How Did Freud Explain Hysteria, And To What Extent Did His Explanations Differ From His Predecessors?

The study of hysteria is very fundamental to the development of psychoanalysis as a mean of investigating a new method of interpretations to its symptoms and therapy (Borossa, 2001). Hysteria is nowadays defined as emotional and neurosis disorder that appears in physical symptoms. The symptoms of hysteria, in this line of thoughts, are unexplained by organic disease. Instead, they arise in the form of psychotogenic disorder such as stress and emotional difficulties. Historically, hysteria was considered as an illness that affects mainly women from upper social and economic class (bourgeois) hysteria was hugely linked to gender and power (Borossa, 2001). The influential Sigmund Freud in his theory of hysteria remains to be the legacy for the development of psychoanalysis. He saw hysteria as a disease of mind. Freud s explanation of hysteria differs to some extent from the previous assumption where hysteria is considered as a disorder that is associated merely with women. The present essay discusses Freud`s definition of hysteria and then proceeds to show how Freud differs in his interpretation to hysteria from his predecessors.

The story of hysteria was complicated to psychoanalytic, and its symptoms were confusing and hard to interpret as they appeared without any apparent explanation (Wald, 2007). The symptoms were often featured as dramatic and disturbing. Hallucinations, loss of appetite, nervous coughing, disturbed vision, languages difficulties and sleeplessness were attributed to hysteria. Back to the ancient Egyption time, the case of hysteria was referred to physical symptoms that are observed in women. Hysteria was described as a spontaneous uterus movement within the female body. It is documented that "The womb is an animal which longs to generate children. When it remains barren too long after puberty, it is distressed and sorely disturbed brings the sufferer into the extremist anguish and provokes all manner of diseases besides." (Borossa, 2011: 10). In this line of thought, hysteria identifies a link between nervous disorders and the evolution of the uterus. In other words, women who suffer from stress and anxiety were thought to have physical pathologies that were somehow linked to the nervous systems.

To Freud, hysteria is a psychological disorder (Freud, 1901). He thought that hysteria is rooted in the repression of unpleasant emotions that caused by a traumatic event in the patient`s life. At first, in 1896, Freud outlined a theory that explains hysteria as caused by the reminiscence of sexual abuse that occurs during childhood. This method was known as seduction theory that Freud initially used to justify hysteria. Freud reputedly says the experience of sexual abuse was the origin of neuroses disorder and other mental health issues. Later, case after case, Freud concluded that the theory of seduction is not universal that covers all the circumstances of hysteria. Consequently, Freud abandoned this approach explaining that it could be impossible that all of his patients had been seduced, add to this it is difficult to distinguish between real abuse and fantasies. Freud sought an alternative explanation of hysteria (Isra ls and Schatzman, 1993). He then asserted that the puzzle of hysteria is explained by internal factors, not external as seen in the case of seduction, which provokes hysterical symptoms. The patient`s sexual fantasies and desires, exclusively towards one`s parents, would be the base of any hysterical symptoms. As these fantasies established as abominable by the patient, they had to be repressed in the unconscious mind as a result. The hysterical signs appear on the patients only if a traumatic event triggers them to be noticeable. The repressed desire towards the parents in Freud terminology is called Oedipus complex which Freud argues that it holds the interpretation of any case of hysteria. He cites "A single idea of general value dawned on me. I have found, in my case too [the phenomenon of] being in love with my mother and jealous of my father, and I now consider it a universal event of early childhood" (Borossa, 2011, p.45).

In his famous work Fragment of an Analysis of a Case of Hysteria, 1905, Dora case, Freud relentlessly deploys his theory of Oedipus complex. Dora was eighteen years old when she was consulted by Freud after she had been committed with threatened suicide. Dora was suffering from symptoms such as migraine, extensive cough, socially withdrawn, difficulty breathing and loss of voice. To Freud, these symptoms are the result of a traumatic event that Dora might have experienced sexual conflict in her life. In her narrative stories, Dora expressed that she was exposed to sexual abuse from her father`s friend Herr.K whom her father was in a love relationship with his wife Frau.K. Dora expressed her feeling of disgust to Freud when Herr.K forcibly tried to kiss her. At that time, Dora had a conflicted relationship with her mother. However, she exhibited an intense and emotional relationship with her father. Freud documented that Dora`s father and Herr.K both denied Dora`s accusation and asserted that she had imagined this sexual seduction (Freud, 1997). Freud thought that Dora`s hysterical symptoms are results of her forbidden sexual wishes towards Herr.K. For Freud, this repression of an erotic desire indicates that Dora indeed was attracted to Herr.k. However, she repressed her feelings towards him and showed disgust instead. After analysing Dora`s dreams, Freud concluded that the hysterical symptoms were rooted in Dora`s unconscious mind. Dora had repressed sexual fantasies and impulses towards her father. When she had the sexual abuse from Herr.k, the repressed wishes towards her father returned and influenced her hysteria. Freud confirms that sexual desires that are repressed continuously in the unconscious mind are the fundamental aspects of hysteria. Freud sought to understand the reaction that Dora made on Herr.K`s courtship. He connected her refusal and feeling of disgust towards Herr.K as a jealousy of her father`s relationship with Frau, K. Freud explains that she was acting like "jealous wife" (Freud, 1901: 47). Freud revealed that some of her hysterical symptoms manifested in nervous coughing rooted in her sexual fantasies regarding her father as she, according to Freud, imagined that her father and Frau, K were engaged in oral intercourse (Holmes, 1983). Dora had suffered sexual frustration during her infancy as she repressed her sexual instincts to her father, as Freud proposed, that lead her to have anxiety and functional disorders. Freud seems to attribute emotional symptoms to the existence of repressed, unwanted emotions regarding the parents that the child establishes they are unacceptable they tend to be repressed and pushed to the unconscious mind. As the child grows up, the sexual conflict gets intense that is becomes something that resembles sexual love` (Freud, 1901: 47).

In his co-authored work of "The study on Hysteria" (1895), Freud and Breuer- with whom Freud had been collaborating to study hysteria, illustrated that hysteria were highly connected with traumas in the person`s past. Patients often are not able to recall all the traumatic events that lead them to experience hysteria unless they are triggered. According to the authors, based on their case studies of hysteria, repressed unpleasant memories and events are the main contributors to hysteria. The symptoms of hysteria are psychic originated from the mind, and that opposed the notion of the physiological cause of hysteria. Both Breuer and Freud provided that hysterics suffer mainly from "reminiscences" and both emphasied on the psychological aspect of hysteria in their accounts. Breuer noted that in all hysteria cases there were frequently sexual components. The sexual component of hysteria is presented as "where desire comes into contradictions with incapacity to find fulfilment" (Borossa, 2011, p.42). However, Freud strenuously asserts that the traumatic sexual event was always and everywhere the fundamental cause of hysteria (Scull, 2009).

In this joined work which consists of five case studies of women recorded their narratives about their illness, Breuer`s patient Bertha Pappenheim, known as Anna O, becomes very exceptional. Without the case of Anna O, there would have been neither a study on hysteria nor a development in psychoanalysis. Anna O was suffering from dramatic symptoms after the death of her father in 1880s. Her symptoms included: splitting of personalities, hallucinations, spasms of coughing, refusal to eat, lose the ability to speak and use certain words, and finally a failure of language- she spoke in English as her native language, German, was unintelligible (Scull, 2009). After many observations, Breuer concludes that Anna O felt offended by events that were psychologically painful which she insisted not to speak about them. Breuer encouraged Ann O to constructed her story tail and talked about her life. Once she expressed her repressed emotions, all her relevant symptoms disappeared. The death of her father was so traumatic to her and was not integrated into her understanding. Anna O was the patient herself who coined the term "the talking cure" or "chimney sweeping . Breuer called it catharsis to describe a therapeutic way in which the patients heal their symptoms by expressing their unpleasant feeling of the traumatic experience the patient spoke and, was heard, and then the symptoms gradually would vanish (Freud and Breuer, 1971).

Another aspect of Freud and Breuer of a new perspective of hysteria is the treatment process. Breuer thought that if the patients were able to recognise the primary cause of their physical symptoms by talking about their experiences, the patients would be able to state these originated thought or events. The patients in this process are in a position to think loud of these unbearable events or emotions that previously had been rejected by the mind. According to Breuer, the treatment process should include hypnosis and cathartic. Freud appreciated the method of hypnosis and cathartic techniques as tools for understanding hysteria. However, he asserts that although cathartic session heals some of the symptoms, this treatment is temporary. Thus, Freud refuses the idea of using cathartic techniques and hypnosis solely as a fundamental basis of therapy (Scull, 2009). Freud noted that there must be a new approach that is necessary to understand the underlying factors of hysteria. He began to reconstruct his explanation of the characteristics of hysteria opposed to other neuroses. He involves physical pressure in his method that allows him to exert influence on the patient s head as a way of pushing them to answer during the talking cure session (Scull, 2009). Freud also looks at the nature of the traumatic event and how the patient reacts to it. He affirms that sexual desires which had been thwarted considered being the causal of the hysteria. Freud concluded that hysteria is a form of pathological defence mechanism that is deployed by the self to protect the mind from mental collapse. The psychic conflict between the self and the repulsive, undesirable memories are manifested and converted physically. In Miss Lucy R case, the young lady who worked for widower as a caretaker to his children, Freud applied his methods of treatment. Miss Lucy R suffered from suppurative rhinitis and developed olfactory hallucinations of the smell of burnt pudding which Freud asserts was the origin of her hysteria. Freud suggested that she was in love with the widower, but she was determined to hide this affection due to the difference in her social class. Freud believed that a real event is very fundamental to retrieve the hidden and repressed memories that stimuli the symptoms. Freud declares that this event that motivated the symptoms is not the cause of these hysterical symptoms. Instead, it is a sign of a more profound reason. In Miss Lucy R case, the cigar smoke triggered the scent of the burnt pudding that, according to Freud, is associated with her underlying emotions toward her employer which she was unable to tolerate. Freud concluded that her hysteria is presented in a physical display of her unpleasant desire, however, the relationship of these wishes to its origin is unknown to Miss Lucy R.

The work of the French neurologist Jean Martian Charcot hugely influenced Freud explanation of hysteria. Charcot emphasis that hysteria is genetic that is a person would genetically inherit to develop hysteria. He proposes that "Heredity is interesting because it always brings us back to the same principle: it proves to us that hysteria does not grow all by itself, like a mushroom" (Borossa, 2001, p.18). He sees that hysteria is not a female malady that is men also could be diagnosed. Unlike Freud who affirms that hysteria is a psychological disorder, Charcot declares that "hysteria is a disorder of the nerves system" (Scull, 2009: 105). Charcot observed the pattern of the symptoms that manifest in his patients. He spent time and energy to map out the disorders of the nervous system, the aesthesis, the seizures, and paralysis that were thought to be elements in hysteria attacks. He came to conclude that hysteria is caused by lesions of the nervous system which cause the hysterical symptoms. Freud was immensely delighted with Charcot`s idea that the symptoms of hysteria appeared all in one on the patient when an event stimulate and trigger the symptoms. Further, Freud and Charcot emphasis on the family dynamics as a source that leads to hysteria. However, Freud affirms that sexual fantasies during childhood hugely contribute to the hysteria that releases themselves through physical symptoms. Another important difference between Freud and Charcot is that the latter suggests that working class people are more likely to have hysteria due to poverty whereas Freud proposes that hysteria of the severest kind is compatible with the richest and more original gifts" (Freud and Breuer, 1895: 95).

As mentioned, the application of hysteria was historically associated to the female malady. Traditionally, the female body was treated as inferior to that of man`s. Scholars before Freud inclined to accept Hippocrates notion of female body and its functions is rooted in the causes of hysteria symptoms. Hippocrates was using the word "hysteria" to describe women experiencing stress and anxiety, and by the Middle Ages, hysteria was associated with original sin and witchcraft. Hippocrates asserted that the womb is the origin of all diseases` (Scull, 2009: 13). According to Scull (2009), Edward Jorden, for example, believed in female susceptibility to being diagnosed with hysteria. He explains that the womb is close to the brain and heart displaced uterus in women led to various medical pathologies such as blindness and speechless (Jorden in Scull, 2009). It is important at this stage of discussion to illustrate that Freud to a large extent differ in his explanation to hysteria from the notion that hysteria is connected to the female reproductive system. He, however, affirms that the nature of hysteria is sexual. Sexual fantasies and desires are repressed involuntarily in the patient`s mind as a mechanism that the self engages to protect itself against unpleasant internal feelings. Although this mechanism is effective to block the unpleasant emotion and event to be consciously active, however, Freud was obvious when he explains that under certain circumstances these repressed emotions can be easily retrieved paving the way to hysteria. As Scull (2009) mentioned, Freud and Breuer documented that "Every hysteria is the result of a traumatic experience, one that cannot be integrated into the person`s understanding of the world"(P.139). In this line of thought, Freud seemed to significantly differ from his predecessors who claim the hysteria is caused by the spontaneous movement of the female body.

In conclusion, Freud saw hysteria as a psychological disorder. He argued that the origin of hysteria is sexual. Repressed sexual fantasies and desire during childhood and later in adulthood are the primary source of hysterical symptoms. Such claim presents that Freud differed to a large extent in his interpretation to hysteria from his predecessor. Historically, hysteria was seen as a disease that was linked exclusively to women. The movement of the uterus within the female body was a justification to hysteria. His predecessors concentrated on the body to understand hysteria rather than the mind. I would argue that although Freud appeared to explain hysteria from a psychological sphere, he did not neglect the physical aspect of hysteria Freud took into account his predecessor s explanation of hysteria. Freud explains that the physical manifestations of hysteria are seen as conversion reactions because the potential cause of the symptoms is believed to be converted into physical symptoms. The treatment for hysteria, Freud argues, requires psychological techniques rather than medicine or technological treatment. In other words, Freud s explanation to hysteria included both mental and physical aspects and that lead to conclude that Freud differs to some extent with his explanation to hysteria from his predecessors.

References list:

Borossa, J. 2001. Ideas in psychoanalysis: Hysteria. Cambridge: Icon.

Freud, S. 1901. A Case of Hysteria. London: Oxford University Press.

Freud, S. 1997. Dora: An analysis of a case of hysteria. Simon and Schuster.

Freud, S. Breuer, J., Strachey, J. and Freud, A., 1971. Studies on hysteria.

Holmes, J. 1983. Psychoanalysis and family therapy: Freud`s Dora case reconsidered. Journal of family therapy, 5(3), pp.235-251.

Isra ls, H, and Schatzman, M. 1993. The seduction theory. History of Psychiatry, 4(13), pp.23-59.

Oppenheim, J.1991. Shattered nerves": Doctors, patients, and depression in Victorian England. New York, NY, US: Oxford University Press.

Scull, A. 2009. Hysteria: the biography. OUP Oxford.

Wald, C. 2007. Hysteria, Trauma and Melancholia: Performative Maladies in Contemporary Anglophone Drama.