Showalter on Hysterical Diseases

Review of Elaine Showalter, Hystories: Hysterical Epidemics and Modern Media. New York: Columbia University Press, 1997. ISBN 0231104596 (pb.), x, 244 pp., $11.96.

Elaine Showalter, a Professor of Humanities and English at Princeton, describes herself as a literary critic, a historian of medicine, and a feminist. In her previous book, The Female Malady (1986), she argued that “epidemic hysteria” is an extreme and self-destructive form of feminine protest, a body language expression of women’s rebellion against patriarchal oppression.

Her present book, published in 1997, looks at certain current phenomena in a historical context using a psychoanalytic approach. Showalter’s position is that hysteria and hysterical epidemics are cultural symptoms of anxiety and distress. She sees hysteria as something that has been with us for a long time, continues today, and will be with us in the future, as long as there are group fantasies and fears. Her central thesis is that hysterical epidemics involve the coming together of three factors: vulnerable people who can become patients; doctors and theorists who define the syndrome; and a supportive cultural environment. She believes that hysteria, while primarily psychogenic, is quite real and universal. Her attitude toward those suffering from the symptoms of hysteria is consistently respectful and empathic throughout the book.

The book has three sections: “Histories,” reviews the history of the concept of hysteria from the 17th century until the present; “Cultures” examines the presentation of hysteria in literature, theater, and film; while the third section, “Epidemics,” gets down to cases. The last is the longest section of the book and the most controversial. Showalter has a chapter each on six phenomena which she labels as hysterical epidemics: chronic fatigue syndrome, Gulf War Syndrome, recovered memory, multiple personality disorder, satanic ritual abuse, and alien abduction.

Showalter, by publishing this book, has become acutely aware of how controversial her stance is. She expresses surprise at the depth of the

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hostility it has generated. As she says in her preface, “I didn’t foresee that my editors at Columbia University Press would be called ‘cunt sucking maggots’ to let this one slither through.” Or that she would receive quantities of hate mail which would “advise me to get a bodyguard, threaten to rip me apart, or warn me of assassination unless I recanted.” However, even before the book was published, she was well aware that she was dealing with provocative material. She says:

I expect that defining recovered memory, chronic fatigue, and Gulf War Syndrome as contemporary hysterias, and analyzing them on a continuum with alien abduction stories and conspiracy theories will infuriate thousands of people who believe they are suffering from unidentified organic disorders or the aftereffects of trauma.

One of the most valuable contributions that Showalter makes in this book is her emphasis on historical context. She points out that hysterical epidemics seem to reach peaks as the turn of a century approaches. The Salem witch trials happened in the 1690s; the 1790s saw a flurry of interest in “mesmerism”; and interest in “classical” hysteria, stimulated by the work of Janet, Charcot, Bernheim, and the early Freud, peaked in the 1890s. The six examples of the current phenomena she calls hysterical epidemics seem to be reaching their peaks with the approach of the millennium.

Showalter also examines some of the historical evolutions “hysterias” have gone through. She reminds us of the history of what we now call post-traumatic stress disorder (PTSD): from the mid-19th-century “railway spine” (the cluster of PTSD symptoms observed in survivors and witnesses to railway accidents), to “shell shock” in World War I, “battle fatigue” in World War II, and finally PTSD following the Vietnam war. She suggests that Gulf War Syndrome is the latest manifestation along this historical continuum.

Similarly, she points out the virtual identity between the symptom cluster which was labeled “neurasthenia,” a very widespread diagnosis in the late 19th and early 20th centuries which has totally disappeared today, and the contemporary symptom cluster labeled “chronic fatigue syndrome” or “fibromyalgia.”

Showalter sees all of these “hysterias,” past and present, as being some of the many ways that humans react to the conditions and circumstances of their lives which they find difficult. She is careful to reiterate that she does not believe that “hysterics,” people who are suffering with a variety of symptoms, painful feelings, and disturbing “memories,” are liars, weaklings, or “neurotics,” or that the physicians, therapists, and others who believe in the literal truth of their stories are villains trying to profit or deceive. Rather, the patients are individuals who have found one of many ways to express their pain and unhappiness, and to protest. They have experienced and suffered from trauma of various sorts, but they may not be correct in their attribution of its sources.

Showalter is interested in the specific form hysterical expression takes with regard to gender differences. She points out that 80% of those diagnosed with chronic fatigue syndrome are women, as are more than 90% of those reporting recovered memories of childhood sexual abuse and those diagnosed with multiple personality disorder. Accusations of Satanic ritual abuse also come overwhelmingly from women. Among those claiming alien abduction there are three times as many women as men. Her explanation is that:

The conflicts women try to resolve with hystories are … complex. Recovered memories of sexual abuse are unreliable, but child abuse, rape, and violence against women is an everyday reality that affects every woman’s sense of security and autonomy. Women have traditionally used

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hysterical disorders to compensate for the absence of adventure and challenge in their lives and to deal with real sorrows, dissatisfactions, and disappointments.

She answers the question, in regard to memories of sexual abuse, Why would anyone choose to take on the pain and turmoil of being a survivor if it were not true?, by suggesting the operation of “a combination of suggestibility and social coercion” along with “the availability of these explanations for a variety of anxieties and discontents in women’s lives.”

Men are the primary sufferers of Gulf War Syndrome and the PTSD diagnoses related to the trauma of warfare. They have to deal with the additional burden that developing a psychological illness in response to the trauma of war is regarded as unmanly. It is far more acceptable to be suffering from a physical illness caused by germs, poisons, or damage to the nervous system.

While Showalter does not identify herself as a psychohistorian, both her methods and conclusions are psychohistorical:

Modern forms of individual and mass hysteria have much to tell us about the anxieties and fantasies of Western culture, especially in the United States and Europe. We can use our knowledge of the past to interpret what is happening today…. And we can lead the way in making distinctions between metaphors and realities, between therapeutic narratives and destructive hystories. If hysteria is a protolanguage rather than a disease, we must pay attention to what it is telling us.

She is quite forceful about the dangers of mistaking metaphor for reality:

Whether the details of these narratives are demonstrably true may not be as important as their imaginative and spiritual resonance for the individual. But extending private psychoanalytic or artistic testimonies to the media and the courts is risky. We must exercise caution as a society when hystories take on that political, judicial form, when they stop being therapeutic and cross the line into accusation and prosecution…. …the hysterical epidemics of the 1990s have already gone on too long, and they continue to do damage: in distracting us from the real problems and crises of modern society, in undermining a respect for evidence and truth, and in helping support an atmosphere of conspiracy and suspicion.

Her concluding chapter is entitled “The Crucible,” a reference to Arthur Miller’s play about the Salem witch trials. I would like to conclude this review with the author’s closing exhortation, with which I am in agreement:

Men and women, therapists and patients, will need courage to face the hidden fantasies, myths, and anxieties that make up the current hysterical crucible; we must look into our own psyches rather than to invisible enemies, devils, and alien invaders for the answers.

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