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American Imago 60.4 (2003) 445-479
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Fugitives From Guilt:
Postmodern De-Moralization and the New Hysterias
Donald L. Carveth and Jean Hantman Carveth
In Hystories: Hysterical Epidemics and Modern Media (1997), Elaine Showalter explores a range of conditions—chronic fatigue syndrome, multiple personality disorder, recovered memory, satanic ritual abuse, alien abduction, Gulf War syndrome—that she views as modern forms of hysteria as distinct from the old conversion and anxiety hysterias characteristic of the last fin-de-siècle and associated with the names of Charcot, Janet, Breuer, and Freud.
Against the widespread claim that hysteria is a thing of the past, having disappeared due to the rise of feminism or a level of psychological sophistication incompatible with the formation of hysterical symptoms (except perhaps among culturally "backward" populations), Showalter argues that, on the contrary, far from having died, hysteria is alive and well in the form of the psychological plagues or epidemics of "imaginary illnesses" and "hypnotically induced pseudomemories" that characterize today's cultural narratives of hysteria (4-5).
Although she provides a rich description of the new hysterias—the "hystories" or hysterical stories of chronic fatigue, alien abduction, etc.—Showalter does not pretend to offer a depth-psychological account of the psychodynamics underlying these conditions beyond identifying the role of suggestion on the part of physicians and the media in their creation and dissemination. Her definition of hysteria as "a [End Page 445] form of expression, a body language for people who otherwise might not be able to speak or even to admit what they feel" (7) and as "a cultural symptom of anxiety and stress" arising from conflicts that are "genuine and universal" (9) is accurate enough as far as it goes. From a psychoanalytic point of view, however, it does not go far enough.
Although she does not appear to share Juliet Mitchell's (2000) insight that "there is violence as well as sexuality in the seductions and rages of the hysteric" (x), Showalter does call attention to the centrality of externalization (i.e., projection) in these conditions. She writes: "Contemporary hysterical patients blame external sources—a virus, sexual molestation, chemical warfare, satanic conspiracy, alien infiltration—for psychic problems" (1997, 4). In recognizing the paranoid element in hysteria, albeit without theorizing the connection, Showalter contributes to the evolution of a deeper understanding. In the following, we will fasten upon this externalizing feature and offer a psychoanalytic—more particularly, a modern Kleinian—understanding of hysteria (including so-called multiple chemical sensitivity, environmental illness, and fibromyalgia syndrome) as subtypes of a more general hystero-paranoid syndrome.
Whereas traditional psychoanalytic accounts have emphasized the role of oedipal and preoedipal sexual wishes and conflicts in hysteria, seldom associating it with aggression and paranoia, we will argue that such overlooked psychological factors as unconscious aggression, envy, hostility, malice, destructiveness, and the resulting persecutory "guilt" and need for punishment occupy a central place in both the old and the new hysterias. 1 Following a previously articulated (Carveth 2001) conception of the unconscious need for punishment as a defensive evasion of unbearable conscious guilt, rather than (as in Freud's view) its equivalent, we view hysterical, psychosomatic, depressive, masochistic, and other self-tormenting conditions as defensive alternatives to facing and bearing conscious guilt.
Although our analysis has much in common with both Showalter's Hystories and Edward Shorter's From Paralysis to Fatigue (1992), we at the same time seek to correct their occasional blurring of the important distinction between hysteria [End Page 446] and psychosomatic conditions and their use of the term "somatization" in the description of both. Showalter, for example, even while correctly noting that "on the whole, Freudians make strict distinctions between hysterical symptoms and psychosomatic symptoms" (1997, 44), refers to "psychosomatic conversion symptoms" (36). She muddies the waters further by describing the conversion symptom as a particular form of "symbolic somatization" (44). But psychosomatic symptoms result from a process of somatization in which psychological and emotional forces contribute to the development of genuine organic disease and in which symbolization, if it is operative...