A DGB Analysis of The Evolution of Psychoanalysis..Part 1: Hysteria (Background Material From The Internet)

Part 1: Hysteria and Its Influence on Freud and The Birth of Psychoanalysis


In Freudian Psychology -- i.e., Psychoanalysis -- Freud started out by treating 'hysterical' women -- meaning women who complained of, and/or demonstrated characteristics or 'symptoms' of physical disease, without any doctors being able to find the underylying 'physical causes' or 'roots' of these characteristics/symptoms. Such cases -- rightly or wrongly -- were lumped into the category of 'hysteria' meaning essentially 'case demonstrations of physical disease without the diagnosed underlying physical causes that would normally lead the doctor in the direction of the "cure"'. From the beginning of time practically such diseases have been classified as 'a woman's disease' -- 'hysteria' as it was originally defined (by Hippocrates) meant 'wandering uterus', meaning that it was associated with being a woman, or worse, 'a crazy woman' or 'demonized woman', and throughout the course of history there have been an equally 'crazy and/or not so crazy assortment of "doctor cures" aimed at correcting this diagnosed and/or misdiagnosed 'female problem'...

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From Wikipedia, the free encyclopedia


This article is about the state of mind. For other uses, see Hysteria (disambiguation).

Hysteria, in its colloquial use, describes a state of mind, one of unmanageable fear or emotional excesses. The fear is often caused by multiple events in one's past that involved some sort of severe conflict; the fear can be centered on a body part or most commonly on an imagined problem with that body part (disease is a common complaint. See also Body dysmorphic disorder and Hypochondriasis. People who are "hysterical" often lose self-control due to the overwhelming fear.

Psychiatrists and other physicians have in theory given up the use of "hysteria", replacing it with more euphemistic terms that are essentially synonyms. These include "psychosomatic", "functional", "nonorganic", "psychogenic", and "medically unexplained". In 1980 the American Psychiatric Association officially changed the diagnosis of "hysterical neurosis, conversion type" to "conversion disorder". Hysteria also has significant overlap with the diagnostic term "somatization disorder" and with somatoform disorders in general.


History

Main article: Female hysteria

The term originates with the Greek medical term, hysterikos. This referred to a medical condition, thought to be particular to women, caused by disturbances of the uterus, hystera in Greek. The term hysteria was coined by Hippocrates, who thought that suffocation and madness arose in women whose uteri had become too light and dry from lack of sexual intercourse and, as a result, wandered upward, compressing the heart, lungs, and diaphragm.

The same general definition, or under the name female hysteria, came into widespread use in the middle and late 19th century to describe what is today generally considered to be sexual dissatisfaction.[1] Typical treatment was massage of the patient's genitalia by the physician and later vibrators or water sprays to cause orgasm.[1] By the early 1900s, the practice and usage of the term had fallen from use until it was again popularized when the writings of Sigmund Freud became known and influential in Britain and the USA in the 1920s. The Freudian psychoanalytic school of psychology uses its own, somewhat controversial, ways to treat hysteria.

The knowledge of hysterical processes was advanced by the work of Jean-Martin Charcot, a French neurologist. However, many now consider hysteria to be a legacy diagnosis (i.e., a catch-all junk diagnosis),[2] particularly due to its long list of possible manifestations: one Victorian physician cataloged 75 pages of possible symptoms of hysteria and called the list incomplete.[3].

Current psychiatric terminology distinguishes two types of hysteria: somatoform and dissociative. Dissociative hysteria includes amnestic fugue states. Somatoform disorders include conversion disorder, somatization disorder, chronic pain disorder, hypochondriasis, and body dysmorphic disorder. In somatoform disorders, the patient exhibits physical symptoms such as low back pain or limb paralysis, without apparent physical cause. Recent neuroscientific research, however, is starting to show that there are characteristic patterns of brain activity associated with these states. All these disorders are thought to be unconscious, not feigned or intentional malingering.

Freudian psychoanalytic theory attributed hysterical symptoms to the subconscious mind's attempt to protect the patient from psychic stress. Subconscious motives include primary gain, in which the symptom directly relieves the stress (as when a patient coughs to release energy pent up from keeping a secret), and secondary gain, in which the symptom provides an independent advantage such as staying home from a hated job. More recent critics have noted the possibility of tertiary gain, when a patient is induced subconsciously to display a symptom because of the desires of others (as when a controlling husband enjoys the docility of his sick wife). There need be no gain at all, however, in a hysterical symptom. A child playing hockey may fall and for several hours believe he is unable to move, because he has recently heard of a famous hockey player who fell and broke his neck.

Jungian psychologist Laurie Layton Schapira explored what she labels a "Cassandra Complex" suffered by those traditionally diagnosed with hysteria, denoting a tendency for those with hysteria to be disbelieved or dismissed when relating the facticity of their experiences to others.[4] Based on clinical experience, she delineates three factors which constitute the Cassandra complex in hysterics: (a). dysfunctional relationships with social manifestations of rationality, order, and reason, leading to; (b). emotional or physical suffering, particularly in the form of somatic, often gynaecological complaints, and (c). being disbelieved or dismissed when attempting to relate the facticity of these experiences to others.[5]

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4. Jean-Martin Charcot


Jean-Martin Charcot
From Wikipedia, the free encyclopedia
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Jean-Martin Charcot


Born November 29, 1825(1825-11-29)
Paris, France
Died August 16, 1893
Lac des Settons, Nièvre

Residence France
Nationality French
Fields Neurologist and professor of anatomical pathology
Institutions Pitié-Salpêtrière Hospital
Jean-Martin Charcot (29 November 1825 – 16 August 1893) was a French neurologist and professor of anatomical pathology.[1] He is known as "the founder of modern neurology" and is "associated with at least 15 medical eponyms", including Charcot-Marie-Tooth disease and amyotrophic lateral sclerosis (Lou Gehrig's disease).[1] His work greatly influenced the developing fields of neurology and psychology. He was the "foremost neurologist of late nineteenth-century France"[2] and has been called "the Napoleon of the neuroses".[3]

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Jean-Martin Charcot

(November 29, 1825-August 16, 1893)
French Neurologist



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Influences

Student of:
Influenced by:
Students: Freud, Binet
Influenced:
Time Period: Modern Foundations
Education

Paris Medical School (1843-1853)
Career

Appointed Chef de clinique, Paris Medical School (1853-1855)
Appointed Médecin du Bureau Central, Paris Medical School (1856-1860)
Becomes Associate Professor at the Paris Medical School (1960-1861)
Elected Vice President of Société de Biologie (1861)
Appointed Chef de service, Salpêtrière Hospital in Paris (1862-1872)
Professor and Chair of Pathological Anatomy, Salpêtrière Hospital (1872-1893)
Major Contributions

He was one of the most famous neurologists of all time
He was an influential teacher: Sigmund Freud and Alfred Binet studied under him at the Salpêtrière
He discovered and described a variety of neurologically-based diseases, including Charcot Joint, Charcot Foot, Charcot Disease (Amyotrophic lateral sclerosis) and Charcot-Marie-Tooth Disease
He was among the first to match specific anatomical lesions to a variety of neurological disorders, including epilepsy, multiple sclerosis and strokes (Goetz, et al., 1995, p. xix).
Ideas and Interests

21st century psychologists are primarily interested in Charcot's research into the causes of Hysteria. Although this disorder expressed itself differently in each patient, most suffered a combination of physical and psychological symptoms, which could include delirium, paralysis, rigidity and contraction of muscles, blindness, inability to speak, loss of feeling, vomiting, hemorrhaging, seizures, joint deformity and distended abdomens. Many contemporary physicians accused the hysterical patients of malingering and fraud, but Charcot was convinced that the patients believed that their symptoms were real, and that the physical symptoms were indicative of a genuine psychological problem (Fancher, 1985, p. 53).

To investigate his hypothesis, Charcot combined his traditionally meticulous diagnostic methods with novel experimental techniques involving hypnotism, magnetism and electricity. Although modern science acknowledges that both his methods and his conclusions were flawed, he is still recognized as a pioneer in the effort to link physiological and mental processes (Goetz et al., 1995, p. 197-198).

Charcot is also famous for his theatrical teaching style. He replaced traditional hospital rounds at the Salpêtrière with clinical demonstrations and patient interviews in the hospital amphitheater. These dramatic "hysteria shows" (Hunter, 1998) caught the attention of non-medical intellectuals, and aroused public curiosity to the extent that hysteria became almost vogue. Although Charcot was charged with voyeurism and exploitation, he is credited with adding the word "neurology" to the everyday vocabulary of the Parisian populace (Goetz et al., 1995, p. xix).

Charcot's contributions to the history of intelligence testing are fourfold. First, he established and popularized neurology as its own science. Second, his work with hypnotized hysterics blurred the line between physiological and psychological investigation, paving the way for intelligence researchers interested in neurophysiological and genetic correlates for intelligence. Third, he maintained a moderate (and sometimes unpopular) stance on the heredity-environment problem. He was one of the first advocates of the diasthesis-stress model; that is, he believed that hysteric patients inherited a genetic predisposition to the disease, but that the disease became manifest only after exposure to specific environmental stressors. This model is widely accepted today as an explanation for the interaction between genetics and the environment. Fourth, both Alfred Binet and Sigmund Freud spent time working with Charcot at the Salpêtrière.

For five months during 1885 and 1886, Freud attended Charcot's clinical hysteria demonstrations in the Salpêtrière amphitheater. At the time of his visit Freud was a neurologist, and many historians believe that his sojourn with Charcot is partially responsible for his future professional interest in unconscious processes. Indeed, some historians contend that Charcot's investigations into the causes of hysteria may have been a precursor to Freudian psychoanalysis (Goetz et al., 1995, pp. 210, 336).

Alfred Binet spent seven years working with Charcot's hypnotized hysterics, and there is little doubt that the experience changed the course of his career. Charcot had come to believe that susceptibility to hypnosis was an indicator of latent hysteria. He based this belief on the fact that hysterical symptoms could be reproduced by hypnotic suggestions (Fancher, 1985, p. 54). Binet saw Charcot's demonstrations, and wholeheartedly accepted his mentor's hypothesis. He quickly published four articles describing the success of Charcot's experiments. However, when evidence began to mount that Charcot's experimental design was seriously flawed, Binet was forced to admit publicly that he had been wrong (Wolf, 1972, p. 5). This embarrassment taught Binet to be a more careful researcher, so it is likely that the quality of his future intelligence work was positively affected by this experience. Additionally, Charcot's preference for detailed case-study analysis would come to be reflected in Binet's methodology (Fancher, 1985, p. 57).

Selected Publications

Charcot, J.M. (1875). Sur les localizations cérébrales. Comptes-Rendus des Seánces et Mémoires de la Société de Biologie, 24, 400-404.

Charcot, J.M. (1877). Lectures on the diseases of the nervous system, delivered at La Salpêtrière. London.

Charcot, J.M. (1882). Physiologie pathologique. Sur les divers états nerveux déterminés par l'hypnotisation chez les hystériques. [Pathological physiology: On the various nervous states determined by the hypnotisation of hystericals]. Comptes rendus de l'Académie Des Sciences, 94, 403-405.

Charcot, J.M. (1885). Oeuvres complètes. [Complete works]. Paris: Bureau du Progrès Mèdical.

References

Fancher, R.E. (1985). The intelligence men: Makers of the IQ controversy. New York: W.W. Norton & Company.

Goetz, C.G., Bonduelle, M., & Gelfand, T. (1995). Charcot: Constructing neurology. New York: Oxford University Press.

Hunter, D. (Ed.). (1998). The makings of Dr. Charcot's hysteria shows. Lampeter, Cerdigion, Wales: The Edwin Mellen Press, Ltd.

Wolf, T.H. (1973). Alfred Binet. Chicago: University of Chicago Press.

Image courtesy of the National Library of Medicine


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Jean Charcot -- mentioned in three of the internet passages above -- very much influenced the beginning of Freud's psychological career, and demonstrated to Freud, as well as to many others, that hysterical symptoms could be either added or subtracted by his use of hypnosis, persuasion, and 'mind control' on whoever he was able to put into a hypnotic trance. The idea here was to demonstrate that hysterical symptoms were 'psychologically as opposed to physically caused'.

This subject matter -- hysteria, its validity and/or non-validity as a 'legitimately diagnosed disease', and its relation to the birth of Psychoanalysis -- is a very complicated, convoluted issue, with many people disagreeing on many different nuances of the issue.

Freud still has many supporters -- and non-supporters -- and DGB Philosophy-Psychology continues to work as an 'integrative-dialectical theory', weighing the pros and cons of both Freudian supporters and detractors while at the same time adding in its own continually evolving editorial opinions.

Since at least one source of Freud's interconnection of ideas sprang strongly from the ideas of Charcot and particularly, the 'psycho-genesis' of hysteria, often both Freud and Charcot are seen in the same light here, either strongly positively or strongly negatively without too many noticeable people taking a 'middle ground position' which is mainly where DGB Philosophy-Psychology operates out of.

Here are two editorial perspectives, the first coming from a Psychoanalytic organization and website that is 'pro-Charcot and pro-Freud', the second writer who I am just now becoming introduced to, coming out strongly in opposition to the legitimacy of both Charcot's and Freud's ideas and their resulting diagnoses of 'hysteria' back in the 1880s and 1890s...

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Some Aspects of Charcot's Influence on Freud

Julian A. Miller, M.D.


IN PREVIOUS PAPERS (15), (22), (23) members of the Workshop on Scientific Methodology have considered the origins and modifications of some early concepts in psychoanalysis. We had been interested in the influences impinging on Freud during the early days of discovery and concept formation. In this context, Freud's trip to Paris to study with Charcot seemed pivotal in his shift from neurological and physiological to psychopathological work. Although Jones (19) traces the principles upon which Freud constructed his theories back to the influence of Brücke, he also states: "It was assuredly the experience with Charcot in Paris that aroused Freud's interest in hysteria, then in psychopathology in general, and so paved the way for resuscitating Breuer's observation and developing psychoanalysis" (Vol. 1, p. 75).

We have examined Charcot's writings (3) as well as some of those who have commented upon his work (5), (16), (17), (18), (24) to understand Charcot's theoretical

[This is a summary or excerpt from the full text of the book or article. The full text of the document is available to subscribers.]

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From the internet...


Freud, Charcot and hysteria: lost in the labyrinth

RICHARD WEBSTER

The origins of psychoanalysis in the diagnostic darkness and medical errors of the late nineteenth century.
www.richardwebster.net/freudandcharcot.html - 48k - Cached - Similar pages


Charcot demonstrates a case of 'hysteria' c. 1885

The following essay consists of four sections from my volume in the Weidenfeld 'Great Philosophers' series: Freud (2003). For a more detailed discussion of the medical diagnosis of hysteria and further comment on Charcot, click here for an extract from Why Freud Was Wrong (1995).

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Hysteria, Anna O., and the Invention of Psychoanalysis
Sigmund Freud was born in 1856, in the small Austro-Hungarian town of Freiberg. Unusually he was born in a caul – a kind of membrane – and his mother immediately took this as a portent of his future fame. She called him ‘mein goldener Sigi’, and throughout his childhood and early adolescence in Vienna he was surrounded by his parents’ adulation and by their urgent expectation of his future greatness. As Freud embarked on a career in medicine, which eventually led him to study in the newly emerging field of neurology, these expectations seem to have become increasingly burdensome. For, although outwardly successful, he appears to have begun to despair of ever being granted the kind of world-redeeming revelation which he felt inwardly compelled to seek.

Freud’s earliest unsuccessful skirmish with fame took place in 1885 when, after experimenting with taking cocaine, he sought medical glory by publishing a paper on the drug as a miracle-therapy. In writing this paper, however, he failed to observe the crucial properties of the drug as a local anaesthetic while simultaneously omitting to warn against cocaine addiction. Freud, however, was not deterred by this unfortunate episode from seeking medical distinction. He almost immediately left Vienna for Paris where, from October 1885 to February 1886, he studied under the famous neurologist Charcot.

Charcot specialised in treating patients who were suffering from a variety of unexplained physical symptoms including paralysis, contractures (muscles which contract and cannot be relaxed) and seizures. Some of these patients sporadically and compulsively adopted a bizarre posture (christened arc-de-cercle) in which they arched their body backwards until they were supported only by their head and their heels. Charcot eventually came to the conclusion that many of his patients were suffering from a form of hysteria which had been induced by their emotional response to a traumatic accident in their past – such as a fall from a scaffold or a railway crash. They suffered, in his view, not from the physical effects of the accident, but from the idea they had formed of it.

Freud was immensely impressed by Charcot’s work on traumatic hysteria and took from it the notion that one of the principal forms of neurosis came about when a traumatic experience led to process of unconscious symptom-formation. He now began to develop this idea, and did so partly by reference to the work of a medical colleague, Josef Breuer. Freud was especially interested in the most unusual of all his colleague’s patients, the celebrated ‘Anna O.’ whom Breuer had begun to treat in 1880.

Anna O. was a twenty-one-year-old woman who had fallen ill while nursing her father who eventually died of a tubercular abscess. Her illness began with a severe cough. She subsequently developed a number of other physical symptoms, including paralysis of the extremities of the right side of her body, contractures, disturbances of vision, hearing and language. She also began to experience lapses of consciousness and hallucinations.

Breuer diagnosed Anna O.’s illness as a case of hysteria and gradually developed a form of therapy which he believed was effective in relieving her symptoms. He came to the conclusion that when he could induce her to relate to him during the evening the content of her daytime hallucinations, she became calm and tranquil. Breuer himself saw this as a way of ‘disposing’ of the ‘products’ of Anna O.’s ‘bad self’ and understood it as a process of emotional catharsis. The patient herself described it as ‘chimney sweeping’, and as her ‘talking cure’.

Breuer went on to extend this therapy. At one point in her illness, for a period of weeks, Anna O. declined to drink and would quench her thirst with fruit and melons. One evening, in a state of self-induced hypnosis, she described an occasion when she said she had been disgusted by the sight of a dog drinking out of a glass. Soon after this she asked for a drink and then woke from her hypnosis with a glass at her lips.

In his published account of the case, written some twelve years later, Breuer treated the story which Anna O. had related in a trance as a true account of an incident which had given rise to her aversion to drinking. He said he had concluded that the way to cure a particular symptom of ‘hysteria’ was to recreate the memory of the incident which had originally led to it and bring about emotional catharsis by inducing the patient to express any feeling associated with it..

The sudden disappearance of one of Anna O.’s many symptoms thus became the basis for what Breuer later described as a ‘therapeutic technical procedure’. According to both Freud and Breuer, this method had been applied systematically to each of Anna’s symptoms and as a result she was cured completely of her hysteria.

The case of Anna O. played a fundamental role in the development of Freud’s thought. She has frequently been described as the first psychoanalytic patient, a view which Freud himself, lecturing at Clark University in the United States, once endorsed:

If it is a merit to have brought psychoanalysis into being, that merit is not mine. I had no share in its earliest beginnings. I was a student and working for my final examinations at the time when another Viennese physician, Dr Josef Breuer first (in 1880-2) made use of this procedure on a girl who was suffering from hysteria. [1]

Freud, however, was understating his own role. Psychoanalysis would never have come into being if he had not transformed Breuer’s ‘talking cure’ by marrying it with Charcot’s views on traumatic hysteria and his own elaborate technique for reconstructing repressed memories through interpretation and free-association.

The patients whom Freud endeavoured to psychoanalyse at this early stage of his career, however, almost all resembled Anna O. in at least one respect; they came to Freud not because they were experiencing emotional distress but because they were suffering from physical symptoms. Freud’s first patient, for example, Frau Emmy von N., suffered speech difficulties, which Freud described as ‘spastic interruptions amounting to a stammer’. She was also plagued ‘by frequent convulsive tic-like movements of her face and the muscles of her neck’ and was compulsively given to making repetitive verbal exclamations and clicking sounds. Another patient, Lucy R., an English governess, suffered from strange olfactory hallucinations centring on the smell of burnt pudding. Yet another, Elisabeth von R., came to Freud because she had been suffering for more than two years from pains in her legs.

In all these cases Freud construed his patients’ illness as hysteria and set about uncovering the traumatic incident which had supposedly given rise to their symptoms. In order to help the process of analysis he developed what he called his ‘pressure technique’. This consisted in applying pressure to his patients’ forehead with his hands and instructing them to report faithfully ‘whatever appeared before their inner eye or passed through their memory at the moment of pressure’. Freud rapidly developed such faith in the effectiveness of this method for evoking pictures, ideas or unconscious ‘memories’ that he came to regard it as infallible, maintaining that if no images or memories were produced by the first application of pressure, repeated pressure would invariably be effective. When, in the course of treating Elisabeth von R. for her lameness, he suspected her of concealing thoughts from him, he decided to reinforce the physical pressure with mental pressure:

I no longer accepted her declaration that nothing had occurred to her, but assured her that something must have occurred to her. Perhaps, I said, she had not been sufficiently attentive, in which case I would be glad to repeat my pressure. Or perhaps she thought that her idea was not the right one. This, I told her, was not her affair; she was under an obligation to remain completely objective and say what had come into her head, whether it was appropriate or not. Finally I declared that I knew very well that something had occurred to her and that she was concealing it from me; but she would never be free of her pains so long as she concealed anything. By thus insisting I brought it about that from that time forward my pressure on her head never failed in its effect. [2]

At this period Freud believed that, in the final stages of therapy, it was helpful ‘if we can guess the ways in which things are connected up and tell the patient before we have uncovered it’. [3] When, however, he presented Elisabeth von R. with his conclusion, namely that her illness had been precipitated by her falling in love with her brother-in-law, she objected that that this was not true. Freud, however, persisted in his explanation and eventually reported that his patient had been cured.

. . . . . . . . . . . . . . . . (at this point six or seven sections of the original book are omitted) . . . . . . . . .


Freud and Charcot
The psychoanalytic movement is undoubtedly a powerful one which has endured one century and is likely to endure another. But from its very beginnings it has attracted criticism. This criticism has tended to become better informed with the passing of time. With almost a hundred of years of Freud scholarship to draw on, it is now possible, perhaps for the first time, to offer a considered and balanced judgement on the value both of Freud’s thought and of the movement he founded.

One of the obstacles which, perhaps more than any other, has stood in the way of a full understanding of Freud’s ideas, is that many of those who have written about psychoanalysis, in Europe, in Britain or in America, have been scholars involved in the humanities. Whether writing as champions or critics, they have tended to present psychoanalysis as a humanistic discipline. As a result we often forget that it was in its origins a medical movement.

Psychoanalysis was born not, as is frequently claimed, out of the foibles of emotionally unstable middle-class women who came to consult Freud in Vienna. It was born amidst the florid and sometimes extreme physical symptoms displayed by patients who had been consigned to one of France’s greatest hospitals – La Salpêtrière in Paris. The original begetter of the theory of unconscious symptom-formation – a theory which lies at the heart of psychoanalysis – was not Freud, nor even Breuer, but Jean Martin Charcot.

Charcot was not a psychologist, he was a neurologist. His greatest gift was a genius for anatomical dissection and post-mortem diagnosis. His greatest handicap was that he practised neurology at a time when techniques of tissue-staining were primitive, X rays had not been discovered and the instruments of investigation which have made modern neuroscience possible did not exist. The electroencephalogram (EEG), which would revolutionise neurology and psychiatry, was not in general use until the 1940s. Other techniques for brain-imaging, such as Magnetic Resonance Imaging (MRI), were not introduced until the closing decades of the twentieth century. Even today, at the beginning of the twenty-first century, the process of charting the brain’s intricate functioning has barely begun. As Rita Carter writes in her book Mapping the Mind, ‘the vision of the brain we have now is probably no more complete or accurate than a sixteenth-century map of the world.’ [4]

In 1886, at the time of Freud’s crucial encounter with Charcot, the map was scarcely drawn at all. Neurologists inhabited a world of almost complete diagnostic darkness, illuminated only by the occasional gleam of medical insight. Perhaps more importantly still, leading neurologists remained blissfully unaware of the depth of their ignorance. Charcot himself believed that the work of neurology was almost complete.

What this meant in practice was that many subtle neurological disorders, such as temporal lobe epilepsy, and frontal-lobe epilepsy, were unrecognised in Charcot’s day. At the same time, the internal pathology of head injuries remained an almost complete mystery. Closed head injuries, which produce concussion without leaving any external injury, were simply not recognised. This was the diagnostic darkness within which the fundamental principles of psychoanalysis were formulated. The medical and intellectual consequences are perhaps best illustrated by Charcot’s classic case of traumatic hysteria – a case involving a patient known as ‘Le Log–––’.

Le Log––– was a florist’s delivery man in Paris. One evening, in October 1885, he was wheeling his barrow home through busy streets when it was hit from the side by a carriage which was being driven at great speed. Le Log–––, who had been holding the handles of his barrow tightly, was spun through the air and landed on the ground. He was picked up completely unconscious. He was then taken to the nearby Beaujon hospital where he remained unconscious for five or six days. Six months later he was transferred to La Salpêtrière. By this time the lower extremities of his body were almost completely paralysed, there was a twitching or tremor in the corner of his mouth, he had a permanent headache and there were ‘blank spaces in the tablet of his memory’. In particular he could not remember the accident itself. But, because there had never been any signs of external injury, Charcot decided that Le Log––– was a victim of traumatic hysteria and that his symptoms had arisen as a result of the psychological trauma he had suffered. Charcot came to this conclusion knowing full well that some weeks after his accident Le Log––– had suffered heavy nose-bleeds and a series of violent seizures – seizures which Charcot deemed hysterical.

In the century which has passed since Charcot made this diagnosis, the face of neurology – and of general medicine – has been transformed. If Le Log––– were to be brought today to a hospital in practically any part of the Western world there can be no doubt that doctors would recognise a case of closed head injury complicated by late epilepsy and raised intracranial pressure.

From this we may derive a conclusion which is both simple and terrible in its implications: Le Log–––, the classic example of a patient who supposedly suffered from traumatic hysteria, did not forget because he was frightened. He forgot because he was concussed. His various symptoms were not produced by an unconscious idea. They were the result of brain damage.

We are here confronted by what may well be the most momentous medical misunderstanding which has taken place in the last two centuries. For Charcot’s failure to recognise cases of closed head injury, and the symptoms they gave rise to, would shape the development of psychoanalysis. It was the main factor which would eventually lead Freud to elaborate his entire theory of unconscious symptom-formation – or ‘repression’.

(If you are interested in reading the rest of this rather provocative Webster article, please visit Richard Webster's rather provocative website. I am still trying to get a full handle on his ideas and what they do and don't mean relative to my own beliefs about Psychoanalysis and the good and bad legacy of Freud relative to the evolution of Clinical Psychology, Psychotherapy, and his influence on the still evolving ideas of DGB Philosophy and Psychology which remain extremely significant.)

I will start to explore some of these good and bad ideas, as well as offering a counter-thesis to Webster's thesis here above in Part 2 which will appear above.

-- dgbn, Dec. 14th, 2008, finished Dec. 17th, 2008.

-- David Gordon Bain,

-- Democracy Goes Beyond Narcissism,

-- Dialectical Gap-Briding Negotiations...

Are still in process....


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