There are few terms that have been misconstrued and reinterpreted more frequently and sparked more debate than that of hysteria. The term, already used by the famous ancient doctors Hippocrates and Galen, has a completely different meaning today and is better researched than two and a half thousand years ago. But there is still much work to be done by scientists and psychologists.
What is hysteria?
Histrionic personalities tend to exaggerate and often stage themselves to arouse sympathy or to put themselves in the foreground.
According to abbreviationfinder, hysteria derives from the ancient Greek word for uterus, “hystera”, and nowadays describes a conspicuous, extremely extroverted behavior that is triggered by a mental disorder.
With the conversion disorders and the dissociative disorders, two groups of symptoms are distinguished today. The former are traumatic experiences that the mind cannot process and are therefore “converted” into physical complaints. The dissociative disorders have the same trigger, but are expressed in disorders of consciousness.
In ancient times – and also for a long time afterwards – the cause of the disease was not suspected to be in the brain but in the uterus and was therefore exclusively attributed to women. Famous physicians like Hippocrates, for example, assumed that the symptoms were triggered by the migration of the uterus to other organs. Therefore, as a treatment for hysteria, they prescribed sexual intercourse and pregnancy to re-place the uterus properly.
Even if the causes of hysteria have not yet been fully clarified, it is now assumed that it developed in early childhood, around between the 4th and 6th year of life.
During this time, the researchers see an enormously important step in the development of the child, both physically and mentally. At this point, the child has already acquired many motor and mental abilities, but faces the problem of beginning integration into the adult world.
If there is a lack of strong role models in this phase who would make this new and still unknown world seem interesting to her – for example if a parent or another important person is missing – this can lead to the development of hysteria.
Symptoms, Ailments & Signs
A sign of hysteria, as defined by histrionic personality disorder, is a strong desire for attention. This need is met through various means. According to Alarcon (1973), seven central features of hysteria can be distinguished.
One of them is theatrical behavior. Histrionic personalities tend to exaggerate and often stage themselves to arouse sympathy or to put themselves in the foreground.
Another symptom of hysteria is emotional lability. Histrionic personalities often experience drastic mood swings, with the individual feelings usually being very pronounced. This can make them seem moody and unpredictable. The feelings shown do not always match the situation, but they can also be socially inappropriate.
Another sign of hysteria is that people voluntarily make themselves dependent on one or more other people. However, they do not completely subordinate themselves. This often creates a paradoxical situation in which the histrionic personality wants to make self-determined decisions on the one hand and is looking for someone to take care of them like a child on the other.
Overreactions, egocentrism and suggestibility are other symptoms typical of hysteria. The influence can not only emanate from others, but also from the histrionic personality itself. In addition, many histrionic personalities behave in a sexually seductive manner in order to also evoke attention and admiration in this way.
Diagnosis & History
The biggest problem in diagnosing hysteria is classifying the symptoms, whether psychological or physical, as a result of it. If, for example, visual disturbances or symptoms of paralysis occur, the causes are usually first sought in other areas.
The situation is similar with disturbances of consciousness, which can also occur as a result of many other diseases of the central nervous system. Misdiagnoses are therefore quite common and also difficult to avoid. A diagnosis can actually only be reliably made by an experienced therapist who is familiar with the field of hysteria.
Psychiatry understands the actually obsolete concept of hysteria as a neurotic disorder. This is accompanied by unstable and superficial affects, a need for recognition, manipulative behavior and a pronounced need for recognition. Today, people tend to talk more about conversion disorder or histrionic personality disorder.
This explains why there can be complications associated with these behaviors, especially with the environment. Those affected demand excessive attention, are subject to unpredictable mood swings and push themselves to the fore. People generally find this annoying and keep their distance.
This is especially true when they see through the manipulation techniques hidden behind them. However, people with histrionic personality disorder in particular cannot understand this reaction and reinforce the strategies they learned early on, resulting in a vicious cycle. Because of this, patients prone to hysteria are either often excluded or sometimes find fellow human beings who exhibit codependency.
However, this is also unfavorable for the therapeutic process. Stable, healthy relationships are very difficult for those affected to build. Since these are behavioral patterns whose roots go back to childhood, they are difficult to influence therapeutically. They are deeply anchored in the personality of those affected. The therapeutic process is lengthy and tough. Even experienced therapists have to be careful not to let themselves be taken in.
When should you go to the doctor?
A diagnosis with the term hysteria no longer exists today, as it is an old term. Nevertheless, a doctor should be consulted as soon as the symptoms associated with the expression appear. Behavior that is perceived as abnormal in direct comparison to other people should be professionally assessed by a doctor.
A particularly aggressive appearance or self-endangering behavior are reasons for a doctor’s visit. States of experience in which the affected person overreacts emotionally, can no longer fulfill their everyday duties and can no longer achieve their usual level of performance are worrying. Apathy, sexual abnormalities, or memory loss need to be evaluated and treated.
False memories or memory gaps are uncommon and can also indicate organic problems. Therefore, medical examinations must be initiated as soon as possible in these cases. If sensory disorders or changes in personality occur, a doctor should be consulted. A strong experience of fear, the loss of contact with reality or very selfish behavior are indications of existing disorders.
A doctor’s visit is necessary to prevent further deterioration in health. In the case of mental illness, there is often a lack of insight into the illness. This is one of the symptoms and should be taken into account accordingly. A good relationship of trust with people you relate to and with the doctor are of particular importance.
Treatment & Therapy
The treatment of hysteria is also not exactly simple and cannot be carried out according to a fixed scheme. Rather, the therapist must specifically address the subjective disorders – and their causes – of each individual patient.
In numerous sessions, it is important to find out what is causing the respective symptoms and then to look closely at which psychoanalytic approaches are most likely to bring about an improvement. Due to the often very possessive and engaging nature of hysteria, therapy in most cases proves to be very lengthy and difficult to carry out.
Due to the fact that the triggers for hysteria have not yet been fully researched, their possible prevention is not really clear.
However, based on the current state of research, a sheltered parental home and a solid social environment during early childhood could counteract psychological repression and any resulting hysteria.
Since the causes and starting point of hysteria are better known today and the ancient ideas have been largely refuted as a result, new terms such as dissociative disorder or histrionic personality disorder have become established in medicine. However, the exact reasons are still partially unclear and thus also make treatment more difficult.
You can do that yourself
Hysteria is an outdated term for a mental disorder. Since it is very imprecise, the possibilities of self-help in everyday life must be evaluated individually. In order to obtain a differentiated diagnosis, cooperation with a psychotherapist or psychologist is necessary. Methods and various individual behavioral techniques for self-help can then be determined together.
Generally speaking, the affected person shows a behavior that deviates from the norm, which he cannot adequately regulate himself. The mental illness leads to the fact that the patient is not aware of his own behavior. As a result, the self-regulatory measures are very limited. Some patients pose a risk to themselves and others. Despite education, there is no insight into the illness and one’s own occurrence cannot be controlled.
In many cases, the relatives and people in the immediate environment are strongly influenced by the mental disorder in their way of life. You are advised to educate yourself fully about the symptoms of the condition. This improves interactions and promotes mutual understanding. An emotional demarcation is facilitated and the sensitivity for a necessary intervention is learned. In many cases, the sick people cannot go about their daily lives without outside help. They depend on support and need people they can trust.