Academic journal article International Journal of Psychoanalysis

The Expulsion of Evil and Its Return: An Unconscious Fantasy Associated with a Case of Mass Hysteria in Adolescents

Academic journal article International Journal of Psychoanalysis

The Expulsion of Evil and Its Return: An Unconscious Fantasy Associated with a Case of Mass Hysteria in Adolescents

Article excerpt

The formal study of hysteria started with psychoanalysis, which opened paths to studying the unconscious. However, we have found no psychoanalytic or psychiatric studies in the literature reporting epidemics of hysteria in hundreds of adolescent girls affected for several months like the one we describe. This epidemic occurred in a religious boarding-school in a rural area of Mexico. Our study aimed to determine psychoanalytic and sociocultural elements contributing to explain a behavioural epidemic outbreak during which young girls were unable to walk normally and which led to a temporary cessation of routine activities at the boarding-school. Key informers were interviewed, including the first cases of affected adolescent girls and the nuns. Interviews included questions concerning informers' life history and their life at the boarding-school before and during the epidemic. We found that this boarding-school functioned as a large family affected by a psychotic episode which resulted from modes of communication of its members. This article describes the phenomenon and emphasizes perceived communication among members of the boarding-school and visitors at the time of the outbreak.

Keywords: adolescent, development, hysteria

Silence and solitude

Like two little animals guided by the moon

Drink from those eyes,

Drink from those waters.

(Octavio Paz)

Introduction

In this article I describe a clinical picture of mass hysteria in adolescents which occurred in a religious boarding-school for girls in Latin America. In March, 2007, as a representative of the Secretary of Health, I was asked to participate as the person responsible for providing a diagnostic explanation in the area of mental health, as well as for resolving the epidemic. This project motivated me to publish this article, whose objective is to exemplify: (1) individual and group psychoanalytic characteristics which favoured this epidemic, and (2) the predominant psychological state of both the group and individuals during the epidemic.

I began by interviewing the first adolescents affected, those whose symptoms were most severe and clearly conversional who were still living at the boarding-school, the Mother Superior and other religious mothers in charge. In the case of adolescents, we used semi-structured interviews1 aimed at discovering unconscious fantasies through semiology of the clinical picture and narrations of dreams and associated memories during the mass phenomenon, their history at the boarding-school and the history of their lives in general.

Background

Unconscious fantasy and personality in conversion hysteria

Unconscious fantasies exist throughout human development, from earliest infancy. They include phylogenetic and ontogenetic elements, forming unconscious memory traces which begin as feelings and later become more complex as different symbols (Isaacs, 1948) in connection with the baby- mother relation (Bion, 1963; Winnicott, 1965b). Therefore, they are intimately interwoven with personality development and interaction with the real world (Segal, 1994). Personality in turn involves a long process that begins when babies are born and are supported by an environment which is hopefully good enough for their ego to integrate as a unit and for their sense of Being which gives them a sense of existence, spontaneity and illusion which Winnicott (1965b) terms the 'true self'. It originates in "little more than sensory motor life (p. 149)"and develops alongside the basis for symbolization; this consists in the infant's spontaneity or hallucinations and what is external, created (by the mother) and finally cathected. Whatever separates the child from that object rather than uniting them blocks symbol formation. The more splitting there is between the child's internal life and the real world, the deeper the child will sink into psychosis.

The eminently important role of the body in hysteria relates to this defect in capacity for symbolization which is associated with primary fantasies: archaic hysteria (Ferenczi, 1926; McDougall, 1989) attempts to use the body to translate unconscious infantile anxieties of fear, rage or abandonment which surpass the capacity of absorption of habitual defences; this is not an attempt to preserve the subject's sex or sexuality but the entire body and life itself. …

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