Friday, September 9, 2022

Hysteria

Hysteria (pronounced hi-ster-ee-uh (U) or hi-steer-re-ah (non-U))

(1) In casual use, an uncontrollable outburst of emotion or fear, often characterized by irrationality, laughter, weeping, etc.

(2) In psychoanalysis, a psychoneurotic disorder characterized by violent emotional outbreaks, disturbances of sensory and motor functions, and various abnormal effects due to autosuggestion.

(3) In clinical psychiatry, conversion disorder.

(4) In (historic) clinical medicine, a mental disorder characterized by emotional excitability etc without an organic cause (archaic).

1795-1805: From the New Latin hysteria, from hysteric, from Classical Latin hystericus, from the Ancient Greek στερικός (husterikós) (a suffering in the uterus, hysterical), from στέρα (hustéra) (womb).  It’s from the same classical root that French gained hystérie and the long-archaic alternative English form is hysterick.  Now entirely obsolete as a medical term, hysteria is most often used as (1) a descriptor of someone behaving in an emotionally over-wrought way (with many feminist critics noting the loaded associations whether applied to men or women) or (2) in sociology and psychology (as mass hysteria) to describe a phenomenon that manifests as a collective illusion of fears in a whole or a sub-set of a population.  Like many terms that start with a non-silent h but have emphasis on their second syllable, some people precede hysteric with an, others with a.  Both practices are acceptable in modern English as long as use is consistent.  Hysteria & hystericalness are nouns, hysteric is a noun & adjective, hysterical is an adjective and hysterically is an adverb; the noun plural is hysterias, hysteriae or hysteriæ (the latter two rare even in the medical literature).  According to the trackers, the most common noun plural is hysterics.

Once exclusively female

For reasons both of linguistic and physiological determinism, until the nineteenth century it wasn’t possible for men to receive a diagnosis of hysteria, regardless of how hysterically they might have behaved.  Western medicine had long accepted the Ancient Greek belief hysteria was caused by a disturbance in the uterus and thus was exclusively a condition of women; an alternative description was uterine melancholy.  While drawn from the Greek hystera (uterus), the word is not ancient, the phrase in Greek medicine being hysterical suffocation.  The Greeks thought the uterus moved through the body, eventually strangling her and inducing disease, hence the tradition of centuries the disorder could exist only in women.  The mysterious tarassis was suggested as a name for male hysteria but is noted by only a few sources and then as either obscure or archaic although the Tarassis (male hysteria) mini-skirt is available from RedBubble as part number 31587934.

Jean Martin Charcot, Une leçon clinique à la Salpêtrière (A Clinical Lesson at the Salpêtrière, 1887), oil on canvas by André Brouillet (1857–1914), Paris Descartes University, Paris.

Jean-Martin Charcot (1825–1893) was a French neurologist and professor of anatomical pathology with a great interest in hysteria, most notably that exhibited by his patient Louise Augustine Gleizes (1861-1904), the woman who is the focus of this painting.  Professor Charcot was one of the seminal influences on early-modern neurology, psychology & psychiatry but his protocols for treating patients like Mademoiselle Gleizes would appal modern ethics committess.  First exhibited at the Salon of 1887 in the Louvre's Salon CarréBrouillet's painting however is one of the most famous in the history of neurology so there's that. 

Lindsay Lohan, hysteria scene, The Canyons (2013).  Professor Charcot would have known what to do.

Late in the nineteenth century, Sigmund Freud's (1856-1939) early work with diagnosed hysterics was important in his development of psychoanalytic therapy, one patient ever calling the treatment a "talking cure" and within the profession it’s still known as “talk therapy”.  It wasn’t until 1980 the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) withdrew the word.  In the first edition of the DSM (DSM–I (1952)) the condition was named “conversion reaction” while, in DSM–II (1968), it was grouped with dissociation disorder under the new diagnostic category of “hysterical neurosis” although, later, conversion disorder was conceptualised as a disorder of the brain associated with disordered emotions.  The transition to a system that classified psychiatric disorders by clinical phenomenology rather than aetiology resulted in the elimination of “hysterical neurosis” from DSM–III (1980), supplanted by “dissociation  disorders” and “conversion disorders” with the latter separated from the former and listed as a “somatoform disorder”. Thus, since 1980, somatoform disorders and the dissociative disorders have been separate categories in the DSM (the changes generally reflected in the World Health Organization’s (WHO) International Classification of Diseases (ICD)), the nomenclature progressing thus:

1952 DSM–I: Conversion reaction

1968 DSM–II: Hysterical neurosis (conversion type)

1980 DSM–III: Conversion disorder

1992 ICD–10: Dissociative (conversion) disorder

1994 DSM–IV: Conversion disorder

2013 DSM-5: No substantive changes, confirming symptoms once labeled under the broad umbrella of hysteria would fit under what is now referred to as somatic symptom disorder.

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