The Hysteric and the HSP.

This paper examines twenty-first-century research on sensory processing sensitivity (SPS) alongside mid-nineteenth-century research on hysteria. Doing so sheds light on how we have long thought of sensorial-emotional experience as progressing along a medical narrative from cause to cure. Today's rhetoric around the highly sensitive person (HSP) begins to diverge from the rhetoric around hysteria through the theorized cause and the dismissal of the need for a cure. When current perspectives remove the emphasis on a cure, the narrative emphasizes a broader need for social-emotional learning and cultural revision to stigma around sensitivity.

Battey's operation as a treatment for hysteria: a review of a series of cases in the nineteenth century.

Ovarian resection as a treatment for hysteria, called 'Battey's operation' or 'normal ovariotomy', was performed in the nineteenth century. Battey later reported that the resected ovaries appeared to have 'cystic degeneration'. Currently, patients with acute neuropsychiatric symptoms are screened for teratomas for the differential diagnosis of anti-NMDA receptor encephalitis. There is now a hypothesis that ovarian lesions resulting in paraneoplastic encephalitis were among the patients who underwent Battey's operation. We identified 94 published cases of Battey's operation for neuropsychiatric symptoms in the late nineteenth century. Among 36 cases with detailed descriptions, we found 3 patients who showed acute onset neuropsychiatric symptoms with macropathological ovarian findings that were compatible with teratoma. They showed favourable prognoses after surgery and might have motivated the surgeons to perform the operation.

Traumatic Hystero-Neurasthenia in Professor Charcot's Leçons du Mardi.

At the end of the 19th century, several authors became interested in the physical and psychological symptoms resulting from traumatic life events. Oppenheim presented 42 detailed clinical observations. He suggested the term "traumatic neurosis." Charcot, who was interested in male hysteria, published over 20 cases of traumatic hysteria between 1878 and 1893. The symptoms were considered to have a dynamic or functional origin. The role of horror and terror during the trauma was emphasized. However, Charcot opposed the idea of traumatic neuroses as specific syndromes as he considered them to be only an etiological form of hystero-neurasthenia. In The Tuesday Lessons (Les Leçons du Mardi), he presents several observations. They are surprising when compared with the current criteria for posttraumatic stress disorder (PTSD). Although he had rejected this new entity, a hundred years before the appearance of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, Charcot described most of the symptoms mentioned for a diagnosis of PTSD such as intrusion (reliving the trauma, nightmares, and severe emotional distress), avoidance, negative changes in thinking and mood (negative thoughts, lack of interest, etc.), arousal, and reactivity (trouble sleeping, trouble concentrating, being easily startled or frightened, irritability, etc.).

Edgar Adrian (1889-1977) and Shell Shock Electrotherapy: A Forgotten History?

The English electrophysiologist Edgar Adrian (1889-1977) was the recipient of the Nobel Prize for physiology in 1932 for his research on the functions of neurons. During World War I, at Queen Square in London, he devised an intensive electrotherapeutic treatment for shell-shocked soldiers. The procedure, developed with Lewis Yealland (1884-1954), was similar to "torpillage," the faradic psychotherapy used in France. Adrian and Yealland considered that the pain accompanying the use of faradic current was necessary for both therapeutic and disciplinary reasons, especially because of the suspicion of malingering. According to Adrian, this controversial electric treatment was only able to remove motor or sensitive symptoms. After the war, he finally admitted that war hysteria was a complex and difficult phenomenon.

The 'secret' source of 'female hysteria': the role that syphilis played in the construction of female sexuality and psychoanalysis in the late nineteenth and early twentieth centuries.

In the late nineteenth and early twentieth centuries, the unspoken fear of syphilis played a significant role in the development of beliefs about female sexuality. Many women were afraid of sexual relationships with men because they feared contracting syphilis, which was, at that time, untreatable. Women also feared passing this disease on to their children. Women's sexual aversion, or repression, became a focus for Freud and his colleagues, whose theory of psychosexual development was based on their treatment of women. This article examines the case of Dora, the memoirs of Mabel Dodge Luhan and other sources to argue that the fear of syphilis was a significant factor in upper- and middle-class women's avoidance of heterosexual relationships. The fear of syphilis, in turn, became a significant factor in the psychoanalytic construction of female sexuality. The social suppression of the fear of syphilis has had a profound impact on theories of women's development. The implication for psychiatry is that our models of psychological development occur within a sociocultural milieu and cannot escape suppressed aspects of our culture.

Aortic Dissection Presenting as "Hysteria".

BACKGROUND: Patients with medical conditions may present with psychiatric symptoms, which may lead to worse physical health care. Here we present the case of a patient with acute aortic dissection masked by psychiatric symptoms after a stressful event. CASE REPORT: A 29-year-old female medical student presented to the Emergency Department (ED) complaining about the feeling of "hysteria" after an argument with her boyfriend earlier the same day. She did not report other symptoms or pain. Careful physical examination, initially impeded by the patient's agitation, revealed pulseless extremities. Blood gas analysis showed metabolic acidosis. Transthoracic echocardiography and computed tomography ultimately led to the correct diagnosis: Stanford Type-A aortic dissection. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Medical conditions requiring acute diagnostic work-up and therapy may present with psychiatric symptoms. Increased awareness and the use of standardized operating procedures in the ED may prevent fatal misdiagnoses in these patients.

Panic and Culture: Hysterike Pnix in the Ancient Greek World.

Starting perhaps in the second century BCE, and with Hippocratic precedent, ancient medical writers described a condition they called hysterike pnix or "uterine suffocation." This paper argues that uterine suffocation was, in modern terms, a functional somatic syndrome characterized by chronic anxiety and panic attacks. Transcultural psychiatrists have identified and described a number of similar panic-type syndromes in modern populations, and a plausible theory of how they work has been advanced. These insights, applied to the ancient disease of hysterike pnix, demystify the condition and illuminate the experience of the women who suffered from it.

Sigmund Freud and hysteria: the etiology of psychoanalysis?

Sigmund Freud developed a specific interest in hysteria after his stay with Professor Jean-Martin Charcot during the winter of 1885-1886, although his previous activity mainly consisted of neuropathology and general medical practice. Most of his initial studies on hysteria (hysteria in men, influence of subconscious ideas, role of traumas, and psychological and sexual factors) were indeed 'borrowed' from Charcot and his immediate followers, such as Pierre Janet and Paul Richer. Subsequently, Freud developed with Breuer a theory of hysteria which encompassed a mixture of Janet's 'fixed subconscious ideas' with the 'pathological secret' concept of Moriz Benedikt. After their book Studies on Hysteria (1895), Freud interrupted his collaboration with Breuer and developed the concept of conversion of psychological problems into somatic manifestations, with a strong 'sexualization' of hysteria. Firstly, he believed that actual abuses had occurred in these patients (the 'seduction' theory), but then blamed them for having deceived him on that issue, so that he subsequently launched a 'fantasy' theory to explain the development of hysterical symptoms without the necessity of actual abuses. Like many of his contemporaries, and contrary to his claims, Freud did not follow a scientific process of verified experiments, but rather adapted his theories to the evolution of his own beliefs on psychological conditions, selectively emphasizing the aspects of his 'therapies' with patients which supported his emerging ideas, with often abrupt changes in theoretical interpretations. While it remains difficult to get a clear, synthetic vision of what was Freud's definite theory of hysteria, it is obvious that hysteria really was the origin of what would become Freud's psychoanalytical theory. Indeed, psychoanalysis appears to have been initially developed by him largely in order to absorb and explain his many changes in the interpretation of hysterical manifestations.

World War I psychoneuroses: hysteria goes to war.

During the First World War, military physicians from the belligerent countries were faced with soldiers suffering from psychotrauma with often unheard of clinical signs, such as camptocormia. These varied clinical presentations took the form of abnormal movements, deaf-mutism, mental confusion, and delusional disorders. In Anglo-Saxon countries, the term 'shell shock' was used to define these disorders. The debate on whether the war was responsible for these disorders divided mobilized neuropsychiatrists. In psychological theories, war is seen as the principal causal factor. In hystero-pithiatism, developed by Joseph Babinski (1857-1932), trauma was not directly caused by the war. It was rather due to the unwillingness of the soldier to take part in the war. Permanent suspicion of malingering resulted in the establishment of a wide range of medical experiments. Many doctors used aggressive treatment methods to force the soldiers exhibiting war neuroses to return to the front as quickly as possible. Medicomilitary collusion ensued. Electrotherapy became the basis of repressive psychotherapy, such as 'torpillage', which was developed by Clovis Vincent (1879-1947), or psychofaradism, which was established by Gustave Roussy (1874-1948). Some soldiers refused such treatments, considering them a form of torture, and were brought before courts-martial. Famous cases, such as that of Baptiste Deschamps (1881-1953), raised the question of the rights of the wounded. Soldiers suffering from psychotrauma, ignored and regarded as malingerers or deserters, were sentenced to death by the courts-martial. Trials of soldiers or doctors were also held in Germany and Austria. After the war, psychoneurotics long haunted asylums and rehabilitation centers. Abuses related to the treatment of the Great War psychoneuroses nevertheless significantly changed medical concepts, leading to the modern definition of 'posttraumatic stress disorder'.

'Shell shock' revisited: an examination of the case records of the National Hospital in London.

During the First World War the National Hospital for the Paralysed and Epileptic, in Queen Square, London, then Britain's leading centre for neurology, took a key role in the treatment and understanding of shell shock. This paper explores the case notes of all 462 servicemen who were admitted with functional neurological disorders between 1914 and 1919. Many of these were severe or chronic cases referred to the National Hospital because of its acknowledged expertise and the resources it could call upon. Biographical data was collected together with accounts of the patient's military experience, his symptoms, diagnostic interpretations and treatment outcomes. Analysis of the notes showed that motor syndromes (loss of function or hyperkinesias), often combined with somato-sensory loss, were common presentations. Anxiety and depression as well as vegetative symptoms such as sweating, dizziness and palpitations were also prevalent among this patient population. Conversely, psychogenic seizures were reported much less frequently than in comparable accounts from German tertiary referral centres. As the war unfolded the number of physicians who believed that shell shock was primarily an organic disorder fell as research failed to find a pathological basis for its symptoms. However, little agreement existed among the Queen Square doctors about the fundamental nature of the disorder and it was increasingly categorised as functional disorder or hysteria.

Defesa e sexualidade nos primórdios da psicanálise / Défense et sexualité dans les origines de la psychanalyse / Defense and sexuality in the dawn of psychoanalysis

Este artigo pretende investigar como a teoria da defesa que Sigmund Freud propõe no início de suas pesquisas possibilitou a consideração da sexualidade como causa das psiconeuroses. Nesse sentido, afasta-se das leituras que consideram a psicanálise como uma teoria culturalista, isto é, uma teoria que determina os processos psíquicos prevalentemente a partir de fatores sociais e culturais. Percorrendo os artigos pré-psicanalíticos, o autor mostra como Freud se separa dos seus mestres e também como expande a noção de sexualidade para as excitações de outras zonas corporais, ideia que vem a ser desenvolvida na caracterização da sexualidade das crianças como perverso-polimorfa(AU)

Cet article propose d’investiguer la façon don’t la théorie de la défense que Sigmund Freud a proposé au début de ses recherches a rendu possible la considération de la sexualité comme la cause des psychonévroses. Dans ce sens il s’écarte des lectures qui considèrent la psychanalyse comme une théorie culturaliste, c’est a dire, une théorie qui détermine les processus psychiques surtout d’élements sociaux et culturels. Tout en faisant un parcours des écrits pré-psychanalytiques, l’auteur nous montre comment Freud se sépare de ses professeurs et aussi comment il élargit la notion de sexualité pour comprendre l’excitation d’autres zones du corps, une idée qui sera développée dans la définition de la sexualité des enfants comme perverse-polimorphe(AU)

This article aims to investigate the manner in which the defense theory that Sigmund Freud proposed in his early research, made it possible to consider sexuality as the cause of psychoneuroses. In this sense he strays from the readings that consider psychoanalysis as culturalist theory, which means it is a theory that defines the psychological processes as mainly social and cultural products. While he courses through pre-psychoanalytic writings. The author shows us how Freud separates himself from his masters and also how he expands on the concept of sexuality in order to understand the excitement of other parts of the body, an idea that will be develloped into the definiton of children’s sexuality as polymorphous perverse(AU)

Defesa e sexualidade nos primórdios da psicanálise / Défense et sexualité dans les origines de la psychanalyse / Defense and sexuality in the dawn of psychoanalysis

Este artigo pretende investigar como a teoria da defesa que Sigmund Freud propõe no início de suas pesquisas possibilitou a consideração da sexualidade como causa das psiconeuroses. Nesse sentido, afasta-se das leituras que consideram a psicanálise como uma teoria culturalista, isto é, uma teoria que determina os processos psíquicos prevalentemente a partir de fatores sociais e culturais. Percorrendo os artigos pré-psicanalíticos, o autor mostra como Freud se separa dos seus mestres e também como expande a noção de sexualidade para as excitações de outras zonas corporais, ideia que vem a ser desenvolvida na caracterização da sexualidade das crianças como perverso-polimorfa

Cet article propose d’investiguer la façon don’t la théorie de la défense que Sigmund Freud a proposé au début de ses recherches a rendu possible la considération de la sexualité comme la cause des psychonévroses. Dans ce sens il s’écarte des lectures qui considèrent la psychanalyse comme une théorie culturaliste, c’est a dire, une théorie qui détermine les processus psychiques surtout d’élements sociaux et culturels. Tout en faisant un parcours des écrits pré-psychanalytiques, l’auteur nous montre comment Freud se sépare de ses professeurs et aussi comment il élargit la notion de sexualité pour comprendre l’excitation d’autres zones du corps, une idée qui sera développée dans la définition de la sexualité des enfants comme perverse-polimorphe

This article aims to investigate the manner in which the defense theory that Sigmund Freud proposed in his early research, made it possible to consider sexuality as the cause of psychoneuroses. In this sense he strays from the readings that consider psychoanalysis as culturalist theory, which means it is a theory that defines the psychological processes as mainly social and cultural products. While he courses through pre-psychoanalytic writings. The author shows us how Freud separates himself from his masters and also how he expands on the concept of sexuality in order to understand the excitement of other parts of the body, an idea that will be develloped into the definiton of children’s sexuality as polymorphous perverse

[Migraine associated with conversion symptoms (Babinski's migraine): evaluation of a series of 43 cases]. / Jaqueca asociada a trastorno de conversión (jaqueca de Babinski). Análisis de una serie de 43 casos.

BACKGROUND: In 1890 four cases of headache associated with visual symptoms and hysterical disorder were described by the French neurologist Babinski as migraine ophthalmique hystérique, or hysterical ophthalmic migraine. Since that time this association has seldom been described, and the possibly high frequency previously reported still remains to be established. This paper has reused Babinski's description and it tries to rehabilitate the syndrome described by the French semiologist across the relatively frequent experience of this type of patients in a public hospital. Also it analyzes the reason of the oblivion of his description. METHOD: This study presents a series of 43 cases of headache of the migraine type associated with other symptoms, most consistent with basilar-type migraine according to IHS criteria. Diagnosis of conversion disorder (hysteria) was grounded in the criteria set forth in the DSM-IV. RESULTS: All patients exhibited one or more manifestations of hysteria (conversion symptoms) during migraine attacks, and some did in the intervals between attacks as well. Details of the headaches, associated symptoms, and hysterical manifestations are discussed. Most patients improved with antimigraine medication. Altered consciousness may have contributed to the onset of hysterical symptoms. CONCLUSIONS: The basilar type migraine associated with conversion symptoms described of systematized form by Babinski, it is not a rare entity. Similar pictures have been described along the history of the medicine. The later silence possibly is due to the historical difficulty in defining accurately the conversión disorders. The Babinskís migraine is a certain well entity and must be recovered for the clinic.

[Functional somatization: a conceptual review]. / Somatização funcional: uma revisão do conceito.

The authors have brought together and analised texts about the history of the concept of hysteria. In these texts hysteria is fundamentally considered a disease of organic origin (of the womb), and, in the Middle Age, evidence of demonic possession. From the XVII century onwards, apart from the etiopathogenic concepts, also taken into consideration are aspects connected to the differential diagnosis with other similar entities and the therapy used each period. Even, in subsequent centuries, authors such as Syndenham, who consider hysteria to be a multidimensional entity, are rare. Empiricism has contributed to discoveries in biology and physiology, both general and of the nervous system itself, and given birth to the formulation of the Spinal Irritation Theory and Reflex Theory. These theories have led to strictly organic treatment of hysteria, in the same way that hysterectomies were performed to alleviate somatic symptoms connected to this disease. The introduction of hypnosis in medical practice, with Charcot in X1X century, allowed for the element of suggestion to be observed ( a non organic element) which accompanies the symptoms of hysteria. Two of his disciples, Janet and Freud, would define and isolate psychic mechanisms in the symptoms of hysteria: Dissociation of the consciousness (Janet) and Conversion (Freud). The last one developed a therapeutic method of a psychological nature for hysteria. The therapeutic implications and the pertinence of the distinction between unspecific somatization or functional (of somatic origin) somatization and somatization linked to disassociation mechanisms and conversion (psychic origin) are discussed as well as the evolution of international classification systems of somatization and the questions posed by the algorithms chosen for the cataloguing of symptoms. A revision of the relevant empirical studies about the association of somatization with depressive and anxiety disorders, within the general population, is made. The characteristics that permeate the clinical descriptions of somatoform disorders (whose validity criteria remain weak) and are not integrated within the diagnostic criteria for somatoform disorders are considered. We draw conclusions about the difficulties and consequences of the changes that some authors advocate in relation to the new classification system for somatoform syndromes.

[Hysteria according to Charcot. The rise and disappearance of the 'nervous disorder of the century'; a medical historical study]. / Hysterie volgens Charcot; opkomst en verdwijning van de 'zenuwaandoening van de eeuw'. Een medisch-historische studie.

BACKGROUND: This study discusses the course of hysteria during the second half of the 19th century. AIM: To give insight into the changing ideas about hysteria. METHOD: Study of the literature. RESULTS: In 1870 the interpretation of hysteria put forward by the powerful and influential neurologist Jean-Martin Charcot (1825-1893) spread from Paris to the whole of France. In the course of time ideas about the aetiology of hysteria were adjusted twice. The clinical symptoms also underwent a metamorphosis and over the years different interpretations of hysteria were accepted by other groups as well. Up till 1870 hysteria had been regarded as a gynaecological illness that affected almost exclusively women; as a result of Charcot's work the illness was transformed into a neurological disorder. However, shortly before his death Charcot had to acknowledge that he had been mistaken and that hysteria was in fact a psychiatric disorder. CONCLUSION: The course of the 19th century nervous disorder ran parallel to Charcot's medical career. After 1885 both had passed their peak. When Charcot died in 1893 hysteria had practically disappeared from French hospitals. The Parisian neurologist had not discovered the illness, he had in fact created it himself.

Post concussion syndrome: the attraction of the psychological by the organic.

Post concussion symptoms following mild traumatic brain injury are a difficult clinical state to conceptualise. The constellation of symptoms include those with an organic signature (and presumed organic aetiology), and those with overt psychological features. A seemingly trivial head injury may result in enduring symptoms. The validity of post concussion syndrome (PCS) has been the focus of much medico-legal debate, as has its cause. Whether PCS is 'neurogenic' or 'psychogenic' in aetiology remains contestable. Babinski, in 1918, hypothesised that an organic factor initiated the symptoms of the disorder now known as PCS, and that this acted as a 'bait', or attractor, for pre-existing and post-injury psychological influences. This hypothesis, which has been neither proven nor disproven over the subsequent nearly one hundred years, deserves reconsideration for it is an appealing model of PCS.

The mirror neuron system may play a role in the pathogenesis of mass hysteria.

Mass hysteria or collective hysteria usually begins when an individual shows a hysteric manifestation in front of others in the same group who later contagiously acquire the same symptoms. The underlying pathogenesis of mass hysteria is still unknown. It has been demonstrated that the mirror neuron system (MNS) provides an important neural substrate for humans' ability to imitate and there is an inhibitive component of MNS keeping us from imitating everything we see. We proposed that the inhibitive component for MNS automatic imitation may not function well in individuals of the group that results in the outbreaks of mass hysteria. We also provide evidences from emotional contagion, gender difference and treatment in mass hysteria to support this hypothesis.

Hysterical traits are not from the uterus but from the testis: a study in men with sexual dysfunction.

INTRODUCTION: The relationship between testosterone (T) and psychopathology in subjects with sexual dysfunction has not been completely clarified. AIM: To evaluate the association between T levels and different psychopathological symptoms and traits in men seeking treatment for sexual dysfunction. METHODS: A consecutive series of 2,042 heterosexual male patients (mean age 51.8 +/- 13) consulting an outpatient clinic for sexual dysfunction was retrospectively studied. MAIN OUTCOME MEASURES: Several hormonal, biochemical, and instrumental parameters were investigated, including testis volume (Prader orchidometr) and penile blood flow (penile Doppler ultrasound). Patients were interviewed, prior to the beginning of any treatment, with the previously validated Structured Interview on Erectile Dysfunction (SIEDY), and ANDROTEST (a structured interview for the screening of hypogonadism in patients with sexual dysfunction). They also completed the Middlesex Hospital Questionnaire (MHQ) a brief self-reported questionnaire for the screening of the symptoms of mental disorders in nonpsychiatric setting. RESULTS: T levels showed a negative correlation with depressive and anxiety (somatized and phobic) symptoms. Conversely, histrionic/hysterical traits were strongly and positively associated with elevated T. Men with histrionic/hysterical traits had higher androgenization, as suggested by both higher total and free T, higher testis volume and a lower ANDROTEST score. They were also characterized by better self-reported sexual functioning and penile blood flow. Accordingly, when SIEDY scales were considered, SIEDY scale 2 (relational domain) was significantly lower in subjects with histrionic/hysterical traits further indicating a more satisfying sexual relationship. CONCLUSIONS: In men consulting for sexual dysfunction, histrionic/hysterical personality is associated with higher androgenization and better sexual functioning. Hysteria, previously considered as a typically feminine psychopathological trait (the uterine theory), should now be considered as an index of better masculine sexual well-being.