Where has All the Hysteria Gone?*

Although hysteria in its various forms accounts today for only a small percentage of the reported mental illnesses among women, it is not clear why, because “hysteria” has been a label used for a potpourri of female ailments and nonailments alike since antiquity.a In reading about the history of hysteria, one is struck by the fact that it has been a common syndrome for so long. The Greeks and Romans called almost all female complaints hysteria and believed the cause of all these female maladies to be a wandering uterus. In the Middle Ages women exhibiting the symptoms that would have earlier been called hysteria were viewed as witches possessed by the devil. In eighteenth- and nineteenth-century Europe behavior that would have been labeled hysteria in ancient times and “witchcraft” in medieval society was once again viewed as hysteria; however, sexual lasciviousness was seen as the cause. At the turn of the century, Freud wrote his famous case studies in which he attributed hysterical manifestations to unconscious processes and conflicts and also changed the concept of hysteria by distinguishing between conversion (similar to the ancient syndrome called hysteria) and anxiety hysteria (phobias).

Despite the fact that hysteria has historically been a common malady, it is not a common diagnosis today. For example, in a British survey of general practitioners covering a million patients, the diagnosis of hysteria was made in only 5.5 percent of the cases referred to psychiatrists.39 And in the United States hysteriab is not ranked as one of three most frequently made diagnoses of males or females admitted to psychiatric facilities.31 One explanation of this is that the diagnosis