The Story Of Z. Freud's Acquaintance With Mrs. Hysteria And The First Psychoanalytic Fruits Of The Tandem (part 1)

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

The story of Z. Freud's acquaintance with Mrs. Hysteria and the first psychoanalytic fruits of the tandem

Psychoanalysis is born in the study of hysteria, and if

we want to understand its features and its development, we, according to his own theoretical dispositions, must refer to these genera."

V. A. Mazin

Hysteria is rightfully considered as a launching pad, a starting point for the evolution of psychoanalytic ideas, and in continuation of many studies on this topic, in a series of scientific articles on hysteria in psychoanalysis, I plan to reflect on this phenomenon of the human soul, which still contains a lot of mysterious and elusive.

Freud learned from his hysterical patients. He wanted to know and therefore he listened carefully to them. Thus, as you know, Freud honed the idea of psychotherapy, which at the end of the 19th century was distinguished by significant novelty.

Thus, this article is about what, on the one hand, no longer exists, and on the other hand, about what there is too much.

In our days, hysteria as a diagnosis has lost its former significance, becoming much less widespread than in ancient historical times or in the era of the life and work of Z. Freud. We can say that it has turned into a ghost disease, since it was even eliminated from the International Classifications of Mental Illness (the latest edition of DSM - IV - R, ICD-10).

The purpose of this article is to find an answer to the question of the relevance of psychoanalysis today to fundamental works on disappearing hysteria, their significance for the formation of psychoanalysis as a theory, as a method of psychotherapy and as a research method.

Hysteria, whose existence can be traced back to ancient times, is said to be in a state of extinction. It seems that hysteria has already passed the peak of its socio-historically determined development, which fell on the time of Charcot and from which Freud was able to benefit. Some colleagues today are of the opinion that hysteria is more of a relic, but is this true?

Let's try to determine the significance of discoveries in the field of psychoanalysis in the course of working with hysteria, highlight the main ones, and analyze the problems of the relevance and existence of hysteria today.

In the course of researching the topic, in addition to the classical basic psychoanalytic works of Z. Freud, O. Fenichel, N. McWilliams, Klein M., texts of other authors and contemporaries such as V. Rudnev, V. Ya. Semke, D. Shapiro, Green A., Arru-Revidi J., Olshansky D. A., Kratchmer E., Zabylina N. A., Shapira L., Jaspers K., Y. Kristeva, M. Foucault, F. Guattari and others.

Thanks to the study of hysteria, psychoanalysis appeared, at the same time where did it disappear today? Does it mean that psychoanalysis itself, as a basic foundation, is shaken today? What transformations can we observe in the reading of hysteria today? What should be the clinical description and understanding of the hysterical warehouse?

Of course, now hysteria has changed significantly, but has it disappeared from the psychoanalytic field? The discoveries made in the study of hysterics work to this day and do not find significant refutations.

Today, they try to correlate hysteria in its transformed form with obsessive neuroses, narcissistic manifestations, psychosomatics, refer to preoedipal early relationships with the mother, pregenital fixations (oral, anal-sadistic), borderline disorders and even psychosis.

Remaining a ground for discussion and controversy, Mrs. hysteria irrefutably continues to exist both in the time of Freud and to this day.

Diagnosis "hysteria"

Since the time of Ancient Egypt (the first description is found in the Kahun Medical Papyrus of 1950 BC), many women's diseases have been considered diseases of the uterus, although there is still no mention of behavioral or emotional disorders (except that it mentions “the treatment of a woman who likes to be in bed … "Diagnosed with uterine spasms").

The diagnosis "hysteria" (from ancient Greek. Ὑστέρα (hystera) - "womb") first appears in Ancient Greece and is described by Hippocrates. His contemporary Plato describes the "fury" into which a woman's uterus falls, unable to conceive. Based on these ideas about the nature of hysteria, assumptions about the possibility of hysteria in men were not allowed for a long time. The diagnosis "hysteria" was extremely popular in medicine in the late 19th and early 20th centuries. On the basis of hysteria, J. M. Charcot and S. Freud made a number of important discoveries in the treatment of mental disorders. Today this diagnosis is outdated and is not officially used either in ICD-10, according to which this “term is undesirable to use in view of its ambiguity,” or in DSM-IV. The diagnosis of "hysteria" (300.11 Hysterical neurosis) has broken down into numerous more specific diagnoses, such as:

F44. Dissociative Disorders

F45.0 Somatisation disorder

F45.1 undifferentiated somatoform disorder

F45.3 Somatoform autonomic dysfunction

F45.4 Chronic somatoform pain disorder

F45.23 Adaptive reaction with predominance of disturbance of other emotions

Meeting point: at Charcot's

Skipping discussions of the four thousand year history of the concepts of hysteria, starting with the Kahun papyrus (1900 BC), which describes the uterus as the site of the localization of the disease, to the International Psychoanalytic Congress of 1973, which put on the agenda the question of how this problem in the era of Charcot, I propose to move closer to the days of Freud's acquaintance with hysteria. [25]

At the end of the 19th century, the standard methods of treatment for what was then called "nervous diseases" were massage, "electrotherapy" and, which became the parable of the voyazyse, treatment on the waters. Disappointed with the effectiveness of the methods of treatment generally accepted at that time, ignoring the sidelong glances of his colleagues, the young doctor Sigmund Freud in 1886. went to Paris to study a new method of treatment - hypnosis.

A six-month course at the Salpetriere hospital in Paris with the famous French psychiatrist Jean Charcot had a huge impact on Freud. Charcot's main discovery was that in a hypnotic state in patients suffering from hysteria, symptoms disappeared, and also that hysterical symptoms through hypnosis could be induced in healthy people.

Although it was Charcot in 1895 who gave Freud a significant impetus to begin the study of hysteria and sexuality, the meeting with Breuer was still decisive for Freud, for it led to the first scientific discussions even before the publication of Essays on Hysteria.

Hysteria as Freud's Muse. The first joint works

"If the creation of psychoanalysis is merit, it is not my merit. I did not take part in the first endeavors. When another Viennese physician, Dr. Joseph Breuer first applied this method to a hysterical girl (1880-1882), I was a student and held his last exams. It is this case history and its treatment that we will deal with first of all. You will find it in detail in the "Studien über Hysterie", subsequently published by Breuer with me. " Z. Freud.

It is known that it was by listening to hysterics that Freud discovered a completely new mode of human relations. Psychoanalysis was born of an encounter with hysteria, so where did the hysteria of that time disappear? Anna O, Emmy von N. - do the lives of these amazing women already belong to another world?

To a certain extent, the book "Studies of Hysteria" (1895) can be considered the first psychoanalytic work. Prior to that, the designer of psychoanalysis, Dr. Sigmund Freud, wrote works on histology and physiology, neuropathology and psychopathology, aphasia and cocaine."Research on hysteria" - an analysis of the etiology, course and therapy of mental disorders. At the same time, Investigations into Hysteria is a dizzying account of the birth of psychoanalysis. Not the deliberate report described by Sigmund Freud, but the report that we become aware of many decades later, we interpret it in hindsight. The careful reader will not escape the details of the genera of psychoanalysis.

The development of Freud's theory of hysteria spans the period between 1893 and 1917 and can be considered in stages.

"Research on hysteria" ("Essays on hysteria"), "On the etiology of hysteria" (1893 - 1896) - the result of the joint work of Breuer and Freud. However, the actual Freudian theory of hysteria begins to emerge only with a consideration of defensive neuropsychoses (1894 - 1986, letter to Wilhelm Fliess). There is a mutual definition of hysteria, phobias and obsessive-compulsive disorder. Together they formed a field that was to become a field for the application of psychoanalysis. During this period, the traumatic theory is presented. The role of trauma is due to its consequences: the splitting of a specially formed mental nucleus. In this context, we must recall the two-phase structure of trauma (childhood and adolescence), and the second phase is the phase in which the event is remembered, awareness occurs in the aftereffect. “The hysteric suffers from memories,” and the significance of these memories is determined by the fact that the conflicts of the past are fulfilled in a body changed by puberty. From the “presexual” traumatic period, the individual moved to the sphere of the sexual. Ultimately, protective neuropsychoses from a clinical point of view confirm the existence of an unconscious organization in conflict with the self. The function of the hysterical symptom is that the conversion weakens the unconscious idea. The emphasis is on the mandatory withdrawal and transfer of mental conflict, which is now resolved at a different level. Nevertheless, desire gratification is also achieved in the bodily sphere, since the conversion is about symbolic somatization. Somatic receptivity is the means by which desire is gratified. Along the way, it should be noted here that phobia is a mental manifestation of the neurosis of fear, that is, the result of the action of a mechanism that counteracts conversion, since fear, which manifests itself (in somatic form) in the neurosis of fear, namely in the exchange between the conscious and the unconscious, is transformed and linked by the mental representative, and this happens from different points of view: economic, dynamic and topical-functional.

"A fragment of the analysis of one case of hysteria." (Dora's case) 1901 Here the relationship between dreaming and hysteria is characterized. In addition to conversion, the definition of which has already been given, Freud describes the role of the transformation of affect, in which antipathy takes the place of desire and amnesia, which makes the hysterical so incomprehensible. But above all, during this period, important facts are described:

1. transfer;
2. the meaning of hysterical symptoms, as a result of conversion, the hysterical symptom creates a defect through which it is metaphorically expressed;
3. thinking is shackled by forms of imagination, fantasies, in which various identifications are manifested, here we are talking about the pure form of fantasies that have manifested, and therefore about the tendency not to remember, but to act out;
4. the oedipus complex, which, in terms of the role of identification, is characterized by bisexuality and its consequences, hysteria is the sphere of the predominance of eros, transference, oedipal feelings of love in their bisexual form;

After the publication of Dora's case, numerous works appeared, the purpose of which was to investigate the reasons for Freud's failure, as well as the real value of his theory. Some explain this failure by an insufficient analysis of homosexuality, that is, a point that Freud himself later recognized, there are still other versions and the controversy on this topic does not subside.

"Fantasies and Hysterical Attacks" (1908-1909)

In the years 1908-1909, Freud produced two of the most important and, no doubt, completed works on hysteria. The article "Hysterical Fantasies and Their Relationship to Bisexuality" (1908) establishes a connection between dreams, lucid and unconscious fantasies, masturbation and hysterical symptoms. The notion of an unbearable representation of the trauma underlying the symptom is complemented by the notion of a thickening of multiple fantasies. As a result of the "associative return" the symptom becomes their ersatz.

The work "General View of the Hysterical Attack" (1909) completes the preceding observations. With regard to hysterical attacks, it is now solely about projected and activated fantasies, in which the action (in the dramatic sense) is played out like a pantomime. But in this way - as in the dream - various distortions occur on the path from fantasy to symptom. And just like in dreams, analysis sheds light on their causes and significance. The analysis, however, proves: the predominance of condensation mechanisms, the interaction of various kinds of identifications, the presence of opposite sexual sensations and homosexuality in the process of what is happening. The etiology and function of fantasies is to provide a substitute for repressed infantile sexual gratification. In reality, there is an alternation: repression / failure follows repression / return of the repressed.

In Works on Metapsychology (1915-1916), Freud turns to the topic of conversion hysteria for the last time. Freud's attention is drawn to the fate of affective impulses, the repression of which must be explained by “belle indifference”. The drive representative leaves consciousness, taking the form of conversion. This is the result of thickening, leading to the formation of ersatz. Thanks to him, the affective is neutralized. True, such an achievement is of a transitory nature, so that the individual is forced to create new symptoms.

"Inhibition, symptom and fear" (1926) - in this work, there is practically no talk of hysteria - here the phobia is analyzed in detail and, first of all, Freud pays attention to the problem of inhibition. And although this work is not explicitly related to hysteria, to the extent that inhibition is for Freud a consequence of excessive eroticization of a nonsexual or desexualized function, one can perhaps assume that inhibition precedes conversion. Moreover, many authors already in the post-Freudian period consider inhibition (especially when it concerns sexuality) as one of the modalities of at least some forms of hysteria. Once the inhibition has arisen, it damages the I.

We have seen that Freud dealt almost exclusively with the genital problems of hysteria. Conversely, little attention was paid to so-called pregenital fixations. Anality and orality are mentioned only in connection with their topical regression function. In the same way, the ego only becomes the subject of careful scrutiny only to a small extent. The very same conversion hysteria is regarded by Freud as a success, since in this case - in contrast to a phobia or obsession (see P. Kutter's article) - the economy of displeasure is almost all-encompassing.

Freud, in his work On Female Sexuality (1931), discovered the pregenital roots of hysteria. The predominance of female hysteria and the prevalence of oral fixations can, perhaps, be explained by the peculiarities of the girl's attitude to her primary object (mother's breast), due to which libidinal, sexual, aggressive and narcissistic fixations arise, the importance of which increases even more due to the mirror girl-mother relationship. … Conversely, the mother's catheting of the boy has different implications. In addition, the role that culture plays in shaping female sexuality and thus in hysterogenesis has enriched the controversial issue.

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