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31 December 1969

health issue

NOV 27 -
Once people are labeled of any mental illness—regardless of the nature of the suffering—they risk being ostracised, even discriminated in society. Not just laymen, but even medical professionals often tend to ridicule or take lightly the problems of these patients, deeming their mental afflictions to be “fake”. One of the worst of these sufferings is hysteria; the stigma and myths attached with the term itself are burden enough for the victim, much worse than the actual illness. Consequences are higher when the sufferer is a young female; the prevalent misconception that the hysteria is a result of unfulfilled sexual gratification can devastate her social life. It is for this reason that the label prompts parents to hasten marriage for their adolescent daughters, causes husbands to become suspicious of their wives’ fidelity, and encourages leery youths to target these supposed “easy victims” in their taunts etc. Scientific facts, however, don’t match up with these common myths about the

condition.

In Greek, ‘hystera’ means uterus, which is where the word hysteria was derived from and wherein lies the root of the contemporary concept that the disease originates from a ‘wandering uterus’ within the body. This theory was rejected by the scientific community as early as the 17th century, since it was observed that even men could suffer from hysteria—albeit at a lesser rate (half to 1/5th). And in the 20th century, Sigmund Freud, who worked elaborately on the topography of the mind, explained that symptoms of hysteria are an unconscious “cry for help”, occurring when unresolved unconscious psychological conflicts are converted into some other physical symptoms, thereby naming it ‘conversion disorder’. It was agreed upon by the scientific community that these conflicts could arise from everyday issues and life problems, and were not necessarily limited to sexual frustration only. Despite evidence to the contrary, though, the rest of the world has retained, even till date, the fixed sexual connotations associated with hysteria—perhaps also popularised by media, literature, movies etc. Thus, to maintain some distance from these myths, the current scientific classification discourages the use of the word ‘hysteria’ altogether, replacing it with ‘Dissociative/Conversion Disorder’

COMMON SYMPTOMS

Usually the symptoms for dissociative disorders appear and disappear very dramatically and can confuse even astute clinicians. In fact, Freud, who was a neurologist initially and later became known as the father of modern psychiatry, had himself been deeply intrigued by this disorder. The first symptoms usually appear early in life, and rarely after the age of 30. The common presentations seen in our country are: repeated sudden fainting/convulsions, weakness/paralysis/abnormal sensations in body parts, trance and possession-like spells, abrupt memory deficits etc. While the much-hyped multiple personality disorder that we hear about on the news or read about in Western literature is a rare phenomenon in the Indian subcontinent; mass-sociogenic illness (older term: mass hysteria) is still quite common.

Since these symptoms are essentially transformed psychological conflicts,

suffers may often appear unduly relaxed, and lack concern for their symptoms or for their recovery. They might even begin enjoying the attentions and privileges of being ill, which is a major reason people with hysteria are assumed to be feigning their symptoms. Eventually, of course, some may develop depression or additional anxiety disorders.

HOW TO HELP

Even in today’s seemingly modern times, people continue to resort to faith healings before seeking medical attention. Many undergo unnecessary interventions, some of which are totally inhumane and irrational, nothing but an addition to their suffering. Even though dissociative disorders are usually time-bound and seldom life-threatening, prompt intervention by expert mental health professionals could prevent a lot of untoward consequences. Unless the sufferer exhibits additional depression or anxiety features, medication has only a limited role to play in the management of this disorder. In fact, more effective is a strong suggestion, taken in deep faith by the patient, which could have dramatic results in transient symptom removal. This might be one of the reasons sometimes even faith healings have had successful results, which are then touted as miracles. But despite being temporarily efficient, these suggestions are not a permanent fix; the patient still has a high risk of relapse. Thus the patient’s signs and symptoms should not be given much attention and undue secondary gain should be discouraged. In order to resolve the problem in the long-term, one has no choice but to address the actual conflict at the root of the condition. And herein lies the difficulty; oftentimes, discovering the exact source of conflict is easier said than done. And even when it is discovered, all efforts will be in vain unless an environment is created that is conducive for the patient to express and resolve their issues.

Dr Shakya is an Associate Professor at the Patan Academy of Health Sciences and the General Secretary of the Psychiatrists’ Association of Nepal

Posted on: 2011-11-28 09:41 NOV 27 -
Once people are labeled of any mental illness—regardless of the nature of the suffering—they risk being ostracised, even discriminated in society. Not just laymen, but even medical professionals often tend to ridicule or take lightly the problems of these patients, deeming their mental afflictions to be “fake”. One of the worst of these sufferings is hysteria; the stigma and myths attached with the term itself are burden enough for the victim, much worse than the actual illness. Consequences are higher when the sufferer is a young female; the prevalent misconception that the hysteria is a result of unfulfilled sexual gratification can devastate her social life. It is for this reason that the label prompts parents to hasten marriage for their adolescent daughters, causes husbands to become suspicious of their wives’ fidelity, and encourages leery youths to target these supposed “easy victims” in their taunts etc. Scientific facts, however, don’t match up with these common myths about the

condition.

In Greek, ‘hystera’ means uterus, which is where the word hysteria was derived from and wherein lies the root of the contemporary concept that the disease originates from a ‘wandering uterus’ within the body. This theory was rejected by the scientific community as early as the 17th century, since it was observed that even men could suffer from hysteria—albeit at a lesser rate (half to 1/5th). And in the 20th century, Sigmund Freud, who worked elaborately on the topography of the mind, explained that symptoms of hysteria are an unconscious “cry for help”, occurring when unresolved unconscious psychological conflicts are converted into some other physical symptoms, thereby naming it ‘conversion disorder’. It was agreed upon by the scientific community that these conflicts could arise from everyday issues and life problems, and were not necessarily limited to sexual frustration only. Despite evidence to the contrary, though, the rest of the world has retained, even till date, the fixed sexual connotations associated with hysteria—perhaps also popularised by media, literature, movies etc. Thus, to maintain some distance from these myths, the current scientific classification discourages the use of the word ‘hysteria’ altogether, replacing it with ‘Dissociative/Conversion Disorder’

COMMON SYMPTOMS

Usually the symptoms for dissociative disorders appear and disappear very dramatically and can confuse even astute clinicians. In fact, Freud, who was a neurologist initially and later became known as the father of modern psychiatry, had himself been deeply intrigued by this disorder. The first symptoms usually appear early in life, and rarely after the age of 30. The common presentations seen in our country are: repeated sudden fainting/convulsions, weakness/paralysis/abnormal sensations in body parts, trance and possession-like spells, abrupt memory deficits etc. While the much-hyped multiple personality disorder that we hear about on the news or read about in Western literature is a rare phenomenon in the Indian subcontinent; mass-sociogenic illness (older term: mass hysteria) is still quite common.

Since these symptoms are essentially transformed psychological conflicts,

suffers may often appear unduly relaxed, and lack concern for their symptoms or for their recovery. They might even begin enjoying the attentions and privileges of being ill, which is a major reason people with hysteria are assumed to be feigning their symptoms. Eventually, of course, some may develop depression or additional anxiety disorders.

HOW TO HELP

Even in today’s seemingly modern times, people continue to resort to faith healings before seeking medical attention. Many undergo unnecessary interventions, some of which are totally inhumane and irrational, nothing but an addition to their suffering. Even though dissociative disorders are usually time-bound and seldom life-threatening, prompt intervention by expert mental health professionals could prevent a lot of untoward consequences. Unless the sufferer exhibits additional depression or anxiety features, medication has only a limited role to play in the management of this disorder. In fact, more effective is a strong suggestion, taken in deep faith by the patient, which could have dramatic results in transient symptom removal. This might be one of the reasons sometimes even faith healings have had successful results, which are then touted as miracles. But despite being temporarily efficient, these suggestions are not a permanent fix; the patient still has a high risk of relapse. Thus the patient’s signs and symptoms should not be given much attention and undue secondary gain should be discouraged. In order to resolve the problem in the long-term, one has no choice but to address the actual conflict at the root of the condition. And herein lies the difficulty; oftentimes, discovering the exact source of conflict is easier said than done. And even when it is discovered, all efforts will be in vain unless an environment is created that is conducive for the patient to express and resolve their issues.

Dr Shakya is an Associate Professor at the Patan Academy of Health Sciences and the General Secretary of the Psychiatrists’ Association of Nepal

Posted on: 2011-11-28 09:41

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