Psychology Essays – Hysteria

Hysteria has been seen as both a form of political protest and as the failure to negotiate and resolve the Oedipus complex. Discuss with reference to the Dora case.

In many ways, hysteria and the hysteric patient go right to the very heart of psychoanalysis. It was after all, as we shall see, the basis of Freud and Breuer’s assertions on the validity of psychoanalysis and psychodynamic treatment and has been used ever since by theorists and practitioners as a test case with which to continually asses those initial findings. In the late nineteenth century, as now, the hysteric patient exists in a kind of hinterland of diagnosis, being appropriated for the good, sometimes, of not themselves but the larger discourse of psychiatry or critical theory. The many case histories that litter the canonical texts of psychoanalysis are testament to the wide variety of symptoms and manifestations of hysteria that are as numerous as are the patients themselves. Karl Abraham, in his essay on Hysterical Dream States (1988) gives us this same sense as early as 1910:

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these states differ greatly in degree, exhibit considerable variations in their duration, are often associated with the affect of anxiety(and)I myself have come across these state sin a number of patients whom I have treated with psychoanalysis. (Abraham, 1988: 90)

With this in mind, in this essay I would like to look at two of the most important aetiological views of hysteria of the last hundred and twenty years; those of Freud and the non-resolution of the Oedipus complex and those of the French and American feminists who viewed hysteria as being, not only a manifestation of phallocentric social registers but also a protest against them. In order to centre this study within an existing analytical framework I will constantly refer both views back to Freud’s case history of Dora (Freud, 1977), itself of course, one of the seminal early works on the formation of psychoanalysis and thinking of hysteria and hysterical symptoms.

One can only appreciate the impact of Freud’s work on hysteria, I think, if one first places it into the context of contemporary and preceding medical theory. Niel Micklem in his The Nature of Hysteria (1996) details the condition’s long history:

The lively interest for medicine that hysteria has aroused since it was first recorded in ancient Egypt more than 3,000 years ago has yielded a substantial amount of writing(and)the most accomplished research worker would be hard pressed to account for all the literature. (Micklem, 1996: 1)

As Micklem suggests, hysteria is a protean and multifaceted disease (Micklem, 1996: 3) that is difficult to discern both by the physician and the historian. However right from its earliest beginnings, the notion of hysteria has always been associated with the notion of sexual development and, in particular, that of women. Greek myth is littered with countless examples of phantasmatic conditions brought on by either sexual excess or repression; from the mythological portrait of Demeter to Plato’s assertions in Timaeus that:

When (sexual) desire is unsatisfied the man is over-mastered by the power of the generative organs, and the woman is subjected to disorders from the obstruction of the passages of the breath, until the two meet and pluck the fruit of the tree. (Plato, trans. Howett, 1970, steph.91)

As Micklem suggests, this swing between repression and nymphomania has been a constant leitmotif in aetiological thinking regarding hysteria since Plato and Homer. However, in the nineteenth century work of Pierre Briquet and, later Jean Martin Charcot, the reliance upon sex and frustration as a central feature of hysteria was abandoned in favour of an approach that concerned itself far more with genetic and hereditary factors. It was at this time, also, that the psychiatric profession began to take hysteria seriously as a condition and it was chiefly through this that it was twinned with neurosis; a factor that was to have a marked impact on Freud’s interest in it as a basis for psychoanalysis.

Around the end of the nineteenth century, then, the work of Briquet and Charcot had instilled hysteria into the annals of neurological illness. Charcot’s work on hysteria concretized the condition as one that could be studied through recognition of underlying psychopathological causes rather than physical symptoms, as Stanley Finger asserts:

Charcot hypothesized that mental events can act as agents provocateurs, or triggers, for hysterical reactions, at least in an individuals with weak constitutions. He found provoking agents in the loss of a loved one, fears about a real illness, and work-related trauma. (Finger, 2000: 194)

This notion, as Ernest Jones suggests in his The Life and Work of Sigmund Freud (1961: 208) was to have a profound effect on Freud and form the basis of his and Breuer’s Studies on Hysteria (1972).

The case history of Dora stands, along with Anna O, Little Hans and the Rat Man, as seminal texts in the history of psychoanalysis. Freud prefaces his study with the caution that it represents only part of the over all research, however it is a remarkably illuminating and complete record of the early applications of psychoanalysis. The case itself surrounds Dora, an eighteen year old woman who suffered a variety of neurotic illness including shortness of breath (dyspnoea), lose of voice, paralysis, fainting spells, depression and threats of suicide.

In analysis, Dora revealed that she had been pursued by Herr K. a family friend, whose wife was conducting a sexual affair with Dora’s father; Dora’s mother was an ineffectual figure in the story who was marginalized both by Dora and, subsequently by Freud himself. Dora’s bouts of hysteria coincided with real and imaginary contact with Herr K. and reveal themselves through a series of paraparaxes and dreams that provide material for Freud’s interpretation.

For Freud, of course, hysteria existed as a psychic rather than a physical condition (Freud, 1972: 25). His and Breuer’s Studies in Hysteria and his own case notes on Dora follows, in some senses, what we have seen as Charcoldian lines of thought, tracing the source of the patient’s hysterical symptoms back to some childhood event or trauma. In the first dream analysis, for instance, Freud links Dora’s dream concerning the burning of a house in which she stays with childhood memories of bedwetting and being woken up by her father:

Think of the expressions you used: that an accident might happen in the night, and that it might be necessary to leave the room. Surely the allusion must be to a physical need? And if you transpose the accident into childhood what can it be but bedwetting? (Freud, 1977: 108)

The Dora study is interesting, I think, in that it provides us with an ideal fulcrum around which to place Freud’s thought. We can note echoes still of Charcot in the analysis and of Freud’s earlier insistence on childhood trauma but, of course, by the study’s publication in 1905 Freud had formulated his concept of the Oedipus complex (Jones, 1961) and it is this, along with transference perhaps, that provides much of the analytical undercurrent of the text.

The symbolism of Dora’s first dream, for instance, is suffused with Oedipal imagery and reference. It details the dreamer trapped in a burning house whereupon she is awoken by her father. Her Mother, in the meantime, attempts to save her jewelry box but is stopped again by her father; as Dora exists the house she awakens.

Freud interprets this dream as an indication of Dora’s repressed sexual desires for her father; the jewelry box becoming symbolic of both her womb and the favour of her father for her mother. The dream reoccurred whilst the subject was visiting the lakeside holiday home that became the scene of the attempted seduction by Herr K. and this was seen by Freud as an indication that Dora’s repressed sexual desires for her father were being awakened in order to further suppress her mature desire for her suitor:

My interpretation was that she had at that point summoned up an infantile affection for her father so as to be able to keep her repressed love for Herr K. in its state of repression. This same revulsion in the patient’s mental life was reflected in the dream. (Freud, 1977: 124)

Here we have two important features of Freud’s notion of the importance of the Oedipus complex in the formation of neurosis, firstly that this manifests itself in dreams and secondly that Dora unconsciously drew upon her unresolved Oedipal or Electra complex in order to repress mature sexual desire.

If we return again to the first dream we note tropes and Oedipal leitmotifs that even Freud did not discover. The locking of the jewelry box, for instance, is linked with the locking of her brother’s room by her mother:

My brother’s room, you see, has no separate entrance, but can only be reached through the dining-room. Father does not want my brother to be locked in like that. (Freud, 1977: 101)

We can detect quite clearly here the extent of the Oedipal reference in the dream. Commensurate with Freud’s notions of condensation (Freud, 1965: 312) and displacement (Freud, 1965: 340), Dora suggests that her brother is, in fact the treasure or jewel that her Mother wants to lock away; by not allowing this, her Father both displays his own Oedipal affect (in reality) and strengthens Dora’s Oedipal attachment to him (in her dream). For Freud, of course, this unresolved complex is repressed and manifests itself as hysteria.

Of course, the third element of Oedipal attachment here (after her father and Herr K) is the transference onto Freud himself and the Dora case history stands, perhaps, as one of the greatest stories of seduction, of reader by author, in psychoanalysis. In Freud and the Passions, John O’Neil suggests that:

Listening with the third ear to Dora meant taking on the part of a hysterical daughter caught in a series of transgressive erotic triangles, while at the same time, attempting to preserve his own discrete boundary as analyst-father. It meant supplementing a fractured verbal narration (her story) with meanings he read into her physical symptoms (his story), joining them together as a single story. (O’Neill, 1996: 101)

Whereas, as many commentators have pointed out (Blass, 1992; Krohn and Krohn, 1982) there is a wealth of Oedipal content in the Dora case and Freud’s interpretation it has also been the basis for much criticism.

Much of this criticism, in recent years has centered around Freud’s phallocentric interpretation of Dora’s symptoms (Horrocks, 2001). Freud’s assertions that Dora’s revulsion upon being kissed by Herr K. is reflective of her repressed desires, be they Oedipal in the first instance or for Herr K in the second, is for instance refuted by Roger Horrocks in Freud Revisited: Psychoanalytic Themes in a Postmodern Age (2001), who sees her actions as merely the understandable reactions of a woman caught up in a, mainly masculine, play of power.

In her essay The Hysterical Woman: Sex Roles and Role Conflict in 19th Century America (1992), Carroll Smith Rosenberg highlights this phaollocentric construction of the hysterical patient:

Contemporaries noted routinely in the 1870s, 1880s and 1890s that middle class American girls seemed ill-prepared to assume the responsibilities and trials of marriage, motherhood and maturation. Frequently women, especially married women with children, complained of isolation, loneliness and depression. (Smith Rosenberg, 1992: 26)

This views hysteria as the outcome of an oppressive masculine society that both controls and diagnoses. Dora, for instance, is defined by the wishes of her father, as daughter; as lover by Herr K. and as hysteric by Freud. The phallocentric construction of the feminine binary in the text, displaying on the one hand the ineffectual housewife in the shape of Dora’s mother and the cause of desire in the form of Frau K. traps Dora who fits into neither and so is labeled neurotic.

Smith Rosenberg (and others such as Elaine Showalter in The Female Malady [1987]) also point to the adoption of hysterical symptoms as a sociopolitical protest by the women against the impossible situation that they found themselves in:

It is quite possible that many women experienced a significant level of anxiety when forced to confront or adapt in one way or another to these changes. Thus hysteria may have served as one option to tactic offering particular women otherwise unable to respond to changes (Smith Rosenberg, 1992: 26)

We can note, for instance, that there is a distinct link between the concept of illness in the case of Dora and the inability to accept social roles. Her Father’s illness precludes him from satisfactorily fulfilling his role as father, lover and husband and Dora’s hysterical attacks seems to occur at times of stress, when she is being forced, either by her father, Herr. K or Freud to adopt an external, clearly defined feminine role to which she is not accustomed. In fact Freud mentions but then glosses over this very point in his early analysis (Freud, 1977: 74-75).

Caught within a binary of feminization, Dora exists as the projections of the male presences around her and, in order to protest against this, withdraws into hysteria, and as Mari Jo Buhle suggests:

Freud’s most acclaimed study of a hysteric discloses such a huge blind spot that the celebrated case of “Dora” documents more clearly the author’s own avoidance mechanisms. (Buhle, 1998: 30)

As we have see, then, there are cases to made for hysteria to be based in both Freudian notions of the unresolved Oedipus complex and the creation of feminine ideals and social norms by a largely masculine society. Freud’s case study is as interesting to the student of the development of Freudian psychoanalysis, I think, as the psychoanalyst him or herself.

Of course, we have here looked briefly at only two of the many psychoanalytical frameworks that have been designed to study hysteria. We might mention, for instance Lacan’s discussion of the Dora case in essay Function and Field of Speech and Language (Lacan, 2004) or Klein’s notions of the father as ‘good object’ in the aetiology of feminine sexuality and how it relates to the resolving of the Oedipus complex. What we can assert, by looking at these two specific instances, is the extent that psychoanalytic and socio-political interpretations of hysteria say as much about the wider culture than they do about the condition itself. This view, of course, is commensurate with Foucault’s concept of enunciative discourses in his Madness and Civilization (2004) and The Archaeology of Knowledge (1989)

The case of Dora provides us with an interesting picture of Freud struggling to come to terms with not only concepts such as hysteria and the Oedipus complex but transference, negative transference and, in fact, the whole basis of modern psychoanalysis. As we have seen, the criticism of the second wave feminists was, perhaps, well founded. The case study, whilst being an exemplar in the ways that analysis can be used is also just as indicative of its problems and shortfalls.

References

Abraham, Karl (1988), Hysterical Dream States, published in Selected Papers on Psychoanalysis, (London: Karnac)

Adler, Alfred (1956), The Individual Psychology of Alfred Adler, (London: Harper Torchbooks)

Beizer, Janet (1994), Ventriloquized Bodies: Narratives of Hysteria in Nineteenth Century France, (Ithaca: Cornell University Press)

Buhle, Mary Jo (1998), Feminism and its Discontents: A Century of Struggle with Psychoanalysis, (London: Harvard University)

Finger, Stanley (2000), Minds Behind the Brain, (Oxford: Oxford University Press)

Freud, Sigmund (1977), Case Histories 1: Dora and Little Hans, (London: Penguin)

Freud, Sigmund (1965), The Interpretation of Dreams, (London: Discus Books)

Freud, Sigmund and Breuer, Joseph (1972), Studies in Hysteria, (London: William Benton)

Freud, Sigmund (1976), The Psychopathology of Everyday Life, (London: Penguin)

Freud, Sigmund (1974), Introductory Lectures on Psychoanalysis, (London: Penguin)

Foucault, Michel (2004), Madness and Civilization, (London: Routledge)

Foucault, Michel (1989), Archaeology of Knowledge, (London: Routledge)

Foucault, Michel (1990), The History of Sexuality: Vol. 3: The Care of the Self, (London: Penguin)

Horrocks, Roger (2001), Freud Revisited: Psychoanalytic Themes in the Postmodern Age, (London: Palgrave)

Jones, Ernest (1961), The Life and Work of Sigmund Freud, (London: Pelican)

Kahane, Claire (1990), In Dora’s Case: Freud, Hysteria, Feminism, (New York: Columbia University Press)

Klein, Melanie (1997), The Psycho Analysis of Children, (London: Verso)

Lacan, Jacques (2004), Ecrits: A Selection, (London: Routledge)

Micklem, Niel (1996), The Nature of Hysteria, (London: Routledge)

Murohy, Sean and Popay, Jennie (eds), Health and Disease: A Reader, (Milton Keynes: Open University Press)

O’Neill, John (1996), Freud and the Passions, (Pennsylvania: Pennsylvania State University)

Plato (1970), Dialogues of Plato, (trans. B. Jowett), (London: Sphere)

Showalter, Elaine (1987), The Female Malady, (London: Virago)

Smith Rosenberg, Carroll (1992), The Hysterical Woman: Sex Roles and Role Conflict in 19th Century America, published in Black, Nick, Boswell, David, Gray, Alastair, Wolheim, Richard (1971), Freud, (London: Fontana|)

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