Mad Men and Medusas by Juliet Mitchell Allen Lane, pounds 20, 346pp Mental illnesses, it would seem, breed like rabbits. The standard diagnostic manual lists about 180 in 1968, but today this figure is over 350. Have we got better at recognising discrete maladies, or can we no longer see the wood for the trees? And is it a coincidence that new illnesses so often start to exist at the same time as the drugs supposed to act on them?
Parallel to this proliferation of maladies is a series of casualties: many of the older, robust categories have vanished from psychiatry and, increasingly, from Anglo-American psychoanalysis. Juliet Mitchell's new book is about one of them, the hysteria that was once the darling of Freud and the first generation of analysts and that is now, in some circles, a mere historical curiosity.
How could such a spectacular ailment take its farewell? Where are the inexplicable paralyses, fits and swellings that helped to give hysteria its reputation as both theatre and a thorn in the side of medicine? Although it has just about disappeared from English- language psychiatric and psychoanalytic literature, most commentators agree that hysteria has in fact taken new forms, ranging from ME to, arguably, Gulf War Syndrome. Mad Men and Medusas continues this line of thought, arguing for the presence of hysteria all around us in modern civilisation.
So why did hysteria disappear from the textbooks? Mitchell thinks that the main problem came with the First World War. As clinicians realised that traumatised soldiers were exhibiting symptoms of hysteria, they shied away from the diagnosis. Since hysteria was seen as feminine, the only way to avoid the unpleasant notion that men were - or could become - feminised was to exclude it and introduce new labels such as "shell shock". If hysteria could be marginalised, then traumatised soldiers wouldn't have to be labelled hysteric.
As Mitchell argues, female hysteria followed male hysteria into oblivion. What had been labelled as "hysteria" became "femininity". Meanwhile, interest in what should have been recognised as male hysteria passed into the development of object-relations theory, with its stress on infantile helplessness.
For Mitchell, putting hysteria back on the map involves both a recognition of this secret history and a deeper understanding of what the dynamics of hysteria are all about. Just as male hysteria, in her view, was repressed by psychoanalysis, so too was the importance of sibling relations. We tend to see everything in terms of the parent-child model, without giving enough importance to the tragic moments when we are displaced by a sibling, or someone in the position of a sibling.
A glance at the index of the Standard Edition of Freud's works might offer support to this claim: we can find an entry for "Siberia" but none for "Sibling". English-language psychoanalytic literature until the early 1980s contained barely a single case where the transference relation with the analyst was conceived primarily in terms of a sibling relationship.
To compensate, Mitchell gives a central place to siblings in her theory of hysteria. The key trigger for her is the realisation that one is not unique. When a sibling displaces us, there is a desperate demand to be everything for the mother - not simply in the sense of being the baby one once was, but also in a new and more complicated way. Since, in Mitchell's chronology, one will by now have had one's first experiences of sexual play, our demands to the mother will be inflected with sexuality.
The child may retreat to a fantasy of being at one with mother, in the form of being her, giving birth like her, and being her baby. If something stands in the way of this fantasy, the …