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13. The History of Hysteria Dr. Renée Sentilles
98 Plays10 months ago
Hysteria is an outdated psychological term that has evolved significantly over time. Historically, hysteria was a diagnosis given predominantly to women and was characterized by a wide variety of symptoms, including anxiety, fainting, nervousness, sexual forwardness, and emotional outbursts. The term comes from the Greek word "hystera," meaning uterus, reflecting the ancient belief that hysteria was linked to disturbances in the female reproductive system.
In the 19th and early 20th centuries, hysteria was commonly diagnosed and treated by methods that are now considered barbaric and sexist (e.g. removal of key sexual organs!). Sigmund Freud and Jean-Martin Charcot were notable figures who studied and wrote about hysteria, contributing to the understanding and treatment of the condition.
In modern psychology and psychiatry, hysteria is no longer a recognized medical diagnosis. The symptoms once attributed to hysteria are now understood within the context of other disorders, such as anxiety disorders, conversion disorder, and somatic symptom disorder. The term has largely fallen out of use due to its historical connotations and the advancement in understanding of mental health conditions.
This week, I have invited back Dr. Renée Sentilles to discuss the history of hysteria and Dr. Karen Tang’s new book: It's Not Hysteria: Everything You Need to Know About Your Reproductive Health (but Were Never Told). Dr. Renée Sentilles is Henry Eldridge Bourne Professor of History at Case Western Reserve University, where she has been teaching since 2000. She is the author of two books and various articles, and is currently working on a new book, “In Her Shoes: Getting to the Sole of 20 th Century American Women’s History,” which uses historic shoes engage readers in women’s history.
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Transcript
Introduction of Guests and Topics
00:00:00
Speaker
Welcome back to Arwell Mandy. I am very excited to have Dr. Renee Centiel back. She is the Henry Eldridge-born professor of history at Case Western Reserve University, my alma mater, so we love Case Western, where she's been teaching since 2000. She's the author of two books and various articles and is currently working on a new book. called In Her Shoes, getting to the soul of 20th century American women's history, which uses historic shoes, engaging readers in women's history. She has been on the show before. She's a wealth of information. And I thought this would be particularly relevant because also amazing person and OBGYN Dr.
Historical Context of Hysteria
00:00:38
Speaker
Karen Tang just published this book, It's Not Hysteria. And she does go into the history a bit of Hysteria in her book. But what better opportunity would be to bring on
00:00:48
Speaker
our historian locally to talk about the history of hysteria. So thank you so much, Renee, for being here. And I'd love to just pass it over to you to start chatting about this topic. Thanks. Well, I can't say I'm an expert in hysteria, so I'll say that from the outset. But I do do work on American women's in medicine. Hysteria, of course, is pretty dominant when you get to the 19th century. So one of the things I've come to see with hysteria, it's one of the strangest diseases. I'm not quite sure what to call it. It's literally been around for over a couple millennium. It first appears, and I've sort of tried to figure out what is meant by that exactly.
00:01:25
Speaker
apparently the Egyptians talk about the womb and how it affects women's health. And so when the Greeks start to talk about the wandering womb, and that is the basis of hysteria, meaning the womb, then it it becomes the sort of basically all women's illnesses lead back to the womb. And there's all these ideas about the wandering womb, which the womb wanders with the abdominal cavity and causes all kinds of mischief. and So the idea like literally thought that the uterus was kind of moving around our body. Well, this is where I find it hard to get information.
19th Century Evolution of Hysteria
00:01:59
Speaker
the Yes and no. I think the medical literature suggests that it's wandering through the abdominal cavity. I think it gets picked up as if it's wandering around the body because of this whole thing about the suffocation of the mother and how it can affect vocal cords and all of these things. and i think
00:02:15
Speaker
People are assuming the womb is like rising up into the throat, which is not what the medical people are saying. So when we get to the 19th century and medicine has changed and science has changed, it's still about the womb and the idea that women's health is connected to their wombs. But hysteria in the 19th century gets very much connected to Victorian images of sort of fainting women and gets tied to a nervous disorder. So it's it's moving from the womb is causing all these ills to
00:02:50
Speaker
The womb is causing mental illness, essentially. And if you look like Elaine Showalter and Carol Smith Rosenberg are probably the two historians that are most well known for their work in this area, but in sort of suggesting what's happening in the 19th century with hysteria, it gets tied to ideas of what's causing this nervous prostration and convulsions and seizures and all of this. So there are all kinds of symptoms that are getting put under this umbrella term
Hysteria and Women's Societal Roles
00:03:18
Speaker
hysteria. So if a woman seemed to have seizures and convulsions and all these things, it could be hysteria, which is caused by problems with the reproductive system. And early, like the 1840s, it gets tied very much to masturbation.
00:03:32
Speaker
So, the idea that women are masturbating, well, masturbation is tied to all kinds of things. It's it's called onanism, and it's tied to men's illnesses as well, like male and Santa. But it's very much tied to hysteria in the 19th century as a cause of hysteria. So, other causes of hysteria are women not being married. So, if it's an unmarried woman and she's hysterical, she should get married. So, marriage was a prescription. marriage and inclusion. Exactly. Women are falling apart for problems having to do with the reproductive systems that can be solved by good old fashioned heterosexual relationships. but Sometimes it's married women, in which case there's a problem within the marriage that needs to be but I imagine the medical community at that time trying to make sense of things that they could not understand. And
00:04:24
Speaker
I mean, people were doing autopsies at that point, right? They were kind of operating or or dissecting bodies to try to make sense of things and really very just rudimentary trying to put pieces of puzzles together. But it seems like their framework was the right way or the healthy way would be a heterosexual marital relationship. And so that was kind of the framework that they're using. You're absolutely right. i said Well, what Smith Rosenberg argues when part of her argument is you can't you can't take the women out of the social circumstance. So whatever the social dynamics of the time are determining the way medicine looks at women. So she really parses out how this idea of a very intensely patriarchal society with women who are supposed to be on the one hand
00:05:13
Speaker
fragile and sensitive and retiring. On the other hand, mothers are supposed to be fierce and uncompromising and strong. And so these women getting caught in these counter currents and having no way to really express their discomfort and this coming out in hysteria. ah But what's interesting about hysteria is it kind of reaches its hysterical apex. by the end of the 19th century. So it becomes a very prevailing diagnosis in the 19th century for women, for middle class and upper class women, women who are trying to live up to this sort of social ideal of the Victorians. By the end of the 19th century, Freud and his friends get in the mix and it becomes much more about sexuality. And so by the end of the 19th century, it's
00:06:04
Speaker
no longer about the womb at all.
Freud's Impact on Hysteria's Perception
00:06:06
Speaker
It's about women having more delicate nervous systems, more thinner blood sensitivity too. And I do want to say it's not like it's on all male medical world coming down on women. One of the most prominent female physicians of the 19th century, Mary Putnam Jacobi, who's just one of my heroines, is also saying women are more sensitive. And I think what you said about the prevailing knowledge base that they come from really matters. Older idea of hysteria has been left behind, but the roots of it haven't. The idea that women are controlled, that women's illnesses stem from their reproductive systems, that that determines everything.
00:06:46
Speaker
And they were doing hysterectomies to cure hysteria, correct? And removing the ovaries at the same time. And they were doing- They're also doing hysterectomies. They're also, yeah, which are horrific to read about. I don't recommend it as reading because there's a belief by the end of the 19th century, and like 1870s, 1880s, that hypersexuality is creating hysteria. That if you remove the source of the pleasure, then you remove the problem. Right. You control it. That's the same thing for female genital cutting, right? If you keep women from being able to experience pleasure, then they're not going to be promiscuous. Or is is the thought in some cultures for female genital cutting. That's fascinating. And am I wrong that people were doing hysterectomies for hysteria too? Or is that just a... I mean, I have to say, I haven't run across that in the 19th century. And then I have to say, I just don't know. I mean, what I know is that we have anesthesia with 1840s. We have, I'm sure you know, women's gynecology owes a whole lot of advances to enslaved women who become like the, basically the victims and the patients for this. But I haven't read about hysterectomies. I've only read about repairs. As far as I know, they're not doing much inner cavity work. But what I do think is interesting is that hysteria was around for a couple millennium and it disappears in the beginning of the 20th century.
Hysteria and Witchcraft Trials
00:08:14
Speaker
By the way, hysteria, I mean, it's tied to the witchcraft trials before it becomes the 19th century nervous condition and sexuality. It's anytime someone has a convulsion or whatever, is it witchcraft or is it hysteria?
00:08:27
Speaker
becomes sensitive That was the differential diagnosis. was actually question Yes. So it's really interesting that this catch all diagnosis disappears in the 20th century. It kind of reaches this height at the turn of the century. And then there are hysterical men too. And with World War I, there's this rise of hysterical men diagnoses. Because by then, it's no longer tied to the uterus, it's tied to
Disappearance of Hysteria as a Diagnosis
00:08:51
Speaker
nerves. Yeah. We're thinking this is like a post-traumatic. Yes. Yeah. Disorder from, yeah. Shell shock. They'll say shell shock and the male hysteria are tied together. So there's a historian, Mark McCallis, who is this book called Approaching Hysteria. And he's probably the leading historian on a lot of this, that what happens in the 20th century is,
00:09:13
Speaker
Basically, medicine evolves, although he doesn't use that terminology, but evolves and creates other diagnoses. So in other words, the convulsions are then given to epilepsy and hysterics are given to maybe anxiety, depression, other neuroses. And so it's not that it disappears, it's that it it ends up being down into other disorders. Yeah, that's interesting.
Modern Implications and Closing Remarks
00:09:34
Speaker
And yet the one thing that has remained is this phrase hysterical or the word hysterical, which, you know, I think most women would find offensive today, but was used very broadly. It's still used. Although a lot of times we say that's hysterical and we don't mean it in a gendered way, I think labeling women as hysterical is more common than labeling men as hysterical. Right. And literally, I mean, from what I know, it means like kind of losing your mind. Exactly, losing your mind. And that's kind of what it always meant. So in that sense, hysterical remains kind of unchanged. It's like,
00:10:10
Speaker
this unwieldy women losing their minds. Is it created by social factors? Is it created by medical problems? It's a disease where there's no physical origin that can be seen. And so then what is causing it? Yeah. Okay. That makes sense. Well, thank you so much. This has been super interesting. And I know that there's more that we could dive into, but this is a really good summary of the history around this word and around hysteria. And again, I do want to promote Dr. Tang's book, which is really good resource for women who have been told that it's all in their head or they're losing their minds. And it truly is actually a kind of collagical issue like endometriosis, different pelvic pains, chronic pains.
00:10:51
Speaker
And so it's a great resource for women out there to be able to learn more about your own health because that's the best way to be your own advocate is to really understand. And, you know, not everyone can go to medical school necessarily or and should be to go to medical school to understand what's happening to them, but at least getting more health literacy around these conditions, I think is very helpful to be an advocate for oneself. So thank you so much. I really appreciate your time. Thank you.