Hysteria and the Origins of Psychoanalysis

This assignment delves into the complex relationship between hysteria and the founding of psychoanalysis. It examines Anna O.'s case and its influence on Freud's theories, while acknowledging the limitations and biases inherent in early psychoanalytic thought. The paper also highlights how the concept of hysteria has evolved with advancements in psychological literature and diagnostic criteria.

qwertyuiopasdfghjklzxcvbnmqwertyui
opasdfghjklzxcvbnmqwertyuiopasdfgh
jklzxcvbnmqwertyuiopasdfghjklzxcvb
nmqwertyuiopasdfghjklzxcvbnmqwer
tyuiopasdfghjklzxcvbnmqwertyuiopas
dfghjklzxcvbnmqwertyuiopasdfghjklzx
cvbnmqwertyuiopasdfghjklzxcvbnmq
wertyuiopasdfghjklzxcvbnmqwertyuio
pasdfghjklzxcvbnmqwertyuiopasdfghj
Psychology
Hysteria and Psychoanalysis
23-Jan-18
(Student Details: )

Psychology
Hysteria refers to the ungovernable emotional sense in the colloquial use of this term. In
general, the modern medical professionals have stopped using this term for the purpose of
denoting a diagnostic category; and this has now been replaced with more appropriate defined
categories, like somatisation disorder. This led to the American Psychiatric Association in 1980,
changing the diagnosis of hysterical neurosis, conversion type to conversion type in 1980
(Kellner, 1991). Yet, in the historical context, this concept holds significance due to its
contribution in the origin of psychoanalysis. It holds particular significance in this regard as it
allowed psychoanalytic history to develop the talking treatment (Psychologist World, 2018). Dr.
Josef Breuer was a colleague of Freud who told the latter about the unusual patient called Anna
O. She suffered from severe hysteria. Breuer used to see her every day and she used to talk about
the beginning point of her symptoms. It was noted by Breuer that when she began telling him
about the origins of symptoms, they tend to disappear. This led to Feud adopting this treatment in
figuring out the beginning of hysteria (Skues, 2006). This discussion is predominantly focused
on highlighted what exactly hysteria is and how it proves to be of help in origins of
psychoanalysis.
In the history of psychology, hysteria has been used for describing the symptoms of the
illness which was atypical to the diseases already established (Feinstein, 2011). The 1800-1900s
neuro-psychiatrists described hysteria as such an illness which came with dissociation and the
reasons for such dissociation were not obvious. The symptoms which were shown in the patients
suffering from hysteria included amnesia, anaesthesia, changes in personality, abulia and motor
control disorders (Haule, 1986). In today’s world, these symptoms were known as the type of
psychoneurosis which resulted in emotional excitability, and the provocation of emotions like
panic or fear. The disturbance of the motor, cognitive and sensory functions of the humans also
Page 2

Psychology
resulted from this specific neurosis (Jones, 2016). There have been arguments by the DSM
(Diagnostic and Statistical Manual) critics that hysteria, as a condition, lacked the validity and
the only reason for it to have remained as being a disease category across the history was due to
the tradition. This led to the removal of hysteria in 1994 by DSM-IV as being an established
disease and they divided the symptoms of this disease in two distinctive sections, which are now
referred to as dissociative disorder and somatoform disorder. The issues in the two ambits
covered the symptoms which had been accepted by hysteria, which was the original term. It was
stated by DSM-IV that the diagnoses for conditions which were present in the ambit of the two
terms, i.e., dissociative disorder and somatoform disorder, were specifically applicable to the
earlier known diagnostic categories of the erstwhile disease of hysteria. These conditions were
dissociative amnesia, somatisation disorder and conversion disorder (Feinstein, 2011).
The conversion disorder had been most closely associated to disorders which had been
treated by Freud and Charcot during the 1900s and had been referred to as the symptoms which
mimicked the neurological disorders like sensory and motor deficits, mixed presentations and
pseudo seizures. Such indicator could not be related to any kind of organic source of illness and
also could not be associated with use or abuse of substance or the participation of patients in the
culturally endorsed behaviours like trances in the religious ceremony for creating them to be or
have to be diagnosed as hysteria (Feinstein, 2011). Even though the present day has separated
categories of mental disorders in DSM, the term hysteria continues to be encapsulated in every
system.
Stirling (2010), through his literature, has highlighted that the causes of hysteria are
linked to undue stress like bereavement, and with conflict, history of abuse and past trauma.
Hysteria has also been theorized as a repression of aggressive or sexual behaviour which acts as
Page 3

Psychology
its trigger. As highlighted in the introductory segment, this concept had been conveyed through
the work of Freud on Anna O, and this led to the beginning of psychoanalysis. For the symptoms
of hysteria, Anna O was treated by Freud by joining Breuer in his talk therapy and by joining
view of hysteria of Charcot (Borch-Jacobsen, 2014). The symptoms of Anna O represented the
basic and typical manifestations of this disease. The physical symptoms of hysteria included
paralysis of right side of body, disturbance in vision, language and hearing, contractures and
cough. The psychological systems covered lapse in consciousness and very recurrent
hallucinations. These symptoms had been similar to the present day indicators of conversion
disorder. The doctors could not find any organic cause for the symptoms of Anna O. Due to
these reasons, she was diagnosed with hysteria. With the work done on Anna O, the outline for
psychoanalysis started to emerge. Freud continued on using the very same therapeutic techniques
on the other patients as well, who were displaying the symptoms of hysteria. This resulted in the
full bloom of psychoanalysis (Webster, 2004). The procedures regarding the exploration of
certain concepts like repression, intrapsychic conflict and unconscious conflict in the hysteria
patients also helped in the psychoanalysis’s development. Directive and abreactive techniques
early form of free association and hypnosis were used on such patients. Freud was able to bring
more strength to the very basics of psychoanalytical theory by the use of these experiments and
by adding such techniques to the psychoanalysis practice (Krohn, 1978).
The psychoanalytical theory given by Freud and the practices associated with it place an
emphasis over the unconscious mind. It has been proposed by Freud that the mind was formed of
three key components, i.e., the id, the ego and the superego (Rennison, 2015). A major role was
played by the suggestion of these components in the development of hysteria and has been best
explained through the association of psychosexual stages regarding the development. The
Page 4

Psychology
psychosexual stages regarding the development cover anal, genital, latent, phallic and oral
phases. This theory is based on the standpoint that ego is developed in the oral phase and in the
phallic phase, the superego is developed. There have been a number of studies on the subject of
hysteria particularly in the ego psychology and there is an enhancement in the understanding due
to the more recent studies conducted in the literature. An example of this is personality disorder
being related to conflict in ego and the ones within it (Yarom, 2005).
Through the psychoanalytic theory, it has been proposed that both ego and superego had
been developed through the psyche for putting in effect certain control during the psychosexual
development over the libido. In view of Freud, the need for gratification is associated with varied
parts of body in each and every stage covered under the psychosexual development. This leads to
the conflict in between the three, i.e., id, ego and superego being associated with every
psychosexual stage of a person. The conflict at the phallic stage in as has been theorized is what
brings out the Electra and Oedipus complex in the people (McLeod, 2008). Freud had made the
suggestion that hysteria was linked with the rejected sexuality. He also presented very strong
references towards the female sexuality. This connection had been made through the Electra
complex theory where the females are stated to hold unconscious incestuous wishes, and even
feel envious about the male body parts of their caregiver males. As a result of this, hysteria
became a disease which was strongly related to the women (Yarom, 2005)
The non-Freudian approaches on the other hand, for instance that of Horney (1967) made
the suggestion that made part envy could not be deemed as secondary in comparison to the
primary phenomenon. This was in the sense that the sexual identity of women is more focused
over the aspiration of bearing a child, instead of attaining orgasm. Though, it could be suggested
that this is a sexist standpoint against the women since it shows that the women were only
Page 5

Psychology
interested in having children. Irrespective of this, sexism was slowly and gradually overcome
due to the progression of history and this became evident through the very fact that hysteria
started being deemed as a disorder with was associated to both men and women (Yarom, 2005).
Again, there have been contradictory literatures which depicted that in the period of 1970s, there
was an insistence on hysteria being prevalent more in women in comparison to the men, with
high co-morbidity being evident in between hysteria and sociopathy in women (Cloninger &
Guze, 1970).
Lerner (1974) came in support of these findings and stated that hysteria was a disease
which applied frequently to females and for men this was very less frequent, if not non-existent.
Though, even with these studies have shown that hysteria is a female only disease but the
literature has shown evidence to the fact that this is due to the patriarchal and chauvinistic nature
of society across the history and that this has influenced the findings where the males have
shown to exhibit hysterical behaviours. In this regard, it has been stated that the demonstration of
such hysterical behaviours does not necessarily mean that they, i.e., the men, have hysteria as a
condition. This may be due to the fact that the male researches did not want this weakness in
character to be associated to the male population and as a result of it they put this as a female
only illness, where the strong image of men was maintained. This is coupled with the fact that
the majority of researchers in this particular area of interest had been males, it could easily be
suggested that there was an absence of understanding of emotions and empathy in the behaviours
which the females exhibited. This resulted in the women being interpreted as being more
hysterical in comparison to the ones being exhibited by the males.
As opposed to this, the paper by Lerner (1974) showed that hysterical symptoms like
dissociative phenomena and conversion reactions were being observed in case of males but the
Page 6

Psychology
patients did not show signs of personality and cognitive features present in the hysterical
individuals, which led to the conclusion of such individuals not having hysteria. Despite this,
where the contextual and social factors were taken into consideration, it does bring attention over
the fact that the researchers and the doctors who have been involved in the study of hysteria were
predominantly men and this led to the reinforcement of the notion that the literatures was
dominated by the observations which had been influenced through the patriarchal men. In order
to support this very notion, it had been propagated that the explanation of hysteria being present
amongst the women on behalf of psychoanalysts was based on the oedipal and pre-oedipal
development tasks, which had to be achieved by women and men, and yet the libidinal
development of the two genders provided only a partial explanation over the claimed upon
sexual differences in hysteria. Thus, it was more sensible to hold the belief that the cultural and
the social factors had an important role to play in this matter (Lerner, 1974).
In context of the conflicts which are present in the psyche in each of the psychosexual
stage, the main goal of the psychoanalysis was helping or assessing the patients in bringing forth
the repressed emotions and thoughts, to the consciousness, which had been associated with these
particular phases. In resolving such conflicts, the ego is strengthened (Zimberoff & Hartman,
2000). Accordingly, the chances of developing of hysteria would be reduced. This idea is
supported by the tension in each of the phase being reliant upon the manner in which ego deals
with anxiety. This is along with the fact that hysteria due to the repressed manifestation of
incompatible idea on part off ego (Vaillant, 1992). Thus, there is clear evidence on which the
relation in between id, ego and superego, particularly in the development of hysteria and
psychosexual stages, and a major role was played by these three as being the catalyst in bringing
forth this very theory of psychoanalysis into practice. This can be demonstrated through the
Page 7

Psychology
manner in which the psychosexual conflicts strengthen the ego and help in avoiding hysteria
from being developed.
Even though the role played by hysteria in the development of psychoanalysis is
prominent and also very clear, there is a need to put on record that Freud and the other
researchers had adopted a patriarchal approach during their study of hysteria and reflected on
practice and theory of psychoanalysis (Bernheimer & Kahane, 1985). McLeod (2008) clear
provides that the writings of Freud are majorly based on male development. Through this, two
things are implied; the first is that Freud held the belief regarding the female development being
mirrored in male development; or the second thing that the female development, in comparison
to male development, was inferior. Thus, it is actually fitting for one to raise the question on the
theory regarding where hysteria was only a female based disease, whether the same was a mirror
of male hysteria. In turn, this would imply that the men were also prone to the development of
hysteria, which would weaken the literature covered in the history regarding hysteria being only
applicable or limited to the women. Another suggestion which could be made conversely was
that where the hysterical symptoms were the only thing which men faced, and which was
mirrored by the females, and which were present in the females as a full blown hysteria, it would
mean that hysteria was in reality a disease which was present in full bloom in both the genders.
Where the case was the females mirroring the very way in which the males behaved, it would
suggest and would also reinforce the notion that the psychoanalysis was just a product created by
the patriarchal foundation. This is because hysteria was the catalyst which had been attached to it
by the patriarchal influences. Due to these reasons, an individual is left in such a position where
they question whether the studies on hysteria had actually influenced psychoanalysis or that this
had been influenced by the history and findings of hysteria, since these appear to be present in
Page 8

Psychology
unity when it comes to the matter of sexism mentioned across the literatures. It cannot be denied
that hysteria continues to be a mental disorder which exists equally between the two genders
(Tucker, 2009).
To conclude, it is undeniable that hysteria had a major role to play in the development of
psychoanalysis and was also a catalyst for its development. Though, owing to the fact that in
itself, hysteria was a flawed phenomenon in the manner that it had been reflected across the
literatures of different time, which in turn led to psychoanalysis also becoming a skewed theory
which was based on chauvinistic and patriarchal theories. Nevertheless, the fact is not changed
that Anna O and hysteria contributed to the founding of psychoanalysis. There is also a need to
state that hysteria has become an outdated term now. This is due to the changed and revisions,
and the categorization of symptoms by DSM which demonstrates the progression of
psychological literature since Freud’s time.
Page 9

Psychology
References
Bernheimer, C. & Kahane, C. (1985). In Dora’s case. New York: Columbia University Press.
Borch-Jacobsen, M. (2014). Remembering Anna O.: A century of mystification. Oxon:
Routledge.
Clonninger, C. & Guze, S. (1970). Psychiatric Illness and Female Criminality: The Role of
Sociopathy and Hysteria in the Antisocial Woman. American Journal of Psychiatry,
127(3), 303-311.
Feinstein, A. (2011). Conversion disorder: advances in our understanding. Canadian Medical
Association Journal, 183(8). 915-920.
Haule, J.R. (1986). Pierre Janet and dissociation: the first transference theory and its origins in
Hypnosis. Am J Clin Hypnosis, 29, 86-94
Horney, K. (1967). Feminine psychology. New York: W.W. Norton.
Jones, C.W. (2016). Neurosis and Assimilation: Contemporary Revisions on The Life of the
Concept. London: Springer.
Kellner, R. (1991). Psychosomatic syndromes and somatic symptoms. Washington, DC:
American Psychiatric Publication.
Krohn, A. (1978). Hysteria, the elusive neurosis. New York: International Universities Press.
McLeod, S. (2014). Psychosexual Stages | Simply Psychology. Retrieved from:
http://www.simplypsychology.org/psychosexual.html
Page 10

Psychology
Psychologist World. (2018). Sigmund Freud – Psychology Issues – Psychologist World.
Retrieved: http://www.psychologistworld.com/psychologists/freud_1.php
Rennison, N. (2015). Freud And Psychoanalysis: Everything You Need To Know About Id, Ego,
Super-Ego and More. Harpenden: Oldcastle Books.
Skues, R. (2006). Sigmund Freud and the history of Anna O.: reopening a closed case. London:
Springer.
Stirling, J. (2010). Representing epilepsy: myth and matter (Vol. 3). Liverpool University Press.
Vaillant, G.E. (1992). Ego Mechanisms of Defense: A Guide for Clinicians and Researchers.
Washington, DC: American Psychiatric Press.
Webster, R. (2004). Anna O and Hysteria: Charcot and the origins of psychoanalysis. Retrieved:
http://www.richardwebster.net/print/xfreudandcharcot.htm
Yarom, N. (2005). Matrix of hysteria. London: Routledge.
Zimberoff, D. & Hartman, D. (2000). Ego Strengthening and Ego Surrender. Journal of Heart-
Centered Therapies, 3(2), 3-66.
Page 11