Hysteria

Dear Editor

The Spring issue of the journal (17(3)) featured reviews of two recent books on hysteria: Hysteria, by Christopher Bollas, and Mad Men and Medusas: Reclaiming Hysteria and the Effects of Sibling Relations on the Human Condition, by Juliet Mitchell. Both books argue for a wider category of contemporary phenomena that could be regarded as hysterical. Whilst each text is thought-provoking, challenging and illuminating in various respects, there is a potential scientific and professional problem inherent in a loose use of the diagnosis of hysteria.

For example, Bollas refers as follows to another recent book on the subject:

Indeed, as Elaine Showalter (1997) has argued in her brilliant book Hystories, hysteria is alive and well in the form of attention-deficit disorder, chronic-fatigue disorder, alien-abduction movements and the like. (p. 178)

Elaine Showalter is a professor of English who writes about psychiatry, film, theatre and television (according to the note in her book). As such she is not required to adhere to the same standards of scientific and professional care that apply to clinicians who see patients or who write about clinical matters. In that respect, it does not matter that her book is polemical rather than a sober examination of what is currently known about various conditions that may or may not, in any particular case, contain a hysterical element. However, for the clinician faced with an actual patient it has enormous implications if it is assumed that a presenting symptom is hysterical without consideration of a variety of other diagnostic possibilities.

Showalter refers to ‘six psychogenic syndromes of the 1990s: chronic fatigue, Gulf War syndrome, multiple personality disorder, recovered memory of sexual abuse, satanic ritual abuse, and alien abduction’ (p. 12, italics added). There is extensive literature about each of these complex and controversial subjects. Showalter lumps them all together and calls them ‘hysteria’. On what basis can