Hysteria is a term used to mean ungovernable emotional excess and can refer to a temporary state of mind or emotion.[1] In the nineteenth century, female hysteria was considered a diagnosable physical illness in women. It is assumed that the basis for diagnosis operated under the belief that women are predisposed to mental and behavioral conditions; an interpretation of sex-related differences in stress responses.[2] In the twentieth century, it shifted to being considered a mental illness.[3] Many influential people such as Sigmund Freud and Jean-Martin Charcot dedicated research to hysteria patients.[4]
Currently, most physicians do not accept hysteria as a medical diagnosis.[5] The blanket diagnosis of hysteria has been fragmented into myriad medical categories such as epilepsy, histrionic personality disorder, conversion disorders, dissociative disorders, or other medical conditions.[5][6] Furthermore, lifestyle choices, such as choosing not to wed, are no longer considered symptoms of psychological disorders such as hysteria.[5]
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However, during the sixteenth and seventeenth centuries activists and scholars worked to change the perception of hysteria back to a medical condition. Particularly, French physician Charles Le Pois insisted that hysteria was a malady of the brain. In addition, in 1697, English physician Thomas Sydenham theorized that hysteria was an emotional condition, instead of a physical condition. Many physicians followed Lepois and Sydenham's lead and hysteria became disassociated with the soul and the womb. During this time period, science started to focalize hysteria in the central nervous system. As doctors developed a greater understanding of the human nervous system, the neurological model of hysteria was created, which further propelled the conception of hysteria as a mental disorder.[4][11] Joseph Raulin published a work in 1748, associating hysteria with the air quality in cities, he suggested that men and women could both have hysteria, women would be more likely to have it due to laziness.[7][12]
In 1859 Paul Briquet defined hysteria as a chronic syndrome manifesting in many unexplained symptoms throughout the body's organ systems.[13] What Briquet described became known as Briquet's syndrome, or Somatization disorders, in 1971.[14] Over a ten-year period, Briquet conducted 430 case studies of patients with hysteria.[13] Following Briquet, Jean-Martin Charcot studied women in an asylum in France and used hypnosis as treatment.[4] Charcot detailed the intricacies of hysteria, understanding it as being caused by patriarchy.[8][12] He also mentored Pierre Janet, another French psychologist, who studied five of hysteria's symptoms (anaesthesia, amnesia, abulia, motor control diseases, and character change) in depth and proposed that hysteria symptoms occurred due to a lapse in consciousness.[15] Both Charcot and Janet inspired Freud's work. Freud theorized hysteria stemmed from childhood sexual abuse or repression. Briquet, Freud and Charcot noted male hysteria; both genders could exhibit the syndrome. Hysterics may be able to manipulate their caretakers thus complicating treatment.[7][8]
L.E. Emerson was a Freudian who worked at the Boston Psychopathic Hospital and saw hysteric patients. Investigating the files, Elizabeth Lunbeck found that most of hysteric patients at this hospital, were typically single, either being young or purposefully avoiding men due to past sexual abuse. Emerson published case studies on his patients and was interested in the stories they told, relating their stories to sex and their inner sexual conflicts. Emerson stated that their hysteria, which ranged from self-harm to immense guilt for what happened, was due to the patients' traumas or a lack of sexual knowledge, to which he stated that they were sexually repressed.[16]
In the late nineteenth century, French neurologist Jean-Martin Charcot tackled what he referred to as "the great neurosis" or hysteria.[25] Charcot theorized that hysteria was a hereditary, physiological disorder.[25] He believed hysteria impaired areas of the brain which provoked the physical symptoms displayed in each patient.[25] While Charcot believed hysteria was hereditary, he also thought that environmental factors such as stress could trigger hysteria in an individual.[26]
Charcot published more than 120 case studies of patients who he diagnosed with hysteria, including Marie Wittman.[27] Whittman was referred to as the "Queen of Hysterics", and remains the most famous patient of hysteria.[27] To treat his patients, Charcot used hypnosis, which he determined was successful only when used on hysterics.[27] Using patients as props, Charcot executed dramatic public demonstrations of hysterical patients and his cures for hysteria, which many suggest produced the hysterical phenomenon.[27] Furthermore, Charcot noted similarities between demon possession and hysteria, and thus, he concluded "demonomania" was a form of hysteria.[4]
In 1896 Sigmund Freud, an Austrian neurologist, published "The Aetiology of Hysteria".[28] The paper explains how Freud believes his female patients' neurosis, which he labels hysteria, resulted from sexual abuse as children.[28] Freud named the concept of physical symptoms resulting from childhood trauma: hysterical conversion.[28] Freud hypothesized that in order to cure hysteria the patient must relive the experiences through imagination in the most vivid form while under light hypnosis.[28] However, Freud later changed his theory.[28] His new theory claimed that his patients imagined the instances of sexual abuse, which were instead repressed childhood fantasies.[28] By 1905, Freud retracted the theory of hysteria resulting from repressed childhood fantasies. Freud was also one of the first noted psychiatrists to attribute hysteria to men.[7] He diagnosed himself with hysteria, writing that he feared his work had exacerbated his condition.[7]
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Jean-Martin Charcot started his main work on hysteria around 1870, until his death in 1893. Dsir Bourneville had triggered Charcot's interest in hysteria during his stay as an interne in his department, while Charles Richet's 1875 article on somnambulism was the trigger for Charcot to develop hypnotism. Charcot's collaborators Paul Richer, Georges Gilles de la Tourette, Paul Sollier, Joseph Babinski, Sigmund Freud and Pierre Janet subsequently became most famous in hysteria. In 1908, a "quarrel of hysteria" opposed several of Charcot's pupils, from which Babinski, who had developed the concept of "pithiatism", was considered victorious against Charcot's first successor Fulgence Raymond. There was a surge of interest in hysteria associated with war psycho-neuroses in 1914-1918, and Babinski's pupil Clovis Vincent developed a treatment called torpillage (torpedoing) against war hysteria, associating painful galvanic current discharges with "persuasion". After World War I, the neurological and psychiatric interest in hysteria again faded away, before a renewed interest at the turn of the last century. Contrary to a common view, the modernity of several of Charcot's concepts in hysteria is remarkable, still today, mainly for: (1) his traumatic theory, which encompassed psychological and certain sexual factors several years before Freud; (2) his personal evolution towards the role of emotional factors, which opened the way to Janet and Freud; (3) his claim of specific differences vs. similarities in mental states such as hypnotism, hysteria, and simulation, which has recently been confirmed by functional imaging; and (4) his "dynamic lesion" theory, which now correlates well with recently established neurophysiological mechanisms.
Purpose of review: Instances of mass psychogenic response have occurred throughout history, and across population groups; however, the present-day threat of terrorism and biological warfare is expected to enhance societal vulnerability to epidemics of such events. This paper provides a brief review of the current state of knowledge regarding the conceptualization, diagnosis, and management of mass psychogenic response.
Recent findings: Various terms are nowadays used to denote mass hysteria, such as 'mass psychogenic illness' and 'mass sociogenic illness'. Recent studies investigating personality types predisposed to mass hysteric reactions are inconclusive with a range of results found. Cognitive models of this condition have been effective in promoting empowerment and adaptation among vulnerable individuals. The actions of governments, medical communities, and the media are pivotal in the management of mass hysteria.
Summary: The diagnosis of mass hysteria remains contentious, and the mechanisms underlying its perpetuation are similarly ambiguous. The prevalence of 'threat' within the modern sociocultural climate is likely to increase the incidence of the condition, and this could result in serious implications for health services. A holistic approach entailing the collaboration of various public sectors performing a range of preventive activities will be required to contain future mass psychogenic reactions.
Maria is an insatiably curious soul, particularly fascinated by the mysterious workings of the human brain, medical history, and our relationship with our own bodies, both during and after life. Before joining Medical News Today, Maria worked as a teacher, academic ambassador, and a freelance writer and copy editor. Recently, she finished a Ph.D. in English at the University of Warwick in the U.K. In her spare time, she learns Japanese, occasionally practices taxidermy, and spreads her infectious love of invertebrates. 152ee80cbc
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