Mad, Bad, and Sad: A History of Women and the Mind Doctors

by Lisa Appignanesi

  In her dissociated second state–the deep hypnotic trance she called her ‘clouds’, which took her over as evening approached–Anna would mutter and act out scenes. Breuer observed that if he or someone repeated her words back to her, she would incorporate these into tales, charming at first, though after her father’s death they took on a horrifying aspect. Breuer encouraged her storytelling. After recounting the most ghastly scenes, Anna would feel better. This ‘chimney sweeping’, the beginning of what she named the ‘talking cure’, was in place.

  Not that any of this worked miracles. Anna grew worse, then better, then worse again. She was transported to a country house adjacent to a sanatorium and then back to Vienna for more regular sessions with Breuer. He had become aware that if Anna told a story that related to the first appearance of a symptom, it would disappear. Then, something bizarre happened. It became clear to Breuer that, in her night-time trance state, Anna was living out a period before her father’s death and had forgotten everything that came after, whereas in the daytime, she inhabited the same time frame as everyone else. Freud and Breuer recount:

  The change-over from one state to another occurred spontaneously but could also be very easily brought about by any sense-impression which vividly recalled the previous year. One had only to hold up an orange before her eyes (oranges were what she had chiefly lived on during the first part of her illness) in order to carry her over from the year 1882 to the year 1881. But this transfer into the past did not take place in a general or indefinite manner; she lived through the previous winter day by day.

  Her mother’s diary of the previous year confirmed Anna’s revisiting of the past exactly. The realization brought on an intensive period of clinical work, during which each of Anna’s symptoms was traced to its source in a scene or idea. ‘In this way her paralytic contractures and anaesthesias, disorders of vision and hearing of every sort, neuralgias, coughing, tremors, etc., and finally her disturbances of speech were “talked away”.’

  This was difficult work and it took its toll: Anna’s symptoms intensified as she relived the past of each of them in turn. Her inability to drink, it transpired during this ‘chimney sweeping’, was linked to or ‘converted’ from a memory of asking her governess for a glass of water only to see the dog slobbering and drinking from it. Her hallucinated snakes, paralysis of the arm and disintegration of language came from a terrible night when, sitting by her sick father’s bedside in a waking dream, she had seen a snake (there were snakes in the garden) slithering down the wall to bite him. She couldn’t lift her arm to ward the creature off. It was paralysed, and the fingers had turned into little snakes with death heads. She tried to pray but language failed her, except for English and some childhood rhymes.

  Anna’s case proved, Freud later noted in one of his many formulations on the stepping-stones to psychoanalysis, that

  hysterical symptoms are residues [reminiscences] of profoundly moving experiences, which have been withdrawn from everyday consciousness, and that their form is determined (in a manner that excludes deliberate action) by details of the traumatic effects of the experiences. On this view, the therapeutic prospects lie in the possibility of getting rid of this ‘repression’, so as to allow part of the unconscious psychical material to become conscious and thus to deprive it of its pathogenic power.

  Freud and Breuer emphatically insisted that Anna, like all the other cases in the Studies on Hysteria, was a highly intelligent and accomplished young woman: ‘Among hysterics may be found people of the clearest intellect, strongest will, greatest character and highest critical power.’

  This insistence is important for a number of reasons. First of all, it obviates any slippage between inferior mental abilities and a proclivity for madness in women, who before the First World War form the majority of cases of what is diagnosed as hysteria. Such a slippage had long played into the hands of nineteenth-century nerve doctors. Then, too, Breuer and Freud want to distinguish their stance from Janet and indeed Charcot, both of whom were prone to find fundamental explanations for insanity in inherited degenerative tendencies, perhaps in part because their patients came from the poor in mental institutions rather than from the middle class. For Freud ‘dissociation’ or hysteria itself is not due to any constitutional incapacity in the patient for holding mental processes together. Rather, the disintegration of mental life, or dissociation, comes from the psychical process he calls ‘repression’–a psychic procedure common in all human development. The exorbitant energy this splitting off of an unwanted part of a past self takes in certain people is what gives patients an air of mental incapacity. He suggests thinking of dissociation as akin to ‘preoccupation’, a mental activity which might make any ordinary person seem momentarily less than intelligent.

  It is clear in all this that even as early as the Studies on Hysteria, Freud’s project differs substantially from Janet’s and the other psychologists who focused in on doubling or multiples, and the sleep states and hypnosis which produced them. None of Freud’s hysterics are somehow navigated under hypnosis into a sphere where ‘alters’, or alternating personalities, with different characters take shape. Indeed, Freud is less interested in the startling phenomena splitting can give rise to, than in what in life motivates it. These motive forces range as broadly as conflicts over the sexual morality of the day, which hypocritically enshrines abstinence and ignorance as virtues, particularly for women, to childhood sexual seduction, to traumas occasioned by fears irreconcilable with desires. More specifically, Freud talks of splitting as a psychic defence against mutually incompatible ideas. Later in his work, he describes the growing child as subject to conflicts which come from both within and without and need defending against. Inner instinctual demands may be coped with through repression: demands from the external world can be so distressing that only disavowing any perception of them will leave the child intact.

  By the time the Studies is written, Freud is no longer practising hypnosis. He is as sceptical of it as he is of the cathartic method, even though that may work well enough for the removal of hysterical symptoms and provide momentary relief for the patient. Hypnosis, however, has often failed him therapeutically. Symptoms thus removed tend to recur. Some patients cannot be easily hypnotized. Others are too malleable under hypnosis, produce symptoms or their relief simply to please their doctor, or fall in love with him. Freud found he could get to what occasioned the illness simply by insisting that the patient knew what it was and by working through associations to his or her ‘resistance’ to knowing. But Freud’s later work grows into another story, which dominates the next century.

  Meanwhile, Janet’s ideas about therapeutic hypnosis and associated sleep states such as automatic writing in order to remove ‘subconscious fixed ideas’ continued to have a significant influence. In the United States, his procedures, like his understanding of the doubling of personality, were to be of particular importance both to William James and to Morton Prince. In Switzerland, they helped to set the scene for a ground-breaking study of a medium and the many personalities who spoke through her.

  SPIRITIST SLEEP

  During the fin-de-siècle, the séance served as a popular site for those interested in encounters with their dear departed dead or in reassurance about the existence of a spiritual sphere. The rise of spiritualism–‘spiritism’ for the French–alongside the theosophy of Madame Blavatsky and a general interest in the occult and reincarnation, gave equal and opposite rise to a rash of critics and sceptics. They judged the mediums’ activities as hypnotic charlatanry performed for the ignorant and gullible. In the historical stakes, this latter perspective has won out. But at a time when wireless telegraphy made telepathy seem a scientific possibility worth exploring, when telephones brought disembodied voices into a room, when astronomers hailed the discovery of canals on Mars and the possibility of its habitation, science and spiritualism could occasionally be confused–or at least seen to have some common strands of reality and, through experim
entation, a common goal.

  Certainly, spiritualism’s emphasis on proof, on giving evidence for the existence of an afterlife, took its impetus from science, its twin, rather than from traditional religion’s emphasis on faith, belief, and the received wisdom of a hierarchy. Then, too, the high priests of this modern movement were largely in fact priestesses, thoroughly modern women who could transgress the boundaries of gender by taking on male roles in trance, who might even be paid for the wisdom that spoke through them.

  Mediums, and the spirits they heard or embodied in trance, were also subjects of fascination for a wide variety of researchers into the new psychical sciences. Both philosophers and psychologists, amongst them William James, the Geneva-based Théodore Flournoy and Frederick Myers, considered automatic writing, crystal gazing, speaking in trance–and doing so in a number of languages unknown to the sleeper or perhaps entirely invented (glossolalia)–activities demanding scientific study for what they revealed about the human mind.

  During the 1880s Myers, whom William James called the founder of ‘Gothic’ psychology, wrote a series of articles on the abnormal and the supranormal where he probed what he called the subliminal as it emerged in trance states and dreams. He was one of the founders, in 1882, of the Cambridge-based Society for Psychical Research, which attracted the attention of Freud and Jung and so impressed James that he founded an American equivalent some years later. The Society and its subcommittees set out to make an unbiased study of thought transference (which Myers renamed telepathy), mesmerism, hypnotism and clairvoyance; of ‘sensitives’ and mediums; apparitions of all types; levitations, materializations and other physical phenomena associated with séances.

  Myers, like his friend the creator of Sherlock Holmes, Arthur Conan Doyle, ended up believing in the mediums he studied and in the truth of the spiritualist claims. Théodore Flournoy’s research took him in a more earth-bound direction, though the famous medium he studied, Hélène Smith, travelled From India to the Planet Mars (1900), as he entitled the bestselling and instantly translated book he wrote about her case.

  Flournoy (1854–1921), two years older than Freud, had, like Janet, both a philosophical and a medical formation. He had also studied experimental psychology in Leipzig with its most famous protagonist Wilhelm Wundt, and it was undoubtedly because of Wundt’s influence that when he was appointed Professor of Psychophysiology in 1891 in Geneva he insisted on the post being in the Faculty of Sciences, where he also founded a psychological laboratory. But, as he noted, where human psychology is concerned, an hour spent in a nursery or in a séance is worth several years in the laboratory. Indeed, the medium herself, with her many voices and many selves, provided a living laboratory for how the psyche worked.

  In Spiritism and Psychology Flournoy described the medium as a person ‘ordinarily of the feminine sex’ who, having experienced nothing more than a little sleepwalking, daydreams and presentiments, is thrust by the death of a dear one into this new activity. She tries her hand at table tapping or automatic writing, and finds she is receiving messages. What makes the medium talented and distinguishes her from ordinary people is simply the permeability of the usual barrier between sleep and waking. In her, this borderline isn’t stable: hallucinations, both auditory and visual, submerged ideas and emotions easily make their way across. Some doctors collided the medium with the hysteric and bemoaned the popularity of mediumship. It encouraged dissociation and increased the number of hysterics. Flournoy, however, made a distinction between the two and thought they should be studied separately. Unlike hysterics, mediums were healthy when out of the trance state which accompanied the séance. Through his medium Hélène Smith he also noted that in the trance state a ‘subliminal imagination’ was at work and at play. With its ‘mythopoetic’ potential, this was the source of all creativity as well as the source of the medium’s revelations. Moreover, this subliminal sphere provided compensation for what life hadn’t fulfilled, and offered psychic protection. Flournoy thus gives us a conception of the unconscious as both the fount of creativity and play and the sphere that shores up the individual.

  Given this understanding of the unconscious and of trance, it follows that Carl Gustav Jung, whose personal history incorporated a number of ‘seers’, should find inspiration, when still a young man working at the Burghölzli Hospital, in Flournoy’s From India to the Planet Mars and in Flournoy himself, a teacher to set against Freud and his rationalism. Jung’s doctoral dissertation, ‘On the Psychology and Pathology of So-Called Occult Phenomena’, written in the first years of the new century, includes his own research into mediumistic states. The medium in question was his cousin Hélène Preiswerk, whose trances he had witnessed and probably influenced during the years leading up to 1900. She has certain features in common with Flournoy’s Hélène.

  Helly, as the family called her, was interested in the Italian Renaissance and while still a schoolgirl had imagined herself in a previous life as betrothed to a nobleman named Sforza. In trance, she became a Renaissance princess who lived vivid romantic adventures. These florid accounts were interspersed with strange information about her family, which subsequently proved to be true, as if she had received the news telepathically. Helly developed a crush on Carl, who was six years older than her. When she heard that he claimed an ancestor in Goethe, she found her own ancestral worthies. She received visits from their mutual dead grandfather, a one-time head of the Swiss Reformed Church who now took her on far-flung spiritist journeys.

  The ‘family’ séances which Jung attended began in 1895, when Helly was only fourteen. When he embarked on his psychiatric studies, he decided to observe Helly in controlled circumstances. The talented adolescent took on not only the elders’ voices, but could sing–something she couldn’t do when awake. She also, he discovered as he explored her mediumship, incorporated present and long-ago reading into her ‘visions’. These, as time passed, grew increasingly sexual: her trance persona became Carl’s lover. It was clear to all that the séances were being enacted in order to attract Carl’s attention. The family grew worried and when Helly, after one séance, could not be woken from delirium, her mother took action. By the autumn of ’98, the girl had been sent off to France to apprentice as a dressmaker.

  In his dissertation, Jung lightly masked Helly and the family’s identity, though they were recognizable to themselves and upset at the terminology which linked their ‘occult’ propensities with medical problems and a weak inheritance. Not that Jung, himself subject to visionary experience, altogether disavowed the spiritualist content of what he nonetheless argued was mostly a psychological, rather than a mystical, state of trance in his cousin’s case.

  Flournoy left less room to occult possibility than Jung, even though the sources of his medium’s spirit journeys were more difficult to locate in her own experience; and, unlike Helly, she had moved out of that adolescent impressionability and mimetic potential so close to the plasticity of hysteria. Hélène Smith, who, it seems, chose this name for herself–perhaps borrowing the Hélène from Flournoy’s daughter–was in fact born Elise-Catherine Müller in Martigny, Switzerland, in 1861. At the time that Flournoy met her in December 1894 she was a highly placed employee in a department store, a woman of ‘irreproachable character’ who offered her mediumistic services ‘unpaid’ in séances, since she was a believer. Her father was Hungarian and had a capacity for languages, which Flournoy later linked to his medium’s own skills in the invention of ‘Martian’ while on her mother’s side there was some experience of ‘automatisms’. Tall, healthy, attractive, intelligent and with none of the tragic aspect of the sibyls of tradition, Hélène perfectly suited Flournoy’s search for an experimental subject. After six months and some twenty séances, he wrote jubilantly to William James in Boston: ‘this woman is a veritable museum of all possible phenomena and has a repertoire of illimitable variety: she makes the table talk,–she hears voices,–she has visions, hallucinations, tactile and olfactory,–automatic writing–s
ometimes complete somnambulism, catalepsy, trances…all the classical hysterical phenomena–present themselves in turn, in any order and in the most unexpected fashion’.

  As Flournoy observed Hélène, he developed a theory to accompany the observations: ‘the phenomena were evidently the automatic reproduction of forgotten memories–or memories registered unconsciously. There is actually in the nature of this medium a second personality who perceives and recalls instants which escape ordinary awareness.’ He calls this ability ‘Cryptomnesia’. The medium, like all of us, knows more than she knows, and in that trance state which is a waking unconsciousness, exhibits the perceptions her unconscious has stored, transforming them along the way, adding a component of fantasy.

  Flournoy understands buried memory and the unconscious as a storehouse for romantic fabulation. He is alert to the workings of suggestion. His medium effectively complies with his expectations. Her powers develop the more he observes, interviews, pinches, prods, asks her to repeat her strange linguistic structures: ‘Even if total somnambulism would have inevitably been eventually developed by virtue of an organic predisposition and of a tendency favourable to hypnosis states,’ Flournoy writes, ‘it is nevertheless probable that I aided in hastening its appearance by my presence as well as by a few experiments which I permitted myself to make upon Hélène.’ William James had already in 1890 made the point about the suggestibility of the medium or hysteric and the way in which visions or symptoms were joint creations. ‘With the extraordinary perspicacity and subtlety of perception which subjects often display for all that concerns the operator with whom they are en rapport, it is hard to keep them ignorant of anything he expects. Thus it happens that one easily verifies on new subjects what one has already seen on old ones, or any desired symptoms of which one may have heard or read.’