Hysteria and the “Transformation Spectrum”1

Contrary to prevailing opinion, hysteria makes people think — there are countless theories on the subject. A perfect Babel of confusion, each theory seems to speak to a different clinical entity. In trying to understand hysteria, one might be reminded of trying to know O, Bion's (1970) term for Ultimate Reality, Absolute Truth, and the Formless Infinite (Grotstein, 1981). One can make inferences about O, strive to know O, but ultimately it is ineffable. Likewise, there are scores of attempts to know hysteria, to apply knowledge and understanding; yet hysteria remains elusive.

Due to Bion's influence, thinking and knowing capacities are a primary focus in contemporary psychoanalytic theory and technique. The degree to which a patient can utilize thinking processes (in Bion's language, use alpha function and maintain K, or knowledge, links) indicates the level of distortion or clarity in his relationship to external and internal reality. Thinking, in Bion's sense of alpha function, is impossible without an ability to tolerate reality, the truth, or O. Furthermore, one's incapacity to form an honest relationship to reality perpetuates thinking difficulties and engenders resistance to thinking as thinking leads to being in O (Bion, 1965). Today's analyst, influenced by Bion, will often position herself so as to execute the alpha function missing in the patient's mind. This stance assumes that the patient will internalize the capacity for alpha function, which will facilitate his thinking and tolerance for being in reality.

Bion did not write about hysteria, although hysterics are famous for their troubles with thinking and knowing. Freud described hysteria as a “particular situation of knowing and at the same time not knowing” (Freud & Breuer, /1955, p. 165). Hysterics know (sense) psychic reality and at the same time do not know it — they do not learn from it. While the problem of strained thinking and knowing capacities is not unique to the hysterical personality, hyste