TRAUMA AND HYSTERIA, by Bettina Bergo, chapter 11 from The Trauma

Controversey

Freud’s concept of hysteria goes from: hereditary--->effect of traumatic

incidents--->displacements toward repressed ideas or fantasies. (The
evolution of Freud’s theory diminished the importance of trauma as a main
cause of hysteria)
Freud’s understanding as against the understanding of his time was that
hysteria did not manifest itself as a disease of the “womb” but of the
imagination. The human imagination structurally replaced the image of the
floating womb as the central etiology of hysteria. (no longer a disease of
the body, but of the imagination, p209)
What was removed from the category of hysteria was its insistence on
another group, the Jews
But, trauma, under the form of child abuse, even after Letter 69 of Sep 21,
1897 to Fliess (I no longer believe in my Neurotica…) Freud continued to
deliberate about the role of “seduction” in neurosis. In a word trauma and
memory remained together at the root of hysteria’s complex aetiology.
Phase 1 Phase 2 Phase 3
Pre-Charcot Charcot & Freud
Bourneville
Physiological Trauma and Memory/fantasy
Or religious aberrancy seduction Disease of the
imagination,
But sometimes with a
remainder--seduction

Anatomical Theory Imbalanced Nervous System & Neural

Animal Spirits Irritation
Dynamic physiology of Unbalanced Disease of neural system
tissues animal spirits in and neural irritation
a body
container
 Locus of
pathology was
tissular SF59
Present throughout the The womb was said to be
Enlightenment along with connected by nerves &
suspicions about veins to every other bodily
demonic possession of organ; it influenced in a
certain women polymorphic fashion other
organs therein
Uterus floated Released Radiated neural irritation
humors

Innovations of Jean-Martin Charcot:

That mind and body are so fundamentally intertwined that a psychological
event could produce extraordinary neurological symptoms
Hysteria is a disorder that affected women and men
In June 1870 Charcot and Desire Bourneville argued that hysteria should
be separated from epilepsy and pointed out the distinctively affective
component in the hysterics’ convulsions—réminiscences
Only when a significant part of the pathological field could be shifted from
physiology to psychology could there be a properly masculine hysteria.
Philippe Jean-Etienne Charcot/Bourneville
Pinel Esquirol Diagnostics moved from the
1745- Salpêtrière Hospital neurophysiology of hysterical ischiuria
1826 1799 (retention of urine) to traumatism (affecting
Favorite student of
Pinel
the illocalizable “psychic apparatus
Mania Reason/mania Separation of hysteria from hysteron-
without epilepsy
delirium
Charcot ultimately insisted on three things in the matter of hysteria:
First the disease was a single physiological reality, though he was given to
referring to its most visible symptoms in a rather Catholic vernacular as
“stigmata, thereby mythologizing them: He developed a precise taxonomy
of 4 phases ( I-the epileptoid; II-the grand movements; III-the emotional-
attitude passionelle-hallucinatory phase; IV-the delusional phase), as well
as 14 ancillary type of hysteria
Secondly, He argued for a certain duplicity—a histrionicism—on the part of
the hysteric in the mise-en-scene of her or his hallucination (in the third and
most unique phase of hystero-epileptic attack
Thirdly, he maintained that the predisposing factor in hysteria was the
neurological degeneration that ran in “psychopathic families”. The
importance of such a predisposition became manifest in the disease’s
precipitating causes: physical trauma, including everything from an acute
fright to railroad accidents, falls, or war neuroses. Which produced
paralysis and contractures, and psychological traumata, consisting of a
different set of symptoms (paraesthesia, retention of urine, vomiting)
Charcot steadfastly maintained that la chose génitale lay at the root of the
disease in women and presumably all hysterics, remaining sufficiently
ambiguous to connote: sexual fixations, dysfunction or again rape.
Page 214 Charcot’s provocative insight—“the idea of movement is already
the movement in its process of enactment”—led to two parallel etiologies
for hysteria
Traumatic accidents Traumatic incidents
Such as the train wrecks Such as shock, sudden fright, or

That produce “railroad spine” or Or the acutualization of a lost memory

war injuries through association with an occurent
mental image or representation

.Freud moved from giving up Charcot’s techniques of grand and petit

hypnose (& also his metallo-and magnetic therapies)
to “hysteria was more traumatism than disease” when he returned to
Vienna while preserving Charcot’s hysterogenic trigger points. (principally
in the areas of the ovaries of women and in a structurally similar area of
men!!)
Authentic traumatism requires that it be cumulative and disruptive.
To Bourneville’s characterization of hysteria, as a disease of memories.
To a resemblance between events whose incipience might not have been
traumatic, and an ongoing event that revealed the sexual meaning of the
earlier ones. endowed them suddenly with an affective force and ideational
form that overwhelmed the psyche, producing traumatism retroactively.