Hysteria is a variety of mind illness or neurosis tending to occur in hereditarily predisposed persons. It appears most often during the age period of fifteen to thirty, and, although more common in women, is not exclusively confined to them. Certain forms of " shell-shock" were true examples of hysteria.
A bad environment in childhood and faulty early education accentuate any innate morbid tendencies and lead to the development of the hysterical make-up.
This may be considered as the fundamental predisposing factor; fright, shock, disappointment and injury act as directly exciting causes of attacks. According to Freudian psychopathology, the hysterical symptoms represent "a compromise between an unconscious wish and its conscious inhibition or repression."
Symptoms of Hysteria
The mental make-up of the hysteric is characterized primarily by emotional instability with deficiency of control along with morbid craving for sympathy. There is extreme egotism. The hysteric is self-centered and introspective; judgment is unreliable; conduct is impulsive and erratic. Suggestibility is marked; the hysteric is easily hypnotized. Dissociation of the mind may be revealed in the peculiar condition known as "multiple personality"- where two or more distinct personalities exist in the same person. Somnambulisms, fugues (wandering fits), trances and narcolepsy (paroxysms of sleep) are also evidence of mental dissociation found in severe forms of hysteria.
The physical symptoms of hysteria consist of an unconscious simulation (rarely complete) of the manifestations of any organic disease. These include commonly false angina, flushing, sweating, dyspepsia, cough, pains of every variety, anesthesias, deafness, blindness, loss of smell or taste, tremors, paralysis, loss of voice, air-swallowing, refusal of food (anorexia nervosa) and occasionally convulsions.
The hysterical fit or convulsion is, as a rule, a histrionic affair. An emotional crisis precedes the dramatic outburst.
The hysteric falls to the ground (in the presence of onlookers - never alone) avoiding injury, and undergoes various contortions, attitudinizing, grimacing- but never losing consciousness. Sympathy prolongs the performance; an unpleasant stimulus hastens a return to the normal.
The prognosis in hysteria, so far as the outward signs are concerned, is fairly good provided treatment is efficiently carried out, but to alter a hysteric's personality, to change the hysteric's outlook on life is a very difficult task. The damage done in childhood is well-nigh irreparable, and, although some amelioration may result when the hysteric is removed from the home friends, a return to the old environment is often promptly followed by a relapse.
Treatment of Hysteria
The first endeavor should be to bring about a change of environment. Friends and relatives are either sympathetic or scolding- inclined to treat the hysteric as a long-suffering invalid or as a malingerer. The bodily health must be improved by rest, diet, tonics, massage and baths. Physical exercise is of great value. In severe cases isolation in bed may be necessary. Psychological methods of treatment include suggestion, persuasion, and hypnotism. According to the psycho-analysts, the " only radical cure for hysteria is to discover the unconscious strivings which have given rise to the disease, and, in so doing, to reveal them to the patient,"
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