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Hysteria and Humiliation

a
Sam Gerson Ph.D.
a
California School of Professional Psychology and Psychoanalytic
Institute of Northern California
Published online: 11 Oct 2011.

To cite this article: Sam Gerson Ph.D. (2011) Hysteria and Humiliation, Psychoanalytic Dialogues: The
International Journal of Relational Perspectives, 21:5, 517-530, DOI: 10.1080/10481885.2011.611730

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 Psychoanalytic Dialogues, 21:517–530, 2011
Copyright © Taylor & Francis Group, LLC
ISSN: 1048-1885 print / 1940-9222 online
DOI: 10.1080/10481885.2011.611730

Hysteria and Humiliation

Sam Gerson, Ph.D.

California School of Professional Psychology and Psychoanalytic Institute of Northern
California
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The phenomena of hysteria are first considered from a historical perspective that emphasizes the role
of domination and power relations between the sexes. This permits an examination of the dynamics
and impact of humiliation in interpersonal relations on the formation of hysteric symptomatology.
Humiliation is viewed as having a powerful deleterious effect on the development of the capacity
to think and feel in a coherent and meaningful manner. The relationship between humiliation and
hysteria is explored theoretically and illustrated with clinical material that emphasizes developmental
dynamics through which relationally based injuries fracture the ability to know and communicate
one’s experience.

Psychoanalysis has long been occupied with the multiple meanings of hysteria as a concept, as
a dynamic organization, and as a mode of being; yet the fluid manifestations of hysteria defy
any singular description of its origins, psychodynamics, and treatment. Intriguingly, this elusive
quality permits hysteria both to obscure and to reveal psychological processes that symbolically
express the ever-shifting cultural conflicts of different eras. Throughout the history of its usage,
we can identify how the constants of sexuality, gender, and power are signified in curious psy-
chological and psychosomatic forms that, paradoxically, provide insights to the very concerns
that hysteria seeks to conceal. In this paper, I approach the mysteries of hysteria by focusing on
how affect is lived and transformed in the relational configurations that eventuate in states of
humiliation and that give form to hysteria’s mercurial presence.
Paul Russell (1976/1998) wrote that “psychopathology represents the scar tissue of the injury
to the capacity to feel” (p. 34). In what follows I illustrate how the maladies of hysteria represent
the injurious effects of humiliation on the experience and articulation of one’s affective life.
In this attempt I also hope to contribute to a relational approach for understanding and working
with the varied phenomena of hysteria.
I begin with a brief set of vignettes from an analysis that informed the ideas in this paper. Very
early on in our work Ms. C opens an hour in a fretful and disjointed manner and, as she tries to
relate the content of her concerns, she conveys above all else a sense of dread. I tell her about my
sense of her distress, and she replies that she is scared to let me know the extent of her anxiety.
She is certain that I will be disgusted by her terrors and by her inability to subdue her fears, and
that I, therefore, will want nothing more to do with her. Shortly, a memory comes to her of her

Correspondence should be addressed to Sam Gerson, Ph.D., 2252 Fillmore Street, San Francisco, CA 94115. E-mail:
samgerson@aol.com
 518 GERSON

first solo sailboat race—she is 8 years old and her father, an avid competitive sailor who has
taught her since she was a toddler, has eagerly awaited this day. She sails out of the cove and is
doing well until she has to round the buoy. Here she loses control of the ropes, can’t negotiate the
turn, and instead heads farther out, zigging and zagging but never turning. She begins to sob, lets
go of the ropes, and drifts. After everyone else has finished the race, an interminably long time
in her memory, her father comes to retrieve her. As she sees him approaching she feels relieved,
but soon she notices the stern look on his face and, as he loudly demands an explanation for her
failure, her sobs return and she is unable answer. He screams, “What is wrong with you, tell me
what is wrong with you!” She cries all the way back, is taken home without any discussion of
what transpired, and now can remember nothing more of the event—adding only that she never
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sailed again.
The next day she begins her analytic hour in silence, but soon, with a mixture of trepidation
and curiosity, she relates another memory. Now she is 12 and is on a trip with school friends
to the beach. Suddenly she becomes aware that she is menstruating; she runs back toward the
dunes, digs a hole in the sand, and sits crying as she watches her friends play until someone,
much later, finds her and helps her back. The following week, as she once again talks of her fear
that I will be disgusted by her, the previous memories are joined by another episode from age
14. Mother is away for the weekend and the patient has spent considerable effort in preparing
dinner for her father. She proudly surveys the table she has set and cheerily calls to her father to
come eat. She recalls, however, that her mood of pleasurable anticipation was, upon his arrival,
immediately replaced by a fearful premonition. Her father’s face is frozen in a steely stare and,
without noticing her work or her pleasure in the presentation, a scowl forms on his face, and he
abruptly admonishes her for not wearing a brassiere. It is as if, she recalls, “a mirror was broken
and everything good was shattered.” She runs to her room sobbing, her father does not attempt to
console her, and she is left with the devalued sense of herself as her only company—a self that
cannot comprehend his actions or her reactions—and she cries herself to sleep.
In the moments of her memories she is humiliated and hysterical. The mortifying experience
of having others witness her inability to control her body, as well as to refuse to acknowledge
her pride in her body, incapacitates her and renders her unable to know and speak her feelings
and needs. She is confused and frightened, and in the absence of an other who can recognize and
accept her own emergence, she cannot contain herself, she cannot give voice to her experience,
and she is named hysteric.
Hysteria is a name for the inexplicable—bodies put to use or paralyzed in peculiar ways,
language permeated by private meaning, activity primed to stimulate yet incompetent in the
achievement of its purpose, narratives urgent with wishes to communicate yet made brittle and
incoherent by despair. In all of these phenomena, the social conventions that constitute how
affective experience is to be lived are profoundly opposed by private urgencies that can find no
agency. Hysteria has always served as a designation draped over the incomprehensible; yet since
its first usage, hysteria has also revealed the very “laws of nature” that, at first blush, it seemingly
defied. As we know, psychoanalysis itself was built on the premise that the symptoms of hysteria,
rather than conveying the unnatural, contained a logic that indicated hidden yet universal laws of
life. The madness of hysteria expressed that which could be neither known nor forgotten, and, of
course, sexuality was the presence that no disavowal could erase.
Hysteria is the name of a condition that seeks to communicate itself through means other than
direct verbal articulation. It resists articulation because it represents itself as an essence that offers
 HYSTERIA AND HUMILIATION 519

no perspective from which to examine itself. It refers to itself even as it is not self-reflective. The
hand that will not grasp, the mouth that cannot speak, the eyes that will not see, the affects that
cannot be organized into a coherent narrative or the narrative that is made incomprehensible due
to misaligned affects—all of these are conditions that are as inexplicable to the other as they are
unthinkable by the hysteric and, therefore, have been traditionally designated as symptoms of an
internal disorder (Showalter, 1997).

A HISTORICAL, FEMINIST PERSPECTIVE ON HYSTERIA

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Throughout Western history, hysteria, and the falseness signified by the term, has been located
in, and defined by, the feminine. The etymology of the word hysteria, the recipients of the diag-
nosis, and the uses to which the diagnosis has been put make it clear that hysteria has always
been reserved for service as a female malady (Benjamin, 2001; Dimen & Harris, 2001). When
the symptomatology of hysteria was observed in males, new diagnoses such as neurasthenia
and “shell-shock” were created; these concepts and terms carried masculine connotations that
avoided the denigrations of cowardice, indulgence, and passivity associated with the diagno-
sis of hysteria (Mitchell, 1996; Showalter, 1993). Just as is the case in the phenomenology
of hysteria, the history of its etiology has likewise always been culturally mediated. Theories
about the causes of hysteria have evolved from anatomy (the wandering womb), to demonology
(witchcraft), to physiology (a weaker constitution), to sexuality (repressed desire). While each
of these explanations of the origins of hysteria was promulgated with certainty, they each now
reveal the oppressive cultural structures that framed the attempt at understanding while leaving
the phenomenology of hysteria itself free to morph through time.
Times change, yet the hysteric is constant in her compromised mimicry of the cultural forms
that define her constrained identity. Luce Irigary (1985) captured this essence of hysteria when,
in describing the obligatory constrictions of gender norms for women, wrote, “She borrows the
disguise which she is required to assume. She mimes the role imposed on her. The only thing
really expected of her is that she maintain, without fail, the circulation of pretense by enveloping
herself in femininity.” (p. 186)
By focusing on the fundamental quality of inexplicability that marks hysteria, we place our-
selves in a position to note both what could not be articulated and what articulation was placed
in its stead. Indeed, we might even be able to draw a dialectical relation between the inexplicable
and its explanation in a manner that renders the former more comprehensible just as is makes the
later unsustainable. Nowhere is this more evident than in the original definition of hysteria—by
locating the phenomena that came to be known as hysteria in a wandering womb, and offering
the antidote of pregnancy, the explanation itself was in the service of regulating possibilities for
autonomy in women.
Freud’s revolutionary formulations about the role of repression in the creation of hysteria
made available the vast domain of sexuality for understanding psychic life and its transformations
in cultural and bodily representation. He made the remarkable discovery that hysteria was the
result of constrained desire, and he placed the origin of the constraint first on sexualized trauma
and later on conflicted libidinal wishes arising in childhood. Repressions of sexual impulse, stim-
ulated anew in adolescence, gave rise to compromise gratifications expressed in symptoms. What
was required to free the hysteric from the suffering occasioned by unconscious reminiscences
 520 GERSON

was an historical reconstructive interpretation of the original stimulus, be it eroticized trauma

or wish (Guttman, 2006; Young-Breuhl, 1990). Yet, even as we encounter the enduring clinical
relevance of Freud’s discovery, we need also to consider how his reliance on sexuality as the
terra firma upon which development and pathology germinate obscured how patriarchy makes
use of sexuality to serve its own aims. It seems to me that if we complement Freud’s drive theory
formulations with a deconstructive methodology, then we may conclude that where hysteria had
revealed secrets of sexuality we now also find a hidden record of domination via the gendering
of experience. I believe that pursuing this line of thought permits us to formulate a nuanced and
multifocused perspective on how the intrapsychic dynamics of repression of sexual desire joins
with the experience of interpersonal humiliation in the domain of gender to yield the complex
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development and meanings of hysteria.

Freud, in the main corpus of his work on hysteria (Breuer & Freud, 1895; Freud, 1894, 1896,
1905, 1908, 1909), did not contend with the intricate relational matrices within which hysteria
developed. In particular, as he traced the vicissitudes of the wish, he did not consider that the
wish became compromised because of the failure of the relationship to first contain, and then to
safely elaborate the content of the wish, in a way that transformed the wish into something that
could be owned by the patient rather than experienced as a vexation mysteriously imposed on
the body. At a later date, Freud (1926), in his discussion of danger situations, suggested that loss
of the object’s love is causal in hysteria. Yet as Sprengnether (1990) pointed out, his venture into
the nonoedipal aspects of relational security was in service of constituting separation anxieties as
derivatives and signifiers of castration anxieties. Freud, by displacing actual threats to attachment
with phantasies of threats of bodily harm, left unelaborated the implications of dependency and
loss in the formation of hysteria. The legacy of this neglect of actual interpersonal experiences
in favor of an emphasis on endogenously derived and erotically based phantasy in the formation
of hysteria is especially evident in contemporary Klienian thinking. Consider Britton’s (2003)
assertion that
a central feature of hysteria is the use of projective identification by the subject to become, in phan-
tasy, one or both members of the primal couple. This phantasized identification . . . creates an erotic
drama or invests everyday events with an erotic resonance. (p. 10)

By exclusively locating the origins of hysteria in terms of the subject’s libidinal wishes and their
taboos, psychoanalytic formulations of this sort continue to obscure the truths that Freud initially
discovered when he implicated the traumatic failure of the containment of the wish by adults as
causing the phenomena of hysteria (Davies, 1996; Davies & Frawley 1992).
A theoretical position that maintains the motivational primacy of libidinal drives ultimately
leads to a bifurcation between sexuality and dependency (Mitchell, 2000)—a splitting that
ignores the relationship between sexuality and power and thus obfuscates how dependency
and passivity are often the culturally designated erotic posture for women. The connection
between passivity and the feminine is an issue that deserves particular attention, in part because
it neglects and often labels as hysteric attempts to actively assert an autonomous position within
the constraints of a subjugating dynamic. It is intriguing in this regard that when Freud’s (1905)
Fragment of an Analysis of a Case of Hysteria became the subject of feminist academic schol-
arship, his work achieved the unintended fate of serving to illustrate the impact of power
differentials between the sexes (rather than the role of libido and family romance phantasies), in
the formation of hysteria (Bernheimer & Kahane, 1985). Consider, for example, Helene Cixous’s
 HYSTERIA AND HUMILIATION 521

(as cited in Showalter, 1993) question, “What woman is not Dora?”; a query that seeks to locate
the hysteric as an inevitable manifestation of the constraints of social constructions of femininity.
For Cixous (1975),
Dora seemed to me to be the one who resists the system, the one who cannot stand that the family and
society are founded on the body of women, on bodies despised, rejected, bodies that are humiliating
once they have been used. (p. 154)

This perspective allows us to revise our thinking about the meaning of Dora’s opposition to
the family dynamics into which she was thrust and, particularly, her refusals of Herr K’s sexual
advances, of the sacrifice she was asked to assume so that her father’s affair with Frau K might
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continue, and finally of Freud’s attempt at a psychoanalytic cure. We can now understand these
refusals as not being prototypes of intrapsychic resistance but rather as a poignant illustration of
what Carol Gilligan (1991) and her colleagues described as the female adolescent’s resistance to
the continuous message to obscure her own affective truth. As Gilligan put it, “Cover up, girls
are told as they reach adolescence, daily, in innumerable ways. Cover your body, cover your
feelings, cover your relationships, cover your knowing, cover your voice, and perhaps above all,
cover desire” (p. 16).

A RELATIONAL PERSPECTIVE ON HUMILIATION AND HYSTERIA

Humiliation is a powerful mode for enforcing the injunction against knowing and valuing one’s
own experience, and hysteria is that which what follows a humiliation that cannot be articulated.
Humiliation is experienced as a mortification, a dying, that signifies a death of a positive image
of oneself that, one imagines and hopes, is held in the other’s mind. Humiliation destroys the
hope of being a good object in the other’s mind. And in the realization that one exists for and
in the other as a bad object, one also senses that his or her communications are fated to be
misrecognized as they are likely to be received with the hostility accorded to a bad object. Our
words cannot be perceived as good when the other to whom they are addressed has no positive
internal representation of us in his or her mind. We may ask, then, what sort of speech follows
from the realization that the other neither wants to nor is often able to receive us? The imagined or
actual death of oneself as a good object in the other’s mind effectively fractures communication
as it distorts the voice that can be a bridge between the one who experiences a dying and the
other who was both the cause and the site of the death.
The developmental precursors for this sequence are early and powerful constituents of one’s
sense of self. The maternal gaze that initiates the infant into subjectivity and intersubjectivity
is transformed by the child from perceptions of the external environment to representations of
internal objects and self. The way the other looks when they see us becomes part of what we
imagine they think of us and how we think of ourselves. To experience oneself as devalued in the
other’s mind is equivalent to not being seen and thereby thrown via regression into a world that is
presymbolic and carries the terrors of loss of communicative ability and self-delineation. It is by
means of this regressive process that humiliation is transformed into hysteria—a formless affec-
tivity filled with the desire to be resurrected in the other’s mind but without a mind to accomplish
that. Humiliation drags us back into a state of virtual speechlessness—one that leaves an out-of-
control, spilling-over, messy body that cannot be articulated in and through its own language.
 522 GERSON

Humiliation creates unspeakable and unthinkable affects by situating the humiliated within
the malevolent thoughts of the other. Formed in the abject silence of humiliation, the resultant
hysteria makes use of the body to mark, remember, and retell that which could not be contained
in the relationship, and so could not be spoken. Hysteria, from this perspective, is a product
of failed interpersonal and cultural negotiations of bodies, sexualities, and gender enforced by
humiliation of that which is unacceptable to the dominant. We might wish now to extend Breuer
and Freud’s (1895) dictum that “hysterics suffer from reminiscences” by adding that these are
reminiscences of humiliations in which one’s desire and/or capacity to desire was not received
and thus was rendered mute.
Excluded from the other’s benign recognition, the humiliated person sees himself or herself
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reflected in the other’s narrowed gaze as one who is unworthy—a state that moves one toward
a life of passivity, or on the margins, or, as is more apt to be the case for males, toward vio-
lent attempts to avoid abjection by breaking his subjection (J. Gilligan, 1996). In this regard,
we can better understand how issues of humiliation figure prominently in the political arena
where “saving face” becomes a justification for violence of even the most self-destructive sort.
Schafer (1997) observed that the deadly power of humiliation is captured in both narrative and
unconscious fantasies of mortification, defacement, and being brought to the ground (humus)
as excrement. He defined humiliation as an extreme version of shame in which one is not only
disgraced but ostracized, and noted that “the fantasy of being ostracized implies being sentenced
to a kind of emotional or spiritual death” (p. 96).
Humiliation is a trope of marginalization that aims at the “destruction of the illusion of having
belonged at all” (S. Miller, 1996, p. 157). As such, it may be a particularly pernicious outcome
that may result from conflicts of desiring to be included in a relationship or community while
wishing to retain a sense of self-defined desires that are at odds with the cultural norm. Because of
the challenge that he or she embodies, the autonomous desiring subject is targeted for exclusion
in an effort to render the noncommunal desire reprehensible and make repudiation of such desire
the only route toward acceptance. In the act of banishment attendant to humiliation, one is left
with the conviction that the other retains what is necessary for our well-being and is actively
withholding it due to our worthlessness. The humiliator denies and devalues the worth of the
other, just as the humiliated either idealizes and valorizes as magical the possessions of the other
or wishes only for their destruction.
This is particularly true in the domain of gender and sexuality wherein states and feelings of
humiliation act as powerful constituents of the form and content of sexual and gender identities
and saturate the affective experience and articulation of these realms. Humiliation configures
identity and unlike “embarrassment (which) lingers on the surface of the body, humiliation is
located at its deepest center” (W. Miller, 1993, p. 161). In her explication of female fears of
castration, Mayer (1985) illuminated how the threat of loss of an openness to experience—a
receptivity to one’s own and others affective life—was a core anxiety for women, and one that
was often represented in terms of loss of the female genitals. When we integrate Mayer’s under-
standing with an appreciation of how humiliation is aimed at foreclosure of affective possibility,
we are able to think of the distortions of experience that are emblematic of female hysteria as
consequent to feelings of castration, albeit primarily of a loss of a sense of power rather than of
a phantasy penis. This perspective enables us to connect the relational aspects of hysteria expli-
cated in this paper with more traditional ideas about the hysteria’s sexual significations. These
 HYSTERIA AND HUMILIATION 523

differing psychoanalytic perspectives are joined through the fluid nature by which experience
assumes symbolic meaning in all registers. Cooper (1971) captured this well when he wrote,
The events we experience occur simultaneously on all levels of our life, and on each level are
expressed in a different language. A physical violation can become a condemnation on the level
of moral awareness, and conversely, a condemnation can be experienced as a violation on the level
of bodily awareness. In both cases the person is objectified, and if he experiences this objectification
as shame in his heart, he experiences it in his body as a sexual act to which he has been subjected.
(p. 77)

Humiliation strives to regulate the experience of sexuality by substituting shame for pride in the
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expression of desire. It thereby eventuates in compensatory structures marked by compromised

longings and their prohibitions. Consider here Jessica Benjamin’s (1988, 1995) explication of
how masochistic submission is a sequella of wishes for withheld recognition. In recounting the
Story of O, Benjamin illustrates how self-abnegation and suicide are attempts to meet the other’s
sadistic desire and thereby extract the comfort of recognition. In this tragedy we are made aware
that “destruction is recognition’s other side” (Benjamin, 1995, p. 24) and that the aim of the non-
recognition inherent in humiliation is domination. Implicit here is the premise that sexuality gains
coherence within interpersonal and intersubjective experiences of successful and failed recogni-
tion, acceptance, and reciprocity of desire. Bromberg (1994) captured the sense of repudiation of
desire attendant to a failure in recognition when he noted that “nonrecognition is equivalent of
relational abandonment, and it is that which evokes the familiar and often bewildering accusation
‘you don’t want to know me”’ (p. 537).
Humiliations that aim to exclude and marginalize aspects of desire often seek to achieve their
purpose by destroying the continuity and commonality between the subject of “objectionable”
desires and the objects of his or her desire. The insidious nature of this destruction is regularly
accomplished by making the desiring subject experience the desire itself as the source of humili-
ation and subsequent isolation. In this dynamic process, the wish is transformed into a desire that
must be repudiated and repressed; it then may represent itself masked in the familiar disguises of
hysteria.

“AFFECTIVE COMPETENCE,” HUMILIATION, AND HYSTERIA

The manner by which humiliation seeds hysteria is rooted in the basic developmental processes
whereby the capacity to consciously know and act upon one’s feelings is furthered or truncated.
Russell (1976/1998, 1979) described the developmental achievement of “affective competence”
and delineated five essential dimensions of affects—feelings are always wishing, informing,
communicating, attaching, and carrying the history of each of these actions within the partic-
ular affective state of the moment. In what follows, I illustrate, both theoretically and clinically,
how each of these aspects of affective life are forged in relational contexts.
First, “to feel is to wish”—the expression of an affect always includes intentionality. In this
regard, affects are purposive, they aim to have an impact, and their motive is to transform pri-
vate subjectivity by altering the external world. Competence in wishing requires that the feeling
containing the wish be directed toward an external world that recognizes and accepts the wish.
As Benjamin (1995), in reviewing the work of contemporary developmental psychology, put
 524 GERSON

it, “Mother’s recognition is the basis for the baby’s sense of agency” (p. 24). The fortuitous
reciprocity between wish and response creates the safety required for the elaboration of desire.
We now understand that affects represent a response to the fate of agentic impulses (Benjamin,
1988). Confidence about the potential for having an impact on the other builds when the intention
carried by the affect is realized in the response of the other—these are the “moments of meet-
ing” that are of crucial import both developmentally and therapeutically (Boston Change Study
Process Group, 2002; Lyons-Ruth & The Boston Change Study Process Group, 1998). An inter-
nal state received and responded to by the external world creates a sense of harmony between
these two domains of lived experience and allows for the meaningful coherence of affective
experience.
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Imagine, then, the consequences for feeling when the intentionality of the wish occasions a
counterwish aimed at its destruction. When the wish and the person who affectively signals the
wish both become objects of ridicule and exclusion, then not only is the wish repressed but, as
importantly, the affect that carries the wish is also distorted. Now affect and wish are split from
each other, and affects no longer convey wishes in a manner whereby they can be reliably known
and realized. Rather, affects now are imbued with the loss of a sense of agency and with subjective
states reactive to that loss. This results in the development of a passive attitude toward one’s
experience and a lack of a sense of responsibility for one’s own affects that is so often noted as a
mark of hysteria (Krohn, 1978). It is a passivity born in cumulative moments of nonrecognition
of the wish by those who were the objects of desire, and the subsequent destruction of agency
is the legacy of these traumatic humiliations. Russell (1976/1998), in considering the role of the
other in the fate of the wish, noted that
failure of containment is traumatizing. It is traumatizing because the individual must attempt to do
the containing himself, but in a way which costs him or her the capacity, later on, to render the wish.
Real containment occurs, to begin with, only in a relationship. . . . The essence of trauma is that
without containment the wish costs the individual the relationship. (p. 25)

Humiliation leaves no one to receive the wish and so renders the affect desperate in its longing.
What remains is a sense of hopeless necessity, an urgency without the agentic capability to satisfy
the need; in other words, a form of hysteria.
Let me very briefly reintroduce the patient whose stories framed the beginning of this paper.
Ms. C is a 31-year-old artist with a doctorate in art history. She is the second of two daughters
who grew up in a well-to-do family where father was often away on business trips or engaged
in his social and sport pursuits. He is described as absent but benign; at home he was a sleepy
alcoholic, and mother was the sole source of nurturance and attention. I had seen Ms. C in
twice-per-week psychotherapy for 6 months prior to the commencement of four-times-per-week
psychoanalysis on the couch. Upon first lying down on the couch, she was silent awhile and then
said:
Patient: “This feels incredibly strange, makes me really nervous, what a bizarre thing to do.”
Analyst: “Being on the couch changes your relation to me in a way that scares you.”
Patient: “I’m afraid; I can’t see you, your voice doesn’t have a body attached to it. . . . I like you to
have a body, I can keep an eye on you, make you laugh and smile, and now I can’t see—[she begins
to sob]—I’m really sorry, I have no idea why I am crying . . . it feels really lonely, I feel like our
whole relation has changed.”
 HYSTERIA AND HUMILIATION 525

Analyst: “As if you are no longer the same in my mind.”

Patient: “It used to be that I’d sit across from you and have a conversation but now I feel dumped and
angry—[the crying grows more intense]—This just feels awful, it is so disempowering, I don’t know
what to do and I feel like getting up and running out but that would be even more humiliating.”
Analyst: “I certainly sense how very distressed you feel . . . Do you think it may be possible to talk
some more about your loss of power?”
Patient: “I’m not in a position to evaluate what you say anymore, now I am just the object of your
thoughts and that is completely disorienting.”
Analyst: “And that has something to do the position of our bodies?”
Patient: “You don’t have one anymore and that is all I have.”
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In these moments, Ms. C registers her profound disorientation over her loss of the analyst as a
visible presence upon whom she can effect a response. It is noteworthy that she perceives her
impact entirely in terms of the analyst’s direct physical response and in the absence of this she
feels that is left with nothing but a disembodied mind that objectifies her as a body (Britton, 1998,
2003). She also signals that the treatment will involve attempts to understand how sensation, both
in herself and in the analyst, will be signified now that communication is unembedded in directly
observed physical responses. The loss of a register through which to express and to measure her
impact on the other has thrown her into a confusion marked by the powerlessness of a body that
cannot find another that recognizes and welcomes hers.
A second perspective on affect is that all feelings serve a cognitive function; feelings inform
. . . “we can think only to the extent and the degree to which we feel, and vie versa” (Russell,
1976, p. 35). In hysteria, however, affects yield no knowledge; rather they baffle. Wrapped in
ambiguity, the hysteric’s feelings preclude knowledge. The illuminative possibilities of affects
are transformed into veils of ignorance that no longer protect the person from the internal dan-
gers of anxiety and the external dangers of trauma. Feelings stripped of their informative power
result from concerted efforts, by others as well as by oneself, to deny the truth of experience.
Humiliation creates this state by dint of the imperative not to know. It is of interest here to
note the frequent references in the literature about hysterics’ seeming lack of knowledge about
the world and general cognitive constrictions (Krohn, 1978; Shapiro, 1965), and we may sur-
mise that conflicts over specific knowledge that are implicated in states of humiliation makes the
process of knowing itself fraught with anxiety.
Gilligan (1991) and her colleagues documented this form of development in their observation
of the frequent occurrence of the statement “I don’t know” in the narratives of adolescent girls.
We have learned from Gilligan that affects and ideas that value relationship yet do not receive a
resonant response from others may ultimately and ironically come to be perceived as the enemy
rather than guarantor of relatedness. In such circumstances, feelings may lose their informative
power and, rather than providing accurate signals about the world and one’s relation to it, affects
come to be experienced as events in and of themselves (Bollas, 1987).
Bion’s (1962) work on the development of the capacity to think adds to our understanding of
how affects, and their fate in interpersonal transactions, carry the possibility of either knowing or
being mystified by the external world. Bion highlighted that the ability to tolerate frustration, a
key element in the capacity to think, depends on the successful communication of the threatening
affect to another who can recognize it and contain it in a manner whereby it can be returned as
a thinkable event rather than as a nameless dread. When thinking about experience is rendered
impossible, the distressing affect is transformed into a bad object representation, and this negative
 526 GERSON

representation, in turn, needs to be evacuated via projective identifications. In consequence, there

is a further diminishment of the possibilities of communication within the relationship, a decrease
in the experience of recognition and containment, and ultimately damage to the capacity for
thinking itself. In states of humiliation there is a severe constriction in the capacity to utilize the
informative power about experience made possible by thoughtful reflection about one’s affective
life. What remains then is a formless affectivity and a magical reliance on sensation rather than
thought as the sole route of connection to internal and external experience.
Ms. C began treatment with the hope of mastering anxiety states that occurred when she
needed to publically present herself in professional settings. These states would leave her unable
to articulate her knowledge and often culminated in a disjointed and teary performance. It was
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in the aftermath of a particularly disastrous appearance, one that left her feeling humiliated and
marginalized in her academic career pursuits, that she decided to seek psychotherapy. Our explo-
rations of this situation and related events regularly included her view that she was an “imposter”
and that her knowledge was that of a dilettante whose expertise would fade at the first challenge
and leave her exposed and helpless. One day, as we explored these anxieties, she associated to her
first dating experience and, with some hesitancy, revealed that the man was African American,
and then went on to say,
Patient: “We were dating because I couldn’t get anyone else, the only reason a black would date a
white girl was as a sign of his power. I was a pale imitation then and now too. Everything is false,
everything is a substitute. . . . I wasn’t what he really wanted.”
Analyst: “Just as you weren’t the boy your father wanted.”
Patient: “Even as a tomboy I was a poor excuse for what he really wanted.”
Analyst: “It seems to me that you are describing how you feel worthless except as the object of
someone else’s desire for you, and as you try to make this desire your own, the desire itself feels
false.”
Patient: “I am always so convinced that everything I do is a performance, that it isn’t real.”
Analyst: “I think that this experience of yourself is knotted together with experiences and phantasies,
both now and in the past, that others wish you to be someone you are not. This must leave a profound
doubt about your own as well as other’s wishes and needs and makes it impossible to have faith in
anything you know. You are left only with feelings that you fear will betray your own uncertainties.”

A few days after this interchange the patient appeared wearing a T-shirt that was boldly and
repetitively emblazoned with the words “whore, slut, tramp, bitch.” It was through this mask
of names that Ms. C illustrated to me her often courageous but ill-fated attempts to escape the
trap of being configured by the other’s desire. Yet this very appropriation of the symbols by
which she would be humiliated by imaginary others had the paradoxical effect of obscuring
her own sensibilities. The mimicry of others’ eroticization of her body, as well as her conflicted
identifications with these desires, graphically illustrated Riviere’s (1929) pioneering explorations
of how a woman’s sense of herself as feminine was subject to the alienating and humiliating force
of being that which the other both wanted and rejected. Irigaray (1985) captured an essence of
Ms. C’s dilemma when she wrote that “the masquerade ... is what women do . . . in order to
participate in man’s desire, but at the cost of giving up their own” (p. 47).
This brings us to a third perspective on affects as fundamentally developing and exist-
ing within as an intersubjective communication system: The capacity to feel, on one hand,
and a human relationship, on the other, require each other and contain each other (Russell,
 HYSTERIA AND HUMILIATION 527

1976/1998). The contagious nature of feelings allows others to know us via their own sensorial
experience and serves to enlist other minds as necessary presences for containing and elaborating
our own affective states (Spezzano, 1993). Certainly, this is a process fraught with complexity and
danger as the integrity of the internal world requires that an external other recognize and return
the feeling without appropriating, replacing, or destroying the feeling and the one in whom it
originated. Yet we are inevitably faced with the task of negotiating these destructive possibilities,
for in the last analysis it is the other person acting as a real interlocutor of our experience that
informs our own subjectivity.
Moreover, the communicative aspects of affect allow us to create states in the other that did
not exist without our presence. This performative potential of affects may be thought of as the
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basis for processes of unconscious communication, including projective and introjective identi-
fications, and is a dynamic constituent of the “relational unconscious” of every dyad (Gerson,
2004). Although this performative property is similar to the agentic element of affects spoken
of earlier, it differs in that a specific motive or wish need not be at issue—what matters here is
the capacity of affects to touch the other in a way that allows the other to feel us and in this
engagement to help us to elaborate our own experience.
This is the capability of affects to create and/or call forth, in Bollas’s (1989) fortuitous phrase,
the “transformative object” who recognizes and extends, without appropriating, our own experi-
ence and “idiom.” In the absence of this receptive and resonant presence, the world seems barren
and repetitive. The hysteric attempts to fill this void by registering his or her distress through
bodily states that impinge on our sensibilities, gestures that paradoxically create more estrange-
ment, for as Bollas (1987) observed, “Seeing is not knowing and hearing is not understanding.
It is as if the sensational discourse undermines true communication, and indeed as if the lan-
guage of the body is a substitute for mental representation and thinking” (p. 193). For Bollas, the
developmental origins of this mode of functioning evolve from the absence of a maternal pres-
ence who could transform affective states into meaning via the use of language. Making use of
a formulation similar to Bion’s (1962) work on the development of the capacity to think, Bollas
(1987) noted that “hysterics ... do not believe in using language for the reciprocal exchange of
feeling and meaning because the mother did not give the hysteric a continuous experience of find-
ing through language adequate transformation of unintegrated affective and instinctual states”
(p. 194). Developmental histories of this sort lead to a profound doubt about being on any other’s
mind and, as a consequence, dispose one to the hysteric solution of becoming a sensational dis-
play in search of recognition. It is in this dynamic that Masud Kahn (1983) located the hysteric’s
enduring “grudge” about the felt necessity of a sexualized exploitation of her body—one that is
unconsciously in the service of a desperate search for withheld maternal love. The imperative to
sacrifice oneself, and particularly one’s body, to avoid the despair of nonrecognition is a theme
that was succinctly captured by Sartre (1963/1983) in his discussion of Jean Genet when he
wrote that Genet “affirmed the priority of the object which he was in their eyes over the subject
which he was for himself, and he experienced himself as being, in the depths of himself, a being
other than himself.”
The profound sense of alienation that ensues from experiencing oneself in terms of the other’s
misrecognition also highlights the binding force of the imperatives of attachment. It is in this
context that we consider a fourth property of affects, namely, that all affects contain within them
vicissitudes of attachment and separation. Particularly poignant for injuries to the capacity to
feel is the paradox inherent in those urgent moments when the need for attachment is met by
 528 GERSON

a situation cast as precluding the possibility of attachment. Faced with the impossibility of the
necessary, affective life is rendered chaotic and is experienced as terrifying panic, as uncontrol-
lable helplessness, as deadened via somatization, or as psychotically organized. We can readily
and regularly observe that uncontainable affect maps the point where feelings and attachment
are experienced as incompatible and thus signifies the failure of relationship. As many have
noted when describing the impact role of the “witness” in the psychic fate of traumatic moments,
the prohibition on communicating affects and experience attendant to abuse itself constitutes a
trauma as it segregates the individual from the possibility of an empathic other who can con-
tain and provide opportunities for the reassimilation of the previously unbearable event (Gerson,
2009; Laub, 1992; Ullman, 2006).
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We are most familiar with the silences exacted by the dominant in return for protection from
even worse abuse, but it does us well to recall the often more pernicious silences that are called
forth by our own inability to hear and bear awful truths. Silence ensues from the conviction,
whether experientially based or defensively organized, that no other person exists who wishes
to, or is able to, hear and bear the anguish; yet by rendering the world deaf, silence leaves the
abused isolated, hopeless, and more prone to hysteric expression.
The fifth dimension of affective organization highlights that all feelings contain a develop-
mental history, a trajectory from the past, through the present and toward the future. Affects are
the routes upon which repetition compulsions travel. And the repetitions found in hysteria are
those caused by traumas of humiliation. This is not the repetition of reliving through symbolic
action a repressed erotic memory but rather repetitions of the myriad ways in which humiliation
has rendered affect incompetent to achieve its aims by destroying its intentionality, informative
power, communicative capability, and its role in attachment. Clinically, we note the repetitive
effects of humiliations in our patients via their persistent felt conviction of lack of agency and
passivity, their lack of knowledge about their own experience and the workings of others, their
inability to convey themselves so that a sense of mutual understanding evolves, and by a con-
tinuous threat to attachment that permeates the transference and haunts the treatment. Trauma,
according to Russell, achieves its status as a repetition by fracturing current experience at that
point where it is weakest—at the point where a relational containment failed and the urgency of
affect spilled over and flooded.
The impossibilities of such moments reminds of Freud’s (1914) incisive insight that “one
must either love or fall ill.” Judith Butler (1993, p. 65) has read this as meaning that “perhaps the
sexuality that appears as illness is the insidious effect of such a censoring of love.” And, it seems
to me, that the pathway by which a “censoring of love” becomes a “sexuality that appears as
illness” is one that traverses the body, marking the body into abject zones devoid of the possibility
of love while stimulating the creation of fantastic eroticism designed to unilaterally rescue the
body from the deadening effects of its censorship.
As psychoanalysts we enter this system prepared to feel the inchoate nature of the patient’s
affective world and to gradually respond to our own feelings as signals rather than as events,
signals through which we may feel the impact of the patient’s desires, understand them, commu-
nicate them, and so forge an attachment that grounds a new history. We hope in this process to
help the patient uncover the potentials, and particularly the potential for a full affective life, that
was castrated by humiliation and rendered the patient hysteric.
 HYSTERIA AND HUMILIATION 529

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CONTRIBUTOR

Sam Gerson, Ph.D., is Professor, California School of Professional Psychology of Alliant

International University, and affiliated with Psychoanalytic Institute of Northern California.