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.

Dreams: Charcot's Last Words on Hysteria.

Jean-Martin Charcot (1825-1893), the leading neurologist of his time, is best remembered for his studies on hysteria presented in clinical lectures at the Paris Salpêtrière hospital. Developing the concept of traumatic male hysteria after accidents in which patients suffered slight physical damage led him to advance a psychological explanation for hysteria. Traumatic hysteria is the context for a close reading of Charcot's "last words" based upon a final unpublished lesson in 1893. This case history concerns a seventeen-year-old Parisian artisan whose various signs of hysteria developed following a dream in which he imagined himself the victim of a violent assault. Charcot identifies the dream/nightmare as the "original" feature determining traumatic hysteria. The dream sets in motion an overwhelming consciousness followed by a susceptibility to "autosuggestion" producing somatic signs of hysteria. Charcot's final lesson on dreams thus culminates his study of the psychological basis of traumatic hysteria.

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.

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.

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.

[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.

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.

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.

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.

Désiré Bourneville: A Socialist in Charcot's Inner Circle.

Désiré Bourneville was one of Jean-Martin Charcot's most important disciples. His previous works as an alienist allowed him to influence his master's interest in hysteria, which led to the creation of a service regarded as a neurological mecca. During his time under Charcot, Bourneville, a passionate left-wing radical, had to coexist with characters representative of the conservative, bourgeois Parisian society. The aim of this study is to describe Bourneville's life and work, as well as the ambiguity of a progressive man such as him, immersed within the economic and cultural elites.

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.

[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.

[Reconversions of hysteria]. / Re-conversions de l'hystérie.

What has become of the hysterics of yesteryear? Despite the evolution of nosographic categories, their symptoms cannot be reduced to this, and they invite all clinicians to listen to the power of their words to express the effects of the unconscious. Disappointed lovers, worshippers of knowledge, they challenge those who would try to squeeze them into overly restrictive diagnostic boxes, to silence their truth. For they embody in their tribulations the effects of language on the being, a metonymy that they wear on their bodies. Their posture invites us to listen to the singularity of each case by highlighting the dignity of the symptom.

[The hysterical 'truth strike' and the questions it addresses to the contemporary master]. / La "grève de la vérité" hystérique et les questions qu'elle adresse au maître contemporain.

Today's hysteria, contemporary with its clinical disappearance from current nomenclatures relayed by neuroscience, is scattered in the 'catch-all' categories of conversion disorders, histrionic personality, etc. These approaches convey what Jacques Lacan called the foreclosure of the subject, or what amounts to saying, its rejection or oblivion, in particular in the relationship to knowledge and to the jouissance of the symptom. The Freudian discovery of the unconscious, and its studies on hysteria, which made hysterical conversion a message to be deciphered, is reduced in the contemporary clinic to the dimension of a disorder to be and no longer to be interpreted, because interpretation implies the subject, its word. Fortunately for the clinic, hysteria has other strings to its bow in which the subject ultimately finds his word.

[From "hysterical anorexia" to anorexia nervosa]. / De l'"anorexie hystérique" à l'anorexie mentale.

Anorexia nervosa and hysteria are two entities whose concepts have evolved through the ages, from "hysterical anorexia" to become distinct both in their presentations and in the representations within the community. Today, the psychiatric approach has been enriched by the contribution of neuroscience. Hospital treatment of anorexia nervosa allows intervention on the symptoms of the disease, but also takes into account the associated needs and disorders.

[Hysteria, a product of society]. / L'hystérie, un produit d'origine sociétale.

According to Ernest-Charles Lasègue (1878), "the definition of hysteria has never been given and never will be". The plurality of symptoms and clinical manifestations accounts for the polymorphism of this disease. From the first descriptions in antiquity to the present day, hysteria remains unclassifiable and defies the laws of medicine. Yet there is a continuous thread to its history: each conception of hysteria reflects the cultural and social concerns of the time. The disease affects both men and women. Nevertheless, the etymology of the concept points to the female gender. The place of the woman, in public and in private, is to be compared with the treatment of these patients, ill in a body, in a gender, in an era.

[Hysteria: history of a concept and its clinical reality]. / L'hystérie : histoire d'un concept et de sa réalité clinique.

Hysteria is one of the oldest and best known clinical terms. Its history reveals the extent to which pathological entities, some more than others, are the fruit of successive conceptions of experts, themselves undoubtedly influenced by the prevailing currents of thought of their time. From its uterine origin to its psychogenic etiology, here is the history of hysteria and its controversies. A history that belongs to that of medicine, neurology, psychiatry, psychology and psychoanalysis.

[Hysteria in the 19th century]. / L'hystérie au xixe siècle.

At the beginning of the 17th century, well before the time of Jean-Martin Charcot, numerous medical theses related to hysteria were defended, particularly in Paris. Among these theses, the work of Auguste Lepecq de la Clôture stands out for a controversy that questions the "matrix" origin of hysteria. Although Charcot, Babinski and Freud showed considerable interest in this pathology, its source remained mysterious to the point of disappearing from the Diagnostic and Statistical Manual of Mental Disorders. In this turmoil, women, reduced to the world of silence, have been tossed around throughout history, abused by politicians. While some have tried to make themselves heard, no one seems to have heard them.

Hysteria or epilepsy?

Hysteria and epilepsy have long been compounded by the term "hysteria-epilepsy" among neurologists and physchiatrists, including Jean Martin Charcot. In a 114 page unpublished manuscript written circa 1815, Jean-Baptiste Louyer Villermay, French physician and student of Philippe Pinel, considered the signs that would differentiate hysteria from epilepsy. This differential diagnosis approach was proposed long before Charcot's lecture in 1868 at Salpêtrière hospital.