Hysteria that they published in 1895, in which they unearthed again and again in their patients these traumatic founding moments of mental illness. Looking at Studies on Hysteria one notices first that all the case histories presented are of women. Freud and Breuer’s work, by stressing the life stories these women had to tell, shifted the focus of the search for the causes of hysteria from biological sources to narrative sources: the lives the women led, and the stories they told themselves, and refused to tell themselves, about their lives made them susceptible to diseases of the nerves. Recent historians of nineteenth-century hysteria have seen hysteria as a disease that was inseparable from the social position of women at the time. Hysteria has been viewed as a passive form of resistance to the social expectations that surrounded the nineteenth-century bourgeois woman. In an increasingly industrialised society, the middle-class woman was looked up to as a representative of the purity, order and serenity of an earlier time – the guardian of the home fire, the angel at the hearth. A victim of demands that were seemingly at odds with themselves, the nineteenth-century woman was supposed to be gentle, submissive and naive, while also expected to be strong and skilled in her domestic management – a pillar for men to lean on. Hysteria signalled an unconscious protest against these conflicting expectations as well as against the lack of career and educational opportunities available to women. For instance, in Studies on Hysteria Joseph Breuer describes his patient Anna O. as unusually intelligent, with a quick grasp of ideas and penetrating intuition. He points out the limited possibilities of her life, considering her immense potential: ‘She possessed a powerful intellect which would have been capable of digesting solid mental pabulum and which stood in need of it – though without receiving it after she had left school … This girl, who was bubbling over with intellectual vitality, led an extremely monotonous existence in her puritanically-minded family’ (Freud and Breuer 1895:73–4). The hysterical woman was frustrated by the tasks expected of nineteenth-century womanhood. She found herself at odds with an image of the maternal figure who nursed the sick and tended to domestic duties. As Carroll Smith-Rosenberg describes her, the hysterical woman began to see what it was like to have her own way: No longer did she devote herself to the needs of others, acting as a self-sacrificing wife, mother or daughter: through her hysteria she could and in fact did force others to assume those functions. Household activities were reoriented to answer the hysterical woman’s importunate needs. Children were hushed, rooms darkened, entertaining suspended. Fortunes might be spent on medical bills or for drugs and operations. Worry and concern bowed the husband’s shoulders; his home had suddenly become a hospital and he the nurse. Through her illness, the bedridden woman came to dominate her family to an extent that would have been considered inappropriate – indeed, shrewish – in a healthy woman. (Smith-Rosenberg 1985:208) Hysteria was a double-edged sword for the nineteenth-century woman patient; on the one hand, illness promised both freedom and attention that was not usually hers for the asking. On the other hand, it increased her dependence, made her a slave to doctors and cures, and made her suspect as a malingerer.
TALKING AND LISTENING CURE Freud’s and Breuer’s attempts to cure hysteria must seem humane to us if we look at them in the context of the treatments that were being recommended for neurotic illness at the time. By the 1890s neurosis was seen as a woman’s problem that needed firm-handed cures. The assumption that the patient was, at least in part, faking her illness often dictated the term of the cures for hysteria. Throwing water on patients, slapping patients’ faces or stopping their breathing were some of the recommended methods for putting an end to hysterical fits (Showalter 1985:138). In 1873 the American physician Silas Weir Mitchell developed his ‘rest cure’ for the treatment of neurasthenia, a slightly less violent version of hysteria. Mitchell’s rest cure depended upon isolation from family and friends, immobility, no intellectual stimulation of any kind, and an overinflated diet in which the patient was expected to gain as much as 50 lb. Regaining health often depended upon the fact that the patient would be so happy when the mind-numbing, bodily debilitating cure was finally over that she would take up the burden of her neglected domestic duties with renewed energy. From this set of recommended cures Freud’s and Breuer’s experiments with what eventually became the psychoanalytic method made a radical break. They not only believed that their patients’ illnesses were real, they also listened to what they had to say. Psychoanalysis relied on the idea that the material of the cure could come only from the patient him or herself. Instead of looking for physical reasons for why someone had a nervous disease, Freud and Breuer listened to their patients’ stories, believing that it was in these stories that a cure would be found. Buried in the unconscious were the associations and connections which could make the patient’s past and childhood memories make sense. The psychoanalyst’s job, like the archaeologist’s (one of Freud’s favourite comparisons), was to enable the excavation. When Charcot began studying hysteria in the Salpêtrière in the 1880s, one of his explicit goals was to make the study of hysteria into a respected scientific endeavour. He brought to his efforts a passion for careful observation and classification, and he diagnosed his patients’ symptoms in detail. However, looking at the records from the Salpêtrière (especially the photographic evidence of the hysterics in their various poses), one gets the disturbing sense that Charcot was not terribly interested in curing the women under his care. More interested in classification and study than in therapy, he became famous for his public medical displays in which the patients of the Salpêtrière would perform under hypnosis the symptoms of their diseases – arching their backs, frothing at the mouth, showing an incredible tolerance of pain when pins and needles were stuck into their bodies when they were anaesthetised by hypnotic suggestion. Freud and Breuer used Charcot’s discoveries about hysteria but took them out of the medical theatre, into the private space of the consulting room. If Charcot’s classifications of hysteria depended upon looking, Freud’s and Breuer’s attempts to cure changed the emphasis to listening.