The Hysterical Self: Psychology in the Clinic

1. The Hysterical Self: Psychology in the Clinic

3. Jean-Martin Charcot (1825-1893) Clinico-Anatomic Method Inscribed to Freud, on the day Freud left the Salpêtrière

4. Charcot (profile, far left) at theatrical reading, with writers Emile Zola and Edmond de Goncourt

5. Photographic Iconography of theSalpêtrière (1876-77)

6. Charcot’s Four Stages of Grand Hysteria • Tonic rigidity: limb contractures that mimicked a typical epileptic fit. • Dramatic body movements: contortions, illogical movements; clownism. 3. Passionate Attitudes: expressions of vivid emotional states. 4. State of delirium

7. Stages of the Hysterical Attack

8. “AUGUSTINE”

9. Beginning of the Attack

10. Tonic Rigidity—Stage 1

11. Contracture of the Face Stage 1

12. Stage 2—Clownisms, Illogical Movements “Circular Arch”

13. Passionate Attitudes Stage 3 “Menace”

14. Passionate Attitudes Stage 3 “Menace”

15. Passionate Attitudes Stage 3 “Aural Hallucinations”

16. Passionate Attitudes: “Loving Supplication”

17. Passionate Attitudes “Ecstasy”

18. Passionate Attitudes: Crucifixion

19. Metalloscopy: Use of Magnets to shift areas of anaesthesia Zones of Hysterical Anesthesia

20. Artificial Contracture

21. Catalepsy produced by sound

22. Charcot and Blanche Wittman

24. A Case of Traumatic Male Hysteria

25. Hippolyte Bernheim (1840-1919) Suggestive Therapeutics (1886) head of the Nancy School

27. Pierre Janet (1859-1947) Dissociation— Traumatic event and accompanying memories split off from consciousness Imperative Suggestion— suggestion that these memories didn’t exist

28. Janet’s Somnabulisms • Monoideic—dominated by one idea, usually a transient episode. • Polyideic--complex states or ideas; called fugue states, could involve a loss of identity for extended period. • Recriprocal or Dominating Somnabulism (double personalities)—relatively permanent transition into another state; memory impaired across these states

29. Reciprocal Somnambulism Lady MacNish/Mary Reynolds

30. Alfred Binet (1857-1911) On Double Consciousness (1890) Alterations of the Personality (1896)

31. Examples of Automatic Writing with an anesthetic hand Binet (1890 and 1896)

32. Insensible Arm—hearing a Metronome Sensible arm Insensible arm while subject counted to five Sensible Arm Subject held dynamometer, connected to a recording cylinder. Binet (1896, p. 201)

33. Sigmund Freud (1856-1939) “…it still strikes me as strange that the case histories I write should read like short stories and that, one might say, they lack the serious stamp of science.” Studies on Hysteria

34. Freud’s Neuropathological Training • At the University of Vienna (Medicine.1873) • At the Institute of physiology in Vienna, headed by Ernst Brücke (1876) • In the neuro-anatomical laboratory of Theodor Meynert (1883-1886) at Vienna General Hospital

35. Freud’s 1877 publication on the function of the large Reissner cells in the spinal cord of primitive fish Petromyzon, assigned to him by Professor Ernst Brücke.

36. Freud’s unpublished manuscript for a scientific psychology of 1895

37. Berggasse 19, Vienna (May 1938)

38. Joseph Breuer (1842-1925) STUDIES ON HYSTERIA 1895 Breuer and Freud

39. Anna O./ Bertha Pappenheim (1859-1936) “TALKING CURE” or “CHIMNEY SWEEPING” “hysterics suffer mainly from reminiscences” Studies in Hysteria

40. Cathartic Method or Abreaction • An original response to a traumatic event is suppressed, and the affect or emotion is not expressed • The original affect then expresses itself in bodily symptoms, a process called hysterical conversion • Cure consists of verbally remembering and reviewing the event, and releasing the original affect.

41. Janet vs. Freud • Dissociation, Splitting vs. Repression • Mental Weakness of Patients vs. Active Forgetting • Degeneracy (Hereditary weakness) for synthesis of psyche vs. psychic conflict, competing wishes, or opposing forces. • Experimental Psychology vs. Therapeutics • Hypnosis vs. Insistence on Remembering • Inability to remember vs. Resistance to remember • Innate Incapacity vs. Dynamic conflict

42. Carl Jung (1875-1961) “Psychological Complex” Uncovered with the use of association tests with patients Collaborated with Freud 1906-1912

43. Freud’s couch– for use of“free association” technique

44. Freud and the Couch

45. Active Repression: patient was motivated to actively repress traumatic information from consciousness. Content of repressed material was often sexual. Freud’s formulated the Seduction Theory in 1895- patient underwent sexual event at developmentally early age, caused hysterical symptoms at puberty He rejected the theory in 1897.

46. Controversial 1980’s Historiography on Freud

47. Freud’s Structural Model of the Mind, 1923 • SUPER-EGO • source of repression, moral conscience • EGO: emerged from Id, but adapted to society • ID: locus of fantasies, desire, unconscious (pcpt-cs: percpetual conscious; turned toward the world)

48. Traumdeutung, or Interpretation of Dreams, 1900 Freud Dreams as Wish-fulfillment Manifest Content of Dream—its story-line, a conscious process DREAM CENSOR—lets some information out, represses, disguises other information Latent Content of Dream—dream thoughts, unconscious, often unacceptable wishes

49. Traumdeutung, Interpretation of Dreams (1900) • Condensation: dream concentrates or compresses a number of different ideas into one; a composite picture. • Displacement: transformation of dream thoughts into more acceptable thoughts in order to conceal unconscious meaning. • Representation: all material gathered into a single situation in the dream. • Symbolization: a certain set of symbols exist in unconscious, and become part of the dream (later addition to his theory).

50. International Psychoanalytic Congress, Weimar 1911