What is hysteria, and why were so many women diagnosed with it? - Mark S. Micale

Summary

The script explores the historical concept of 'hysteria', a term used from 300 BCE to the early 1900s to diagnose a wide range of ailments in women, stemming from a supposed wandering womb. It traces the evolution from a physical ailment to a mental disorder, reflecting societal attitudes towards women. The narrative highlights how hysteria was used to pathologize female behavior and the eventual shift to more accurate, less gendered diagnoses, with hysteria being removed from the DSM in 1980.

Takeaways

• 🚺 Hysteria was a term historically used to diagnose women with a wide range of unexplained medical conditions.
• 🌍 The concept of hysteria originated in ancient Greece and was linked to the uterus, suggesting it was a 'wandering womb' causing various ailments.
• 🤔 The term was used as a cultural signifier for behaviors that male authorities found contemptible or incomprehensible in women.
• 🏥 Roman physicians rejected the 'wandering womb' theory but still considered the uterus the source of hysteria, treating it by inducing orgasms.
• 🕰️ By the late Middle Ages, hysteria was viewed as a spiritual malady influenced by Satan, reflecting a misogynistic shift in medical practice.
• 🔮 During the 16th and 17th centuries, women, especially non-conforming ones, were at risk of being accused of witchcraft due to hysteria.
• 🎩 In Victorian times, hysteria was considered a mental condition, and 'nerve doctors' used rest cures to treat middle-class women's emotional distress.
• 📚 Charlotte Perkins Gilman's 'The Yellow Wallpaper' reflects the distressing treatments for hysteria, including isolation and intellectual deprivation.
• 🧠 Sigmund Freud believed hysteria was caused by repressed emotional trauma and not unique to women, leading to the concept of 'male hysteria' or 'shell shock'.
• 📉 Over the 20th century, hysteria was replaced by more specific, less gendered diagnoses, and was removed from the DSM in 1980.
• 🏛️ The legacy of hysteria reflects a long history of medical sexism and the misattribution and trivialization of women's pain in Western medicine.

Q & A

What was the term used by European and American doctors from 300 BCE to the early 1900s to describe unexplainable medical conditions in women?

The term used was 'hysteria', which was a catch-all term for various ailments and symptoms experienced by women.

What is the origin of the term 'hysteria'?

The term 'hysteria' is derived from the Greek word for uterus, and it was first used in the 4th century BCE.

What was the 'wandering womb' theory proposed by the Greeks?

The Greeks believed that hysteria was a malady of the womb, arguing that the uterus could dislodge and move throughout the body, causing various ailments, and that it wandered because it longed to bear children.

How did Roman physicians view hysteria differently from the Greeks?

Roman physicians rejected the wandering womb theory but still considered the uterus as the source of hysteria, believing it produced a secretion similar to semen that could corrupt the blood and irritate the nerves if not released.

How did the spread of Christianity influence the medical understanding of hysteria?

With the spread of Christianity, physicians began to view hysteria as a malady of the soul, reflecting Satanic influence, and blamed women's symptoms and pain on their supposed inherent weak wills and susceptibility to sin.

What was the consequence for women who didn't conform to social expectations during the 16th and 17th centuries?

Women who didn't conform to social expectations risked being accused of witchcraft, which often carried heavy consequences.

What was the approach to treating hysteria in late Victorian Europe and North America?

Middle-class women were referred to 'nerve doctors' who used isolating and unfounded rest cures to treat emotional and psychological distress.

What is the connection between Charlotte Perkins Gilman's 'The Yellow Wallpaper' and the treatment of hysteria?

Gilman drew from her own distressing treatment for her so-called hysterical tendencies in her semi-autobiographical short story 'The Yellow Wallpaper', where the narrator is confined and denied intellectual activity.

What was Sigmund Freud's perspective on hysteria?

Freud believed hysteria, like other nervous conditions, was caused by repressed emotional trauma and required drawing these memories out of the unconscious to be acknowledged and addressed.

How did the concept of 'male hysteria' emerge?

Belief in 'male hysteria' became prominent during and after the First World War, but it was framed as 'shell shock', a more masculine term.

When was the term 'hysteria' officially removed from the Diagnostic and Statistical Manual of Mental Disorders?

The term 'hysteria' was officially removed from the Diagnostic and Statistical Manual of Mental Disorders in 1980.

What is the current scholarly consensus on the historical diagnosis of hysteria?

Most scholars argue that the blanket disease hysteria was always a figment of doctors' imaginations and a reflection of medical sexism.

Outlines

00:00

🏥 Hysteria: A Historical Misdiagnosis

This paragraph discusses the historical diagnosis of hysteria, a term used from 300 BCE to the early 1900s to describe a wide range of unexplainable medical conditions in women. It was considered a malady of the womb, with the uterus believed to wander and cause various ailments. Treatments included marriage, impregnation, or uterine fumigations. Roman physicians later rejected the wandering womb theory but still saw the uterus as the source. During the Middle Ages, hysteria was seen as a soul-related issue influenced by Satan. In Victorian times, it was considered a mental condition, with 'nerve doctors' prescribing rest cures. Sigmund Freud later attributed hysteria to repressed emotional trauma, and the term was eventually replaced by more specific diagnoses, and removed from the Diagnostic and Statistical Manual of Mental Disorders in 1980.

05:04

📚 Legacy of Hysteria in Western Medicine

The second paragraph reflects on the legacy of hysteria, suggesting it was a product of medical sexism and a misattribution of women's pain. As medical sexism declined, so did the diagnosis of hysteria. The paragraph emphasizes the ongoing history of Western medicine trivializing women's health issues and the shift towards more accurate, gender-neutral diagnoses.

Keywords

💡Hysteria

Hysteria was a term historically used to describe a wide range of symptoms, particularly in women, that were considered to be of psychological or emotional origin. In the script, hysteria is highlighted as a catch-all diagnosis given to women with unexplainable conditions, often reflecting societal views on women's behavior and health. The term is derived from the Greek word for uterus, indicating an early belief that the uterus was the root of the issue.

💡Wandering Womb Theory

The 'Wandering Womb Theory' was an ancient Greek belief that the uterus could move around the body causing various ailments, particularly when it was not 'fixed' by childbearing. The script mentions this theory as an early example of how hysteria was linked to the uterus and used to justify prescribing marriage and pregnancy as treatments.

💡Uterine Fumigations

Uterine fumigations were a treatment method mentioned in the script where smoke or vapors were used to entice the 'wandering' uterus back into place. This reflects the misguided medical practices of the time that aimed to 'cure' hysteria.

💡Manual Induced Orgasms

As per the script, Roman physicians believed that hysteria could be treated by inducing orgasms, which they thought would release a secretion similar to semen that could otherwise corrupt the blood. This method was used by midwives and is an example of how hysteria was approached as a physical condition.

💡Christianity and Hysteria

The script discusses how the spread of Christianity influenced the medical view of hysteria, with physicians suggesting it was a malady of the soul influenced by Satan. This reflects the religious and moral dimensions that were intertwined with medical diagnoses during the Middle Ages.

💡Witchcraft

In the context of the script, the term 'witchcraft' is used to describe the extreme consequences women faced if they were accused of it during the 16th and 17th centuries. Hysteria was sometimes used as a basis for such accusations, particularly for women who did not conform to social expectations.

💡Nerve Doctors

Nerve doctors, as mentioned in the script, were medical practitioners in late Victorian Europe and North America who treated hysteria by prescribing rest cures. This reflects a shift in the understanding of hysteria from a physical to a psychological condition.

💡The Yellow Wallpaper

The script references 'The Yellow Wallpaper,' a short story by Charlotte Perkins Gilman, which is semi-autobiographical and depicts the narrator's experience with postpartum depression and the isolating treatment she received for her 'hysterical tendencies.' This work illustrates the negative impact of the hysteria diagnosis on women's mental health.

💡Sigmund Freud

Sigmund Freud, a prominent figure in the script, believed that hysteria was caused by repressed emotional trauma. His approach to treatment involved drawing out these memories from the unconscious. Freud's theories were influential in shifting the understanding of hysteria towards a psychological framework.

💡Shell Shock

The term 'shell shock' was used during and after the First World War to describe what was believed to be a masculine version of hysteria. The script notes that this term was used to frame hysteria in a way that was more acceptable for men, reflecting societal gender norms of the time.

💡Diagnostic and Statistical Manual of Mental Disorders (DSM)

The DSM is a key reference work in the field of psychology and the script mentions that hysteria was officially removed from it in 1980. This removal signifies a shift away from the broad and gendered diagnosis of hysteria towards more specific, less gendered diagnoses.

Highlights

Hysteria was historically diagnosed in women with unexplainable medical conditions.

The term 'hysteria' is derived from the Greek word for uterus and was first used in the 4th century BCE.

Ancient Greeks believed hysteria was a malady of the womb, causing the uterus to wander and cause ailments.

Unmarried women were most likely to be diagnosed with hysteria due to the belief in a 'wandering womb'.

Roman physicians rejected the wandering womb theory but still viewed the uterus as the source of hysteria.

Hysteria was treated by midwives inducing orgasms to release a supposed secretion similar to semen.

During the Middle Ages, hysteria was considered a malady of the soul reflecting Satanic influence.

Women's symptoms were dismissed as a result of their weak wills and susceptibility to sin.

In the 16th and 17th centuries, women not conforming to social expectations risked accusations of witchcraft.

Late Victorian doctors argued hysteria originated in the mind, affecting middle-class women facing social pressures.

Charlotte Perkins Gilman's 'The Yellow Wallpaper' was inspired by her own distressing treatment for hysteria.

Sigmund Freud believed hysteria was caused by repressed emotional trauma and not unique to women.

After WWI, 'male hysteria' was recognized as 'shell shock', a more masculine term.

The term hysteria was replaced by specific, less gendered diagnoses over the 20th century.

Hysteria was officially removed from the DSM in 1980.

The concept of hysteria is now seen as a figment of doctors' imaginations and a product of medical sexism.

The legacy of hysteria reflects Western medicine's history of misattributing and trivializing women's pain.

Transcripts

Do you ever feel tired? Overwhelmed?

Nervous? Depressed?

Do you have headaches, dizziness, cramps, difficulty breathing?

From 300 BCE to the early 1900s,

if you answered yes to these questions and you had a uterus,

a European or American doctor would likely diagnose you with hysteria.

No, not mass hysteria.

Ladylike hysteria.

The catch-all term “hysteria” was used by physicians, who were mostly men,

to describe just about any unexplainable medical condition

suffered by female patients.

By some interpretations,

being a woman was itself long considered a pathology

from which all kinds of problems arose.

Throughout its long history, hysteria was used as a cultural signifier

for what men with authority found contemptible and incomprehensible

in the behavior of women who lacked, or tried to exercise, power.

The term hysteria is derived from the Greek word for uterus,

and was first used in the 4th century BCE.

Drawing on earlier Egyptian beliefs, and not a great deal of medical rigor,

the Greeks viewed hysteria as a malady of the womb,

arguing that the uterus could dislodge and move throughout the body,

causing a variety of ailments.

They believed the uterus wandered because it longed to bear children,

and for that reason,

unmarried women were the most likely to get a hysteria diagnosis.

The usual prescription was immediate marriage, impregnation,

or the use of uterine fumigations

to entice the rebellious organ back into place.

By the 2nd century CE,

Roman physicians rejected the wandering womb theory.

But they still viewed the uterus as the source of hysteria,

believing, without much evidence, that it produced a secretion similar to semen,

which— if not released— corrupted the blood and irritated the nerves.

As a result, midwives would often treat hysteria by manually inducing orgasms

in female patients.

By the late Middle Ages, Christianity had spread throughout Europe,

and its influence had likewise infiltrated Western medical practice.

Physicians started to posit that hysteria was a malady not of the womb,

but of the soul, and reflected Satanic influence.

Doctors continued to dismiss women’s symptoms and pain,

now misogynistically shifting the blame to their supposed inherent weak wills

and susceptibility to sin.

This situation worsened through the 16th and 17th centuries,

as women, especially those who didn’t conform to social expectations,

risked being accused of witchcraft, which often carried heavy consequences.

In late Victorian Europe and North America,

some medical doctors started arguing that hysteria’s true origin

lay not in the body or soul, but rather, in the mind.

Middle class women, facing intense demands of social respectability

and strict codes of sexual conduct,

were often referred to “nerve doctors”

who’d use isolating and unfounded rest cures

to treat any emotional and psychological distress.

When writing her semi-autobiographical short story, “The Yellow Wallpaper,”

Charlotte Perkins Gilman drew from the distressing treatment she underwent

for her so-called hysterical tendencies.

The narrator, suffering from what would now likely be diagnosed

as postpartum depression,

describes being confined alone in an attic

and being denied any intellectual activity,

including reading or writing.

Around this same time, Sigmund Freud was rising to fame.

He believed hysteria, like other nervous conditions,

was caused by repressed emotional trauma.

His treatment required drawing these memories out of the unconscious

so they could be acknowledged and addressed.

Freud also dismissed the idea that hysteria was unique to women.

Belief in “male hysteria” became prominent during and after the First World War,

but was framed as the more masculine-sounding “shell shock.”

Over the 20th century,

the term hysteria was slowly replaced by specific, less gendered diagnoses,

including anxiety, depression, PTSD, and epilepsy.

And hysteria was officially removed

from the “Diagnostic and Statistical Manual of Mental Disorders” in 1980.

Today, most scholars argue that the blanket disease hysteria

was always a figment of doctors’ imaginations.

As outright medical sexism declined, so did its diagnosis.

Nevertheless, its legacy reflects Western medicine’s

long, storied, and ongoing history

of misattributing and trivializing women’s pain.