Hysteria

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Hysteria, in its colloquial use, describes a state of mind, one of unmanageable fear or emotional excesses. The fear is often caused by multiple events in one's past that involved some sort of severe conflict; the fear can be centered on a body part or most commonly on an imagined problem with that body part (disease is a common complaint. See also Body dysmorphic disorder and Hypochondriasis. People who are "hysterical" often lose self-control due to the overwhelming fear.

Psychiatrists and other physicians have in theory given up the use of "hysteria", replacing it with more euphemistic terms that are essentially synonyms. These include "psychosomatic", "functional", "nonorganic", "psychogenic", and "medically unexplained". In 1980 the American Psychiatric Association officially changed the diagnosis of "hysterical neurosis, conversion type" to "conversion disorder". Hysteria also has significant overlap with the diagnostic term "somatization disorder" and with somatoform disorders in general.

History

Main article: Female hysteria

The term originates with the Greek medical term, hysterikos. This referred to a medical condition, thought to be particular to women, caused by disturbances of the uterus, hystera in Greek. The term hysteria was coined by Hippocrates, who thought that suffocation and madness arose in women whose uteri had become too light and dry from lack of sexual intercourse and, as a result, wandered upward, compressing the heart, lungs, and diaphragm.

The same general definition, or under the name female hysteria, came into widespread use in the middle and late 19th century to describe what is today generally considered to be sexual dissatisfaction. Typical treatment was massage of the patient's genitalia by the physician and later vibrators or water sprays to cause orgasm. By the early 1900s, the practice and usage of the term had fallen from use until it was again popularized when the writings of Sigmund Freud became known and influential in Britain and the USA in the 1920s. The Freudian psychoanalytic school of psychology uses its own, somewhat controversial, ways to treat hysteria.

The knowledge of hysterical processes was advanced by the work of Jean-Martin Charcot, a French neurologist. However, many now consider hysteria to be a legacy diagnosis (i.e., a catch-all junk diagnosis), particularly due to its long list of possible manifestations: one Victorian physician cataloged 75 pages of possible symptoms of hysteria and called the list incomplete..

Current psychiatric terminology distinguishes two types of hysteria: somatoform and dissociative. Dissociative hysteria includes amnestic fugue states. Somatoform disorders include conversion disorder, somatization disorder, chronic pain disorder, hypochondriasis, and body dysmorphic disorder. In somatoform disorders, the patient exhibits physical symptoms such as low back pain or limb paralysis, without apparent physical cause. Recent neuroscientific research, however, is starting to show that there are characteristic patterns of brain activity associated with these states. All these disorders are thought to be unconscious, not feigned or intentional malingering.

Freudian psychoanalytic theory attributed hysterical symptoms to the subconscious mind's attempt to protect the patient from psychic stress. Subconscious motives include primary gain, in which the symptom directly relieves the stress (as when a patient coughs to release energy pent up from keeping a secret), and secondary gain, in which the symptom provides an independent advantage such as staying home from a hated job. More recent critics have noted the possibility of tertiary gain, when a patient is induced subconsciously to display a symptom because of the desires of others (as when a controlling husband enjoys the docility of his sick wife). There need be no gain at all, however, in a hysterical symptom. A child playing hockey may fall and for several hours believe he is unable to move, because he has recently heard of a famous hockey player who fell and broke his neck.

Jungian psychologist Laurie Layton Schapira explored what she labels a "Cassandra Complex" suffered by those traditionally diagnosed with hysteria, denoting a tendency for those with hysteria to be disbelieved or dismissed when relating the facticity of their experiences to others. Based on clinical experience, she delineates three factors which constitute the Cassandra complex in hysterics: (a). dysfunctional relationships with social manifestations of rationality, order, and reason, leading to; (b). emotional or physical suffering, particularly in the form of somatic, often gynaecological complaints, and (c). being disbelieved or dismissed when attempting to relate the facticity of these experiences to others.

Mass hysteria

Main article: Mass hysteria

The term also occurs in the phrase mass hysteria to describe mass public near-panic reactions. It is commonly applied to the waves of popular medical problems that "everyone gets" in response to news articles.A similar usage refers to any sort of "public wave" phenomenon.

See also

• Catalepsy
• Conversion disorder
• Female hysteria
• Histrionic Personality Disorder
• Hysterical contagion
• Hysterical paralysis
• Hysterical strength
• Hysterical vision disturbances
• Suggestibility

References

• Halligan, P.W., Bass, C., & Marshall, J.C. (Eds.)(2001). Contemporary Approach to the Study of Hysteria: Clinical and Theoretical Perspectives. Oxford University Press, UK.
• Sander Gilman, Roy Porter, George Rousseau, Elaine Showalter, and Helen King (1993). Hysteria Before Freud (Berkeley, Los Angeles, and Oxford: University of California Press).