BPD = HYSTERIA?

 

Well, OK, I know that people are not diagnosed with "Hysteria" anymore.

Last time I checked, no-one seemed to think that wombs move around in the female body and they certainly don't try to return the errant organs back to their proper place with smelling salts or other sharp scented potions. Women don't seem to have fainting spells anymore either, come to think of it.

Its all pretty much evidence-based now.

Women with troublesome sexuality and emotions have always provided a threat to mainstream medicine (as well, apparently, as their husbands). If we want to get fancy we could say that women are, and have been, the speculative object of the male medical gaze. The essential nature of femininity -  its "dissolute" sexuality and "pervasive" emotionality, have been regarded as unruly, and liable to overwhelm an always precarious hold on logic at any moment.

In the late 19th century, Sigmund Freud travelled to the Salpetriere in Paris to learn the dark art of hypnotism from the famous neurologist and showman Jean-Martin Charcot. His notorious Tuesday forums were attended by everyone with an interest in learning more about hysteria and, incidentally, female sexuality (men, mainly, including such luminaries as writer Guy de Maupassant). Astonishingly, women were masturbated as part of the climax (!) of these evenings.  

Sitting astride vats of iron filings, prodded with magnets and tuning forks, photographed by eager and intrusive professionals, the famous hysterics of the Salpetriere hardly experienced an undocumented, or unmediated moment. They had learnt to perform their illness (which was theorised as gender and sexuality-based) and found that the more outrageously they behaved, the more they were rewarded with attention. But was it the kind of attention that actually helped them get better?  I dont think so.

Their underlying trauma was never addressed.  

The young women diagnosed with hysteria were often poor, and most had escaped abusive families. Some had been raped and sexually abused. It was hard for them to earn a living, and harder still to deal with the trauma of their upbringing. So they found their way to the Salpetriere, where Charcot and his colleagues used them to explore tenuous theories regarding the therapeutic use of mesmerism and various other experimental treatments. As a clinician, Charcot was very much a visual thinker and documented his female patients, so we have a photographic record of their poses and postures.  Female sexuality and the nervous system were the twin poles around which his practice revolved. He turned the "hysterics" and their emotional wounds into spectacles and there were many sceptics regarding the veracity of hysteria as a genuine illness, even in Charcot's own time.  

I am pretty sure that people with BPD are not performing in the way of the hysterics. I am also pretty sure that Charcot's hysterics would attract a diagnosis of BPD if they found themselves in the milleu of 21st century psychiatry.

 

Images from Iconographie Photographique de la Salpetriere.


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