{"agent_id":"janet","agent_name":"Pierre Janet","slug":"hysteria-as-a-real-disease","label":"Hysteria as a real disease: is hysteria a genuine disorder of mental synthesis rather than malingering or mere suggestion?","topic":"Hysteria as a real disease","question":"Is hysteria a genuine disorder of mental synthesis rather than malingering or mere suggestion?","position":"Hysteria is not the pretense of the malingerer nor the mere product of the physician's suggestion, though suggestion plays its part. It is a real malady, and its essence is a malady of the personal synthesis: a narrowing of the field of consciousness, in which the mind, lacking force to hold all its functions together, contracts — abandoning a portion of its sensations, memories, and members, which then fall out of awareness and out of voluntary control. The anesthesia is a real not-perceiving, the paralysis a real not- willing; the patient does not feel the pricked limb, does not command the still arm — not because she feigns, but because that sensation, that movement, has been dropped from the contracted field of the personal consciousness. Hysteria is the disease of a mind that cannot keep itself whole. To call it imaginary is to misunderstand it; the splitting is real, the loss is real, and it follows laws that can be studied and treated.","paragraphs":[[{"t":"Hysteria is not the pretense of the malingerer nor the mere product of the physician's suggestion, though suggestion plays its part.","n":[]},{"t":"It is a real malady, and its essence is a malady of the personal synthesis: a narrowing of the field of consciousness, in which the mind, lacking force to hold all its functions together, contracts — abandoning a portion of its sensations, memories, and members, which then fall out of awareness and out of voluntary control.","n":[1,2]}],[{"t":"The anesthesia is a real not-perceiving, the paralysis a real not- willing; the patient does not feel the pricked limb, does not command the still arm — not because she feigns, but because that sensation, that movement, has been dropped from the contracted field of the personal consciousness.","n":[]},{"t":"Hysteria is the disease of a mind that cannot keep itself whole.","n":[]}],[{"t":"To call it imaginary is to misunderstand it; the splitting is real, the loss is real, and it follows laws that can be studied and treated.","n":[3,4,5]}]],"texts":"The Mental State of Hystericals (1901); The Major Symptoms of Hysteria (1907 — hysteria as a narrowing of the field of consciousness and a disease of personal synthesis). Reception: the collapse of 'hysteria' as a diagnosis and its dispersal into modern categories (conversion/functional neurological disorder, dissociative disorders, PTSD); the historical critique that Salpêtrière hysteria was partly an artifact of Charcot's clinic and of suggestion; the modern recovery of functional and dissociative disorders as real.","works":["The Mental State of Hystericals (1901)","The Major Symptoms of Hysteria (1907 — hysteria as a narrowing of the field of consciousness and a disease of personal synthesis)"],"reception":"the collapse of 'hysteria' as a diagnosis and its dispersal into modern categories (conversion/functional neurological disorder, dissociative disorders, PTSD); the historical critique that Salpêtrière hysteria was partly an artifact of Charcot's clinic and of suggestion; the modern recovery of functional and dissociative disorders as real.","status":"Janet's account of hysteria as a genuine disorder of mental synthesis (a narrowing of the field of consciousness), not malingering, was a major clinical advance and is broadly vindicated in its core. The diagnostic category \"hysteria\" has since dissolved and been dispersed into modern categories — conversion / functional neurological disorder, the dissociative disorders, and post-traumatic conditions — but these are recognized as real disorders with real (functional, dissociative) mechanisms, which is Janet's central contention. The historical qualification is that the florid grande hystérie of the Salpêtrière was partly shaped by Charcot's clinic and by suggestion (a point Janet himself helped establish), so specific period presentations are read as clinically constructed; but the underlying claim — that these are real disorders of synthesis and dissociation, not fakery — is exactly the modern view.","era":"1859-1947","discipline":"Psychology","refs":[{"n":1,"work":"The Major Symptoms of Hysteria","page":"","canonical":"","quote":"When you have once admitted this retraction of the field of consciousness as one of the conditions of suggestion itself, why should you maintain that it can produce noth- ing but suggestions? Why should you not admit that this disease of the mind may be manifested by some- thing else? If this retraction has given too much power to certain ideas, does it not produce, on the other hand, some blanks?","label":"The Major Symptoms of Hysteria"},{"n":2,"work":"The Mental State of Hystericals","page":"","canonical":"","quote":"Here, then, we have a new formula more precise than the foregoing. Anaes- thesia is an extended and chronic absent-mindedness, which prevents those subject to it from connecting cer- tain sensations with their personality; it is a contraction of the field of consciousness.","label":"The Mental State of Hystericals"},{"n":3,"work":"The Major Symptoms of Hysteria","page":"","canonical":"","quote":"I think it results from a general disposition of the hysterical mind, which urges it to move in its entirety to one side, while neglecting the rest of the body and mind, then to move in its ensemble in another direction, while forgetting the first.","label":"The Major Symptoms of Hysteria"},{"n":4,"work":"The Major Symptoms of Hysteria","page":"","canonical":"","quote":"At the third moment, he will write at dictation, having the perception of the sound of the voice, of the vision of the letters and of the muscular movements, but forgetting and neglecting all the other elementary sensations, as T, T', T\", Mf, M\", V, V\", A', A\". This individual is absent-minded, and this (Figure 22) is an attempt to schematize what is called normal absent- mindedness.","label":"The Major Symptoms of Hysteria"},{"n":5,"work":"The Mental State of Hystericals","page":"","canonical":"","quote":"If no such association exists, we ' The study of certain cases of hysterical diplopia, which shall be made later in the second volume of this work, will perhaps show us a little better how this negligence of the sensations furnished by one eye, and which causes gradually the unilateral amaurosis, takes place.","label":"The Mental State of Hystericals"}],"answer":null,"siblings":[{"slug":"dissociation-and-the-subconscious-fixed-idea","label":"Dissociation and the subconscious fixed idea: are hysterical symptoms the work of split-off ideas acting below awareness?"},{"slug":"priority-over-freud","label":"Priority over Freud: did Janet discover the subconscious and the traumatic origin of neurosis first, and is psychoanalysis an overreach?"},{"slug":"force-and-tension","label":"Force and tension: is neurosis a lowering of the mental level — a failure of psychological energy and synthesis?"},{"slug":"psychotherapy-by-mental-means","label":"Psychotherapy by mental means: can the mind be treated systematically by managing its psychological force and its fixed ideas?"}]}