The Symbolism in a Case of Hysterical Psychosis.

The authors take inspiration from a case of hysterical psychosis to illustrate a typical condition of this evocative disease: the symbolic language of hysteria, conjurer of archetypical images. The authors encourage the clinician not to decode such aspects in rational analytical terms, rather to have a more wide-open approach that promotes the emergence of the individual unconscious, reconnecting with the collective imagination. This approach could help psychiatrists better understand a subject's inner experiences and interpersonal behavior.

Affective Permeability: On Hysteria and Atmospheres.

BACKGROUND: Phenomenological literature has recently given much attention to the concept of atmosphere, which is the pre-individual affective tonality of the intersubjective space. The importance of atmospheres in psychopathology has been described for various disorders, but little is known about the interaction with hysteria. The aim of the present paper was to describe the psychopathology of hysteria from the angle of the phenomenon of atmosphere, focussing on the hysterical person's peculiar "affective permeability". SUMMARY: Hysterical people have difficulty defining themselves autonomously. As compensation, they adopt models transposed from the external environment such as social gender stereotypes or are influenced by the gaze and desire of others. They also possess a special sensitivity in perceiving the affectivity present in a given social situation, by which they are easily impressed and influenced. Their sensibility to environmental affectivity may allow them to take centre stage, assuming the postures and behaviours that others desire and that they sense by "sniffing" the atmosphere in which the encounter is immersed. Thus, a paradox may take place: sensibility is not mere passivity in hysteria but may become a tool for "riding" the emotional atmosphere and manipulating it. KEY MESSAGES: Affective permeability to environmental atmospheres and manipulation of the environment are the two sides of the same coin. This overlap of passive impressionability and active manoeuvring is necessary to be grasped in the clinical encounter with hysterical persons not to be submerged by their theatricality, that is, by the hyper-intensive expressivity of their feelings and behaviours.

The Most Hysterical Psychoanalyst.

This paper is an investigation into the prominence of hysteria in Lacan's work and the enduring significance of the diagnosis for contemporary practice. Beginning with Lacan's theory of neurosis, the importance of language, and symbolic functions, we will begin to understand why the hysterical symptom is the symptomatic structure par excellence. Lacan lauds hysteria as the neurosis in direct dialogue with a given historical moment, teaching the psychoanalyst where we are in the unfolding struggle between neurosis and civilization. He returned to the case of Dora throughout his twenty-eight years of teaching to refine his work. He even saw psychoanalysis as the progressive "hystericization" of the patient and depicted himself as an hysteric walking around on a stage, not knowing what he was saying, while attempting to teach the psychoanalysts. Lacan's reading of Dora seems to mark important shifts in his own life, from his beginning to write as a psychoanalyst, to being thrown out of the IPA, to struggling with his own school and the ensuing political eruptions in France in 1968. By tracking his elaboration of Dora we can witness the evolution of Lacan's work and how he uniquely positions the analyst in the transference.

Phenomenon of Nightclub Shots: Mass Psychogenic Disease?

BACKGROUND: This article examines the possibility that the "nightclub shots" epidemic is a "mass psychogenic disease" phenomenon, by comparing the various cases of "mass sociogenic diseases" reported in the literature. We carried out a literature review on PubMed. The keywords used were "mass hysteria", "mass sociogenic disease", "mass psychogenic disease" and "epidemic of multiple unexplained symptoms". RESULTS: Our review of the literature revealed several elements common to the various "mass hysterias" we identified. These phenomena generally appear in a climate of anxiety specific to the era in which they occur, in this case the fear of bioterrorism in the 21st century. Symptoms are generally benign and transient, appearing and resolving easily without the identification of an organic cause. They usually occur in a small group of individuals, and more frequently in young people and women. The media can exacerbate the phenomenon. CONCLUSION: The phenomenon of epidemics of nightclub shots seems to fit into the common framework of "mass psychogenic diseases" identified in the literature. This diagnosis could therefore be evoked, in the absence of any other objective somatic explanation.

Distinct requirements for Tcf3 and Tcf12 during oligodendrocyte development in the mouse telencephalon.

BACKGROUND: E-proteins encoded by Tcf3, Tcf4, and Tcf12 are class I basic helix-loop-helix (bHLH) transcription factors (TFs) that are thought to be widely expressed during development. However, their function in the developing brain, specifically in the telencephalon remains an active area of research. Our study examines for the first time if combined loss of two E-proteins (Tcf3 and Tcf12) influence distinct cell fates and oligodendrocyte development in the mouse telencephalon. METHODS: We generated Tcf3/12 double conditional knockouts (dcKOs) using Olig2Cre/+ or Olig1Cre/+ to overcome compensatory mechanisms between E-proteins and to understand the specific requirement for Tcf3 and Tcf12 in the ventral telencephalon and during oligodendrogenesis. We utilized a combination of in situ hybridization, immunohistochemistry, and immunofluorescence to address development of the telencephalon and oligodendrogenesis at embryonic and postnatal stages in Tcf3/12 dcKOs. RESULTS: We show that the E-proteins Tcf3 and Tcf12 are expressed in progenitors of the embryonic telencephalon and throughout the oligodendrocyte lineage in the postnatal brain. Tcf3/12 dcKOs showed transient defects in progenitor cells with an enlarged medial ganglionic eminence (MGE) region which correlated with reduced generation of embryonic oligodendrocyte progenitor cells (OPCs) and increased expression of MGE interneuron genes. Postnatal Tcf3/12 dcKOs showed a recovery of OPCs but displayed a sustained reduction in mature oligodendrocytes (OLs). Interestingly, Tcf4 remained expressed in the dcKOs suggesting that it cannot compensate for the loss of Tcf3 and Tcf12. Generation of Tcf3/12 dcKOs with Olig1Cre/+ avoided the MGE morphology defect caused by Olig2Cre/+ but dcKOs still exhibited reduced embryonic OPCs and subsequent reduction in postnatal OLs. CONCLUSION: Our data reveal that Tcf3 and Tcf12 play a role in controlling OPC versus cortical interneuron cell fate decisions in MGE progenitors in addition to playing roles in the generation of embryonic OPCs and differentiation of postnatal OLs in the oligodendrocyte lineage.

The conservation of nervous energy: Neurophysiology and energy conservation in the work of Sigmund Exner and Josef Breuer.

This article explores the assimilation of the law of energy conservation in the psychological sciences of the late nineteenth century by comparing two similar neurophysiological projects conceived in largely the same social milieu and at the same time - namely, Sigmund Exner's Project for a physiological explanation of psychic phenomena (1894) and Josef Breuer's "Theoretical" chapter for Studies on Hysteria (1895). As shall be demonstrated, even within the narrow context of fin-de siècle Viennese neurophysiology, energetic concepts were used in apparently similar models, but defending widely distinct perspectives on life and the mind. While Exner formulated his project with a view of reducing mental processes to the exchange of neuronal energy, thus eliminating remnants of vital force in psychology, and generally following the methodological precepts of organic physics and of the thermodynamic method, Breuer in turn formulated a model whereby the electricity of neuronal exchanges was considered equivalent to a modified version of vital forces. Although the difference in their approach cannot be reduced to a single factor, the article suggests that the role played by medical practice in theory-construction provides one key condition for the variation in their otherwise analogous projects. While Exner conducted his work exclusively within the physiological laboratory, and still shared the "therapeutic nihilism" characteristic of the Second Vienna Medical School, for Breuer instead theory was both intimately allied with, and secondary to, his medical practice.

[The historical diagnosis of 'hysterical scoliosis']. / Die historische Differenzialdiagnose der 'hysterischen Skoliose'.

BACKGROUND: Until the beginning of the 20th century, 'hysterical scoliosis' could be considered an established diagnosis in Middle Europe's German-speaking countries. The responsible physicians claimed that certain cases of scoliosis were caused solely by psychological factors, and they did not distinguish between real scoliosis (e.g. with neuromuscular cause) and abnormal posture caused by psychological reasons. Instead, 'hysterical scoliosis' was obviously believed to be a real scoliosis caused by psychologically induced contractures. OBJECTIVE: This study critically discusses the historical diagnosis 'hysterical scoliosis' from today's point of view. MATERIALS AND METHODS: This work is based on historical research (including journals and literature) approximately from the time around 1900. Furthermore, it is also based on recently discovered original material. RESULTS: The original material is a correspondence between H. Schlesinger and G. Muskat, who published an article about 'hysterical scoliosis' in Schlesinger's journal. CONCLUSIONS: Obviously, the underlying medical concepts of 'hysterical scoliosis' were wrong and led to clear diagnostic problems and inaccuracies. 'Hysterical scoliosis' can be considered one of adolescent psychiatry's early fashionable illnesses around the year 1900.

[From preconceived ideas on hysteria to functional neurological disorder]. / Des idées reçues sur l'hystérie au trouble neurologique fonctionnel.

Functional neurological disorders (FND), formerly called «conversion hysteria¼, are still poorly understood diseases that suffer from an outdated, sometimes erroneous and stigmatizing conception on the part of health care teams. Enlightened by historical concepts, we propose a modern reading of FND with the aim of deconstructing preconceived ideas and proposing a global, benevolent and individualized approach.

Les troubles neurologiques fonctionnels (TNF), appelés autrefois «hystéries de conversion¼, sont des maladies encore mal connues qui souffrent à l'heure actuelle d'une conception désuète, parfois erronée et stigmatisante de la part des équipes soignantes. Éclairés par les concepts historiques, nous proposons une lecture moderne des TNF dans l'optique de déconstruire les idées reçues et proposer une approche globale, bienveillante et individualisée.

From hysteria to gait dementia: History of the concept of astasia-abasia.

Paul Blocq (1860-1896) and his teacher Jean-Martin Charcot (1825-1893) introduced the expression "astasia-abasia" into medical terminology in 1888 to designate a pathology they believed to be caused by hysteria. This condition makes it impossible to remain erect and to walk, whereas the ability to move the legs while lying down remains normal. At the turn of the 20th century, and now almost exclusively, this motor disturbance is recognised as a syndrome with multiple possible organic causes, and now described as "higher-level gait disorder". After briefly mentioning earlier descriptions by other authors, I will review Charcot's Tuesday lessons in 1889 that covered astasia-abasia and elucidated the beginnings of the breakdown into organic aetiologies: medial-frontal and corpus callosum tumors, damage to the cerebellar vermis, lacunar state as described by Pierre Marie (1853-1940), Parkinson's disease, and Parkinson-plus syndrome. The long history of astasia-abasia reveals a cluster of neurologists, often emerging from oblivion herein and all of whom, through the precision of their clinical examinations and their pathophysiological findings, helped advance the understanding of the mechanisms by which human beings are the only erect, constantly bipedal mammals, whether immobile or walking.

The Body in Question in the Existence of Hysteric Persons: A Phenomenological Perspective.

The concept of hysteria, although apparently surpassed by contemporary nosographic classifications, continues to be talked about. Following Charbonneau's attempt to de-feminize and de-sexualize hysteria, clinical phenomenology can offer a perspective which, freed from stigma and prejudices through the suspension of judgement, allows us to understand hysteria not as a diagnostic category but as an existential position. In this sense, hysteria would be based on a hypo-sufficiency of the embodied self, which is not perceived as solid and continuous and needs external confirmations of its adequacy. According to the optical-coenaesthetic disproportion hypothesis, the hypo-sufficiency of the embodied self originates from the difficulty of experiencing one's body from the first-person perspective and from the consequent use of the gaze of others as a prosthesis to achieve a sense of selfhood and identity. Hysteric persons develop a mode of access to their corporeality mediated by visual representations - hence the theatricalization, centrality, and seductiveness of hysteric persons' behaviour. We suggest to call "figural body" the visual apprehension of one's body which tries to compensate for the weakness of coenaesthetic apprehension of the lived body. Over time, the figural body ends up superimposing itself on the immediate experience of the lived body. Placing itself on a representative register, this image conveys not only individual ghosts but also cultural aspects, social prejudices, gender stereotypes. Thus, the attempt to experience one's own body with the mediation of the other's gaze becomes an involuntary and unaware throwing of oneself into the meshes of representation that are necessarily alienating for the person. Hysterical persons remain stuck in their inability to access an experience of their body that is not figurative, alienating themselves in representations which always come from outside.

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 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.

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.

Diagnosing Desire: Imaginative Experiments with Sexuality and the Nerves.

American fiction often tells us that there is something sick about romantic desire. But the writers who I discuss in this article told their readers this even as they critiqued the medical profession's pathologization of women's desires and non-normative sexual subjectivities. In particular, this article looks at two literary responses to the medical notion that marriage was a cure for hysteria and other nervous disorders: Oliver Wendell Holmes's A Mortal Antipathy (1885) and Elizabeth Stuart Phelps's Doctor Zay (1886). While the medical rhetoric of nervous pathology could be repressive and stigmatizing, these fictions sought to reclaim and reimagine the medical treatment of nervous desire in subversive ways.

Uma leitura teórico-clínica de uma análise: o fato clínico como operador metodológico / A theoretical-clinical reading of an analysis: the clinical fact as a methodological operator / Una lectura teórico-clinica del análisis: el hecho clínico como herramienta metodológica

O presente artigo é oriundo de pesquisa acadêmica que teve como objetivo estudar a clínica psicanalítica e seus efeitos por meio da apresentação de fragmentos de uma análise já encerrada. Para alcançar esse objetivo, utilizamos a ferramenta metodológica do fato clínico, articulando o material clínico com alguns pontos da teoria psicanalítica. Como resultado, apontamos que é possível fazer uma leitura teórico-clínica de uma experiência de análise sob a perspectiva dos movimentos discursivos, em especial do sujeito do inconsciente ($) e do objeto a, conforme apresentados na proposição dos Quatro Discursos de Lacan. Acreditamos que este estudo enfatiza a importância da especificidade da pesquisa em psicanálise em sua dimensão clínica e os possíveis efeitos produzidos por esse processo terapêutico. Dessa maneira, entendemos que a divulgação deste trabalho pode contribuir para a discussão da prática clínica entre colegas do campo psicanalítico e acadêmico, bem como para a difícil tarefa da apresentação do material clínico com a sustentação teórica necessária, a fim de fortalecermos a sempre fundamental transmissão da psicanálise.(AU)

This article comes from academic research that aimed to study the psychoanalytic clinic and its effects by presenting fragments of an analysis that has already ended. To achieve this goal, we used the methodological tool of the clinical fact, articulating the clinical material with some points of psychoanalytic theory. As a result, we point out that it is possible to make a theoretical-clinical reading of an analysis experience from the perspective of discursive movements, in particular, the subject of the unconscious ($) and of the object a, as presented in the proposition of Lacan's Four Discourses. We believe that this study emphasizes the importance of the specificity of research in psychoanalysis in its clinical dimension and the possible effects produced by this therapeutic process. In this way, we understand that the dissemination of this work can contribute to the discussion of clinical practice among colleagues in the psychoanalytic and academic fields, as well as to the difficult task of presenting clinical material with the necessary theoretical support, to strengthen the always fundamental transmission of psychoanalysis.(AU)

Este artículo surge de una investigación académica que pretendió estudiar la clínica psicoanalítica y sus efectos mediante la presentación de fragmentos de un análisis que ya terminó. Para lograr este objetivo, se utilizó la herramienta metodológica del hecho clínico articulando el material clínico con algunos puntos de la teoría psicoanalítica. El resultado permite señalar que es posible realizar una lectura teórico-clínica de una experiencia de análisis desde la perspectiva de los movimientos discursivos, en particular el sujeto del inconsciente ($) y el objeto a, como se presenta en la proposición de los cuatro discursos de Lacan. Este estudio enfatiza la importancia de la especificidad de la investigación en psicoanálisis en su dimensión clínica y los posibles efectos que produce este proceso terapéutico. De esta forma, la difusión de este trabajo puede contribuir a la discusión de la práctica clínica entre colegas del campo psicoanalítico y académico, así como a la difícil tarea de presentar material clínico con el soporte teórico necesario para fortalecer la siempre fundamental transmisión del psicoanálisis.(AU)

Les démoniaques dans l'art: Charcot and the "hysterical saints".

Professor Jean-Martin Charcot was the founder of clinical neurology and one of the prominent researchers in the field of hysteria in the 19th century. His book Les démoniaques dans l'art is a representation of hysterical symptoms in religion and religious art. This paper aims to discuss Charcot's descriptions of hysteria in religion and his "hysterical saints".

Professor Jean-Martin Charcot foi o fundador da neurologia clínica e um dos pesquisadores mais proeminentes no campo da histeria durante o século XIX. Seu livro Les démoniaques dans l'art é uma representação dos sintomas histéricos na religião e arte religiosa. Esse artigo objetiva discutir as descrições de Charcot de histeria na religião e seus "santos histéricos".

Hysteria as a Trigger for Epidemic Decompression Sickness Following Hypobaric Hypoxia Training.

INTRODUCTION: Although hypobaric hypoxia training (HHT) is an essential component of aviation physiology training, it poses a risk of decompression sickness (DCS). DCS can sometimes be observed as a cluster of cases, which is referred to as epidemic DCS. In this report, we aim to evaluate an epidemic DCS episode that occurred following two consecutive HHT sessions.METHODS: A total of 16 trainees, all of whom were medical doctors, attended the aviation medicine training course in the aeromedical research and training center. They went through HHT in two sessions, each with eight trainees.RESULTS: Following two HHT sessions, five Type 1 DCS cases occurred among 18 personnel (16 trainees and 2 inside observers). DCS incidence rate was found to be 27.77%. They were successfully treated with hyperbaric oxygen therapy (HBOT).DISCUSSION: Since the DCS incidence rate was found to be higher than the average in such a short period of time, this cluster of cases was labeled as epidemic DCS. We carried out a thorough investigation into all possible causes by following some templates that were developed to conduct comprehensive investigations into epidemic DCS episodes. According to the psychological arguments discussed here, we placed a special emphasis on hysterical and psychosocial components, among other probable factors. In cases where the possibility of hysteria and placebo-nocebo responses exist, it is appropriate to conduct the training and treatment processes with these factors in mind. No matter what the triggering factor is and how the symptoms manifest, HBOT remains crucial in the treatment of DCS.Demir AE, Ata N. Hysteria as a trigger for epidemic decompression sickness following hypobaric hypoxia training. Aerosp Med Hum Perform. 2022; 93(10):712-716.

Distinguishing between neurosis and psychosis: discourses on neurosis in colonial Korea.

This article analyses the origins and formation of medical and social discourses on neurosis in colonial Korea. With the introduction of Western medicine after the Opening of Korea in 1876, neurasthenia and hysteria began to be understood as neurotic diseases, and their importance was further highlighted during the colonial period of 1910-45. The article also addresses the role of neuropsychiatry in forming discourses on neurosis. In medical communities during the colonial period, the main source of these discourses gradually shifted from internal medicine to neuropsychiatry. In particular, Korean neuropsychiatrists distinguished between neurosis and psychosis as a way to reinforce their authority. Neuropsychiatrists tried to explain the temperamental and environmental factors of neurosis from a psychoanalytic standpoint.

Mass Hysteria among Beneficiary Students of the School-Feeding Program in Addis Ababa, Ethiopia.

Background: Mass hysteria is described as the rapid spread of conversion disorder without organic basis among a group of people. Mass hysteria can occur in work place and commonly in schools. There are usually some factors attributable to the episode; however, the lack of a pathogen upon investigation is a fundamental characteristic. We are reporting an episode of mass hysteria from two schools in Addis Ababa, Ethiopia. Methods: Clinical record, laboratory investigation, toxicology study from the food and psychiatric evaluations. Results: On November 25, 2019 a total of 113 students were brought from two schools in Addis to Tikur Anbessa Specialized Hospital. Most were between the ages of 10 and 15 years and were female students. Their school breakfast of bread and marmalade was attributed as the cause of the episode; however only 49% of the students brought in had eaten the food. The majority complained of nausea and vomiting but most had normal physical finding; and their symptoms were resolved without treatment. The laboratory investigation on samples of blood and stool were negative for bacterial growth and food culture and toxicology were non-revealing. Most were reassured and few were given symptomatic treatment. Conclusion: This mass hysteric episode is similar to episodic reports from other school feeding programs in some Asian and African countries. The finding of this report is important for health care practitioners to consider mass psychogenic illness in case they face similar mass presentation without objective finding; and will help to avoid unnecessary costly investigations.