In the 19th century, hysteria was a common diagnosis, describing a condition in which psychological problems were transformed into dramatic physical symptoms. Doctors still study these curious and debilitating effects.
The ancient Greeks thought that the womb was a free-floating organ that could move around the body, creating problems – any mysterious ailments in women were therefore ascribed to ‘hysteria. ‘Although the notion of a wandering womb disappeared, that of hysteria did not. In the 19th century, the condition was held responsible for a host of symptoms in women, including emotional fits, numbness, weakness, sensory dysfunction, and fainting.
A Parisian neurologist, Jean-Martin Charcot, studied hundreds of ‘hysterical’ patients and described how they went through four phases: physical rigidity, muscular spasms, emotional outbursts, and delirium. He discovered that he could induce these states in some of his patients and held demonstrations in which women were taken through the phases and then miraculously cured. Sigmund Freud was fascinated by Charcot’s work, and hysteria became central to his theory of psychoanalysis. He concluded that hysteria was caused by repressed sexual desires and conflicts that were converted into physical symptoms.
Hysteria Today-Conversion Disorder
The term hysteria is rarely used by doctors now; ·in everyday· usage, it usually just means a display of dramatic emotion. However, the 19th-century idea lives on in a set of conditions known as conversion disorders. These are no longer thought to be primarily sexual in origin or limited to women, but Freud’s basic idea – of physical symptoms caused by. Unconscious conflict or pain – remains fundamental.
Conversion disorder is defined as the appearance of symptoms, usually affecting movement or the senses, which cannot be explained by physical disease and are judged to be associated with some psychological stress. Patients have no conscious control over the symptoms and are usually unaware of the underlying cause. In severe cases, symptoms may include paralysis, blindness, deafness, and hallucinations. More often, though, they are vague and can include dizziness, lack of balance or coordination, headaches, nausea, tics and tremors, and numbness. Conversation symptoms often overlap with another state called derealisation – the sensation that the world is distant, unreal, or shifting. Depersonalization – a feeling of watching oneself from outside- is also common.
Female conversion disorder patients outnumber males by two to one, and the condition seems mainly to affect young people who are naive about the way their bodies work. The symptoms often mimic popular ideas of how a disease might manifest itself. For example, a patient complaining of chest pain may be unconsciously terrified of lung cancer; however, in real lung cancer cases, chest pains do not appear until the disease is far advanced, usually after a host of other symptoms.
Root Causes
The symptoms of conversion disorder are not imagined; they occur because the brain functions abnormally. In a brain scan of a woman who was unable to move her left leg, the brain area that plans action became active, showing that she intended to move, but this instruction was not transmitted to the neighboring motor cortex, which tells the muscles to move.
Dissociation- A Protection Mechanism
Some symptoms of conversion disorder – the modern term for hysteria – may be caused by the ‘dissociation’ of one part of the brain from another. This type of brain dysfunction is similar to that seen in extreme emotional trauma, when people may ‘cut off’ the conscious parts of the brain from the parts sensing the outside world. The traumatic event is thus not consciously experienced, and memories of it cannot be recalled in the normal way. They may, however, be triggered in the form of a ‘body memory’ – a replay of the physical sensations that were present in the trauma. The replay of such memories is thought to account for many cases of conversion disorder.
Dissociation probably evolved as a survival mechanism – by cutting out damaging sensations, it leaves the rational part of the brain free to work out a response. And when there is nothing to be done, it produces a dreamy, passive state that would be more useful than panicking. Women and children dissociate into this passive state earlier in the course of trauma than men. Men also dissociate from pain and emotion but act aggressively before becoming passive. Dissociation can thus be useful in extreme situations, protecting the individual from damage.
A Case Of Hysterical Blindness
Hannah was 22 when she experienced blindness following a family tragedy. ‘We have a stream running through our farm where the children liked to play. It was quite safe because, usually, the water was only a foot deep. I used to leave the children there while I took my husband his lunch.
‘Last autumn, we had a downpour one night, and the next day, I saw that the water had risen to about three feet. I left the two older children – aged three and five – on the bank as usual but told them not to go in the water. Then I went with the baby to see my husband. When I returned a few minutes later, the children were nowhere to be seen. I walked back along the bank, then I looked down and saw their bodies in the water. I remember dropping the baby and plunging in-then it all went black.
‘When I came around the next day, everything was still black. I thought my eyes were bandaged and tried to drag the bandage off, but there wasn’t one. I had gone blind.
‘I don’t remember how long it lasted. In the hospital, the doctors kept telling me that it was just a “nervous shock.” Over the next few weeks, I started doing things again, slowly. But one day, I was with my husband, and I said, without thinking, “Pass me that cup,” and I realized that I had seen it.
