Panel on 'Hysteria Today'

Serge Lebovici introduced the panellists and invited them to give summaries of their papers, which had been precirculated.

The first participant, David Beres, asked several questions arising out of the subject of the panel: If what we call 'hysteria' has changed over the years, what has changed? Is it its clinical aspect, is it our understanding of its psychodynamics, or is it a combination of both?

Regarding the clinical aspect, Beres limited himself to a few remarks. In trying to define the concept of hysteria (an 'ever more amorphous entity', according to Ernst Kris), one meets a further difficulty in that the colloquial use of the term may unwittingly intrude into the writings of even psychiatrists and psychoanalysts.

According to Beres, the patients that we see today are not the same as those described by Charcot, Freud or Breuer. The most obvious clinical difference is that hysteria is today less frequently a symptom condition and more often a character or personality disorder; nor do we see 'pure' hysteria, either as a symptom or as a personality disorder. Hysterical symptoms (or, specifically, conversion symptoms) may be accompanied by phobic, obsessive or compulsive manifestations. Similarly, an apparently hysterical personality may also manifest infantile, narcissistic, paranoid or schizoid traits.

In terms of nosology, however, one must take account of other bodily manifestations, such as anxiety equivalents, organ neuroses, psychosomatic disorders, somatopsychic disorders and hypochondriasis. If we restrict the concept of conversion to changes in body functions that express specific unconscious fantasies and are revealed by psychoanalytic scrutiny, then we must accept that not all functional disturbances or organic changes are hysterical in nature.

Beres devoted the greater part of his paper to the psychodynamic aspects of hysteria. Our advances in hysteria come from the increasing development of psychoanalytic psychology along three lines: (1) the s