Trauma and Recovery: The aftermath of violence – from domestic abuse to political terror,” by Judith Herman, M.D. It was published by Basic Books, a member of the Perseus Books Group, New York. I highly recommend this book to all interested in the subject.
In part, this article relies on the work of Harold Bloom, principally, his 1998 book, “Shakespeare: The invention of the human,” and a few of his interviews related to Sigmund Freud. The book was published by Riverhead Books, a member of Penguin Putnam Inc., New York.
At the time Sigmund Freud (1856–1939) began his research into Hysteria, it was understood as a malady peculiar to women (according to 25 centuries of medical thinking) and accounted for any disease whose symptoms could not be found to have an organic cause. It was manifest in symptoms like partial paralysis, hallucinations, sensory losses, convulsions, and amnesias. Lumped into these symptoms was anything found (by men) to be mysterious or incomprehensible in women. The source of the problem, it was believed, resided in the uterus, and thus the medical term, Hysteria.
Sigmund Freud discovered the cause and the treatment of the disorder known as Hysteria. Also, the cause and treatment were discovered, independently, by Pierre Janet (1859–1947). The causes were violence, sexual assault, and incest beginning in childhood, sometimes at very early ages. The treatment involved a place of safety from abuse, the recalling of memories of the actual traumas, and the recounting and speaking of the events and the emotional content in great detail. Janet found the same. Freud referred to the aetiology of Hysteria as the 'seduction theory.'
“Each individual hysterical symptom immediately and permanently disappeared when we had succeeded in bringing clearly to light the memory of the event by which it was provoked and in arousing its accompanying affect, and when the patient had described that event in the greatest possible detail and put the affect into words. Recollection without affect almost invariably produces no result.” Sigmund Freud, 1895.
Within one year, Freud had repudiated, privately, his 'seduction theory' of Hysteria. By the first decade of the twentieth century, he formally renounced his historic and groundbreaking work: “I was at last obliged to recognize that these scenes of seduction had never taken place, and that they were only fantasies which my patients had made up.” He said all his patients had lied to him. What is noteworthy is that he proffered this 'final word' on the subject with absolutely no data or findings to support his claim of universal mendacity in hysterics. In the words of Judith Herman:
“Out of the ruins of the traumatic theory of hysteria, Freud created psychoanalysis. The dominant psychological theory of the next century was founded in the denial of women's reality. Sexuality remained the central focus of inquiry. But the exploitative social context in which sexual relations actually occur became utterly invisible. Psychoanalysis became a study of the internal vicissitudes of fantasy and desire, dissociated from the reality of experience.”
“Protesting too much, he dissociated himself at once from the study of psychological trauma and from women. He went on to develop a theory of human development in which the inferiority and mendacity of women are fundamental points of doctrine.”
Three questions arise:
1. How did Freud, with his collaborator and mentor, Joseph Breuer (1842–1925), and independent rival, Pierre Janet, discover the traumatic basis of hysteria as well as its treatment?
2. Why did Freud repudiate his findings on the traumatic basis for Hysteria?
3. In the face of his prior scientific investigation, how did Freud come to develop psychoanalysis, and his psycho-sexual theory of development that were based upon women's inferiority, their mendacity, and erotic fantasies and desires?
The answer to the third question is easy. He made it up. He concocted a fairy tale that suited him and his larger society. Freud became his own poster child for rationalization, denial, intellectualization, and depersonalization. He did this by bringing in a couple of heavy hitters to assist him – the creators of ancient western mythologies, and William Shakespeare. I will discuss more of this later. Now, let's turn to the first two questions.
1. How did Freud and Janet discover, independently, the cause and treatment of Hysteria?
The title of Judith Herman's sub-chapter, “The Heroic Age of Hysteria,” sums up, nicely, two decades at the end of the 19th century, after 2,500 years of recorded medical knowledge. This 'Heroic Age' began with the great French neurologist Jean-Martin Charcot [1825–1893]. In 1870 he took over a long neglected hospital, the Salpetriere in Paris, that had become a dumping ground for the insane, the destitute, prostitutes, and criminals. Famously, it was known for it's population of rats. He developed it into a center for scientific investigation of medical neurology, and is considered the fountainhead of modern psychiatry. Today it is a world class medical teaching institute, where Jacques Chirac underwent by-pass surgery,and Princess Diana died.
His interest in studying Hysteria was motivated by his own personal and scientific goals, as well as the scientific and political struggle to displace the Church as the arbiter of truth – at least in this world. Where the Church saw demonic possession, sickness of the soul, malingering, and sin, modern science was seeking to explain the phenomenon as a medical disease. The anti-clerical thinking, at that time, was that women needed to be claimed by science, otherwise, they would be reclaimed by the church. The modern conflict of Church authority versus scientific investigation was already underway. This was also the time of the Church's pronouncement on Papal Infallibility.
Charcot was an observer, data collector, describer, and taxonomist. The basic function of all science is to describe the properties of things. He chose to describe the disease of Hysteria. By using hypnosis, he was able to relieve some symptoms, as well as induce other symptoms. Thus, he concluded that the nature of Hysteria was fundamentally psychological and not neurological. This, alone, was a monumental discovery that changed the course of 2,500 years of medicine.
Charcot was a bit of a showman. His weekly lectures and demonstrations became famous in medicine and with the informed public, and were well attended. His technique of 'stage demonstration' has been parodied in countless movies. Among them is Mel Brooks' “Young Frankenstein,” with two scenes – one at the beginning, and one in the latter part of the film. It is probable that some of the hysterics in his demonstrations were too obliging in 'performing' the way he expected. However, his fundamental findings still stand. Although Charcot objectified women, and was little interested in their inner lives, his hospital became a safe place for women who experienced violence of all kinds. In retrospect, Charcot was unaware that he discovered the first element in the treatment of victims of trauma – having a place of safety.
Drawn to Charcot's hospital to participate in groundbreaking research were many young scientists and doctors. Among them were Sigmund Freud and Pierre Janet. Charcot had shown that the manifestation of Hysteria was psychological in nature. Now, the race was on to discover the underlying cause for Hysteria. As rivals, Freud and Janet were motivated to be the first to find and publish the discovery. This is always a great impetus for scientific research, now as it was then. The rivalry bore fruit. For a solid decade, doctors asked women to tell their stories and listened to what women had to say. In 2,500 years of medicine, this was unprecedented.
Contrary to Freud's expectations, or even his desires, the women were telling intimate stories of horrible abuse and sexual assault in their childhoods. He quickly realized that this personal history, including violence and incest, was fundamental to understanding their symptoms. He found that their Hysteria was relieved by recalling or recovering memories of abuse, and then verbalizing both the events and the attending feelings in great detail. Freud (also Janet) discovered the second element in the treatment of victims of trauma – talking out the story of one's trauma, recovering the details and the affect. Modern therapies modify this by having the victim tell their story to others who have experienced similar trauma.
Freud and Janet came to the same conclusion about the origin of Hysteria. Severe psychological trauma caused an extreme emotional response that resulted in an altered state of consciousness and produced the somatic symptoms. Janet called the altered state of consciousness 'dissociation,' while Freud and Breuer called it 'double consciousness.' Freud and Janet understood that the observed somatic symptoms were psychological representations of the actual experiences of sexual trauma.
In May of 1895, Freud and his collaborator, Breuer, published their “Studies on Hysteria.” This was a collection of papers on theory, therapy, and case histories. Among the case histories was included the famous Anna O. She coined the phrase, “talking cure.” All the same, Breuer was not easy with the traumatic sexual origins of Hysteria. Shortly afterward, Freud was to confide in his friend, Wilhelm Fleiss, “Not long ago, Breuer made a big speech to the physician's society about me, putting himself forward as a convert to belief in sexual aetiology. When I thanked him privately for this, he spoiled my pleasure by saying, 'But all the same, I don't believe it.'” In mid-October, in a letter to Fliess, Freud affirms his 'seduction theory' that sexual shock and premature sexual pleasure underlie Hysteria. At the end of October, Freud was beginning to have doubts about his theory on the origins of Hysteria.
In April of 1896, Freud gave a lecture to the Society for Psychiatry and Neurology in Vienna. It was based upon “The Aetiology of Hysteria,” a report on 18 case studies, and published the following month. Judith Herman remarks, “A century later, this paper still rivals contemporary clinical descriptions of the effects of childhood sexual abuse. It is a brilliant, compassionate, eloquently argued, closely reasoned document. Its triumphant title and exultant tone suggest that Freud viewed his contribution as the crowning achievement in the field.”
His reception by the Society was unfriendly, if not hostile. With the publication of “The Aetiology of Hysteria,” Freud expected his place in science would be assured, and his professional livelihood would flourish. Instead, he was hurt and greatly disturbed by the deafening silence and indifference of his colleagues and his profession. In September of 1897, Freud writes to Fliess that he has abandoned his 'seduction theory.' He now pursues work on understanding fantasy.
2. Why did Freud repudiate sexual exploitation of women as the root cause of Hysteria?
There is a good deal of debate as to why Freud repudiated his 'seduction theory' as the origin of Hysteria. We can sum up the various reasons as follows:
Freud's career and livelihood were at stake in an atmosphere of hostility from his colleagues. Further, his patients did not stay with him, and his practice was collapsing. He wrote to Fliess, “I am as isolated as you could wish me to be: the word has been given out to abandon me, and a void is forming around me.”
Given the pervasiveness of hysteria in the larger society, it would stretch the credulity of people who are not involved in the sexual exploitation of children. However, it would threaten the exposure of all those who perpetrated the horrors; And, it would bring to light those who were aware of sexual exploitation of children, but who did not act on behalf of the victims. Put differently, they all knew who they were.
This was too big a pill for society to swallow. As late as the 1970s, some professional reference texts estimated the frequency of incest at one per million. The entire professional and medical culture transformed themselves, on the matter of sexual exploitation of women, into “The People of the Lie.” Had Freud been loyal to his research and his patients, he might have become the lone truth teller, bearing the hostility and reproach of society. Janet never backed down from his research or his patients, and suffered the consequences of being the lone truth teller. Charcot was also assailed on the matter. He never repudiated his research findings, but, he did regret ever getting into the study of Hysteria.
There was no political or cultural movement, save a nascent feminist movement, that was powerful enough to support his research findings and theory. By the beginning of the 20th century, the anti-clerical forces had won the day, and there was no continuing need to make the study of Hysteria a demonstration of science versus Church authority. The brief period of time when male doctors listened to women, and took them seriously, had come to an end. “The Heroic Age of Hysteria” lapsed into historical amnesia, and 2,500 years of dismissing women as inferior, lying, and hysterical by nature picked up where it left off before Charcot.
Fortunately, a growing feminist movement was taking shape in Europe and in the United States, but things wouldn't begin to produce results till the 1970s. The eventual recognition of sexual trauma, and the sexual exploitation of women in general, as the precursors to Hysteria, came about by the action of women themselves. It is not an overstatement to say that the feminist movement, particularly consciousness raising, forced the male bastions of power to listen to what women had to say, and to accept their understanding of reality as valid.
There was a strong possibility that Freud and his siblings had been sexually abused by their father. The formulation of the Oedipus complex was a tailor-made defense for his own coming to terms with what happened in his childhood. By his own admission, Freud was suffering from Hysteria. This was emerging in his own personal analysis. From 1895 to 1897, Freud was becoming more absorbed by 'insights' from his own personal analysis. These become the inspiration, if not an excuse, for further work, at the expense of leaving his research findings behind. He was conscious of manifesting deeply neurotic behavior. In October 1896, his father, Jacob Freud, dies. This comes at a crucial point in his life, and he struggles with his father's death for years to come.
In the next, and final, part of this article, I will deal with how he concocts a story line for psychoanalysis and psycho-sexual development, ignoring his own research, and relying on an intense and deep familiarity with Shakespeare and western mythology. Thank you for reading, do take the opportunity to comment, and please come back on March 1, 2010.