The Hysterical Self: Psychology in the Clinic

Jean-Martin Charcot (1825-1893)

Inscribed to Freud, on the day Freud left the Salpêtrière

Clinico-Anatomic Method

Charcot (profile, far left) at theatrical reading, with writers Emile Zola and Edmond de Goncourt

Photographic Iconography of theSalpêtrière (1876-77)

Charcot’s Four Stages of Grand Hysteria

1. Tonic rigidity: limb contractures that mimicked a typical epileptic fit.

2. Dramatic body movements: contortions, illogical movements; clownism.

3. Passionate Attitudes: expressions of vivid emotional states.

4. State of delirium

Stages of the Hysterical Attack

“AUGUSTINE”

Beginning of the Attack

Tonic Rigidity—Stage 1

Contracture of the FaceStage 1

Stage 2—Clownisms, Illogical Movements “Circular Arch”

Passionate AttitudesStage 3

“Menace”

Passionate AttitudesStage 3

“Menace”

Passionate AttitudesStage 3

“Aural Hallucinations”

Passionate Attitudes: “Loving Supplication”

Passionate Attitudes“Ecstasy”

Passionate Attitudes:Crucifixion

Zones of Hysterical Anesthesia

Metalloscopy:Use of Magnets to

shift areas of anaesthesia

Artificial Contracture

Catalepsy produced by sound

Charcot and Blanche Wittman

A Case of Traumatic Male Hysteria

Hippolyte Bernheim (1840-1919)

SuggestiveTherapeutics (1886)

head of the Nancy School

Pierre Janet (1859-1947)

Dissociation—Traumatic event and

accompanying memories split off from consciousness

Imperative Suggestion—suggestion that thesememories didn’t exist

Janet’s Somnabulisms• Monoideic—dominated 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

Reciprocal SomnambulismLady MacNish/Mary Reynolds

Alfred Binet (1857-1911)

On Double Consciousness (1890)

Alterations of the Personality (1896)

Examples of Automatic Writing with an anesthetic hand Binet (1890 and 1896)

Insensible Arm—hearing aMetronome

Sensible arm

Insensible arm while subjectcounted to five

Sensible Arm

Subject held dynamometer,connected to a

recording cylinder.Binet (1896, p. 201)

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

Freud’s 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

Freud’s 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.

Freud’s unpublished manuscript

for a scientific psychologyof 1895

Berggasse 19, Vienna (May 1938)

Joseph Breuer (1842-1925)

STUDIES ON HYSTERIA1895

Breuer and Freud

Anna O./ Bertha Pappenheim (1859-1936)

“TALKING CURE” or

“CHIMNEY SWEEPING”

“hysterics suffer mainly fromreminiscences”

Studies in Hysteria

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.

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

Carl Jung (1875-1961)

“Psychological Complex”

Uncovered with the use of association tests

with patients

Collaborated with Freud 1906-1912

Freud’s couch – for use of“free association” technique

Freud and his Couch

Active Repression: patient was motivated to actively repress traumatic information from consciousness.

Content of repressed material was often sexual.

Freud’s formulated the Seduction Theory in 1890s and rejected it in 1897.

Controversial 1980’s Historiography on Freud

Freud’s 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

In 1900 Freud published Traumdeutung, or Interpretation of Dreams

Manifest Content of Dream—its story-line, a conscious process

DREAM CENSOR—lets some information out, represses, disguises other information

Latent Content of Dream—dream thoughts, unconscious, often unacceptable wishes

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.

International Psychoanalytic Congress, Weimar 1911

Freud’s Secret Committee (1922)

“Hotel Log Hints at Illicit Desire That Dr. Freud Didn’t 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

Freud, Hall, Jung

Morton Prince &James Jackson Putnam: Boston School of

Psychotherapy

Freud’s Visit to Clark University, 1909

1945

Alfred Hitchcock and Salvador Dali “Spellbound”

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