The Etiology of Hysteria in Mitchell’s Mad Men and Medusas
In her book Mad Men and Medusas (2000), Mitchell starts with an exploration of male hysteria and ends with the discovery of the importance of siblings, and the subsequent need for a lateral “sibling” axis, to complement Freud’s vertical “parent–child” axis. The aim of this chapter is to outline the complex arc of this theoretical development, starting with Freud’s original theory.
Freud’s science of psychoanalysis owes its origin to the experiences of attempting to categorize and treat the malady called hysteria. Hysteria, in the nineteenth century, comprised a wide range of psychological and physical symptoms, and of personality traits. These included anesthesia and motor control (i.e., movement) problems, abulias (inhibitions of will), amnesia, and characterological disturbances such as craving, flirtatiousness, compulsive lying, shallowness, jealously, and overemotionality. Hysteria could present with a range of physical symptoms such a pseudo-fits, death-like trances, neurologically unexplained paralyses, contractures, and “tics.” It was noted to mimic a range of organic diseases, but also had theatrical qualities, in which the hysterical person could display a range of bizarre postures or movements. Dissociative states and “la belle indifference” (i.e., a lack of concern about manifest physical symptoms) were psychological symptoms assigned to hysteria, as were anxiety, depression, hallucinations, breathing difficulties and choking sensations, and loss of the ability to speak. The wide range of symptoms present in hysteria made it difficult to describe or categorize, but, by Freud’s time it was accepted that these symptoms were of psychological, not physical (i.e., organic), origin.
Unlike “obsessional neurosis,” hysteria did not come into existence as a Freudian category. Hysteria itself, as a concept, has an ancient history,
which has been well described (Tasca et al. 2012). In Mad Men and Medusas
, Mitchell examines the apparent “disappearance” of hysteria in the twenty-first century, in the context of the lack of recognition of male hysteria, and argues that hysteria, affecting both men and women, is still present but has become hidden. This chapter will explore Mitchell’s development, first set out in Mad Men and Medusas
(2000), of fundamental and original Freudian ideas regarding the origins and manifestations of hysteria and indicate how these complex arguments have illuminated the need to further explore the psychic consequences of siblings, which led to Mitchell’s development of a theory of the lateral axis.
Freud developed his theories of the etiology of hysteria throughout his early writings. Charcot, by whom Freud was greatly influenced, had attributed hysteria in men to a psychological reaction to trauma (Freud 1893b, 20–22, 27–39; Mitchell 2003, 8). Freud’s initial observations regarding hysteria stressed the psychically traumatic aspect of the occurrence, which first produced a hysterical symptom (1893a, 30–1).
Freud’s initial belief was that hysterical symptoms are the result of sexual trauma, caused by enforced sexual activity, which occurs before sexual maturity. These were assaults, by adults, including fathers, against children, but also assaults by older brothers against younger sisters (Freud 1896a, 151–156; 1896b, 162–185). The role of actual sexual trauma is described clearly in his account of the “analysis” or conversation with Katharina, who complained of hysterical symptoms, which Freud traced back to an unsuccessful sexual assault on the girl by her father/uncle (Freud 199, 190–201).
In the subsequent years, Freud revised his theory and the idea of a traumatic element was to some extent replaced with the idea that “hysteria originates through the repression of an incompatible idea from a motive of defence” (Freud 1991, 370–1). To defend itself from this incompatible idea the ego deploys the defence mechanism of repression (1894, 53–55). In Freud’s account of the origin of hysterical symptoms, the ego “represses” the traumatic event into the unconscious part of the
mind, meaning that the person no longer has any conscious awareness of it. The excitation attached to the incompatible idea is transformed into a physical symptom. Freud named this process “conversion,” and with this explanation provided a mechanism whereby incompatible or repressed ideas in hysteria can find expression through the body (1894, 48–49).
Freud later adjusted his etiology of hysterical symptoms, from one which suggested an origin in childhood sexual abuse, to one in which the sexual relationship that forms the incompatible idea is a phantasized one, and thus a universal facet of human development (i.e., not limited to victims of childhood sexual abuse) (Freud 1896b, 168, footnote 1; 1917, 370).
Freud now suggests that it is a prohibited and incompatible idea or desire, not an actual traumatic event, which is repressed.1
This change marks a shift in the conceptualization of the etiological kernel at the heart of hysterical symptoms, from an actual traumatic experience to a sexual idea or desire, incompatible with the ego. The result of Freud’s revision of his ideas was that the emphasis on sexuality remained, but the possibility of actual trauma was less stressed. Importantly Mitchell’s theory returns to the idea of an originating trauma in her development of the part that siblings play in the etiology of hysteria.
According to Freud, the developmental time at which the seeds of hysteria are laid is the time of the formation and resolution of the Oedipus complex, when both boys and girls wish to take the role of sexual partner for their mother, and to conceive a baby with her. This wish is prohibited because of the incest taboo. Acceptance of this prohibition is a step in the path toward relatively healthy “normal” psychic development. Rejection of the prohibition sets the young subject on the path of neurosis. For boys and girls the permutations of the Oedipus complex differ, as does the path to its eventual resolution. For boys the Oedipus complex, which contains the desire to be a sexual partner for the mother and to conceive a child by her, is destroyed under the threat of castration, while the wish for a woman and to father a baby is deferred into adulthood. For the girl (who is in Freud’s terms, psychically speaking, already castrated) the Oedipus complex is not completely destroyed, but in the face of her mother’s rejection, on account of her castrated state, she must redirect her incestuous wishes toward her father, and then defer them into adulthood, when her desire will be fulfilled by a father substitute. She must
also accept that she is “castrated” and transform her desire for a penis into a desire for a baby, originally from her father, but again deferred until adulthood, and conceived in partnership with another man (Freud 1917, 329–338; 1924, 395–401; 1925, 402–411).
This formulation, at face value, makes it easy to see why Freudian theory can be used to suggest that hysteria would affect women more frequently than men. The girl child is lacking (a penis), and rejected (by both mother and father as a sexual partner). A failure to accept this state of affairs, and the prohibition which brings it about, and to continue to desire (unconsciously) what she cannot have, leads to classical hysterical symptoms affecting personality such as insatiable wanting, coquettishness, and dissatisfaction, which demonstrate a sense of lack, as well as movement between the feminine and masculine positions, in an attempt to be the subject of desire for the mother, or object of desire for the father. The trauma of Oedipal rejection can be reactivated by subsequent perceived rejections or prohibited ideas later in life. The failed repression of the forbidden desire or idea will manifest itself, in hysteria, in conversion symptoms that somatically express that which is desired and which is lost or forbidden. This is the template for hysterical symptoms of Oedipal origin in women.
For boys the situation plays out somewhat differently. Given the above explanation of the origins of the hysterical woman’s sense of “lack” we might ask “what lack is the hysterical man unconsciously trying to make up for?” Clearly the boy comes to experience his father as a threat and as an obstacle to having his mother. He has a small penis compared to his father (a comparative lack), but he can take his father’s place (with another woman), not now but later. The symbolic castration introduces the threat of the destruction of the boy’s phallic, narcissistic pleasure, but this is an unrealized threat, unlike the “already carried out” castration of the girl (Freud 2005, 410). However Freud also believed (and Mitchell has emphasized) that children, at and slightly preceding the time of the Oedipal crisis, do not simply want to be the sexual partner of their mother: they want to have a baby as she can (Mitchell 2003, 39; Freud 1909, 1–150). This desire to produce a baby parthenogenically, out of narcissistic plenitude, in identification with the mother, precedes the girl child’s wish for a baby as a penis substitute. And for boys and girls this second, somewhat eclipsed, desire is also prohibited as they come to understand the reality of their reproductive positions, but has separate outcomes for the girl and for the boy. This time it is the girl who is told that she cannot have a baby now, but that she can later. For the boy he must accept that fact that he cannot give birth to a baby. This is also a prohibition experienced as “lack.” Mitchell coins the phrase the “Law of
the Mother” to express this second prohibition on parthenogenic birth.2
As the “Law of the Father” prohibits the child from becoming the sexual partner of his or her mother, so the “Law of the Mother” prohibits boys from giving birth to babies. This opens the way for a theoretical explanation of male hysterical symptoms, which can include phantasies of pregnancy or of anal birth, but which does not rely on concepts of male homosexuality. That is not to say that bisexual factors do not exist in male hysteria, but it is to point out that the origin and expression of these parthenogenic symptoms of male hysteria need not be inevitably associated with them.
So far we have considered only the vertical, parent–child axis, which is central to Freud’s etiology of hysteria. As a complement to this classical Freudian etiology, Mitchell’s important contribution to theorizing hysteria is the realization that a second, lateral axis is also involved in the events that constitute the genesis of hysterical symptoms. This is the axis of relationship along which we encounter siblings, and peers. This axis is not constituted by generational difference and crucially is where reproductive potential does not operate.
If the vertical axis constitutes structural “place” in a kinship sense (i.e., son of the father, daughter of the mother), the lateral axis involves differentiation, and identity, within a series that is constituted neither in terms of generational difference, nor reproductive/sexual lack. Differentiation along this axis is a more subtle affair, and, as Mitchell has pointed out, small differences often assume tremendous importance, because of the narcissistic need to attain identity in the place of structural sameness (i.e. where generational or parental relationships do not differentiate).
For siblings, rivalries and distinctions—such as who is the tallest, who gets more pocket money, who goes to bed first—are squabbled over incessantly. For peers, the “narcissism of small differences” comes into play (Freud 1930, 114), where those nations and groups who are in fact almost indistinguishable emphasize their differences and feel mutual hostility (e.g., Germans/Austrians, Americans/Canadians, splinter groups within religious sects).
Mitchell argues that the experience of the lateral axis, and of coming to terms with siblings, marks the human psyche, scars it and possibly structures it. Whereas the effects of the lateral axis on the individual are the realm of psychoanalysts and their patients, the wider importance of Mitchell’s emphasis on this axis lies in the fact that the effects of the lateral axis are also distinguishable at a cultural level in terms of violent sexuality and sectarianism. It is this playing out of the effects of the lateral axis on a cultural and societal level that makes the concept so important beyond the field of clinical psychoanalysis.
Mitchell formulates her theory of the lateral axis in her book Mad Men and Medusas: Reclaiming the Effects of Sibling Relations on the Human Condition
, published in 2000. In the book, Mitchell sets out to examine three facets of hysteria: the nonrecognition of male hysteria, including hysterical violence; the elaboration of the death drive in hysteria; and the neglect, in classical Freudian theory, of the role played the construction of the psyche by lateral relationships (Mitchell 2000, ix, x). These three are entwined at a conceptual level. In exploring the origins of hysteria, Mitchell argues that the effect of trauma, and the threat of death/annihilation, have been neglected, and that this neglect has facilitated (and been facilitated by) the nonrecognition of male hysteria.
In returning to trauma as an originating factor in the genesis of hysteria, Mitchell argues for a position that can recognize hysteria as a universal (not simply feminine) possibility. In stressing the lateral axis, Mitchell allows space for a type of difference that is not predicated on the complementarity of two roles (male and female) in reproduction. It is the recognition by the mother, of a series of children, each in the same structural and generational position, but different in their unique identities that allows this alternative difference. Difference that is not determined by polar opposites can accommodate diversity and “transversality.” The coincidence of sameness and distinction, along a lateral axis, allows for both/and, rather than the either/or (male/female; mother/father; castrated/whole) of vertical relationships (Mitchell 2000, xi–xii).
For Mitchell, sibling relationships are the first social relationship and one characterized by love and murderous hatred (Mitchell 2000, 20). The love derives from the child’s expectation that the sibling will be a narcissistic extension of itself (Mitchell 2003, 29, 64). The other side of this coin is the realization that the sibling occupies the same place as the child, both in the family structure, and, crucially in relation to the mother. The realization, produced by the appearance of a sibling, that the baby/child is not the only person in the position of “child to the parent” is experienced as a trauma and as a possible annihilation (Mitchell 2000, 20–21). The fragile subject (baby to the mother) is annihilated because another baby has taken its place. This annihilation of the “baby-subject,” unlike the threatened annihilation of castration anxiety, is actual. The child/baby has lost its subjective identity. It is, to its immature mind, nowhere and nobody, because of the arrival of the sibling who has replaced it. The child/baby has lost its unique identity because the sibling is the same as it. Because of the premature birth of
the human infant, and its complete dependence on its parents, displacement may be fatal. The realization of a sibling’s existence can, Mitchell argues, reawaken or cause regression to the state of infantile helplessness and the anxieties that accompanied it. Loss of place, as the mother’s (only) baby threatens death, and murder becomes a possible solution for survival. On the other hand the arrival of a sibling may also be understood as a narcissistic extension of the self, and someone so like oneself, yet not oneself, can be loved, in a manner that may be on the border of narcissistic and object-love (Mitchell 2003, 36). Mitchell insists that both love and death are inherent in the sibling experience, and also in hysteria, which she argues is provoked by the “catastrophic awareness that one is not unique” (Mitchell 2000, 20).
Mitchell suggests that the love and h...