Hysteria and psychosis

The relationship between endogenous-psychotic and hysterical behavior is presented in this paper on the basis of typical patients' accounts. Various patterns of behavior are revealed: chronic hysterical psychotic syndromes, acute hysterical psychotic syndromes, hysterical exalted psychotic episodes, simulated hysterical psychotic syndromes, hysterical behavior in the attempt to cope with psychosis, and pseudohysterical behavior in endogenous psychoses. The specific aspects of the doctor-patient relationship in the case of these patients are described.     

Causality-Interpretation and Obsessive versus Hysterical Functioning

Relationships were predicted between the relative salience of the theme of voluntary control (VC) and the relative predominance of obsessive versus hysterical personality traits, and between the relative salience of VC and the relative predominance of obsessive versus hysterical neurotic symptoms. A coding system for VC was applied to TAT stories written by 89 males and 96 females solicited from undergraduate populations. 20 males and 20 females who scored high on VC and 20 males and 20 females who scored low on VC were given further instruments pertaining to obsessive/hysterical personality traits and neurotic symptoms. As predicted, high VC Ss were significantly more obsessive (or less hysterical) in their personality traits than low VC Ss. Predicted relationships between VC and obsessive/hysterical neurotic symptoms were not significant.     

Konzepte der Identifizierung

The authors investigate primary, hysterical, narcissistic identification, and introjection as conceptualised by Freud, Melanie Klein’s projective identification, and Anna Freud’s identification with the aggressor and altruistic surrender. It is pointed out that hysterical identification, narcissistic identification, and introjection are unconscious processes leading into a state of primary identification, and that they can be distinguished on a clinical level as regards the emotional meaning the object has for the subject. In hysterical identification the aspects of an object with which one identifies and all its other aspects retain their emotional meaning, in narcissistic identification these other aspects also keep their emotional meaning, but in this case the aspects with which one identifies lose their emotional meaning, and in introjection all aspects of an object lose their emotional meaning. Furthermore, it is shown that hysterical or narcissistic identifications are the mechanisms underlying the identification with the aggressor, and that—along with projections—hysterical re-identification also plays a decisive role in projective identification and altruistic surrender, whereby in these latter processes the object identifies himself unconsciously with the contents projected onto him in a hysterical or narcissistic manner.     

Le clinicien face à la crise hystérique : enjeux théoricocliniques de l'épreuve du féminin

Hysterical crisis shows unexpected hallucinations and delirium happening into hysterical structure. Although subject of many psycho-analytical works, hysterical crisis is always matter of debate. That kind of crisis happens when hysterical women and their lover have fallen out. Analysing the case of madam M., we will propose a reflexion about the real raison of those love-affairs to reconsider hysteria in relation to feminity. We will propose a new conception of feminine climax in connection with hallucinations and delirium happening into hysteria. We will debate about position of psycho-clinician, precisely the transference-using face to hysterical subject in state of emergency. Finally, we will propose to think over singularity of subjective structure using the supply concept.     

The Relationship between Defense Preference and Response to Free Association

Psychoanalytic theories suggest that individuals with obsessive defenses, with hysterical defenses, and borderline psychotic individuals respond differently to free association. An experimental analogue of the psychoanalytic session was used to test these ideas. The subjects were 68 male college students, chosen on the basis of the Rorschach and MMPI. Contrary to predictions, obsessive subjects generally associated more freely and showed more involvement in the sessions than hysterical subjects. As expected, hysterical subjects were more silent and blocked and made fewer self-observations than obsessive subjects. Borderline subjects were judged to have less control over drive than the two defensive types.     

A conceptual model and case study for the psychological assessment of hysterical pseudo-seizures with the Rorschach

Conceptual models are being increasingly utilized to guide psychological assessment of complex clinical problems. In this article, I present a conceptual model to direct the assessment of personality processes involved in producing hysterical pseudo-seizures. Pathological personality processes present in hysterical reactions are outlined. Rorschach parameters that have been validated and that are therefore considered good indicators of the relevant personality processes are presented. A case study of a patient with both documented genuine and hysterical pseudo-seizures demonstrates use of the model. I offer a treatment plan that is related to the psychological structure of the patient. Use of this model may improve psychological consultation in medical settings.     

Hysteria,A Century Later: Post-Kleinian Theory and Technique

ABSTRACT

Freud developed many of his theories and technique while attempting to help hysterical patients. This article approaches hysteria not just as a syndrome consisting of a group of signs and symptoms, but primarily as an inner world configuration that fuels object relations patterns. The internal world hysterical profile informs the transference/countertransference experience and the therapeutic process. I attempt to describe some of the technical problems psychoanalysts have to deal with while working with these patients. Hysterical object relations do not necessarily manifest themselves as somatic symptoms—epileptic-like, paralysis, blindness, etc.—even in patients that show the relational hysterical patterns. These object relations modes can appear in any analysis irrespective of the primary diagnostic conceptualization.     

Hysterical personality and sexuality of the female

The investigation involved 30 hysterical women, who were interviewed and who completed four questionnaires relating to: psychosexual development; attitude towards sexuality; sexual activity; and reactivity. Dysharmonic sexual development, and low levels of activity and reactivity in their sexual life was revealed. Contrasted with other groupings of female psychiatric patients, from a sexual point of view the female hysterical personality presents a special psychological case.     

Hysterical syndromes in a population of ambulatory neuropsychiatric patients in northwest Ethiopia. Phenomenology, psychosocial and sociocultural background

Among 1240 first-time patients in the out-patient department of Gondar College of Medicas Sciences during the period September 1985-Juli 1986, there was, be European standards, an astonishingly high percentage of hysterical symptoms: 12.5% of all cases, 33.5% of all neurotic cases, with markedly "classic" symptomatology. These hysterical behavior patterns were interpreted as being, in the main, special problem solution mechanisms with secondary acquisition of illness under rapidly changing social conditions.     

The Marital System of the Hysterical Individual

The purpose of the present article is to supplement the considerable body of clinical literature that focuses on hysterical behavior from an individual perspective. Based on findings from a total sample of 16 couples, this paper accomplishes this task in a threefold manner. First, the characteristic type of individual who selects and is selected by the hysterical individual as a life partner is described. Second, the type of relationship these two individuals typically develop, which promotes and reinforces severely maladaptive behavior on the part of both is delineated. Third, a number of specific recommendations regarding psychotherapy for this type of relationship are proffered.     

Die Hysterie im neuen Gewand und im Wandel der Zeit

Classical symptoms of hysteria – especially symptoms of hysterical neurosis (conversion type) – are not commonly seen any more. On the one hand, general knowledge about the function of hysterical has led to suppression of the underlying hidden conflicts, possibly up to resomatization. On the other hand, those affected may have rather subtle symptoms, e.g., vague pain, circulatory disorders, or fatigue. Overall, the hysterical phenomena have not become less common but have become “contemporary” and, therefore, more difficult to identify. Reliable epidemiological data, however, are difficult to obtain. Rough estimates indicate that 2–6?% of all people have dissociative disorders (ICD-10 definition). Histrionic personality disorder is estimated to occur with a frequency of 2–3?%. In 75?% of cases, the disease manifests relatively early, between the ages of 17 and 32 years and with a 3:1 female to male ratio. An average of 7 years elapses between first manifestation and the start of psychiatric–psychotherapeutic treatment.     

Field independence, lateralization and defensive style

This study investigated the relationship between field independence and defense clustering as measured by the Defense Mechanisms Inventory and lateral eye movements. Subjects had previously been classified either as hysterical or obsessive style by the Rorschach and WAIS Comprehension subtest. Previous findings indicate that these subjects have a preferred direction of lateral eye movement in a questioning format (hysterical style = left; obsessive style = right). This study found no relationship between field independence and defense clustering and lateral eye movements. To the extent that eye gaze indexes hemispheric activation, we conclude that neither field independence nor defense clustering was related to hemispheric lateralization.     

FORMS AND THEIR STRUCTURIZING POWER IN PSYCHOSIS

The author has developed a dynamic approach to psychosis, based on the dialectics of forms. In the case of a borderline patient, it was possible to integrate an hysterical hallucination with the aid of the structurizing power of the mirror.     

Hysteria and Self Psychology

ABSTRACT

The article uses a self psychological lens to explore the notion of hysterical personality from our earliest understanding of it as the root of all psychogenic disorders, as discovered by Breuer and Freud, to its present elimination in the DSM-V. Can hysteria still be considered an applicable diagnosis or character style in the modern time? Or is it a culturally and historically limited phenomenon that no longer holds validity? Considering the case of Dora from Heinz Kohut’s revolutionary view, which privileges the subjective and empathic stance in treatment, one can infer that Dora’s own hysterical symptoms were not pathological, as Freud thought, but rather healthy attempts to bolster an enfeebled self. Nevertheless, both Kohut and his followers conclude that from a self psychological perspective both object-instinctual understandings, and self-object transferences, are essential for successful analytic treatment.     

Revisiting the Rorschach of Sirhan Sirhan

The published Rorschach (Kaiser, 1970) of Sirhan Sirhan, the man who assassinated presidential aspirant Robert F. Kennedy in 1968, was studied. Psychostructural and psychodynamic analyses were conducted using, reliable and valid methodology that was unavailable at the time of examination. In contrast to the defense experts at trial who diagnosed paranoid schizophrenia, the data suggest a depressed and suicidal individual organized at a borderline level of personality. Character pathology is hysterical, paranoid, and dependent. When the Rorschach findings are compared to the developmental history of Sirhan and the behavior around the time of the assassination, the data are somewhat consistent with the theme of psychic trauma, are very consistent with the theme of recurrent loss and pathological mourning, and validate a characterological distrust and hatred of, yet hysterical dependence on, the object world. Rorschach indices of predatory violence (Meloy, 1988a) in relation to the planned and purposeful assassination are also discussed.     

The choice of a name: "Dora" and Freud's relationship with Breuer

I have suggested that Freud's choice of the pseudonym Dora for his eighteen-year-old hysterical patient, Ida Bauer, was over-determined. Dora, it seems likely, was named not only after Freud's sister's nursemaid, as Freud himself explained, but also after Dora Breuer, Josef Breuer's youngest daughter. This theory is based on an examination of the similarities in the lives and symptoms of Anna O. (Breuer's famous hysterical patient of 1880-1882) and Dora; on an analysis of the transferences and countertransferences in the cases of these two young women; and on evidences of the persistent significance of Josef Breuer in Freud's life after 1895. These specific inquiries also call attention to the nature of hysteria at the end of the nineteenth century and to the ever-present complexities of the physician-patient relationship.     

Comparisons of the Shamans and Pseudoshamans of the Apaches of the Mescalero Indian Reservation: A Rorschach Study

Psychoanalytical oriented interviews and quantitative Rorschach findings were used to investigate personality structure of the Mescalero Indian Reservation Apache. From 250 Rorschachs, 72 protocols were divided into three groups: (1) a control group of 52 Apaches, 50 years and over; (2) 12 shamans, defined as native medicine men arrogating to themselves supernatural powers and accorded shamanistic status by their culture mates; and (3) 7 pseudoshamans, claiming to possess power but not believed by societal co-members or accorded the position of shaman but denying power-possession. The shamans possessed more hysterical features than the pseudoshamans, were mentally able to approach ambiguous material similarly to the control group, showed a high degree of reality testing potential, keener awareness of peculiarities, more theoretical interest, and the capacity to regress in the ego's service. The pseudoshamans possessed neither the prominent shaman characteristics nor hysterical features; they appeared to be impoverished personalities floating between the shaman and Apache norm groups.     

MODES OF IDENTIFICATION: FREUD'S CONCEPTS REORGANIZED

The author examines Freud's conceptualizations of identification, Melanie Klein's projective identification, and Anna Freud's identification with the aggressor and altruistic surrender of one's own instinctual impulses. After demonstrating that Freud's concept primary identification refers not to a process but to the state of being identified, he suggests the substitution of it with Sandler's term “oneness”. He notes that hysterical identification, narcissistic identification, and introjection are unconscious processes that lead to a state of oneness and that they can be distinguished clinically in terms of the emotional meaning that an object holds for the individual. Furthermore, it is shown that the concept of identification with the aggressor represents a defense mechanism of its own and a specific mode of narcissistic identification, which together with projections and hysterical re-identification play a decisive rôle in projective identification and altruistic surrender of one's own instinctual impulses.     

Revisiting the Rorschach of Sirhan Sirhan.

The published Rorschach (Kaiser, 1970) of Sirhan Sirhan, the man who assassinated presidential aspirant Robert F. Kennedy in 1968, was studied. Psychostructural and psychodynamic analyses were conducted using reliable and valid methodology that was unavailable at the time of examination. In contrast to the defense experts at trial who diagnosed paranoid schizophrenia, the data suggest a depressed and suicidal individual organized at a borderline level of personality. Character pathology is hysterical, paranoid, and dependent. When the Rorschach findings are compared to the development history of Sirhan and the behavior around the time of the assassination, the data are somewhat consistent with the theme of psychic trauma, are very consistent with the theme of recurrent loss and pathological mourning, and validate a characterological distrust and hatred of, yet hysterical dependence on, the object world. Rorschach indices of predatory violence (Meloy, 1988a) in relation to the planned and purposeful assassination are also discussed.     

Pavlov and the mind-body problem

I. P. Pavlov claimed that the mind-body problem would ultimately be resolved by empirical methods, rather than by rational arguments. A committed monist, Pavlov was confronted by dualism in the case of an hysterical person. Under normal conditions, her body's left side was insensitive to pain, but when she was hypnotized, there was a reversal of her sensitivity to pain, with the right side becoming insensitive. Pavlov acknowledged that the divergence between stimulation and response suggested dualism, yet condemned his disciple G.P. Zelenyî as well as Charles S. Sherrington, for their dualistic tendencies. Pavlov's continuous adherence to monism is attributed to the influence of popular scientific books that he read during his adolescence. The books maintained that science was based upon monism. Pavlov proposed that by introducing the concept of emotions, an hysterical person's condition could be explained within the framework of his theory of higher nervous activity, thereby obviating the need to change his paradigm.