Female hysteria

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Female hysteria
Classification and external resources
SpecialtyPsychiatry

Female hysteria was once a common medical diagnosis for women. It is no longer recognized by medical authorities as a medical disorder, but still has lasting social implications. Its diagnosis and treatment were routine for hundreds of years in Western Europe.[1] In Western medicine hysteria was considered both common and chronic among women. The American Psychiatric Association dropped the term hysteria in 1952. Even though it was categorized as a disease, hysteria's symptoms were synonymous with normal functioning female sexuality.[1] Women considered to have it exhibited a wide array of symptoms, including anxiety, shortness of breath, fainting, nervousness, sexual desire, insomnia, fluid retention, heaviness in the abdomen, irritability, loss of appetite for food or sex, (paradoxically) sexually forward behaviour, and a "tendency to cause trouble for others".[1] In extreme cases, the woman may have been forced to enter an insane asylum or to have undergone surgical hysterectomy.[2]

Early history[edit]

Water massages as a treatment for hysteria (c. 1860)
Female patient with sleep hysteria

The history of hysteria can be traced to ancient times. Dating back to 1900 BC in Ancient Egypt, the first descriptions of hysteria within the female body were found recorded on the Kahun Papyri.[3] In this culture, the womb was thought capable of affecting much of the rest of the body, but "there is no warrant for the fanciful view that the ancient Egyptians believed that a variety of bodily complaints were due to an animate, wandering womb".[4] Prolapse was also known.[4]

In ancient Greece, wandering womb was described in the gynecological treatise of the Hippocratic Corpus, "Diseases of Women".[5] which dates back to the 5th and 4th centuries BC. Plato's dialogue Timaeus compares a woman's uterus to a living creature that wanders throughout a woman's body, "blocking passages, obstructing breathing, and causing disease".[6] Aretaeus of Cappadocia described the uterus as "an animal within an animal" (less emotively, "a living thing inside a living thing"), which causes symptoms by wandering around a woman's body putting pressure on other organs.[5] The standard cure for this "hysterical suffocation" was scent therapy, in which good smells were placed under a woman's genitals and bad odors at the nose, while sneezing could be also induced to drive the uterus back to its correct place.[5] The concept of a pathological "wandering womb" was later viewed as the source of the term hysteria,[6] which stems from the Greek cognate of uterus, ὑστέρα (hystera).

While in the Hippocratic texts a wide range of women were susceptible - including in particular the childless - Galen in the 2nd century omitted the childless and saw the most vulnerable group as "widows, and particularly those who previously menstruated regularly, had been pregnant and were eager to have intercourse, but were now deprived of all this" (On the Affected Parts, 6.5).[5] He also denied that the womb could "move from one place to another like a wandering animal".[5] His treatments included scent therapy and sexual intercourse, but also rubbing in ointments to the external genitalia; this was to be performed by midwives, not physicians.[5] While most Hippocratic writers saw the retention of menstrual blood in the womb as a key problem, for Galen even more serious was the retention of "female seed".[7]

Another cause was[when?] thought to be the retention of a supposed female semen, thought to have mingled with male semen during intercourse. The female semen was believed to have been stored in the womb. Hysteria was referred to as "the widow's disease", because the female semen was believed to turn venomous if not released through regular climax or intercourse.[8] If the patient was married, this could be completed by intercourse with their spouse. Other than participating in sexual intercourse, it was thought that women could position the uterus back into place with fumigation of both the face and genitals. Fumigating the body with special fragrances would supposedly place the uterus into its natural spot in the female body.[3]

Middle Ages, Renaissance, and the early modern period[edit]

Through the Middle Ages another cause of dramatic symptoms could be found: demonic possession. It was thought that demoniacal forces were attracted to those who were prone to melancholy, particularly single women and the elderly. When a patient could not be diagnosed, or cured of a disease, it was thought that the symptoms of what would now be diagnosed as mental illness, were actually those of someone possessed by the devil.[9] After the 17th century, the correlation of demonic possession and hysteria were gradually discarded and instead was described as behavioral deviance, a medical issue.[10]

In the 16th and 17th centuries, hysteria was still believed to be due to retention of humours or fluids in the uterus, sexual deprivation, or by the tendency of the uterus to wander around the female body causing irritability and suffocation. Self-treatment such as masturbation, was not recommended and also considered taboo. Marriage, and regular sexual encounters with her husband, was still the most highly recommended long-term course of treatment for a woman suffering from hysteria.[9][11] It was thought to purge the uterus of any built up fluid, and semen was thought to have healing properties, 'In this model ejaculation outside the vagina was conducive to uterine disease, since the female genitalia did not receive the health benefits of male emission. Some physicians regarded all contraceptive practices as injurious to women for this reason'. Giovanni Matteo Ferrari da Gradi cited marriage and childbearing as a cure for the disease. If pleasure was obtained from them then hysteria could be cured.[11] If a woman was unmarried, or widowed, manual stimulation by a midwife involving certain oils and scents was recommended to purge the uterus of any fluid retention. Lack of marriage was also thought to be the cause of most melancholy in single women, such as nuns or widows. Studies of the causes and effects of hysteria were continued in the 16th and 17th century by medical professionals such as Ambroise Pare, Thomas Sydenham, and Abraham Zacuto who published their findings furthering medical knowledge of the disease, and informing treatment.[11][9] Physician Abraham Zacuto writes in his Praxis Medica Admiranda from 1637,

'Because of retention of the sexual fluid, the heart and surrounding areas are enveloped in a morbid and moist exudation: this is especially true of the more lascivious females, inclined to venery, passionate women who are most eager to experience physical pleasure; if she is of this type she cannot ever be relieved by any aid except that of her parents who are advised to find her a husband. Having done so the man's strong and vigorous intercourse alleviated the frenzy.'

— Maines, 29, [11]

There was continued debate about whether it was morally acceptable for a physician to remove excess female seed through genital manipulation of the female patient; Pieter van Foreest (Forestus) and Giovanni Matteo da Grado (Gradus) insisted on using midwives as intermediaries, and regarded the treatment as the last resort.[12]

18th century[edit]

In the 18th century, hysteria slowly became associated with mechanisms in the brain rather than the uterus. French physician Philippe Pinel freed hysteria patients detained in Paris' Salpêtrière sanatorium on the basis that kindness and sensitivity are needed to formulate good care.

19th century[edit]

Jean-Martin Charcot argued that hysteria derives from a neurological disorder and showed hysteria is more common among men than women.[3] Charcot's theories of hysteria being a physical affliction of the mind and not of the body led to a more scientific and analytical approach to the disease in the 19th century. He dispelled the beliefs that hysteria had anything to do with the supernatural and attempted to define it medically.[13] Charcot's use of photography,[14] and the resulting concretization of women's expressions of health and distress, continue to influence women's experiences of seeking healthcare.[15] Though older ideas persisted during this era, over time female hysteria began to be thought of less as a physical ailment and more of a psychological one.[16]

George Beard, a physician who cataloged an incomplete list including 75 pages of possible symptoms of hysteria,[17] claimed that almost any ailment could fit the diagnosis. Physicians thought that the stress associated with the typical female life at the time caused civilized women to be both more susceptible to nervous disorders and to develop faulty reproductive tracts.[18] One American physician expressed pleasure in the fact that the country was "catching up" to Europe in the prevalence of hysteria.[17]

According to Pierre Roussel and Jean-Jacques Rousseau, femininity is a natural and essential desire for women, 'Femininity is for both authors an essential nature, with defined functions, and the disease is explained by the non-fulfillment of natural desire.'[9] It is during this era of industrial revolution and the major development of cities and modern life, that this natural tendency is thought to be disrupted causing lethargy or melancholy leading to hysteria.[9] This melancholy or lethargy is retrospectively thought to have been caused and aggravated by the restrictive views on female sexuality at the time, which held masturbation as something unhealthy and unchaste. This led to a surge in female patients for medical practitioners who were looking for the massage cure to their hysteria. The rate of hysteria was so high in the socially restrictive industrial era that women were prone to carrying smelling salts about their person in case they swooned, reminiscent of Hippocrates' theory of smells coercing the uterus back into place. For doctors manual massage treatment was becoming tiring, laborious and time-consuming and they were looking for a way to increase productivity.[11]

Rachel Maines hypothesized that doctors from the classical era up until the early 20th century commonly treated hysteria by masturbating female patients to orgasm (termed "hysterical paroxysm"), and that the inconvenience of this may have driven the early development of and the market for the vibrator.[1] Although Maines's theory that hysteria was treated by masturbating female patients to orgasm is widely repeated in the literature on female anatomy and sexuality,[19] some historians dispute Maines's claims about the prevalence of this treatment for hysteria and about its relevance to the invention of the vibrator, describing them as a distortion of the evidence or that it was only relevant to an extremely narrow group.[20][21][22] In 2018, Hallie Lieberman and Eric Schatzberg of Georgia Institute of Technology challenged Maines's claims for the use of electromechanical vibrators to treat hysteria in the 19th century.[23] Maines has said that her theory about the prevalence of masturbation for hysteria and its relevance to the invention of the vibrator should be treated as a hypothesis rather than a fact.[19]

Frederick Hollick was a firm believer that a main cause of hysteria was licentiousness present in women.[24]

Freud and decline of diagnosis[edit]

The number of French psychiatric theses on hysteria[25]

During the early 20th century, the number of women diagnosed with female hysteria sharply declined. This decline has been attributed to many factors. Some medical authors claim that the decline was due to gaining a greater understanding of the psychology behind conversion disorders such as hysteria.[25]

With so many possible symptoms, historically hysteria was considered a catchall diagnosis where any unidentifiable ailment could be assigned.[3] As diagnostic techniques improved, the number of ambiguous cases that might have been attributed to hysteria declined. For instance, before the introduction of electroencephalography, epilepsy was frequently confused with hysteria.[26]

Sigmund Freud claimed that hysteria was not anything physical at all but an emotional, internal affliction that could affect both males and females, which was caused by previous trauma that led to the afflicted being unable to enjoy sex in the normal way.[11][13] This would later lead to Freud's development of the Oedipus Complex, which connotes femininity as a failure, or lack of masculinity.[13] Though these earlier studies had shown that men were also prone to suffer from hysteria, including Freud himself,[5] over time, the condition was related mainly to issues of femininity as the continued study of hysteria took place only in women.[27] Many cases that had previously been labeled hysteria were reclassified by Freud as anxiety neuroses.[26] Sigmund Freud was fascinated by cases of hysteria. He thought that hysteria may have been related to the unconscious mind and separate from the conscious mind or the ego.[28] He was convinced that deep conflicts in the mind, some concerning instinctual drives for sex and aggression, were driving the behavior of those with hysteria. Freud developed psychoanalysis in order to help patients that had been diagnosed with hysteria reduce internal conflicts causing physical and emotional suffering. While hysteria was reframed with reference to new laws and was new in principle, its recommended treatment in psychoanalysis would remain what Bernheimer observes it had been for centuries: marrying and having babies and in this way regaining the "lost" phallus.[13]

New theories relating to hysteria came from pure speculation; doctors and physicians could not connect symptoms to the disorder, causing it to decline rapidly as a diagnosis.[29]

Today, female hysteria is no longer a recognized illness, but different manifestations of hysteria are recognized in other conditions such as schizophrenia, borderline personality disorder, conversion disorder, and anxiety attacks.[30]

Relationship with women's rights and feminism[edit]

Hysteria was often used as a political tool in the media to impede women's rights movements and invalidate their arguments and desire for equal rights and a larger role in society.

The most vehement negative statements associating feminism with hysteria came during the militant suffrage campaign.

"One does not need to be against womens suffrage," the London Times editorialized in 1908, "to see that some of the more violent partisans of that cause are suffering from hysteria. We use the word not with any scientific precision, but because it is the name most commonly given to a kind of enthusiasm that has degenerated into habitual nervous excitement."'

— Gilman, 320, [5]

In the 1980s, feminists began to reclaim hysteria, using it as a symbol of the systematic oppression of women and reclaiming the term for themselves.[5] The idea stemmed from the belief that Hysteria was a kind of pre-feminist rebellion against the oppressive defined social roles placed upon women. Feminist writers such as Catherine Clément and Hélène Cixous write in The Newly Born Woman from a place of opposition to the theories proposed in psychoanalytical works, pushing against the notion that socially constructed femininities and hysteria are natural to being female.[5][13] Feminist social historians of both genders argue that hysteria is caused by women's oppressive social roles rather than by their bodies or psyches, and they have sought its sources in cultural myths of femininity and in male domination.'[5]

The 19th century definition of femininity has far reaching implications in modern thought as it cements the idea of woman as child bearer, and denotes women who do not conform to the established norms of sexuality and psychoanalysis, as wrong or defective.[13]

See also[edit]

References[edit]

  1. ^ a b c d Maines, Rachel P. (1999). The Technology of Orgasm: "Hysteria", the Vibrator, and Women's Sexual Satisfaction. Baltimore: The Johns Hopkins University Press. p. 23. ISBN 0-8018-6646-4.
  2. ^ Mankiller, Wilma P. (1998). The Reader's Companion to U.S. Women's History. Boston, MA: Houghton Mifflin Co. p. 26. ISBN 0-6180-0182-4.
  3. ^ a b c d Tasca C, Rapetti M, Carta MG, Fadda B (2012). "Women and hysteria in the history of mental health". Clinical Practice and Epidemiology in Mental Health. 8: 110–9. doi:10.2174/1745017901208010110. PMC 3480686. PMID 23115576.
  4. ^ a b Merskey, Harold; Potter, Paul (1989). "The womb lay still in ancient Egypt". British Journal of Psychiatry. 154 (6): 751–53. doi:10.1192/bjp.154.6.751.
  5. ^ a b c d e f g h i j k Gilman, Sander L.; King, Helen; Porter, Roy; Rousseau, G.S.; Showalter, Elaine (1993). Hysteria Beyond Freud. Los Angeles: University of California Press.
  6. ^ a b King, Helen (1993). "Once upon a text: Hysteria from Hippocrates". In Gilman, Sander; King; Porter, Helen; Rousseau, G.S.; Showalter, Elaine. Hysteria beyond Freud. University of California Press. pp. 3–90. ISBN 0-520-08064-5.
  7. ^ Flemming, Rebecca (2000). Medicine and the Making of Roman Women. Oxford University Press. ISBN 0199240027.
  8. ^ Roach, Mary (2009). Bonk: The Curious Coupling of Science and Sex. New York: W.W. Norton & Co. p. 214. ISBN 9780393334791.
  9. ^ a b c d e Carta, Mauro Giovanni; Fadda, Bianca; Rappeti, Mariangela; Tasca, Cecilia (October 19, 2012). "Women and Hysteria In Mental Health". Clin Pract Epidemiol Ment Health. 8: 110–19. doi:10.2174/1745017901208010110. PMC 3480686. PMID 23115576.
  10. ^ Spanos, Gottlieb, Nicholas, Jack (1979). "Demonic possession, mesmerism, and hysteria: A social psychological perspective on their historical interrelations". Journal of Abnormal Psychology: 527–546.
  11. ^ a b c d e f Maines, Rachel (1999). The technology of Orgasm: 'Hysteria', the Vibrator, and Women's Sexual Satisfaction. Baltimore: The Johns Hopkins University Press.
  12. ^ Schleiner, Winfried (1995). Medical Ethics in the Renaissance. Georgetown University Press. p. 115.
  13. ^ a b c d e f Devereux, Cecily (March 2014). "Hysteria, Feminism, and Gender Revisited: The Case of the Second Wave". eJournal. University of Alberta. Retrieved October 20, 2016.
  14. ^ Goetz, C.G. (1991). "Visual art in the neurologic career of Jean-Martin Charcot". Archives of Neurology. 48: 421–25.
  15. ^ Jones, A. (2010). The Feminism and Visual Culture Reader. New York: Routledge. pp. 248–58, 300–08.
  16. ^ Simon, Matt (May 7, 2014). "Fantastically Wrong: The Theory of the Wandering Wombs That Drove Women to Madness". Wired. Retrieved November 28, 2014.
  17. ^ a b Briggs L (2000). "The race of hysteria: "overcivilization" and the "savage" woman in late nineteenth-century obstetrics and gynecology". American Quarterly. 52 (2): 246–73. doi:10.1353/aq.2000.0013. PMID 16858900.
  18. ^ Morantz RM, Zschoche S (December 1980). "Professionalism, feminism, and gender roles: a comparative study of nineteenth-century medical therapeutics". Journal of American History. 67 (3): 568–88. doi:10.2307/1889868. JSTOR 1889868. PMID 11614687.
  19. ^ a b Maines, Rachel. "Big Think Interview with Rachel Maines". bigthink.com. Retrieved 16 November 2016.
  20. ^ King, Helen (2011). "Galen and the Widow: Towards a history of therapeutic masturbation in ancient gynaecology" (PDF). EuGeStA: Journal on Gender Studies in Antiquity. 1: 205–235.
  21. ^ Hall, Lesley. "Doctors masturbating women as a cure for hysteria/'Victorian vibrators'". lesleyahall.net. Retrieved 29 October 2016.
  22. ^ Riddell, Fern (10 November 2014). "No, no, no! Victorians didn't invent the vibrator". The Guardian. Retrieved 29 October 2016.
  23. ^ Lieberman, Hallie; Schatzberg, Eric (2018). "A failure of academic quality control: The Technology of Orgasm" (PDF). Journal of Positive Sexuality. 4.2: 24–47.
  24. ^ Hollick, Frederick (1853). The diseases of woman: their causes and cure familiarly explained ; with practical hints for their prevention and for the preservation of female health. |access-date= requires |url= (help)
  25. ^ a b Micale MS (September 1993). "On the "disappearance" of hysteria. A study in the clinical deconstruction of a diagnosis". Isis; An International Review Devoted to the History of Science and Its Cultural Influences. 84 (3): 496–526. doi:10.1086/356549. PMID 8282518.
  26. ^ a b Micale MS (July 2000). "The decline of hysteria". The Harvard Mental Health Letter. 17 (1): 4–6. PMID 10877868.
  27. ^ "The History of Hysteria: Sexism in Diagnosis". 2017.
  28. ^ Coon, Mitterer, Dennis, John (2013). Introduction to Psychology: Gateways to Mind and Behavior. Cengage Learning. pp. 512–513.
  29. ^ Micale MS (1993). "On the "disappearance" of hysteria. A study in the clinical deconstruction of a diagnosis". Isis; an International Review Devoted to the History of Science and Its Cultural Influences. 84 (3): 496–526. doi:10.1086/356549. JSTOR 235644. PMID 8282518.
  30. ^ Costa, Dayse Santos; Lang, Charles Elias (2016). "Hysteria Today, Why?". Psicologia USP. 27 (1): 115–124 – via SciELO.

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