Hysteria: Great blunders in the history of psychiatry

Hysteria is pure "classic" Junk science.
Psychiatry is Junk science


Saying to a woman, "stop being hysterical" is charged with historic misogynistic sexism. You can thank psychiatrists.

	Snapshot: Hysteria is a behaviour choice for personal profit. Hysteria has been dropped as a word from the DSM-IV because of its direct connection with the uterus. However, there are many new categories that are essentially identical. See also: History of Psychiatry homepage

A husband who blinds his wife: "A case occurred in which a wife, though she had the normal use of her eyesight for every other purpose, was unable to see her husband at all." (Karin Stephen, 1889-1953, The Wish to Fall Ill: A Study of Psychoanalysis and Medicine, p 7)

A. Snapshot summary:

The blood line of modern psychiatry is one of humiliation and shame to the modern industry. Psychiatrists transformed witches into hysterics and then into the mental illnesses listed in the DSM-IV as a "conversion reaction" and "somatization disorder". Modern versions of Hysteria where people chose behaviour for some personal benefit include:

Postpartum Depression (PPD)
Post-Traumatic Stress disorder (PTSD)
Schizophrenia
Multiple Personality Disorder (MPD) or Dissociative Identity Disorder (DID): "The New York Times ranked Sybil among the ten best-selling nonfiction books of the year and it was quickly turned into a Hollywood movie. Schrieber was deluged with letters from women thanking her for helping them understand that they were "multiples." it was not long before psychologists, in what Spiegel refers to as "a whole new cult, a whole new wave of hysteria,"' began finding cases of MPD among their patients. Quickly, psychologists began to report higher and higher frequencies, eventually claiming occurrences of one person in every hundred in the general population with much higher incidence rates in groups such as sexual abuse survivors, hospital inpatients and chemically dependent individuals." (Manufacturing Victims, Dr. Tana Dineen, 2001, p 259)

2. Hysteria is not a disease but a behaviour made into a disease:

"I maintain, therefore, that Freud did not discover that hysteria was a mental illness. He merely asserted and advocated that so-called hysterics be declared ill." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p37)
"As time went on, new items were added to this class. Some, like brucellosis or tularemia, were added because new medical methods made the identification of new bodily diseases possible. Others, like hysteria and depression, were added, not because it was discovered that they were bodily diseases, but because the criteria of what constitutes disease have been changed—from the physicochemical derangement of the body to the disability and suffering of the person. This is the metaphorical meaning of disease or illness." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p40)

c. "Hysteria is the name psychiatrists give to a form of mental illness characterized by the display of bodily signs, such as paralysis or spasmodic movements, and by complaints about the body, such as lack of feeling or pain. Other terms for the phenomenon are "conversion hysteria" and "dissociative reaction." Bodily communications indistinguishable from those characteristic of hysteria may be presented also by individuals diagnosed as malingering, hypochondriacal, neurasthenic, or schizophrenic, and by so-called normal persons as well. (The Medicalization Of Everyday Life, Thomas Szasz, 2007 AD)

d. "Essential for this process was the deceptive and self-deceptive separation of the abstract noun "mind" as quasi agent from the concrete person as responsible actor. Malingering was thus transformed into hysteria, hysteria was generalized into neurosis, and neurosis proliferated into the 350 distinct "psychopathological" entities now recognized as "mental disorders" by American psychiatry, American psychology, American medicine, and American law as well as by similar national and international authenticating bodies and health insurance companies." (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 14)

e. "Except for a few objectively identifiable brain diseases, such as Alzheimer's disease, there are neither biological or chemical tests nor biopsy or necropsy findings for verifying or falsifying DSM diagnoses. It is noteworthy that in 1952, when the American Psychiatric Association (APA) published the first edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM), it did not include hysteria in its roster of mental diseases, even though it was the most common psychiatric diagnosis-disease until that time. The term's historical and semantic allusions to women and uteruses were too embarrassing. However, the APA did not declare hysteria to be a nondisease; instead, it renamed it "conversion reaction" and "somatization disorder." Similarly, in 1973, when the APA removed deviant sex from its roster of mental illnesses, it first replaced it with ego-dystonic deviant sex; when that term, too, became an embarrassment, it too was abolished. However, psychiatric researchers lost no time "discovering" a host of new mental maladies, ranging from attention deficit hyperactivity disorder to caffeinism and pathological gambling." (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 2)

f. "as illness is reflected by the contemporary psycho-analytic view of malingering. According to it, malingering is an illness—in fact, an illness "more serious" than hysteria. This is a curious logical position, for it amounts to nothing less than a complete denial of the human ability to imitate—in this instance, to imitate certain forms of disability." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p43)

3. Hysteria is the Greek word for Uterus which is why medical doctors paused at diagnosing men with the "disorder". However, just as many psychiatrists historically diagnosed men with Hysteria (even though they have no uterus) today men are routinely diagnosed with Postpartum Depression (PPD).

a. "The phenomena we call "hysteria" and regard as a mental disease have been known since antiquity. Their interpretation, however, has varied throughout history. The term "hysteria" comes from the Greek word hysteron, which means the uterus or womb. Hippocrates thought that the uterus was a peregrinating organ whose wandering about the woman's body caused the malady. Sensing its relation to the sexual passions, he recommended marriage as the best remedy for it. The notion that hysteria is a condition that affects only women had thus been firmly established and was not seriously challenged until the latter half of the nineteenth century by the famed French neurologist-neuropathologist Jean-Martin Charcot. During the first ten centuries of Christianity, medical thought stagnated under the influence of Galenic teaching. As the perspective on sickness changed from naturalistic to theological-demonological, the phenomena associated with hysteria began to be interpreted as a manifestation of witchcraft. Following the Renaissance, hysteria was "rediscovered" as a disease: in the eighteenth century, it was attributed to emotions, passions, and human suggestibility, and in the early part of the nineteenth century, to organic dysfunction. It fell to Jean-Martin Charcot, Pierre Janet, and Sigmund Freud to clarify the distinction between neurological illness and hysteria. They believed that hysteria is a condition resembling physical disease that occurs in persons with healthy bodies. If this was to be considered a genuine disease, it is easy to see why it had to be distinguished from malingering: this was accomplished by defining hysteria as the unconscious imitation of illness and malingering as the conscious imitation of it." (The Medicalization Of Everyday Life, Thomas Szasz, 2007 AD, p 72)

Although Freud wanted to diagnose men with hysteria, the real medical community rejected this since the word hysteria literally means "uterus" in the Greek.

b. "10% of new fathers and 14% of new mothers are affected by Postpartum depression". (psychologist James F. Paulson, assistant professor of pediatrics at Eastern Virginia Medical School in Norfolk, Va)

c. First psychiatrists say PPD is caused by the fluctuation of hormones immediately after childbirth, but then they admit for every 14 women diagnosed with PPD, 10 men are diagnosed with PDD. It also fails to account for the fact that the vast majority of women who give birth never suffer from PPD, even though they do experience the same fluctuations in hormones. Postpartum Depression (PPD) is more junk science for profit seeking psychiatrists masquerading as medical professionals.

It is almost universally accepted that hysterics were faking mental illnesses in order to achieve a personal goal.

This general tendency to fake for profit was certainly never isolated by women, even though they took the initial rap, given the fact that they were by far the most common sex to engage in this theatre. However, the very term hysteria had its origin with female misbehavior.
Although today "hysteria" has been removed from the DSM-4, it has merely been renamed and flowered into a multitude of specific behaviours which men and women equally engage in for profit.
"This brings me to say a few words about malingering. It is found in every phase of hysteria and one is surprised at times to admire the ruse, the sagacity, and the unyielding tenacity that especially the women, who are under the influence of a severe neurosis, display in order to deceive . . . especially when the victim of the deceit happens to be a physician ... In 1899, about six years after Charcot's death, I saw as a young intern at the Salpetriere the old patients of Charcot who were still hospitalized. Many of the women, who were excellent comedians, when they were offered a slight pecuniary remuneration imitated perfectly the major hysteric crises of former times." (J. M. Charcot, quoted by Georges Guillain, 1825-1893, p 138-139)
"deliberate or unwitting, conscious or unconscious? Is the person doing the imitation seeking to advance his own interests, or is he doing it for some other reason? In the theater, for example, it is clear that both actors and spectators know that what looks like money is in fact an imitation, a prop. In ordinary life, on the other hand, only the counterfeiters know that the bills they pass to others are counterfeit; those to whom the bills are passed, and who may pass them on to others, do not know this. Believing that they possess a real object when in fact they only possess its imitation, they are deceived. What, then, is the comparable situation with respect to the imitation of illness? Does the so-called hysterical patient believe that he is "really ill," or does he know that he only "feels ill" but is not? Some insist that the patient offers illness in good faith; others insist that he is faking. There is often evidence to support both of these views. As a rule, the question cannot be answered unequivocally." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p46)
"Now, when there is this conversion, it performs a useful function; and that function occurs principally within the self-system. . . . There one discovers sometimes the almost juvenilely simple type of operation set up to profit from the disabling system. The patient will often tell you in the most transparent fashion: "If it were not for this malady then I could do—" and what follows is really quite a grandiose appraisal of one's possibilities. The disability functions as a convenient tool of security operations." (Conceptions of Modern Psychiatry, Harry Stack Sullivan, p. 216)
"So much for the patient, in his role as actor or message sender. What about the spectators, the recipients of the message? Their reaction to the drama of hysteria will depend on their personality and relationship to the patient. ... The non- psychiatric physician tends to view and treat all forms of disability as objects proper, not as representations: that is, as illness or potential illness. On the other hand, the psychoanalyst tends to view and treat the same phenomena as representations: that is, as symbols or communications." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p47)
"As an illness, hysteria is characterized by conversion symptoms. As a game, it is characterized by the goal of domination and interpersonal control; the typical strategies by which this goal is pursued are coercion by disability and illness, and by deceitful gambits of various kinds, especially lies." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p228)
"If we take this distinction seriously, we shall be compelled to regard psychiatry as dealing not with mental illness but with communications. Psychiatry and neurology are therefore not sister sciences, both belonging to the superordinate class called medicine. Rather, psychiatry stands in a meta relation to neurology and to other branches of medicine. Neurology is concerned with certain parts of the human body and its functions qua objects in their own rights—not as signs of other objects. Psychiatry, as defined here, is expressly concerned with signs qua signs--not merely with signs as things pointing to objects more real and interesting than they themselves." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p47)
"In short, so-called mental illnesses share only a single significant characteristic with bodily diseases: the sufferer or "sick person" is, or claims to be, more or less disabled from performing certain activities." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p47)
"The most obvious function of body language is its pro-motive use. By communicating through such "symptoms" as headache, backache, or menstrual pains a housewife who feels overburdened or dissatisfied with her life may be able to make her husband more attentive and helpful toward her. And if not her husband, then perhaps her physician. And if not her physician, then perhaps some specialist to whom he might refer her. And so forth. This action-inducing meaning of iconic body signs may be paraphrased as follows: ("I am sick, therefore . . .) Take care of me!—Be good to me!—Make my husband do such and such!—Tell my draft board to stop bothering me!—Tell the court and the judge that I was not responsible!" And so forth." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p121)

Treating hysteric behaviours with drugs is like smashing a computer because of a software virus.

a. "Skeptical physicians long ago recognized that there is no mystery about hysteria. It is not a disease and is not the name or diagnosis of a disease; instead, it is a collusive deception between a person playing disabled patient and a psychiatrist playing doctor diagnosing disease. This type of collusive medical deception is more common today than ever." (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 35)

6. Saying to a woman, "stop being hysterical" is charged with historic misogynistic sexism.

a. Today, calling a woman "hysterical" when she misbehaves is equivalent to saying, "What's wrong? Do you have your period?"

b. However, it must be remembered that it was the woman's bad behaviour that got her labeled "hysterical" not her good behaviour.

c. Men have always looked for ways to explain in biological terms why a woman behaves in inexplicable ways. Welcome to Hysteria! Thank your psychiatrist!

d. Today, psychiatrists actually think that Premenstrual syndrome (PMS) is a disease: "What Causes PMS and PMDD? Although the etiology of PMS and PMDD remains uncertain at present, researchers now concur that these disorders represent biological phenomena rather than purely psychological events. Recent research indicates that women who are vulnerable to premenstrual mood changes do not have abnormal levels of hormones or some type of hormonal dysregulation, but rather a particular sensitivity to normal cyclical hormonal changes. Fluctuations in circulating estrogen and progesterone cause marked effects on central neurotransmission, specifically serotonergic, noradrenergic and dopaminergic pathways. In particular, accumulating evidence implicates the serotonergic system in the pathogenesis of PMS and PMDD. Recent data suggest that women with premenstrual mood disorders have abnormal serotonin neurotransmission, which is thought to be associated with symptoms such as irritability, depressed mood and carbohydrate craving. There may also be some role for gamma amino-butyric acid (GABA), the main inhibitory neurotransmitter, in the pathogenesis of PMS/PMDD, however this remains to be defined." (Premenstrual syndrome and Premenstrual dysphoric disorder, The Center for Women's Mental Health at Massachusetts General Hospital)

B. Historic overview of Hysteria:

1. In 1691 AD, Robert Boyle (inventor of Boyle's Law of the relationship between pressure and volume of gas), believed that the mind, not the body caused insanity. Boyle gave two case histories of hypochondria which he correctly labels as "emotional shock". He clearly shows that the cause is purely of mind affecting the body: "Instances I have met with, that shew the great Power which sudden Passions of the mind may have upon the Body". One was the case of a woman who became immediately paralyzed when her son drowned in a river while under her supervision. She "was struck with so much horror upon the sudden accident that tore from her a favorite Son, that among other mischiefs, she fell into a Dead Palsy of her right Arm and Hand, which continu'd with her in spight of what she had done to remove it, till the time she complain'd of it to me, who had not opportunity to know what became of her afterwards" The other case, was an account of himself some 40 years earlier as a youth where he lost use of his hands and feet for several months during the Civil War in Ireland and had to be carried around by his friends even to church. When the soldiers besieged the town his friends fled the church and left him all alone. He suddenly was cured and ran out for fright of death. It is a clear case of the well documented was malingering where someone fakes insanity in order to avoid draft or responsibility. He notes that it never happened again. "when he was a Youth, fell into a violent and obstinate Sciatica, which continu'd with him so long, that it left him little hope of Recovery; but the Devotion of this Young man's Friends invited them to make him be carry'd, since he could not go to Church upon Sundays; and there it happen'd, that the Town being a Frontier Garrison, the Guards were so negligent, that there was occasion given to a very hot Alarum, that the Enemy was got into the Town, and was advancing towards the Church to Massacre all that were in it. This so amaz'd and terrifi'd the People, that in very great and disorderly hast, they all ran out of the Church, and left my Relator in his Pew upon a Seat that they plac'd him, and whence he could not remove without help : But he being no less frighted than the rest, as they forgot him, he forgot his Disease, and made a shift to hamper off the Pew, and follow those that fled; but it quickly appearing, that the Alarum had been a false one, his Friends began to think in what a condition they had left him, and hasten'd back to help him out of the Pew, which whilst they were going to do, they, to their great surprise found him in the way upon his feet, and walking as freely as other Men. And when he told me this Story, he was above forty years Elder than when he was thus strangely rescu'd, and in all that time, never had one Fit of the Sciatica." (Experimenta & Observationes Physicae, Robert Boyle, 1691 AD)

In 1787 AD, William St. Clare, doctor, wrote about a classic case of hysteria where, "a girl put a mouse into the breast of another girl who had a great dread of mice. The girl was immediately thrown into a fit, and continued in it with the most violent convulsions for 24 hours". A total 24 girls began to imitate the symptoms and the cotton mill where they all worked was shut down for fear of a plague that entered the factory from a bag of cotton. Clare cured them all instantly with his electric shock machine! Here is an example of how a form of torture, instantly snapped these girls out of their acting. The motive was likely a combination of fun, attention and getting a few days off work. Meric Casaubon had correctly speculated in his "A treatise concerning enthusiasme" (1655) that such events were contagious (learned and imitated), "should be contagious: though not contagious in the same manner, as the Plague, or the Pox is; yet contagious in their kind". In 1701 AD, John Freind noted a case of two related families of what became known, "the barking girls", who "barking and howling like dogs . . . accompanied by violent rhythmic movements of the head and contortions of the face . . . when their breath failed they would one by one fall into a paroxysm like an epileptic fit". These three cases show that "insane behaviour" is often a game and play acting, known also as hysteria. (An Epidemic Of Hysterics, William St. Clare, 1787 AD)

3. In 1806 AD Philippe Pinel said: "Mania, as well as demoniacal possession, epilepsy, catalepsy and other nervous disorders [like hysteria], may be counterfeited, either from views of interest or from worse motives." (A Treatise on Insanity, Philippe Pinel, 1806 AD)

4. 1850 - 1800 AD: "Roughly between 1850 and 1880, malingering became transformed into hysteria, and psychiatry-increasingly distinct from neurology- became a popular belief system, a medical-secular religion. Terms such as imposturim, malingering, and self-caused disease fell into disrepute and were abandoned, and the terminology of hysteria and other counterfeit maladies was incorporated into the vocabulary of medicine.' Modern psychiatry- with its Diagnostic and Statistical Manuals of nonexisting diseases and their coercive cures-is a monument to quackery on a scale undreamed of in the annals of medicine." (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 18)

5. In 1862 AD Jean Martin Charcot: "In 1862, at the age of thirty-seven, Charcot became the director of the Salpétriere and created the greatest neurological clinic of the nineteenth century. Seeking to record the visible manifestations of neurological disorders in the movements of the body, he employed Desire Magloire Bourneville (1840-1909) and Paul Regnard (1850-1927)-both physician pioneers in medical photography-to create a unique photographic chronicle of the patients at the Salpetriere, mainly individuals diagnosed as hysterics whose performances were the most dramatic and photogenic. It became the legendary Iconographie photographique de la Salpetriere, Service de M. Charcot." ("Seeing is Believing," in Iconographic photographigne de la Salpêtriere, Service de M. Charcot (Paris: Bureau du Progres Medical, V. Adrien Delahay et Cie, 1877-1880), Photography Collection, Miriam and Ira D. Wallach Division of Art, Prints, and Photographs, the New York Public Library, http://seeing.nypl.org/198t.html)

b. "Charcot had recognized the role played by emotion, imagination, suggestion, fabrication, and prevarication in all hysteric phenomena. . . Charcot, for example, was very much aware of the malingering found among some hysterics. In one of his lectures he said: "This brings me to say a few words about malingering. It is found in every phase of hysteria and one is surprised at times to admire the ruse, the sagacity, and the unyielding tenacity that especially the women, who are under the influence of a severe neurosis, display in order to deceive, especially when the victim of the deceit happens to be a physician." (Georges Guillain, Biography of J. M. Charcot, His life and word, p 138-39)

c. "In short, Charcot was not an innocent victim of scheming hysterics; he was a knowing conspirator in one of the greatest medical hoaxes of the modern age. ... Unquestionably, Charcot was one of the giants of late nineteenth century French medicine and neurology. This status may be why psychiatrists and psychiatric historians have failed to see that he was also a quack, albeit a new kind of quack. The old quacks-such as Franz Mesmer and Mary Baker Eddy-duped people into believing that fake cures were real cures. The new quacks-such as Charcot and Freud-duped people into believing that fake diseases were real diseases." (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 42)

d. "I have some very vivid recollections of a conversation that I had with Charcot a short time before his death.. . . He told me that his concept of hysteria had become decadent and his entire chapter on the pathology of the nervous system must be revised. . . Charcot had foreseen the need of dismembering his theory on hysteria and was preparing himself to dynamite the edifice to which he had personally contributed so much in building. Is it not interesting that perhaps I am the only one today to be aware of this fact?" (Georges Guillain, Biography of J. M. Charcot, His life and word, p 176)

e. "Just as hysteria was diagnosed various photographs of "hysterics", so too, psychiatrists today diagnose mental illness with mere talk and observation. It certainly is not science. "By using the microscope to study the histology of the brains and spinal cords of cadavers, Charcot was able to see lesions of the central nervous system. Later, he turned to photography to similarly visualize and objectify what he took to be the lesions of "hysteria." But the photographic images of persons in various poses are in no way comparable to microscopic images of abnormal central nervous system tissues." (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 36)

6. In 1888 AD Sigmund Freud said: "A proper assessment and a better understanding of the disease [hysteria] only began with the works of Charcot and of the school of the Salpetriere inspired by him. Up to that time hysteria had been the bête noire of medicine. The poor hysterics, who in earlier centuries had been burnt or exorcized, were only subjected, in recent, enlightened times, to the curse of the ridicule; their states were deemed unworthy of clinical observation, being simulation and exaggerations. Hysteria is a neurosis in the strict sense of the word-that is to say, not only have no perceptible changes in the nervous system been found in this illness, but it is not to be expected that any refinement of anatomical techniques would reveal any such changes. Hysteria is based wholly and entirely on physiological modifications of the nervous system. ... Hysteria must be regarded as a status, a nervous diathesis, which produces outbreaks from time to time. The aetiology of the status hystericus is to be looked for entirely in heredity. ... In a number of cases, to be sure, the hysteria is merely a symptom of a deep-going degeneracy of the nervous system which is manifested in permanent moral perversion. ... The methods of earlier generations of physicians (who treated hysterical manifestations in young people as naughtiness and weakness of will and threatened them with punishment) were not bad ones, though they were hardly based on correct views." (Sigmund Freud, "Hysteria", 1888 AD, p 41, 50, 52, 54)

a. "What was Freud's basis for regarding "neurosis" as a real disease rather than a counterfeit disease? Only that Charcot said so. Like Charcot, Freud emphasized that neuroses lacked a neuropathological basis. What, then, was the problem Charcot, Freud, and others called "hysteria" and "treated" as if it were a disease? It was that the medical practitioner often found himself in the presence of a person, usually a young woman, who said she was sick or was said to be sick by a relative or caretaker, but whose medical examination revealed her to be healthy. The physician suspected that the patient was malingering. What was he to do? Socially, the person called "patient" was considered to be sick before encountering the physician. The physician was expected to validate the subject's disability as owing to disease by diagnosing the illness and treating it. The doctor's most obvious but professionally most incorrect option was to conclude either that the subject malingers or that he, the physician, is unable to find a disease to account for the patient's complaints, and decline to care for her or him. Some physicians did that very thing, ceding the ground to charlatans such as Franz Anton Mesmer (1734-1815) and the hypnotists. The doctor's other option was to conclude that the patient was mentally ill, that she suffered from hysteria. That decision is what Freud and the post-neuropathological psychiatrists made. Thus arose the modern idea of mental illness, the product of the conflation of having a disease and occupying the sick role (voluntarily or involuntarily)." (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 23)

7. In 1895 AD Alexander Skene said: "I take it for granted that all will agree that insanity is often caused by diseases of the procreative organs, and on the other hand, that mental derangement frequently disturbs the functions of other organs of the body, and modifies diseased action in them. Either may be primary and causative, or secondary and resultant. In the literature of the past, we find the gynecologist pushing his claims so far as to lead a junior in medicine to believe that if the sexual organs of women were preserved in health, insanity would seldom occur among them." (Medical Gynecology, Alexander Skene, 1895 AD)

8. In 1901 AD, Richard Maurice Bucke, psychiatrist, and the first chief psychiatrist at the Hamilton Psychiatric Hospital (HPH) in Ontario Canada and spent the 25 years in the asylum in London, Ontario, removed over 200 ovaries from women, partly because he believed the sex organs caused insanity and partly because he felt he was doing mankind a favor by practicing eugenics and "Darwinian natural selection" through sterilization. (Cosmic Consciousness, Richard Maurice Bucke, 1901 AD)

In 1902 AD, S. Weir Mitchell, doctor, popularized rest therapy where a hysteric is forced to lay in bed for up to three months at a time. Mitchell understood that most of the female hysterics were manufacturing symptoms as a way to escape an unhappy home life, daily work and responsibility. He identified them as being selfish and lazy, "having a taste for invalidism", "mimic fatigue". He has many such women in his practice: "Nothing is more common in practice than to see a young woman who ... is tired all the time, by and by has a tender spine, and soon or late enacts the whole varied drama of hysteria. As one or other set of symptoms is prominent she gets the appropriate label, and sometimes she continues to exhibit only the single phase of nervous exhaustion or of spinal irritation. Far more often she runs the gauntlet of nerve-doctors, gynecologists, plaster jackets, braces, water- treatment, and all the fantastic variety of other cures." ... Curiously, having a sore back is a common faked complaint: "They acquire tender spines, and furnish the most lamentable examples of all the strange phenomena of hysteria." Mitchell sees these fakers as causing others much harm and trouble: "There is one fatal addition to the weight which tends to destroy women who suffer in the way I have described. It is the self-sacrificing love and over-careful sympathy of a mother, a sister, or some other devoted relative. Nothing is more curious, nothing more sad and pitiful, than these partnerships between the sick and selfish and the sound and over-loving. ... The patient has pain, —a tender spine, for example ; she is urged to give it rest. She cannot read; the self-constituted nurse reads to her. At last light hurts her eyes; the mother or sister remains shut up with her all day in a darkened room. A draught of air is supposed to do harm, and the doors and windows are closed, and the ingenuity of kindness is taxed to imagine new sources of like trouble, until at last, as I have seen more than once, the window-cracks are stuffed with cotton, the chimney is stopped, and even the keyhole guarded. It is easy to see where this all leads to: the nurse falls ill, and a new victim is found. I have seen an hysterical, anemic girl kill in this way three generations of nurses." Typical of the insane, they are insulted when you openly accuse them of being selfish to the needs of others: "If you tell the patient she is basely selfish, she is probably amazed, and wonders at your cruelty. To cure such a case you must morally alter as well as physically amend, and nothing less will answer." Mitchell's solution is to replace the sympathetic relative who is deceived into a slavery of needless service of a faker, with order, discipline and obedience: "The first step needful is to break up the companionship, and to substitute the firm kindness of a well-trained hired nurse." He warns to keep a look out for the faker hysteric who is "always able to do what it pleases her to do, and who is tired by what does not please her". Mitchell's sleep therapy, therefore was a way to turn the tables of control enjoyed by the hysteric. He basically bores them back to activity. It is all about a battle of wills and control: He first describes the kind of life the hysteric enjoyed before they met Mitchell: "To lie abed half the day, and sew a little and read a little, and be interesting as invalids and excite sympathy, is all very well" The he describes his approach in contrast: "but when they are bidden to stay in bed a month, and neither to read, write, nor sew, [or to use the hands in any active way except to clean the teeth] and to have one nurse, who is not a [sympathetic and deceived] relative, then repose becomes for some women a rather bitter medicine, and they are glad enough to accept the order to rise and go about when the doctor issues a mandate which has become pleasantly welcome and eagerly looked for. ... the man who resolves to send any nervous woman to bed must be quite sure that she will obey him when the time comes for her to get up. What is amazing about all this, is that Mitchell understood that laying in bed for 3 months harmed the body. NASA understands weightlessness without exercise is a huge problem. "When we put patients in bed and forbid them to rise or to make use of their muscles, we at once lessen appetite, weaken digestion in many cases, constipate the bowels, and enfeeble circulation. When we put the muscles at absolute rest we create certain difficulties". This proves that sleep therapy had little to do with actual "recharging the body", and everything to do with boring the hysteric back to her home duties and responsibilities. It is a case of reverse psychology: She can either do a few hours of work each day at home and then be free to do what she wants, or she can be sent back to the asylum where she is grounded to her bed for 3 months doing nothing that she wants. (Fat And Blood, treatment of Neurasthenia And Hysteria, S. Weir Mitchell, 1902 AD)

"Some nineteenth-century physicians-notably the famous American neurologist Silas Weir Mitchell (1829-1914), inventor of the legendary "rest cure" named after him-recognized that hysterics were malingerers. Having worked as a physician during the Civil War, he saw a good deal of malingering and understood it for what it was: the rational assumption of the sick role. Confronted with such persons-regardless of whether they were called "hysterics"-he realized that the person who assumes the sick role is not necessarily sick and that hysteria is not a bona fide disease. ... Realizing that the problem he was called upon to treat was drama, not disease, Mitchell treated it accordingly. Consulted about a woman believed to be mortally ill, Mitchell dismissed all present in the room and then left himself. "Asked of her chances of survival he answered: 'Yes she will run out of the door in two minutes; I set her sheets on fire.' Seeing another hysterical woman who claimed to be unable to get out of bed, he "threatened her with rape and commenced to undress. He got to his under-garments when the woman fled the room screaming."" (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 26)

C. Hysteria, mental illness: Faking for personal profit: Unknown Etiology

1. "Why does a "patient" develop "hysteria"? In this way, Freud ended up with a classic medical problem: namely, with the problem of the "etiology of hysteria." However, if hysteria is a language, looking for its "etiology" is about as sensible as looking for the "etiology" of English. A language has a history, a geographic distribution, a system of rules for its use—but it does not have an "etiology."" (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p123)

2. "It follows, then, that if hysteria is an idiom rather than an illness, it is senseless to inquire into its "causes." As with languages, we shall be able to ask only how hysteria was learned and what it means. It also follows that we cannot meaningfully talk about the "treatment" of hysteria." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p146)

3. "The etiology of somatization disorder is unknown, but it is clearly a familial disorder. In several studies, approximately 20% of the female first-degree relatives of patients with somatization disorder also met criteria." (Textbook of Clinical Psychiatry, Hales, Yudofsky, 2003 AD, p 669)

4. "somatization disorder (Conversion disorder): An etiological hypothesis is implicit in the term conversion. The term conversion, in fact, is derived from the hypothesized conversion of psychological conflict into a somatic symptom." (Textbook of Clinical Psychiatry, Hales, Yudofsky, 2003 AD, p 677)

5. "somatization disorder: Initial observations on the pharmacological treatment of several of the disorders, namely hypochondriasis and body dysmorphic disorder, are promising and not only may add to our therapeutic armamentarium but also may suggest avenues for improved pathophysiological as well as etiological understanding of these two somatoform disorders." (Textbook of Clinical Psychiatry, Hales, Yudofsky, 2003 AD, p 686)

6. "A case occurred in which a wife, though she had the normal use of her eyesight for every other purpose, was unable to see her husband at all." (Karin Stephen, 1889-1953, The Wish to Fall Ill: A Study of Psychoanalysis and Medicine, p 7)

7. "To begin with, we would have to personalize "hysteria" and recognize that the hysterical person is a forger, a cheat who impersonates the sick role. Next, we would have to conceive of hysteria as a dialect of the language of sickness, a form of communication especially appropriate to medical situations in which persons endeavor to define themselves as sick or disabled. The language of hysteria is composed of iconic signs, is nondiscursive, and hence easily misunderstood or misinterpreted by the receiver. This may be useful to the sender, the receiver, or both. In short, the language of hysteria is a type of rhetoric, useful for inducing strong feeling in others and an urge to action; it is not a type of dialectic, useful for conveying accurate information. What do I mean when I assert that hysteria is a form of rhetoric? Let us examine what he, or she, does. He complains of pain and suffering, exhibits bodily signs suggesting that he is sick, and arouses and alarms those about him. He does all this by confronting them with what seems like a desperate situation requiring immediate intervention. Why does he do this? Because he knows that he lacks a legitimate ground for making demands on others and knows that the language of illness is more effective as a rhetorical device than the language of everyday speech. To identify a person, we use his photograph or fingerprint, not a verbal description of his appearance. The hysteric uses a similar principle. If one person seeks the attention or help of another individual, he can achieve his aim best by a dramatic display of messages that say, in effect, "I am sick! I am helpless! You must help me!" This goal is better accomplished by displaying the image or icon of illness—a seemingly sick body—than by simply stating that one feels ill. A picture is worth a thousand words. A hysterical symptom is worth two thousand. That sums up the rhetoric of hysteria." (The Medicalization Of Everyday Life, Thomas Szasz, 2007 AD, p 77)

8. "He plays a game by disguising his personal problem as a medical disease. The advantage derived from such a one-person game corresponds closely to the psychoanalytic idea of primary gain. However, humans are not solitary beings. People generally do not live in isolation. Therefore the interpersonal and social aspects of "hysterical communications" are the most practically relevant. For example, if a person complains to a physician of abdominal pain and insists that it is due to an inflamed appendix even though there is no other evidence to support this view, his interpretation will first be discredited, then he himself will be discredited. The more he enlarges the social situation where he makes this false claim, the more he risks being seriously discredited by being labeled schizophrenic and committed to a mental hospital. In a manner of speaking, such a person plays a game of fooling others. To the extent that he succeeds and is accepted as sick, he profits from his strategy. This advantage corresponds closely to the psychoanalytic idea of secondary gain." (The Medicalization Of Everyday Life, Thomas Szasz, 2007 AD, p 77)"Mania, as well as demoniacal possession, epilepsy, catalepsy and other nervous disorders, may be counterfeited, either from views of interest or from worse motives." (A Treatise on Insanity, Philippe Pinel, 1806 AD)

"Freud himself acknowledged that hysteria is not an illness but an idiom or language, not a disease but a dramatization or game." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p229)
"Hysterical language thus resembles other picture languages, such as charades. Those who want to deal with so-called hysterical patients must therefore learn not how to diagnose or treat them, but how to understand their special idiom and how to translate it into ordinary language. In a game of charades, one member of a team enacts an idea or proverb, and his team-mates try to translate his pantomime into ordinary, spoken language. Similarly, in a game of hysteria, the "patient" enacts a belief or complaint—which is what makes him the "patient"; and his teammates—family members, physicians, or psychiatrists—try to translate his pantomime—now called "hysterical conversion"—into ordinary language." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p230)
"They may then begin to act offstage as if they were on it. Roles can and do become habits. In many chronic cases of mental illness, we witness the consequences of playing hysterical, hypochondriacal, schizophrenic, or other games over years and decades, until they have become deeply in-grained habits." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p238)

12. A man, forty-five years of age, confined in the felon department of Bicetre, on account of his political opinions, was guilty of numerous acts of extravagance, made many absurd speeches, and at length succeeded in obtaining his removal to the lunatic department of the same place. This happened before my appointment. In the course of some months after my entrance upon the functions of my office, I determined to examine carefully into the history and state of his malady, in order to ascertain accurately the class of the disorder to which his case belonged. For this purpose I frequently visited his chambers. At every visit he exhibited some new antic. Sometimes he wrapped up his head in cloths or blankets and refused to reply to my questions. At other times he poured fourth a torrent of unmeaning and incoherent jargon. On other occasions he assumed the tone of an inspired or affected the airs of a great personage. The assumption of so many and opposite characters, convinced me that he was not well read in the history of insanity, and that he had not studied the characters of those whom he endeavoured to counterfeit. The usual changes in the expression of the eyes and other features, characteristic of a nervous maniacal excitement,' were likewise wanting. I sometimes listened at the door of his chamber in the course of the night, when I invariably found him asleep, which agreed with the report of the hospital watchman. He one day escaped from his chamber while it was cleaning and setting in order, took up a stick and applied it, with great effect, to the back of a domestic, in order to impress him and others with the idea of his violence and his fury. All these facts, which I collected and compared in the course of one month, appeared to characterise no decided variety of mania, hut rather a great desire of counterfeiting it. I was no longer the dupe of his artifices; but as he had been sentenced to be confined on account of political matters, I adjourned my report of him, under pretence of wishing to learn some new facts. The 9th of Thermidor (July 28) succeeding put an end to the prosecution which had been commenced against him. (A Treatise on Insanity, Philippe Pinel, 1806 AD)

13. "In 1960, I coined the term myth of mental illness to suggest that the distinction between bodily illness and mental illness rests on a misuse of the term illness. When we say that Smith has a mental illness, we misidentify his strategic behavior as a bodily disease (an objectively identifiable physical phenomenon with its origin not directly under human control). If we limit the use of the term illness or disease to observable biological-anatomical and physiological-phenomena, then, by definition, the term mental illness is a metaphor. Mind is not matter, hence mental illness is a figure of speech. The idea of two kinds of diseases, one bodily, the other mental, is an unintended product of the scientific revolution: the imitation of science, called "scientism." Hysteria, schizophrenia, mental illness, and psychopathology are scientistic, not scientific, terms." (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 25)

14. "The doctor who says his neurotic patient is being ill on purpose is very near the truth. ... Of all the possibilities which they recognize as being open to them, their illness appears to them to be the least evil it has been created with extraordinary skill to protect them from an even more terrible situation which seems to them to be the only alternative. It enables them to carry on somehow. ... Psychogenic illness is a piece of behavior as purposive as putting a hand up to ward off a blow." (Karin Stephen, 1889-1953, The Wish to Fall Ill: A Study of Psychoanalysis and Medicine, p 4, 27)

15. "The behavior of neurotics and psychotics, criminals and eccentrics has been understood as a form of self- deception, a surrender to a fictitious existence. ... Patients want sympathy, want to create a sensation or evade some obligation, want to get a pension or enjoy certain fantasy pleasures. Determination and surrender of this sort play a great part in neurotic illnesses as well as in the development of pseudologia phantastica (self-credited, fantastic lying)." (Karl Jaspers, 1883-1969, General Psychopathology, The Determination to Fall Ill, 1913 AD, p 329, 424)

16. "A disease may be cured. A person may be coerced or influenced to conform or change himself. Does the hysteric want to be changed? Often he does not. He prefers to change others. This insight, poorly understood and even more poorly articulated, led many physicians in the past to conclude that such patients were "social parasites" who, in the words of an early-twentieth-century French writer, "would . . . steal anything conveniently within reach, lie, cheat, make work and trouble for others."' Because hysteria is a form of rhetoric, it often evokes a counterrhetorical response. The patient tries to coerce through symptoms. The physician tries to coerce through hypnosis. The result is often a mutually antagonistic, mutually deceptive relationship. Sometimes the patient dominates, sometimes the doctor does, and sometimes the contest ends in a draw." (The Medicalization Of Everyday Life, Thomas Szasz, 2007 AD, p 79)

17. "Most psychiatrists who regard hysteria as an illness qualify it as a mental illness. Its pathology, therefore, is sought not in the patient's brain but in his psyche: it is a form of psychopathology. Specifically, hysterical bodily signs are believed to represent an unconscious conversion of repressed ideas, feelings, or conflicts into bodily symptoms. This explanation is also unsatisfactory." (The Medicalization Of Everyday Life, Thomas Szasz, 2007 AD, p 73)

18. "I describe in my book The Myth of Mental Illness. I regard so-called hysterical symptoms as a type of communication or language, used in a context of game playing: hysterics act disabled and sick; their illness is not real but an imitation of a bodily illness. Because the hysteric impersonates the sick role, the result is "genuine" disability. If we call this condition an "illness," we use the term metaphorically, whether we realize it or not. By means of body language, hysterics communicate with themselves and others, especially those willing, perhaps even eager, to as-sume the role of protecting and controlling them." (The Medicalization Of Everyday Life, Thomas Szasz, 2007 AD, p 76)

19. "Psychiatry, psychoanalysis, and the mental health professions are the intellectually, morally, and politically toxic side effects of the development of scientific medicine. Still, regardless of evidence or reasoning, most people "believe" in mental illness, claiming that "its" existence is obvious." (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 16)

20. "The rules I just articulated depend on the materialist-pathological definition of disease that became the gold standard of medicine only during the second half of the nineteenth century. The practice of mad-doctoring, however, had been well established before that time, when medicine was still based on the so-called humoral theory of disease. According to that view, every condition that a doctor or patient called "disease" was, a priori, a material-corporeal, "humoral" abnormality. Everyone believed to be ill was regarded as suffering from a "humoral imbalance." The mad-doctor's principal duty was to incarcerate the patient and attach a diagnostic label to his alleged disease. Curing the madman, like curing any sick patient, required correcting his humoral imbalance. For the most part, prisoner patients were deprived of liberty not because they were ill but because they annoyed others. The diseases attributed to them were rationalizations for their involuntary detention and for the interventions forcibly imposed on them." (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 12)

21. "Disease has been simulated in every age and by all classes of society. The monarch, the mendicant, the unhappy slave, the proud warrior, the lofty statesman, even the minister of religion, as well as the condemned malefactor, and "boy creeping like snail unwillingly to school," have sought to disguise their purposes, or to obtain their desires, by feigning mental or bodily infirmities. . . . Those who simulated diseases were formerly punished as forgers; and it appears from history that the Greeks were exceedingly severe against such persons. . . . Malingerers in this [Austrian military] service are severely punished: sometimes they receive corporal punishment, and at other times they are sentenced to serve for life. (H. Gavin, On Feigned and Factitious Diseases Chiefly of Soldiers and Seamen, on the Means Used to Simulate or Produce Them, and on the Best Modes of Detecting Impostors, i, vii)

22. "From the start, diseases called "mental" were characterized by the failure of physicians to find somatic signs or markers for their putative maladies." (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 13)

23. "Medicalization is not a new phenomenon. Wherever diseased or disabled persons receive care or are excused from certain obligations, the scene is set for nondiseased and nondisabled individuals to pretend that they are diseased or disabled. This situation is an example of "medicalization from below," from powerlessness, for the benefit of the self-defined patient. "Medicalization from above," the attribution of disease to another to control, punish, and disable a person by treating him as a patient, in the guise of protecting him-is a more recent development, associated with the birth of psychiatry and psychoanalysis, exemplified by Charcot's classification of "hysteria" as a neurological illness, Krafft-Ebing's "discovery" that (certain) sex crimes are diseases, and Freud's fabrication of "neuroses" as "psychogenic" diseases." (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 9)

a. "In the 1890s, Krafft-Ebing succeeded in convincing his medical colleagues that sexual perversions-for example, oral and anal sex-are symptoms of bodily diseases. At the same time, Freud failed to convince them that men, too, could "have hysteria." Why did nineteenth-century physicians believe that hysteria could affect only women? Because it was called "hysteria," a term that derives from the Greek hystera, which means "uterus,"" (Psychiatry: The Science of Lies, Thomas Szasz, 2008 AD, p 10)

Conclusion:

1. Hysteria is a behaviour choice not a disease. Hysteria is a behaviour whose origin is the human spirit not the body. There is no scientific evidence that Hysteria is caused by a chemical imbalance in the brain.

2. Biopsychiatry says: "factitious disorder: Psychodynamic explanations for these paradoxical disorders have been provided by several authors. Many have noted the apparent prevalence of histories of early child-hood physical or sexual abuse, with disturbed parental relationships and emotional deprivation. Histories of early illness or extended hospitalizations also have been noted. Nadelson (1979) conceptualized factitious disorder as a manifestation of borderline character pathology rather than as an isolated clinical syndrome. The patient becomes both the "victim and the victimizer" by garnering medical attention from physicians and other health care workers while defying and devaluing them. Projection of hostility and worthlessness onto the caregiver occurs as he or she is both desired and rejected. Plassmann (1994b, 1994c) viewed the disorders as a "symptom of a psychic problem complex." Early traumas are dealt with narcissistically and through dissociation, denial, and a type of projection. The patient's body, or part of the body, becomes perceived as an external object or as a fused, symbiotic combination of self and object, which then comes to represent negative affects (hate, fear, pain), the associated negative object concepts, and negative self-concepts. In the face of early deprivation and assaults, the "body self " is split off to preserve the "psychic self" (Hirsch 1994). When subsequent life events activate these affects or concepts, the result is extreme anxiety and growing derealization. Eventually, the patient acts out or involves the medical system in a type of countertransference identification, which results in manipulations of the body of the patient. The manipulation results in emotional relief, albeit transient and incomplete, in the manner of most repetitious compromises. Other intrapsychic, cognitive, social learning, and behavioral theories have been advanced as well (Barsky et al. 1992; Ford 1996b; Schwartz et al. 1994; Spivak et al. 1994) . Neuropathological bases for the disorders also have been suggested, on the basis of abnormal single photon emission computed tomography (SPECT) scans (Lawrie et al. 1993; Mountz et al. 1996), computed tomography (CT) abnormalities (Babe et al. 1992), magnetic resonance imaging (MRI) abnormalities (Fenelon et al. 1991), and neuropsychological testing (Pankratz and Lezak 1987). No consistent findings have yet been reported. Intriguing, however, is the suggestion that pseudologia fantastica may be a syndrome related to, but distinct from, factitious disorders, with its own associated pathol-ogy (Abed 1995; Hardie and Reed 1998; Mountz et al. 1996; Newmark et al. 1999)." (Textbook of Clinical Psychiatry, Hales, Yudofsky, 2003 AD, p 965)

"Psychologically and socially, hysteria offers a good example of how a so-called mental illness may now be most adequately conceptualized in terms of sign-using, rule-following, and game-playing. In other words, hysteria is (1) a form of nonverbal communication, making use of a special set of signs; (2) a system of rule-following behavior, making use of the rules of illness, helplessness, and coercion; and (3) an interpersonal game characterized by, among other things, strategies of deceit to achieve the goal of domination and control. … Much of what I have said so far has utilized a game model of human behavior, first clearly articulated by George Herbert Mead." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p10)
"Thus, whereas in modern medicine new diseases were discovered, in modern psychiatry they were invented. Paresis was proved to be a disease; hysteria was declared to be one." (The Myth of Mental Illness, Thomas Szasz, 1961 AD, p12)

5. Hysteria is the gold standard of historic Biopsychiatric junk "pop" psychology gone to seed.

6. It is important to ask, "What benefit is this individual deriving from engaging in this behaviour of hysteria." Hysteria is a means to an end for personal gain.

7. Jesus commanded us not to be deceivers.

By Steve Rudd: Contact the author for comments, input or corrections.

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