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This volume is a collection of perceptive essays which trace the development of the concept of hysterical personality, delineate its clinical features, and elaborate the psychic mechanisms underlying its manifestation. I. Veith's "Four Thousand Years of Hysteria" and L. Temoshok and C. Attkisson's scholarly epidemiological review of hysterical phenomena emphasize the significance of historical and cultural contexts as they influence the nebulous condition called "hysteria," but the other contributors, D. Allen, K. Blacker, A. Metcalf, J. Tupin, and M. Horowitz, the editor of the volume, highlight more the psychoanalytic concepts of character formation for understanding the genesis of this syndrome.
These latter authors agree that the core determinants of the difficulty are both early maternal deprivation and, later, a distorted resolution of the oedipal situation and of the emergent sexual role identification. They assert that the hysterical cognitive style or cognitive structure, as elaborated by David Shapiro, represents the hysterical personality's special mode of adapting to deprived and conflictual childhood situations. The hysterical personality's limited ability to process inner and outer events and to ascribe meaning to experience is largely responsible for the patient's various traits and behavioral manifestations. The more severe the early maternal deprivation, the more flagrant will be the disturbance in cognitive structure, the more difficult it will be to treat, and the more the patient will appear to be a "bad hysteric." Nonetheless, all types of hysterical personalities, whether "neurotic" or closer to "borderline," have in common these special features of their cognitive structure.
Horowitz's own contribution is a discussion of the changes that occurred in a young woman with a relatively "good" hysterical personality whom he psychoanalyzed over a four-year period. His presentation is thoughtful and is a valuable addition both to the understanding