The recognition and study of psychological trauma has emerged 3 times allied to political events since the late nineteenth century. Firstly, it was labelled hysteria during the French anticlerical republican movement. Then there was shell shock arising from the first world war and war trauma was studied and peaked during and after the Vietnam war – a journey through a culture of war moving into the anti-war movement. And finally, more recently the growing awareness of domestic and sexual trauma within the context of the political rise of the feminist movement.
Jean-Martin Charcot (considered to be the father of neurology). Prior to Charcot hysteria had been considered a strange disease that affected women but changed but Charcot’s interest removed it from the hitherto status of malingering.
Pierre Janet in Paris and Sigmund Freud (mentored by Joseph Breuer) in Vienna took on the study and realised that hysteria was a result of trauma and both men independently discovered that when the traumatic events in these women’s lives could be recovered along with the accompanying intense feelings, then the symptoms of hysteria would lessen or go altogether.
It was Freud who took the work further and began to realise the root of hysteria was sexual trauma and he realised that the tales he heard of early incest and abuse were there result of the hysteria being triggered by a recent event that has activated the trauma. In the Aetiology of Hysteria Freud recorded his findings but he privately repudiated his assertions as he became aware of the social implications – hysteria being as prevalent among the higher echelons of Austrian society as anywhere else. Hysteria was once again assigned to ‘malingering’. The political and social conditions of the time enabled Freud’s discoveries to be forgotten but out of the ruins was born the discipline of psycho analysis.
Moving on to the First World War the term shell shock was created by the psychologist Charles Myers who saw some of the first cases of men who were exhibiting nervous disorders that he realised were caused by the concussive effects of exploding shells. However, culturally men were supposed to glory in war and not display signs of terror.
The British psychiatrist Lewis Yelland advocated treatments, for these stricken men, based on shaming threats and punishments. Fortunately, not everyone thought the same was and there were more progressive treatments. The champion of these treatments was W. H. R. Rivers working at the Craiglockhart War Hospital near Edinburgh. He was spoken highly of by Robert Graves and Siegfried Sassoon and has become well known featuring in Pat Barker’s book Regeneration (and the 1997 film of the book) -in my opinion a rather harrowing book and film. Rivers founded the practices that were continued, modified and expanded throughout the continuing wars.
By the early 1980s the treatment of Vietnam War Veterans consolidated and legitimised the diagnosis of PTSD appeared for the first time in the American Psychiatric Association official manual of mental disorders (the DSM).
During the 1970s however, realisation was dawning that most traumatic stress disorders were showing up in woman living a civilian life rather than the men of war. The first ever International Tribunal on Crimes against women was held in Brussels in 1976. Shortly before that there had been a huge surge in the research of the effects of rape and sexual assault on women. The spectre from which Freud had recoiled was out in the open. We have come full circle.
My thanks to Judith Herman M.D. This is mostly a very brief summary of the first chapter of her book Trauma and Recovery.
The good news now is that the treatment for the relief and resolution of trauma has come on in leaps and bounds and we are gaining much knowledge of how our brains store trauma and how we can release/restore it. No need for any more hysteria!