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Holding Your Nerve 1

In the introduction to Medical Muses, a study of hysterical patients in the Salpêtrière Hospital in the nineteenth century, Asti Hustvedt notes that there is today “a crop of bizarre new illnesses that, like hysteria, afflict mostly young women and stubbornly resist biological explanation”. She observes that “No drug exists to cure anorexia, bulimia, self-mutilation, chronic fatigue syndrome, and multiple personality disorder, and no genetic flaw has been found to explain them”; and, somewhat more tenuously, that “today’s scientists are scrambling to find biological explanations for behaviour, and everything from human mating strategies to homosexuality, from shyness to alcoholism, has been supposedly located in biology”.1

Broadly speaking, it is true that biological explanations came to be favoured over psychoanalytic ones within the psychiatry (though not within the psychology or the social work) of the Western world by the end of the twentieth century. More recently, however, the theoretical reductionism and mental health guild wars of the twentieth century have begun to give way to a broader appreciation of the factors that contribute to the many and various conditions that are commonly found sheltering under the umbrella term of ‘mental disorder’. Some may be biological, others behavioural, still others environmental. The profile of most ‘disorders’ is shaped by a combination of these factors, arising from discrete sets of circumstances and requiring individual attention. The examples given by Hustvedt are illuminating. The most helpful perspective from which to view alcoholism or anorexia is probably behavioural, at least as far as remedy is concerned, while the diagnosis of multiple personality disorder may be understood as an extreme example of a life story in critical need of rescripting. As far as the nineteenth-century diagnosis of ‘hysteria’ is concerned, Hustvedt does not deny that the “fatherless, unmarried, and poor” subjects of her study were really ill, but finds it impossible to say “to what degree their disease was socially determined and to what degree it was physically determined”. She began her study expecting to find “a clear-cut world of exploited women and exploiting men” within the Salpêtrière, but found instead “a hospital culture that was in many ways less oppressive than the world beyond it”. If it is true “hysteria was at least partly an illness of being a woman in an era that strictly limited female roles”,2 perhaps amelioration of the plight of ‘hysterical’ patients was never likely to be more than partial, a fact for which the doctors of the time had limited responsibility and over which they had little control.

This territory will be ploughed by a new exhibition at Museum Dr Guislain in Gent, Belgium. Nervous Women opens on 13 October 2012 and runs until 26 May 2013. Bethlem is making a unique contribution to this exhibition; we intend to tell our blog readers what it is in the near future.