Hysteria and Somatization

• HYSTERIA by Ashwin khalap, 3/13/98
  
  

"Hysteria" is no longer used in DSM IV as a diagnostic category. Somatization disorder is the present name of arguably the oldest mental health diagnosis, which is “hysteria”. The history of the concepts of hysteria and somatization reveals something of their complexity and the relatively arbitrary basis of their definition. The ancient Greeks believed that multiple somatic symptoms were caused by the uterus wandering through the female body. In the middle of the 19th century, the French physician Briquet described a polysymptomatic somatic condition, for many decades known as Briquet's syndrome. Guze (1963) redefined this syndrome as “somatization disorder” in the 1950s as a precursor of the current diagnostic criteria.

Freud suggested that hysterical patients direct their libido inwards, whereas healthy persons typically direct their libido at external objects. Eventually, internally directed libido would build up and result in physical symptoms. Other psychodynamic theories suggested that physical symptoms developed in individuals defending against low self-esteem because a sick body is attached with less stigma than a sick mind. There is virtually no empirical evidence to support any of these theories. "Hysterical" behavior is probably best viewed as a type of abnormal/maladaptive illness behavior and treated with cognitive-behavioral techniques that have been developed for the treatment of abnormal illness behavior.

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