The story of Freud's patient Anna von Lieben - as told by Anna von Lieben.

Anna von Lieben (Cäcilie M.) was treated for some 5 years by Sigmund Freud who discussed her case in Studies on Hysteria. This article presents an alternative view of the case based on the discovery of new primary material, principally, a handwritten corpus of confessional poetry by Anna herself. The poems were studied using a qualitative research methodology, interpretative phenomenological analysis (IPA), the findings of which were then further explored through the lens of her husband's unpublished diary entries. On this basis, it is suggested that Anna's ill-health appears to have been due mainly to chronic gynaecological disease, morphinism, troubles of iatrogenic origin and possibly phenomena similar to what are now termed psychogenic non-epileptic seizures (PNESs). Overall, the findings contradict Freud's account of satisfactory therapeutic progress culminating in a cure.

The natural history of terms describing functional (neurological) disorders in the medical literature of the last 60 years.

BACKGROUND: Functional neurological disorders (FND), a subtype of functional disorders (FD), are a frequent motive for neurology referrals. The various presentations and the unknown physiopathology of FD have led to the multiplication of terms describing these disorders over the years. METHODS: We examined the FD-related articles published from 1960 to 2020 in PubMed and PsycINFO databases. We searched for: psychogenic, somatization, somatoform, medically unexplained symptoms, hysteria, conversion disorder, dissociative, functional neurological disorder, and functional disorder. Use rates in the title, abstract, keyword, or MeSH fields were collected over successive 5-year periods. After correcting for off-topic results, we examined proportional distribution over time, term associations, and disciplinary fields (neurology and psychiatry). Term impact was estimated via H-index and number of citations. RESULTS: We found that none of the terms is prevailing in the recent medical literature. We observed three trends in the use rates: stability, increase, and decrease of use over time. While most of the terms were present in a stable proportion of the publications, hysteria and psychogenic lost popularity over time. We found a differential preference for terminology between disciplines. Functional neurological disorder showed the highest citation impact, yielding 10% of highly cited publications. CONCLUSION: We found a dynamic and evolving use of the different terms describing FD in the last 60 years. Despite the tendency to use the term functional in the recent highly cited publications, its low prevalence and coexistence with several other terms suggest that a precise, explanatory and non-offensive term remains yet to be found.

[Striving for power and aggression - underestimated aspects in the psychotherapy of hysteria]. / Machtstreben und Aggression ­ unterschätzte Aspekte in der psychotherapeutischen Behandlung der Hysterie.

Question: For decades hysteria has been psychodynamically interpreted sexualized as part of a frustrated desire with a depressive core. However, this "victim" side should be faced with the other often hidden aspects of hysteria with aggression and striving for power. Method: The basic hypothesis pursued here is that the hysterical/histrionic person was not primarily "disadvantaged" in his or her development, but that his or her striving for power and thus his or her potential for aggression is to be understood above all as a learned mode of global relationship that the adolescents have learned to respond and assert themselves to an intra-familiar situation of tension and pressure. Results: Any therapy that does not take this sufficiently into account falls short and reinforces the underlying mechanism of the therapeutic relationship dynamics. During treatment the patient must increasingly feel how much destruction and loneliness this global relationship implies. Conclusions: Only if the patient experiences that reduction of dominance and self-reference as well as increase of "true" felt empathy lead to more satisfying relations, the "imprisonment" in hysterical mode can be gradually lifted.

"Dyspepsia," "seduction" and "violent hysteria": reports, reforms and the Irish asylums of the 1850s.

While many countries developed asylums for the mentally ill during the nineteenth century, Ireland's asylum system grew faster than those elsewhere, was larger in size and was slower to decline. This paper focuses on two reports central to this process in the 1850s: the 1854 "Report on the status of disease" and the 1858 "Report of the commissioners of inquiry into the state of the lunatic asylums and other institutions for the custody and treatment of the insane in Ireland." In 1854, the "Report on the status of disease," based on the 1851 census, was published, co-authored by Dr. William Wilde, now best known as father of Oscar. Wilde, however, was also a prominent surgeon and author of works on medicine, archaeology and folklore. He was knighted in 1864 owing in large part to his work on the census, which highlighted an apparently high rate of mental illness with such diverse causes as "dyspepsia," "seduction" and "violent hysteria." Four years later, in 1858, the "Report of the commissioners of inquiry into the state of the lunatic asylums and other institutions for the custody and treatment of the insane in Ireland" added fuel to the fire by reporting that "the lunatic asylums of Ireland wear more the aspect of places merely for the secure detention of lunatics than of curative hospitals for the insane." Reform, it seemed, was urgently needed. This contribution examines these two key reports in the fevered, panicked context of Ireland's perpetual reform and expansion of its nineteenth-century asylums.

Seeking double personality: Nakamura Kokyo's work in abnormal psychology in early 20th-century Japan.

This paper examines Nakamura Kokyo's study of a woman with a split personality who lived in his home as a maid from 1917 until her death in 1940. She was his indispensable muse and assistant in his efforts to promote abnormal psychology and psychotherapy. This paper first explores the central position of multiple personality in Nakamura's theory of the subconscious, which was largely based on the model of dissociation. It then examines how it became a central issue in Nakamura's disputes with religions including the element of spirit possession, which invoked Western psychical research to modernize their doctrines. While both were concerned with the subconscious and alterations in personality, Nakamura's psychological view was distinguished from those spiritual understandings by his emphasis on individual memories, particularly those that were traumatic, and hysteria. The remaining sections of the paper will examine Nakamura's views on memory and hysteria, which conflicted with both the academic mainstream and the established cultural beliefs. This conflict may partly explain the limited success of Nakamura's academic and social campaigns.

Histeria masculina: Os impasses na assunção da posição sexual / Male hysteria: The impasses in take on the sexual position / Histeria masculina: Los impasses en asumir la posición sexual

Dada a associação histórica da histeria com a mulher e sua relação com o feminino, muitos trabalhos buscam compreender os atravessamentos dessa posição subjetiva para a sexualidade da mulher. O presente artigo promove a urgência em discutir as implicações de sua incidência sobre os homens, anatomicamente falando. Sendo assim, visa discutir os efeitos da dinâmica da histeria para o homem, no que concerne à assunção da posição sexual. Para tanto, se tratando de uma pesquisa teórica, partiremos de um rastreamento dos textos de Freud e do primeiro ensino de Lacan, buscando referências sobre a histeria masculina e, sobretudo, considerações sobre casos de homens histéricos. Posteriormente, articularemos os aspectos destacados pelos autores com o que, na teoria psicanalítica, se apresenta como particular à posição masculina, tal como a relação com o significante falo, com a castração e a identificação simbólica, bem como os efeitos disso na dinâmica do desejo e da fantasia.(AU)

Given the historical association of hysteria with women and their relation to the feminine, many papers seek to understand the difficulty of this subjective position for women's sexuality. The present article promotes the urgency to discuss the implications of its incidence on men, anatomically speaking. Thus, this work aims to discuss the effects of the dynamics of hysteria for men, in its concerns to the sexual position assumption. For this, as it is a theoretical research, we will start with a screening of Freud's and Lacan's first period of teaching texts, looking for references of masculine hysteria and, mainly, considerations on cases of hysterical men. Subsequently, we will articulate the aspects highlighted by the authors, with which, in psychoanalytic theory, is presented as particular to the masculine position, such as the relation with the signifier phallus, with castration and symbolic identification, as well as its effects in the dynamics of the desire and fantasy.(AU)

Dada la asociación histórica de la histeria con la mujer y su relación con lo femenino, muchos trabajos buscan comprender los atravesamientos de esa posición subjetiva para la sexualidad de la mujer. El presente artículo, promueve la urgencia en discutir las implicaciones de su incidencia sobre los hombres, anatómicamente hablando. Por lo tanto, este trabajo trata de discutir los efectos de la dinámica de la histeria para el hombre, en lo que concierne a la asunción de la posición sexual. Para ello, si se trata de una investigación teórica, partiremos de un rastreo de los textos de Freud y de la primera enseñanza de Lacan, buscando referencias sobre la histeria masculina y, sobre todo, consideraciones sobre casos de hombres histéricos. En la teoría psicoanalítica, se presenta como particular a la posición masculina, tal como la relación con el significante falo, con la castración y la identificación simbólica, así como los efectos de ello en la dinámica del hombre, el deseo y la fantasía.(AU)

Psicossomática: um fenômeno entre o saber e o gozo / Psychosomatics: a phenomenon between knowledge and jouissance / Psicosomática: un fenómeno entre el saber y el goce

O presente artigo se propõe a investigar o fenômeno psicossomático na clínica psicanalítica a partir das proposições freudo-lacanianas. Primeiramente, diferenciaremos o sintoma conversivo na histeria do acometimento corporal na psicossomática, apresentando a distância entre um sintoma e um fenômeno clínico. Entendemos que a psicossomática diferentemente do sintoma não porta uma mensagem passível de interpretação, é, antes, efeito de uma escrita que não pode ser lida. Uma escrita que sem a devida ascensão ao simbólico, mantém-se cristalizada no campo do gozo, portanto, sem representação psíquica. Para empreendermos essa discussão traremos a noção de letra em Lacan e, por fim, problematizaremos as possibilidades de atuação da psicanálise nos casos de psicossomática

The present article proposes to investigate the psychosomatic phenomenon in the psychoanalytic clinic from the Freudo-Lacanian propositions. First, we will differentiate the converting symptom in the hysteria of the bodily affection in psychosomatic, presenting the distance between a symptom and a clinical phenomenon. We understand that psychosomatics differently from the symptom does not carry a message that can be interpreted, it is rather an effect of a writing that cannot be read. A writing that, without the proper ascent to the symbolic, remains crystallized in the field of jouissance, therefore, without psychic representation. In order to undertake this discussion, we will bring the notion of letter in Lacan and, finally, we will problematize the possibilities of psychoanalysis in the cases of psychosomatics

El presente artículo se propone investigar el fenómeno psicosomático en la clínica psicoanalítica a partir de las proposiciones freudo-lacanianas. Primero diferenciaremos el síntoma conversivo en la histeria del acometimiento corporal en la psicosomática, presentando la distancia entre un síntoma y un fenómeno clínico. Entendemos que la psicosomática diferentemente del síntoma no porta un mensaje pasible de interpretación, es, antes, efecto de una escritura que no puede ser leída. Una escritura que sin la debida ascensión a lo simbólico, se mantiene cristalizada en el campo del goce, por lo tanto, sin representación psíquica. Para emprender esa discusión traemos la noción de letra en Lacan y, por fin, problematizaremos las posibilidades de actuación del psicoanálisis en los casos de psicosomática

Female anatomy and hysterical duality.

This article attempts to add another layer to our understanding of the phenomenon of hysterical duality. The author postulates that hysterical duality can be explained based on the dual-aspect model of feminine sexuality, which exhibits two initially contradictory paths: one derived from primary vaginal sensations and the other from clitoral pleasure. At first, these two paths create a fundamental split between representations of internal space, containment and motherhood and representations related to auto-eroticism and the effacement of the Other's presence and needs. The author argues that this manifest contradiction makes the attainment of integration in feminine development an intricate and protracted process, which involves an act of inversion. This inversion entails a post-Oedipal disavowal of primary vaginal sexuality, pending its rediscovery through the encounter with the Other. Hysteria is thus viewed as the result of a failure to perform this inversion and an inability to extract oneself from the position of a "Vaginal Girl", who defines herself through the desire of the other. This pathological course of development leaves the hysteric's sexuality in a split state and traps her in the duality of clitoral pleasure versus penetration, which unconsciously represents humiliation and exploitation.

Travelling into Alienation and Neurology with a Painter: Georges Moreau (1848-1901).

Georges Moreau (1848-1901) was a painter and the son of the famous psychiatrist Jacques-Joseph Moreau de Tours. Early in his career, his paintings aspired toward figurative perfection, exalting patriotic and historical themes. His prolific production includes numerous paintings for which he drew inspiration from psychology and certain mental pathologies. At the age of 45 years he suffered right hemiplegia which forced him to set aside large-scale subjects and focus instead on intimist, almost pointillistic works, which brought him closer to the Impressionists, as his portrait of Paul Cézanne shows. Possibly his most well-known painting, Les fascinés de la Charité, service du Dr. Luys, is analysed here by comparison with La Leçon clinique à La Salpêtrière by André Brouillet, which depicts Jean-Martin Charcot and his students.

Writers as Shell Shock Witnesses during World War I.

The issue of First World War shell shock has been documented mainly from a medical perspective. Many medical texts dealing with war psychoneuroses and their aggressive treatments, such as electrotherapy, were published during the war. Accounts from shell-shocked soldiers are rare. Nevertheless, shell shock was described from a non-medical point of view by a few writers who had undergone or witnessed this pathology. Their texts deal mainly with the psychiatric forms, the most striking ones, but also with the more common concepts of commotion, emotion and pathological fear. The French philosopher Émile Chartier (1868-1951), alias Alain, described the commotional syndrome from which he suffered. The German writer Ernst Jünger (1895-1998), a brave officer and an example for his men, reported his emotional shock. Some psychiatric forms of shell shock are present in the work of the pacifist writer Jean Giono (1895-1970), the naturalist Maurice Genevoix (1890-1980), who suffered himself from a section of the left median and ulnar nerves, or the British poet Siegfried Sassoon (1886-1967). War hysteria and pathological fear have been described, on several occasions, by Blaise Cendrars (1887-1961) or the German writer Erich Maria Remarque (1898-1970). Electrotherapy has been scarcely reported except by Louis-Ferdinand Céline (1894-1961).

Coletividade e histeria: psicanálise e manifestações sociais / Collectivity and hysteria: psychoanalyses and social events / Colectividad e histeria: psicoanálisis y manifestaciones

A proposta deste trabalho é trazer uma contribuição partindo da noção psicanalítica de histeria que percorre o avanço teórico em Freud e em Lacan, para dizer de organizações coletivas. Para isso, pretendemos dedicar-nos às elaborações de Freud (1921) sobre 'identificação por meio do sintoma' -- que dão margem a uma suposta 'histeria coletiva' -- e a posterior teoria dos discursos de Jacques Lacan (1969-1970) sobre o enquadramento dos laços sociais, nos atentando em sua provocação aos 'revolucionários' de maio de 1968, indicando-os como alocados ao que denominou de 'discurso da histérica'. Com isso, pretendemos defender, a partir da noção de histeria em psicanálise, a existência de ao menos dois desdobramentos diferentes que se originam do mesmo tipo clínico: 'histeria coletiva' e 'discurso da histeria'. Assim, tentamos contribuir para melhor compreensão das possibilidades e limitações das manifestações coletivas e grupamentos sociais, especialmente alguns que permearam a cena política brasileira nos últimos tempos. (AU)

The proposal of this paper is to bring a contribution starting from the psychoanalytic idea of hysteria that goes of theoretical advance by Freud and by Lacan to think about collective organisations. For this purpose, we intend to dedicate our studies especially to elaborations by Freud (1921) about 'identification to a symptom' - that permit it a suppose 'collective hysteria' - and the succeeding theory of the discourses by Lacan (1969-1970) about the social ties' framework, observing his provocation to the 'revolucionaries' of 1968 May, pointing them as being allocated to the 'Discourse of the Hysteric'. Therefore, we intend to defend from the idea of hysteria in psychoanalyses, the existence at least two different ramifications originating from the same clinical type. Thus, we will try to contribute to a better comprehension of the possibilities and limitations of the social events and social groups, especially those that permeated the Brazilian political scene in recent times. (AU)

La propuesta de este trabajo es aportar una contribución a respeto de las organizaciones colectivas partiendo de la formulación psicoanalítica de histeria, haciendo un recorrido por los avances teóricos encontrados en la obras de Freud y de Lacan. Nos dedicaremos a las elaboraciones de Freud acerca de la 'identificación a través del síntoma' - que abre una grieta para pensar en una supuesta 'histeria colectiva'- y la posterior teoría de los discursos de Lacan acerca del encuadre de los lazos sociales, llamando nuestra atención a su provocación a los 'revolucionarios' de mayo de 1968, indicándonos de que se trataba de hallarse emplazado en lo que él ha denominado el 'Discurso de la Histérica'. De esta manera, nuestra intención es defender, partiendo de la noción de histeria en psicoanálisis, la existencia de al menos dos desenlaces distintos que tienen origen en la misma tipología clínica. Así pensamos contribuir para avanzar en una mejor comprensión de las posibilidades y limitaciones de las manifestaciones, en especial algunos de los cuales formaron parte de la escenario político brasileño reciente. (AU)

Jean-Martin Charcot's influence on career of Sigmund Freud, and the influence of this meeting for the brazilian medicine / Influência de Jean-Martin Charcot na carreira de Sigmund Freud, e a influência desse encontro para a medicina brasileira

Background - Jean-Martin Charcot had a profound influence on Sigmund Freud's life and career. The founders of Brazilian neurology and psychiatry were influenced by the ideas of Charcot and Freud. Objective - To describe Charcot's influence on Freud, and both on the beginning of Brazilian Neurology and Psychiatry. Results - After Freud's stay in Charcot's neurology service during the winter of 1885-1886, there was a shift in his interest from general neurology to hysteria, hypnosis and other psychological issues, which greatly influenced the development of psychoanalytic theory. Like Charcot, Freud would become an admirer of the arts, literature, and culture. When Freud began his collection, in the late 1890s, Charcot served as an important model. In Salpêtrière Hospital, Charcot was staging a show different from modernity, capable of inspiring Freud. Antonio Austregesilo founded the first Brazilian school of Neurology, in Rio de Janeiro, inspired in Charcot. Austresegilo also practiced psychiatry, and, together Juliano Moreira and others, is considered propagator of Freud's ideas in Brazil. Conclusion - The ideas of Charcot and Freud were fundamental in the formation of physicians who helped to found and to consolidate the Brazilian neurology and psychiatry.(AU)

Introdução - Jean-Martin Charcot exerceu uma profunda influência na vida e na carreira de Sigmund Freud. Os fundadores da neurologia e da psiquiatria brasileiras foram influenciados pelas ideias de Charcot e de Freud. Objetivo - Descrever a influência de Charcot sobre Freud e de ambos sobre o início da Neurologia e da Psiquiatria brasileiras. Resultados - Após a permanência de Freud no serviço de neurologia de Charcot durante o inverno de 1885-1886, houve uma mudança em seu interesse da neurologia geral para histeria, hipnose e outras questões psicológicas, o que influenciou muito o desenvolvimento da teoria psicanalítica. Como Charcot, Freud se tornaria admirador das artes, literatura e cultura. Quando Freud começou sua coleção, no final da década de 1890, Charcot serviu de modelo importante. No Hospital Salpêtrière, Charcot era a representação da modernidade, capaz de inspirar Freud. Antonio Austregésilo fundou a primeira escola brasileira de Neurologia, no Rio de Janeiro, inspirada em Charcot. Austresegilo também praticou psiquiatria, e, juntamente com Juliano Moreira e outros, é considerado propagador das ideias de Freud no Brasil.Conclusão - As ideias de Charcot e Freud foram fundamentais na formação de médicos que ajudaram a fundar e consolidar a neurologia e a psiquiatria brasileiras.(AU)

Hypnosis and Psychoanalysis: Toward Undoing Freud's Primal Category Mistake.

Hypnosis predates psychoanalysis, when autohypnotic pathologies were identified through the lens of hypnosis, and labeled "hypnoid hysteria" in the language of the day. The broad spectrum of disorders then subsumed under that term is still reflected in ICD-10's subset, "F44-Dissociative (Conversion) Disorders." Freud initially embraced both hypnoid hysteria and hypnosis, but came to abandon hypnosis and, by extension, hypnoid hysteria as well. Since that fateful decision, which I term herein Freud's "Inaugural Category Mistake," references to both hypnosis and hypnoid pathology largely vanished from the psychoanalytic mainstream, thereby neglecting conditions afflicting a significant portion of the mentally ill, and needlessly restricting the therapeutic repertoire of psychoanalysis. This contribution argues that psychoanalysis could best re-embrace hypnosis and hypnoid pathology together, as a related pair, and would benefit from doing so. Two examples of the differences of understanding and interventions such a rapprochement might encourage are offered: (a) how hypnoid pathology alters the transference and countertransference; and (b) how the appropriate use of hypnosis alters the nature of interpretation.

Diferentes destinos de lo no neurótico: introducción al tema monográfico / No disponible

No disponible

A fotografia e a “descoberta” da histeria / La photographie et la “découverte” de l’hystérie / La fotografía y el “descubrimiento” de la histeria / Photography and the “discovery” of hysteria

Historicamente marcado na oposição entre orgânico e psíquico, o conceito de histeria continua no centro de controvérsias entre saberes influentes como psicanálise e psiquiatria. Contrapondo uma concepção que defende a existência de um mundo independente da mente humana (realismo) e uma que a nega (antirrealismo), buscamos pensar como se deu a criação desse conceito. Em acordo com o movimento científico do século XIX, o médico francês Jean-Martin Charcot utilizou a fotografia, entendida na época como a “verdadeira retina” do cientista, para criar uma classificação do ser humano. Inserir essa construção de conhecimento em seu contexto sociocultural possibilita diversos questionamentos quanto à sua objetividade. Nossa concepção é a de que refletir criticamente sobre a formação dos conceitos contribui com elementos para um melhor exercício da alteridade no interior da psicopatologia.

Historiquement marqué par l’opposition entre l’organique et le psychique, l’hystérie continue au centre des débats entre d’influents savoirs tels que la psychanalyse et la psychiatrie. En mettant en contre-position deux conceptions - l’une qui défend l’existence d’un monde indépendant de la psyché humaine (réalisme) et l’autre qui la nie (anti-réalisme) - nous cherchons à penser comment s’est construit le concept de l’hystérie. Suivant le mouvement scientifique du siècle XIX, le médecin français Jean-Martin Charcot se sert de la photographie, sous-entendue à l’époque comme “véritable rétine” du scientiste, pour créer une typologisation de l’être humain. En insérant la construction de ce savoir en son contexte socioculturel, il est possible de se poser plusieurs questions sur son objectivité. Notre conception est de penser qu’une critique réflexive sur la formation des concepts apporte des éléments pour un meilleur exercice de l’altérité au sein de la psychopathologie.

Históricamente marcado por la oposición entre lo orgánico y lo psicológico, el concepto de histeria sigue en el centro de la controversia entre los conocimientos influyentes como lo de psicoanálisis y la psiquiatría. Contrastando una concepción que defiende la existencia de un mundo independiente de la mente humana (realismo) a otra concepción que la niega (anti-realismo), buscamos investigar cómo se creó el concepto de histeria. De acuerdo con el movimiento científico del siglo XIX, el médico francés Jean-Martin Charcot utilizó la fotografía, entendida en su momento como la “verdadera retina” del científico, para crear una clasificación de lo humano. Introducir esta construcción del conocimiento en su contexto sociocultural permite muchas preguntas acerca de su objetividad. Nuestra concepción es que reflejar críticamente sobre la formación de los conceptos contribuye con elementos que visan mejorar el ejercicio de la alteridad dentro de la psicopatología.

The concept of hysteria has been historically situated in the opposition between the organic and the mental.It continues to be at the center of controversies between important areas, such as psychoanalysis and psychiatry. Wetried to elucidate the origin of the concept of hysteria by contrasting a conception that defends the existence of aworld independent of the human mind (realism), and another that denies it (antirealism). Following the scientific trendof the 19th century, the French physician Jean-Martin Charcot used photography – at that time photography wasseen as the scientist’s “true retina” – to create a typology of human beings. Situating this construction of knowledgeand its sociocultural context provokes a questioning as to its objectivity. Our suggestion is that to think in a criticalway about the origin of the concepts gives us elements for a better exercise of alterity in psychopathology.