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In Studies on Hysteria, Freud surprises himself, from the standpoint of his scientific training as a neurologist, at the nature of his own discourse:
‘I am myself singularly taken aback by the fact that the case histories I write can be read as novels and, if I can put it that way, lack the seal of scientific severity.
Nonetheless, he understands that this is not due to his personal preferences, but to the nature of the object with which he deals. Traditional medical treatments, such as electrotherapy, have no actual value in the study of hysteria, whereas ‘a thorough report of psychic processes such as we usually get from writers’ might enable him to arrive at an understanding of the origin of a hysteria case. Freud has replaced the psychoanalytical epistemology of listening for the medical epistemology of looking. The ‘patient’ no longer speaks as a mere informant of the site and characteristics of his pains, but relates an historical account, through which he will emerge as a subject. The objective is no more to refer symptoms and signs to an established nosography system but to discover — or construct — their meaning. He is concerned with their symbolic value which refers back to a universe of desires which have not been consciously recognized as such.