I picked up Hysteria: The Disturbing History when I went to visit the Bedlam Exhibition at the Wellcome Collection on 8 October 2016 with my writing partner, K.F. Goodacre. Due to the fact that the protagonist of my work-in-progress, The Mayor, is incarcerated in an asylum for 9 years, I was hoping to learn a little bit more about the treatment of the patients in the hospital during the 18th century, attitudes to madness during those times, patient recovery (if any) and also about the hospital itself. However, the exhibition was significantly more art and literature-based than I was expecting and I wasn’t able to glean much that was informative or useful, so I was hoping that this book – along with a few others that I picked up in the shop – might fill in the gaps.
This book is very well-written and I found Andrew Scull’s narrative style engaging, despite having to refer to the glossary upon occasion to look up words I’ve never heard of (e.g. ‘parturition’, or childbirth). Starting with the first use of the term ‘hysteria’ in 1602 up until it’s disappearance from modern-day diagnoses, Scull gives a relatively short historical account addressing changing understanding, treatments and attitudes of the medical profession over a long period of time. He also explores how doctors struggled to pin hysteria down to physiological causes, the notion of a mental illness at the time being virtually non-existent. One particular chapter about the ‘shell-shock’ suffered by soldiers during World War I being thought of in terms of ‘male-hysteria’ I found particularly interesting given my perception of hysteria as being thought of only as a ‘woman’s disease’, linked to their ‘inferior’ biology and repressed sexuality; a tool used by men to diminish them and write off their emotions and experiences as nonsense.
Certainly this book does dwell on this latter aspect of the disease quite a bit. If you’re a woman and hadn’t felt before that being called ‘hysterical’ was insulting, you certainly will after reading this book! There’s plenty of gory, upsetting detail as to some of the more brutal treatments of hysterical patients contained within these pages, including female genital mutilation and Freud’s, quite frankly, disgusting treatment of his sexually abused patient Ida Bauer. Surprisingly, the opposite end of the spectrum for treatment – manual genital stimulation – that famously led to the invention of the vibrator – is completely ignored. Scull does not even go so far as to briefly acknowledge this particular avenue of history. I found this very odd considering how Scull also went to great lengths to illustrate how some doctors felt victims of hysteria were taking ‘flight into illness’ for the secondary gains that a sick role could provide.
It’s actually in relation to this last point that I dropped my rating from five stars to four. In the conclusion to his book, Scull talks about the disappearance of the disease of hysteria, and how it has since been redefined as post-traumatic stress disorder, post-natal depression etc. However, rather than talking about a more developed scientific understanding of mental illnesses and changing cultural attitudes towards women, Scull then spends an inordinate amount of time almost discrediting those who claim to suffer from mental illnesses to conclude that hysteria (in it’s more stereotypical, hypochondriac form) has never really disappeared, citing Myalgic Encephalomyelitis (ME) and chronic-fatigue syndrome as particular sources of contention. This gave me a bad taste in my mouth, as whilst our modern-day understanding of mental illness is by no-means perfect, ever-changing, and often driven by the profits made by Big Pharma, simply dismissing claims of mental illness as being all in the victim’s head is completely counter-productive. The very definition of a mental illness is that it is in the victim’s head, but that doesn’t mean that their suffering is not real or unworthy of treatment. To automatically assume that the patient is making it up for attention is as pervasively dangerous as it was 200 years ago.
Despite Scull’s conclusion being a bit of a let down, overall I really enjoyed this book. I do not read non-fiction very often so to keep me engaged for 200-odd pages is an achievement in itself.
Andrew Scull presently resides as a faculty member at UC San Diego, specialising in researching the development of modern-day psychiatric medicine. A list of his works and courses are available on the UCSD website:
Bedlam: The Asylum and Beyond is an exhibition currently running until 15 January 2017 at the Wellcome Collection in London: