The Hysterical Self: Psychology in the Clinic

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The Hysterical Self Psychology in the Clinic
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Jean-Martin Charcot (1825-1893)
Clinico-Anatomic Method
Inscribed to Freud, on the day Freud left the
Salpêtrière
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Charcot (profile, far left) at theatrical
reading, with writers Emile Zola and Edmond de
Goncourt
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Photographic Iconography of theSalpêtrière
(1876-77)
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Charcots Four Stages of Grand Hysteria

• Tonic rigidity limb contractures that mimicked a
  typical epileptic fit.
• Dramatic body movements contortions, illogical
  movements clownism.
• 3. Passionate Attitudes expressions of vivid
  emotional states.
• 4. State of delirium

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Stages of the Hysterical Attack
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AUGUSTINE
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Beginning of the Attack
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Tonic RigidityStage 1
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Contracture of the Face Stage 1
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Stage 2Clownisms, Illogical Movements Circular
Arch
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Passionate Attitudes Stage 3 Menace
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Passionate Attitudes Stage 3 Menace
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Passionate Attitudes Stage 3 Aural
Hallucinations
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Passionate Attitudes Loving Supplication
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Passionate Attitudes Ecstasy
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Passionate Attitudes Crucifixion
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Metalloscopy Use of Magnets to shift areas of
anaesthesia
Zones of Hysterical Anesthesia
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Artificial Contracture
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Catalepsy produced by sound
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Charcot and Blanche Wittman
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A Case of Traumatic Male Hysteria
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Hippolyte Bernheim (1840-1919)
Suggestive Therapeutics (1886) head of the
Nancy School
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Pierre Janet (1859-1947)
Dissociation Traumatic event and accompanying
memories split off from consciousness Imperative
Suggestion suggestion that these memories
didnt exist
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Janets Somnabulisms

• Monoideicdominated by one idea, usually a
  transient episode.
• Polyideic--complex states or ideas called fugue
  states, could involve a loss of identity for
  extended period.
• Recriprocal or Dominating Somnabulism (double
  personalities)relatively permanent transition
  into another state
• memory impaired across these states

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Reciprocal Somnambulism Lady MacNish/Mary Reynolds
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Alfred Binet (1857-1911)
On Double Consciousness (1890) Alterations of
the Personality (1896)
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Examples of Automatic Writing with an anesthetic
hand Binet (1890 and 1896)
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Insensible Armhearing a Metronome Sensible
arm Insensible arm while subject counted to
five Sensible Arm Subject held
dynamometer, connected to a recording
cylinder. Binet (1896, p. 201)
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Sigmund Freud (1856-1939)
it still strikes me as strange that the case
histories I write should read like short stories
and that, one might say, they lack the serious
stamp of science.
Studies on Hysteria
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Freuds Neuropathological Training

• At the Institute of physiology in Vienna, headed
  by Ernst Brücke (1876)
• In the neuro-anatomical laboratory of Theodor
  Meynert (1883-1886)
• at Vienna General Hospital

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Freuds 1877 publication on the function of the
large Reissner cells in the spinal cord of
primitive fish Petromyzon, assigned to him by
Professor Ernst Brücke.
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Freuds unpublished
manuscript for a scientific psychology of
1895
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Berggasse 19, Vienna (May 1938)
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Joseph Breuer (1842-1925)
STUDIES ON HYSTERIA 1895 Breuer and Freud
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Anna O./ Bertha Pappenheim (1859-1936)
TALKING CURE or CHIMNEY SWEEPING hysteric
s suffer mainly from reminiscences Studies in
Hysteria
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Cathartic Method or Abreaction

• An original response to a traumatic event is
  suppressed, and the affect or emotion is not
  expressed
• The original affect then expresses itself in
  bodily symptoms, a process called hysterical
  conversion
• Cure consists of verbally reviewing the event,
  and releasing the original affect.

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Janet vs. Freud

• Dissociation, Splitting vs. Repression
• Mental Weakness of Patients vs. Active Forgetting
• Degeneracy (Hereditary weakness) for synthesis of
  psyche vs. psychic conflict, competing wishes, or
  opposing forces.
• Experimental Psychology vs. Therapeutics
• Hypnosis vs. Insistence on Remembering
• Inability to remember vs. Resistance to remember
• Innate Incapacity vs. Dynamic conflic

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Carl Jung (1875-1961)
Psychological Complex Uncovered with the use
of association tests with patients
Collaborated with Freud 1906-1912
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Freuds couch for use offree association
technique
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Freud and his Couch
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• Active Repression patient was motivated to
  actively repress traumatic information from
  consciousness.
• Content of repressed material was often sexual.
• Freuds formulated the Seduction Theory in
  1890s and rejected it in 1897.

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Controversial 1980s Historiography on Freud
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Freuds Structural Model of the Mind, 1923

• ID locus of fantasies, desire, unconscious
• EGO emerged from Id, but had adapted to society
• EGO-IDEAL (Super-ego) source of repression,
  moral conscience

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• In 1900 Freud published Traumdeutung, or
  Interpretation of Dreams
• Manifest Content of Dreamits story-line, a
  conscious process
• DREAM CENSORlets some information out,
  represses, disguises other information
• Latent Content of Dreamdream thoughts,
  unconscious, often unacceptable wishes

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Traumdeutung, Interpretation of Dreams (1900)

• Condensation dream concentrates or compresses a
  number of different ideas into one a composite
  picture.
• Displacement transformation of dream thoughts
  into more acceptable thoughts in order to conceal
  unconscious meaning.
• Representation all material gathered into a
  single situation in the dream.
• Symbolization a certain set of symbols exist in
  unconscious, and become part of the dream.

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International Psychoanalytic Congress, Weimar 1911
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Freuds Secret Committee (1922)
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• Hotel Log Hints at Illicit Desire That Dr.
  Freud Didnt Repress

Sigmund Freud with his wife, Martha Bernays
Freud, center, and her sister, Minna Bernays,
left, in 1929. from New York Times December 24,
2006
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Freud, Hall, Jung
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Morton Prince James Jackson Putnam Boston
School of Psychotherapy
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Freuds Visit to Clark University, 1909
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1945
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Alfred Hitchcock and Salvador Dali Spellbound
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Our story deals with psychoanalysis, the method
by which modern science treats the emotional
problems of the sane. The analyst seeks only to
induce the patient to talk about his hidden
problems, to open the locked doors of his mind.
Once the complexes that have been disturbing the
patient are uncovered and interpreted, the
illness and confusion disappear ... and the
evils of unreason are driven from the human
soul. Spellbound, 1945
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