Defining Mental Illness and Psychiatric Disability
Joel Michael Reynolds, Christine Wieseler in The Disability Bioethics Reader, 2022
A glimpse into the history of psychiatry reveals a number of troubling biases that made their way into diagnosis. In the Antebellum South, the mental illness diagnosis of drapetomania was used to describe the pathology of enslaved people who tried to flee, and dyaethesia aethiopica was applied to explain perceived laziness among freed former slaves. During the 1960s, the diagnosis of schizophrenia went from being associated with a relatively harmless neurosis among middle-class housewives to being associated with violent aggression in Black men, so-called “protest psychosis” (Metzl 2010). Into the twentieth century, psychiatrists and other therapists offered the label of hysteria, based on the ancient notion of a “wandering uterus,” to women who were perceived as overly emotional, sexually frustrated, or incapable of having biological children. Neurasthenia (“nervous exhaustion”) was commonly associated with “unfulfilled” women during industrialization at the turn of the nineteenth century, and concerns were raised that educating women could also give rise to this problem (Tripathi, Messias, Spollen, and Salomon 2019). Heteronormativity and cisnormativity have influenced diagnostic categories as well; homosexuality, “transvestism,” and “gender identity disorder” all appeared in the DSM. These examples show how groups who are vulnerable in their social context can have their vulnerability exacerbated through medicalization and ensuing presumptions about their mental health.
Hysteria
Francis X. Dercum in Rest, Suggestion, 2019
All of the symptoms of hysteria are, as has been pointed out, mental in character. The essential features of the mental condition itself have also been discussed. It still remains to consider various special mental or psychic phenomena that present themselves. These, like the sensory, motor and visceral symptoms, at once impress us with their unreality and unessential character. In fact, there is something about them which even to the lay mind suggests their true nature. The simulation of abnormal mental phenomena is grossly imperfect. States of emotional excitement are very common, but the shrieks, screams, wild cries and weeping deceive no one. At most, a delirium or mental confusion may be simulated, but here as in the case of the physical signs, the symptoms have the appearance of something that is not genuine, something assumed, something voluntarily and artificially produced. This is usually quite obvious in the ordinary hysteric paroxysm. Hysteric attacks may vary greatly in intensity, as well as in the symptoms which they present. They may be limited to comparatively slight emotional disturbances attended by weeping and laughter, or by transient changes in speech and conduct in which the emotional factors are so evident that even the laity recognize the attacks as hysteric.
Physical presentations of emotional distress
Quentin Spender, Judith Barnsley, Alison Davies, Jenny Murphy in Primary Child and Adolescent Mental Health, 2018
Hysteria has been defined as the presence of physical symptoms in the absence of disease, or where the disease is present but insufficient to explain the symptom. An alternative way to look at hysteria is as abnormal illness behaviour. By taking on the sick role, the child may be gaining a number of advantages such as: more attention from parentsnot having to separate from parentsreduced conflict at homepermission not to attend schoolan opt-out from expected high achievementadditional supportattention from multiple professionals.
Ernst Brücke and Sigmund Freud: Physiological roots of psychoanalysis
Published in Journal of the History of the Neurosciences, 2022
Moreover, what is hysteria? Hysteria is, in a nutshell, just a wrong way of discharging energy (S. Freud 1991c, 57). When a person cannot discharge the energy due to the repression of “unthinkable thought,” the same energy finds its way in some other way. That other way is a somatic manifestation of the perfectly natural first stimulus. This fundamental principle of keeping the body’s energy level low—or as, he later directly attributed to Fechner and named it the principle of constancy (S. Freud 1986f, 9)—is just a psychological equivalent of physiological principle. It is easy to identify in Freud’s later writings. When he discovered his second topographical model, he assured that the duty of psychoanalysis was strengthening the ego over the id and the superego (Smith 1999, 90–91). This process proved itself fruitful for Freud because, obviously, what the superego does is block the ways of discharge by enforcing a sense of guilt in subjects (S. Freud 1986g, 135–37). When the superego gets stronger, as he realized in Totem and Taboo, it can pave the way for fatal consequences through the omnipotence of thought and become a self-destruction machine simply by inhibiting the discharge of the energy from the body or discharging the energy through displacement (S. Freud 1986e, 30). In the tribes he studied, Freud saw that members of some tribes could have died simply because they had misconduct with the taboo, and they believed that they were going to die (S. Freud 1986e, 42–43).
Jean-Martin Charcot´s medical instruments: Electrotherapeutic devices in La Leçon Clinique à la Salpêtrière
Published in Journal of the History of the Neurosciences, 2021
Francesco Brigo, Albert Balasse, Raffaele Nardone, Olivier Walusinski
Jean-Martin Charcot (1825–1893) is widely considered the father of modern neurology. The lectures he delivered at the Salpêtrière Hospital in Paris attracted a large number of visitors from all over the world (Goetz, Bonduelle, and Gelfand 1995). While working as chief of service at this hospital (1862–1893), Charcot became increasingly interested in hysteria, which he described in its various stages and forms (Bogousslavsky 2014; Bogousslavsky and Moulin 2009; Goetz, Bonduelle, and Gelfand 1995). For him, hysteria was a condition with distinctive neurologic signs but no detectable morphological lesions in the brain identified at autopsy. Charcot had initially considered hysteria as the consequence of a “dynamic lesion” (lésion fonctionnelle or lésion dynamique) of the nervous system (Goetz, Bonduelle, and Gelfand 1995). Furthermore, he vehemently rejected the equation between hysteria and simulation. Only shortly before his death, he became increasingly convinced of the importance of psychological factors in the genesis of hysteria (Bogousslavsky and Moulin 2009). Because he believed only hysterical subjects could be hypnotized, Charcot advocated the use of hypnotism for studying this phenomenon (Goetz, Bonduelle, and Gelfand 1995).
The mysteries of hysteria: a historical perspective
Published in International Review of Psychiatry, 2020
In fact, after the transient rise of interest associated with World War I, hysteria came back to where it had been before Charcot, i.e. a no-man’s land between psychiatry and neurology, with a marked decrease in scientific interest and studies as an immediate consequence. Indeed, available clinical experience suggests that hysteria did not disappear at all, and even has remained rather stable over the years. Already in 1955, Guillain was stating in his book on Charcot that there had been no change in the prevalence of hysteria, while the way and the terms to report it had evolved into “functional disorders”. This discrepancy between medical historians and clinicians reflected mainly a “diagnostic reconceptualization”, where nosographical refashioning gave to non-clinicians the illusion of a disappearance. Stone et al. (2008) recently examined 68 textbooks published between 1877 and 2005, showing a marked decrease both in the use of the term “hysteria” and in the interest in the corresponding condition.
Related Knowledge Centers
- Conversion Disorder
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- Emotion
- Histrionic Personality Disorder
- Stress
- Uterus
- Epilepsy
- Female Hysteria
- Somatization Disorder
- Male Hysteria