Hysteria in the Late Nineteenth-Century
The National Institute of Health clearly ascribes hysteria as the “first mental disorder attributable to women, accurately described in the second millennium BC, and until Freud considered an exclusively female disease (“Women and Hysteria”). However, in some cases men were diagnosed with hysteria. It was not until the 1980 DSM-III that the diagnosis of hysteria is deleted from the psychiatric canon (“Women and Hysteria”). Historically, there was a “magic-demonological” view of women associated with the disease in which a woman was presumed weak, easily influenced, or “somehow ‘guilty’ (of sinning or not procreating)” and this led to a culture-bound diagnosis in which the understanding of the suffering a woman was going through was perceived through the lens of gender (“Women and Hysteria”). In the nineteenth and twentieth centuries, hysteria gradually came to be understood as that which both women and men were susceptible until, eventually, the diagnosis dropped out of the population in Western societies (“Women and Hysteria”). Hysteria as a diagnosis has been with us since 1900 BC Egypt, ancient Greece, Rome, the Middle Ages, the Renaissance, to the modern world. Treatments of both sexual abstinence as well as sexual gratification have been proscribed (“Women and Hysteria”). One continuum through the discourse of a female ailment is that it was sexualized and this gives weight to what feminist have understood as the long standing patriarchal order mobilizing society towards men’s views, however rash or exploitative. Hysteria in the nineteenth century demonstrated cultural conditions in which men in power withheld that power from women to maintain their own authority and through this diagnosis, genuine medical conditions – perhaps realized under the very weight of maxims in a sexist society – were given as natural to a womanly condition, which was not understood or empathized with.
As this short video on the history of hysteria demonstrates, the diagnosis of hysteria is about men trying to control women:
In this short video interview with Big Think, Rachel Maines, author of The Technology of Orgasm: “Hysteria,” the Vibrator, and Women’s Sexual Satisfaction (Johns Hopkins Studies in the History of Technology), claims that in the nineteenth century it was believed that ¾ of all women suffered from some type of hysteria, which ultimately, Maines puts forward was the diagnosis placed around sexual frustration:
Maines also states that in the nineteenth century, doctors write about the classical treatment of making a woman achieve orgasm as a “good source of revenue” as since they were not sick, they would actually be healed and they would be back for further treatments. Maines states that three things helped to bring change away from this type of treatment: Freud’s reinterpretation of hysteria, early sexology, and the vibrator appearing in early pornography which brought what doctors were doing to a state of admission. Hysteria was “a catch-all diagnosis for a slew of vexing lady problems that dates back a couple millennia—included fainting, anxiety, sleeplessness, irritability, nervousness and ‘a tendency to cause trouble for others’” (Dusenbery). Still, it is important to remember that the diagnosis of hysteria was not exclusively the annunciation of sexual frustration. There was the very real conflation of serious disorders women suffered and because they were women, their conditions were sexualized. Let’s consider the case of Louise Augustine Gleizes, just a young teenager, and note the titles of the photographs taken of her in various states.
The girl in the picture above, just one of many circulated photos of her denoting hysteria in the late-nineteenth century, is Louise Augustine Gleizes, a patient of French neurologist Jean-Martin Charcot. Charcot started as an intern at Salpêtrière and was made “Chef de Clinique” in 1853 (Jean-Martin Charcot).
Augustine was subject to the culture of sexism in medical treatment, rather than advanced medicine. Augustine had just turned fourteen when she entered Salpêtrière, which only occurred after some stay at L’Hôpital des Enfants-Malades for suffering convulsive attacks and paralysis (Hustvedt 148). Jean-Martin Charcot was a prominent neurologist, admired by many physicians, including a young Freud. Hustvedt notes the diagnosis and treatment for hysteria, at this time, came before Freud’s concept of the unconscious, which no doubt would have altered the nature of diagnosis and treatment (5-6). Hysteria was a condition that women were subject to because of the worldview of men in privileged positions imposing their power and influence.
This photograph is titled: “Hystero-Epilepsy: Normal State”
“Onset of the Attack: Cry”
“Onset of the Attack: Cry”
“Contraction”
“Passionate Attitudes: Auditory Hallucinations”
“Passionate Attitudes: Amorous Supplication”
“Passionate Attitudes: Menace”
“Passionate Attitudes: Mockery”
Pages 166-184 of Asti Hustvedt’s Medical Muses offer a photo essay of Augustine. The portrayal of Augustine in these photographs suggests far more about those witnessing her condition than they do about Augustine. When Augustine entered the hospital, even at such young an age she had already suffered a great deal. Her parents worked for a man referred to as Mr. C (Hustvedt 151). At the age of thirteen Augustine left school to live with Mr. C in Paris where she was suppose to learn music and sewing but instead was subject to Mr. C’s harsh sexual advances. The more she refused to more demanding Mr. C became, even attempting to force her to move into his room and sleep in his bed (Hustvedt 151-152). It is reasonable to assume that the harsh reality of misogyny and predation has some influence over the very real manifestation of symptoms that led to a diagnosis that no longer exists: hysteria.
Hysteria was more than just a simple disease, Laura Briggs writes. It was “the way nineteenth-century U.S. and European cultures made sense of women’s changing roles” such as “their increasing participation in a (rapidly changing) public sphere, paid employment, and declining fertility” (246). It is interesting to emphasize that Briggs, like other scholars, represents hysteria as a condition imposed on white women. There were racial elements to this diagnosis. Briggs also points out that it was a condition that middle class white women were subject to as lower class white women and women of color were understood to not be subject to the consequences of “overcivilization” (Briggs 246). However, Augustine and the other women profiled in Asti Hustvedt’s book, Medical Muses: Hysteria in Ninteenth-Century Paris, were poor, lower class women and girls (Hustvedt 4). The three women profiled in this book “lived at a time when women were exclusively defined through their relations with men. Fatherless, unmarried, and poor, these three women found themselves in a world that had little use for them” (Hustvedt 4). One has to make the conclusion that hysteria was forced upon women of all classes, as “overcivilization” for middle class women and by association an extension of that subversive criminality for lower class women.
For some of these women, had they been subject to the same conditions today, they would be diagnosed with schizophrenia, conversion disorder, or bipolar disorder, or perhaps, never would have become ill at all (Hustvedt 5). Even if Augustine was stricken with one of these conditions, her gender in nineteenth-century France condemned her to a diagnosis even before her symptoms were observed. It was observed before the onset of her symptoms that “Everything about her […] announced the hysteric. The care that she takes with her toilette; the styling of her hair, the ribbons she likes to adorn herself with” (Hustvedt 169). Though medical tests followed, she was clearly condemned from the initial proceedings based on her gender and the ideas imposed on her gender.
The misogyny in the classification of hysteria is further evident in how physicians interacted with the condition the patient was subject to. Charcot classified something called hysterogenic zones. It is through interacting with these zones that it can be said the patient is suffering from hysteria and not other condition such as epilepsy.
The image above, a drawing by Paul Richer from 1881, shows the believed hysterogenic zones (Hustvedt 51). It was understood by Charcot when in the midst of a bout of aggressive symptoms, the doctor could apply pressure to one of these zones and if the symptoms ceased that the correct diagnosis was hysteria as someone with epilepsy would not respond to such stimulation (Hustvedt 173). Freud carried on the idea of hysterogenic zones. He discusses in Studies on Hysteria that when pressing on these zones, if the patient feels pleasure instead of pain, then “it could only be reconciled with the view that her disorder was hysterical, and that the stimulation had touched upon a hysterogenic zone (Breuer and Freud 79). Augustine’s young age, still just fourteen, did not prevent Charcot from sexualizing her. She was subject to sexual violence twice, first from Mr. C then by her doctors.
Jan Goldstein studied the occurrences of the diagnosis of hysteria at Salpêtrière in Paris. From 1841-1842, with 648 women admitted to the hospital, only 1% received the diagnosis of hysteria. From 1882-1883, with 500 women admitted, 17.8% were diagnosed with hysteria (Goldstein 209). If, Goldstein continues, “these admissions figures are corrected as to exclude the senile and the idiots and imbeciles (who also found their way to this house of refuge) and to leave only a bona-fide mentally ill population, the proportion of hysterics rises to an even more imposing 20.5 percent” (209). One in five women were subject to the male-imposed gendered diagnosis of hysteria that was as much cultural as it was medical. It is important to note that these women were forced to live their lives in a society permeated with misogynistic treatment of women and the perceived understanding of women’s place in society, only to be victimized again when they were at there most vulnerable state, ill and in the hospital.
Towards the end of the nineteenth century, Dr. Richard Maurice Bucke serviced as Medical Superintendent at the London Asylum for the Insane. A leader in gynecology, Bucke “adopted the popular Victorian idea that the female reproductive organs were connected to emotional and physical well-being, and were thus the most likely cause of mental illness” (“The Hysterical Female”). In the nineteenth century U.S. it was also “commonly believed that most physical ailments of women were caused by their sexual organs or mental disorders, resulting in painful, sometimes lethal treatments” (Women’s Health Care). Horrifically, these theories led to advances in women’s health care. The ideology of domesticity was brutal and woman who “rebelled against Victorian domesticity risked being declared insane” (“Women and Psychiatry”). The Victorian era was dominated by patriarchal power-holds, which forced women to succumb to this diagnosis. Just like any expression of control and abuse, the abuser claims that the reason one resists is the reason for their behavior and with this behavior being culturally and socially proscribed, there was virtually no escape for women who were labeled with this diagnosis.
Hysteria is been thought of as the greatest of disorders with have historically risen in prominence only to disappear. Fulgence Raymond, in 1907, referred to the late nineteenth century as hysteria’s “heroic period” (Micale 497). Mark S. Micale writes in “On the ‘Disappearance’ of Hysteria” that the symptomology associated with hysteria in both Charcot’s writings as well as in Freud’s and Breuer’s Studies on Hysteria “are regarded today as extreme rarities” (498). In fact, medical journals in the mid-twentieth century commonly noted its demise (Micale 498). Micale offers an interesting thought. He proclaims “the disappearance of hysteria is the result of de-Victorianization” (499). While globally, women’s liberation has yet to be realized, in the West, women are more involved in gender neutral roles as well as men’s roles and it could be argued that such has led to be a decrease of the diagnosis in the West and, furthermore, would subsume the blame of the diagnosis on women’s roles in society under the weight and pressures of male dominance. To put it succinctly, dominance of the other is bad for their health.
The diagnosis and presumed need for need for treatment by Freud of Dora makes this evident. Dora’s father took her to Freud after he found a suicide note. Dora so-called hysterical symptoms included “nervous cough, loss of voice, migraine, depression, and what Freud calls ‘hysterical unsociability’” (Moi 181). What is interesting is that Freud admitted that his treatment of Dora was not only not a success but also that she was “being used as a pawn between her father and Herr K., the husband of father’s mistress” (Moi 182). The idea was that if Dora’s father has access to his mistress that her husband would be granted access to Dora. She was only eighteen. Freud engages in the patriarchal dynamics through his attempt to treat Dora. As Toril Moi states, through his attempt to help Dora, he is an “authoritarian, a willing participant in the male power game conducted between Dora’s father and Herr K., and at no time turns to consider Dora’s own experience of the events” (182). In the face of so much evidence of what is the heart of the problem, Freud still thinks she is in need of a cure, which he cannot offer her. This is a testament to the severity of male domination and the coercing of women’s forced subjection that even in a case such as this the doctor sees a need to go along with the assumptions and not look at the facts.
Domoniac. Sketch by Rubens in Désiré-Magloire Bourneville and Paul Regnard. 1877.
Hysteria is featured prominently in popular culture, literature, and paintings. Among the most well-known works from the United States was Charlotte Perkins Gilman’s The Yellow Wallpaper.
Gillman was prescribed the resting cure to deal with her diagnosis and in response she wrote the short story. In an October 1913 issue of The Forerunner she published “Why I Wrote The Yellow Wallpaper.” In that she states that she suffered from nervous breakdowns for years and that she was ordered not to write. Again, we see the diagnosis of being “over-civilized.” In the short story the protagonist must confront the suppression of her inner emotions not just from her doctor but from her husband as well until she is completely outside of herself. In her article “On Hysterical Narrative,” Elaine Showalter writes that “hysterical narratives [have] become the waste-basket term of literary criticism […] taken as a synonym for women’s writing and the woman’s novel” (24). Indeed, Roy Porter writes in the forward to Nerves and Narratives: A Cultural History of Hysteria in 19th Century British Prose that “the history of medicine has finally ceased to limit itself to the biographies of great doctors and has addressed itself to the wider social and cultural history of health and sickness, ideas whose ramifications spread far beyond medicine proper” (xi). It is worth considering that quote in light of what it discussed here are about the disappearance of hysteria. We can consider The Yellow Wallpaper as a calling out to be freed from the chains of patriarchy and as such finding relief. Relief in doing the creative work of self-expression, which to that point, had previously predominantly been a man’s role. With self-expression and social exploration of that role, we see the parallel of the vanishing of the diagnosis.
The above engraving is the “representation of religious ecstasy as a pathological sign” from Paul Regnard, 1887. This again, is from Salpêtrière. These women were exploited as a medical curiosity within the full range of human experiences and emotions. Sander L. Gilman considers Regnard’s work evidence of the “warfare between theology and science” that is occurring “within secularized nineteenth century psychopathology” (374). What is either real suffering of what today would be associated with bipolar or schizophrenia is contrasted with the image below of a witch.
Also from 1887, Regnard used this Abraham Palingh image is evidence of maddening spirits. The eclipse between science and superstition is not a rational divide as can be seen in Regnard’s projection of spirituality and madness. This is the same as with Freud’s treatment of Dora. It is also the same as physicians considering women’s sexual frustrations to be in the same arena as very serious maladies.
The above Regnard image is clearly Louise Augustine Gleizes. Not only once was her image represented in the image of power holding men, but here that image is recreated in the imagination of a man who relegates her to a curiosity and at the same time bewitched. Again, demonstrating incongruity, here is an image depicting what is in fact religious “cure” occurring for hysteria.
This is from Louis Basile Carré de Montgeron and is from 1745-47. It is worth considering what photography in the nineteenth century did for scientific thought and how that thought permeated both the sciences and humanities. There may have been real consequences felt by women receiving the diagnosis. The late nineteenth century is when photography began to become common and also when we see the great increase in diagnosis of hysteria. Does this give us a window into what they were thinking? Where they only looking on the surface, like a photograph?
Clearly, there are “complex social relations that undergirded [the] diagnosis” of hysteria (Guenther 479). We see in the diagnosis and dismantling of Augustine’s character and being the sexualization and gendering of an ailment that would have best been served by, interestingly, some form of social services and intervention. The same can be said of Dora. Charcot is hailed from separating symptoms associated with hysteria from other conditions such as epilepsy (Guenther 478). Freud took that a step further to see what he considered to be unseen and diagnosis deeper psychological trauma as resulting in the surfacing of hysterical symptomology. Both Freud and Charcot neglected these women’s social circumstances in their attempt to construct “the pathological anatomical model” as well as the invisible psychiatric model (Guenther 478). In their quest to proscribe expertise on a long vexing medical mystery, men such as these projected gender standards and divisions of their time to enforce women’s perceived roles in society. It has been noted that there is a parallel between when these divisions of roles began to deteriorate so did the diagnosis. Thus, we can offer Mark S. Micale’s “de-Victorianization” hypothesis (499). Changing societal roles and standards brought changes in diagnoses and manifestation of symptoms. As such, the diagnosis slowly disappeared. What we can learn from this change in medical standards and the parallel in societal changes is that we must consider the intersection of the slow drum of enforced social convention and how medical manifestations are present in our lives. There is a connection and we are best served to cross-diagnose.
Bibliography
“A Short History of Hysteria.” YouTube, uploaded by Victorian Trades Hall. 13 Jul 2016. https://www.youtube.com/watch?v=Nomw5fdlvno
Bernheimer, Charles, and Claire Kahane, eds. In Dora’s Case: Freud-Hysteria-Feminism. New York: Columbia University Press, 1990.
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“What was ‘Female Hysteria,’ Really?” YouTube, uploaded by Big Think. 23 Apr 2012. https://www.youtube.com/watch?v=8-CcnAzt0ZI
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Images Cited
Image 1. Augustine. Dusenbery, Maya. “Timeline: Female Hysteria and the Sex Toys Used to Treat It.” Mother Jones. Jun 1 2012. Web. Nov 5 2016.
Image 2. Charcot. “Jean-Martin Charcot: The Father of Neurology.” National Institute of Health. Web 9 Mar 2011. 20 Nov 2016.
Images 3-10. Hustvedt, Asti. Medical Muses: Hysteria in Nineteen-Century Paris. New York: W. W. Norton & Company, 2011.
Image 11. Wellcome Images. André Brouillet, A Clinical Lesson at the Salpêtrière (1887).
Image 12. Hustvedt, Asti. Medical Muses: Hysteria in Nineteen-Century Paris. New York: W. W. Norton & Company, 2011.
Image 13: Sigmund Freud. “Sigmund Freud, Dora: An Analysis of a Case of Hysteria.” The University of British Colombia. Web 20 Nov 2016.
Image 14. “Words have Meanings: Hysteria.” Screaming in All Caps: Another Feminist Response to Pop Culture.” Web 20 Nov 2016.
Image 15. Hustvedt, Asti. Medical Muses: Hysteria in Nineteen-Century Paris. New York: W. W. Norton & Company, 2011.
Image 16. Charlotte Perkins Gilman. “The Evolution of Charlotte Perkins Gilman.” Radcliff Magazine. Harvard University. Web. 20 Nov 2016.
Images 17-20. Paul Regnard. Hysteria Beyond Freud. Berkeley: University of California Press, 1993.