Chapter 3. History of Dissociation (2) From Hysteria to Dissociation (7)

From our current standpoint, one of the major mistakes that Charcot made was that he tried to understand hysteria primarily as a neurological disease. After he made so much success in his neurological research, with the discovery of ALS, Charcot-Marie-Tooth disease and so on, Charcot must have assumed that the same scientific methodology can be applied to hysteria as well. However, unlike ALS that has a set of neurological signs and demonstrable pathological change to the central nervous system, hysteria has very amorphous and non-specific symptoms without clear-cut neurological lesions.
In fact, hysterical symptoms have a potential of taking any form depending on the patient’s interpersonal context. If his examiner suggests that he show symptoms A, he might actually demonstrate A without conscious effort. In other words, the patient might take in whatever symptoms he is suggested to have. This is what hysterics’ suggestibility is about, but Charcot failed to take it into account as the essential feature of this illness.
Despite these problems, Charcot made a major contribution to the study of hysteria. He found that hysteria is not only seen by women but also men, by demonstrating male hysterical patients in his lecture. Charcot also found that hysteria is caused by emotional trauma in general, either sexual trauma before the adolescence or head injury caused by railroad accident or fall from the ladder. This “trauma theory” of hysteria made a big influence on Freud and Janet. However, it is also true that Charcot carried over some of the lay belief regarding hysteria, and it was also what Freud inherited as well.
One day when Freud was invited to a reception hosted by Charcot, he heard his master say regarding a woman who has serious illness, “Dans ces cas pareil, c’est toujour la chose génitale, toujours, toujours.” (“in that type of case, it is always the matter of genitals. Always, always”.) Imitating Charcot, a famous Viennese gynecologist was reported to have ascribed a woman’s anxiety attack to her husband’s impotence and stated that a prescription for her should be “Penis Normalis dosum repetatur”(”normal penis. Repeated use”).（Gay, 1998, P92.）