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Do read Christopher Bollas's recent book, Hysteria. It provides an experience of immersion in the now often neglected conceptualization of the neurotic constellation, hysteria. Best in his direct clinical descriptions and psychoanalytic understandings, Bollas also offers theory to bring hysteria back to life. Taking us into the day-to-day experience of the hysteric, he reanimates understanding of the origins of this mode of being.
Bollas notes that his decision to write the book came from his clinical supervisions in the United States in the mid-1980s:
The cases being presented were clearly hysterics, but the majority of the presenters thought of them as borderline personalities … and thinking the hysteric through the theoretical lenses of the borderline personality had become something of a tragedy.
This view resonates with my experience of psychiatric hospital work in the mid 1980s when some—though I suspect many—of the patients with bizarre presenting pictures may have been hysteric neurotics. And many clinicians, not recognizing these patients' fundamental strengths, joined in seeing them as more profoundly disturbed. This misdiagnosis took the form of supposed multiple personality disorders and all variety of eating disorders. I wish we had this book then.
Bollas bases his study on the premise that “the core issue of hysteria is both genders' sense that the mother has withdrawn her love of the self's genitalia” (p. 57). Starting with Freud's view that the hysteric suffers from a “scene of seduction,” Bollas writes that it is “… the disruptive arrival of sexuality-in-itself” (p. 15) and the loss of the image of the solely comforting mother that leads to this sense of the mother's withdrawal. He focuses on the mother's contribution in this dyad. Anticipating critiques that his focus will seem one-person in nature, he acknowledges how: