On the scientific prospects for Freud’s theory of hysteria

Hysteria (or conversion disorder) is once again attracting concerted scientific attention. This paper looks at the extent to which recent scientific research supports Freud’s theory of hysteria, which posits that repressed impulses are converted into physical or behavioral symptoms. Specifically, it looks at two prominent empirical studies, representing the most rigorous direct efforts to date to test Freud’s key ideas about hysteria, in conjunction with an important new theoretical account. The empirical studies are Nicholson et al.’s (2016. Life events and escape in conversion disorder. Psychological Medicine, 46(12), 2617–2626.) survey-based study, which examines the impact of life events on hysteric patients, and Aybek et al.’s (2014. Neural correlates of recall of life events in conversion disorder. JAMA Psychiatry, 71(1), 52–60.) brain-imaging study, which looks at the neural correlates of the recall of such life events. The theoretical account is Edwards et al.’s (2012. A Bayesian account of “hysteria”. Brain, 135(11), 3495–3512.) Bayesian account of hysteria, in which somatic symptoms are seen as the result of the entrenchment of prior expectations that appear to explain (by predicting) otherwise unexplained bodily sensations. The conclusions of the present paper are that the empirical studies offer considerable evidence in support of key aspects of Freud’s theory of hysteria, that this theory is compatible with the Bayesian account of hysteria, and that reservations about Freud’s theory expressed by the authors of the Bayesian account are allayed by the empirical studies.