Thursday, June 02, 2005

Afflicted by an Idea

I think this article serves to shed some light on phenomena like those Holy Rollers (Pentecostals) as well as other cases of "shared" supernatural experiences.

Farewell to hysteria

Jean-Martin Charcot vigorously supported and defended the theory of cerebral localizations in man; several of his outstanding courses dealt with this theory and its application to Jacksonian epilepsy (John Hughlings Jackson, 1835-1911 – Jackson was one of the early appointments to the National Hospital for the Paralysed and Epileptic, Queen Square, London, now the National Hospital for Neurology and Neurosurgery, and will be profiled in a later issue of Headlines), aphasia, and Beard’s neurasthenia (George Miller Beard, 1839-1883). Charcot believed that he had discovered a new disease he called "hystero-epilepsy," a disorder of mind and brain combining features of hysteria and epilepsy. The patients displayed a variety of symptoms, including convulsions, contortions, fainting, and transient impairment of consciousness.

Joseph Babinski, his student, however, decided that Charcot had invented rather than discovered hystero-epilepsy. The patients had come to the hospital with vague complaints of distress and demoralization. Charcot had persuaded them that they were victims of hystero-epilepsy and should join the others under his care. Charcot's interest in their problems, the encouragement of attendants, and the example of others on the same ward prompted patients to accept Charcot's view of them and eventually to display the expected symptoms. These symptoms resembled epilepsy, Babinski believed that a municipal decision to house epileptic and hysterical patients together (both having "episodic" conditions) was the cause of the condition. The hysterical patients, already vulnerable to suggestion and persuasion, were continually subjected to life on the ward and to Charcot's neuropsychiatric examinations. They began to imitate the epileptic attacks they repeatedly witnessed.

Babinski eventually won the argument. He persuaded Charcot that doctors can induce a variety of physical and mental disorders, especially in young, inexperienced, emotionally troubled women. There was no "hystero-epilepsy." These patients were afflicted not by a disease but by an idea. With this understanding, Charcot and Babinski devised a two-stage treatment consisting of isolation and counter suggestion.

First, "hystero-epileptic" patients were transferred to the general wards of the hospital and kept apart from one another. Thus they were separated from everyone else who was behaving in the same way and also from staff members who had been induced by sympathy or investigatory zeal to show great interest in the symptoms. The success of this first step was remarkable. Babinski and Charcot were reminded of the rare but impressive epidemic of fainting, convulsions, and wild screaming in convents and boarding schools that ended when the group of afflicted persons was broken up and scattered.

The second step, counter-suggestion, was designed to give the patients a view of themselves that would persuade them to abandon their symptoms. Dramatic counter-suggestions, such as electrical stimulation of "paralysed" muscles, proved to be unreliable. The most effective technique was simply ignoring the hysterical behaviour and concentrating on the present circumstances of these patients. They were suffering from many forms of stress, including sexual feelings and traumas, economic fears, religious conflicts, and a conviction (perhaps correct) that they were being exploited or neglected by their families. In some cases their distress had been provoked by a mental or physical illness. The hysterical symptoms obscured the underlying emotional conflicts and traumas. How trivial a sexual fear seemed to a patient in whom convulsive attacks produced paralysis and temporary blindness every day!

Staff members expressed their withdrawal of interest in hysterical behaviour subtly, in such words as, "You're in recovery now and we will give you some physiotherapy, but let us concentrate on the home situation that may have brought this on." These face-saving counter-suggestions reduced a patient's need to go on producing hystero-epileptic symptoms in order to certify that her problems were real. The symptoms then gradually withered from lack of nourishing attention. Patients began to take a more coherent and disciplined approach to their problems and found a resolution more appropriate than hysterical displays.

Charcot removed his patients from the special wards when he realised his mistake.


rh said...

Those penticostal christians really are crazy. Like I live in the UK for instance and right now there's a story all over the news about an African girl who was tortured because the people who were meant to be looking after her including her aunt, thought that she was a witch. Just because the pastor of this cult, erm, I mean "church", said so. Apparently they send them to "deliverance services" to get the devil beaten out of them. It's crazy and sick.

And I've read of this hysteria study before ... it's always interesting to see how people's perceptions of illness have changed over time.

Nice blog, btw. :) I am a Reform Jew and grew up in a non-religious family where half of them are not Jewish, and have only in the last few years really began to get in touch with my Jewish heritage. It's interesting looking at views from people that have left orthodoxy or thinking about it. I know a number of people who have left orthodoxy for various reasons and now attend the synagogue that I go to.

See you around...shalom :)

Orthoprax said...


I think it's sad when modern religions still tend to reach back and we see repeats of mistakes from the Dark Ages. But then again, we probably shouldn't be surprised since orthodoxies are inherently conservative.

I have "left" Orthodoxy in mind and thought already. But I am not uncomfortable (or not very uncomfortable) living the lifestyle I have lead so far...with perhaps some modifications.

And I still think that Jewish identity and heritage are very important. So what brought you to go to synogogue when your family was non-religious when you were being brought up. Or was it that they went to synogogue too even though they weren't religious?