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The History of Hysteria

Until 1980 hysteria was a formally studied psychological disorder that could be found in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. Before its classification as a mental disorder, hysteria was considered a physical ailment, first described medically in 1880 by Jean-Martin Charcot. Even before this, hysteria was thoroughly described in ancient Egyptian and Greek societies. But what really was hysteria?

Today, when we say someone is hysterical, we mean that they are frenzied, frantic, or out of control. Until 1980, however, hysteria was a formally studied psychological disorder that could be found in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. Before its classification as a mental disorder, hysteria was considered a physical ailment, first described medically in 1880 by Jean-Martin Charcot. Even before this, hysteria was thoroughly described in ancient Egyptian and Greek societies. So what was hysteria? How did it just go away? Why was it a major point of contention for second wave feminists, and how was it treated?

Throughout history hysteria has been a sex-selective disorder, affecting only those of us with a uterus. These uteri were often thought to be the basis of a variety of health problems. The ancient Egyptians and Greeks, for example, believed wombs capable of affecting the rest of the body’s health. In ancient Greece specifically, it was believed that a uterus could migrate around the female body, placing pressure on other organs and causing any number of ill effects. This “roaming uteri” theory, supported by works from the philosopher Plato and the physician Aeataeus, was called ‘hysterical suffocation’, and the offending uterus was usually coaxed back into place by placing good smells near the vagina, bad smells near the mouth, and sneezing. The philosopher and physician Galen however disagreed with the roving uterus theory, believing instead that the retention of ‘female seed’ within the womb was to blame for the anxiety, insomnia, depression, irritability, fainting and other symptoms women experienced. (Throughout these classical texts, pretty much any symptom could be attributed to the female sex organs, from fevers to kleptomania).

Other writers and physicians at the time blamed the retention of menstrual blood for “female problems.” Either way, the obvious solution was to purge the offending fluid, so marriage (and its implied regular sexual intercourse) was the general recommendation. Male semen was also believed to have healing properties, so sex served two purposes. For young or unmarried women, widows, nuns or married women unable to achieve orgasm via the strictly penetrative heterosexual sex that was common at the time, midwives were occasionally employed to manually stimulate the genitals, and release the offending liquids. A 1637 text explains that when sexual fluids are not regularly released, ‘the heart and surrounding areas are enveloped in a morbid and moist exudation’, and that any ‘lascivious females, inclined to venery’ simply had a buildup of these fluids. It’s obviously laughable to think that doctors believed everything wrong with women could be attributed to their liquid levels, but contrarily it is interesting how close doctors got to the truth, in their belief that extreme sexual desire was caused by a lack of regular orgasm.

It was Jean-Martin Charcot, in 1880 France, who first took a modern scientific sense to the female-only disease of hysteria. He lectured to his medical students, showing them photos and live subjects, on the hysteria symptoms he believed were caused by an unknown internal injury affecting the nervous system. One of these medical students was none other than Sigmund Freud, the founder of psychoanalysis. Freud, working with his partner Breuer in Austria, developed Charcot’s theories further, and wrote several studies on female hysteria from 1880-1915. He believed that hysteria was a result, not of a physical injury in the body, but of a ‘psychological scar produced through trauma or repression’. Specifically, this psychological damage was a result of removing male sexuality from females, an idea that stems from Freud’s famous ‘Oedipal moment of recognition’ in which a young female realizes she has no penis, and has been castrated. (I don’t have the time to open that particular bag of worms, but feel free to click here to read about it)

In essence, Freud believed that women experienced hysteria because they were unable to reconcile the loss of their (metaphoric) penis. With this in mind, Freud described hysteria as ‘characteristically feminine’, and recommended basically what every other man treating hysteria had through the years- get married and have sex. Previously this was done to allow for the ridding of sexual liquids, whereas now the idea was that a woman could regain her lost penis by marrying one, and potentially giving birth to one. If marriage wasn’t an acceptable or possible treatment however, there was another technique of treatment for hysteria, prolapsed uteri and any gynecologicals problem really, rising in popularity in the late 17th century- uterine massage.

Yes, uterine or gynecologicals massage was exactly what you think it was.

Invented by a Swedish Army Major named Thure Brandte, and though initially used to treat conditions in soldiers like prolapsed anuses, uterine massage quickly became the norm for treating everything in women from tilted uteri to nymphomania. Brandte opened several clinics, all of which were remarkably successful. He employed 5 med students, 10 female physical therapists, and had doctors from across the globe apprenticing at his clinics, which were known to treat as many as 117 patients in 1 day. Most recommended techniques were bimanual, meaning 1 hand was placed outside the body on the abdomen, and the other inserted into either the vagina or anus to perform massage, until a ‘paroxysmal convulsion’ (we now call these orgasms) was achieved. These sessions were considered ‘long and physically exhausting’ for doctors, for obvious reasons. This problem led to the creation of stimulation devices- namely, vibrators. (You can see some early vibrators by clicking here)

At least officially, the sexual nature of these treatments was not realized, or at least acknowledged. While it’s hard to not see this procedure as a primarily sexual process when looking back, doctors at the time feared it becoming conflated with sex. So much so that some advocated hurting the female patients, or at least causing them discomfort. It still baffles me how any doctor could purposefully and unnecessarily hurt patients, but this is just another example of the many unethical medical processes women have been subject to. After about 1910, gynaecological massage fell into the category of alternative medicine, and while I’m sure you can still find someone practicing it today, advancements in medical knowledge (and feminist movements) have led to the understandings that the uterus is not at the heart of most medical problems, and that many of the symptoms previously attributed to hysteria truly belonged to mental illnesses, or were just normal, if unacceptable to historic societies, behaviours for females.

Hysteria was basically the medical explanation for ‘everything that men found mysterious or unmanageable in women’, a conclusion only supported by men’s (historic and continuing) dominance over medicine, and hysteria’s continued use as a synonym for “over-emotional” or “deranged.” It’s also worth noting how many of the problems physicians were attempting to fix in female patients, were not problems when they presented in male patients. Gendered stereotypes, like the ideas that women should be submissive, even-tempered, and sexually inhibited, have caused tremendous damage throughout history (and continue to do so today). It doesn’t seem so coincidental then that most modern treatments for hysteria involved regular (marital) sex, marriage or pregnancy and childbirth, all ‘proper’ activities for a ‘proper’ woman.

All things considered, most doctors and women alike were glad to see hysteria deleted from official Diagnostic and Statistical Manual of Mental Disorders in 1980.