How did Freud change our understanding of hysteria?

Hysteria is a psychological disorder defined by historian Luckhurst as one which “is famed for the tormenting of the body by the troubled mind-as among the most pervasive human disorders; yet, at the same time, it is the most elusive. 1 And it is indeed this ‘elusiveness’ that has made the study of hysteria a subject of much popularity, particularly amongst many famous psychologists including: Sigmund Freud, Joseph Breuer and Jean Martin Charcot.

However, this essay will focus on the one man who is famed for being the “Father of Psychoanalysis”, and although his ideas were not entirely developed independently, they were truly compilations of ideas forged by the network of intellectuals during the late nineteenth century, yet Freud is the man we remember, the man who utterly transformed our perspective of hysteria and how we view it in today’s society.

In order to fully understand how Freud changed our understanding of hysteria this essay will look at the treatment of hysteria, in particular the famous case of Anna O, and his theories which were developed as a consequence of this study- some of which caused controversy, but all of which still very much alive today in the twenty-first century, whether they are credible or not.

To understand how Freud changed our understanding of hysteria, it must first be looked at how hysteria was originally viewed and treated, in order to fully highlight the changes Freud bought about.

1 Starting from the earliest recordings of the disorder, logged in Egyptian papyri circa 300 BC, intellectuals like Hippocrates and other ancient philosophers put a definition to the word ‘hysteria’.

Greek mythology stated that a “female’s uterus becomes displeased and displaced and therefore wanders through the female’s body, which then strangles her as it reaches her chest, supposedly causing the disease.

2 With such a myth being the origin of the term, (hysteria means “uterus” in Greek), it would not be hard to change ones understanding of it, however hysteria only really developed substantially from this at the beginning of the 18th century. Historian Rachel Maines believes that the history of hysteria can be followed back to during the Victorian era, in which women were deemed to be “an epitome of conservative human beings that are too vulnerable to any outside destruction thus they are kept safe”

3. They would have symptoms that included feeling faint, paranoia, severe lack of sleep, water retention, trouble controlling their breathing, loss of libido and appetite, and possibly an aggressive nature. Read about ath Body works marketing strategy

4 Hysteria then begins to evolve further into the nineteenth century where hysteria changes into a widespread disorder or a disorder for females as it was related with their removal of sexual intercourse. These myths and theories (as they were referred to) continued to exist until Freud and his studies came into existence and linked hysteria to psychological illnesses, which gave a much clearer perspective on the nature of the disease.

Moving onto how hysteria was treated, with the earliest methods of hysteria being dealt with based on the idea of the supposed cause, which was “sexual deprivation” of women. This led to various methods such as massaging the pelvic area, which required much time and attention from the medical practitioners. Treatments such as this one gradually developed and grew into much more modern gadget inventions, i. e. massage devices, commonly known in today’s modern society as the vibrator.

Historian Maines also discusses that among the ‘cures’ for hysteria (still focusing on genital stimulation) were that of manual massage and water propelled stimulator devices, along with steam powered devices, and electric powered devices. She then states that “spa therapies used jets of waters aimed as female’s genitals to induce spasm and crises followed by periods of lassitude and insensibility where the bath was one of the most famous treatments for hysteria during the early period.

5 Maine continues, claiming that the majority of the physicians found it very difficult in undertaking the monotonous task of massaging and that the mass of women patients could sometimes take up to three hours to reach an orgasm, which, at the time, was the main remedy for the disease.

As mentioned above, it wasn’t until the creation of a massage device, which rapidly reduced the time to reach “hysterical paroxysm”, a medical term for orgasm.

6 Historian Maines also mentions within her publication that during the turn of the mid nineteenth century, the ‘hydrotherapy device’ became available and was built in baths and many leading bathing resorts became famous in and around Europe and also in the USA.

7 Finally, during the late 1800’s, Maine also mentions the creation of an “AC-powered vibrator” during and the first “electromechanical vibrator”, which was first operated at an asylum in France as the main remedy for hysteria.

During the start of the second century, Galen, a famous physician wrote about the cause of hysteria to be sexual deprivation specifically in the case of overzealous women. This was based from the examination that hysteria was commonly found in virgins, nuns, and widows and only infrequently for married women. Due to this study, medical practitioners during the medieval and renaissance period prescribed the cure as intercourse- for married women, to get married for the single women, and finally the last resort would be to get a pelvic massage from a medical practitioner.

According to historians Regina Markell Morantz, and Sue Zachoche the most balanced explanation for the rate of the disease was linked with the stresses caused by the swift changes brought about by modern life, which therefore supposedly made women become more vulnerable to nervous disorders that resulted in faulty reproductive tracts.

9 In the turn of the twentieth century, the diagnosis of hysteria gradually became eradicated until it was virtually unrecognizable during the times we live in today. The psychological diagnosis of such a disorder has become evidently understood during the current times.

The present diagnosis of hysteria has become associated with symptoms such as anxiety neurosis, medical schizophrenia, and conversion disorder. When looking at how Freud changed our perceptions on hysteria we must look to his theories, and it was believed that Freud was inspired and developed the majority these theories after working closely with fellow psychologist Breuer, and it was these theories which would change how we viewed hysteria forever. The theories by Sigmund Freud were very much established on the works of Charcot and Breuer.

Historian Richard Webster argues that: “Freud was enormously overwhelmed by the work of Charcot on traumatic hysteria which took from it a concept that one of the major forms of neurosis came about when a traumatic experience led to development of unconscious symptom-formation. ” It was from this that Freud now started to expand this idea, and did so in part by indication to the work of a leading psychologist, Josef Breuer.

Freud was unusually immersed in the most unexpected of all his colleague’s patients, the renowned distinguished ‘Anna O. ‘ whom Breuer had instigated to treat in 1880.

10 Historian Webster continues and believes that the most famous case on ‘Anna O’ was accurately acknowledged as one of the most renowned examples of hysteria.

11 Within Webster’s work, the historian comments on how, “Anna O. was a twenty-one-year-old woman who had fallen ill while nursing her father who eventually died of a tubercular abscess. Her illness began with a severe cough. She subsequently developed a number of other physical symptoms, including paralysis of the extremities of the right side of her body, contractures, and disturbances of vision, hearing and language.

She also began to experience lapses of consciousness and hallucinations.

12″ It was indeed Breuer who diagnosed Anna O. ‘s sickness as a case of hysteria and steadily developed a form of therapy which he thought was successful in reducing her symptoms. Breuer then came to the conclusion that when he was able to induce her to recount to him, during the evenings, the content of her daytime hallucinations, she became peaceful and relaxed. Breuer then viewed this as a method of ‘disposing’ of the bad elements within Anna O. ‘s ‘bad inner-self’ and implicated it as a development of ’emotional catharses.

The patient, Anna O, defined her feelings as ‘chimney sweeping’, and as her ‘talking cure’”. Historian Webster then goes on to expand on this therapy. During one stage within Anna O’s illness, for what would be viewed as weeks, Anna O. refused to drink and would often quench her thirst with various fruits and peaches. On one occasion, in a state of self-induced hypnosis, she recounted an occasion in which she had been watching a dog, and then had been shocked and sickened by the sight of the animal drinking out of a wine-glass.

Soon after she had described such an event, in what appeared to be the cure of ‘talking’ she then asked for a drink of water, as she awoke from her hypnosis state with a glass held to her lips.

However, Breuer himself, decided to stop treating Anna O, when she fell in love with him and claimed to be carrying his child, this was viewed as a ‘hysterical pregnancy. ‘ Yet, after eleven years or so he, along with Freud published an account on the case. Breuer credited the tale which Anna O. had related in a trance as a true account of an event which had been the sole cause to her aversion of drinking.

Breuer stated that he had come up with a cure that would change the way in which a patient with hysteria was treated. This method was to recount the memory of the occasion which had initially led to it and bought about emotional catharsis by inducing the patient to communicate any emotions linked with it. Like Breuer had stated, it was the unexpected disappearance of one of Anna O. ‘s various symptoms and thus became the central foundation for what Breuer would later go on to describe as a ‘therapeutic technical procedure’.

Both Breuer and Freud stated that it was this method that had been applied methodically to the individual components of Anna’s symptoms and this led to the supposed breakthrough that she had been cured completely of her hysteria. However it was the importance of the case of Anna O, which played an essential role in the advanced progression of Freud’s thoughts. A lot of historians have credited this case to Freud, and often described Anna O as being the first psychoanalytic patient- a view which Freud himself did not take credit for: “If it is a merit to have brought psychoanalysis into being, that merit is not mine.

I had no share in its earliest beginnings. I was a student and working for my final examinations at the time when another Viennese physician, Dr Josef Breuer first (in 1880-2) made use of this procedure on a girl who was suffering from hysteria. ”

13 However, although Freud was humble enough to not accept credit for theories such as the ‘talking cure’, various historians believe that he should be fully accredited with successfully developing psychoanalysis and changing how we view hysteria in today’s society.

Such an example is historian Louis Breger in his work, states that that “Sigmund Freud was considered to have contemplated the definitive study on the psyche of hysterics where it was manifested in his observations of Anna O, his writing and lecturers are numerous on the topic which was his fascination with the topic of nervous disease lead to the idea of the “talking cure”, better known as his development of psychoanalysis”

14 With the revolutionary idea of merely talking to a patient, Breuer and Freud changed the face of hysteria; patients could now seek help without being classified as ‘mental’, and the stigma of approaching what we now call therapists has been removed. This argument continues, and can be seen to be entirely justified as Freud, however, was clearly understating his own role which he had played so successfully.

Webster further supports this argument and that Freud changed our understanding of hysteria by stating that: “Psychoanalysis would never have come into being if he had not transformed Breuer’s ‘talking cure’ by marrying it with Charcot’s views on traumatic hysteria and his own elaborate technique for reconstructing repressed memories through interpretation and free-association. ”

15 The publication itself by Breuer and Freud, “Studies on Hysteria”, was a book that explained their theories, which showed consistency to the fact that every case of hysteria was caused by a traumatic experience, and this experience is a memory that the patient is not capable of remembering, or understanding. Emotions or symptoms caused by the traumatic event are displayed in fragile, weak or unclear ways. As soon as the patient is made aware and understands the causes behind their symptoms, their symptoms will begin to disappear.

In simple terms, the emotions are trapped and repressed in the unconscious to the point where the patient needs to vent, and due to this they begin to display many different physical symptoms, with an unidentified mental cause. Once the patient’s emotions have finally been expressed consciously by acknowledging the alleged cause, the emotions may be released safely, and their symptoms will begin to disappear. It was soon after the publication of “Studies on Hysteria”, that Breuer and Freud had a gracious falling out. This led leading psychologist Breuer to follow a different path and he began to concentrate his studies more on physical medicine, and taking up the position as an internist, whilst Freud began to further develop the ideas of hysteria and hypnosis.

16 Freud began to study and theorize that of the libido, and began to think that it was answerable for all studies of hysteria as the primary cause. This would then lead to some of his most controversial theories. It appeared to be the case that based on Freudian belief that everything, good or bad, was the consequence of sexual repression. To say the least, this was considered extremely unorthodox for possessing such an idea in such a closed-off society during this time period. Freud set the theory in place that everyone was living in a sexually consumed world, however leading psychologists at the time Charcot and Breuer refused to acknowledge this within society.

It would therefore appear that Freud seemed to be the only one who believed in his theory at the time. In modern society it is more broadly accepted, but definitely not completely accepted. According to historian John McComber, Sigmund Freud, the considered father of Psychology provided for the “Etiology of Hysteria” in his famous “seduction theory” which asserted that child sexual abuse was the single cause of adult hysteria. Historian McComber then further argues that the failure of Freud to persuade his audience can be attributed not only of their rejection of sexual abuse but also to his failure to explain how psychoanalysis could comport with conventional models of medical authority.

Historian Douglas Davis’ article explains Freud’s ‘Seduction theory’ stating that the disagreement viewed by Freud on the etiology of hysteria began as a post pubertal result of having played a passive role in childhood sexual episodes, while obsession-compulsion suggested that the child had been stimulated to active arousal by childhood seduction therefore affirming that hysteria resulted in that of “presexual shock” while obsession neurosis is the result of a presexual sexual pleasure.

17 Sigmund Freud acknowledges that past experiences were a cause of the psychological disorder to evolve into hysteria. He believed that the disorder is the psychological manifestation of the past sexual experience throughout the patient’s childhood, which can therefore be related to sexual abuse. As mentioned previously, that sexual deficiency or the incapability to reach the peak of orgasm during sexual intercourse was seen as prime physical cause of hysteria.

However, it was the failure of the ‘Seduction theory’ Freud had championed at the start of 1900’s that Freud’s new theory of infantile sexuality was to materialize. The urges, fantasies and differences that Freud claimed to have exposed underneath the neurotic symptoms of his patients stemmed not from external contamination, he now understood, but from the psyche of the child itself.

18 However, there were some serious negative costs of this move in thought. The most apparent negative consequence was that of a restricted interpretation of Freud’s theory of infantile sexuality which would begin a chain of therapists and other psychologists to deny any reports of any sexual abuse as a fantasy.

However, Freud can be seen to have changed our understanding of hysteria, as without the rejection of the ‘Seduction Theory’ and other ideas such as the unconscious, suppressions, therepetition compulsion, transference and conflict, and the unfolding psychosexual stages of childhood, these concepts would never have been known or added to human knowledge.

19 Yet, as mentioned earlier, it was not Freud who changed our understanding of hysteria by himself alone, in fact, quite the contrary. Paul Briquet, a leading psychologist of his time introduced an extremely important concept into his work, “Traiti?? de l’Hysti??rie” that was published in 1859.

Briquet defined hysteria as a “Neurosis of the Brain” in which an assortment of unbecoming environmental events acted upon the “affective part of the brain” in a vulnerable and inclined individual. He reasoned that the brain had to be the “seat of hysteria” because it was the main route of the numerous manifestations of the condition. In the midst of his various other noteworthy contributions, Briquet’s study finally laid to rest hysteria’s historic association with physical disease of the female genitalia.

20 To conclude, Hysteria today is known as “conversion disorder”. The term “conversion” disorder has its origins in Freud’s theory that anxiety is “converted” into physical symptoms. The fact that hysteria has been renamed after Freud shows his huge impact of making sense of the disorder.

It is treated in today’s society with a number of different methods, such as physiotherapy, occupational therapy, treatment of depression and anxiety, and of course, the ‘talking cure’ and hypnosis, both treatments heavily credited to Freud. Freud has changed our understanding of hysteria as we see in Freud’s theories a inherent extension of the psychiatric project and of psychiatric influence. In the start of the 1890s, such symbolic explanations could be linked to the paralytic symptoms and introverted traumas of the hysteric. By the start of the twentieth century, it can be said that everyone was viewed as having a repressed unconscious memory of infantile sexual life, and that everyone was constantly exhibiting this in their dreams, jokes, and conversations. Therefore psychoanalysis can be viewed as a method for making everybody the subject of psychiatry.

Freud attributed the rehabilitation of hysteria as a topic for scientific study, and he changed hysteria by not only revolutionizing the way in which patients were treated, and bringing new medical terms to our vocabulary, but when he made us realized that each and every single one of us has a repressed unconscious life, and therefore everyone is susceptible to hysteria and each one of us is supposedly in need of psychoanalytic treatment. Freud was an outstanding observer of the human condition, and enough of what he said has importance today that he will be a part of personality articles and books for years and years to come. Even when the inevitable happens and theorists come up with noticeably diverse ideas about how we work, they contrast their ideas with that of Freud’s.