Ep 10. History of Hysteria
From the uterus, to witchcraft, hypnotism and more, we go through the history of what unexplainable symptoms have been blamed on and how they've been explained through history all the way up to more modern day classifications like Briquette's syndrome, somatoform, conversion, or functional disorders. We tease apart risk factors and other patterns that have been identified to lead to symptoms commonly labelled as ‘hysteria’, and the resulting biases that have carried through into modern medicine towards patients with these types of presentations. This episode is a somewhat lighter, funny change of pace from the pain education heavy start and continues to dive into why hard to treat patients with difficult to explain symptoms have struggled to be taken seriously - since the beginning of time.
Introduction
In this episode of "It's Not In Your Head," hosts Dr. Dan Bates and Justine Feitelson (Dan and Juz) delve into the fascinating and controversial ‘history of hysteria’ in how patients with weird, unexplainable symptoms are perceived in the medical world. They explore how this concept has evolved over time and its impact on modern medicine, particularly in the context of chronic pain and women's health.
Historical Context
Ancient Origins
The concept of hysteria dates back to ancient Egypt and Greece. Hippocrates, the father of modern medicine, believed that the uterus could wander around the body, causing various symptoms. This idea persisted for centuries, shaping medical understanding and treatment of women's health issues.
Middle Ages to Renaissance
During this period, hysteria became increasingly associated with witchcraft and demonic possession. Women exhibiting symptoms of what we now recognize as various medical conditions were often subjected to exorcisms or worse punishments.
Victorian Era
The 19th century saw a surge in diagnoses of hysteria, particularly among upper-class women. Treatments ranged from the infamous "pelvic massage" to more extreme measures like hysterectomies.
Modern Understanding
Freud's Influence
Sigmund Freud played a significant role in reshaping the concept of hysteria. He proposed that hysteria was a result of repressed trauma or sexual desires, shifting the focus from physical to psychological causes.
Debunking Myths
The hosts emphasize how modern medicine has debunked many of the myths surrounding hysteria. They discuss the importance of recognizing that symptoms once attributed to hysteria are often manifestations of real, physical conditions.
Impact on Chronic Pain Treatment
Gender Bias in Medicine
Dan and Juz highlight how the historical concept of hysteria has contributed to gender bias in medicine. Women with chronic pain conditions are more likely to have their symptoms dismissed or attributed to psychological causes.
Psychosomatic Misconceptions
The podcast addresses the persistent misconception that chronic pain conditions are purely psychosomatic. They stress the importance of understanding the complex interplay between physical and psychological factors in pain experiences.
Moving Forward
Education and Awareness
The hosts emphasize the need for better education among healthcare professionals about the history of hysteria and its lingering effects on medical practice.
Patient Empowerment
Dan and Juz encourage listeners to advocate for themselves and seek healthcare providers who take their symptoms seriously, regardless of gender or preconceived notions.
Conclusion
The episode concludes by reinforcing the importance of understanding medical history to improve current practices. By recognizing the flaws in past approaches, we can work towards more equitable and effective healthcare for all individuals experiencing chronic pain
References:
[1] C. Tasca, M. Rapetti, M. G. Carta, and B. Fadda, “Women and hysteria in the history of mental health,” Clin. Pract. Epidemiol. Ment. Health, vol. 8, pp. 110–119, Oct. 2012.
[2] “A treatise on hysteria,” Med. Chir. Rev., vol. 13, no. 25, pp. 30–39, Jul. 1830.
[3] H. Kramer, Malleus Maleficarum - The Hammer of Witches. DigiCat, 2022.
[4] R. A. Kallivayalil and V. P. Punnoose, “Understanding and managing somatoform disorders: Making sense of non-sense,” Indian J. Psychiatry, vol. 52, no. Suppl 1, pp. S240-5, Jan. 2010.
[5] J. Katz, B. N. Rosenbloom, and S. Fashler, “Chronic Pain, Psychopathology, and DSM-5 Somatic Symptom Disorder,” Can. J. Psychiatry, vol. 60, no. 4, pp. 160–167, Apr. 2015.
[6] P. Wall, “Pain: The science of suffering,” Jun. 1999.
[7] S. A. Nordhoff, “KINETIC THERAPEUTICS IN GYNECOLOGY OR THURE BRANDT’S SYSTEM,” JAMA, vol. XXIV, no. 11, pp. 389-393., 1895.
[8] The Editors of Encyclopedia Britannica, “Oedipus complex,” Mar. 2024.
[9] B. Pelz and Herkimer Community College, “Introduction to Somatoform Disorders,” in Abnormal Psychology, Open SUNY Textbooks, 2017.
[10] World Health Organization., “International statistical classification of diseases and related health problems,” no. 11th, 2019.