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I. A BRIEF HISTORY: PAST AND PRESENT
The Taita people live in the Coast province of Kenya. They recognize two categories of illnesses: those of the heart and those of the head. One illness predominant among the Taita is saka. Like all illnesses that involve fears, urges or cravings, saka belongs to the heart; as the Taita describe it, it is an illness of `wanting and wanting'. Customarily, the Taita men have herded goats, sheep and a few cattle, and grown and sold cash crops: mainly vegetables, wattle, chilli and coffee. Increasingly, however, they work as domestic or agricultural wage labour away from the tribal reserve. Meanwhile, women have cultivated the basic grain, root crops and greens for eating. Marriage takes place within the tribe and the descent line is patrilineal: women may inherit neither land nor livestock, although as wives or widows they have extensive rights to their use. Likewise, wives and widows are the main purchasers and controllers of consumer goods and define the needs of a household. Their tasks are dependent on the use of money but they themselves can earn only `pin money' — small amounts for their own domestic use. Taita education seems to emphasize women's dependence and men's enviable privileges. The women have little contact with the world beyond the reservation.
It is almost entirely Taita wives who suffer from saka — indeed, as many as 50 per cent of married women may be afflicted at some point in their lives. Saka can originate in a mood of restlessness and anxiety or in a self-induced hypnotic state. In its dominant expression saka begins with the upper body of the sufferer going into convulsions, her shoulders shaking and her head rolling; then come some or all of the following symptoms: the monotonous repetition of an action or of words that are usually from another (scarcely known) language, closed eyes, expressionless face, loss of consciousness, a trance state, rigidity and teeth-clenching. Sometimes saka's main characteristics occur without any of the preceding convulsions.
Instances which are cited as having triggered saka include the sight of a car in an area where such an object is scarcely known; the sudden striking of a match; the intense desire or craving for a particular object, such as sugar, a cigarette, bananas, or an action, such as playing the concertina (a man's instrument). In one woman's case, saka was triggered by her wish to hear her son's band play after she had missed it; in another, by her desire to have her husband's blood to suck; in another, by her wanting to drink the water in which her favourite nephew had washed.
Christian elders often consider saka the work of the Devil; others think it has been sent by foreigners who, having failed to seduce the Taita women, make them barren instead, by means of saka; still others do not regard it as an illness at all, but rather as a deliberate feminine con trick to make husbands procure whatever their wives want.
Treatments range from making sure the woman has what she wants to the prescription of various medicaments and the use of herb-infused smoke; from drinking the water in which a man's lower garments have been washed to becoming a Christian, or performing the saka dance. For this dance, the afflicted women line up wearing some or all of the following items, which must be provided by their husbands: a man's felt hat or fez, a hunter's or explorer's red and white bandolier, a man's belt and bells on one ankle. The sufferers wear dresses which may be tied under the shoulder like a woman's or around the waist like a man's. The women carry a man's dancing staff or a young man's walking stick. Gender ambiguity and fluidity is all-pervasive.
The treatments, however, do not seem to produce permanent cures. But such cures as there are, particularly those brought about by the saka dance — like the illness to which they respond — involve the negotiation of gender differences. Women crave and get consumer goods that men must pay for (clothes, sugar) or objects or attributes that `belong' to men (bananas, cigarettes, their clothes, their blood); they want to have and do the things which are prohibited to women but are allowed to men and, at least as a token, the treatments allow this. The gender difference is not absolute, but clearly the illness is experienced by women who can be cured, at least for the time being, if they can temporarily have or do or be the things men have, do and are. Commenting on her observations of the saka complex during the 1950s, the anthropologist Grace Harris writes: `In the saka attacks we see what appears at first to be a highly aberrant form of behaviour. The symptoms strike one as being of an hysterical sort, using the term in an everyday rather than a technical psychiatric sense.' The 1950s were a decade in which hysteria was not an acceptable diagnosis or medical concept. Although she backs off from using it and in the title of her essay about the Taita women calls it `Possession "Hysteria"', with double quotation marks, Harris can find no other appropriate term for the phenomenon which she observed.
Hysteria is a universal phenomenon, a possible response to particular human conditions that can arise at any time or anywhere. Just over ten years ago, in Religion in Context: Cults and Charisma (1986), the anthropologist I. M. Lewis wrote that it was incorrect to regard witchcraft, spirit possession, cannibalism and shamanism as discrete phenomena found in different social contexts in different places and times. Instead, he argued, these are just so many aspects of mystical power or charisma; they are the various facets of a single phenomenon. This unity becomes clearer if one asks who are the chief actors in all these apparently different instances. A strict scrutiny of the empirical data produces the answer that in all the apparently discrete cases the actors are the same: occasionally they are disadvantaged men, but predominantly they are women.
Lewis, like Harris, is nervous about using the term hysteria. Yet if we ask the same questions about hysteria, it is no accident that the answers are also the same. They are the same, too, for the many discrete `illnesses' into which hysteria has been transmuted or, in part, transferred in the twentieth-century Western world. Hysterics may be `disadvantaged' men, but they are predominantly women. So too are the actors of the many different aspects of Western hysteria such as eating disorders, multiple personality and `borderline' conditions.
The analogy between mental illness and adherence to `alternative' religious cults runs sotte voce throughout Lewis's book. Lewis's argument is about the interdependence of orthodoxy and mysticism, about, essentially, male and female modes of religious power. The unorthodox mystical cults which he describes are in fact crucial to orthodoxy; they are its essential `other side'. To take that argument further, in the context of Western medico-psychiatric practices, it is just such an interdependence that we witness between so-called psychic health and hysteria. Hysteria is the alternative or other side of the coin of what is regarded as normal behaviour. Women are thought to be, or assigned to be, its main practitioners.
Hysteria is also the mental condition which provides the relevant point of comparison for both witchcraft and spirit possession, for shamanism and even for cannibalism. However, there is only one reference to hysteria in the index to Religion in Context, although there are, in fact, twelve references in the text. Lewis praises Grace Harris's account of saka but omits the term `hysteria', even though Harris had translated saka as `possession "hysteria"'. `Hysteria' does not therefore appear to be a term that Lewis is prepared to use in this context.
Lewis was criticized for deploying the notion of hysteria in his earlier book, Ecstatic Religions (1971), and he clearly wanted to eschew it subsequently. Yet his descriptions clearly point to it. Hysteria and cults cannot be reduced entirely to each other. It is rather that, within the contexts in which they are practised, possession, cannibalism, trance, shamanism are the social expressions and actions which make use of hysteria. The cults which Lewis describes are ritualized forms of hysteria; as they are socially organized, they may well be the obverse of religious orthodoxy, just as hysteria is the flipside of psychic `normality'. In both transitional societies, such as that of the Taita, where women are in the reservations and men are becoming part of an urban proletariat or unemployed, and the complex societies of the Western world, where by and large religion is no longer a major principle of organization, the human potential for hysterical behaviour and experience may not be made manifest in alternative religions or rituals, apart from in dances or at carnivals; it may instead appear as an illness.
There are, then, forms of behaviour, particular states of being, ranges of symptoms, which seem to have something in common and of which the actors are nearly always women. Those who describe these manifestations try to eschew the term `hysteria', but are repeatedly drawn back to it.
Except for the rare occasions when it is claimed by artists and writers, hysteria tends to be an opprobrious term. Is this because, as the Taita demonstrate, it displays fear and craving — and both are synonymous with weakness? Such an explanation tallies with the bobservation that hysteria is expressed by disadvantaged groups such as women. In which case, we have to add to the weakness that what is being shown is the power of the weak. Charisma, a demonstrative egotism, a need to control others, witchcraft, are all expressions of power. Hence it would be wrong to see hysteria as the protest of the inferiorized without adding that it is the deployment of weakness as power. But is even this a sufficient or, in fact, accurate explanation? Too much today is expounded in terms of power struggles; hysteria demonstrates how these are only manifest forms. For the powerful can also be hysterical. There is little to choose in terms of hysteria between the rhetoric of the prosecutors described in the Malleus Maleficarum (1484) and the aberrant behaviour of the witches they were accusing; and it was the dominant Nazis who drummed up mass hysteria against the weak, creating panic that the Jews, the Gypsies, the politically or genetically `undesirable', would displace the Aryans. It is also important to say that hysteria can be a source of creativity, as it is in shamanism and charisma, or as it was used by artists such as Flaubert and the Surrealists to demonstrate its proliferating fantasy aspects and its flamboyant dislocation of normal thought processes as an artistically innovative stance. This creative dimension would seem to be returning in the performative practices prevalent in the West today.
All human emotions, psychic states, and indeed even organic illnesses, take place within specific social contexts. They cannot exist outside of them. Yet discussions of hysteria are remarkable for a particular sort of unawareness of this self-evident fact. Clearly, there are human emotions — love, hate, anxiety, envy, jealousy, pity, fear, compassion, just to start the list — and there are human behaviours — making love, fighting, eating, drinking, playing, talking, listening, seeking revenge — to name the first that come to mind. There are also both so-called normal and so-called pathological expressions of these emotions and behaviours which we all come across everywhere. Knowing what they are in the abstract, however, does not help us to understand them properly, but perceiving them in their different contexts enables us to build a general picture.
It is not the abstraction but the aggregate of different manifestations that reveals the general condition. For example, finding what different languages have in common enables us to understand something about our universal human ability to speak. Love is defined by the twelfth-century Provençal troubadour as the pursuit of the unattainable ideal; in the black humour of a 1960s joke, the mother of a schizophrenic man is said to have held him as a baby out of an eleventh-floor window in order to declare that this showed how much she loved him because she didn't drop him. These two different versions of love serve to prove not that it is not a general human emotion but rather that it is a complex state in which at one time and place idealization may be predominant while in another it will be ambivalence that comes to the fore. Idealization and ambivalence are both inevitable within a state of love. The twelfth-century poet and the twentieth-century mother each allow us to understand different aspects of love, and so enrich our concept of it as a universal phenomenon.
My contention about hysteria follows the same pattern of argument. It has been fashionable in the twentieth-century West to argue that hysteria has disappeared. To my mind, this is nonsensical — it is like saying `love' or `hate' have vanished. There can be no question that hysteria exists, whether we call its various manifestations by that name or something else. For hysteria is a potential human experience that we can bring some understanding to by looking at the particular contexts which shape it. I would not expect hysteria to always look the same — any more than I would expect love to do so — but that does not mean that it is not a universal possibility. There are clear links, for instance, between how the Taita understand and deal with saka and how the Hippocratic doctors of fifth-century BC Athens conceptualized usterie (from which our particular word derives), or how, with the demise of beliefs in witchcraft, Renaissance scholars recreated this Greek illness to produce a humanistic tradition of `suffocation of the mother'. All yield up similarities and differences within their own contexts which help us to construct a picture of what we now call `hysteria'. Conversely, there must be specific reasons for the current notion that hysteria (or something that may be recognized as such) has disappeared.
Every context which describes hysteria links it to gender — but not, of course, always in the same way. Historically, the various ways in which gender differences and hysteria are seen to interact should tell us something both about gender as it is defined at any given time and place and about hysteria: for instance, sometimes it is feminine to have the vapours, at others to be a lovely woman caring for the sick, at others to be an emaciated girl. Sometimes `hysteria' is a medical diagnosis, sometimes just an insult. These diverse expressions could be used for specific historical and cultural analyses. My question, however, is different: Why is hysteria linked to women? Using the psychoanalytic understanding of hysteria as an exemplary case, I challenge the assumption that there is an equivalence between femininity and hysteria, arguing instead that hysteria has been feminized: over and over again, a universal potential condition has been assigned to the feminine; equally, it has disappeared as a condition after the irrefutable observation that men appeared to display its characteristics.
In its turn, my investigation of the gendering of hysteria has led me to question some of the basic psychoanalytic theory that was itself built up from an understanding of hysteria. Thinking about hysteria has led me to a different reading of the Oedipus complex and to the need to insert the experience of siblings and their lateral heirs in peer and affinal relationships into our understanding of the construction of mental life.
Until recently it was argued that hysteria could be found throughout the rest of history and cross-culturally, although it has disappeared today. However, this has been energetically challenged from a post-modern standpoint. Hysteria has been deconstructed and its universality, its unity as a disease entity or illness category, more importantly its very existence at any time or place, has been called in question. The prevalent clinical argument that hysteria has disappeared from hospitals and consulting rooms in the twentieth-century Western world now runs parallel to the intellectual challenge to the existence of hysteria at all. Not only is it said to have `disappeared', but scholars are finding that it never existed. This scholarly deconstruction is exemplified in a brief, tightly argued essay by the British classicist, Helen King, `Once Upon a Text' (1993), which challenges the standard work on the subject, Hysteria: The History of a Disease (1965), by Ilza Veith. Under the all-pervading influence of post-modernism, we are made aware daily that traditions are invented. In keeping with this trend, King shows that part of the Renaissance project of finding a tradition for its new humanism in all things Greek was to find its own observed illness in the Hippocratic texts. King argues that the Renaissance invented classical Greek hysteria in order to create its own illness heritage. However, surely, although traditions are indeed created, they are not invented out of thin air: there is always something there that has been selected, embellished, recreated — aspects of the past that have been given meaning in the present. Hysteria seems to be indicated both by the Greek texts and their Renaissance dependants. However unfashionable its `universalism' and `essentialism', Veith's history, which regards `hysteria' as something that really exists, is still very useful because it documents the symptoms over time and place.
For the Hippocratic doctors of the fifth century BC, the dominant symptoms of what we will call `hysteria' were breathing difficulties and a sense of suffocation. The main sufferers were recently bereaved widows; the explanation offered by most doctors was that the womb, craving the satisfaction of which it had been deprived, was wandering urgently around the body causing pressure on other organs and hence obstructing other processes such as breathing. The cures ranged from remarriage (and so presumed sexual satisfaction) to herbal fumigation through the vagina, to hypnosis. In the third century BC, Galen of Pergamon, who argued that the womb produces a secretion analogous to semen (as has been claimed in both the seventeenth and twentieth centuries), suggested that blocked-up semen or its analogue, in both women and men, could also produce hysteria. There are notions latent here of hysteria as an essential but explosive discharge. The explanations for hysterical behaviour in the ancient world became increasingly sexual until the growth of Christian mysticism and the decline of medicine in the late third century AD.
Christianity, initially and most influentially in the person of Saint Augustine, transformed the hysteric from a sick being (nearly always a woman) with physical and emotional needs which a doctor could help, into a person (again nearly always a woman) who was wilfully possessed and in league with the Devil. Under Christianity symptoms included anaesthesia, mutism, convulsions and imitations of bizarre behaviour (such as swallowing needles and the marks on the body thought to be stigmata diaboli). The treatment — or persecution — of the condition was religious or juridical, but not medical. The hysteric most frequently showed herself as a witch or, depending on your viewpoint, the behaviour of witches was characteristically hysterical.
The late Renaissance, referring back to ancient Greece, began the remedicalization of hysteria and the refutation of supernatural religious causes. In 1603, a doctor, Edward Jorden, published a book in England, Briefe Discourse of a Disease Called the Suffocation of the Mother, which demonstrated how all the signs that hitherto had been regarded as marks of witchcraft could be found in cases of clinical hysteria. At this time, the treatments matched the renaturalizing of hysteria into a disease that could be cured — so, for instance, energetic exercise such as horse-riding was strongly recommended (again we can see here the theme of physical discharge). As for the ancient Greeks, symptoms that received prominence in the sixteenth and early seventeenth centuries included problems of breathing and choking (the so-called `suffocation of the mother'), convulsions, fits and compulsive imitations. The vast majority of recorded observations and descriptions of hysteria also noted mimetic imitation, although this feature was not to gain diagnostic significance until the eighteenth and nineteenth centuries. Observing a case of hysterical epilepsy, Giorgio Baglivi (1668-1706), a physician, observed: `In Dalmatia, I saw a young Man seiz'd with violent Convulsions, only for looking upon another Person that lay groveling upon the Ground in a Fit of an Epilepsy.' The relationship between hysteria and epilepsy was to gain ever greater importance until the twentieth century. However, Baglivi's observation also points to the significance of death-like states. One definitional but overlooked feature of hysteria is the particular way in which it relates to death both as concept and as fact.
Excerpted from MAD MEN AND MEDUSAS by Juliet Mitchell. Copyright © 2000 by Juliet Mitchell. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.