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 accurate terms such as somatization disorder. In 1980 the American Psychiatric Association officially changed the diagnosis of "hysterical neurosis, conversion type" to "conversion disorder".
Until the seventeenth century, hysteria was regarded as of uterine origin (from the Greek "hustera" = uterus) in the Western world. Hysteria referred to a medical condition, thought to be particular to women, caused by disturbances of the uterus. 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 belief was that hysterical symptoms would emanate from the part of the body in which the wandering uterus lodged itself.. Originally defined as a neurotic condition peculiar to women and thought to be caused by a dysfunction of the uterus" ("Hysterical").
The same general definition, or under the name female hysteria, came into use in the middle and late 19th century to describe what is today generally considered to be sexual dysfunction. Typical treatment was massage of the patient's genitalia by the physician and later vibrators or water sprays to cause orgasm.
The modern knowledge of hysterical processes was advanced by the work of Jean-Martin Charcot, a French neurologist. In 1893 Sigmund Freud attributed the rediscovery of hysteria to Charcot from the medieval conception in which a hysteric person suffers from "dissociation of consciousness". In a controversial move Charcot replaced the medieval religious terminology of demons (which had fallen out of favour with the experts at the time) with a "scientific" one. Charcot came to his theory on the mechanism of hysteria through his investigations of "nervous diseases" with outpatients in France in 1887 and 1888. Later, Charcot fully turned his attention to hysteria while working at the Salpetriere in France where he claimed that the cause of hysteria is "heredity... which is therefore a form of degeneration". Charcot employed hypnotic methods for therapy.
In the early 1890s Freud published a series of articles on hysteria which popularized Charcot's earlier work and begun the development of his own views of hysteria. By the 1920s Freud's theory was influential in Britain and the USA. The Freudian psychoanalytic school of psychology uses its own, somewhat controversial, ways to treat hysteria.
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 disorder that were previously labelled 'hysteria': somatoform and dissociative. Dissociative disorders 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. Additionally, certain culture-bound syndromes such as "ataques de nervios" ("attacks of nerves") identified in Hispanic populations, and popularized by the Almadovar film Women on the Verge of a Nervous Breakdown, exemplify psychiatric phenomena that encompass both somatoform and dissociative symptoms and that have been linked to psychological trauma.  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 facts 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.
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, and has been used to describe the periodic widespread reappearance and public interest in UFO reports, crop circles, and similar examples. Also, when information, real or fake, becomes misinterpreted but believed, e.g. penis panic. Hysteria was often associated with events like the Salem Witch Trials, or slave revolt conspiracies, where it is better understood through the related sociological term of moral panic.
|"Converation Galante" was first published in 1917 in T. S. Eliot's book Prufrock and Other Observations|
As she laughed I was aware of becoming involved in her laughter and being part of it, until her teeth were only accidental stars with a talent for squad-drill. I was drawn in by short gasps, inhaled at each momentary recovery, lost finally in the dark caverns of her throat, bruised by the ripple of unseen muscles. An elderly waiter with trembling hands was hurriedly spreading a pink and white checked cloth over the rusty green iron table, saying: "If the lady and gentleman wish to take their tea in the garden, if the lady and gentleman wish to take their tea in the garden ..." I decided that if the shaking of her breasts could be stopped, some of the fragments of the afternoon might be collected, and I concentrated my attention with careful subtlety to this end.
HYSTERIA, a term applied to an affection which may manifest itself by a variety of symptoms, and which depends upon a disordered condition of the highest nervous centres. It is characterized by psychical peculiarities, while in addition there is often derangement of the functions subserved by the lower cerebral and spinal centres. Histological examination of the nervous system has failed to disclose associated structural alterations.
By the ancients and by modern physicians down to the time of Sydenham the symptoms of hysteria were supposed to be directly due to disturbances of the uterus (Gr. barEpa, whence the name). This view is now universally recognized to be erroneous. The term "functional" is often used by English neurologists as synonymous with hysterical, a nomenclature which is tentatively advantageous since it is at least non-committal. P. J. Mains has defined hysteria as "a state in which ideas control the body and produce morbid changes in its functions." P. Janet, who has done much to popularize the psychical origin of the affection, holds that there is "a limitation of the field of consciousness" comparable to the contraction of the visual fields met with in the disease. The hysterical subject, according to this view, is incapable of taking into the field of consciousness all the impressions of which the normal individual is conscious. Strong momentary impressions are no longer controlled so efficiently because of the defective simultaneous impressions of previous memories. Hence the readiness with which the impulse of the moment is obeyed, the loss of emotional control and the increased susceptibility to external suggestion, which are so characteristic. A secondary subconscious mental state is engendered by the relegation of less prominent impressions to a lower sphere. The dual personality which is typically exemplified in somnambulism and in the hypnotic state is thus induced. The explanation of hysterical symptoms which are independent of the will, and of the existence of which the individual may be unaware, is to be found in a relative preponderance of this secondary subconscious state as compared with the primary conscious personality. An elaboration of this theory affords an explanation of hysterical symptoms dependent upon a "fixed idea." The following definition of hysteria has recently been advanced by J. F. F. Babinski: "Hysteria is a psychical condition manifesting itself principally by signs that may be termed primary, and in an accessory sense others that we may call secondary. The characteristic of the primary signs is that they may be exactly reproduced in certain subjects by suggestion and dispelled by persuasion. The characteristic of the secondary signs is that they are closely related to the primary phenomena." The causes of hysteria may be divided into (a) the predisposing, such as hereditary predisposition to nervous disease, sex, age and national idiosyncrasy; and (b) the immediate, such as mental and physical exhaustion, fright and other emotional influences, pregnancy, the puerperal condition, diseases of the uterus and its appendages, and the depressing influence of injury or general disease. Perhaps, taken over all, hereditary predisposition to nerve-instability may be asserted as the most prolific cause. There is frequently direct inheritance, and cases of epilepsy and insanity or other form of nervous disease are rarely wanting when the family history is carefully enquired into. As regards age, the condition is apt to appear at the evolution periods of life - puberty, pregnancy and the climacteric - without any further assignable cause except that first spoken of. It is rare in young children, but very frequent in girls between the ages of fifteen and twenty-five, while it sometimes manifests itself in women at the menopause. It is much more common in the female than in the male - in the proportion of 20 to 1. Certain races are more liable to the disease than others; thus the Latin races are much more prone to hysteria than are those who come of a Teutonic stock, and in more aggravated and complex forms. In England it has been asserted that an undue proportion of cases occur among Jews. Occupation, or be it rather said want of occupation,;s a prolific cause. This is noticeable more especially in the higher classes of society.
An hysterical attack may occur as an immediate sequel to an epileptic fit. If the patient suffers only from petit mal (see Epilepsy), unaccompanied by true epileptic fits, the significance of the hysterical seizure, which is really a post-epileptic phenomenon, may remain unrecognized.
It is convenient to group the very varied symptoms of hysteria into paroxysmal and chronic. The popular term "hysterics" is applied to an explosion of emotionalism, generally the result of mental excitement, on which convulsive fits may supervene. The characters of these vary, and may closely resemble epilepsy. The hysterical fit is generally preceded by an aura or warning. This sometimes takes the form of a sensation as of a lump in the throat (globus hystericus). The patient may fall, but very rarely is injured in so doing. The eyes are often tightly closed, the body and limbs become rigid, and the back may become so arched that the patient rests on her heels and head (opisthotonos). This stage is usually followed by violent struggling movements. There is no loss of consciousness. The attack may last for half-an-hour or even longer. Hysterical fits in their fully-developed form are rarely seen in England, though common in France. In the chronic condition we find an extraordinary complexity of symptoms, both physical and mental. The physical symptoms are extremely diverse. There may be a paralysis of one or more limbs associated with rigidity, which may persist for weeks, months or years. In some cases, the patient is unable to walk; in others there are peculiarities of the gait quite unlike anything met with in organic disease. Perversions of sensation are usually present; a common instance is the sensation of a nail being driven through the vertex of the head (clavus hystericus). The region of the spine is a very frequent seat of hysterical pain. Loss of sensation (anaesthesia), of which the patient may be unaware, is of common occurrence. Very often this sensory loss is limited exactly to one-half of the body, including the leg, arm and face on that side (hemianaesthesia). Sensation to touch, pain, heat and cold, and electrical stimuli may have completely disappeared in the anaesthetic region. In other cases, the anaesthesia is relative or it may be partial, certain forms of sensation remaining intact. Anaesthesia is almost always accompanied by an inability to recognize the exact position of the affected limb when the eyes are closed. When hemianaesthesia is present, sight, hearing, taste and smell are usually impaired on that side of the body. Often there is loss of voice (hysterical aphonia). It is to such cases of hysterical paralysis and sensory disturbance that the wonderful cures effected by quacks and charlatans may be referred. The mental symptoms have not the same tendency to pass away suddenly. They may be spoken of as interparoxysmal and paroxysmal. The chief characteristics of the former are extreme emotionalism combined with obstructiveness, a desire to be an object of interest and a constant craving for sympathy which is often procured at an immense sacrifice of personal comfort. Obstructiveness is the invariable symptom. Hysteria may pass into absolute insanity.
The treatment of hysteria demands great tact and firmness on the part of the physician. The affection is a definite entity and has to be clearly distinguished from malingering, with which it is so often erroneously regarded as synonymous. Drugs are of little value. The moral treatment is all-important. In severe cases, removal from home surroundings and isolation, either in a hospital ward or nursing home, are essential, in order that full benefit may be derived from psychotherapeutic measures.
BIBLIOGRAPHY. - Charcot, Lecons sur les maladies du systemb nerveuse (1877); S. Weir Mitchell, Lectures on Diseases of the Nervous System especially in Women (1885); Buzzard, Simulation of Hysteria by Organic Nervous Disease (1891); Pitres, Lecons cliniques sur l'hyste'rie et l'hypnotisme (1891); Richer, Etudes cliniques sur la grande hysterie (1891); Gilles de la Tourette, Traite clinique et therapeutique de l'hysterie (1891); Bastian, Hysterical or Functional Paralysis (1893); Ormerod, Art. "Hysteria," in Clifford Allbutt's System of Medicine (1899); Camus and Pagnez, Isolement et Psychotherapie (1904). (J. B. T.; E. BRA.) ,„
Hysteria is when someone has a very strong emotion that is unmanageable. Often, this means a very strong sense of fear. When someone has hysteria, it is called "hysterics". Hysteria could be caused by traumatic events in a person's life.
Today, many psychiatrists and other doctors do not use the word "hysteria" for a patient. They use other words that have the same meaning. Some of the words they may use are "psychosomatic", "functional", "nonorganic", "psychogenic", or "medically unexplained".